In junior high school, educators with many different types of specialty jobs are involved in “education on the proper use of pharmaceutical products” and “drug-abuse resistance education”. Examples of these different jobs are physical education teachers, school nurses, school pharmacists. The aim of this study was to elucidate novel ideas and new directions in the future of medicine instructional education by clarifying the aims and thoughts of educators with different jobs on the education of pharmaceutical medicines and drug use. Based on the technique of Personal Attitude Construct (PAC) analysis, junior high school staff members involved in “education on the proper use of pharmaceutical products” and “drug-abuse resistance education” were interviewed regarding their aims and thoughts. Their responses were analyzed qualitatively. Five school pharmacists, five school nurses, and four physical education teachers were interviewed. The responses revealed that school pharmacists engaged in student education from the specialized perspective of pharmacology, school nurses engaged in student education from the perspective of imminent situations, and physical education teachers engaged in student education more from the perspective of student environment. This study suggested that “education on the proper use of pharmaceutical products” and “drug-abuse resistance education” should be a collaborative effort, so there were the different perspectives and aims of educators with different specialty jobs in the instruction of junior high school students on these subjects.

In Japan, tuberculosis (TB) control activities are conducted by public health centres (PHCs) and treatment support is provided by public health nurses (PHNs). This study describes the TB situation in the affected areas and assesses the effectiveness of Japan’s TB control efforts after the disaster.

Objectives: To clarify the preferences for survival time (ST) or quality of life (QOL) in the treatments for advanced cancer. Method: Patients with breast cancer, oncologists, and healthcare-providers including nurses, pharmacists and medical clerks were asked to anonymously complete a survey: The survey included questions regarding 1) priority among treatment options for a fictitious cancer patient, 2) preference of treatment aggressiveness for fictitious cancer patients by age group, 3) preference of treatment among options, with different weight on ST and QOL. Results: 1) Cancer patients' priority regarding ST and QOL was clearer than healthcare providers. 2) Oncologists tended to prioritize ST than cancer patients and other medical staffs in elderly patients. 3) Patients and oncologists tended to prioritize ST, whereas and other medical staffs prioritized QOL. Conclusion: Cancer patients and healthcare providers may have different perception regarding a treatment goal, which should be recognized in the practice of oncology.

Objectives : High and medium-dose combination hormone agents have long been used in their off-label use as oral contraceptives. Oral contraceptives (the low-dose pill) are expected to be approved by the standing committee of the Central Pharmaceutical Affairs Council in June 1999, and are expected to be on the market by autumn, available to anyone bearing a doctor's prescription. A survey was conducted of pharmacy students to determine their acceptance and their perceptions of oral contraceptives (the low-dose pill). The results are discussed along with ways of dealing with the scientific information on the possible soon to be approved oral contraceptives (the low-dose pill), and some proposals are made for the future.
Methods : The survey was conducted by distributing questionnaire sheets to female pharmacy college students in September 1996. Of the 670 subjects, 98 responded positively to the use of oral contraceptives (the positive group), while 572 preferred not to use them (the negative group). The two groups were compared and the data was analyzed. Mantel-Haenszel test was used to evaluate demographic and background data, their views on using oral contraceptives (the low-dose pill) and ways of obtaining necessary information.
Results : In the responses to the questions on how the subjects feel about oral contraceptives (the low-dose pill), the positive group gave these reasons more frequently than those in the negative group : simple to use (p<0.001), a method with a high contraceptive rate (p<0.001), a means of contraception controlled by the woman (p<0.001). On the other hand, the reasons given more frequently by the negative group : feeling concerned about adverse drug reactions (p<0.001), a method allowing sexually transmitted diseases to propagate (p=0.009), a method increasing the burden on the woman (p<0.001).
In terms of the subjects' knowledge of oral contraceptives (the low-dose pill), although there has been some improvement observed during their four-year college life, they did not seen to understand accurate information.
Conclusion : The surveyed subjects had not understood accurate information, and this lack of knowledge may have formed their biased views on oral contraceptives (the low-dose pill). Given such results, it is anticipated that such misconceptions may affect their own decision-making in their use of the drug, and that it would cause inefficiency in providing future users with accurate information when these students become pharmacists. In the near future, there is expected to be a deluge of information concerning the low-dose pill. It is clearly necessary in pharmaceutical education to provide proper training of pharmacy students for self-education so as to increase efficiency when considering and evaluating information.

This study was designed to evaluate nutritional status of older endurance runners (age ; 62.5±2.5 yr., weight ; 53.8±4.2 kg, %fat ; 12.0±2.1%, mean±SD) by comparing with agematched sedentary individuals (63.6±3.5 yr., 58.4±9.1 kg, 15.6±4.0%) and middle-aged long distance runners (35.2±3.1 yr., 61.2±5.6 kg, 11.8±1.9%) . Average training distance of the older runners was a half of that of the middle-aged runners (44 vs. 85 km/week) . Maximal oxygen uptake in the older runners was significantly higher than in the older sedentary controls, but lower than in the middle-aged runners (50.4±4.1 vs. 30.6±3.5 vs. 64.0±2.2 ml/kg/min, respectively) . No differences were observed in the concentrations of serum albumin, serum iron and blood hemoglobin among the three groups. Intake levels of the three groups with regard to the major nutrients were sufficient as compared with the recommended dietary allowance appropriate for age, sex and physical activity level. Total caloric intake in the older runners was not remarkably higher than in the older controls in terms of kcal/day (2, 430 vs. 2, 230), but was significantly higher in terms of kcal/kg wt/day (45.5 vs. 38.9) . Percents to the total caloric intake of protein (15.2%), fat (25.4%) and carbohydrate (52.6%) in the older runners were almost identical to the other two groups. Ratios of animal to total in protein and fat were not significantly different among the groups. The intakes of calcium, iron, and vitamins A, B1, B2 and niacin were higher, but statistically not significant, in the older runners than in the older controls. These results suggest that nutritional status of older endurance runners is adequate for maintaining their health in a good state while keeping their active lifestyle.

