This study was performed to evaluate management of cancer pain in 322 patients who were treated in our pain clinic between January 1986 and December 1997. For this purpose, the change in the number of cancer patients and the annual morphine consumption during the period in our hospital were investigated. We found that as morphine consumption increased, the number of cancer patients visited the pain clinic decreased. Although 90% of them who visited the pain clinic underwent neural block therapy before 1996, the parcentage dropped to only 79% in 1996 and 50% in 1997. The increasing rate of morphine consumption in our hospital was on a par with the national average between 1986 and 1996. The use of adjuvant drugs did not change throughout the 12-year period.
We believe the consumption of morphine is not enough. It is necessary for us to become more skilled in using narcotics for relief of cancer pain along the guidelines of the World Health Organization.

The School of Medicine, University of Tsukuba, was founded in 1974 and had graduated 1, 561 students by 1994. From 1980 through 1987, 44% to 73% of graduates became hospital staff, 16% to 40% became university staff, and 0% to 8% became general practitioners. More than 80% of graduates did a 2-year residency (sotsugo-kenshu) at our university hospital and 40% completed a 6-year residency. Almost 10 years of postgraduate training was required to become an established medical practitioner. This length of time indicates that postgraduate training is the most important part of the medical career. About 80% of graduates earned doctor of philosophy (Ph. D.) degrees, whereas 93% became registered specialists, indicating that graduates tended to become specialists rather than to pursue Ph. D. degrees. This difference is more evident among female graduates: 85% became specialists whereas only 53% received a Ph. D. Most graduates considered the School of Medicine to have a good curriculum, but some younger graduates had complaints. The graduates chose their career specialties on the basis of their own interests and aptitudes. We should take these data into account to prepare a system of life-long education and learning.

BACKGROUND: The existence of a gap between research evidence and clinical practice has been described recently. Several drugs are effective in preventing secondary events after acute myocardial infarction (AMI), but it is not certain whether this evidence is employed in daily practice. We investigated the drugs currently employed for patients with a history of AMI in Japan.
METHODS: Medical records of patients who developed AMI during the calendar year of 1999 were retrospectively identified at three teaching hospitals in Japan. We collected data on drugs prescribed at three time points (upon admission for AMI, at the time of discharge, and one year after discharge) for each patient.
RESULTS: Data were available for 149 patients with AM!. Drugs prescribed at the time of discharge were aspirin (77.5%), nitrates (68.3%), and angiotensin converting enzyme inhibitors (52.8%) . β-blockers were prescribed for only 12.0% of patients. The drugs used one year after discharge were to a large extent similar to those at the time of discharge. There were no significant correlations between the use of these drugs and comorbidity.
CONCLUSION: Despite established evidence that β-blockers offer benefits to patients with a history of AMI, they have not been prescribed frequently, for reasons that remain unclear. To improve the quality of clinical care, further systematic effort is needed to bridge this evidence to practice gap.

Adenocarcinoma currently accounts for 10–25% of all uterine cervical carcinomas and has a variety of histopathological subtypes. Among them, mucinous carcinoma gastric type is not associated with high-risk human papillomavirus (HPV) infection and a poor prognosis, while villoglandular carcinoma has an association with high-risk HPV infection and a good prognosis. They show relatively characteristic imaging findings which can be suggested by magnetic resonance imaging (MRI), though the former is sometimes difficult to be distinguished from lobular endocervical glandular hyperplasia. Various kinds of other tumors including squamous cell carcinoma should be also differentiated on MRI, while it is currently difficult to distinguish them on MRI, and HPV screening and pathological confirmation are usually necessary for definite diagnosis and further patient management.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Hyperplasia ; Magnetic Resonance Imaging ; Mass Screening ; Prognosis ; Uterine Cervical Neoplasms ; Uterus

