Introduction: The Japanese government implemented a community-based integrated care system that provides community healthcare resources for elderly people focusing on home health care in particular. To achieve this, interprofessional teams in the community need to function seamlessly. Thus, we explored the process by which healthcare professionals change their recognition of the relationships and problems among them through the dialogue of home health care promotion.Methods: We held the World Cafe to discuss with healthcare professionals about home health care in a city in Ibaraki Prefecture. All dialogues were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.Results: Although healthcare professionals had strongly recognized the hierarchical relationship, they deepened their mutual understanding by sharing their background and values. While sharing the hope to make equitable relationships, they changed their recognition as follows: home health care was not "someone else's problem" but "their own problem" and "their own community's problem".Conclusion: It is necessary for healthcare professionals to share issues and explore methods to solve them in the community, and to change the relationships among stakeholders because problems related to home health care promotion are complex. This study clarified that healthcare professionals are motivated to seek solutions to problems proactively via their relationships in interprofessional teams in the community.

Association between smoking prevention education for elementary and junior high school students and the modification of their parents' smoking behavior — Can child education change parental behavior?
Introduction : This study aimed to investigate an association between a smoking prevention education program for elementary and junior high school students, and the subsequent behavior modifications of their parents.
Methods : Preventative education programs for smoking were provided to four elementary and three junior high schools in Kamisu City, Ibaraki Prefecture, Japan. We encouraged participating students to discuss the knowledge derived from the education sessions with their families. One month after completing the program, questionnaires were distributed to the parents of the students to investigate whether they had modified their smoking behavior as a result of what they had learnt from their children.
Results : Two questionnaires were distributed to each of 1109 families, and 1427 valid responses were received. Analysis showed that 794 parents had been informed about tobacco use from their children (55.6%) and 271 parents had modified their smoking behavior (19.0%) as a consequence. This included smoking cessation, decreasing tobacco consumption, and smoking avoidance in the presence of their children. Behavior modification was significantly correlated with the knowledge they had derived from their children based on the preventative smoking education program (odds ratio = 3.3 ; 95% CI : 2.4-4.6).
Conclusion : Implementation of an education program for smoking prevention focused on elementary and junior high school students can lead to modification of smoking behavior in both students and their parents, respectively.

Introduction : This study aimed to clarify any associations between familial smoking, especially parental smoking, and high school students' perceptions of smoking.
Methods : Questionnaires on familial smoking and the Kano Test for Social Nicotine Dependence (KTSND) were distributed to junior high school students. The KTSND is a tool to evaluate positive perceptions of smoking. We analyzed the relationship between the total KTSND score and school grade, gender, familial smoking, paternal smoking, and maternal smoking.
Results : We received 761 valid responses (valid response rate : 90.4%). Five hundred forty-three students had family members who smoked (71.4%), 394 had smoking fathers (51.8%), and 214, smoking mothers (28.1%). The total KTSND score correlated with familial smoking (10.55 vs 9.46, p=0.009) and maternal smoking (11.18 vs 9.87, p=0.002).
Conclusion : Familial smoking, especially maternal smoking, correlated with positive perceptions of high school students towards smoking. Promoting smoking cessation in women with children may be effective in preventing tobacco use among children.

Introduction: We investigated the relationship between knowledge of the common cold and desire for medical treatment.Methods: We administered an anonymous self-questionnaire about the common cold to citizens receiving health checkups in City X, Ibaraki Prefecture, between August and September 2012. We assessed citizens' knowledge about the common cold and whether they sought medical treatment for it, in addition to their demographic attributes.Results: We included 1079 citizens (response rate, 74.5%) in the analysis. The majority of participants believed that receiving intravenous (IV) infusions or injections for the common cold led to faster recovery times (75.9%). Roughly half of the participants (42.0%) did not believe that antibiotics are not effective against virus-based colds, while 28.6% were unsure. Finally, endorsement of the questionnaire items "taking cold medications early leads to faster recovery" (OR: 1.61) and "IV infusions or injections lead to faster recovery times" (OR: 1.86) were associated with a desire for medical treatment.Conclusion: Our results indicate that patients' knowledge about the common cold and their understanding of treatment options available at medical institutions were inadequate. Furthermore, we found that an awareness of how cold medicines, IV infusions, or injections may shorten treatment duration was associated with a desire for treatment.

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.

Since 2009, a five-day, regional health care, clinical clerkship in medically underserved areas has been available to all fifth-year medical students at the University of Tsukuba. In the program, students listen to and observe health problems in non-clinical settings, wherever these problems actually exist. Students can experience health care lectures and health examinations. They can also experience a clinical work environment. The short stay helps students to understand the living environment of the area they observe. It is also effective for students to consider health problems from the perspective of the local inhabitants. This program aims to directly convey the interest and importance of community medicine, and to contribute to the supply of physicians in these areas. A longitudinal study is needed to evaluate the effect of the program.

Ulcerative colitis (UC) is 1 of the 2 major phenotypes of chronic inflammatory bowel disease (IBD), which afflicts millions of individuals throughout the world with debilitating symptoms that impair function and quality of life. Further, IBD often affects women during childbearing age. Indeed, UC activity frequently increases during pregnancy, and the medications used to induce remission may adversely affect the health of the mother and the unborn child. We report successful induction of a remission in a UC case who experienced a flare-up in the first trimester of pregnancy. Upon relapse, she was treated with steroids and adsorptive granulomonocytapheresis (GMA) with the Adacolumn plus tacrolimus. This combination therapy induced a stable remission that was maintained during her entire pregnancy. She gave birth to a healthy child at 36 weeks of pregnancy with no maternal or fetal complications. Our experience indicates that GMA, as a non-drug therapeutic intervention with a favorable safety profile, plus tacrolimus might be a relevant treatment option for patients with active IBD during pregnancy. A future study of a large cohort of pregnant patients should strengthen our findings.
Child ; Cohort Studies ; Colitis, Ulcerative* ; Female ; Humans ; Inflammatory Bowel Diseases ; Mothers ; Parturition ; Phenotype ; Pregnancy Trimester, First ; Pregnancy* ; Quality of Life ; Recurrence ; Steroids ; Tacrolimus* ; Ulcer*