In the coming ″Super-aging society″ , collaboration between medical professionals and health workers in home-care will be critical. Thus, undergraduate interprofessional education is important for the improvement of a collaborative attitude. We ran a 2-day IPE program for a medical and a rehabilitation student focused on collaboration for patients who have chronic diseases and problems in Activities of Daily Life (ADL) . As a result, one showed marked improvement in ADL while the other did not. Students learned not only roles and perceptions of other professionals but also a sense of worth and an appreciation of the difficulty of patient-centered home-care.

Increased emphasis on community-based education in medicine requires close collaboration with and cooperation from general practitioners. This study examined what motivates community physicians to participate in office-based education, to explore the most appropriate method for recognizing physicians' efforts and keeping them motivated with their precepting role. A large majority of respondents to a questionnaire survey thought that the opportunity to learn from their own teaching was an important reward. When the preceptors were asked what support would be most appropriate, a teaching certification plaque, continuing medical education courses, and a title were ranked highest, while financial reward was listed as the least important. Considered most essential by community preceptors were constructive feedback from students, medical-school instructors' understanding of the importance of community-based medicine, and the instructors' enthusiastic promotion of primary-care education.

Objective: To investigate the association of nutritional risk with gait function and activities of daily living (ADLs) in older adult patients with hip fractures. Methods: The retrospective data of older adult patients diagnosed with hip fractures who visited the recovery-phase rehabilitation ward between January 2019 and December 2022 were reviewed. Nutritional risk was evaluated using the Geriatric Nutritional Risk Index; gait function and ADLs were assessed using the modified Harris Hip Score subitem and Functional Independence Measure, respectively. Multivariate linear regression and path analysis with structural equation modeling were used to examine the factors associated with ADLs and the associations among the study variables. Results: This study included 206 participants (172 females and 34 males; mean age, 85.0±7.3 years). In the multivariate analysis, gait function (β=0.488, p<0.001), cognitive function (β=0.430, p<0.001), and surgery (β=-0.143, p<0.001) were identified as independent factors. Pathway analysis revealed that nutritional risk was not directly correlated with ADLs but was directly associated with gait and cognitive functions. Gait and cognitive functions, in turn, were directly related to ADLs. Conclusion Nutritional risk was found to be associated with ADLs through an intermediary of gait and cognitive functions.

OBJECTIVEThe relation between daily maximum temperature and mortality rate has a V-shaped pattern; the mortality rate is lowest at a certain temperature, that is, optimum temperature (OT), and the mortality rate increases when the temperature becomes higher or lower than OT. OT is associated with climate, but the relation between OT and long-term average temperature, which is a frequently used index of climate, had an outlier (Okinawa) even in Japan alone. Our objective is to determine the best climate index for OT estimation.

METHODSWe obtained death certificate data, meteorological data and population data for Japan from relevant government ministries. All the data obtained were from 1972 to 1995 except for Okinawa's mortality data (1973 to 1995). Using smoothing spline with the degree of freedom fixed to 6, we computed the OTs for 47 prefectures in Japan. These OTs were exhaustively compared with percentiles of daily maximum, average, and minimum temperatures, along with the long-term average temperature.

RESULTSAmong the candidates of the best climate index, 80 and 85 percentiles of daily maximum temperatures (Tmax80 and Tmax85) showed the highest correlation coefficient with OT (R>0.9, much higher than the R for the long-term average temperature, i.e., 0.63), and the regression models using Tmax80 and Tmax85 best regressed the OT, that is, the difference between the observed OT and the expected OT was smallest when Tmax80 or Tmax85 was used. Unlike previously used average of daily mean temperature, Tmax80 and Tmax85 made Okinawa a nonoutlier. This characteristic is desirable because Okinawa's being an outlier is due to its maritime climate and the capacity to accommodate a different type of climate may expand the applicability of OT estimation method to wider regions in the world. A direct comparison of OT with Tmax75 to Tmax90 revealed that the difference is smallest for the percentile between Tmax80 and Tmax85.

CONCLUSIONWe considered that a daily maximum temperature between Tmax80 and Tmax85 is the best climate index for estimating OT in Japan.

It is difficult to implement interprofessional education (IPE) in the classroom due to COVID-19. To share our knowledge of online IPE, we report on how we provided IPE for first-year students at two universities. At Mie University, a class was implemented to use Zoom. Quizzes and chats promoted interactions between instructors and students. At Hokkaido University of Science, an online team medical experience game was conducted via Zoom and a Learning Management System (LMS). The activity promoted interaction between students through gameplay and clear instructions. In both cases, students could successfully develop online IPE based on existing learning methods. Through their experience, it was clear that students are able to understand other professionals’ roles. They were also to commit to membership and/or teamship. On the other hand, students faced challenges with faculty familiarity and time allocation.

For this second report, we divided the efforts of the University of Tsukuba into two parts. In the first part, we introduced the Interprofessional program, an inter-university collaborative educational program between the University of Tsukuba and Ibaraki Prefectural University of Health Sciences. Before the COVID-19 pandemic, this program was conducted using TBL (Team-based learning) in a large conference room. After the pandemic, this was conducted online (using Zoom). The main changes due to the online implementation were the following five points; (1) online faculty meetings, (2) advance distribution of materials, (3) testing using Google Forms, (4) group work using the breakout function, and (5) simultaneous editing using Google Docs. In the future, we would like to examine the possibility of new educational methods while creating innovations that are possible only through online interprofessional educational programs.

In the second part of the second report, we introduce the Care Colloquium, an inter-university collaborative educational program between the University of Tsukuba and the Tokyo University of Science. The Care Colloquium is an interprofessional education program that uses PBL (Problem-based learning). In response to the COVID-19 pandemic, this program was implemented online using Microsoft Teams, with advance preparation including manual maintenance and communication testing. The same learning outcomes were achieved as the face-to-face implementation. Undergraduate interprofessional education tends to be a large-scale program, and the shortage of faculty and classrooms is challenging, but online education could overcome these obstacles. The development of hybrid programs that use the merits of both face-to-face and online education may lead to the promotion of interprofessional education in the future.