Nihon eiseigaku zasshi. Japanese journal of hygiene
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Nihon Eiseigaku Zasshi · Jan 2011
Review[Physician shortage in Japan: the new postgraduate medical education program and physicians as a human medical resource].
Japan now faces a serious physician shortage. After introducing the new postgraduate medical education (PGME) system and doctor-to-facility matching system, residents shifted their teaching hospitals from university hospitals to non-university hospitals. Because university hospitals had played a central role in allocating physicians to communities, the decrease in the number of physicians at university hospitals has driven this physician shortage. ⋯ However, a simple increase does not solve the problem of physician shortage unless it also addresses the problem of physician maldistribution. Fourth, the number of females entering medicine is increasing, and women constituted 30% of newly certified physicians in 2010. In this era of physician shortage, female physicians are highly recommended as a human medical resource.
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Nihon Eiseigaku Zasshi · Oct 1997
Review[Low-level lead exposure and children's intelligence from recent epidemiological studies in the U.S.A. and other countries to progress in reducing lead exposure and screening in the U.S.A].
From the 1980s many well-designed epidemiological studies have confirmed that low-level, subclinical lead exposure in early life is associated with decrements in children's intelligence. Neurodevelopmental deficits from exposure to a low level of lead have been held to be not only an American problem, but also a worldwide issue in the past decade. Good epidemiological studies were reported from England, Scotland, Germany, Greece, Australia and New Zealand. ⋯ In cases where these levels persist, there should be environmental investigation and intervention. All children with blood levels of 20 micrograms/dl or greater should receive environmental evaluation and medical examination. Such children may need pharmacological treatment.
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Securing access to medical services, controlling costs and improving quality are goals of health care system. Although they are all the same all over the country, each country has its own culture, health care system and health care problems. In the United States, employer-based and individual purchases of private health insurance coverage play a major role, although governmental programs such as Medicaid and Medicare exist for the poor and the elderly. ⋯ However, it is difficult to improve the quality of health care services within the present system. Japan can learn the system about disclosure of health care information from the managed care in the U. S.
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Nihon Eiseigaku Zasshi · Oct 1996
Review[Epidemiology of lung cancer and prevention strategy in Japan].
The incidence of and mortality from lung cancer have been increasing rapidly during recent decades in Japan, and in 1993 lung cancer became the leading cause of death from cancer in males. This increasing tendency is most striking for older age groups, especially those above 70 years of age. The incidence of multiple cancers related to lung cancer has been also increasing. ⋯ When divided by histologic type, above 90% of cases of squamous cell carcinoma and small cell carcinoma can be explained by direct smoking, while this is true for only about 40% of adenocarcinomas. Although the efficacy of lung cancer screening is still controversial, its role in lung cancer control strategy appears to be limited. Therefore, a multi-disciplinary control program, including anti-smoking activity, chemoprevention and early detection by new techniques should be developed.
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Japan was defeated in World War II and almost all of the nation was demoralized by the destruction and damage to much of the nation. The medical and health care system during and before World War II needed to be reformed radically and fundamentally since almost all medical and health institutes were destroyed. On the other hand, many health personnel came back from overseas after the war. ⋯ As for medical care services, many new medical needs have emerged in recent years, including "quality of life," "palliative medicine in terminal care," "establishment of a primary care system" and "comprehensive care connecting health and medical care with welfare" etc. Improved living standards resulting from economic growth, called the "economic miracle" internationally, have helped to bring about a rapid and wide range of change in daily lifestyle, such as eating habits, working conditions and environment. The Ministry of Health and Welfare has made every effort to revise the laws in relation to health and medical care systems, in order to adjust to recent