To investigate medical student interest in medical ethics and associated factors, a self-administered questionnaire was distributed to 187 5th-year medical students who attended a 2-hour small-group class, “ Introduction to Biomedical Ethics, ” which is held as part of bedside teaching at the University of Tokyo. This study was performed from April 1995 through March 1998. All 187 questionnaires were returned. The degree of student interest in biomedical ethics was significantly associated with student perceptions of the importance of the medical ethics class relative to other classes and with the strength of the connection between medical ethics and 1) clinical practice, 2) law and the courts, e. g., malpractice suits, and 3) health policy. Students who perceived medical ethics as having greater importance or a stronger connection to these issues had more interest. Students were also asked what topics related to medical ethics they were interested in and what type of class was best. Finally, factors that should be taken into account when developing a medical ethics curriculum were discussed.

Emerging ethical issues have prompted Western countries to focus more attention on public health ethics in medical education. To assess the current and future states of public health ethics education in Japan, we analyzed the opinions of public health educators in Japanese medical institutions and explored potential topics for public health ethics curriculums. 1) We mailed self-administered questionnaires to 201 hygiene and public health departments to inquire about their current curriculums and the state of public health ethics education at their institutions. 2) Of the 101 responding institutions, 60.4% were spending 8% of teaching hours on lectures related to ethical issues in public health. 3) Most institutions agreed with a proposal to require the completion of a public health ethics course in medical education programs. 4) Among the major topics chosen to be included in the potential course were ethical issues surrounding public health policy and medical research.

To investigate the status of ethics education in Japanese medical schools, a self-administered questionnaire was sent to all 80 medical schools in 1995. Sixty-four (80.0%) medical schools responded, of which 60 answered they offer or will offer courses in which medical ethics topics are taught. Most classes are compulsory and are held before bedside teaching begins. Nineteen medical schools have separete medical ethics courses, and the others have medical humanities courses in which medical ethics are taught as part of the course. The respondents rated “the physician's duty, ” “informed consent, ” and “patients' rights” as the three most important topics that should be taught to medical students.

There is no objection that the medical ethics enters basic matters of the undergraduate medical education. The curriculum plan of medical ethics in the medical school in our country is proposed. This curriculum aims at the participating education that the student personally chooses and discovers the result to be studied instead of the passive lecture like the boring preaching from the platform. This is the curriculum throughout a few years, because it is necessary to repeatedly study adjusting to the learning achievement.

We proposed the curriculum plan of medical ethics in the medical school in our country. That was the curriculum throughout a few years and the participating education. Now we present the manual for one case of the each six strategies. When the teacher holds classes according to this manual or with some modifications, the medical students will probably participate the education with high motivation to learn.

The first workshop on medical ethics education was held for 28 members including mainly university tutors and hospital tutors in November 2002 at Gifu. Trail for training of several kinds of medical ethics education technique was evaluated to a certain extent. We submit report of the practice and participants' evaluation of the workshop.

To examine the present state of postgraduate ethics education for residents in Japan, we sent an anonymous self-administered questionnaire to the directors of all 640 hospitals in Japan with a registered postgraduate clinical residency program. A total of 258 hospitals returned the questionnaire (response rate: 40.3%). Of these hospitals, 69 (26.7%) had a program for ethics education and 189 (73.3%) did not. The presence of a program was strongly correlated with the number of hospital beds and a history of problems with ethics education. Respondents showed a high degree of awareness about such significant topics in ethics education as “informed consent, ” “patient privacy, ” “patient rights, ” and “physician duties.”

