We held an interest group session at the 16th Annual Conference of the Japanese Primary Care Association to share best practices for diagnostic excellence in primary care. In addition to physicians, pharmacists and a medical clerk participated in the session. Participants provided examples of good practices for patient engagement and interprofessional collaboration during group discussion, which included themes such as "sharing diagnostic information," "safety netting to address diagnostic uncertainty," and "feedback about diagnostic errors."

no abstract available.

Objectives  The Japan International Cooperation Agency, Japan Anti-Tuberculosis Association and the Lusaka district health office conducted Community Mobilization for TB/HIV Care Project at three health centres in Lusaka, Zambia from 2012 to 2015. This study describes the assessment of the factors associated with high participation rates of tuberculosis (TB) treatment supporters (TSs) in patient support activities. Methods  A cross-sectional study was conducted for the evaluation. Information about individual participation to the weekly patient support activities at the health centres between September 2014 and February 2015 was drawn from the health centres’ administrative records. Data were collected between February and March 2015 via a structured questionnaire administered to TSs working at the health centres. Descriptive, univariate and multiple logistic regression analyses were done to identify factors associated with high participation of TSs. Results  For the 74 respondents, the average monthly participation rate between September 2014 and February 2015 was 83.2%. The rate was tended to be over 80% for the TSs who had temporary work or no work, or were housewives, and those who had experience as a group leader. The TSs who did not complete primary education were positively associated with participating over 80% of the time compared to those who had a secondary or higher education. Conclusion  The study provided information on the higher participation of TSs’ activities including their job, education status and leadership experiences. In recruiting TSs, priority should be given to those who have a temporary job or no work, or are housewives. Those who have lower education levels should not be excluded from the selection because they participated more often. Selecting an individual as a leader may facilitate the commitment of the person to the activities. These can be used in selection criteria of TSs in the similar setting.

High fat diet consumption induces fat accumulation in the liver. An understanding of when liver fat accumulation begins is important for exploring the mechanisms underlying fatty liver. The aim of this study was to investigate the processes of fat accumulation in the liver during high fat diet consumption with or without exercise using computed tomography (CT). Male 6 week old C57BL/6J mice were randomly assigned to the normal diet or high fat diet group. After 6 weeks, mice in the high-fat diet group were further divided into voluntary wheel exercise (HFD+Ex) and no exercise (HFD) groups. We measured body weight, food intake and locomotor activity in all mice. Liver fat accumulation was measured by CT scan weekly. Blood and tissue sampling was performed at the end of the experimental period. Following the 6 week exercise period, total body, mesenteric fat and liver weight in the HFD+Ex group were significantly lower than those in the HFD group. Alanine aminotransferase levels improved in HFD+Ex mice compared with those of HFD mice. The hounsfield unit value in HFD mice decreased between 3 and 8 weeks, suggesting that liver fat accumulation accelerated during this period. In contrast this decrease was not observed one week after exercise in HFD+Ex mice. These results suggest that liver fat accumulation estimated by CT was not observed until the 3rd week of high fat feeding while the effects of voluntary wheel exercise appeared immediately.

The environmental contaminant benzo[a]pyrene (B[a]P) has been regarded as one of the pathogens of oral premalignant and malignant lesions. To elucidate the pathogenesis of oral premalignancies, B[a]P-induced dysplasia of the murine tongue was investigated for G1-associated cell cycle regulation. B[a]P solution was applied orally up to six weeks to induce epithelial dysplasia of the tongue. BrdU incorporation and the expression of p21, cyclin D1, and CDK4 were examined by immunohistochemistry and Western blotting. Rb phosphorylation and E2F-Rb binding were examined by immunoprecipitation and Western blotting. B[a]P treatment resulted in dysplastic changes and active DNA synthesis in the tongue epithelia. Immunohistochemical analyses showed p21 up-regulation and cyclin D1/CDK4 overexpression in B[a]P-induced dysplasia. Rb hyperphosphorylation and E2F release were caused by B[a]P treatment. Thus, dysregulation of G1-phase regulation is likely to be an important event in the development of oral epithelial dysplasia in mice.