Medical interviewing skills were assessed with the objective structured clinical examination using simulated/standardized patients (SP) in 36 5th-year medical students. ultaneously, assessment of cognitive-behavioral characteristics was performed using 7 kinds of scales (locus of control, social skills, self-esteem, general self-efficacy, medical interviewing-specific self-efficacy, person perception of self, and person perception of the patient) on the same students to clarify correlations with medical interviewing skills. Students who had attended a small-group mini-workshop session for medical interviewing skills showed only a significantly better ability to summarize. Personal familiarity with the patient was the only factor among the cognitive-behavioral factors studied which was a significantly correlated with medical interviewing skills. Among the six medical interviewing skills, only summarization and confirmation skills were positively correlated with the students' self-efficacy and the objective assessment with the objective structured clinical examination. We conclude that 1) medical interviewing skills can be taught regardless of the cognitive-behavioral abilities of each student; 2) teaching summarization and confirmation skills are especially valuable and important in teaching medical interviewing to medical students.

Relationships between physicians and pharmaceutical companies have received considerable attention regarding the professionalism of health care professionals in recent years. Pharmacists may also have a conflict of interest if they are provided some benefits from pharmaceutical companies. We conducted a survey of pharmacists in hospitals, clinics, and pharmacies in mid 2011. The response rate was 58.8％（235/400）. Most pharmacists（94％） reported some type of relationship with pharmaceutical companies, which included receiving ballpoint pens and notebooks（88.5％）, or receiving food in a meeting（56.6％）. Managerial level pharmacists received more “textbooks and guidelines”, “gifts” than other pharmacists. The results of this survey indicate that relationships between pharmacists and companies is common. The formulation of guidelines and more responsible behaviors are needed.

Objective: To evaluate the efficacy of high-flow nasal cannula oxygen (HFNC) for dyspnea in patients with advanced disease. Methods: A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Ichu-shi Web. Inclusion criteria were: 1) randomized controlled trials evaluating the effect of HFNC on dyspnea; 2) aged 18 years or older with advanced disease with hypoxemia; 3) control group was conventional oxygen therapy or noninvasive positive pressure ventilation. Exclusion criteria were: 1) patients in intensive care unit, 2) weaning from ventilator. Results: Six studies (4 from database searches, and 2 from hand searches) were included. In the 2 studies evaluating short-term intervention, one showed HFNC was more efficacious, and the other conventional oxygen was more efficacious. In the 2 studies evaluating long-term interventions: one showed HFNC was more efficacious, and the other showed no significant difference. In the 2 studies evaluating the intervention during exercise, one showed HFNC was more efficacious, and the other showed no significant difference. Conclusion: HFNC may be effective for dyspnea in patients with advanced disease associated with hypoxemia.

Objective: Almost half of all patients with cancer experience dyspnea, which can have various causes. Although systemic corticosteroids are administered to relieve symptoms, their efficacy has not been established. This systematic review aims to determine the efficacy of systemic corticosteroids for dyspnea in patients with cancer. Methods: CENTRAL, MEDLINE, EMBASE, and Ichushi-Web databases were searched for articles published from their inception to September 23, 2019, on studies of systemic corticosteroid administration for dyspnea in patients with cancer. The primary outcome measure was dyspnea intensity, as assessed by patient-reported outcomes. Secondary outcome measures were quality of life, delirium, and severe adverse events. Results: Two RCTs were included in the meta-analysis. With regard to alleviating dyspnea, the systematic corticosteroid group was associated with significantly greater dyspnea relief than the placebo group (mean difference: −0.71 [95% CI: −1.4 to −0.03]). However, a meta-analysis of quality of life and delirium could not be performed due to insufficient data. Analysis of severe adverse events showed no significant difference in their incidence between the corticosteroid and control groups (relative rate: 0.96 [95% CI: 0.19-4.93]). Conclusions: Systemic corticosteroids may be effective in treating dyspnea in patients with cancer, particularly those with lung involvement. Limiting the conditions for which corticosteroids are approved is expected to promote their appropriate use and minimize their adverse effects. However, further investigation is needed to determine the appropriate dosage, and the conditions in which corticosteroids are effective.