Purpose: The learning situation of pharmacy students failing their final exam the previous year (referred to as US) was investigated, and a method of learning support for students with low scholastic abilities was examined.

Method: Questionnaires were completed by students who were unsuccessful in the previous year's final exam a total of three times from April to July 2014, and changes in their academic record were compared with the questionnaire results. Questionnaire contents were: (1)self-learning time, (2)learning support method, (3)weak subject area, (4) progress in the printed material we distributed.

Results: The students with a low academic performance hoped to study by themselves. They felt that physicochemistry and pharmacology were weak subject areas, because high-level understanding was necessary. We realized that the quality of learning was more important than the number of practice problems the students could complete, based on the tests we distributed. In addition, a decline in academic ability was seen in many students at the beginning of the following fiscal year.

Discussion: It is necessary to begin physicochemistry and pharmacology education support when students start their programs for those with a low scholastic ability. Support that incorporates unification-type learning for students unsuccessful in their final exams is also necessary. Furthermore, it is important to design specialized practice problems and individual guidance for students with a low academic performance.

The curricula for Japanese medical schools are being dramatically reformed. Under these conditions, the number of hours allocated to the anatomical dissection course has decreased in the last decade. In the current environment of understaffing, we face a conflict between good educational practice and superior research performance at the University of Yamanashi. To address this problem and to cultivate research-oriented thinking and the teaching ability of medical students, we introduced a novel teaching system in which senior students (3rd to 6th years) serve as teaching assistants (TAs) in the dissection course. In this trial, we undertook the following procedures.1) We performed two surveys of 2nd-year students and TAs to evaluate the performance of the system during the middle and late phases of the laboratory course.2) By referring to the results of the first survey, we simultaneously improved the system.3) Research topics related to anatomy were assigned to the TAs.4) Overall, this system was viewed favorably by both the second-year students and the TAs, although the consistent participation of TAs throughout the term remains to be addressed. By taking these issues and evaluations into account, we will improve the system and propose it as a new elective educational style for Japanese medical schools.

　A crucial step in clarifying and consolidating the learning gained from simulations in healthcare is to debrief those simulation experiences-that is, to methodically review what happened and why. Leading a debriefing is a learned skill, and can be improved with practice and feedback. The Debriefing Assessment for Simulation in Healthcare （DASHTM） Handbook and Rating Forms are designed to assist in evaluating and developing debriefing skills. Additional information, rating forms, and contact information can be found at the DASH website: http:／／www.harvardmedsim.org／dash.html.

Introduction :
 This article aims to explain the new Membership of Royal College of General Practitioners (nMRCGP), new postgraduate general practice training in the UK. It will also compare this with that of the Japan Primary Care Association to identify areas requiring further development in postgraduate family medicine training in Japan.
Methods :
 The introduction of the nMRCGP based on the available literature, followed by discussion amongst family physicians and trainees in Japan.
Results :
 Following a comparison between the postgraduate general practice training in the UK and Japan, the following three points were raised : 1) The need for a clear definition of the role that family physicians play in Japan. 2) The importance of formative assessment as part of the membership examination in the form of portfolios. 3) The need for clear competency areas to form the framework for formative assessment, and for the clear standard that trainees are judged against in each of those competency areas.
Conclusion :
 The above results were highlighted and discussed as possible areas for further development in postgraduate family medicine training in Japan.

The effects of bathing with inorganic salts and carbon dioxide (ISCD) on body temperature, systemic circulation, food ingestion and absorption have been studied in healthy volunteers. The peripheral blood flow in the forearm was found to increase in and after immersion of the forearm into a 25l bathing receptacle containing ISCD, as compared with plain water. The peripheral blood flow tended to increase in a dose-dependent manner with ISCD bathing. The skin core temperature, the skin surface temperature and the peripheral blood flow were significantly higher after ISCD bathing than after plain water bathing. The influences of ISCD bathing on food ingestion and absorption were also studied in healthy volunteers. Blood glucose and insulin levels after food ingestion tended to be suppressed by ISCD bathing as compared with plain water bathing. There was no difference between ISCD and plain water bathing in total protein, total cholesterol, triglyceride, HDL cholesterol, and uric acid levels in the blood. These results suggest that ISCD bathing may contribute to the promotion of human health.

Recently, the problem of the high incidence of throwing injuries in young people has been gaining attention. Identifying high-risk players before the onset of the throwing injury is important for prevention. One of the most widely used screening tests for sports-related injuries is the Functional Movement Screen (FMS), which assesses the quality of movement; however, its correlation with throwing injuries has not been established. The purpose of this study was to investigate the correlation between the FMS score and throwing injuries. The FMS was used during the medical check for two hundred and thirty junior high school baseball players. We allotted those who had experienced throwing injuries multiple times to the injury group and those who had never experienced throwing injury to the control group. We then calculated the FMS cutoff value using the receiver operating characteristic curve. In addition, we investigated differences in the incidence of throwing injury between above and below the cutoff value using chi-square test. The FMS cutoff score was 17. Players who scored ≤17 had a significantly higher incidence of throwing injuries than those who scored ≥18. Conclusion: We believe that FMS score is correlated to throwing injuries. In addition, the results suggest that throwing injuries might be prevented in junior high school baseball players who scored ≤17 on the FMS if they undergo training in the correct movement patterns.

Background/Aims: Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL. Methods: The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake. Results: In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p<0.001). Moreover, the occurrence of MWFL was significantly higher in patients with hypergastrinemia (p=0.005). In the multivariate analyses, oral PPI intake was the only significant independent factor associated with the presence of MWFL (p=0.001; odds ratio, 5.78; 95% confidence interval, 2.06–16.2). Conclusions Our findings suggest that oral PPI intake is associated with the presence of MWFL (UMINCTR 000030144).

OBJECTIVE: This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. METHODS: The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. RESULTS: A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06-2.81) and during the night shift (OR 2.29, 95% CI 1.30-4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97-2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70-2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47-3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76-4.84). CONCLUSION Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.
Case-Control Studies ; Cerebral Palsy ; epidemiology ; etiology ; Delivery, Obstetric ; statistics & numerical data ; Health Facilities ; statistics & numerical data ; Humans ; Incidence ; Infant, Newborn ; Japan ; epidemiology ; Parturition ; Perinatal Care ; statistics & numerical data ; Retrospective Studies ; Time Factors