Background: Clinical clerkship training does not always provide an ideal environment for self-regulated learning (SRL) among medical students, and how students manage their learning during this period remains unclear. This study aims to explore how medical students perceive their SRL during clinical clerkship training in the emergency medicine department.　Methods: Semi-structured interviews were conducted with 28 fifth-year medical students at University A. Thematic analysis was performed using the SRL cyclical model as a theoretical framework.　Results: Eight themes were identified, including the emergence of professional identity through clinical training, the flexible selection of learning goals and tools in uncertain environments, and the appropriate planning of next-day goals and learning strategies through dialogue.　Discussion: The findings suggest that dialogue with colleagues, participation in team-based care, and clerkship structures grounded in the cyclical SRL model positively influence the transformation of students' perceptions of SRL.

This study aimed to identify new competencies for an educational program designed to cultivate the ability to improve health professions education from an overview and interactive perspective, in response to its increasing complexity. At the Center for Medical Education Development, Gifu University, a competency framework was drafted based on systems thinking, design thinking, and adaptive leadership. A questionnaire survey was conducted to assess the needs of potential participants. The survey targeted 138 medical university staff members who attended the 91st Medical Education Seminar. Multiple regression analysis revealed that willingness to participate was significantly associated with being a healthcare professional and having strong motivation for collaborative improvement. Based on these findings, four competencies were identified: (1) organizational analysis, (2) problem evaluation, (3) improvement design, and (4) collaborative improvement. This study introduces a marketing-informed perspective into FD/SD development, offering a learner-centered approach to educational design and highlighting the importance of collaboration between healthcare professionals and administrative staff in driving educational reform.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Intracranial germ cell tumor is more common in Asian countries, including Japan, than in Western countries. The disease is characterized by juvenile onset with a mean age at diagnosis of 18 years. Most patients with intracranial germ cell tumors in the basal ganglia manifest paralytic symptoms, but few of these patients have been reported to have long-term progression of motor paralysis and rehabilitation interventions.A young male patient was diagnosed as having right basal ganglia germinoma and left hemiplegia at the age of 10 years. He received intervention and long-term follow-up for upper limb function. He underwent hybrid assistive neuromuscular dynamic stimulation therapy at the age of 14 years and modified constraint-induced movement therapy (modified CI therapy) at the age of 20 years. With such a gradual neurorehabilitation intervention, the Fugl-Meyer assessment score for the upper limb improved from 41 to 58 points, and the frequency of use of the paralyzed hand also improved. We hope that this report will provide guidance when considering treatment options for similar diseases in the future.

Intracranial germ cell tumor is more common in Asian countries, including Japan, than in Western countries. The disease is characterized by juvenile onset with a mean age at diagnosis of 18 years. Most patients with intracranial germ cell tumors in the basal ganglia manifest paralytic symptoms, but few of these patients have been reported to have long-term progression of motor paralysis and rehabilitation interventions.A young male patient was diagnosed as having right basal ganglia germinoma and left hemiplegia at the age of 10 years. He received intervention and long-term follow-up for upper limb function. He underwent hybrid assistive neuromuscular dynamic stimulation therapy at the age of 14 years and modified constraint-induced movement therapy (modified CI therapy) at the age of 20 years. With such a gradual neurorehabilitation intervention, the Fugl-Meyer assessment score for the upper limb improved from 41 to 58 points, and the frequency of use of the paralyzed hand also improved. We hope that this report will provide guidance when considering treatment options for similar diseases in the future.

Regular physical activity has been regarded as a possible means to minimize the adverse physiological changes associated with aging, as well as to contribute to mental health and well-being in later life. To encourage increased participation in exercise among elderly people, and to emphasize the value of exercise in geriatric health care, this article provides an overview of the effects of primary care based physical activity on healthy aging. It is clear from the number of recently published papers on this topic that daily participation in 30 minutes or more of moderate physical activity should be recommended for elderly people. The results of physical activity interventions focusing on balance and resistance training in both home- and group-based exercises suggest that it is possible to improve physical functions and to prevent falls and disabilities in daily living. Multiple-element interventions (e. g., advice, as well as strategies to increase self-efficacy and motivation, and to eliminate barriers to participation), tailored to individual activity preferences, are likely to be more successful than more prescriptive single-focus interventions. A home-based physical therapy program can successfully enhance the independence of the frail elderly in community dwellings.