Introduction: Reimbursement for breathing care services was started with the revision of the nation's medical service fee system in 2010. Our hospital was not properly equipped in the light of certain standards governing facilities. Nonetheless, we started giving instructions to nurses on how to check the respirator at work. In addition to the on-the-job training, we are engaged in educational activity and information gathering. Out team comprises clinical engineers, physical therapists and registered nurses. They are all certified respiratory therapists. We hereby report our activities and refer to future problems.　　Activities: 1. Safety checks of respirators while in use. 2. Respiratory rehabilitation during hemodialysis. 3. Respirator-related workshops. 4. Review of accidents.　　Results: 1. It has become easier to discover potential problems and meet them at once. This is because our team is made up of different specialists, each used to looking at things differently. 2. Being constantly on the alert for any indication of a trouble ensures safety during breathing rehabilitation. 3. The number of accidents during 2012 decreased from 2011.　　Future: We think that since “safety management” is the center piece of our activity, our team ought to be recognized as an official organization of the hospital.

Medical therapies, adapted to local requirements, are necessary in the field of community medicine. Generalized medical treatment is often all there is in Japan's Konsen Area, due to the large number of elderly people and a paucity of medical institutions. Kampo medical treatment is useful for elderly patients with plural diseases, and the demand for such treatment has been increasing. Therefore, we collected data on Kampo prescriptions prescribed by the doctors at the Nakashibetsu Municipal Hospital, which is the main local hospital in the Konsen Area, from 2010 to 2013. We conducted similar investigations at the Kushiro Red Cross Hospital in Kushiro city, which is centrally located in the Konsen Area, and at Asahikawa Medical University Hospital in Asahikawa, central Hokkaido. The aim of these investigations was to compare Kampo medicine use based on hospital location and size. The results can be used in community medicine to enhance the use of Kampo medicine with increase for its demand. Medical students and doctors should be educated in Kampo medicines, since their prescriptions have a significant impact on community health.

Abstract:

 This study examined the ability of medical students to self-assess basic clinical competence and learning strategies including simulation-based medical education for sixth-year medical students (n=903) at nine universities in Japan. About 40% of 27 procedures to achieve clinical skills in a model curriculum were taught using simulators with or without clinical training in hospitals. We noted that significant numbers of procedures were not practiced through any learning strategies. Higher self-assessment scores were observed among students in 4 schools who had more frequent learning opportunities through simulation-based education than among those with less frequent opportunities in 5 schools.

OBJECTIVESThis study investigated the incidence of caries in infants and explored the risk factors related to noteworthy variations between urban and rural areas.

METHODSSubjects were 232 infants (111 males and 121 females) aged 1.6 and 3 years born in "N" town between the fiscal years of 1997 and 2001. Infants aged 1.6 and 3 years had 99.6 and 100% participation in health checkups, respectively. Of the total, 148 and 84 infants were living in the urban and rural areas, respectively, of "N" town.

RESULTSCaries incidence and the average number of carious teeth (decayed/missing/filled teeth, dmft) for infants aged 1.6 years were significantly higher in the rural area than in the urban area, indicating that environmental factors that predispose infants to develop dental caries exist in the rural area. In addition, logistic regression analysis for infants in each of the two areas revealed that risk factors of the child-care environment, for example living with grandparents and brushing by parents, stood in marked contrast with each other. Moreover, the odds ratio of the risk factor dozing off while drinking showed a marked difference between the areas, although this risk factor was common in both areas.

CONCLUSIONSThe results of this study indicated that several factors of the child-care environment, for example the daytime caring person, are related with caries development. Scientific elucidation of the risk factors that give rise to high prevalence of caries in specific regions and access to the whole picture of the disease mechanism may have great potential to lead to the development of effective countermeasures and to contribute to the reduction of dental caries in preschool children.