In the medical education curriculum of the School of Medicine, University of Tsukuba, an interprofessional education （IPE） program has been implemented from the first through fifth academic years as the core program in the “Essentials for Medical Professionals” course. From immediately after admission to the start of clinical training in the senior year, students have many opportunities to interact with a variety of health professionals and to systematically develop competence for interprofessional work.
　The School of Medicine and Medical Sciences, University of Tsukuba, consists of the School of Medicine, the School of Nursing, and the School of Medical Sciences. We have step-by-step IPE programs: students from 2 or more professions learn with, from, and about each other. In the first academic year early exposure to IPE is provided by team discussions of students from the 3 schools. In the second academic year the IPE program uses team-based learning （TBL）. In the third academic year, the Care Colloquium （a teamwork training course） is provided. The TBL program and the Care Colloquium are conducted though interuniversity collaboration with the Ibaraki Prefectural University of Health Sciences and with the Tokyo University of Science, respectively. One strategy to improve the effectiveness of the IPE program is interuniversity collaboration with the participation of a larger number of professions.

Background: Sleep apnea syndrome (SAS) is a common medical condition with significant adverse effects; however, it remains undiagnosed in many individuals. This study was conducted to assess the prevalence of SAS in fatigued subjects and to elucidate the factors associated with SAS.
Methods: From March 2008 to March 2011, a cross-sectional, observational study was conducted in patients with persistent (≥1 month) fatigue. Patients with known causes of persistent fatigue were excluded. Data on patient characteristics (e. g., blood pressure, neck circumference, etc.) and overnight pulse oximetry were collected. SAS was defined as a 3% oxygen desaturation index (ODI) of 15 or more.
Results: Among 46 subjects, the prevalence of SAS was 6.5% (95% CI, 1.4-17.9%). SAS was significantly more prevalent in patients with high systolic blood pressure (≥140 mmHg) than in patients with normal systolic blood pressure (<140 mmHg) (33.3% vs. 2.8%, P=0.049). Even after adjustment for age and sex, high systolic blood pressure showed a statistically significant association with SAS.
Conclusions: Promoting awareness about SAS could be necessary in patients with persistent fatigue, especially in patients with high systolic blood pressure.

Objective: The aim of this study was to investigate diagnostic characteristics to distinguish bacterial meningitis (BM) from aseptic meningitis (AM) in meningitis patients. Indicators from the initial consultation were combined with a measure of time since the onset of fever.
Methods: This was a retrospective chart review. We examined the sensitivity and specificity of the clinical information for BM. The diagnostic characteristics for BM were analyzed by considering the duration of fever for each patient at consultation, together with the presence or absence of changes in their mental status.The study examined 117 inpatients diagnosed with meningitis in their clinical record at the time of admission. The patients were admitted into two emergency hospitals in Japan between 2001 and 2011. Meningitis was defined as the presence of five or more cells per mm³ of CSF.
Results: Twenty-five patients were diagnosed with BM and 92 patients with AM. There was no single clinical symptom that could distinguish BM from AM in patients suspected of meningitis. The sensitivity and specificity of the clinical information for fever duration and disturbance of consciousness at consultation were 95.0% and 40.3%, respectively, for BM patients with disturbance of consciousness or with duration of fever less than three days. Thus, the proportion of BM patients without disturbance of consciousness for three or more days after fever onset was only 5%.
Conclusions: Patients without disturbance of consciousness for three or more days after fever onset are rarely suffering from BM.

Introduction : To reveal patients' impressions of physicians working short-term in community clinics, and to explore methods for physicians to work short-term in community clinics.
Methods : We conducted a qualitative analysis of recordings of individual interviews performed on patients in community clinics using a partially revised SCAT (Steps for Coding and Theorization) method.
Results : Patients indicated that they felt reassured by the constant presence of a chief physician at community clinics. They expected care within the scope of primary care, but were not expecting every element within this scope to be met. Patients had the attitude of accepting the current situation and were selecting how to receive medical care from the available options based on their personal priorities.
Conclusion : Physicians working short-term in community clinics were satisfying a portion of the patients' needs. Providing care within the scope of primary care and taking the initiative in getting to know patients are essential elements for physicians working short-term in community clinics.

Association between smoking prevention education for elementary and junior high school students and the modification of their parents' smoking behavior — Can child education change parental behavior?
Introduction : This study aimed to investigate an association between a smoking prevention education program for elementary and junior high school students, and the subsequent behavior modifications of their parents.
Methods : Preventative education programs for smoking were provided to four elementary and three junior high schools in Kamisu City, Ibaraki Prefecture, Japan. We encouraged participating students to discuss the knowledge derived from the education sessions with their families. One month after completing the program, questionnaires were distributed to the parents of the students to investigate whether they had modified their smoking behavior as a result of what they had learnt from their children.
Results : Two questionnaires were distributed to each of 1109 families, and 1427 valid responses were received. Analysis showed that 794 parents had been informed about tobacco use from their children (55.6%) and 271 parents had modified their smoking behavior (19.0%) as a consequence. This included smoking cessation, decreasing tobacco consumption, and smoking avoidance in the presence of their children. Behavior modification was significantly correlated with the knowledge they had derived from their children based on the preventative smoking education program (odds ratio = 3.3 ; 95% CI : 2.4-4.6).
Conclusion : Implementation of an education program for smoking prevention focused on elementary and junior high school students can lead to modification of smoking behavior in both students and their parents, respectively.

Introduction : This study aimed to clarify any associations between familial smoking, especially parental smoking, and high school students' perceptions of smoking.
Methods : Questionnaires on familial smoking and the Kano Test for Social Nicotine Dependence (KTSND) were distributed to junior high school students. The KTSND is a tool to evaluate positive perceptions of smoking. We analyzed the relationship between the total KTSND score and school grade, gender, familial smoking, paternal smoking, and maternal smoking.
Results : We received 761 valid responses (valid response rate : 90.4%). Five hundred forty-three students had family members who smoked (71.4%), 394 had smoking fathers (51.8%), and 214, smoking mothers (28.1%). The total KTSND score correlated with familial smoking (10.55 vs 9.46, p=0.009) and maternal smoking (11.18 vs 9.87, p=0.002).
Conclusion : Familial smoking, especially maternal smoking, correlated with positive perceptions of high school students towards smoking. Promoting smoking cessation in women with children may be effective in preventing tobacco use among children.

Introduction: The University of Tsukuba has a one-week in-home care course combining a problem-based learning style tutorial and lectures in the comprehensive community-based learning curriculum for 2^nd year students. This study aimed to investigate what medical students are learning concretely from this course.

Methods: We performed a qualitative date analysis of the contents of all 111 student course reports written in the free description using a modified Steps Coding and Theorization method employing the framework of patient-centered clinical method (PCCM).

Results: Medical students learned with keen interest based on their experiences and in the framework of PCCM such as 'Exploring health, disease and the illness experience', 'Understanding the whole person'. These processes led to the awareness of responsibility as a physician.

Conclusion: The in-home care course in the classroom may provide medical students with an opportunity to become aware of their responsibility as a physician.