BACKGROUND: Before the COVID-19 vaccine became available, many Japanese people were undecided about whether or not to receive them. Their decisions were keys to achieving herd immunity. The impact of the type of information source on the COVID-19 vaccine uptake decision-making process remains unclear. We aimed to investigate the association between information source usage on COVID-19 and subsequent vaccine uptake status among those who have yet to decide whether to receive vaccines from non-prioritized people for vaccination. METHODS: Prospective cohort online self-administered surveys were conducted in February 2021 (T1), before the start of the mass vaccination program, and September-October 2021 (T2), when the vaccines were available to all citizens. The survey's target population was registered monitors of an Internet research company. Participants who answered "I want to get vaccinated after waiting to see how it goes." at T1 were eligible for analysis. The outcome variable was the COVID-19 vaccine uptake status in T2, and the predictors were 20 types of information sources, categorized based on people (family members, etc.), institutions (governments, etc.), or media (TV news, etc.). Adjusted odds ratio and 95% confidence intervals were estimated using logistic regression adjusted for possible confounders. RESULTS: The 5,139 respondents, mean age and standard deviation was 42.8 ± 12.5, 55.7% female, were eligible for analysis. 85.7% completed vaccination (including reserved/intended people) in T2. In the multivariate logistic analysis, odds ratios (95% confidence interval) for vaccine uptake were 1.49 (1.18-1.89) for workplaces/schools, 1.81 (1.33-2.47) for LINE, 0.69 (0.55-0.86) for Internet news and 0.62 (0.48-0.82) for video sharing sites. CONCLUSIONS The type of information source usage played an important role in the decision to vaccinate against COVID-19. Although caution is needed in interpreting the results, obtaining information from workplaces/schools and LINE was influential in promoting immunization.
Humans ; Female ; Male ; Information Sources ; COVID-19 Vaccines ; Prospective Studies ; Intention ; Japan ; COVID-19/prevention & control* ; Vaccination

BACKGROUND: Ibaraki's Amabie-chan is a COVID-19 infection control system unique to Ibaraki prefecture, Japan. It requires residents to register each time they visit events, commercial facilities, and restaurants. The number of registrations has been limited, and its function alerting about people positive for COVID-19 infection seems not to be working. Nevertheless, registration with the system might have some impact on the user's behavior. In the current preliminary survey, the possible impact of Ibaraki's Amabie-chan on infection prevention behavior and fear of COVID-19 was investigated. METHODS: A cross-sectional, web-based, anonymous, and self-administered survey was conducted at two workplaces in Tsukuba Science City, Ibaraki, Japan. The first survey was conducted at one of the workplaces in November 2020, and the second survey, at the other workplace in February 2021. Variables of interest were sex, age group, marital status, employment status, Ibaraki's Amabie-chan use, COVID-19 Contact-Confirming Application use, ten items of infection prevention behaviors, and fear of COVID-19. Hierarchical linear regression analysis was performed. RESULTS: In both surveys, use of Ibaraki's Amabie-chan was significantly associated with COCOA use and with "physical condition management such as body temperature measurement." No association was found with other infection prevention behaviors or with fear of COVID-19. CONCLUSIONS Our findings did not provide sufficient evidence for the effectiveness of Ibaraki's Amabie-chan in regard to users' infection control behavior. Further detailed study is needed to investigate the effectiveness in terms of infection prevention and the cost-effectiveness of Ibaraki's Amabie-chan.
COVID-19/prevention & control* ; Cohort Studies ; Cross-Sectional Studies ; Fear ; Humans ; SARS-CoV-2

BACKGROUND: Flourishing, defined as the coexistence of hedonic and eudaimonic well-being, is the most favorable end of the mental health spectrum. A growing body of evidence has demonstrated the association between flourishing mental health and favorable work-related outcomes. However, epidemiology of flourishing mental health is scarce in Japan. Moreover, the relationship between flourishing mental health and occupational stress has not been elaborated. Therefore, the aim of this study was to elucidate (1) the prevalence of flourishing mental health and (2) the association between flourishing mental health and occupational stress among Japanese workers. METHODS: The present survey was conducted in from February to March 2017 via an anonymous, self-administered, and web-based questionnaire among workers in Tsukuba Science City, Japan. Mental Health Continuum Short Form was used to assess flourishing mental health. We performed binomial logistic regression analyses to calculate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) of occupational stress for flourishing mental health, controlling for sociodemographic factors. RESULTS: A total of 7012 respondents (4402 men, 2610 women) were analyzed. The overall prevalence of flourishing mental health among the respondents was 12.4%. Full-time (permanent) workers were less likely to be flourishing. Reward from work (AOR = 2.34, 95% CI = 2.04-2.68), support from colleagues and superiors (AOR = 1.67, 95% CI = 1.44-1.94), and workload (AOR = 1.19, 95% CI = 1.05-1.36) were positively associated with flourishing mental health, whereas mental workload (AOR = 0.65, 95% CI = 0.57-0.75) was inversely associated with flourishing mental health. CONCLUSIONS The findings of the present study shed light on the association between flourishing mental health and occupational stress.