Background
 Under resource-limited circumstances, standard clinical practice for prioritized illnesses and conditions were introduced to nurses and midwives in primary health care (PHC) facilities in Timor-Leste. This research aims to asses the use of medicines and standard treatment guidelines (STGs) in community health centers (CHCs) in Timor-Leste and to analyze factors that influence adherence to STGs.
Methods
 Randomly sampled 20 CHCs without beds were visited from February to August, 2006. In each CHC, 100 retrospective samples from patient registration books and 30 prospective observations were collected and then quantitatively analyzed. Open-ended interviews to three members of health personnel per CHC were qualitatively analyzed.
Results
 Use of injections in Timor-Leste was extremely low when compared to results from other countries that used the same international indicators. The percentage of encounters with an antibiotic prescribed was significantly lower for prescribers with clinical nurse training than those without the training. A significantly higher level of prescribing adherence was observed among clinical nurse prescribers. None of the facility characteristics investigated was associated with the CHC's overall prescribing adherence to STGs. Open-ended interviews to CHC health personnel revealed that changes brought about by the introduction of STGs were positively perceived by respondents, especially clinical nurses.
Discussion
 Unlike previous studies on physician adherence to STGs in western countries, changes brought about by the introduction of STGs were positively perceived by PHC health personnel in Timor-Leste. STGs were developed and introduced in a policy framework that reflected local needs and reality and related with the Basic Package of Health Services policy and other policies and programs, such as human resource development, medicines policy and resource allocation plans. That fact was considered to have produced positive results in this study. Timor-Leste's experience implies a potential of STGs for non-physician health personnel working at PHC level in other resource-limited areas.

Introduction
The use of medicines among Brazilian workers in Japan has not been documented. This study examines the preferences and use of medicines among Brazilian workers of Japanese origin in Japan.
Methods
A cross-sectional survey was conducted in 2011 in a community in Nagoya, where many Brazilian workers lived. Questionnaires were distributed to 206 Brazilian households, and asked about preferences and use of Japanese or Brazilian medicines. Associations with socioeconomic factors were analyzed using Fisher's exact test.
Results
The response rate was 36% (74 households). Of these, 66% had lived in Japan for over 10 years, and 88% held health insurance. Over 80% reported a preference for Japanese medicines. However, Brazilian medicines were used in more than 40% of the households. Employed Brazilians tend to use Brazilian medicines compared to the unemployed. Most respondents answered that Brazilian medicines were more effective, but were more expensive and produced worse side effect than Japanese medicines.
Households with children showed a preference for Japanese medicines for children's illnesses. However, more Brazilian medicines were used when the length of household's stay in Japan was less than 10 years, and when the respondent's perceived listening ability of Japanese language was poor.
Conclusion
Almost all respondents were using the medicines they preferred, suggesting that access to medicine was generally good in the community. However, 40% of respondents used Brazilian medicines, despite their long stay in Japan, their health insurance status, and their recognition of Japanese medicines as inexpensive and safe. This might be explained by familiarity with Brazilian medicines, or perception of their effectiveness.
Continuous self-administration of medicines without consultation has potential harm to the health. This study also suggests the importance of arranging social environments such as facilitating the taking of sick leaves, so that immigrant workers can secure their access to health services.

Objective  Everyone has the right to obtain information through understandable language. Nevertheless, it has been pointed out that in Japan, a language barrier prevents it. Plain Japanese (easy Japanese) has been proposed as a solution. Plain Japanese is a language form simplified to be suitable for non-native Japanese peoples’ Japanese abilities. However, there are limited studies on healthcare professionals’ use of plain Japanese. The objectives of this study were to examine changes, moreover associations between knowledge and rephrasing skills among nursing students.Method  Eighty nursing students were subjected to this study. We conducted a lesson on “plain Japanese”. Data were collected before and after the lesson using questionnaires. We compared the number of knowledge items and rephrasing scores before and after the lesson. After the lesson, we also compared the number of knowledge items between the high rephrasing score group and the low rephrasing score group. We compared perceptions about communication with non-native Japanese people before and after the lesson.Results  Seventy-two nursing students participated in this study. There was a significant difference in the number of knowledge items before and after the lessons（from 2 to 8) (p<0.05). Rephrasing skills scores were increased as well (from 3 to 4) (p<0.05). The positive answers about “plain Japanese” increased after the lesson. However, the median number of knowledge items among the high rephrasing score group was 10 and the median number among the low rephrasing score group was 8 after the lesson. There was no significant difference between the two groups (p>0.05). Conclusions  Overall, both the number of knowledge items and rephrasing skills scores were increased. However, it is unknown whether the increase in rephrasing skills were improved based on increased knowledge. Students will more specific knowledge and repetitive practice to improve skills in using plain Japanese.

Objectives  To describe the current situation regarding the medical information provided for foreign residents by the official websites of cities and municipalities in Aichi Prefecture and to investigate associations between the characteristics of each city/municipality and their provision of online medical informationMethods  Using a checklist of 24 items, the official websites of all 54 cities and municipalities (hereafter local governments) in Aichi Prefecture were checked. Each item was descriptively summarized. Associations between three selected items and local government characteristics were analyzed by Fisher’s exact test.Results  The official websites of 49 local governments (90.7%) were translated into at least one foreign language. An automatic translation system was used by 43 websites (79.6%). Information on emergency medicine was translated into at least one foreign language on 45 websites (83.3%), child health checkups on 44 websites (81.5%), and adult health checkups on 42 websites (77.8%). However, only eight local governments (14.8%) provided information on where child health checkups were available, and 23 (42.6%) translated a list of medical facilities where adult health checkups were available. The provision of a link to the Aichi Medical Information System was significantly associated with the size of the local government and the number of foreigners. Ten (76.9%) out of 13 local governments categorized in the highest quartile for proportion of foreigners had not translated the list of medical facilities for adult health checkup.Conclusion  Many local governments rely on the automatic translation system, which does not have the capacity to manage all the information accurately. Compared to information on emergency care, access to information on child health checkups and adult health checkups, which will be increasingly needed in the future, was poor and limited. An external website for shared use was not fully utilized, in particular, by smaller local governments.

Introduction  It has been pointed out that in Japan the language barrier prevents non-native Japanese speakers from accessing medical services and health information. “Yasashii Nihongo” is considered as a way to overcome this barrier. This is not the language native speakers use but a version adjusted to suit the audience’s Japanese ability. This study aimed to describe nursing students’ skills in rewriting Japanese medical information for non-native Japanese residents and knowledge for the skills and to examine a trial intervention to improve their skills and knowledge.Methods  A cross-sectional study and an interventional study were conducted. In each study, data were collected through self-reported questionnaires targeting nursing students. Their skills and knowledge were summarized. The associations between skills and knowledge were examined, as well as the association between skills in rewriting two example sentences. In the interventional study, a workshop teaching “Yasashii Nihongo” was offered to participants. Changes in skills and knowledge after the intervention were also assessed statistically.Results  In the cross-sectional study, a median general score to assess skills was four out of five, and the number of knowledge items was two out of sixteen.  In the interventional study, an association between skills in the two example sentences was found (p-value = 0.04). However, there was no significant difference in skills or knowledge before and after the intervention.Conclusion  In the cross-sectional study, participants suggested only few knowledge items of “Yasashii Nihongo”, but they suggested high skill scores. In the intervention study, we could not confirm the effectiveness of teaching “Yasashii Nihongo”. To increase the knowledge level of nursing students and to use the knowledge in actual rewriting, it is necessary to reconsider the teaching contents and to allow appropriate time for the intervention.