Emphysema with bronchial asthma (BA) in chronic obstructive pulmonary disease (COPD) causes severe respiratory dysfunction and severely limits a patient's daily activities. This paper reports the case of a COPD patient whose respiratory symptoms were successfully improved with acupuncture. In July 1998, a 69-year-old male visited the Department of Respiratory Internal Medicine at Gifu University Hospital, complaining of dyspnea on exercise, and asthma attacks. His general condition had worsened despite strictly controlled medication and home oxygen therapy (HOT). Acupuncture was thus added to these treatments from ******. Before initiating the acupuncture treatment, the severity of dyspnea in the patient was diagnosed as level III (Severe), according to the GOLD classification. Spirometry showed severely disturbed respiratory function (%VC: 90.7%, FEV₁%: 35.1%, %FEV₁: 38.2%, V 25: 0.20 L/S). The basic combination of meridian points used in this case included LU 1 (Zhongfu), LU 5 (Chize), LU 9 (Taiyan), CV 4 (Guanyuan), CV 12 (Zhongwan), CV 22 (Tiantu), ST 40 (Fenglong), BL 13 (Feishu), BL 23 (Shenshu) and KI 3 (Fuliu). The patient received acupuncture treatments once a week for 10 weeks. Respiratory function and symptoms were measured. After 10 weeks of acupuncture treatment, asthma attacks, walking distance, the Borg scale and respiratory functions were significantly improved compared with the baseline. This suggests that acupuncture treatment was effective in treating advanced cases of both asthma and COPD.

[Aim] Diffuse pan-bronchiolitis (DPB) causes severe respiratory dysfunction and severely limits a patient's daily activities. Case: This paper reports a case of a DPB patient whose respiratory symptoms were successfully improved by acupuncture. In a case report in January 2002, a 62-year-old male visited the Department of Respiratory Internal Medicine at Gifu University Hospital, complaining of cough, pumlent sputum and dyspnea on exercise. His general condition had worsened despite ordinary medical treatment. Thus acupuncture was added to the treatment in August, 2001. Intervention: The patient received acupuncture treatments once a week for 50 weeks. The acupuncture treatment was based on the Chinese medicine theory. Measurements: Outcome measures were respiratory symptoms using the Fletcher-Hugh-Jones (F-H-J) classification, 6-minute walking distance (6 MWD), blood test, arterial blood gas and pulmonary function tests. Computed tomography (CT) was assessed. Each evaluation was done after 15 weeks and 50 weeks later.
[Results] After 15 weeks of acupuncture treatment, cough, pumlent sputum, walking distance, the Borg scale and respiratory function were significantly improved compared with the baseline. Moreover, the effect of the acupuncture treatment continued for 50 weeks.
[Conclusion] This suggests that acupuncture treatment was effective in treating the advanced case of DPB.

　At Showa University, which consists of the Schools of Medicine, Dentistry, Pharmacy, and Nursing and Rehabilitation Sciences, systematic interprofessional education for the purpose of training staff who can contribute to the medical team has been introduced with the cooperation of all 4 schools and through all undergraduate years. In the lower years, students study the basics of medical team care through a 4-school joint curriculum of experiential learning （such as early exposure） and problem-based learning inside and outside of the university. In the upper years, to acquire practical skills, students study the practice of medical team care through a joint curriculum of participatory learning in hospitals and the community. Through this curriculum, I expect that the medical staff to promote patient-centered team medical care in a variety of medical fields will grow in the future.

The purpose of this study is to address what undergraduate students of professional healthcare learned in interprofessional education (IPE), and to explore a way to develop interprofessional work (IPW) competencies effectively in IPE. A qualitative analysis was conducted on the portfolios of 9 medical, 8 dental, 16 pharmaceutical, and 16 nursing and rehabilitation students. 6 elements were identified in the undergraduate IPE; 【Patient/Family-Centered care】, 【Value/Ethics for IPW】, 【Communication Necessary for IPW】, 【Roles/Responsibilities as Healthcare Professionals】, 【Understanding of their own profession】, 【Team/Team work】. In order to acquire these capabilities, undergraduate education programs based on IPE are required.

The purpose of this study is to address what undergraduate students of professional healthcare learned in interprofessional education (IPE), and to explore a way to develop interprofessional work (IPW) competencies effectively in IPE. A qualitative analysis was conducted on the portfolios of 9 medical, 8 dental, 16 pharmaceutical, and 16 nursing and rehabilitation students. 6 elements were identified in the undergraduate IPE; 【Patient/Family-Centered care】, 【Value/Ethics for IPW】, 【Communication Necessary for IPW】, 【Roles/Responsibilities as Healthcare Professionals】, 【Understanding of their own profession】, 【Team/Team work】. In order to acquire these capabilities, undergraduate education programs based on IPE are required.

Objective：The purpose of this study was to determine the reliability and predictive validity of the Judgement checklist for beneficial falls (hereafter called“Judgement checklist”) in stroke patients.Methods：Five raters evaluated the Judgement checklist for 20 fallers with stroke, and two raters reevaluated the same patients. Fleiss' Kappa and Cohen's Kappa for examination of inter-rater and intra-rater reliability were calculated. For predictive validity, beneficial fallers were identified from among 123 fallers with stroke, using the Judgement checklist. We compared the incidence rate of recurrent falls and motor Functional Independence Measure (FIM) in beneficial fallers and other fallers.Results：Fleiss' Kappa for Judgement was 0.838, and Cohen's Kappa was 1.000. Inter-rater and intra-rater reliability for the Judgement checklist was high. The rate of recurrent falls in beneficial fallers was significantly lower than that in other fallers. The motor FIM in beneficial fallers was significantly higher than that in other fallers, and beneficial fallers tended to have above average ability to recover.Conclusion：The reliability and predictive validity of the Judgement checklist were shown to be high. The Judgment checklist was effective in evaluating the quality of falls and was useful for patient instruction after a fall.

Objective：The purpose of this study was to determine the reliability and predictive validity of the Judgement checklist for beneficial falls (hereafter called “Judgement checklist”) in stroke patients.Methods：Five raters evaluated the Judgement checklist for 20 fallers with stroke, and two raters reevaluated the same patients. Fleiss' Kappa and Cohen's Kappa for examination of inter-rater and intra-rater reliability were calculated. For predictive validity, beneficial fallers were identified from among 123 fallers with stroke, using the Judgement checklist. We compared the incidence rate of recurrent falls and motor Functional Independence Measure (FIM) in beneficial fallers and other fallers.Results：Fleiss' Kappa for Judgement was 0.838, and Cohen's Kappa was 1.000. Inter-rater and intra-rater reliability for the Judgement checklist was high. The rate of recurrent falls in beneficial fallers was significantly lower than that in other fallers. The motor FIM in beneficial fallers was significantly higher than that in other fallers, and beneficial fallers tended to have above average ability to recover.Conclusion：The reliability and predictive validity of the Judgement checklist were shown to be high. The Judgment checklist was effective in evaluating the quality of falls and was useful for patient instruction after a fall.