In search of reasons for regional differences in the death rate from stroke, an extensive factfinding project was carried out in Yamagata Prefecture. Out of the total 44 municipalities in the prefecture, we picked out four townships; two are noted for their high standard mortality rate from cerebrovascular disease and the other two have a low mortality from the disease. In these four townships, a thorough investigation was conducted on the incidence of stroke, along with health examination for cardiovascular disease. The findings are as follows;
1. Despite the fact that Yamagata Prefecture has a high rate of stroke, blood pressure levels stood on a par with, or even lower than, the national average.
2. There were no correlations between the standard mortality rates and blood pressure levels, ECG readings, funduscopic observations, and total serum cholesterol levels.
3. By occupation, white-collar workers showed higher values than blue-collar workers and farmers in diastolic blood pressure, obesity, and cholesterol levels in the blood serum. The occupational difference was observed in each and every one of the four townships.
4. The standard mortality rate and other fatality indices were not correlated with the incidence rate of stroke among the middle-aged and the rate of detection in the health examination for the conditions that might lead to stroke. Interesting to note is the fact that the incidence rate among the middle-aged was parallel with the detection rate. This finding suggests that further study of the incidence rate and the prevalence rate in necessary.

　　With the aim of revamping hospital service as a pillar of our hospital reform movement, the Service Training Committee came into being in 2012.　　A questionnaire survey was conducted on the entire personnel and tenant suppliers (the entire personnel, tenants and contractors’ employees?). About 80% (705 people) of those queried replied. More than 90% of the respondents were of the view that an improvement in the manner of reception should enhance not only the prestige of the hospital, the evaluation its medical treatment and patients&rsauo; degree of satisfaction, but also hospital employees’ degree of satisfaction and their quality of life.　　On the other hand, some respondents said that there was much to be desired in the way hospital employees exchange greetings with their colleagues and in the manners or the language they use when they speak to patients.　　Most of the hospital staff seemed to understand the importance and meaning of service and hospitality very well. It was clear that the hospital employees were willing to join in our drive to improve the quality of service. They also understood the problems they should address to in earnest.　　We thought it was our task to make use of their positive attitude toward the quality improvement of service. What we have in view is to create a hospital culture that makes it seem natural to provide a high-quality service to visitors and patients. To this end, we will develop various activities and hold workshops.