Objective: The aim of this study was to identify the content and methods of ethics education for medical representatives as part of the continuing education program and to suggest a preferable supportive method of ethics education accordingly.
Method: A questionnaire was mailed to the medical representative education managers of all 214 companies, all members of the MR Education & Accreditation Center, Japan.  The questionnaire was carried out from 31st July 2009 to 25th August 2009, and data from this questionnaire survey was analyzed by simple and cross tables.
Results: Out of the 182 (response rate: 85.0%) who responded, we analyzed the 173 institutions for analysis as they responded as having the continuing education program.  In terms of education, “the fair competition code” was the most widely educated (82.6%).  Although “the fair competition code” required most time, “the ethics as a medical representative” was considered as the most important.  The simple kappa coefficient between actual educating item and important item was 0.29.  Answers were affected by whether he/she had experience as a medical representative.  As the method of ethics education, “lecture” style was most common (87.4% of respondents), “group work discussion” was considered the most effective (70.6%) for training a medical representative to think and learn by himself/herself.  The respondents of 82.2% referred to the continuing educations’ guidelines made by MR Education & Accreditation Center, and 81.0% respondents felt “training materials for lectures and/or discussions” necessary in the future.
Conclusion: The ethics education for medical representatives placed a disproportionate emphasis on the importance of “the fair competition code.” Dissociation was seen between the actual education and the education considered as important by the respondents.  Accordingly, there is a need for appropriate materials for training and for a more adequate curriculum, taking time and content of education into consideration, especially for contents which training ways aren’t built up.

OBJECTIVEThe purpose of this study is to delineate the association between residents' perception of the neighborhood's environments and walking time in objectively different regions in Japan.

METHODSTwo regions were selected as high and low walkable regions on the basis of differences in their residential density, mixed land use and street connectivity. The subjects in this study were participants in a health promotion program focused on walking sponsored by local governments. A questionnaire was sent to the participants asking about how their perception of the neighborhood's environment related to walking, and the time spent walking per week. There were 237 residents from the high walkable region and 195 from the low walkable region who completed the study survey.

RESULTSThe high walkable region had a larger residential density, a high mixed land use and a higher street connectivity than the low walkable region. Walking time, and the scores of the perception of the neighborhood's environment for the high walkable region residents were significantly higher than those for the low walkable region residents. Thus, residents' perception of the neighborhood's environment generally reflected the actual physical environmental characteristics. Residents in the high walkable region whose scores for accessibility and aesthetics were high, spent significantly more walking time. Residents in the low walkable region whose scores for accessibility, safety, convenience and aesthetics were high, spent significantly more walking time.

CONCLUSIONThe study results suggested that the neighborhood's environment may influence daily walking time. The perceptions of the neighborhood's environmental factors that correlate with walking times differ between the different regional physical environments. Therefore, to promote physical activity, the consideration of environmental factors unique to residents' neighborhood's environments is needed.

OBJECTIVESTo examine the effects of β(3)-adrenergic receptor gene polymorphism on body weight change during a weight reduction program for middle-aged, overweight women with careful consideration of their energy intake and expenditure.

METHODS

DESIGNIntervention study of weight reduction for 12 weeks in a community setting.

SUBJECTSEighty overweight middle-aged women who completed the individualized lifestyle modification program.

MEASUREMENTSβ(3)-adrenergic receptor gene polymorphism was identified by polymerase chain reaction and consecutive restriction fragment-length polymorphism analysis. Anthropometrical parameters, lifestyle factors, blood lipid and glucose levels, physical activity level and energy intake were measured before and at the end of the program.

RESULTSThe numbers of subjects with the Trp64Trp, Trp64Arg, and Arg64Arg genotypes were 45, 30 and 5, respectively. Baseline characteristics among subjects with the 64Arg allele had significantly smaller decrease in body weight and energy intake than those without the 64Arg allele. The change of other clinical characteristics did not differ between the two groups. After adjusting for the %change of energy intake, the %change of body weight did not differ between the two groups.

CONCLUSIONThe 64Arg allele of the β(3)-AR gene is not likely to be the factor determining the difficulty in losing body weight in Japanese middle-aged, overweight women. Lifestyle factors, such as the decrease in energy intake, might mask the effect of the 64Arg allele on body weight loss. Specific considerations for the management of energy intake would be needed to promote body weight loss for those with the 64Arg allele.