To evaluate a 30-year-old system of graduate entry at Osaka University Medical School, we analyzed the personal profiles and career choices of entrants already holding university degrees. At total of 405 such students have been admitted. Although the number of applicants with degrees decreased during the “bubble period” of asset-inflated economic expansion, it increased after the collapse of the bubble. Ninety-eight percent of graduate entrants were male, and at the time of entrance 82% of entrants were younger than 30 years, with a peak age distribution between 24 and 26 years. Ninety-six percent of entrants were graduates of a national university. Academic degrees held by the graduate entrants were bachelor's degrees, master's degrees, and doctoral degrees in 57%, 36%, and 7%, respectively. Eighty-four percent of entrants had taken science courses before being admitted to our school. After graduation, research in basic medical science was more likely to be chosen as a career by students entering with university degrees than by students entering directly from high school. Although many graduates now hold supervisory positions, such as professor and hospital director, graduate entrants were more likely to enter family medicine than were students entering directly from high school. More than 20 years after graduation, 14% of graduate entrants were working at a university and 44% at a hospital. Furthermore, 9.6% of graduate entrants were professors, 7% were hospital directors, and 27% were family practitioners. These results indicate that our graduate entry system has admitted talented people with a clear purpose in life who received advanced scientific education and has produced a large number of graduates who have assumed leadership positions.

Objectives: Primary aim of this study was to clarify the family evaluation about caring the body of the deceased patient by nurses at Japanese inpatient hospices and palliative care unit. Method: A mail survey was performed on 958 bereaved family members of 103 palliative care units in July, 2010. Result: A total of 597 family members replied（62％）. As a whole, 441（74％）families reported that they were satisfied with the way caring the body of the deceased patient by nurses. A multivariate analysis revealed three factors were significantly associated with the levels of satisfaction:the patient face became peaceful and calm, and nurses treated the patient in the same way before died, and patient age was over 70 years old. Conclusion: Making patient face peaceful and calm, and treating the patient in the same way before died is important in caring the body of the deceased.

Objectives: Primary aim of this study was to clarify the experience and evaluation of families who about caring the body of the deceased patient by nurses at Japanese inpatient hospices and palliative care unit. Method: A mail survey was performed on 958 bereaved family members of 103 palliative care units. A total of 598 family members replied. This study was content analysis about free comments in the questionnaire. Result: A total of 301 comments from 162 questionnaires were identified as the subjects for content analysis. The family was experience satisfaction or dissatisfaction about the way caring the body of the deceased patient. The family felt hesitation and worries about caring the body of deceased patient. A content analysis revealed 3 underlying themes: the family evaluate as a good experience, the family evaluate as an unpleasant experience, the family evaluate as an experience of hesitation and worries. Conclusion: The family was satisfied about treating the patient in the same way before died, making patient face beautiful and calm, facilitates family’s preparation. When nurses recommend families to care the body of deceased patient, which become memorably experience, and they come to be get over sorrow after the bereavement. But they need to confirm the family’s preparation and choose what they can do.

Purpose: The Liverpool Care Pathway is a clinical path for the dying patient. In this study, a pilot study of a Japanese language version of the Liverpool Care Pathway Powered by Editorial Manager® and Preprint Manager® from Aries Systems Corporation (henceforth, “LCP”) was carried out in order to investigate the significance of using LCP and the possibility of its introduction. Method: 1. LCP was used on inpatients in the palliative care wards, and the status of the achieved care goal was evaluated. 2. A questionnaire survey regarding the usefulness of LCP was conducted on the nursing staff of the study facility. Results: The care goal indicated by LCP were achieved in 80% or more of the patients and families. The nursing staff members were asked to evaluate of LCP was evaluated the usefulness of LCP in confirming that the patient is in the dying phase, reviewing end-of-life care, continuous integrated care giving, and education for nurses with limited experience with end-of-life care. Conclusion: The high degree of achievement of the care goal in LCP shows concordance between LCP and end-of-life care at the study facility, and shows that it is possible for LCP to be introduced as an index of clinical pathway for end-of-life care giving. In addition, the nurses' evaluations imply the significance of LCP in reinforcement and education with regard to end-of-life care giving.