BACKGROUND: Meals are provided at nursery schools for Japanese preschool children, and this may result in different energy and nutrient intakes on weekdays and weekends. The purpose of this study was to obtain basic information for public nutrition policies in early childhood by examining differences in energy and nutrient intakes of preschool children between weekdays and weekends using meal categories such as breakfast, lunch, dinner, and snacks. METHODS: Energy and nutrient intakes were examined in 761 Japanese preschool children (423 boys, 338 girls) aged 3-6 years attending childcare facilities in seven regions in Japan. Data collection was based on non-consecutive four-day dietary records (two weekdays, two weekend days) in 2019 or 2020. Energy and nutrient intake by meal category were compared using a generalized linear mixed model adjusted for demographic factors. RESULTS: Total energy intake was significantly higher on weekdays for boys (1,478 vs. 1,415 kcal) and girls (1,349 vs. 1,296 kcal) (both P < 0.001). Weekday lunches had higher protein content and essential micronutrients such as potassium, iron, vitamins, and lower fat, saturated fatty acids, and salt, compared to weekend lunches. Similarly, weekday snacks also had significantly higher nutritional consumption for most nutrients compared to weekend equivalents. CONCLUSION These findings suggest that meals at nursery schools, particularly lunch and snacks, result in more desirable nutrient intake in preschool children. On weekdays, children consume meals with higher nutrient density, possibly due to the role of dietitians in menu planning. However, some children still fail to meet the Dietary Reference Intakes for Japanese, indicating a need for improvements in nursery school and home meals. More communication is needed between nursery schools and families, including sharing menus and recipes is essential. The results of this study are of value for development of public health nutrition strategies targeting early childhood.
Humans ; Child, Preschool ; Male ; Japan ; Female ; Energy Intake ; Meals ; Child ; Nutrients/analysis* ; Diet/statistics & numerical data* ; East Asian People

Objective: Non-alcoholic fatty liver disease is common worldwide, and lifestyle modifications are key to its treatment. This study aimed to identify the barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease and to organize the results using the Capability Opportunity Motivation-Behavior (COM-B) model.Materials and Methods: The framework of Arksey and O’ Malley was used in this scoping review. We searched PubMed, Scopus, and the Cochrane Library without language restrictions for reports published up to September 11, 2022, including peer-reviewed literature reporting barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease. Patient-reported barriers were analyzed inductively and organized into the components (capability, opportunity, and motivation) of the COM-B model.Results: The literature search yielded 583 articles, of which seven qualitative studies, four quantitative studies, and one mixed-methods study met the inclusion criteria. Lack of time, lack of information on the diagnosis and management of non-alcoholic fatty liver disease, negative perceptions of the prescribed exercise and diet, physical symptoms interfering with the behavior, presence of comorbidities, and lack of family cooperation were frequently reported as barriers.Conclusion: The results of this study may contribute to the development of appropriate care and education strategies to promote behavioral changes in patients with non-alcoholic fatty liver disease.

Background: We began conducting pain screenings using an in-house version of the “Ease of Living Questionnaire” for patients undergoing initial radiotherapy. Purpose: The purpose of this study was to classify patients undergoing radiotherapy for different medical purposes and to verify the differences in the responses between the groups identified. Methods: The “Ease of Living Questionnaire” was administered to all adult patients with cancer undergoing initial radiotherapy , and the responses were analyzed together with data concerning the patients’ background characteristics that were extracted from medical records. Results: A total of 543 responses to the questionnaire were collected, and the patients were divided into a palliative group (177), curative group (189), preoperative group (19), and postoperative group (158); statistical differences were observed with respect to patient gender, age, and target disease. Mental and physical distresses were more pronounced in the palliative group compared to the other three groups. Although psychosocial need was high with respect to the questionnaire items concerning symptoms and treatments/activities of daily living, the independent sensitivity values of the check fields were 0.29-0.65 and 0.08-0.38, respectively. Intergroup differences were observed with respect to symptoms and treatment/economic need as well as social security/occupational need. Conclusion: In order to gain an understanding of patient needs, we believe that it is necessary to take sufficient action in consideration of the content of free-response answers based on differences in background by treatment purpose.

A community-based medicine program in the postgraduate clinical training system has been offered as a mandatory program since 2004. Training sites range from clinical attachments in rural/remote areas to public health centers in the city. The role of the program director is important for enhancing the community-based medical program and raising resident doctors. Unique training programs have been carried out, such as medical training in the afflicted area of the earthquake/Tsunami disaster area as well as an exchange program between Hokkaido and Kagoshima residents. The Japanese healthcare system is drawing global attention and local demand. Enrichment of the community-based medicine program is vital for the human resource development that makes the Japanese healthcare system innovative and sustainable.

"Quality of education" has various definitions, and the definitions are classified mainly into five categories. Introducing the definition categories of "quality of education" , we analyze what aspects of the postgraduate clinical training system for physicians as an educational program have been reconsidered and redesigned. According to the analysis, we propose to introduce a programmatic assessment, which compose of several assessment methods, for evaluation at each stage of medical education from undergraduate to continuous professional development. Realizing such evaluation, we also propose to introduce a student/trainee assessment from a patient's perspective.

"The Ordinance of Ministry of Health, Labor and Welfare on Japanese Postgraduate Medical Training System" from 2020 was announced to each prefectural governor on July 3rd, 2018. This Medical Training system has been reviewed once every five years, and has been strongly aware of the consistency between the model core curriculum of the undergraduate medical education and the continuing professional development of Japan Medical Association. In this journal, Postgraduate Education Committee in Japan Society for Medical Education has published six installments of a series entitled "Japanese Medical Training System and Medical Education" . We reviewed the series and discussed medical education trends surrounding the postgraduate medical training system and issues in the committee. We will be reporting the information as part of the seventh installment of the series.

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Under the current postgraduate clinical training system for physicians, three principles have been emphasized in its basic tenets; cultivation of character appropriate for physicians, generation of awareness to the societal role of medical science and healthcare, and mastery of basic clinical skills needed to respond appropriately to injuries and illnesses frequently encountered in general practice. In accordance with its quinquennial review rule, the Clinical Training Committee under the Medical Caucus of the Healthcare Professions Council released draft revisions of a notification published by the Director general of the Health Policy Bureau of the Ministry of Health, Labor and Welfare in March, 2018. The document is entitled "On the operation of the ordinance concerning the postgraduate clinical training prescribed in the paragraph (1) of Article 16-2, Medical Practitioners Act" .　A Key distinction of the revised draft is new learning outcomes featuring core values shared by physicians: commitment to physicians' societal mission of public health, altruistic behavior, respect for humanity, and maintaining one's own integrity. Another key distinction is securement of longitudinal consistency in the set of required faculties, from medical school curriculum to continuing professional development programs. Further improvements in systems and environments to enhance devotion to life-long learning are needed.

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Medical education at college is the very first step of life-long learning as a medical doctor. Curricular reforms in Japan took place in the early 21st century, and can be exampled by the development of a model core curriculum, the emergence of the CAT (common achievement test) examination, the development of clinical clerkship and so on. The International accreditation of medical schools has just started spring of 2017. It highlights outcome-based education, which accelerates the connection of undergraduate education with postgraduate training.