In the title of my keynote speech, "Expanding Our Health Communication Researches in Medical Sociology," I pointed out that the characteristics of the nature of health communication are taking drastic changes in the globalizing world context of health information technologies.

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What is communication design? This new field of studies looks at issues of communication, considering the people involved, and the environment, and proposes practical solutions to overcome obstacles to communication. The factors preventing discourse are not reduced to individual's characters and faculties; communication design examines all factors involved in communication, in order to determine constants, and propose various ways to improve communication. This course introduces the possibilities of this new field of studies, referring to examples of its application in teaching at Osaka University.

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People in modern society are expected to actively engage in the management of their health and to make a wide range of health decisions. Skills in understanding and applying information about health issues may have a substantial impact on health behaviors and health outcomes. These skills have recently been conceptualized as health literacy (HL) , defined as "the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health" by WHO. Based on this conceptualization, Nutbeam proposed a model of HL that includes three levels: (1) basic/functional literacy, (2) communicative/interactive literacy, and (3) critical literacy. In this paper, we report the results of our previous studies developing HL scales in Japan, and discuss the importance of HL in improving health communication in our society.

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The purpose of this article is to find a clue for discussions on the ethics of health communication. It primarily contains an analysis of health communication, specifically, with respect to the CDC's guideline concerning HIV prevention counseling at HIV testing centers. The result of the analysis revealed two key issues of health communication: the asymmetry between a service provider and a client and the restricted scope of health communication. According to the descriptions provided by Bataile and Alain, health communication is multi-dimensional and 'communication concerning health communication' is suggested as the ethics of health communication.

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Health communication strategies in cancer control programs target all levels of human communication. To achieve our cancer control goals, effective and efficient strategies must be designed with the input and collaborating efforts of the key stakeholders. In 2007, a basic plan to promote a cancer control plan was approved in Japan. In line with this program, "Gan Kanja Hikkei," a comprehensive information guide on cancer, was produced and distributed via the Internet and bookstores since 2010. Multi-dimensional communication strategies were employed in the production and distribution of this booklet. Thus, information sharing is the key to overcoming the problems of routine cancer care. More studies on information sharing and community building of stakeholders for the purpose of developing cancer control strategies are necessary.

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Japanese people's widespread perception about cancer patients has changed drastically in recent years because many more people are now cancer survivors. So, Japanese people no longer see cancer as always being fatal, but rather in many case as a chronic condition. As this change in perception has taken place, Japanese people have begun to recognize that cancer survivors need social support systems. In 2006, the Japanese parliament enacted the "Cancer Control Act" which requires that "patients, regardless of where they live, should receive equal, scientifically appropriate medical care." Accordingly, prefectural governments throughout Japan established Supporting Centers for Cancer Counseling. Within these centers, self-help groups such as cancer patients members' clubs (kanjyakai), cancer patients' discussion groups (gan kanjya saron) are increasingly serving as an important arm of social support outside of official medical care. This paper examines the health communications situation in cancer patients' self-help networks from multiple angles and different layers. The author aims to understand how cancer patients and survivors receive social support to cope with their symptoms. The author also examines the dynamism of self-help groups in providing a way for members to share their personal experiences.

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Recently, in the field of audiology, conversation analysis findings were employed for developing better the communication strategy for persons with hearing impairment. On the basis of this movement, this paper examined a conversation between persons with hearing impairment and care workers in nursing homes. In this situation, I observed that persons with hearing impairment could not point a relevant place of a trouble source in the problematic talk, because persons with hearing impairment missed a timing of a repair initiation. Additionally, I found the feature of interactional organization that persons with hearing impairment produce his/her repair initiation that designed sounds his/her heard previous turn. These findings are valuable as the basis for rethinking the "repair" concept in the field of audiology.

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In this paper, I examine "dementia" as the concept, which indicates "who" and "how to" remedy troubles about care. I analyze data collected through participant observations and interviews in self-help groups (SHGs) that family caregivers of the demented elderly attended. I emphasize the following four points. First, if elderlies are represented as " the demented, " they are exempted from the responsibility of remedying troubles. Second, assigning such responsibilities to "family caregivers" implies that they must provide care by considering that people with dementia "cannot think logically, while their emotional abilities are preserved." Third, people with dementia are regarded as "innocent" or "harmless" as a result of this categorization. Fourth, by participating in SHGs, family caregivers can develop a new frame of interpretation for "troubles to remedy" in dementia.

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The purpose of this study was to clarify the needs in preparing for bereavement of informed families of patients with chronic hepatitis advancing to incurable hepatic cancer. Based on the verbatim records of interviews with nine family members, expressions were extracted corresponding to Okado's eight needs of families of dying patients (Okado 1987). Families satisfied their need to know the condition of the disease through information found on the Internet and in newspapers to make up for the lack of explanation from the doctor. Families had the need to stay with the patient and the need to ensure the comfort of the patient when nearing death. Families felt it was inevitable that they could not get enough care from the health providers because they believed that the providers were too busy. This was irrespective of the patient's remaining life expectancy.

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