In recent years, workers have shown a tendency to suffer increasing amounts of stress, and over 60% claim to feel much anxiety towards their jobs. Problems of psychological health are having an increasing impact on workers, their families and their communities. Furthermore, regular health checks are uncovering health problems in more workers each year, indicating an urgent need for measures to promote psychological and physical health. The aim of our research was to assess current job-related lifestyle behaviors, eating behaviors and stress response and to examine the relationships between them. In August 2006, 980 employees from retail business Company A were given self-assessment surveys (response rate: 63.7%). Excluding those which were left mostly incomplete, a total of 624 usable responses were received and examined. Examination of the relationships between stress response and various lifestyle behaviors showed significant correlations of stress response with eating behavior, exercise and body image satisfaction. The variables that had high correlations with psychological stress responses were psychological workload, interpersonal relations at work, relationship with superiors, lifestyle satisfaction, cognitive restraint and emotional eating. On the other hand, the variables whose correlations with physical stress response were high were psychological workload, amount degree of skill use, lifestyle satisfaction, uncontrolled eating and emotional eating. Not only is there a need for behavior modification support to improve lifestyle behaviors, but assistance for increasing support from superiors in the workplace is also essential for stress management. In addition to the clear need for effective supervisor training, various long-term education and consultation programs for employees and their families should also be considered.

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Introduction
This study aims to clarify how patients and local residents regard physicians and medical care in light of the ongoing nationwide tendency of internists to unexpectedly abandon their posts in local community hospitals.
Methods
The subjects of this study were citizens who chose to continue visiting a community hospital in X City after some of its internists recently left their posts in order to return to their previous hospitals. A questionnaire survey was conducted by focus-group interviews of two patient groups.
Results
Three hundred and ninety-nine responses were judged valid. The causative factors cited by the respondents for the internists’ abandonment of their jobs were: the college or university system (81%), the national institutions (79%), and the nation’ s hospital system (72%). Eighty-eight percent of the respondents observed that internists had done the best they could, while 88% pointed out that internists could not avoid changing their workplaces, 96% wanted internists to exert their utmost efforts for their patients, and 85% found internists trustworthy.
Conclusions
Patients affected by internists' job changes were actually inconvenienced by these, and considered it a matter of course that the results should have meant some loss of freedom for themselves. Moreover, it was suggested that that the physicians had lost their trust in the medical organizations, and the patients were left with very mixed emotions about the physicians. Many patients considered that the practice of medicine is a vocation, and, even though they experienced the physicians' withdrawals from their posts, they still expected a humane attitude in the doctors and communication with them, and they trusted them. However, there were some patients who regarded medicine as a service industry, so that it was suggested that there may be a change in the nature of the trust that patients have in doctors.

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OBJECTIVE: To describe gender differences in job satisfaction, mental health and work conditions of Japanese hospital internists
METHODS: A self-administered, mailed survey was conducted among hospital internists throughout Japan. The survey included questions such as job satisfaction, time allotted for an ambulatory patient, and work environments.
RESULTS: Two hundred thirty-four hospital internists were eligible (59 women). Female internists allotted more time for each patient in an ambulatory care setting than their male colleagues (new patient/consultation: P<0.01, routine follow ups: P=0.046). Female internists worked continuously for as long as their male colleagues when they were on night duty (average: 31.1 hours), but their replies indicated that they were not able to maintain continuous high-quality care for as long as the male internists (-4 hours, P=0.02).
CONCLUSIONS: Female internists allotted more time for each ambulatory patient, and their replies showed that they were able to maintain quality care continuously for less time than were the males.

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[in Japanese]

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Introduction
There are about 3,000 facilities for the elderly (elderly facilities, EFs) where physicians are employed to manage the health of the elderly in Japan. To date, neither a system nor a continuing educational program has been developed for certifying or supporting physicians in the management of EFs. Hitherto, various medical problems have been reported in EFs. Physicians serving in them are required to maximize the safety of the elderly with limited financial support and medical costs.
Methods
Continuing educational needs for EF physicians were elucidated by qualitative methods, with reference also to their practical needs and preferred learning styles, via questionnaires distributed in 35 EFs in Hyogo Prefecture (response rate: 31%).
Results
The results showed that relevant and complementary educational needs were required for: (i) diagnosis of dementia, (ii) management of the behavioral psychological symptoms of dementia, and (iii) familiarization of the medical staff involved in elderly care. The most favored learning styles involved lectures, textbooks and journals. In contrast to those 40% of physicians who preferred to use educational web sites, those with more than 40 years of experience in medicine tended not to.
Conclusion
Relevant complementary and supporting educational programs based on the results of this study should be developed for physicians at EFs to facilitate provision of health care.

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As a result of introducing swallowing rehabilitation at a special nursing home for the elderly, a resident became able to take food orally for the first time in about 4 years since having a PEG tube inserted. Further, the resident's FIM, FG, and DSS values improved to some extent. While nutritional care using the PEG tube is recognized as a long-term enteral nutritional therapy, the tube is mostly used as a “PEG tube for survival” and scarcely used as a “PEG tube for eating”, which indicates a PEG tube for supporting oral ingestion. The result indicates that it is preferable to use the PEG tube “for eating” in addition to its use as an option for long-term enteral nutritional therapy. The result also indicates the need to conduct, with the cooperation of nurses and nursing care workers, the nutritional care and regular follow-ups of all nursing home residents, as well as to maintain and improve the residents' swallowing function and their activities of daily living (ADL) by continuing swallowing rehabilitation, oral care, and measures against gastroesophageal reflux disease.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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 This article summarizes the history of the modern Japanese healthcare system from the viewpoint of medical education, with emphasis on the role of general medicine and its core values as embraced by the members of the Japanese Society of General Medicine. The introduction of a German-based system, the role of universal national health care resulting in accessible healthcare, and the abolishment of American-type internships during Japan's period of student activism are among the topics covered. General medicine in Japan has been built upon the foundation of the Japan Society for Medical Education and the Japanese Society of General Medicine. The recent introduction of mandatory postgraduate clinical training for all medical graduates has alerted clinician-educators to the importance of competency-based approaches in medical professional education, especially in the areas of patient-centered care, team approaches, evidence-based medicine (EBM), and quality and safety. Generalist physicians should assume an active role as frontrunners in the current global trend toward healthcare reform, which requires healthcare providers be accountable and transparent in their professional activities.

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