Here we present a brief anthology of selected reports produced in a problem-based learning (PBL) course required of medical students in their first year of studies at Juntendo University. None of the reports selected for this anthology deal with medical issues per se, but rather reflect the abilities of students in their first attempts to delve into a new subject and engage in teamwork with fellow students to explore an unfamiliar subject and produce a coherent report on their findings.

Why would this be a useful exercise? After all, there is such a huge body of knowledge and clinical procedures that medical students are expected to absorb over just a few short years. How can we justify time spent on subjects not directly relevant to the practice of medicine or its scientific foundations?

The answer is that we must prepare students for lifelong careers that will involve teamwork and continuous learning. Some of our international readers also need to know that in Japan, students enter medical school straight out of high school. Almost none have experience with self-driven research, as would be required to write an undergraduate term paper in the US. Moreover, while the students often bring valuable teamwork experiences from their club activities in high school (such as in sports or music), teamwork experience in more serious pursuits is frequently lacking. Yet, they will soon be tasked with teamwork aimed at ensuring high quality care for their patients. While the knowledge and skills they are taught during their six years of medical school are important, over the course of their careers their abilities will depend even more on their own active efforts to remain current with medical advances and to improve their skills. Equally important, their patients’ outcomes will depend on their abilities as doctors to cooperate and communicate effectively with other caregivers and administrators.

After 12 years spent passively learning materials selected by their teachers, and with a few more years of similar studies yet ahead of them, it is time for the students to take their first steps in setting their own tasks and learning goals.

In 2015, 14 PBL themes were offered, and within each theme, the students divided themselves into groups of two to four students centered around specific topics, often in the form of a question, chosen or even proposed by the students themselves. The PBLs themselves were conducted over the course of 5 days in early September before the start of the regular fall semester. While the fourteen themes offered included a number centered around the natural sciences, mathematics and medical issues as detailed in the table, the reports included here were all selected from the PBLs tutored by faculty members of the General Education English section, and hence written originally by the students in English. We were quite encouraged by the efforts the students put into their reports, and particularly proud of the four reports below.

Objective: Following the Tohoku Earthquake, residents of the disaster area were encouraged more to “Ganbappe”, which means “Hang in there” in their local dialect, than to “Ganbatte”, which has the same meaning in standard Japanese. This led us to examine what comprises effective words of encouragement.

Design: We first examined what types of words are related to motivation. The words found in previous studies were too simply and obviously differentiated from among those words. Therefore, in this study, we selected words that might have different effects depending on a person’s character and examined how motivations changed as a result.

Method: To verify our research, we sent questionnaires to 142 university students via the Internet and examined how their motivations changed when presented with various motivational phrases. The questionnaire comprised 11 short phrases purporting to contain words uttered by school teachers or athletics coaches. Students evaluated the motivational effects of each phrase by allotting it points from -50 to 50.

Results: We established a hypothesis that the influence of encouraging words would differ by sex and educational background. However, the data demonstrated that a similar tendency occurs regardless of sex and major. Although different words and phrases are used, the data suggest that participants’ experiences and how they have been brought up affect the results.

Conclusion: For this reason, in order to encourage and raise motivation, many factors need to be considered when using motivational words.

This study compared the Test of English as a Foreign Language (TOEFL) Internet-based test (iBT) with the International English Language Testing System (IELTS) in terms of the contents of the test and scale and history of the test. Although the two tests appear similar as they both have the same four sections (reading, writing, speaking, and listening sections), these two tests do not necessarily measure the same abilities. After the comparison of the TOEFL iBT and the IELTS section by section, we found that the IELTS is better than the TOEFL iBT in the reading, listening, and speaking sections, and that the TOEFL iBT is superior to the IELTS in the writing section. We also found that the TOEFL iBT is much more popular than the IELTS in Japan, although the opposite is true worldwide. We considered why the TOEFL iBT is dominant in Japan and suggested measures to make the IELTS the dominant one in Japan, considering that the IELTS is superior in terms of including tasks that simulate daily life tasks. These measures would increase the number of IELTS test centers, reconsider American-oriented thinking of Japanese people, encourage educational institutions to recommend the IELTS more strongly to students, and decrease the IELTS’s test fee.

