The human gut microbiota changes under the influence of environmental and genetic factors, affecting human health. Extensive studies have revealed that the gut microbiome is closely associated with many non-intestinal diseases. Among these, the influence of the gut microbiome on cancer biology and the efficacy of cancer therapy has attracted much attention. Prostate cancer cells are affected by direct contact with the microbiota of local tissues and urine, and a relationship between prostate cancer cells and the gut microbiota has been suggested. In the human gut microbiota, bacterial composition differs depending on prostate cancer characteristics, such as histological grade and castration resistance. Moreover, the involvement of several intestinal bacteria in testosterone metabolism has been demonstrated, suggesting that they may affect prostate cancer progression and treatment through this mechanism. Basic research indicates that the gut microbiome also plays an important role in the underlying biology of prostate cancer through multiple mechanisms owing to the activity of microbial-derived metabolites and components. In this review, we describe the evidence surrounding the emerging relationship between the gut microbiome and prostate cancer, termed the “gut-prostate axis.”

　　The impact of health guidance is recently becoming higher quality health services, and the next task is finding ways to establish a system that delivers higher quality services. Institutions that provide health guidance need to improve their services by analyzing the lifestyle habits and health examination results (e.g., BMI and blood pressure) of their clients. This study conducted simultaneous health and dietary habit checkups so that key elements for guidance (e.g., individual dietary habits, population characteristics, and main tasks) could be shared among guidance providers and be utilized for follow-up guidance. Most subjects were in their sixties or seventies, many of whom were diagnosed with obesity and/or dyslipidemia based on health examination results. Dietary habit evaluations revealed high intake of a main dish among both men and women. Intake of a main dish and a sweet snack was particularly high among men. Many subjects who excessively take in both a main dish and sweet snack were obese with a high percentage of saturated fatty acid-derived energy, indicating that this subgroup needs to be prioritized to receive guidance. Those with an appropriate intake of both a main dish and sweet snack might have consumed inadvisable levels of other dietary components, including luxury food items. However, an individual approach is also required to address the risk associated with intake of a low percentage of protein-derived energy. Similar studies in other populations and other communities are needed to assess whether the characteristics revealed in this study are specific to this particular population.

Introduction : Municipal government scholarships for the purpose of support of rural health & medically underserved areas has increased, but repayment exemption conditions of the scholarships vary. We conducted a survey of scholarships to clarify their impact on physician careers.
Methods : A web-based cross-sectional survey was conducted from November 2013 to January 2014 among municipal governments administering scholarships associated with selective medical school admissions for medically underserved areas in 2013.
Results : There were 59 scholarships administered by 42 municipal governments connected with 53 universities. The mode of the total loan amount was 14.4 million yen. Features of the loan agreements were a high repayment interest rate (over 10%) in 70% of the scholarships and a requirement for lump-sum repayment in 41 scholarships. Three programs allowed free choice of residency training for 3 years or more during the obligatory term, while 48 programs did not allow such choice during the entire obligatory term.
Conclusion : Eighty-percent of the scholarship programs do not allow for the minimum 3 years of basic post-graduate training required by specialty training program guidelines. In order to prevent the anticipated reduction in future applicants to these scholarship programs, appropriate interest rates, repayment rules, and allowance for specialty training are required.

Introduction : Selective admission for medically underserved areas (Chiiki-Waku) has been increasing, but qualifications vary. We investigated the current state of these selective admissions to gain a better sense of their nature and to elucidate problems.
Methods : A web-based cross-sectional survey was conducted among 77 medical schools that accepted applications for selective admission for medically underserved areas in 2013.
Results : There were a total of 1305 applicants for 148 slots at 62 universities. We observed 86 admissions at national universities, and 90 admissions through recommendation/ admissions office-based entrance exams. Thirty programs placed restrictions on employment after graduation, 84 required accepting scholarships, 8 required joining a specific organization as a condition in the pledge and 83 placed limits on place of origin of the applicant. Only 13 programs had special curricula for education in community medicine.
Conclusion : In some Chiiki-Waku, problems such as restriction on employment, the obligation to accept scholarships, and other inappropriate conditions were noted. Definition of students from rural backgrounds in Japan differs from the WHO guideline definition. Few programs offer special curricula covering community medicine.

Introduction : Japanese elderly men tend to refuse social network even if they need to use them. The objective is to explore Japanese elderly men's perceptions of social network including daycare services.
Methods : Qualitative studies using focused group and semi-structured interviews for elderly men more than seventy-five years old who live in Nagi-cho, Okayama, Japan were conducted.. All interviews were recorded and transcribed. Data analysis was done with modified grounded theory approach.
Results : Three categories were made as internal factors (role seeking, adapt aging), relationship factor (female attendance, staff communication), and external factor (transportation, economy).
Conclusion : By conducting intervention focusing on causes of relationships and external factors inclusive of day care services , it may be possible to improve social involvement of elderly men. 10 proposals were made to government.

BACKGROUND: Focusing on the respiratory function for health effect indices, we conducted a cross-sectional study on workers who did and did not handle toner to compare the longitudinal changes. METHODS: Among 116 individuals who worked for a Japanese business equipment manufacturer and participated in the study, the analysis included 69 male workers who we were able to follow up for 4 years. We categorized the 40 workers engaged in toner-handling work as the exposed group and the 29 workers not engaged in these tasks as the referent group, and compared their respiratory function test results: peak expiratory flow rate (PEFR), vital capacity (VC), predicted vital capacity (%VC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume in 1 second as a percent of forced vital capacity (FEV1%). RESULTS: The cross-sectional study of the respiratory function test results at the baseline and at the 5th year showed no statistically significant differences in PEFR, VC, %VC, FEV1, and FEV1% between the exposed and referent workers. Also, respiratory function time-course for 4 years was calculated and compared between the groups. No statistically significant differences were shown. CONCLUSION: Our study does not suggest any toner exposure effects on respiratory function. However, the number of subjects was small in our study; studies of larger populations will be desired in the future.
Asian Continental Ancestry Group ; Cohort Studies* ; Commerce ; Copying Processes ; Cross-Sectional Studies ; Follow-Up Studies* ; Forced Expiratory Volume ; Humans ; Male ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Vital Capacity

Introduction : As one of the strategies for the introduction of collaborative drug therapy management (CDTM) into a community healthcare system in Japan, we constructed a ‘positive list’ which was agreed by a family physician in advance, and subsequently validated the effects on healthcare insurance fees, the number of prescription question and the changes of utilization rate for generic drugs.
Methods : The items that replaced prescription questions with regard to ex post facto approval were defined as ‘Resolved Questions’ in our constructed positive list. By adopting the ‘Resolved Questions’, we then examined the effect on healthcare insurance fees, prescription questions and the changes of utilization rates for generic drugs.
Results : Among all prescription questions accepted from January through May 2012 inclusive, 178 (22.7%) were ‘Resolved Questions’, without there being change in the therapeutic strategies by the prescribing physicians. During this period, 17,455 healthcare insurance fees were reduced. In addition, the utilization rate for generic drugs were increased up to 46.6%.
Conclusion : The reduction of healthcare insurance fees, prescription questions and the increased utilization rates of generic drugs were facilitated by prudent pharmacist judgements based on ‘Resolved Questions’.