Purpose : To seek opinions of medical doctors regarding self-management of assessed personal problems in health information records (SAPPHIRE) by patients themselves.
Methods : Ten-item questionnaires regarding SAPPHIRE were sent to each of two groups of medical doctors, using regular mail for A) doctors of private clinics, and hand-delivered to B) doctors working in a large hospital.
Results : Of the responding 292 medical doctors, 72.9% were in favor of using SAPPHIRE. More medical doctors of private clinics indicated preference for recording and assessment by a medical doctor (47.4%) than doctors working in a large hospital (25.2%). On average, responding medical doctors answered that problem lists could be recorded by co-medical staff (44.1%), but in the end, need to be created with the trustworthy assessment of a medical doctor (79.7%).
Conclusion : More than 70% of medical doctors responded in favor of using SAPPHIRE. Patients' reliable problem lists could be recorded by co-medical staff or a medical doctor, but need to be created with the trustworthy assessment of a medical doctor.

There are few reports on the disclosure of survival prediction to patients themselves in Japan, and how concretely it is performed. We retrospectively studied the disclosure of survival prediction to patients who were referred for the first medical examination to the Palliative Care Department between April 2013 and March 2016. Two hundred forty-eight patients (and their families) met the study criteria. Forty-three percent of the patients and their families had received information on definite periods of life expectancy without probability or ranges. On the other hand, 19% of the patients and families had not been told about survival prediction by the previous physician. Our results suggest that patients and families often received information on definite periods of life expectancy. There will be a need for improvement of end-of-life discussion in Japan.

We established the Early Palliative Care (EPC) outpatient department for patients who had received chemotherapy at other hospitals in August 2015. We retrospectively investigated medical records of patients who consulted the EPC outpatient department and patients who consulted the Medical Oncology outpatient department of our hospital between August 2015 and January 2016. The length of the first medical examination, the contents of the medical examination, period to hospitalization and period to death were investigated. Nineteen EPC outpatients and 11 Medical Oncology outpatients consulted a total of 80 times and 117 times at the respective outpatient department. The median length of the first medical examination in the EPC and Medical Oncology outpatient departments was 45 minutes (range, 10-106 minutes) and 38 minutes (range, 23-60 minutes), respectively (p=0.17). The contents of the examination in the EPC outpatient group included discussion about symptom management, coping, etc. Five patients (26%) in the EPC outpatient group passed away less than 60 days from the first medical examination. It would be possible for palliative physicians to establish and manage an EPC outpatient department in Japanese hospitals. However, some patients had late referral to the EPC outpatient department. Public awareness about EPC and the practice of EPC are important.

In late August 2014, three autochthonous dengue cases were reported in Japan. Since then, as of 17 September 2014, a total of 131 autochthonous cases have been confirmed. While cases were reported from throughout Japan, the majority were linked to visiting a large park or its vicinity in Tokyo, and the serotype detected has been serotype 1. We report preliminary findings, along with the public health response activities, of the first documented autochthonous dengue outbreak in Japan in nearly 70 years.Dengue is an acute, mosquito-borne febrile illness caused by a flavivirus found widely in the Asia-Pacific region, particularly in South-East Asia. While the most competent mosquito species for dengue virus transmission is believed to be Aedes aegypti, Aedes albopictus is also a competent vector present in much of Japan during the warmer months. Infection with dengue virus may cause fever, headache, muscle pain and/or rash but may also be mild or asymptomatic. While there is no specific treatment, with early and appropriate medical care, the likelihood of infections resulting in severe forms or death is rare. In Japan, dengue has been a notifiable disease since April 1999. Physicians are required to report demographic, clinical and exposure history information of laboratory-confirmed cases to the local public health centre that are then reported to the Ministry of Health, Labour and Welfare (MHLW) and the National Institute of Infectious Diseases (NIID).