This paper deals with general survey of hot spring curative treatment at Higashine Spa, Yamagata Prefecture, and the effect of this spa on the capillary resistance and the variation in the blood pressure.
The results of the medical survey are summarized as follows:
1) Higashine Spa consists of saline weak common salt springs, in each of which chemical components are almost the same.
2) The visitors to this spa are inhabitants of Yamagata Prefecture, farmers being the largest in number.
3) Most of them (78%) are old men and women over 50 years of age, and the number of women are four times that of men.
4) The examination of spa visitors reveals that hypertension stands at the top. However, in most cases, the chief complaints are of rheumatic disorders in natwe and hypertension is found at the time of medical examination.
5) Those who bathe five times a day are the largest in number.
6) Those who noticed the bathing reaction are small in number. The bathing reaction may be considered as a serious thermal crisis.
7) Bathing in this hot spring increases the capillary resistance and lowers the blood pressure.
Accordingly, bathing in this spa, under a proper guidance, may be effective in the treatment of hypertension. For balneal treatment of hypertension, physicians' directions as to how and when patiens should bathe, will be necessary: unplanned bathing cannot be approved of.

The results of our general and medical survey are summarized as follows:
(A) About Shinjo Spa
1) Most of visitors to this spa are residents of Yamagata Prefecture and engaged in agriculture.
2) In age they are 20 to 50.
3) Visitors who are few in number came to this spa for the purpose of spa treatment. Most of them visit this spa for recreation.
4) Most visitors take bath 2 to 3 times a day.
5) The bathing reaction and its effect are obscure, because most visitors do not stay here long enough for observation of the effect. It is, however, verified that this spa is effective in keeping the body father warm for a long time.
(B) About Niiyama Spa
1) Most visitors are residents of Yamagata Prefecture and those from neighboring prefecture are small in number. Half of visitors are farmers.
2) Most visitors are old in age, male and female visitors are almost equal in number.
3) The larger number of visitors come here for balneotherapy of or rehabilitation from diseases, especially neuralgia, rheumatism.
4) Most visitors are conscious of the good effect of bathing, but those who are conscious of thermal crisis are relatively few in number, being 9.8% of the total number of visitors.
The authors are indebted to the Pharmaceutical Section, Sanitation Bureau, Yamagata Prefectural Office and the Sanitation Section, Shinjo City Office for assistance given to the present survey, and to Shinjo and Niiyama Spa Associations for careful cooperation.

Background
The national tuberculosis (TB) control program established Phnom Penh as a pilot area for TB and human immunodeficiency virus (HIV) infection collaborative activities because of the high prevalence of HIV among patients with TB.
Process
In 2005, we provided transportation fees so that patients could travel to an operational district referral hospital for HIV counseling and testing by dispatched counselors. However, only around 10.3 patients with TB (range 0-21) per month in all 4 operational districts made use of this service. In 2006, we modified the program by providing HIV counseling and testing by four trained TB/HIV coordinators in TB wards. Thereafter, in-depth, individual, semi-structured interviews were conducted with the TB staff (not the coordinators) of 18 health facilities from April through November 2006 to identify problems in the current TB/HIV collaborative activities in Phnom Penh and to investigate ways for further improving the program.
Results
TB staff members encouraged their patients to undergo an HIV test under directly observed treatment, short course. Some TB staff lacked confidence to discuss HIV issues because they lacked sufficient HIV/ acquired immunodeficiency disease syndrome (AIDS) knowledge. Furthermore, there was no formal referral structure between TB and HIV services or sharing of information on the treatment of patients co-infected with TB/HIV with the antiretroviral treatment clinic.
Conclusions
We started the program to enable TB patients to receive HIV counseling and testing at the same venue as they received TB treatment. However, problems such as low confidence among TB staff in discussing HIV/AIDS and weak collaboration between TB and HIV services were identified. We found that training of TB staff, development of Information, Education and Communication (IEC) materials, regular meetings among stakeholders, and encouragement for the TB/HIV coordinators to supervise all TB/HIV activities in their operational districts were needed to improve the program.

