Yukinori Nagakura

INTRODUCTION: In Japanese pharmacy education, success on the National Pharmacist Examination is a key objective. This study evaluated learning gain across face-to-face, mixed-attendance, and live online participation patterns in a four-month HyFlex National Pharmacist Examination preparation course under controlled conditions. METHODS: Sixth-year pharmacy students at Musashino University, Tokyo, Japan, participated in a four-month HyFlex course and chose their attendance mode for each session. Students with ≥90% attendance who completed the pre- and post-course examinations were classified as face-to-face (≥75% in-person attendance), live online (≥75% online attendance), or mixed-attendance (<75% in either modality). Learning gain was defined as the post-course examination correct-answer rate (%) minus the pre-course examination correct-answer rate (%). RESULTS: The overall cohort (n = 208) showed a learning gain of 16.9 ± 0.5%. Learning gain was 20.2 ± 1.2% in the face-to-face group (n = 23), 16.4 ± 0.8% in the mixed-attendance group (n = 41), and 16.5 ± 0.6% in the live online group (n = 144). Learning gain tended to be higher in the face-to-face group than in the mixed-attendance group (p = 0.061; d = 0.736) and was higher than in the live online group (p = 0.028; d = 0.546), whereas the mixed-attendance and live online groups showed nearly identical learning gain (p = 0.998; d = 0.010). CONCLUSIONS: These findings support the educational value of HyFlex as a flexible learning environment. Face-to-face participation was associated with greater learning gain than live online participation, whereas mixed-attendance and live online participation showed similar learning gain.

OBJECTIVES: Chronic pain is defined as pain that persists or recurs for more than 3 months. This study focuses on neuropathic pain (NP) and fibromyalgia (FM) which are chronic pain states, and aims to identify lifestyle habits associated with their prevalence. Other neurological disorders are also analyzed as references. METHODS: Association between the variable referring to disease prevalence (number of claims for reimbursement of marker drugs) and the variable for lifestyle habits/health examination results (collected from insured individuals aged 40-74 years) was determined by analyzing Japanese nationwide datasets, which were collected in 2018 and aggregated by prefecture. Pregabalin, donepezil, and levodopa were used as marker drugs for the chronic pain states, dementia-related diseases (Alzheimer's disease and Lewy body dementia) and Parkinson's disease (PD), respectively. Pearson's correlation analysis and multiple linear regression analysis were conducted. RESULTS: Variables showing correlation coefficient (|r|)>0.5 were put into the multiple linear regression. Exercise habits (ꞵ=-0.3182), smoking habits (0.3218), daily drinking (0.2683), and alanine aminotransferase>51 U/L (0.2309) were finally incorporated in the equation for pregabalin (R 2=0.7268). Walking speed (-0.4543) and daily drinking (0.5077) were incorporated in the equation for donepezil (R 2=0.5718). CONCLUSIONS: The prevalence of chronic pain states is associated with lifestyle habits, just like the dementia-related diseases. Exercise in daily life is negatively associated with the prevalence of the chronic pain states, although excessive alcohol drinking, smoking, and high serum ALT are positively associated with it. The prevalence of PD seems less associated with lifestyle habits.