The factors that influence the risk of accidents during the replacement of gastrostomy catheters remain unknown and therefore have not yet been thoroughly investigated. We conducted a nationwide questionnaire survey of 415 rehabilitation-training facilities for the replacement of gastrostomy catheters. We received 221 valid responses. Among the catheter replacement methods submitted, the bumper button replacement method was the most widely chosen, comprising 40% of the valid responses. The measures used to prevent accidental erroneous catheterization included examination of the stomach contents, endoscopic examination of the stomach, and the detection of insufflation sounds, although these measures varied widely among the facilities. Fifty-one out of the 221 facilities that responded to the survey experienced various mishaps, of which 20 were due to erroneous catheterization. In approximately 40% of the facilities, there was no operative manual for the replacement nor was the patient's consent taken before performing the procedure. This investigation elucidates the risks involved in the replacement of gastrostomy catheters. This survey also suggests that the methods used for catheter replacement should be re-examined to prevent accidents during the replacement.

Objective：This study investigated the relationship between posture and voluntary cough strength in healthy people.Methods：The participants were 50 normal adults. We measured cough peak flow (CPF), chest circumferences at maximal inspiratory level and maximal expiratory level, blood pressure, and pulse rate in the supine position, prone position, and prone position with a pillow under the abdomen. The difference between chest circumferences at maximal inspiratory and maximal expiratory levels was calculated and defined as the thoracic expansion difference.Results：CPF and chest circumferences at maximal inspiratory level and maximal expiratory level were significantly higher in the prone position with a pillow under the abdomen than in the supine position. There were no differences in thoracic expansion difference and blood pressure among all the positions. Pulse rate was significantly lower in the supine position compared with the other positions.Conclusion：We concluded that voluntary cough strength would increase in the prone position with a pillow under the abdomen.

Objective：This study investigated the relationship between posture and voluntary cough strength in healthy people.Methods：The participants were 50 normal adults. We measured cough peak flow (CPF), chest circumferences at maximal inspiratory level and maximal expiratory level, blood pressure, and pulse rate in the supine position, prone position, and prone position with a pillow under the abdomen. The difference between chest circumferences at maximal inspiratory and maximal expiratory levels was calculated and defined as the thoracic expansion difference.Results：CPF and chest circumferences at maximal inspiratory level and maximal expiratory level were significantly higher in the prone position with a pillow under the abdomen than in the supine position. There were no differences in thoracic expansion difference and blood pressure among all the positions. Pulse rate was significantly lower in the supine position compared with the other positions.Conclusion：We concluded that voluntary cough strength would increase in the prone position with a pillow under the abdomen.