This study examined the effectiveness of a communication program in undergraduate medical education in improving communication in physicians' clinical practice. The effectiveness of the program was assessed with a mail survey using self-rated questionnaires 9 years later. Ninety participants were follwed up in late 1994; 57.8% of them replied to the questionnaire. Of the respondents, 60% replied that programs concerned with active listening and role-playing had benefits on communicating with patients and families. In addition, 40% of respondents answered that case studies aimed at teaching comprehensive medicine with the team approach was effective in improving communication with co-medical staff. These results suggest that the communication program in undergraduate medical education is effective in improving clinical communication in clinical practice when students are highly motivated.

Physical performance measures, such as gait speed, one-legged stance and hand-grip strength, are known as assessment measures of motor function and predictors for adverse health outcomes, and widely used for assessing motor function in preventive programs for long-term care or screening of frail elderly. However, there is no standard assessment sheet for feedback of the results. In the present study, an assessment sheet on physical performance measures for community-dwelling older adults was developed. A pooled analysis of data from six cohort studies, including urban and rural areas was conducted as part of the Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging. The pooled analysis included cross-sectional data from 4683 nondisabled, community-dwelling adults aged 65 years or older. Quintiles were derived according to age and sex group for six physical performance measures, i.e., hand-grip strength, one-legged stance, and gait speed and step length at both usual and maximum paces. The assessment sheets, which indicated the physical performance level according to age and sex, were developed by fitting third order polynomial curves to the data. The reference values in the present assessment sheet were considered to be derived from better represented community-dwelling older adults by using more large-scale population-based cohort data than that in the previous study. The assessment sheet should be useful for feeding back results on physical performance measures to elderly individuals and help them better understand their own physical performance levels.

The purpose of this study was to examine the contribution of the location-tracking information to the energy expenditure during the soccer-based intermittent sprint run. Twenty-four young healthy men participated in the present investigation (1st experiment: 14 men, 2nd experiment 10 men). In the 1st experiment, the sprint runs were 12 times of the 10 m (SS10), or 6 times of the 20 m (SS20), or td 3 times of the 40 m (SS40). In the 2nd experiment, the sprint runs 15 times of the 10 m (SS), or 15 times of the 10 m of the sprint run with change of direction for 90, 135, 180 degrees (CD90, CD135 and CD180). All course of the experiment, the expired gas was analyzed using the portable gas analyzer. The running index including speed, acceleration, distance, were calculated at 15 Hz interval based on the location-tracking information using the portable global positioning system. The intermittent run with the straight sprint run expended significantly larger calorie compared with that without the straight sprint (p < 0.001). The intermittent run with the changes of direction expended significantly larger calorie compared with that without the changes of direction (p < 0.05). A multiple stepwise regression analysis revealed that body weight, the acceleration and the change of direction were significant determinants of the energy expenditure and accounted for 75% of the total variance. These results indicate that the magnitude of the acceleration is significant predictor for the energy expenditure of the intermittent exercise.

  Objective: Various psychosocial factors were exploratively investigated in order to specify items that influence on immediate effect of acupuncture among patients with chronic low back pain.  Method: Fifty-six outpatients with initial diagnosis of chronic low back pain, visiting the Acupuncture Department of Center for Integrative Medicine, Tsukuba University of Technology between August to December 2019 were included in the study. The baseline lumbar pain intensity of the patients evaluated using the Visual Analogue Scale (VAS) was >30 mm. Psychological scales viz., Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), social factors (cohabitation family situation, final education, social participation status), lumbar dysfunction, and impression on acupuncture were recorded using a self-administered questionnaire during the first visit. Patients showing decreased VAS scale (≦30 mm) after the first acupuncture treatment as well as self-recognition of improvement in pain were classified as “high responders” while the others were treated as “low responders”. Physical and psychosocial factors were exploratively compared between high and low responders and logistic regression analysis of the two groups was performed using a dichotomous dependent variable.   Results and Discussion: The number of high and low responders were 22 and 34, respectively. On comparing these groups exploratively, positive (P＝0.001) and negative (P＝0.004) impression on acupuncture were the only items that showed statistical significance. Among items used as covariates in the logistic regression analysis, the PCS (OR: 0.886 (95% CI: 0.808 to 0.971); P＝0.010), positive impression on acupuncture (OR: 5.085 (95% CI: 1.724 to 15.002); P＝0.003), and number of people living together (OR: 0.355 (95% CI: 0.149 to 0.844); P＝0.019) showed statistical significance. Hence, it may be suggested that psychosocial factors influence the immediate effect of acupuncture among patients with chronic low back pain.

[Objective] In the past, we reported results focusing on the immediate effect of psychosocial factors that influence the effects of acupuncture on patients with chronic low back pain. In the present study, we conducted a retrospective analysis of the data before and after four weeks of acupuncture therapy.[Materials and Methods] Fifty-three patients with an initial diagnosis of chronic low back pain who visited the Acupuncture Department of the Center for Integrative Medicine, Tsukuba University of Technology between August and December 2019 and showed baseline lumbar pain intensity by Visual Analogue Scale (VAS) > 30 mm, were subjects of this study. Psychosocial scales viz, Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), social factors (cohabitation family situation, final education, social participation status), Roland-Morris Disability Questionnaire (RDQ), and impression of acupuncture were recorded using a self-administered questionnaire at the first visit and at four weeks after the first acupuncture therapy. Based on VAS, RDQ, and anchor questions about low back pain before and four weeks after the acupuncture therapy, patients were classified into "effective group" and "non-effective group"; then, the logistic regression analysis was performed using this classification as a dependent variable. In addition, r repeated measures analysis of variance (rANOVA) was performed on the data before and after four weeks of acupuncture therapy.[Results and Discussion] The number of patients in the "effective group" and "non-effective group" were 24 and 29, respectively. Among items used as covariates in the logistic regression analysis, the PCS (OR: 0.924, P = 0.037) and age (OR: 0.418, P = 0.005) showed statistical significance. In the rANOVA, all the evaluated items showed statistically significant differences before and after four weeks; only VAS in motion showed a statistically significant difference (P = 0.046) regarding the presence or absence of an immediate effect. Therefore, it was suggested that it is important to focus on psychosocial factors from an early stage of therapy, and to make appropriate evaluations and judgments based on both physical and psychosocial aspects of patients to treat them effectively.