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Background@#There is a shortage of general practitioners in Japan. With the revision of educational guidelines, general practice (GP) education has improved. However, the amount of education on GP in medical schools remains inconsistent. This study examined the relationship between medical students’ amount of GP-related education and their subsequent choice of GP majors. @*Methods@#A retrospective cohort study was conducted in a teaching hospital in Japan. Participants were residents in the hospital. The exposure comprised compulsory lectures and training time for community-based medicine in medical schools. The outcome included participants choosing GP majors after their initial 2-year junior residency. @*Results@#Fifty-one participants were included in the final analysis. Of these, 14 majored in GP and 37 in non-GP after their initial 2-year junior residency. Of the participants who took GP lectures for 18 hours or more, 11 chose GP majors, and 18 chose non-GP majors (risk ratio, 2.78; 95% confidence interval [CI], 0.88–8.79). Of the participants who underwent training for 12 days or more, 10 chose GP majors, and 16 chose non-GP majors (risk ratio, 2.40; 95% CI, 0.87–6.68). @*Conclusion@#The results do not support the association between the amount of compulsory undergraduate education for community-based medicine and the subsequent increase in the number of residents choosing GP majors in Japan. Educators would do well to explore different approaches, such as improving the quality of education to increase the number of GP residents. Further research is needed to reach more definitive conclusions.
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Introduction: To elucidate the issues surrounding adolescents' Internet use in social minority groups, this study investigated the current situation of Internet addiction among Brazilian students who live in A city in Japan.Methods: The participants were 342 local Brazilian students attending international schools. A cross-sectional study using a self-administered questionnaire in Brazilian-Portuguese was conducted. As a primary outcome, we used Young's Internet Addiction Test (IAT) to evaluate the level of self-reported Internet addiction. Social demographics (i.e. age, sex, etc. ), lifestyle (i.e. the time for Internet use, sleeping hours, etc. ), and depressive tendency (Patient Health Questionnaire 2, PHQ2) were also assessed. The χ-square test and logistic regression analysis were used for analysis.Results: The response rate was 65% (222; 111 males and 111 females). Factors related to an IAT score of 50 or higher were sleeping hours (<7.5 hours) (OR: 0.38, 95%CI: 0.21-0.68), the time for Internet use (≥4 hours) (2.6, 1.4-4.8), and PHQ2 score (≥3) (6.2, 3.3-11.5). On logistic regression analysis, an IAT score ≥50 was positively associated with the time for Internet use and PHQ2 score ≥3.Conclusion: The self-report of high Internet addiction among Brazilian students in A city in Japan was significantly related to the time for Internet use and depressive tendency.
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<p>We, the delegates of the 2016 Japan-UK exchange, herein report our experiences and impressions of British primary care: "the difference between the career paths of general practitioners from Japan and UK", "medical interpreters and care in a multicultural society" and "framework for development of clinical research". We described our experiences in UK with a literature review. The authors wish for the article to support the advancement of Japanese primary care.</p>
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<p><b>Introduction: </b>Currently, there are no studies on changes in health problems due to population aging in Japan. This study was conducted to estimate the changes by comparing the present health problems using the International Classification of Primary care second edition (ICPC-2) with a previous study.</p><p><b>Methods: </b>We conducted a retrospective open cohort study on a rural island in Okinawa. We classified health problems of all patients using ICPC-2, and compared the data with a previous study using the International Classification of Health problems in Primary care-2 defined (ICHPPC-2 defined) from 1990.</p><p><b>Result: </b>The total number of visits to the clinic was 4660 per year (age 0-14 years, n=828; age 15-64, n=2146; age 65 or older, n=1688). In 2015, the frequency of musculoskeletal, skin and general, and unspecified problems was higher. The number of health problems contained within the top 50% of all health problems, which is an indicator of the comprehensiveness of practice, was higher in the previous study.</p><p><b>Conclusion: </b>The present study suggested that orthopedic and dermatological disorders increased, and greater comprehensiveness of practice is needed.</p>
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<p><b>Objective</b>: To explore how rural physicians practicing in the remote islands of Okinawa, Japan experience and manage their negative emotions.</p><p><b>Materials and Methods</b>: We conducted semi-structured interviews with doctors who had worked in a clinic on a remote island in Okinawa prefecture for 2 years. The interviews were conducted using an Internet video conferencing system, and were recorded and transcribed. The transcribed data were then analyzed using the Steps Coding and Theorization method as a framework.</p><p><b>Results:</b> All four participants were male. The mean interview time was 61 minutes. In the category of induction of negative emotions, we extracted five themes: differences in recognition between rural physicians and patients, invasion of professionalism, suppression by one’s role as a rural physician, discordance with multiple occupations, and relationships with unfamiliar hospital physicians. In the category of controlling negative emotions, we also extracted five themes: time flow, reflection, acceptance of islanders’ characteristics, and growth through their role.</p><p><b>Conclusion:</b> Rural physicians in the remote islands of Okinawa experienced negative emotions in relation to patients, other islanders, and medical staff. They deepened their understanding of the islanders, including the cultural background, over time and through discussion and reflection with other medical professionals. In this way, they realized their potential for growth and how to control negative emotions. Thus, rural physicians may be able to effectively control their negative emotions through recognizing temporal changes in human relations and their own adaptation to the remote island life.</p>
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<b>Introduction</b> : This study was conducted to estimate actual reasons for encounters and health problems, which is difficult to assess in a free-access system, in an area with limited access to advanced care by using the International Classification of Primary care second edition (ICPC-2).<br><b>Methods</b> : We conducted a retrospective open cohort study on an isolated island in Okinawa Prefecture, Japan. We encoded reasons for encounter (RFE) and health problems of all patients using ICPC-2.<br><b>Results</b> : The total number of visits to the clinic was 5682 a year (age 0-14 years, n=862 ; age 15-64 years, n=2205 ; age 65 or older, n=2615). The top 3 RFE classified by organic systems were R (respiratory), S (skin) and L (musculoskeletal). Dementia (ICPC-2 code : P-70) was eighth in the rank of chronic health problem among elderly people. Visits due to health maintenance/prevention (ICPC-2 code : A-98) was third in the rank of new health problem among children.<br><b>Conclusion</b> : In the present study, rankings of major RFE and health problems are similar to those in previous studies. Among elderly people, however, the rank order of dementia among chronic health problems was higher than that in previous studies. In addition, among children, the rank order of health maintenance/prevention among new health problems was higher than that in previous studies.