The patient was a 64-year-old woman with rheumatoid arthritis who had been treated with infliximab, prednisolone, and methotrexate. At the end of January 2016, computerized tomography (CT) revealed an infiltrative shadow and ground glass opacity in the middle lobe of the right lung. In March, CT showed some improvement but revealed new infiltrative shadowing and ground glass opacity in the lower lobe of the right lung. Bronchoscopy was performed for further examination with transbronchial lung biopsy and bronchoalveolar lavage. The histological diagnosis was organizing pneumonia. Bronchoalveolar lavage was smear positive for Mycobacterium avium complex (MAC). Infliximab was stopped. Treatment was instituted with tacrolimus, clarithromycin, pyrazinamide, and ethambutol. The infiltrative shadow and ground glass opacity in the lower lobe of the right lung subsequently improved.

A workshop entitled "Health Literacy Primer: Enhancing Patients' Skills to Promote Their Good Health" was held during the 30th Family Medicine Summer Seminar for medical students and residents by the Japanese Primary Care Association. Participants carried out four group activities to learn about health literacy. First, participants watched a skit of a conversation between two women with low health literacy to recognize the importance of promoting health literacy among citizens. Second, they practiced evaluating the reliability of health information based on the Health on the Net (HON) Code and "How to read health news" published by the British National Health Service. Third, they conducted medical interviews with patients who had brought documents containing questionable health information. Fourth, they practiced interviewing citizens with a low literacy in healthcare matters using the "teach back" technique and "Ask Me 3" questions. Many participants stated that our workshop was satisfying and understandable. We think it is necessary to hold such workshops to establish the concept of health literacy in our country, especially in the field of healthcare. In this report, we summarize the content of our workshop, and discuss future objectives for spreading and developing health literacy in Japan.