1）We instituted the “CHANGE Nagasaki University Hospital” project to improve both management and medical education and to boost the number of physicians recruited to this hospital.
2）We first identified the physicians’ problems and complaints via a questionnaire. Next, focusing on the most common complaints, we reduced secondary duties and methodically improved the educational environment by employing the a– b–c–d–strategy, which is based on the principles of medical education.
3）As a result, both, the hospital’s economic growth and the recruitment figures for resident physicians have increased continuously over the past 4 years.

Introduction : We initiated an ambulatory care training program at five community hospitals in Nagasaki, including hospitals on remote islands, for the residents of Nagasaki University Hospital. We examined the educational effect of the ambulatory care training program in meeting the achievement targets for clinical training.
Methods : The study included all residents (n=49) working in Nagasaki University Hospital in 2012. Following completion of the ambulatory care training program, the residents answered a questionnaire on the number of patients and their symptoms, inaddition to a self-assessment, and assessment by their supervisor.
Results : The mean number of patients seen was 3.29 persons / training session. The number of symptoms to be encountered, which are established by Ministry of Health, Labour and Welfare, was positively correlated with the total number of patients seen. Although residents initially had a low rating of self-assessment on diagnosis or treatment, this rating tended to increase with time. The gap in levels on assessment of history taking, diagnosis, or treatment by residents versus those by the supervisors reduced with time in the program.
Conclusion : Our ambulatory care training program is an effective program for meeting the achievement targets in clinical training for residents.

OBJECTIVES: In recent years, transboundary air pollution from mainland East Asia has led to growing concerns about air pollution in Japan. Air pollution is reportedly associated with the exacerbation of respiratory diseases. In this study, we assessed the effects of air pollution on respiratory symptoms and the health status of participants with and without chronic respiratory diseases. METHODS: Participants (n=2753) with and without chronic respiratory diseases who visited healthcare facilities in Japan during February from 2010 to 2015 filled out a self-report questionnaire regarding their symptoms and perceived health status. Participants were followed up during April-May and June-July. RESULTS: Oxidant concentrations were associated with respiratory symptoms, overall health, and quality of life (QoL). Suspended particulate matter (SPM) and particulate matter <2.5 μm levels were associated with physical fitness; SPM was also associated with QoL. Recent experience of an Asian sand dust event had a significant effect on allergic symptoms, change in health, and QoL. CONCLUSIONS Respiratory symptoms were more strongly affected by oxidants than by other pollutants. Significant associations of air pollutants were found with a comprehensive range of items related to perceived health status, including overall health and QoL. Although the effects of air pollutants on respiratory symptoms and health status were more apparent among patients with respiratory diseases, the adverse effects of air pollutants were significant even among participants without such conditions.

The mortality rate of pediatric out-of-hospital cardiac arrest is more than 80% in Japan, which is markedly higher than that in adults. Basic life support (BLS) by bystanders is essential for preventing sudden cardiac death. In the model core curriculum for pharmaceutical education in 2024, students must acquire the ability to ensure public health. As part of our educational policy, pharmacy students provide a workshop on infant BLS. This workshop is incorporated after the PUSH course, an authorized training program for BLS focused on chest compressions and AED use of people over elementary school age, for convenience. We herein investigated whether infant BLS training promoted the comprehension of and motivation to perform BLS for infants and assessed the educational relevance of pharmacy students serving as instructors of the BLS training course. Questionnaire responses were obtained from participants before and after the workshop. The majority of participants were college students and childcare workers. Knowledge of infant BLS by childcare workers was significantly more extensive than that by the other participants; however, overall understanding of infant BLS and the motivation to contribute to it increased irrespective of participant backgrounds. Overall improvement was also observed in the items necessary to implement BLS excluding artificial ventilation even though the instructions were given only by pharmacy students. The present results demonstrate that infant BLS training effectively enhanced public motivation to perform BLS for infants with cardiac arrest.