1) In the field of adult education, there is a lateral relationship of “learning/teaching” between learners and teachers. And the both collaborate for the purpose of “the attainment of the most desirable learning activity” as the subject of learning and the subject responsible for the facilitation of learning.
2) Adult learners have peculiar features in each of the following aspects;‘self-concept’, ‘learning experience’‘the readiness for learning’‘the orientation for learning’‘the motivation for learning’.
3) Self-directed learning is based on the idea of andragogy (the art and science of helping adults learn), and the learners actively and mutually make up their learning plans and put them into practice themselves.
4) Most of the lifelong learning activities in present Japan can be divided into three types (or stages):‘Teacher (and others)-directed learning’, ‘Self-directed learning’ and ‘Self-directed and Mutual transforming leaning’. And in each, the different roles of educators are reguired.
5) The values of adult education such as ‘equality’‘sympathy’‘cooperation’‘mutuality’ and ‘educativeness’ should be consciously shared between learners and teachers in the professional field and in the process of professional training.

Objectives: The first objective of this study was to classify men aged 40-74 yrs with metabolic syndrome (MetS) according to daily rice intake, and the second was to investigate physical measurements, physiological examinations, blood biochemical assays, intake of food other than rice and lifestyle and environmental factors in the study group.
Methods: We analyzed data from 6095 men aged 40-74 yrs who had undergone full medical examinations. The men were classified into 3 age groups: (1) 40-49 yrs, (2) 50-59 yrs, and (3) 60-74 yrs. The men were classified further into 3 groups according to daily rice intake: group 1 (≤300 g), group 2 (300-450 g), and group 3 (≥450 g). The relationship between daily rice intake and the following factors was analyzed in the three age brackets: (1) physical measurements including waist circumference, (2) physiological measurements, (3) serum biochemical indices, (4) whether or not the person was taking medication for hypertension, diabetes mellitus or serum lipid abnormalities, (5) lifestyle, and (6) consumption of foods other than rice.
Results: Daily rice intake was related strongly to the occurrence of MetS in all three age brackets. Multiple logistic regression analysis showed (1) a significant increase in the odds ratio for MetS (1.461 times) for group 3 compared with group 1 in men aged 40-49 yrs and (2) a significant increase in the odds ratio for MetS (1.501 times) for group 3 compared with group 1 in men aged 50-59 yrs. However, there was no significant difference in the odds ratio for MetS among rice intake groups in the 60-74 age bracket.
Conclusion: In men aged 40-59 yrs, daily rice intake strongly influenced the incidence of MetS, whereas in men aged 60-74 yrs, there was no relationship between daily rice intake and MetS.

The external preparation Metronidazole (MTZ) is reported to be useful in controlling the malodor associated with advanced and recurrent breast cancer patients. We prepared two different MTZ external preparations, a 1% MTZ Hydrophilic Ointment and a 0.8% MTZ Carbopol Gel. These preparations were then used to control malodor associated with breast cancer and the results were clinically evaluated. Malodor disappeared within 1 week of administration of either preparation and no adverse reactions were observed. These MTZ external preparations were thus found to be useful in the elimination of malodor as part of the treatment of those patients with advanced and recurrent breast cancer.

Recently, supplements for athletes are being increasingly used. To clarify the current status of supplement intake, we conducted a survey in female university long-distance runners.
An anonymous questionnaire survey was conducted in runners who participated in the 18th Japan Inter-University Women's EKIDEN Championship, We investigated 99 respondents.
The survey showed that 86 runners (87%) took supplements. Iron was most frequently taken (68 runners, 69%) . The common purpose was to reduce fatigue (amino acids, vitamin C) and prevent ane mia (iron) . However, some supplements were taken after their effects were realized, while others were taken without an effect. In some cases, the purpose was not consistent with the effects. Most runners (73%) purchased supplements in shops stores. Fifty percent of them took supplements for supplementation of nutrients deficient in diets. More than 50% of the runners obtained information on nutrition from their coaches.
Furthermore, most runners began to take supplements when they were senior (55 runners, 56%) or junior (31 runners, 31%) high school students. About 70% of them have taken iron. In the highest percentage of them, their coaches recommended the use of supplements.
The results of this survey showed that most female university long-distance runners took supplements, and that a high proportion of them began to take them when they were senior or junior high school students, suggesting the widespread use of supplements among young athletes. In addition, their instructors markedly influenced the runner's nutritional outlook, by being the source of information on nutrition.

