To educate patients with diabetes mellitus, we use a clinical pathway. Pharmacists hold the chair of instruction on the use of drugs and insulin self-injection during the course of the pathway. Until now, teaching contents have been left to discretion of attending pharmacists. Therefore, we draw up a brochure to set standards for instruction.　　By using this brochure, it has become possible to instruct patients without relying only on the knowledge and experience of pharmacists in charge. Additionally, we have become able to share teaching contents of pharmacists with nurses.　　By publishing the brochure, intervention of pharmacists in the pathway has become smoother. For better and more efficient instruction on the use of drugs in a limited time frame in the clinical pathway, we need to overhaul of the brochure and to develop a method to evaluate patient’s understanding.

Background: Understanding the long-term effects of environment on health behavior is important for the promotion of population-based physical activity.Purpose: The purpose of this study was to examine the relationship between perceived environment and active commuting among Japanese adults.Methods: Internet-based cross-sectional survey were conducted to 3,000 Japanese adults aged 30-59 years. Seven sociodemographic attributes (gender, age, marital status, employment status, living status, educational attainment and household income), type of commute and International Physical Activity Questionnaire Environment Module were assessed by self-administered questionnaire.Results: Of all respondents to the survey, 2,032 (mean age: 43.8±9.2, male: 62.5%) were employed. Those who use an active commute were 1,401 (68.9%). In both genders, high residential density (male: OR=2.28, female: OR=3.08), good access to shops (OR=2.03, 3.06), public transportation (OR=1.65, 3.78), recreational facilities (OR=1.31, 1.44), presence of sidewalks (OR=1.42, 1.77), crossroads (OR=1.87, 1.76), having a destination (OR=1.84, 2.34), and not having household vehicles (OR=15.13, 41.24) were associated with an active commute. The results indicated some gender differences. Among male, the presence of a bicycle lane and good aesthetics was positively associated with the active commute, while traffic safety was negatively associated. On the other hand, crime safety was associated with the active commute in female.Conclusion: The results indicate that perceived environment was associated with the active commute among Japanese adults.

Objective : To translate the Abbreviated Neighborhood Environment Walkability Scale into Japanese (ANEWS-J) and to examine its reliability.Methods : One hundred sixty three community residents (male: 38.7%, age: 21-69 years old) of 600 who were randomly selected from the registry of residential addresses of Taitoh Ward in Tokyo and Fujinomiya City in Shizuoka Prefecture, responded to mail survey including ANEWS-J. Seventy-seven of 163 answered same questionnaire twice with ten days interval to examine the test-retest reliability.The questionnaire was translated into Japanese and fixed through the processes of preliminary test, backtranslation into English and discussion with authors of original version.Intraclass correlation coefficients (ICCs) were calculated for the evaluation of reliability of ANEWS-J.Results : ICCs of the eight subscales of ANEWS-J were residential density; r=0.95 (95% confidence interval; 0.93-0.97), land use mix - diversity; r=0.96 (0.94-0.98), land use mix - access; r=0.90 (0.84-0.94), street connectivity; r=0.83 (0.74-0.90), sidewalk / bike lane; r=0.82 (0.71-0.89), aesthetics; r=0.85 (0.76-0.91), traffic safety; r=0.81 (0.70-0.89), crime safety; r=0.76 (0.62-0.86).Stratified analyses by gender and residential district showed satisfactory reproducibility of the subscales (r=0.63-0.97). Conclusion : Acceptable reliabilities of all eight subscales of ANEWS-J were confirmed in this study.

Background: Perceived benefits and barriers to exercise are important correlates of exercise participation. Purpose: To develop a short version of the perceived benefits and barriers to exercise scale and to examine its validity and reliability. Methods: A population-based cross-sectional study of 865 participants (age: 20-69 years old, men: 46.5%) was conducted in four cities in Japan (Koganei, Tshukuba, Shizuoka, Kagoshima). Perceived benefits and barriers scale including five benefit subscales (physical benefit, psychological benefit, social benefit, weight management, self-improvement) with 10 items, five barrier subscales (discomfort, lack of motivation, lack of time, lack of social support, poor physical environment) with 10 items and stage of change for exercise behavior were assessed by self-administered questionnaire. Results: Confirmatory factor analyses to examine the construct validity revealed acceptable fit indices (benefit scale: GFI=.980, AGFI=.951, RMSEA=.058, AIC=151.669, barrier scale: GFI=.973, AGFI=.949, RMSEA=.060, AIC=166.084). Seven of ten subscales indicated significant linear associations with stage of change for exercise behavior, criterion-related validity was revealed. The reliability of the scale was found to be good as internal consistency and inter-rater reliability. Conclusion: The short version of the perceived benefits and barriers scale developed in this study demonstrated acceptable construct validity, criterion-related validity, internal consistency and inter-rater reliability.