It was expected to learn about the education system which is based on clinical instruction and clinical agency-University collaboration. The authors visited the British University and NHS General Hospital in order to explore their system of clinical placement. We heard explanation about the systems of midwifery clinical instruction from a faculty member of the university and a hospital midwife and interviewed them. Our discussions on the system of midwifery clinical instruction revealed that there are clear standards and guidelines by the U.K. Government on Midwifery education, in which clinical agency-University collaboration as well as clinical mentor trainings are mandated, while such systems do not exist in Japan. In order for Japan to establish an effective clinical instruction system in midwifery education, it would be essential to establish a system and clear guidelines for collaboration between clinical agency and the university, as well as for educating clinical mentors to guarantee ability for instruction within the midwifery education system.

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［Purpose］ The aim of this study was to investigate the factors influencing the awareness of change in the medical condition of elderly patients requiring care by visiting rehabilitation workers.［Methods］ After reviewing questionnaire survey results from 334 visiting rehabilitation workers, we used multivariable analysis to weigh the factor scores of the respondents’ characteristics and assessment of the change in medical condition as classified into two groups: presence or absence of awareness［. Results］ Comparison between the two groups showed that older age and length of experience of the visiting rehabilitation workers and their experience with respiratory disease were greater in the presence of awareness group. The values of the second, third, and fourth factor scores in the presence of awareness group were significantly lower than those in the absence of awareness group. Logistic regression analysis results showed that age and years of experience of the visiting rehabilitation workers, their experience with respiratory disease, and the third factor, assessment of basic activities of daily living, independently influenced the awareness of change.［Conclusion］ In addition to the length of experience of the visiting rehabilitation workers and their experience with respiratory disease, assessment of vital signs, level of consciousness, respiratory condition, and activities of daily living also clearly affect the awareness of change in the medical condition of elderly patients.

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Development of generic skills in students is required at all universities regardless of field or occupation（ 2011 report by the Central Education Council）. Despite this, a few practical examples or studies in medical schools are found on this topic. The purpose of this study was to clarify students and faculty in perception of career development for first-year medical students. Subjects were 835 first-year students in 10 departments/courses and 73 certified faculty members of Medical School A in Tokyo（ with 149 first-year students and 20 faculty members from the university’s arts and sciences department as controls）. The survey comprised questions on four skill sets（ interaction skills, contemplation skills, seeking skills and description skills） and a subscale measuring career development made up of 16 items. Students gave self-assessment and faculty members were asked about necessity with a four-point Likert scale. The data was analyzed by two-factor mixed subject design analysis of variance. The survey was administered from May 7 to 17, 2014. As a result of study, suggesting the necessity of the training on interaction skills, seeking skills and description skills（ p＜0.05）for their career development of first-year medical students.

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The neural mechanism of controllability of posture and behavior in the bipedal humans for avoiding/protecting falling is highly important as one of the human survival strategies. There have been thus far few functional neuroimaging studies because of the restrictions placed on participants’ movements. Here, we used functional magnetic resonance imaging（fMRI） to investigate the neural mechanism underlying whole body instability, based on the action-observation and self-recognition paradigm. We performed fMRI measurements while 13 adult male subjects viewed video clips of their own and others, in the dynamically unstable, dynamically stable and statically stable conditions, respectively. As a results, the self-specific activity was observed only in the dynamically unstable condition ; the temporoparietal junction, the parieto-insula vestibular cortex, the insular cortex and the anterior prefrontal cortex. This result showed that the neural substrate underlying self-recognition of one’s own body instability consists of the vestibular, emotional, and adaptive systems.

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