Introduction : To promote influenza prevention activities, we investigated the current status of prevention strategies for influenza among college students.
Methods : We handed out a questionnaire regarding prevention strategies for influenza to all students who visited at Oita University's Health Science Center for a medical checkup.
Results : Of the 2,752 students surveyed, 2,579 (93.7%) responded. Valid responses were obtained from 2,489 students (response rate 96.5%). Analysis of the questionnaire data revealed that the percentage of the students who received influenza vaccine was 21.0%. The proportion of the male students who received vaccine was significantly lower than that of female students (19.1% vs 23.7%). Regarding to the daily prevention habits, 71.7% of the students were able to carry out hand-washing, while less than half of the students carried out gargling, wearing a facemask and avoiding crowds. The proportion of the students who carried out daily prevention habits was significantly lower in non-vaccinated students than in vaccinated groups.
Conclusion : These results suggest that promotion of educational activities about prevention strategies for influenza at university is needed. Among them, promotion of vaccination for male students and daily prevention habits for non-vaccinated students are important.

Purpose：This study examined functional outcomes and discharge disposition in patients with and without indwelling urethral catheters, who were admitted to a convalescent (Kaifukuki) rehabilitation ward (KRW) following an acute care hospital stay.Subjects and Methods：We retrospectively reviewed the medical records of 113 patients with cerebrovascular disease and traumatic brain injury who had indwelling urethral catheters at the time of admission to the KRW of our hospital between April 1, 2012 and March 31, 2015. We studied the motor score of the Functional Independence Measure (FIM-M) and discharge disposition from our KRW in patients without indwelling urethral catheters.Results：The ratio of patients without indwelling urethral catheters was 75.2％ (85 cases：catheter-free group). The catheter-free group had higher FIM-M scores and a higher rate of living at home, compared to the 28 patients with indwelling urethral catheters. The average duration until urination independence after catheter removal was 17.3 (standard deviation：21.1) days. Urination independence recovered in 80.9％ of the catheter-free group within 4 weeks after catheter removal.Conclusion：Indwelling urethral catheter should be removed to enable discharge to home.

To clarify how students' awareness is linked to their understanding of Kampo medicine, we carried out a questionnaire and test for 94 fourth-year medical students (MS) following all the lectures at Yamaguchi University School of Medicine.Gender was not associated with performance in the test.MS having been admitted to an undergraduate program had a significantly better performance record in the test than did MS who had passed the usual university entrance examinations (P < 0.0001).MS who had experienced the efficacy of Kampo medicine had a significantly better performance record in the test than did MS who had not.Understanding of both the merits and demerits of Kampo medicine, a desire to see bedside teaching of Kampo medicine currently or in the future, and a desire to integrate Kampo medicine with primary care in the future were associated with a better performance record in the test.Multiple logistic regression analysis showed that admission to an undergraduate program (odds ratio (OR) = 6.9) and having experienced the efficacy of Kampo medicine (OR = 4.5) were independently contributing factors to a good performance record in the test.Taken together, these results suggest that experiencing efficacy and bedside teaching are needed to increase understanding of Kampo medicine for MS.

Objective: The mechanism underlying the development of neuropsychiatric symptoms such as unconsciousness, abnormal behavior, delirium, hallucinations, and convulsions in influenza has not been thoroughly investigated. The relationship between drug administration and neuropsychiatric symptoms during influenza is also poorly understood. This study is the first pharmacoepidemiologic study focused on investigating the relationship between drug administration and neuropsychiatric symptoms.
Design: Cohort study
Methods: Study subjects were patients under 18 years old who had influenza during the 2006/07 season. We prepared two kinds of questionnaires for doctor and for patient's family, and carried out the survey between January and March, 2007. Using data from 9,389 patients, we analyzed the relationship between neuropsychiatric symptoms, such as delirium, unconsciousness and convulsion, and drug administration of acetaminophen and oseltamivir.
Results: Analysis of the relationship between delirium and drug administration provided hazard ratios of 1.55(p=0.061)for acetaminophen and 1.51(p=0.084)for oseltamivir. These hazard ratios, which were adjusted for risk factors by multivariate analysis of the proportional hazard model, showed an increasing tendency of delirium after administration of each drug. In patients who received oseltamivir, a high incidence of delirium was observed between 6 and 12 hours after onset of fever. Furthermore, delirium was found to develop in a shorter time following oseltamivir use than it did after acetaminophen use. There was no relationship between unconsciousness and acetaminophen administration, as demonstrated by a hazard ratio of 1.06(p=0.839). The incidence of unconsciousness increased significantly with oseltamivir use with a hazard ratio of 1.79(p=0.0389), and unconsciousness was found to occur in a short time after oseltamivir use.
Conclusion: The results obtained from this study suggest that there are increased risks of delirium and unconsciousness with drug administration. Further pharmacoepidemiologic studies for hypothesis testing are required to study the relationship between abnormal behavior and drug administration.

Introduction : To promote disease management in the community, general physicians should refer their patients to specialists in a timely and appropriate manner. In this study, we propose an indicator for evaluation of such referrals.
Methods : We analyzed all referrals in an urban clinic from September 1, 2011 to August 31, 2012. Symptoms and diagnoses documented by general physicians were collected from medical records, and the final diagnoses by specialists were collected from their reports. The symptoms and diagnoses were classified using the International Classification of Primary Care second edition (ICPC-2). Referral rates, hospitalization rates, and place of referral were analyzed.
Results : The average number of encounters in the candidate clinic was 1402 per month, and the mean number of referrals was 23 (1.6% of encounters). Of patients who received a referral, 6.75 (29.1%) were admitted to hospitals. The symptoms and diagnoses of the referred patients were distributed across all chapters (A to Z) of ICPC-2. Diagnoses of admitted patients included pneumonia (R81) (24%), urinary tract infection (U70 and U71) (9%), and acute gastroenteritis with dehydration (D73 with T11) (9%).
Conclusion : We identified the referral rates, hospitalization rates, and distribution of referral patients as indicators of the triage function of primary care physicians. These should be evaluated further as potential indicators of “the quality of medical care.”