1) As medicine matures, a more balanced management of human resources, medical skills and technology, and finance is required. Therefore, the importance of business administration as a subject of lifelong learning by physicians is increasing.
2) Japanese medical students and physicians have few opportunities to learn business administration. A distance-learning programme for a masters of business administration (MBA) degree provides a learning opportunity that does not interrupt careers.
3) For both providers and learners, much effort is needed to avoid leaving school without completing the MBA course: while learners need more time management and motivation, providers need to develop a better management system and provide virtual reality situations.

1) The number of newly employed medical residents per 100,000 persons and Gini coefficients were calculated using 2005 census data and the numbers of newly employed medical residents from 2003 through 2008.2) The maximum/minimum number of medical residents per 100,000 persons decreased from 9.3 in 2003 to 3.6 to 4.7 from 2004 through 2008. Gini coefficients also decreased from 0.21 in 2003 to 0.17 to 0.19 from 2004 through 2008.3) The interprefectural inequality was large before the introduction of the new system but decreased slightly after its introduction.

Objectives: To determine the relationship between obesity and cardiac autonomic nerve activity in healthy children. Methods: 16 healthy male children comprising of 9 nonobese and 7 obese subjects (body mass index > 19.1 kg/m2) aged 8−9 years were selected. Electrocardiograms were measured for 10 min. under controlled ventilation (0.25 Hz) in the supine position. Consecutive 256-second RR interval data were transformed by the Fast Fourier Transform method into power spectral data. Very low frequency (VLF; 0.003−0.04 Hz), low frequency (LF; 0.04−0.15 Hz), high frequency (HF; 0.15−0.40 Hz), and total power (TP; 0.003−0.40 Hz) were calculated and transformed into a natural logarithm (ln). Normalized units (nu) were also calculated as follows: LFnu = LF / (TP - VLF) x 100. HFnu = HF / (TP - VLF) x 100. Low/high-frequency ratio (LHR) was calculated as LF divided by HF. Unpaired t test was performed to compare the 2 groups. Results: TP ln and HFnu, reflecting cardiac parasympathetic nerve activity, in obese children were significantly lower than those in nonobese children. In contrast, LFnu and LHF, reflecting cardiac sympathetic nerve activity, in obese children were significantly higher than those in nonobese children. Conclusions: These findings suggest that obese children have higher sympathetic nerve activity and lower parasympathetic nerve activity than nonobese children.
Child ; Hz ; Cardio- ; Nerve ; With frequency

The demand-supply status of manipulative therapies for muscle-skeletal complaints in Japan were observed and analyzed using data published in 1995.
The results were as follows.
1. In Japan, the average prevalence rate was 69.6 for shoulder stiffness, 71.8 for lower back pain, and 46.1 for joint pain as of 1995 (per 1, 000 population). The prevalence rates were higher in women than in men and higher in prefectures located in the west part than in the east part of Japan. Differences in prevalence rates of the three complaints of several times were seen among the 46 prefectures.
2. On average, there were 66.6 massagers/chiropractors, 45.0 acupuncturists, 44.0 moxibustionists, and 20.2 bonesetters as of 1995 in Japan (per 100, 000 population). These numbers were higher in prefectures located in the west part than in the east part of Japan.
3. The rate of outpatients attending massagers, chiropractors, acupuncturists, moxibustionists, or bonesetters as of 1995 in Japan was 23.7per 1, 000 population. The rate of outpatients was higher in women than in men and higher in prefectures located in the west part than in the east part of Japan.
4. The rate of outpatients in each prefecture showed a significant correlation with the prevalence rates of muscle-skeletal complaints (r=0.51 for shoulder stiffness, r=0.44 for low back pain, and r=0.68 for joint pain) and with the numbers of manipulative therapists (r=0.31 for massagers/chiropractors, r=0.36 for acupuncturists, r=0.35 for moxibustionists, and r=0.57 for bonesetters).
5. Based on multiple correlation analysis showing the correlation of the rate of outpatients with the number of therapists, the prevalence rate of shoulder stiffness (partial correlation coefficient: PCC=0.61) and the number of bonesetters (PCC=0.65) showed significant correlation with the number of outpatients visiting therapists, and its multiple correlation coefficient was 0.76 (<0.001).

