Survey on Infection Preventive Behaviors for COVID-19 Among Children and Parents / 日本プライマリ・ケア連合学会誌

Introduction: We aimed to investigate the actual situation of infection preventive behaviors among children, and to investigate changes in parent-child physical contact during the COVID-19 pandemic.Method: We conducted an anonymous questionnaire survey among parents whose children attended the Certified Public Childcare Center in Toyota City between February and March 2021. Descriptive statistics, univariate analysis (Spearman's correlation coefficient, Fisher's exact test), and multivariate analysis were performed.Result: A total of 767 parents responded to the survey. Among them, 78.6% of parents and 76.2% of children always washed their hands when they got home.92.7% of parents and 68.9% of children always wore masks when going out. Breastfeeding and face-to-face contact tended to decrease compared to other behaviors (p < 0.001), but there was most often no change in the frequency of parent-child physical contact.Conclusion: It was difficult for children to take the same infection preventive behaviors as adults. Changes in the frequency of parent-child physical contact were not observed in many parents and children.

Multimorbidity in Primary Care: Current Situation and Research Gap / 日本プライマリ・ケア連合学会誌

In the 1980s, some researchers started using the word "multimorbidity", which is defined as "the co-existence of two or more long-term conditions in an individual". Multimorbidity has become one of the most important topics in recent primary care because of its clinical significance. Multimorbidity is more common among the elderly, and was suggested to be associated with female sex, lower socio-economic status and mental disease. Multimorbidity is associated with a higher mortality, lower quality of life and reduced functional status. It is also associated with the treatment burden such as consultation frequency, fragmented healthcare provision and inadequate polypharmacy. Multimorbidity has negative impact on health care resource use such as hospital visits, unexpected admission and total health care costs. However, the total picture and health care effects of multimorbidity have only been reported in observational studies, and there is little evidence of which interventions are effective for multimorbidity patients. In this review paper, we carried out a literature review of high-quality reports from Japan and overseas. We provide an overview of the current situation of multimorbidity research and highlight the research gaps. Based on these results, we would like to propose approaches for multimorbidity patients in clinical settings.

Point-of-care Ultrasound in Primary Care in Japan: Current Situation and Future Perspectives / 日本プライマリ・ケア連合学会誌

Point-of-care ultrasound (POCUS) has become increasingly employed in recent years. POCUS is the concept of quickly assessing for conditions using ultrasound based on the patient history and physical examinations to make a clinical decision in a timely manner. This concept has been developed and widely used in emergency medicine and other specialties, and has spread to primary care over the past several years. In Japan, POCUS is not well-known in primary care, but the importance of primary care physicians using ultrasound has been reported since the 1990s. However, many physicians depend on higher imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), instead of ultrasound. Although the benefits of integrating POCUS into primary care have been documented, the barriers of POCUS being employed by primary care physicians include a shortage of educational resources and time during busy practice. As primary care settings in Japan vary, such as clinics, hospitals and patient homes, the indications and required skills for POCUS differ. A standardized training curriculum for POCUS needs to be developed according to the primary care setting.