CT radiation risks to children at Japanese hospitals need to be considered more seriously. Physicians should be encouraged to follow diagnostic algorithms that help avoid unnecessary CT usage in children.

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We made a bibliographic search for Japanese and non-Japanese literature on tuberculosis control programs to study the current public health policies for tuberculosis control in Japan especially in regard to cost-effectiveness. Then, we compared the Japanese strategies for tuberculosis control with those in other countries including the United States, and those recommended by World Health Organization (WHO). The current trend of tuberculosis incidence in the Japanese community demonstrates major differences from the situation that had prompted installation of tuberculosis control measures several decades ago. The tuberculosis control measures should be targeted to the elderly people (over 65 years old) because of the following three aspects. (1) A continuing decline of tuberculosis in the young Japanese population, particularly children who might attain benefits from BCG immunization; (2) The enhancement of the prevalence among the elderly people who are not covered by a uniform national surveillance strategy; (3) Cost-ineffectiveness of Mass Miniature Radiography (MMR) being used as a means to screen for tuberculosis. The cost-effectiveness issue must be considered more seriously, and the WHO recommendations especially in regard with the DOTS (directly-observed treatment, short course) strategy need to be incorporated more effectively into the national program since the incidence of drug resistant tuberculosis in Japan has been recently increasing. Finally, we propose to limit BCG immunization further and to discontinue annual MMR in the young population, and instead to develop effective strategies of both active and passive case finding in the elderly through public and community health services.

Informed use of medical tourism services depends on an up-to-date knowledge of the available services, and their costs and risks at various potential destinations. Such information can also assist in the competitive development of healthcare services. Innovation, product development, and health user relationship management by medical service providers is enhanced, as is knowledge base construction and management. This chapter shows that new forms of social media can provide valuable and previously difficult to obtain real-time knowledge on medical tourists' perceptions, concerns, and sentiment towards medical tourism destinations - both those already visited by other users and those under consideration for a possible visit. We show how analysis of comments from such social media as Twitter micro-blogs can be used to reveal potential and recent medical tourism motivations in the medical services markets in various locations.

<p class="MsoNormal" style="text-align: left; margin: 0cm 0cm 0pt; layout-grid-mode: char;" align="left"><span class="text"><span style="font-family: ";Arial";,";sans-serif";; font-size: 9pt;">The rapid growth of digitalized medical records presents new opportunities for mining terra bytes of data that may provide new information & knowledge. The knowledge discovered as such could assist medical practitioners in a myriad of ways, for example in selecting the optimal diagnostic tool from among numerous possible choices. We analyzed the radiology department records of children who had undergone a CT scan procedure at Nagasaki University Hospital in the year 2004. We employed Self Organizing Maps (SOM), an unsupervised neural network based text-mining technique for the analysis. This approach led to the identification of keywords with a significance value within the narratives of the medical records that could predict & thereby lower the number of unnecessary CT requests by clinicians. This is important because, in spite of the valuable diagnostic capacity of such procedures, the overuse of medical radiation does pose significant health risks and staggering cost especially with regard to children.</span></span><span style="font-family: ";Arial";,";sans-serif";; font-size: 9pt;"></span></p>

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