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Background: The relationship between educational outcomes and the use of web-based clinical knowledge support systems in teaching hospitals remains unknown in Japan. A previous study on this topic could have been affected by recall bias because of the use of a self-reported questionnaire., Objective: We aimed to explore the relationship between the use of the Wolters Kluwer UpToDate clinical knowledge support system in teaching hospitals and residents' General Medicine In-Training Examination (GM-ITE) scores. In this study, we objectively evaluated the relationship between the total number of UpToDate hospital use logs and the GM-ITE scores., Methods: This nationwide cross-sectional study included postgraduate year-1 and -2 residents who had taken the examination in the 2020 academic year. Hospital-level information was obtained from published web pages, and UpToDate hospital use logs were provided by Wolters Kluwer. We evaluated the relationship between the total number of UpToDate hospital use logs and residents' GM-ITE scores. We analyzed 215 teaching hospitals with at least 5 GM-ITE examinees and hospital use logs from 2017 to 2019., Results: The study population consisted of 3013 residents from 215 teaching hospitals with at least 5 GM-ITE examinees and web-based resource use log data from 2017 to 2019. High-use hospital residents had significantly higher GM-ITE scores than low-use hospital residents (mean 26.9, SD 2.0 vs mean 26.2, SD 2.3; P=.009; Cohen d=0.35, 95% CI 0.08-0.62). The GM-ITE scores were significantly correlated with the total number of hospital use logs (Pearson r=0.28; P<.001). The multilevel analysis revealed a positive association between the total number of logs divided by the number of hospital physicians and the GM-ITE scores (estimated coefficient=0.36, 95% CI 0.14-0.59; P=.001)., Conclusions: The findings suggest that the development of residents' clinical reasoning abilities through UpToDate is associated with high GM-ITE scores. Thus, higher use of UpToDate may lead physicians and residents in high-use hospitals to increase the implementation of evidence-based medicine, leading to high educational outcomes., (© Koshi Kataoka, Yuji Nishizaki, Taro Shimizu, Yu Yamamoto, Kiyoshi Shikino, Masanori Nojima, Kazuya Nagasaki, Sho Fukui, Sho Nishiguchi, Kohta Katayama, Masaru Kurihara, Rieko Ueda, Hiroyuki Kobayashi, Yasuharu Tokuda. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

Objectives The Japan Academy of Midwifery published "2016 Evidence-based Guidelines for Midwifery Care" (hereinafter, this is called "2016 Guidelines"). The objective of this study was to search and clarify about maternity care policies based on 2016 Guidelines among Obstetric Institutions in Japan. Methods The participants of this survey were 3164 institutions; hospitals, clinics, and midwifery birth centers in Japan. This study was self-administered anonymously questionnaire survey and was conducted with mail or web surveys. The questionnaire included 11 maternity care policies that based on "2016 Guidelines". Data was collected through November to December 2016. The ethics committee of St. Luke's International University, Tokyo, Japan (No.16-A062) provided ethical approval. Results 362 institutions participated in the study (the response rate, 80.4%). Few institutions recommended or provided "Folic acid supplementation" (8.3%), "Screening for domestic violence" (6.9%) and "Antenatal perineal massage" (10.6%). Supplementation in pregnancy; Many institutions did not recommend "Vitamin supplementation" (60.1%) for pregnant women. Conversely, "Iron supplementation" was common (66.1%). The health guidance for discomforts in pregnancy; "Foot bath for leg edema" (74.9%), "Massage for leg edema" (78.4%), "Exercise for low back and pelvic pain" (92.5%) and "Taking dietary fibers for constipation" (96.1%) ware very common at each institutions. The health guidance of taking luxury grocery items; About half of the institutions provided "Health guidance for taking alcohols" (52.6%), but "Health guidance for taking caffeins" were provided still 29.0%. There was significant difference about "Antenatal perineal massage" (χ2: 8.870, OR: 1.385, 95%CI: 1.129-1.699, p=0.003) whether institutions provided midwifery care in ambulatory or not. Conclusion Our results demonstrated that there were some gaps between evidence and clinical practice about maternity care in Japan. This study suggested that necessity of diffusion about "2016 Guidelines" and evidence of maternity care. [ABSTRACT FROM AUTHOR]

We evaluated whether a strict fisheries management measure of closure of fishing for recruiting juveniles (glass eels) could have resulted in the recovery of a local population of Japanese eels, Anguilla japonica , when there was no harmonized management of the other life stages, the relevant ecosystem, or local socioeconomic factors (i.e., Ecosystem-Based Management (EBM) approach not applied). The study was conducted in the Kojima Bay-Asahi River system, Okayama Prefecture, Japan, because this prefecture has not permitted commercial glass eel fisheries since 2003, which provides a unique opportunity to conduct a quasi–experimental evaluation of the effects of a glass eel fisheries moratorium. Longline eel fishery data and fishery-independent sampling data indicate that growth-phase Japanese eel (yellow eel) abundance in this water system has not increased, or maybe even decreased, since commercial glass eel fisheries in this area were closed. Based on the results obtained in this study, we concluded that the closure of glass eel fisheries was not a sufficient countermeasure to recover the Japanese eel population in the study area. To conserve and sustainably use Japanese eels, a series of management measures such as habitat restoration and management of yellow and silver eel fisheries are needed along with the control of glass eel fisheries throughout the species distribution range. The EBM approach might be helpful to progress integrated management at appropriate spatial scales. [ABSTRACT FROM AUTHOR]