In kampo medicine, an illness is considered to affect the entire body, even if the symptoms appear only in the abdomen. Abdominal palpation is considered an important diagnostic physical examination in kampo medicine. Because learning the kampo style of abdominal palpation is difficult, we attempted to simplify the process by developing typical models of 6 important kampo abdominal diagnoses (shinka-hiko, kyokyo-kuman, fukuchokukin-renkyu, shofuku-fujin, shofuku-koman, and shinkabu-shinsuion).1) When we discussed abdominal palpation in lectures on kampo medicine for clinicians we also assessed the opinions and impressions of participants about the abdominal palpation simulators. 2) We administered an anonymous questionnaire survey about interest in kampo medicine, the understanding of abdominal palpation in the kampo style, and an evaluation of the abdominal palpation simulators. We obtained 149 replies from participants of the 11 lectures. 3) Of the participating physicians, 85.2% were interested in kampo medicine. However, 23.5% of physicians were not familiar with abdominal palpation in the kampo style. 4) Furthermore, 58.4% of physicians thought that kampo-style abdominal palpation was explained well or very well in the lecture with the abdominal palpation simulators. The abdominal palpation simulators were judged to be useful or very useful by 72.2% of the physicians. 5) In conclusion, the abdominal palpation simulators were considered to be useful for learning abdominal palpation in the kampo style, even though these simulators have some shortcomings. These models may be useful for simplifying the learning of abdominal palpation by students of kampo medicine.

Objective: We analyzed articles in the Japanese Journal of Drug Informatics with the goal of identifying recent research trends in drug informatics.
Method: The appearance frequencies of keywords in the Japanese Journal of Drug Informatics (2001: vol. 3 (1) to 2009: vol. 11 (4)) and Japanese Journal of Pharmaceutical Health Care and Sciences (2009: vol. 35 (1) to (6)), and words in abstracts in Japanese Journal of Drug Informatics (2009: vol. 11 (1) to 2010: vol. 12 (4)) were analyzed.
Results: To investigate keywords in the Japanese Journal of Drug Informatics, appearance frequencies of information, drug, drugs and pharmacist in 2001: vol. 3 (1) to 2003: vol. 5 (4), those of information, drug, drugs, medical, medication and questionnaire in 2004: vol. 6 (1) to 2006: vol. 8 (4), and those of information, drug, questionnaire, survey, pharmacist, adverse and generic in 2007: vol. 9 (1) to 2009: vol. 11 (4) were higher than those of other keywords.  In the Japanese Journal of Pharmaceutical Health Care and Sciences, appearance frequencies of drug, pharmacy, care, patient, pharmaceutical, cancer, education, training, analysis and drugs were higher than those of other keywords.  Information, drug(s), patients, pharmacists, hospital, use, questionnaire, medical, adverse, survey, agents, generic and pharmaceutical were high frequency words used in abstracts published in the Japanese Journal of Drug Informatics.  These words in abstracts indicate a Zipf’s law-like rank distribution.  Co-occurrence network graphs using abstracts showed that the first cluster consisted of medical, drug, adverse, drugs, pharmaceutical, hospital, doctors, contents and drug around information and pharmacists as hubs, and the second cluster consisted of 3 words (agents, woman and pregnant).  Furthermore, co-occurrence network graphs indicated that care, medical, pharmaceutical, information, adverse, pharmacists, hospital, doctors, questionnaire, woman, pregnant, package and side were matters of important arguments and/or phenomena.
Conclusion: These data suggest that the scope of themes in articles published in the Japanese Journal of Drug Informatics is establishing definitive categories.  The recent themes and contents of the Japanese Journal of Drug Informatics were closely and mutually related.

In Kampo medicine, sickness is regarded as affecting the whole body even though the symptoms may appear obvious only in the abdomen. This makes abdominal palpation an important means of physical examination, and diagnosis. Because learning abdominal palpation in the Kampo style is very difficult, we attempted to simplify learning by building typical anatomical abdomen models for training. To create six abdominal models : Shinka-hiko, Kyokyo-kuman, Fukuchokukin-renkyu, Shofuku-fujin, Shofuku-koman, and Shinkabu-sinsuion, we employed several materials, including artificial leather for epidermal tissue, pile fabric for subcutaneous tissue, cotton cloth or jersey cloth for membrane tissue, polyurethane or natural rubber for muscle tissue, specialized polyester resin for costae, and cotton for internal organs. We employed a harder polyurethane, for example, in Shinka-hiko to simulate resistance in the region beneath the heart, in Kyokyo-kuman to simulate resistance in the subcostal region, and in Shofuku-koman to simulate horseshoe-shaped resistance in the lower abdominal region. Otherwise, in Shofuku-fujin, a lack of resistance was simulated by a defect in the polyurethane at the center of the lower abdominal region. Shinkabu-sinsuion was modeled using a water dabbling sound via a water-filled balloon that could be gently shaken with the fist in the region above the navel. Fukuchokukin-renkyu was modeled as excessive strain of the rectus abdominis muscles via the use of natural rubber. We tried to represent the tenderness on pressure at the para-umbilical region, cecal region, and sigmoid region in the Shofuku-koman model by making a specialized switch with conducting rubber, and using electric device and battery. We believe these models are useful teaching devices, in that they simplify Kampo abdominal palpitation training.
Medicine, Kampo ; Cancer resistance to treatment ; Training ; Tissues ; Palpation

Many of the students belonging to the School of Health and Social Services will be responsible for health education in the future, and it is important that they have an understanding of the importance of Kampo medicine and the ability to give appropriate guidance in the field. But their educational goals need discussing. We conducted lectures on Kampo medicine with medical school students towards this end, and conducted before and after questionnaire surveys to gauge their effect. Students with a desirable degree of awareness toward Kampo medicine in Japanese society increased from 58.0 ± 15.4% to 88.5 ± 10.2%, and students judging Kampo as either useful or extremely useful rose from 58.4% to 95.9%. It is our hope that, with the raised awareness from these lectures as a base, these students will go on to engage in suitable medical educational activities in the future.

Purpose: Palliative care implementation should take into account the perceptions and acceptability of healthcare providers. This study aimed to identify physicians’ perceptions of palliative care and barriers to palliative care practice in the critical care setting. Methods: A nationwide, self-administered questionnaire was distributed to physicians working in intensive care units, and free-text data were qualitatively analyzed. Results: The questionnaire was sent to 873 respondents, and 436 responded (50% response rate). Of these, 95 (11%) who responded to the open-ended sections were included in the analysis. Conclusion: Japanese physicians working in ICUs recognized that palliative care was their role and practiced it as part of their usual care. They felt, however, that the practice was difficult and not sufficient. Barriers to practice included the lack of human resources and availability of palliative care teams, and the lack of uniformity in the perception of palliative care in the critical care setting.