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.

Introduction: Polypharmacy is the practice of prescribing many medications. In this study, we assessed the current status of polypharmacy among elderly patients and cases of inappropriate prescription (IP) at the Department of General Internal Medicine (GIM) at Sendai Medical Center.

Methods: We retrospectively surveyed 136 inpatients who were over 65 years old between April 2015 and March 2016 at the Department of GIM.

We examined the patient's current medications and used the STOPP (screening tool of older person's potentially inappropriate prescriptions) criteria version 2 to analyze potentially inappropriate medication (PIM) cases.

Results: Of 136 study patients, 77 (56.6%) patients were taking more than 6 medications. For patients over 75 years old, the average number of current medications increased.

In addition, 33 cases of PIM were confirmed and the number increased in proportion to the number of current medications. Furthermore, there were 4 cases of adverse reactions in which the STOPP criteria version 2 were not applied.

Conclusion: In this study, we confirmed polypharmacy in the examined patients.

In order to solve the problem of polypharmacy, all medical staff must cooperate and review the prescriptions of individual patients.

General physicians should assume the leading role in the distribution and improvement of polypharmacy and IP.

Purpose: The purpose of this study was to acquire integrated views from previous studies on what interventions by rehabilitation specialists have led to the reduction of the care burden for stroke survivors' families.

Method: Reported randomized controlled trials concerning interventions for the care burden of stroke survivors' families by rehabilitation specialists were extracted from two electronic databases, and their content was assessed by a systematic review.

Results: Among the 11 analyzed studies, no studies focused on the stroke survivors' families. Studies reporting a reduction in the care burden were those comparing the presence of botulinum therapy and those comparing occupational therapy and non-intervention.

There were no significant differences in the care burden for stroke survivors' families between the interventions by rehabilitation specialists and standard rehabilitation.

Conclusion: Interventions for stroke survivor's families by rehabilitation specialists do not reduce the care burden in comparison with standard care.

Objective: The objective of this study was to validate the Japanese version of the STOP-Bang test for risk assessment of obstructive sleep apnea syndrome (OSAS).

Methods: We retrospectively evaluated inpatients who underwent nocturnal pulse oximetry for OSAS screening at the internal medical wards.

Results: One hundred and forty-four subjects were included the study, and 57 subjects who had a 3% oxygen desaturation index ≥10/hr underwent polysomnography. Seventeen and 29 subjects were diagnosed with moderate and severe OSAS, respectively. According to the receiver operating characteristic (ROC) curve analysis, the STOP-Bang test had a higher diagnostic value using a cutoff of 30 kg/m² for BMI than using a cutoff of 35 kg/m². A STOP-Bang score of 3 or greater had a sensitivity of 95.7% and specificity of 42.9% for detecting moderate-to-severe OSAS.

Conclusion: The STOP-Bang test is a simple and useful tool for the risk assessment of OSAS.

Purpose: To clarify the strengths and problems of nursing in multifunctional long-term care in a small group home and home-visit nursing (MLSH).

Methods: Selected case reports using Ichushi, the Current Index to Japanese Nursing Literature, and DiaL were extracted and categorized based on the descriptions of the strengths and issues of service in MLSH.

Results: Strengths included "flexible and continual? users / family support", "care of users with high medical needs, including end-of-life care", "support for a smooth transition from hospital to home with consecutive stay", "reduction of economic burden of users using a fixed monthly system", and "cooperation between nurses and care workers, and growth by learning from each other". Problems included "difficulty in dealing with diverse needs", "economic burden of low-income users and welfare equipment", and "insufficient cooperation with other occupations inside and outside the office".

Conclusion: The strengths of service in MLSH were demonstrated via the support of users with high medical needs and support during the transition period at home. The economic burden of users and cooperation with other occupations are both strengths and problems to be addressed. Support according to user characteristics and public awareness of the existence and strengths of MLSH are required.

Objective: To clarify the involvement of Japanese family physicians with patients and their families in their daily practice.

Methods: Participants were Japanese family physicians with over one year of experience of full-time work in their clinics, and who were able to join the focus group discussions (FGD) and member checks. The study employed a qualitative research design with semi-structured FGD. Two analysts examined video recordings of the FGD, and the results were verified through member checks and external checks.

Results: Eight physicians participated at first, but five of them dropped out because of job commitments or death. The involvement by Japanese family physicians consisted of three stages. The first stage was "the approach of repeated hypothesis testing and normalizing" as safety interventions. The second stage was "reevaluation of the family" utilizing family genograms, family conferences, and others. After exhausting all other efforts, they engaged in "accepting the one who comes to them" in collaboration with the patient and families. The outcomes included awareness of patients, their smiles due to feeling accepted, and their expressed emotions. They did not explicitly boast that they were able to engage with family members. In addition, they also needed case studies of instances of "failure."

Conclusion: Japanese family physicians engaged in three-stage involvement with families.

Idiopathic normal pressure hydrocephalus (iNPH) is a disorder observed in elderly patients causing gait disturbance, urinary incontinence and cognitive impairment. Due to the rapidly aging society, the number of patients with iNPH continues to increase yearly. However, iNPH is often overlooked because of its insidious and variable presentation. In the primary care setting, iNPH can be coincidentally discovered by neuroimaging findings, including disproportionately enlarged subarachnoid space hydrocephalus (DESH). We report two cases of iNPH in the elderly living alone that had different outcomes depending upon the availability of neurosurgery specialists. It is essential for primary care physicians to consult neurosurgeons without delay because prompt diagnosis and treatment can improve the patient's quality of life and prolong their duration of living at home.

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.