Purpose: We conducted a group seminar for lung cancer patients. The purpose of the group seminar was to eliminate the negative notions about opioids and to impart the right knowledge about these drugs. Further, we investigated the notions about opioids and the effectiveness of the group seminar. Methods: A pharmacist conducted a group seminar on opioids for lung cancer inpatients who agreed to participate in the group seminar. Moreover, we performed a questionnaire survey before and after the delivery of the group seminar. Results: Sixty patients answered the questionnaire. After completion of the group seminar, the understanding and knowledge about opioids increased, as indicated by the responses of the patients to all of the questions. Conclusion: Complete elimination of the negative notion about opioids could not be achieved through the group seminar. However, the group seminar was thought to be one of the useful methods of educating patients. If a patient resists treatment with opioids, control of pain may be delayed. This in turn would hamper improvement of the quality of life. Therefore, we consider that it is necessary that a patient has the right knowledge about opioids beforehand. Palliat Care Res 2011; 6(1):109-118

The result of our general and medical survey are summarized as follows:
1) More than half the number of visitors to this spa are those who live in Yamagata Prefecture, and the rest are inhabitants of neighboring prefectures. Compared with the reports of our previous surveys, the number of inhabitants of neighboring prefectures is larger. Farmers are the largest in number, and their ages range from 20 to 60.
2) Considering the fact that more than half the number of spa visitors come here with therapeutic or convalescing purpose, this spa be said to be a spa where the sole object of visitors should be the hot spring curative treatment.
3) Form the viewpoint of classification of diseases, it may be said that patients with rheumatism and neuralgia are more than half the number, followed by those with the diseases of the stomach. This clearly shows the reason why this spa is called “the hot spring for rheumatism and neuralgia”.
4) More than half the number of spa visitors stay for about 2 weeks, and most of them take bath 5 to 6 times a day for curative treatment. Generally the spa visitors tend to bathe in excess.
5) 37.4% of the spa visitors drink hot spring water for curative treatment and this rate of drinking cure is higher than that in our previous reports.
6) Only 5.7% come to the spa under doctors' direction. 31.6% of them are conscious of the bathing reaction, symptoms of which are headache, feeling of weakness, anorexia, constipation, etc.
7) Observation of the effect of hot spring bathing on Thorn's test shows that in the larger number of patients with rheumatism and neuralgia the rate of decrease in eosinophilic leucocyte count becomes clearly higher after single bathing, but in healthy persons it is not uniform. And observation of changes in these rate of variations after succesive curative bathing reveals that in the group in whom the rate of decrease is low at the beginning of the bathing the vate tends to become higher after a week of curative bathing, while in the group in whom the rate of decrease is high it tends to become lower.

The results of our general and medical surveys are summarized as follows:
1) The visitors to this spa are inhabitants of Yamagata prefecture, farmers being the largest in number.
2) Considering the fact that more than half the number of spa visitors come here with therapeutic or convalescing purpose, this spa may be said to be a spa to which visitors come with the sole object of curative treatment.
3) Visitors came for the treatment of common cold, hypertension, neuralgia and diseases of the stomach and intestines respetively from the frequency of diseases. The fact that the visitors with cold were largest in number was probably because of the prevalence of common cold at the time of our survey.
4) Half the number of spa visitors stayed for about 2 weeks, and most of them took bath four to five times a day for curative treatment.
5) 40.1% spa visitors drank hot spring water for curative treatment. Which incidence is higher than that in our previous reports for other Tohoku Area.
6) Only 6.1% of the visitors came to the spa under doctor's direction. Those who noted the bathing reaction: anorexia, feeling of weakness etc., were 23.1%
7) In the tubeless gastric analysis (Gastrotest) scarcely any change was observable for successive drinking of hot spring water.
8) In most cases the oral temperature measured at the time of bathing in this spa never returned to the value before bathing for two hours and the feeling of warmth remained for a long time. This is probably due to the chemical properties of the spring waters and proper treatment after bathing.