Objectives：To clarify effectiveness of educational workshop in advance care planning (ACP) and clinical ethics based on education for implementing end-of-life discussion (E-FIELD) program. Methods：Pre-post questionnaire survey. We held workshop in ACP and clinical ethics based on E-FIELD program. We measured participant’s knowledge of ACP and difficulties of End-of-Life (EOL) discussion before and after the workshop. Results：In 37 participants, 34 participants finished the course. Improvement of knowledge of ACP and clinical ethics in post workshop survey was statistically significant (pre. 18.1 v.s. post 23.9, p<0.001, paired t test). In terms of difficulties of EOL discussion, 7 items in all 13 items questionnaire were improved significantly in post workshop survey (p<0.05, Wilcoxon rank sum test). Conclusion：Educational workshop in ACP and clinical ethics based on E-FIELD program may improve knowledge of ACP and reduce difficulties of EOL discussion.

  Generic drugs have received much attention especially from an economic point of view.  In Japan, the form of medical prescriptions has been revised twice in recent two years to disseminate generic drugs in recent two years.  The pharmacists are irresistibly required the detail knowledge of various generic drugs.  However, sufficient information on generic drugs has not always been provided in comparison with the original drugs.  This study intends to reveal such problems with the generic drugs.  Glibenclamide and gliclazide were selected as the model drugs for this study because these two drugs are often taken together with supplements.  Two approaches were used to compare the original drug and the corresponding generic drugs.  The first approach concerns the amount of information as well as the quality of the information that is provided from manufacturers.  The second approach concerns the physicochemical properties, dissolution test and hardness test.  Regarding the pharmacokinetic information in the package insert of glibenclamide, six generic drugs among eleven samples provided sufficient information while four samples seemed insufficient.  As for gliclazide, three samples among eight did not provide AUC and the time dependence of the blood concentration curve.  The results of the dissolution test revealed that all generic drugs satisfied most of the equivalence to the original drug except for one generic glibenclamide.  On the other hand, different behaviors in the swelling property and the time required to completely disperse were observed.  Two samples for glibenclamide and four samples for gliclazide required a fairly long time to completely disperse.  Irregular and significant variations were observed in the hardness test.  The difference in the dissolution process and hardness test suggested the different drug formulations among manufacturers.

Purpose: We assessed the efficacy of a palliative care team (PCT) in improving quality of life (QOL) among Japanese cancer patients. Patients and methods: This prospective study involved adult patients treated in the Division of Respiratory Medicine and Medical Oncology/Hematology at Kobe University Hospital between November 1, 2009 and March 30, 2010. Every patient had requested intervention by the PCT. Patients were asked to complete the EORTC QLQ-C15-PAL questionnaire at baseline and 1 and 4 weeks after initiation of the PCT intervention. Result: Of the 35 patients enrolled, 26 patients and 15 patients completed the assessments at 1 and 4 weeks after starting the intervention, respectively. Pain subscale (PA) was improved at 1 week after starting the intervention (p<0.05). Dyspnea subscale (DY) and PA were improved at 4 weeks after starting the intervention (p<0.05). Conclusion: We prospectively showed that QOL of cancer patients was improved with the intervention of the PCT, using the Japanese version of the EORTC QLQ-C15-PAL. Even if the PCT can only provide short-term care for cancer patients, this intervention appears worthwhile to improve QOL of cancer patients.