With a view to weighing the clinical significance of asymptomatic cerebral infarction, we analyzed the usefulness of the fluid attenuated inversion recovery method in magnetic resonance imaging. The subjects wee composed of 94 outpatients who participated in our screening program for brain troubles. Indications of asymptomatic cerebral infarction were registered on T2-weighted images of 21 subjects (22%) and on FLAIR images of 31 subjects (33%). The FLAIR method, in which the signals from the cerebrospinal fluid are checked, excelled at detecting lesions, especially those under the cerebral cortex which are almost indistinguishable from gray matter and sulci. The subjects with asymptomatic cerebral infarction had significantly many risk factors for stroke including hypertension and hyperlipidemia. Thus, we concluded that the FLAIR method is very useful in diagnosing asymptomatic cerebral infarction.

With the aim of improving patient compliance with medication regimens, we conducted a questionnaire survey on outpatients who had been diagnosed with asymptomatic cerebrovascular infarction after brain disease screening. Prior to the survey, we gave them instructions to take prescribed medications correctly, using explanatory leaflets. To the question “What do you want to know the most about the drug”, a majority of the respondents said “possible side effects.” “Efficacy” came second. There were some patients who said that they are not much inclined to know about the drug because they entrust the doctor with everything as far as medical treatment is concerned.
Later, to confirm their compliance with prescribed drug regimens, we made a follow-up survery. The results showed that all (almost all?) the patients had a good understanding of the use as well as the dosage of the drug, but that they han not read well the explanatory leaflets.
In this country, medical care services for inpatients have been improved. However, there is still much to be desired about the approach to outpatients who need a proper follow-up. To meet the need of outpatients, we would like to make use of what we have learned from the recent experience.

A shortage of physicians in rural areas has become a serious problem of the new residency training program in Japan. To address this problem, we propose a model for attracting physicians to rural areas by improving residency training programs and by evaluating a curriculum introduced at Kainan Hospital, a community hospital. In this first paper, we describe the short-term evaluation of the curriculum.1) We introduced clinical teams in which residents were able to actively participate in clinical practice as team members by being supervised by senior physicians. We also introduced teaching rounds and case conferences for residents.2) Focus-group interviews of residents showed that "giving educational opportunities to residents" and "an explicit policy of the hospital to improve the residency training program" are examples of ways to improve residency programs.3) The number of residents working at Kainan Hospital increased. The residency training program was somewhat improved.4) An effective and easily generalized way to provide residents with more learning opportunities is to involve clinicians in teaching residents in hospitals.

  The POMS (Profile of Mood States) was used to investigate changes in mood and affect that appeared after the Portrait therapy, a method conceived and initiated by Kenichi Muraoka in 2006. The subjects consisted of 46 new nurses (1 male, 45 females, average age 23.09 years); 1 patient hospitalized in the palliative care ward (1 male in his 80s) and 1 family member attending therapy sessions (1 female in her 60s); 3 ward nurses (1 male, 2 females, average age 38.67 years); 3 students participating in hands-on training (3 females, average age 21.67 years);and an additional 3 staff members (3 males, average age 40.67 years). The POMS was administered before and after the Portrait therapy, and the changes in POMS score were examined. The new nurses showed a significant improvement in mood across all 6 subscales of the POMS. There was a general improvement in mood among the participants from the palliative care ward, exeluding the nurses. The Portrait therapy proved to be an effective means of improving the mood of participants, and bystanders as well, depending on their position. While due care is needed before implementing the Portrait therapy in a hospital ward, this therapy is a viable emotional care alternative, and is also potentially meaningful in the context of grief care. In the future, we intend to follow up with case studies and quantitative studies to find more effective Portrait therapy applications.