Report on the Workshop "Health Literacy Primer: Enhancing Patients' Skills to Promote Their Good Health" / 日本プライマリ・ケア連合学会誌

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.

Beneficial effects of tonsillectomy plus steroid pulse therapy on inflammatory and tubular markers in patients with IgA nephropathy

BACKGROUND: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Tonsillectomy plus steroid pulse therapy has been able to induce clinical remission in early-stage IgAN. However, its possible effect on systemic and local cytokines and tubular markers has not been fully investigated. METHODS: We obtained serum and urine samples from 38 patients just before renal biopsy and third steroid pulse therapy. Markers of tubular damage such as N-acetyl-β-d-glucosaminidase, and kidney injury molecule-1 and inflammation such as interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, and vascular cell adhesion molecule (VCAM)-1 were measured by immunoassay. RESULTS: Before renal biopsy, only urinary inflammatory markers, except MCP-1, were associated with glomerular (proteinuria) and/or tubular damage markers. Proteinuria, hematuria, and estimated glomerular filtration rate dramatically improved after therapy. In addition, levels of serum IL-6 and ICAM-1 and all urinary markers declined significantly; however, serum MCP-1 and VCAM-1 levels did not. None of the urinary markers correlated with the serum inflammatory markers. CONCLUSION: Tonsillectomy plus steroid pulse therapy for patients with IgAN might be useful for improving not only glomerular damage marker but also tubular damage markers through the improvement of local renal inflammation.

Activities Contributing to Happiness of Older Adults in Rural Communities / 日本農村医学会雑誌

Older adults tend to lose the opportunities and abilities to pursue hobbies and perform various activities. Club activities provided in the community for old people seem to be beneficial in that the activities prevent them from becoming housebound, and improve overall QOL. In the present study, we conducted a survey by sending out self-answered questionnaire to 424 elder residents in rural areas. We collected information about their life circumstances, the presence or absence of physical pain, activities of Daily Living (ADLs), the degree of enjoyment from activities on the list, the frequency of going out, PGC morale scale and so on. The activities enjoyed frequently by the elderly were bathing, eating and watching TV. The degrees of enjoying eating and bathing showed positive correlations with the PGC morale scale, but the degree of enjoying gambling correlated negatively with the scale. A regression analysis was performed with the PGC morale scale as dependent variables. As a result, a significant model was structured to predict the life sati of the aged by making interpersonal distress, enjoyment derived from gambling, basic ADLs, physical pain and dwelling alone as indepeudent variables. These results will assist us in providing adequate health care to pelple of advanced age.