1. Postgraduate Clinical Training Center; Shimane University Hospital; Shimane Japan
2. Department of Community-based Health Policy and Quality Management; Shimane University Faculty of Medicine; Shimane Japan
3. Center for Primary Health Care Research; Lund University; Malmo Sweden
4. Okinawa Muribushi Project for Teaching Hospitals; Okinawa Japan
5. Department of Environmental Medicine and Public Health; Shimane University Faculty of Medicine; Shimane Japan
6. Division of Community Medicine and Medical Education; Graduate School of Medicine; Kobe University; Hyogo Japan
7. Division of Neurology; Department of Internal Medicine; Hyogo College of Medicine; Hyogo Japan
8. Shimane University Hospital; Shimane Japan