This paper reviews previous research to show the positive relationship between music and motivation in sports. After defining what motivation means in this paper, the authors review studies investigating the influence of listening to music on motivation to play a sport. The results showed that, by watching music video clips, the participating athletes were able to build strong, successful self-images, which contributed to enhancing their motivation and performance. Based on another set of previous studies, the authors argue that listening to music can promote the secretion of dopamine, which improves motivation and, thus, performance. The authors suggest that students as well as athletes listen to music before an important occasion, such as an exam, to help them become more motivated and perform better.

Objective: This study aimed to examine the ability of barium-confirmed gastroesophageal reflux and the angle of His assessed using upper gastrointestinal series (UGIS) to predict the presence of reflux esophagitis (RE).

Design: A total of 1,628 middle-aged Japanese individuals who underwent a radiographic and endoscopic examination between January 2000 and December 2012 were recruited.

Methods: The receiver operating characteristic (ROC) curves and the area under the curves (AUCs) were used for RE diagnosis according to barium reflux, the angle of His, and their combination. The predictive sensitivity, specificity, and the Youden index were calculated according to the combination of the two indices, and the maximum value of the Youden index was considered as the optimal cutoff value for RE diagnosis.

Results: ROC analysis was performed to estimate the optimal cutoff values of the Youden index for barium reflux and the angle of His. The AUCs for RE diagnosis according to barium reflux, the angle of His, and their combination were 0.76, 0.64, and 0.80, respectively. The optimal cutoff value was an angle of His of 45-46° with barium reflux. The sensitivity, specificity, and the Youden index were 76.3%, 80.4%, and 0.56, respectively.

Conclusion: Our results suggest that barium reflux and the angle of His assessed using UGIS are useful for an early diagnosis of RE.

Objective: This study aimed to explore malignant pleural mesothelioma (MPM) patients’ experiences of post-diagnostic psychological transition.

Design: Qualitative research design was used to investigate MPM patients’ experiences of transition.

Methods: Semi-structured interviews were conducted of five participants with MPM. A phenomenological hermeneutical method was used. Their narratives were translated to the meaning units, they were analyzed to subthemes, themes, and main themes, and identified to the transition attitudes and actions.

Results: Four main themes of transition attitudes were identified: “Attempting to continue independent living and to manage symptoms”, “Accepting the incurability of the disease in spite of being overwhelmed”, “Deciding on treatment and life through uncertainty”, and “Maintaining positive relationships with family”. These themes were influenced on six main themes of transition action: “Creating new self-care regime”, “Gathering information about asbestos exposure and MPM”, “Preparing for dying through self-experience or the experience of other patients”, “Receiving emotional support from family, coworkers, care providers”, “Developing positive rapport with hospital staff toward effective treatment”, and “Awarding of compensation”.

Conclusions: Psychological transition was identified as changes, disruption and reconstruction of aspects of the patients’ physical symptoms management, acceptance of MPM and dying, decision making, and family relationships. A positive psychology transition may result from being able to ease symptoms, obtaining useful information resources, sharing in decision making, and receiving care, including family support. This study has established a framework of analysis, which can be applied to clinical responses and to future studies with larger statistical samplings.

Cancer in its early stages are approximately 1 cm. Actually, we can now detect cancers are as small as 0.5 cm, and it is safe to say that almost all cancers up to 1 cm can be completely and effectively treated. The weight of a 1-cm cancer is 1 gram. The size of a single cancer cell is about 20 microns. This means that it takes about 10 9 cancer cells to make up a 1 cm-cancer. In a time where a cancer with 10 9 cells can be treated 100%, you can imagine how silly it is for a scientist to be desperately looking for a single cell of cancer. It is said to take about 20 years for a clinical cancer to develop. If someone discovers cancer at the age of 40, it means that cancer budded when the patient was 20 years old. In fact, only one in thousands of cancer buds fully blossoms.