Purpose
 Every year, a lot of training programs by Japan International Cooperation Agency (JICA) are conducted in Japan. However, the method of monitoring and evaluation of those trainings are not always conducted other than simple questionnaire survey. The purpose of this research is to demonstrate the significance of daily recording and analysis of the trainee’s voice as a way of the improvement of the quality of training.
 Bureau of International Cooperation in National Center for Global Health and Medicine (NCGM) conducted detailed monitoring and evaluation for “JICA training for Maternal and Child Health in French speaking African countries in 2009” which NCGM itself had planned training curriculum and implemented the training. The key word of this training was “Continuum of care”. At the end of the 5 weeks training, NCGM expected the trainees to obtain comprehensive understanding of continuum of care, especially two different perspectives, which were “the health system” and “the dignity of individual client”.
Method
 NCGM training team kept recording the trainee’s voice, then analyzed them every day during five weeks’ training. At the end of the training course, the team divided trainee’s voice into several categories, and then analyzed their time-dependent change.
Results
 The everyday recording and analysis of the trainee’s voice made NCGM training team possible to differentiate the trainee’s fundamental interest and understanding from simple guesses or curiosity. Based on the result of daily analysis, the training team could introduce unscheduled discussion or fine-tuned the contents of lectures for better understanding of trainees. The trainees’ interpretation about “continuum of care” showed obvious change before and after the training. The active learning program by using Laboratory method gave deeper impact on trainees than the expectation of training team. At the end of training course, the trainees formulated concrete and detailed action plans. The purpose of their action plans was to establish the continuum of care from aspects of both “the health system” and “the dignity of individual client” by analyzing the existing stakeholders and institutions, and ensuring a collaborative linkage among them, which were exactly the expected outcome.
Conclusion
 Daily recording and analysis of the trainee’s voice was effective and useful to monitor the training. The comprehensive analysis at the end of training course revealed the short impact of the training on trainees, which could be used as a self evaluation tool for the training team.
 NCGM plans to visit the trainees’ workplace in their home countries for middle and long term monitoring and evaluation. The results will be feed backed into the training curriculum of next year.

Introduction
 Even though many oversea training programs end in developing an action plan from what they learned during the course, follow-up opportunities are quite limited. Group training program on maternal and child health for Francophone African countries are conducted in Japan since 2003, organized by National Center for Global Health and Medicine and funded by Japan International Cooperation Agency. Follow-up activities in Senegal and Benin are reported with lessons learned.
Methods
 Training organizer team made a semi-structured interview with 11 trainees, 6 superintendents and 4 Japanese advisors, asking “Do trainees implement what they planned at the end of the training course in Japan? If not, what are the difficulties implementing their plans?”Organizer team also provided some interventions to solve the problems they faced.
Results
 In Senegal, actions were not implemented yet, because plans were shared neither with their superintendents nor with Japanese advisors working with trainees as project counterparts. Organizer team set up a meeting with all stakeholders to clarify the objectives and outcomes of the training course within the concept of the project. This process made the superintendents understand and support the action plans, and facilitated to start implementing them. In Benin, trainees started activities by themselves based on their action plan under a small financial support from a Japanese advisor. It was rather easy, because they were decision makers of a hospital, but they faced difficulties to manage the staff to continue the activities. Organizer team encouraged them to continue the activities during the meeting in the hospital.
Conclusions
 Appropriate participants can be selected and training could be effective, when cooperation project are well defined and the role of advisors is clear in the follow-up. Involvement of decision makers or superintendents for the selection and follow-up process can be a contributing factor to improve the effectiveness of the training.

The purpose of this investigation is to study the frequency and penetrance of BRCA1 and BRCA2 germline mutations in Japanese familial breast cancer patients. Mutation analysis of BRCA1 and BRCA2 by protein truncation test was conducted on the 120 breast cancer patients (probands) with at least one breast cancer (site-specific breast cancer families, n=105) or one ovarian cancer (breast/ovarian cancer families, n=15) patient in their first-degree relatives. Eight BRCA1 (7.6%) and ten BRCA2 (9.5%) mutations were found in site-specific breast cancer families (n=105), and seven BRCA1 (46.7%) but no BRCA2 (0%) mutations were found in breast/ovarian cancer families (n=15). In site-specific breast cancer families, mutation frequency of BRCA1 and BRCA2 was high in families with more than three breast cancer patients (30%, 6/20), early onset (40< or = years old) breast cancer patients (41.1%, 14/34), or bilateral breast cancer patients (40%, 6/15). Cumulative incidence of breast cancer by age 70 was estimated to be 78% and 80% for BRCA1 and BRCA2 mutation carriers, respectively, and that of ovarian cancer was 40% and 0% for BRCA1 and BRCA2 mutation carriers, respectively. Family profiles are important determinants of risk for carrying a BRCA1 or BRCA2 mutation. Japanese women with BRCA1 mutation have a high risk of breast and ovarian cancer and those with BRCA2 mutation have a high risk of breast cancer but not ovarian cancer.
Asian Continental Ancestry Group* ; Breast Neoplasms* ; Breast* ; Female ; Germ-Line Mutation* ; Humans ; Incidence ; Mutation Rate ; Ovarian Neoplasms* ; Penetrance