Approximately 14.1 million patients have dyslipidemia in Japan. Promotion of self-medication for the prevention of dyslipidemia is needed. After a change in law in 2014, residents of Japan are allowed to measure HbA1c, cholesterol, and triglyceride levels by self-blood sampling from the fingers under the guidance of pharmacists. In this study, we held an event to measure the lipid levels within a community and evaluated the usefulness of a simple measurement for the early detection of dyslipidemia. Furthermore, we surveyed community members’ knowledge of dyslipidemia by self-questionnaires. Of the 48 local residents who came to the event, 45 had their lipids measured and answered the questionnaires. In 12 applicants, HDL-cholesterol or non-HDL-cholesterol, which are not affected by meals, exceeded the standard range. In the questionnaire study, 89% of applicants selected arteriosclerosis as the main consequence of dyslipidemia. Additionally, over 82% of applicants selected blue-backed fish, dietary fiber, and soybeans as food items that inhibit the rise in lipid levels. However, only 31% of applicants recognized that fruits also affect lipid levels. Although it was disappointing that 60% of applicants did not know that they could measure HbA1c and lipids at community pharmacies, 62% desired measurement of those levels in the future. This study suggested that the simple lipid measurement is useful for the early detection of dyslipidemia but local residents need to be informed about it. Furthermore, improvement in the recognition of dyslipidemia by local residents is needed.

The purpose of the present investigation was to examine the relationships between the exercise history and the bone mineral density (BMD) and bone mineral content (BMC) in female Japanese young adults using dual X-ray absorptiometry (DXA). One-hundred twenty females, aged between 18 to 28 years, participated in the present investigation. The BMD at the lumbar spine (L-BMD), whole body BMD and BMC (WB-BMD and WB-BMC), lean body mass (LBM) and fat mass (FM) were measured by DXA. Using a self-administrered questionnaire, the exercise habits during preschool (4-6 years), primary school (7-12 years), junior high school (13-15 years), high school (16-18 years), and the current habits (>18 years) were eveluated. The L-BMD, WB-BMD and WB-BMC were significantly higher in the subjects with exercise habits during both the period of <18 years and >18 years compared with those in the subjects without an exercise history during all periods (p<0.05). In a separate analysis with the data stratified by the school age, the subjects with an exercise history during primary school, junior high school, or high school had significantly higher BMD and BMC values compared with the non-exercisers (each, p<0.05). In contrast, the BMD and BMC did not differ significantly according to either the exercise history during pre-school nor the current exercise status. A multiple stepwise regression analysis revealed that the body weight, LBM, FM, age of menarche, and exercise habits during high school were significant determinants of the L-BMD, WB-BMD and WB-BMC (p<0.001). The results of the present investigation show that both the exercise history during school age and the current exercise habits affect the BMD and BMC in young adults. In particular, high school females should be encouraged to participate in the regular exercise to increase their bone health. Future studies will be needed to confirm the targeted age-group(s) for participation in sports/exercise for the improvement of bone health, including an analysis of the type and intensity of exercise/sports.

We successfully performed aortic root replacement in an asymptomatic 52 year-old man with dilatation of the Valsalva sinuses (75 mm). The patient had previously undergone a radical operation for the tetralogy of Fallot at 13 years of age and AVR at 46 years of age. Massive bleeding occurred in the lungs after weaning from CPB. Emergency bronchoscopy revealed that the bleeding came from the right middle and lower lobes. The bleeding was stopped conservatively on POD 3 ; however, V-V ECMO was started on POD 5 because of severe hypoxia. ECMO was successfully weaned on POD 11 and he discharged on POD 59. The presence of developed bronchial collaterals and barotrauma during the operation were speculated the causes of the bleeding from the right lung.

We report a case in which feelings of abdominal distension and discomfort of the abdominal wall caused by malignant ascites were relieved by ultrasound-guided rectus sheath block. Case report: A 59-year-old man developed gastric cancer with malignant ascites and experienced feelings of abdominal distension, but no nausea, dyspnea, poor mobility, or limb edema. Symptom control was inadequate with diuretic therapy and abdominal paracentesis. Feelings of distension improved temporarily with ultrasound-guided rectus sheath block. A percutaneous catheter was then used to administer an infusion of 0.25% ropivacaine triweekly until his death 20 days later. Conclusion: Feelings of abdominal distension is one of various symptoms of severe ascites and is difficult to manage. Ultrasound-guided rectus sheath block can be used to relieve this symptom on a case-by-case basis.

In order to promote regional cooperation in palliative care, we developed a regional cooperation clinical pathway for home palliative care that offers simple support and is easy to use. We then administered a questionnaire survey to 14 healthcare professionals with various specialties who were involved in the introduction of the pathway, and we revised the pathway on the basis of the survey results. The revised pathway was then tested in 13 patients who were discharged from 3 designated cancer care hospitals in Toyama City to home care, and another questionnaire survey was conducted afterwards in the same manner. The mean overall score on the questionnaire was 2 in seven, 3 in seven (on a scale of 0 to 3) at the time of introduction, whereas the score after trial use was 1 in one, 2 in four, 3 in five. We believe that more innovative approaches to the implementation of such pathways are required.