Effects of Adolescent Peer Education on the Health Consciousness of Rural Area Residents in the United Mexican States / 国際保健医療

<b>Objective</b><BR>  The authors were engaged in an adolescent peer leader project. While the main target of this peer education was adolescent students, evaluation of a ripple effect on local residents is a necessary step for the development of peer education activities. Accordingly, the object of this study was to assess whether adolescent peer education had improved the health consciousness and knowledge of the local residents of a rural area of Mexico. <BR><b>Method</b><BR>  The subjects were residents aged between 12 and 69 years living in the districts covered by 3 public health centers in the Poza Rica district, Veracruz State. A list of residents in this age group was prepared, and 50% of all the households in each area were randomly selected. From March to April 2010, before the start of the activities, an interview survey was conducted.<BR><b>Results</b><BR>  Regarding the question on self-esteem, the percentage of respondents who reported being as capable as most other people significantly increased (p < 0.001). On lifestyle, the percentage of people who reported consuming vegetables and fruits daily or once in 23 days significantly increased (p < 0.001). Regarding knowledge about STDs and contraception, the rate of correct answers about STDs decreased in the second measurement, while the percentage of correct answers about contraception significantly increased. On peer education, the percentage of people who had heard of the term “peer educator” significantly increased (p < 0.001).<BR><b>Conclusion</b><BR>  The current adolescent peer education activity undertaken in a rural area of Mexico improved self-esteem and health consciousness in other residents of the community. The ripple effect on the entire community was limited for knowledge of STDs and contraception. However it was suggested that the increase of motivation for attendance to health education in the community could be a stepping stone to the spread of knowledge.

Can Screening Invitations from Primary Care Physicians Increase Participation in Cancer Screenings on Remote Islands? / General Medicine

<b>Background:</b> Gastric and colorectal cancers are the leading cause of cancer-related deaths in Japan. In an attempt to control such cancer-related deaths, gastric and colorectal cancer screenings (GCSs) are readily available in Japan. Despite this, the rate of participation has been lower than expected. Previous studies have reported that some intervention tools can improve participation in cancer screenings and others cannot. Such studies conducted in rural areas are quite rare.<br><b>Methods:</b> The subjects were residents of Kozu Island. All subjects were aged 40 and over. In the clinical setting, primary care physicians (PCPs) handed their patients a screening invitation, in an attempt to improve participation in GCSs. We examined participation trends before and after this intervention. In addition, we administered questionnaires to examine subjects' reasons for attendance and relevant characteristics of the subjects.<br><b>Results:</b> Following the intervention, participation in GCSs did not significantly improve in the short term. In 2011, the number of participants in gastric cancer screening was 173 (22.1%) and was not significantly different from the 2010 results (P=0.80). Furthermore, the number of participants from year to year (2005-2011) was not significantly different (P=0.07). In addition, the number of participants in colorectal cancer screening was 145 (16.5%) and was not significantly different from the 2010 results (P=0.65). Moreover, the number of participants from year to year (2005-2011) was not significantly different (P=0.17). 172 out of 211 (82%) participants submitted the questionnaire. Results taken from the questionnaires showed that our screening invitation influenced non-elderly people (49.5±3.9 vs. 56.4±6.5, P=0.04) and first-attendance people showed a significant tendency for more gastrointestinal symptoms (4 vs. 2, P=0.03).<br><b>Conclusion:</b> On the whole, the screening of invitations from PCPs did not improve participation rates in GCSs in the short term. However, we believe that screening invitations can influence non-elderly people, and this intervention can be effective in increasing the numbers of gastrointestinal-symptomatic people attending for the first time (first-attendance people).

Implementation of TB/HIV collaboration program in Phnom Penh, Cambodia / 国際保健医療

<B>Background</B><br>The national tuberculosis (TB) control program established Phnom Penh as a pilot area for TB and human immunodeficiency virus (HIV) infection collaborative activities because of the high prevalence of HIV among patients with TB.<br><B>Process</B><br>In 2005, we provided transportation fees so that patients could travel to an operational district referral hospital for HIV counseling and testing by dispatched counselors. However, only around 10.3 patients with TB (range 0-21) per month in all 4 operational districts made use of this service. In 2006, we modified the program by providing HIV counseling and testing by four trained TB/HIV coordinators in TB wards. Thereafter, in-depth, individual, semi-structured interviews were conducted with the TB staff (not the coordinators) of 18 health facilities from April through November 2006 to identify problems in the current TB/HIV collaborative activities in Phnom Penh and to investigate ways for further improving the program.<br><B>Results</B><br>TB staff members encouraged their patients to undergo an HIV test under directly observed treatment, short course. Some TB staff lacked confidence to discuss HIV issues because they lacked sufficient HIV/ acquired immunodeficiency disease syndrome (AIDS) knowledge. Furthermore, there was no formal referral structure between TB and HIV services or sharing of information on the treatment of patients co-infected with TB/HIV with the antiretroviral treatment clinic.<br><B>Conclusions</B><br>We started the program to enable TB patients to receive HIV counseling and testing at the same venue as they received TB treatment. However, problems such as low confidence among TB staff in discussing HIV/AIDS and weak collaboration between TB and HIV services were identified. We found that training of TB staff, development of Information, Education and Communication (IEC) materials, regular meetings among stakeholders, and encouragement for the TB/HIV coordinators to supervise all TB/HIV activities in their operational districts were needed to improve the program.

Use of computers among Jichi Medical University students / 医学教育

Medical students must have knowledge and skills related to medical informatics, including data analysis, the retrieval of biomedical literature, the creation of presentations, and the use of the Internet.The purpose of this study was to analyze the changes over time in the ability of Jichi Medical University students to use the tools of information technology.<BR>1) Questionnaires were distributed to all Jichi Medical University students during epidemiology classes in 1998, 2002, and 2006.<BR>2) The questionnaires included questions about the frequency of the use of computers, word-processing software, spreadsheet software, statistical software, and the Internet.<BR>3) The first survey showed that ownership of a computer and the use of word-processing software were most common, followed in turn by the use of spreadsheet software, statistical software, and the Internet.The percentage of stu dents who had not used a computer decreased from 22% in 1998 to 2% in 2006.<BR>4) With the rapid changes and progress in our information-oriented society, medical students need to be appropriately prepared to make optimal use of available resources.

A Study of Support Systems for Women in Medicine: Dual Roles of Professional and Mother / 医学教育

We examined issues in balancing professional obligations with family needs, especially parenting, in female physicians. Questionnaires were given to all female physicians who had graduated from Jichi Medical School. Of the 196 graduates, 155 responded (79.1%), and younger graduates accounted for a greater proportion of subjects. Although many female physicians did not live with their parents, female physicians or their parents were usually responsible for caring for children when they become ill. Many respondents demanded better access to day care and greater flexibility in accepting sick children. Female physicians should contribute to society using the knowledge and skills they acquired in medical school; to do so they need support systems in their workplace and child-care services.