Medical Students Learning from a Problem Based Learning (PBL) Style In-home Care Course: A Qualitative Analysis of the Reports / 日本プライマリ・ケア連合学会誌

<p><b>Introduction: </b>The University of Tsukuba has a one-week in-home care course combining a problem-based learning style tutorial and lectures in the comprehensive community-based learning curriculum for 2^nd year students. This study aimed to investigate what medical students are learning concretely from this course.</p><p><b>Methods: </b>We performed a qualitative date analysis of the contents of all 111 student course reports written in the free description using a modified Steps Coding and Theorization method employing the framework of patient-centered clinical method (PCCM).</p><p><b>Results: </b>Medical students learned with keen interest based on their experiences and in the framework of PCCM such as 'Exploring health, disease and the illness experience', 'Understanding the whole person'. These processes led to the awareness of responsibility as a physician.</p><p><b>Conclusion: </b>The in-home care course in the classroom may provide medical students with an opportunity to become aware of their responsibility as a physician.</p>

Prevalence of Sleep Apnea Syndrome in Japanese Patients with Persistent Fatigue / General Medicine

<b>Background:</b> Sleep apnea syndrome (SAS) is a common medical condition with significant adverse effects; however, it remains undiagnosed in many individuals. This study was conducted to assess the prevalence of SAS in fatigued subjects and to elucidate the factors associated with SAS.<br><b>Methods:</b> From March 2008 to March 2011, a cross-sectional, observational study was conducted in patients with persistent (≥1 month) fatigue. Patients with known causes of persistent fatigue were excluded. Data on patient characteristics (e. g., blood pressure, neck circumference, etc.) and overnight pulse oximetry were collected. SAS was defined as a 3% oxygen desaturation index (ODI) of 15 or more.<br><b>Results:</b> Among 46 subjects, the prevalence of SAS was 6.5% (95% CI, 1.4-17.9%). SAS was significantly more prevalent in patients with high systolic blood pressure (≥140 mmHg) than in patients with normal systolic blood pressure (<140 mmHg) (33.3% vs. 2.8%, P=0.049). Even after adjustment for age and sex, high systolic blood pressure showed a statistically significant association with SAS.<br><b>Conclusions:</b> Promoting awareness about SAS could be necessary in patients with persistent fatigue, especially in patients with high systolic blood pressure.