With the goal of improving delirium in cancer patients, quetiapine suppositories were formulated in-hospital and their usefulness was investigated. A retrospective survey of medical records was conducted in 108 patients in whom quetiapine suppositories were used, out of 644 patients admitted to a palliative care ward between April 2011 and October 2014. Patient background information, circumstances of administration, degree of improvement in delirium (evaluation of degree of improvement in hyperactive delirium determined using the Agitation Distress Scale [ADS]), and side effects were investigated. In the overall group, including the quetiapine suppository group and the quetiapine suppository combined with another drug group, a significant decrease in ADS value was confirmed after administration of the suppository (p<0.0001), suggesting that this treatment contributed to improvement in delirium. The side effects were similar to those caused by the oral administration of quetiapine, and issues due to the formulation as a suppository were not observed. In conclusion, it was determined that quetiapine suppositories can be used simply and safely, and it is thought that quetiapine suppositories are useful for delirium in cancer patients.

To seek longitudinal changes in metacognitive processes through problem-based learning (PBL), we analysed the contents of all comments written reflectively by the third-year students after they finished discussions in each PBL session. After dividing their comments into meaningful units, we focused on two major thematic categories and five sub-categories to be analysed.
1) The number of units decreased significantly (chi-square: p=0.02).
2) Only the proportion of units categorised as “comprehension” in “individual learning” showed significant increase (Bonferroni: p<0.001).
3) Comments in this category stated that “I don't understand so-and-so.”
4) The increase of “comprehension” as they experienced more PBL suggested that students' knowledge of ignorance as metacognition was fostered through sessions in medical PBL.