Introduction: Worries and concerns about taking medicine, and related factors in older patients undergoing polypharmacy were investigated.

Methods: Participants (N = 9) aged 65 years or older with chronic diseases who were prescribed more than six types of medicine were selected for this survey. Qualitative data obtained by semi-structured interviews were analyzed by Steps Coding and Theorization (SCAT). Components and concepts are indicated by "" and ' ', respectively.

Results: Worries about taking medicine were affected by "lack of support from medical staff providing polypharmacy", and by "negative experiences and lack of understanding about medicine". "Behaviors for coping with worries", which were composed of "self-control in taking medicine" and "asking advice from the prescribing physician", dispelled worries. Participants that had never been worried had "received adequate support from staff involved in polypharmacy" and had "positive attitudes about polypharmacy".

Conclusion: Worries about taking medicine among older patients undergoing polypharmacy were solved through self-control. Moreover, medical staff involved in polypharmacy should conduct activities to initiate communication with such patients.

Introduction: We conducted a nationwide questionnaire survey for care managers (CMs) regarding their awareness about the role of pharmacists in home medical care, and objectively analyzed the obtained data using text mining.

Methods: Survey targets were CMs belonging to the Japan Care Manager Association (JCMA). A letter of request was mailed to the 47 prefectural branches of the JCMA. Only members of the JCMA who agreed to participate in this survey responded.

Results: Responses were received from 206 CMs, 25% of whom had experience as medical professionals and 75% whom had experience as nursing care welfare staff. 90% of the 206 CMs replied "They are necessary" to the question "Are pharmacists necessary for home medical care?". Using text mining to identify the reason for answering "They are necessary", the characteristic keywords from the CMs with experience as medical professionals were "instruction" and "internal use". On the other hand, the characteristic keyword from the CMs with experience as nursing care welfare staff was "consultation".

Conclusion: The CMs with experience as medical professionals expected the pharmacists "to demonstrate their expertise to patients, families, and other professionals". On the other hand, the CMs with experience as nursing care welfare staff expected the pharmacists "to provide consultation on information about medications and side effects".

Purpose: To clarify intervention methods used by medical professionals in clinical situations and their effects on the health literacy of patients.

Method: Reports on randomized controlled trials for the health literacy of patients were collected from the electronic database. The reports were then evaluated using qualitative systematic reviews conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement.

Result: On examination of the effects by intervention methods, we found that many reports concluded an improvement in health literacy by patients by "only the distribution of handouts". Moreover, many reports also noted improved "adherence for health behavior" by patients following the "distribution of handouts and explanation by medical professionals". Furthermore, improved "health literacy" by "one-way intervention from medical professionals to patients" and "two-way intervention by both medical professionals and patients" was reported.

Conclusion: Based on this study, it may be possible to provide information considering individuality when the medical professional provides an explanation to the patient in addition to giving handouts. Improved disorder comprehension and self-management skills are expected when the medical professional appropriately confirms the patient's comprehension level.

The Young Primary Care Doctors' Organization of the Japan Primary Care Association (JPCA) launched the "Generalist 80 Universities Angya Project" in 2011 to increase contact between generalists and medical students or residents interested in general hospital medicine, family medicine and primary care. The project targeted students interested in family medicine, primary care and hospital general medicine who do not participate in nationwide seminars. The project helps medical students and residents hold voluntary seminars at their university campus about family medicine, primary care and hospital general medicine. From 2011 to 2016, the project supported 129 seminars attended by 3,569 people at 63 universities. A questionnaire survey on 11 seminars between September 2013 and February 2014 revealed that 66% of medical students had never participated in JPCA family medicine summer seminars for students and residents. By holding seminars at university campuses, we targeted different participants from those at the nationwide seminar.

Introduction: This study examined the perspectives of quality surveyors employed by the local government regarding the quality evaluation of agencies for visiting nurses.

Methods: The participants were six surveyors. We carried out semi-structured interviews concerning the quality of agencies for visiting nurses. We conducted a qualitative analysis and derived several categories inductively.

Results: The surveyors found little difference in the quality between for-profit and non-profit agencies for visiting nurses. In addition, they considered the following characteristics to represent good quality agencies: "availability of home-visit nursing 24 hours per day", "information disclosure and maintenance of quality records", and "the nurse manager understands and promotes an integrated community care system".

Conclusion: Eleven categories were identified for the qualitative evaluation of agencies for visiting nurses. The present findings may be used useful for maintaining the quality of agencies for visiting nurses.

Progressive supranuclear palsy (PSP) comprises psychiatric, neurological and physical complications. In the late stage, most patients with PSP are bed-bound because of motor disability. PSP manifests as predominantly axial abnormality in posture and abnormal muscle tone, resulting in cervical retroflexion and somatic pains. Severe retroflexion of the neck is frequently a cause of repeated aspiration pneumonia that affects survival expectancy. We injected botulinum toxin (BTX) for severe retroflexion using a CT-guided procedure to confirm the anatomical locations of paravertebral muscles and to localize the paravertebral target muscles for a patient with PSP who had repeated pneumonia caused by retroflexion-related dysphagia. BTX injection treatment markedly ameliorated the cervical dystonia and concomitant dysphagia. The patient has recovered and may be able to be discharged to home. There are few reports on the BTX injection technique, but BTX has analgesic effects and induces relaxation of abnormal muscle tension. Therefore, it may be applicable to other movement disorders at the late stage.

Open Dialogue is a dialogical approach aiming at "polyphony (multivoicedness) " based on seven principles such as "social network perspective" and "tolerance of uncertainty". This method began as an approach to treat mental illness in Finland, and has great potential in the primary care field. In particular, it may be effective for highly complex and/or uncertain cases.

We introduced the "Health Cafe with Mobile Stalls Project" as an example of community-oriented care. The authors, two family physicians and a medical student held salutogenic dialogues at mobile stalls in the "Yanesen" area in Tokyo and Toyooka City in Hyogo Prefecture. Mobile stalls may be able to demonstrate "small scale multi-functional" roles to approach people who are indifferent to health, and serve as a place where multiple generations can connect.