All residents aged 40 years or more in Oyabe City, Toyama Prefecture, Japan were involved in an annual medical check-up between 1987 and 1988. The cohort was followed and death certificates from cancers were confirmed prospectively. During follow-up to December 31st, 1994, 100 deaths (28 gastric, 17 lung and 55 other cancers) from cancers occurred, and these subjects were included in this study as the case group. Subjects in the control group, matched for gender and age with the cases, were selected randomly from participants whose serum samples had been stocked during annual medical check-up. The concentration of serum thiocyanate in all (79.8 μmol/l), gastric (86.7 μmol/l) and lung (90.0 μmol/l) cancer patients were significantly higher than that of relevant controls (64.3 μmol/l, 59.0 μmol/l and 61.0 μmol/l, respectively; and p<0.001, p<0.001 and p<0.05, respectively). After adjusting for BMI, blood pressure and total serum cholesterol, the results of multiple logistic regression analysis showed that the risk of all cancers (OR=3.40, 95% confidence interval (95% CI): 1.67−6.96, p<0.01), gastric cancer (OR=7.98, 95% CI: 1.91−33.34, p<0.05) and lung cancer (OR=8.83, 95% CI: 1.19−65.65, p<0.05) were elevated significantly with logarithm transformed values of serum thiocyanate increased. The present findings suggested that in epidemiological studies confirmation of smoking status with biomarkers such as serum thiocyanate may be important, although considering the small sample size, a relatively weaker risk to interested factors rather than the strong relationship between smoking and cancer was noted.
L ; Mole, unit of measurement ; lower case pea ; Serum ; Smoking

Objectives: The aim of this study was to identify characteristic lifestyles in children with obese parents. Methods: 8,030 children (4,072 males and 3,958 females) aged 6 to 7 years were investigated. A questionnaire relating to the lifestyles of children was distributed through elementary schools for completion by parents. The heights and weights of parents were self-reported. A parent with a body mass index (weight in kilograms divided by the square of height in meters) greater than the 90th percentile for gender (26.7 kg/m2 for fathers and 24.3 kg/m2 for mothers) was defined as an obese parent. A chi-square test for each trend was applied to evaluate an increasing trend in the frequency or level of each lifestyle in children with obese parents. Results: Children with obese parents were significantly associated with increasing trends in the proportions categorized by irregular intake of breakfast, faster eating, longer TV watching, and shorter sleeping hours. Conclusions: These lifestyles are considered to be possible risk factors for the development of obesity. These characteristic lifestyles observed in children with obese parents could strengthen the relationship between child and parental body compositions, in addition to the genetic predisposition to obesity in children with obese parents. These findings indicate that education with lifestyle modification for obese parents will be required to prevent further weight gain in children with obese parents.
Child ; Parents ; Life Style ; seconds ; trends

Objective: To assess the validity of a questionnaire for evaluating the physical activity of young children as reported by parents. Methods: Twenty-one male 1st grade elementary school children were the study subjects. The questionnaire contained 3 questions relating to the physical activity of children and was completed by their parents. These questions were: preference for physical activity: like very much, like, don't like; physical activity compared to peers: more than, the same as, less than peers; time spent on exercise activity per day: <30 min, 30—60 min, 60 min or more. We also assessed physical activity more objectively, using a small instrument for calculating total steps, energy expenditure originating from exercise, and total energy expenditure per day. The contribution of the questionnaire items to the objective indices was evaluated by linear regression analysis. Results: Preference for physical activity was significantly associated with all the objective indices. Physical activity compared with peers had links with total energy expenditure. Time spent in activity was related to total steps and energy expenditure from exercise. Conclusion: All the questionnaire items were valid measures for evaluating the physical activity level in young children and could be applied to a large epidemiological survey.
Physical activity ; Questionnaires ; Energy Metabolism ; Child ; Minute of time

Since the first paper by Milham et al. suggested that occupational exposure to an electromagnetic field (EMF) could increase the risk of adult leukemia, many epidemiological studies on this problem have been published. In this report the method of meta−analysis was used to summarize the results from these papers quantitatively. The combined relative risk of all leukemia (RR=1.11), as well as acute lymphocytic leukemia (RR=1.38), acute myeloid leukemia (RR=1.07) and chronic lymphocytic leukemia (RR=1.14) increased but not significantly. So far, it is difficult to make a consistent conclusion about the relationship of the occupational exposure to EMF and adult leukemia. Further carefully designed case−control and cohort studies using the more valid means of exposure assessment are required.
Leukemia ; Adult ; Risk ; Electromagnetic Fields ; Analysis of substances

The comfortability and safety on resort were investigated in terms of resort environments focusing on atmosphere temperature.
With regard to the comfortability, first, a discomfort index (DI) defined with atmosphere temperature and relative humidity was demonstrated to be associated with indicators of autonomic nerve activities derived from heart beat variability at the level around DI-70 which was classified into the category of “comfortable for most of people”.
Secondarily, it was suggested that the index could be available to evaluate comfortability for given time courses at different resort points with an example of its hourly average in 24 hours a day for a representative month in each season. With regard to the safety, first, stroke incident rate of each month was associated with monthly average atmosphere temperature when the relationship was analyzed using around ten thousands patients data for 7 years from the community-based stroke registration for in Toyama prefecture. On top of that, it has been demonstrated that the atmosphere temperature on one and two days prior to the stroke development was independently effective on the risk of cerebral hemorrhage and subarachnoidal hemorrhage development with the adjustment for patient's sex and age, calendar year, season, relative humidity and atmosphere pressure. Secondarily, morning raise in blood pressure was affected by the room temperature (10°C and 25°C). The lower temperature the more raise in blood pressure.