Efficacy of 23-valent pneumococcal vaccine in elderly people living on islands / 日本プライマリ・ケア連合学会誌

Purpose: Prevention of pneumonia in the elderly is an important health issue, and pneumococcal vaccination is thought to be effective in preventing pneumonia. We investigated the effects of pneumococcal vaccination among the elderly living on two islands. <br>Methods: We conducted a comparison study before and after vaccination. The study subjects (123 men and 229 women) were elderly (age ≥ 70 years), and were living on two islands of Hagi City, Yamaguchi Prefecture. They were vaccinated between December 2008 and February 2009. The pre-vaccination period was from January 1, 2008 to the date of vaccination, and the post-vaccination period, from 4 weeks after vaccination to December 31, 2009. The number of patients who required emergency transportation and outpatient consultation related to upper respiratory infections was recorded, and the numbers were compared between the pre- and post-vaccination periods. <br>Results: The emergency transportation rate was 0.023/year in the pre-vaccination period and 0.026/year in the post-vaccination period, but the difference was not significant (p = 0.80). The outpatient consultation rate was lower in the post-vaccination period than in the pre-vaccination period (0.49/year and 0.32/year, respectively), but again, the difference was not statistically significant (p = 0.059). <br>Conclusion: Pneumonia pneumococcal vaccination achieved no significant change in the emergency transportation rate or in the outpatient consultation rate of patients over 70 years of age living on islands. As our study has several limitations in its methods, further investigation of the effects of pneumococcal vaccination is needed.

Implementation of a portfolio into clinical clerkship at a teaching hospital in Japan / 医学教育

1) We have implemented a portfolio as a learning and assessment tool into clinical clerkship rotation focusing on primary care medicine.<BR>2) We received favorable responses both from students and teachers.<BR>3) It is further required to promote the understanding of portfolio among teachers and students to enhance its utilization.

Utility and Usefulness of the Skills Laboratory to Improve Practical Training in Clinical Skills / 医学教育

Medical students at Kurume University begin practical training in clinical skills in their fourth year. At that time, students use the skills laboratory to improve their clinical skills. Medical education resources in the skills laboratory include simulators for emergency resuscitation and heart diseases, wireless stethoscopes, and videotapes. All students use the skills laboratory for 2 months, and its usefulness was evaluated with questionnaires after practical training. More than 50 % of students approved of their practice in the skills laboratory. However, some students were unsatisfied because they were unable to make effective use of the simulators. In the future, an improved skills laboratory will be necessary to improve practical training in the clinical skills for medical students.