Background: In Japan, although clinicians have been extremely interested in conducting clinical research, the shortage of clinical researchers is a serious problem. Therefore, it is important to explore barriers to conducting clinical research.1) We mailed a cross-sectional survey to hospital managers asking about their interest in and barriers to conducting clinical research and training clinical researchers at their hospitals.2) Of 810 eligible hospital managers, 301 completed questionnaires (response rate: 37.2%).3) The managers of university hospitals and national medical centers were more interested in conducting clinical research than were managers of other hospitals.4) Furthermore, 60.6% of managers of university hospital and 18.8% of managers of other hospitals reported the need to employ physicians who specialized in clinical research. However, given public research grants, about 50% of hospital managers were willing to employ research residents.5) Our results suggest there are still barriers to conducting clinical research, such as a lack of time set aside for clinicians and specialists to teach clinical research. A substantial strategy is needed to address the shortage of clinical researchers in Japan.

Liverpool Care Pathway (LCP) Japanese version was implemented to electronic medical chart (FUJITSU HOPE/EGMAIN-FX®). The processes were needed as follows; preparation of each templates (criteria for use of the LCP/initial assessment, ongoing assessment, and care after death), preparation of pathway/regimen, incorporation of the templates to the pathway and approval in our hospital clinical pathway committee. One problem we encountered was whether to choose an Excel or a template format for each assessment sheet, and the template format was selected as it presented us with a higher degree of convenience, since each field can be expanded into a table on the screen without scrolling and there is little limitation in the letters of the valiance records that can be used in the template format. The complexity of the three records, “the pathway”, “SOAP & focus” for recording opioid use, and “the progress sheet” for recording vital signs, in addition to the inability to expand enough to capture the same field and show changes in the daily pathway over time through night and day work shifts remain a challenge and need to be improved in the future.

1) Japan Society for Medical Education launched a committee for the graduate education of medical educationists in Japan. The committee proposed a direction toward establishing the system, by way of discussion among the members, needs assessment, information gathering of overseas master courses, and discussion at the open meeting.2) To promote medical education in Japan, we should establish 2 systems concurrently: (1) a graduate education for medical educationists who have a broad base of theories and can lead future medical education, and (2) a broader certificate system for medical teachers who have good practical teaching skills.

1) The committee for the graduate education of medical educationists, Japan Society for Medical Education, investigated needs for the education system of medical educationists.2) A questionnaire was sent to 1831 leaders in healthcare education and the society members, and 644 replied (recovery rate 35.2%). Fifty % of the respondents agreed the necessity of medical educationists. Certificate level was most popular, however, master and PhD degrees were also considered to be necessary. 3) These results support the establishment of educational system for medical educationists in Japan.

1) A BLS training program was held for the first-year students of Tokai University School of Medicine in 2007/08.
2) The training program was based on the objective structured clinical examination. In 2007, our faculty directly instructed first-year students. In 2008, under the guidance of faculty members, fifth-year medical students doing clinical clerkships served as student-instructors for teaching first-year students.
3) To assess the BLS training program, questionnaires were completed by both the first-year students and the fifth-year students. The results of the survey showed that all students participated in this program with high motivation and intensity. The first-year students rated the guidance given by student-instructors more highly than that given by faculty members. Moreover, the program appeared to be enjoyable and challenging for the fifth-year medical students. Thus, the preceptor-based BLS training program (the Yanegawara method) potentially motivates both first-year and fifth-year medical students.

Objectives: Despite the fact that the total energy intake of Japanese people has decreased, the percentage of obese people has increased.This suggests that the timing of meals is related to obesity.
The purpose of the study was to investigate the relationship between the timing of meals and obesity, based on analyses of physical measurements, serum biochemical markers, nutrient intake, and lifestyle factors in the context of Chrononutrition.
Participants and Methods: We analyzed data derived from 766 residents of Toon City (286 males and 480 females) aged 30 to 79 years who underwent detailed medical examinations between 2011 and 2013. These medical examinations included. (1) physical measurements (waist circumference, blood pressure, etc.); (2) serum biochemical markers (total cholesterol, etc.); (3) a detailed questionnaire concerning lifestyle factors such as family structure and daily habits (22 issues), exercise and eating habits (28 issues), alcohol intake and smoking habits; (4) a food frequency questionnaire based on food groups (FFQg);and (5) a questionnaire concerning the times at which meals and snacks are consumed.
Results: The values for body mass index (BMI) and waist circumference were higher for participants who ate dinner less than three hours before bedtime (<3-h group) than those who ate more than three hours before bedtime (>3-h group). The Chi-square test showed that there was a significant difference in eating habits, e.g., eating snacks, eating snacks at night, having dinner after 8 p.m., and having dinner after 9 p.m., between the <3-h group and the >3-h group.
Multiple linear regression analysis showed that skipping breakfast significantly influenced both waist circumference (β = 5.271) and BMI (β = 1.440) and that eating dinner <3-h before going to bed only influenced BMI (β = 0.581).
Conclusion: Skipping breakfast had a greater influence on both waist circumference and BMI than eating dinner <3-h before going to bed.