Does the Distribution of Booklets on After-hours Consultations to All Residents in a Town Affect the Number of After-hours Visits? An Interrupted Time Series Analysis / 日本プライマリ・ケア連合学会誌

Introduction: Optimization of after-hours visits to medical institutions is one of the major problems in medical systems. The purpose of this study was to clarify the effects of the distribution of booklets about after-hours common symptom management to all residents on the number of after-hour consultations.Method: The Tadami town government distributed booklets to all town residents in July 2011. We analyzed the number of after-hours consultations per month at Tadami National Health Insurance Asahi Clinic, which is the only medical institution in the town, from January 2010 to December 2012. We employed an interrupted time series analysis.Result: The number of included after-hours consultations during the study period was 2,399. The baseline trend was 0.0071 (95% confidence interval −0.011, 0.025), and the slope change from the baseline trend was −0.0061 (−0.034, 0.022).Conclusion: On comparison of before and after the distribution of a booklet about after-hours common symptom management to all residents in the town, the number of after-hours consultations did not change significantly.

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).

The relationship between clustering health-promoting components of lifestyle and bone status among middle-aged women in a general population

<p><b>OBJECTIVE</b>The association between clustering health-promoting components of lifestyle and bone status was examined among middle-aged women.</p><p><b>METHODS</b>A cross-sectional study was conducted in Tadami Town, Fukushima Prefecture, Japan, in 2007. A total of 305 middle-aged women (mean age 55.2 years) participated. The Health-Promoting Lifestyle Profile II was used to assess health-promoting components of lifestyle. Participants' bone status was examined using quantitative ultrasonic calcaneal measurement.</p><p><b>RESULTS</b>A total of 139 participants (45.6%) were defined as having low bone stiffness. In the low bone stiffness group, the mean age was significantly higher, and prevalence of interpersonal relationships score over 3.0 was lower than that in the normal bone stiffness group. There were significant trends in the prevalence of low bone stiffness, each health-promoting component of lifestyle, and presence of hypertension and diabetes mellitus, based on the number of frequently selected health-promoting components of lifestyle. The number of frequently selected health-promoting components of lifestyle correlated negatively with the prevalence of low bone stiffness in both crude and adjusted results.</p><p><b>CONCLUSION</b>This research is particularly important as we suggest health-promotion strategies for the prevention of osteoporosis. A synthetic approach, which includes health responsibility, spiritual growth, interpersonal relations, and stress management, and physical activity and nutrition, may be effective and complement traditional strategies.</p>