To enhance the quality of life for cancer patients, it is required that choice and useage of appropriate medications for their symptoms, as well as providing education for patients and their family members be provided. The purpose of this article was to examine the effectiveness of cancer pain management education through a literature review. From a search of key medical databases, potential articles regarding cancer pain management were retrieved. From a thorough literatures review, we found six important trends: (1) discordance of cancer patients and their families pain reports; (2) family perception regarding cancer pain; (3) family's concerns about cancer pain management; (4) family member's role in cancer pain management; (5) helpful resources about cancer pain management and (6) educational programs for cancer patient's family. Further research regarding educational programs for family members is required for improving cancer pain management.

The shortage of physicians in Japan has been a social issue since the new postgraduate clinical training system started in 2004.The difficult working conditions of hospital physicians may influence this problem.We used a questionnaire to investigate the working hours, on-call frequency, work contents, and mental health of supervisors at various residency training hospitals in Japan.
1) We surveyed 479 physicians who worked at hospitals certified as residency-training facilities and who participated in a development workshop for supervisors or for residency training program managers held at 8 locations in 2004.
2) We found that supervisors worked, on average, more than 100 hours longer than statutory working hours per month and that more than one-fifth of supervisors worked more than 160 hours longer.
3) As for mental health, more than one-fifth of supervisors showed a depressive tendency.
4) These results suggest that the working conditions of supervisors at residency-training hospitals in Japan should be improved by reducing their clinical duties or managing their work content.

The new postgraduate clinical training system that started in 2004 is expected to have positive effects on the health of residents and the quality of treatment they provide.We performed a survey to examine the effects of this training system on the mental health of residents.
1) The subjects were first-year residents (458 in 2003 and 549 in 2004) who had started postgraduate clinical training at 38 hospitals in Japan.Self-administered questionnaires, which included items about working conditions and mental health, were mailed to each subject.
2) The mean score on the 12-item version of the General Health Questionnaire was 4.8 both before and after the new training system was introduced.The mean Center for Epidemiologic Studies Depression Scale score was 15.3 before and 14.4 after the system's introduction.The results showed no significant difference in mental health of residents before and after the system was changed.
3) The results suggest that the new training system has a positive effect on residents' mental health by increasing sleep time and decreasing occupational stress; however, the new system has also decreased job satisfaction and negatively affected their mental health.
4) Job satisfaction may significantly affect the mental health of residents.

Improvement of hair thinning was observed after a novel treatment course involving basalt stone and placental extract application in a patient of androgenetic alopecia. The patient was resistant to the general home care treatment. The response to the new treatment may be attributed to the decreased scalp hardness secondary to the improved blood circulation after basalt stone massage and the hair growth-promoting action of the placental extract. Furthermore, recurrence of hair thinning was observed after suspension of this treatment; however, this hair thinning improved when the treatment was resumed.

OBJECTIVEThe present study examined the levels of serum α-Tocopherol (Toc), retinol (Ret), cholesterol (Chol) and triglycerides (TG), and their correlations in the sera of people in Nepal.

METHODSThe survey was conducted on the general populace in the agricultural Terai region in southern Nepal. The study population consisted of 93 males and 83 females aged 10-68 years. Serum Toc and Ret were measured by high-performance liquid chromatography.

RESULTSNo significant differences were observed between the genders for the average of total Chol (T-Chol) (140 and 145 mg/100 ml, respectively), HDL-C (45 and 47 mg/100 ml), LDL-C (94 and 97 mg/100 ml), and TG (106 and 110 mg/100 ml), and the ratio of LDL/HDL (2.16). The levels of mean Toc (4.32 and 4.27 μg/ml) were about the same for both genders, while the mean Ret levels were significantly higher for males (624 ng/ml) than for females (535 ng/ml) (p<0.001). A direct relationship was found between the levels of Toc and Ret (r=0.46, p<0.001 and r=0.28, p<0.05 for males and females, respectively). Serum levels of Toc and Ret were positively related to the levels of Chol (r=0.48 and r=0.58, p<0.001 for males and r=0.49, p<0.01 and r-0.28, p<0.05 for females, respectively). The ratio of Toc/TG normalized to serum TG was directly correlated to the ratio of Ret/TG (r=0.79 for males, and r=0.72 for females, p<0.001, respectively) and the ratios of Toc/TG and Ret/TG were negatively related to the LDL/HDL levels (r=-0.49 and r=-0.43, for males, and r=-0.46 and r=-0.57 for females, p<0.001, respectively).

CONCLUSIONThe levels of Toc and Ret were low in the sera of people living in the southern rural Terai region in Nepal, and it was found that lower levels of Toc and Ret normalized to TG increased the ratio of LDL/HDL. These results suggest that greater intake of foods rich in Toc and Ret should be encouraged to reduce the erisk of coronary heart disease.

Objective: The aims of this study were to (i) clarify whether there are differences between bereaved families and medical staffs in their preferences for life-prolonging treatments, and (ii) investigate the factors associated with preferences for life-prolonging treatments. Methods: Cross-sectional internet survey was conducted in October 2019. Participants are bereaved families(n=618), physicians(n=206), nurses(n=206), and care workers(n=206) who registered with the internet survey company. We asked the subjects about the relative importance of 36 components of a good death in dementia and their preferences for 7 treatment items that they might need at the end of life. Results: Statistically significant differences in end-of-life medical preference between bereaved families and medical professionals included “Nutrition from gastrostomy when oral intake is difficult” (p<0.01), “Surgery for life-threatening disease” (p<0.01). As a result of logistic regression analysis, a surrogate decision-maker among bereaved family members tended to wish intravenous infusion (OR: 1.62, p=0.02) and continuation of oral medicine (OR: 1.74, p<0.01). The medical professionals who regarded good relationships with people as a requirement of good end-of-life care tended to wish surgery (OR: 2.15, p<0.01) and life-prolonging treatment (OR: 2.00, p=0.01). Conclusions: This result suggest that since the medical preferences between medical staff and the family members don’t necessarily correspond, medical professionals need to take it into consideration when they discuss the treatment options.