We attempted the paperless distribution of information in the field of education using QR codes representing the URLlinks of files in online cloud storage. We proposed a method for individuals to receive lecture materials in advance by scanning QR codes with a smart device, such as a smartphone, and receiving handouts via electronic media. They could receive the information via electronic media smoothly, allowing sufficient study and preparation before the lecture. We found this method to be simple, inexpensive, and a useful technique for sharing information.

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　　In recent years, the concept of social capital has been gaining attention. We conducted a quantitative survey to explore the social capital in mountainous regions. A questionnaire asking about personal attributes (10 items) and social capital connection (36 items) was distributed to 682 people (342 living in mountainous regions and 340 living in urban areas). Factor analysis identified four factors as being derived from urban areas: 1. quality of neighborhood relations, 2. attachment to the community, 3. coexisting with nature, and 4. trust. Intimate human relations in the mountainous region was suggested to foster participation in community activities, and this might be due to an underlying specific lifestyle in mountainous regions. The social capital of the mountainous region was characterized by a high degree of intimacy, similar to findings from previous research. In mountainous regions, natural environmental factors may be related to social capital.

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　　The environment of working women is changing dramatically, and therefore corresponding health management modalities are required. This article retrospectively evaluated health management issues of female workers, including age and industry difference, from the perspective of gynecological examination. Regarding menstrual symptoms, irregular menstruation was common in educational and medical workers in their 30s, and dysmenorrhea was common in medical care professionals in their 40s. The prevalence of menopausal disorder was high in manufacturing and clerical workers. Thickness of the endometrium was abnormal in medical, manufacturing, and clerical workers. Thus, differences in these abnormalities were found across industries, with apparent involvement of a unique work environment and stress. For female workers, detailed consideration is needed of women’s health issues from industrial and medical viewpoints including gender sensitivity, disease susceptibility according to age, and working environment.

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　　The aim of this study was to elucidate the difficulties experienced in home-visit nursing care from the viewpoint of work characteristics and to examine preventive methods and countermeasures. We conducted semi-structured interviews with 13 visiting nurses. Types of difficulties were selected from the interview data and qualitative analysis was performed. These were classified into 19 subcategories and 7 categories based on the total 122 responses obtained. The types of difficulties experienced in home-visit nursing care were categorized as follows. Difficulties related to visiting patients alone included (1) difficulties due to visiting patients alone and (2) anxiety and difficulties due to a lack of knowledge of the techniques necessary for home-visit nursing care. Difficulties due to the working environment included (3) difficulties caused by work systems in the workplace, (5) difficulties in collaborating with doctors, and (6) difficulties resulting from interpersonal relationships at work. Difficulties considered due to a change in the individual’s age and physical condition included (4) difficulties from excessive physical demands and (7) difficulties in managing both work and household responsibilities. Therefore, countermeasures for difficulties experienced in home-visit nursing care must be examined from the perspective of work characteristics, work environment, and work/life balance.

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　　Establishment of a new graduate education program is required. This is because the number of newly appointed pharmacists in our hospital has recently been increasing in line with business expansion of the pharmaceutical department. In 2013, we implemented a freshman training evaluation table to crosscheck items mastered during freshman training. In 2014, we introduced a communication form where trainees offer work-related feedback and ask questions and trainers provide comments. To verify whether the evaluation table and communication form are being utilized effectively, we conducted a survey on their use and the content of the form among newly qualified and experienced pharmacists. Regarding the evaluation table, there were many comments received from trainees and trainers, such as the trainee should state their degree of understanding for each item and show them to the trainer. This will likely enhance trainees’ understanding by identifying their degree of understanding and filling any gaps. Many trainers suggested that pharmacological knowledge be included in the table. Regarding the communication form, trainees mentioned that the form was effective in helping them reflect on their daily assignments. Trainers recognized the importance of identifying trainees’ degree of understanding. It may also be possible to identify trainees’ degree of understanding by utilizing the communication form and the evaluation table in combination. The survey results showed the effectiveness of both the evaluation table and communication form, with the need to review the content of the form, the submission method, and the submission interval for further improvement.

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　　We report here a case of residual pain in the anterolateral part of the leg after total knee arthroplasty where the patient had difficulty recovering ambulatory function. The pain in the anterolateral part of the leg was considered to have occurred in combination with joint dysfunction, such as limitation in the range of motion of subtalar joint pronation and associated lateral thrust, as well as tendency towards the “no heel off” gait that is characteristic of knee osteoarthritis. Physical therapy and insole therapy performed to improve the range of joint motion and to correct the lateral force resolved pain in the short term and enabled the patient to resume activities including long-distance walking, weeding, and agricultural work. The possibility of developing pain in the lateral aspect of the leg after total knee arthroplasty due to impaired joint function and malalignment should be considered and physical therapy provided when needed.

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　　An 18-year-old woman with urinary incontinence, and genital rash since childhood visited our urological clinic after researching her symptoms online and learning they may be caused by ectopic ureter. Magnetic resonance imaging revealed a left ectopic ureter derived from a hypoplastic kidney in the retroperitoneal space, and the ectopic ureter opened directly into the vaginal canal. Retroperitoneoscopic nephrectomy was performed and she became continent soon after the operation.

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　　Despite the popular perception among many Japanese persons that being surrounded by one’s personal community (family) at the end of life is an ideal way to die, a regional visiting nursing service station reported that only 40% of their clients died at home in 2014; most of their clients’ families chose to move these homecare patients to a medical or similar facility during the end-of-life period. This study investigated the views of key family caregivers on the location of care and final life events during the end-of-life period, and to discuss the role of visiting nurses. Results of interviews with 40 key family caregivers ｘ revealed that in regard to current caregiving conditions, most respondents ( > 50%) reported providing care but feeling burdened. Also, 70% of respondents reported considering places other than home for end-of-life care and final life events. To explain the reasons for these answers, many interviewees reported no-one was available to provide care and experiencing general anxiety about the process. Regarding potential differences in the understanding of these issues between patients and key family caregivers, about 50% of respondents thought understanding was the same and 25% reported that they didn’t know. Given that key family caregivers often feel burdened by caregiving, it is important for vising nurses to provide them mental health support as part of nursing care delivery. Visiting nurses can help identify anxiety among caregivers, and sharing their experience and offering practical advice about caregiving and support at the end of life has great potential to help these caregivers cope with the challenges. In addition, when choosing where to die, communication between patients and key family caregivers is also important, and these issues should be discussed among all care providers. The results of this study suggest that facilitating opportunities for open communication and decision-making is a vital task for visiting nurses.

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