Effect on cardiovascular system and autonomic nervous system in healthy adults with different body types while performing movements simulating washing of the lower limbs for cardiac rehabilitation.

AIM: To clarify the effects on the cardiovascular system and autonomic nervous system of activities simulating washing of the lower limbs in subjects with different body types (underweight body mass index [BMI] < 18.5, normal weight BMI 18.5-24.9, overweight BMI ≥ 25). METHODS: Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), skin blood flow (BF), and HR variability were measured in 15 healthy adults while performing movements similar to washing the lower limbs. Changes in SBP, DBP, HR, BF, double product (DP), low-frequency values (LF), high-frequency values (HF) and the ratio between the powers of LF and HF (LF/HF) during activities performed from the supine position (ΔSBP, ΔDBP, ΔHR, ΔBF, ΔDP, ΔLF, ΔHF and ΔLF/HF) were compared among subjects grouped according to body type. RESULTS: ΔHR and ΔDP in the overweight group were significantly lower than in underweight and normal weight groups (ΔHR, underweight P < 0.05 and normal weight P < 0.05; ΔDP, underweight P < 0.05 and normal weight P < 0.001). Moreover, ΔDP in the underweight group was significantly lower than in the normal weight group (normal weight P < 0.05). ΔBF and ΔLF/HF in the normal weight group were significantly lower than in underweight and overweight groups (ΔBF, underweight P < 0.05 and overweight group P < 0.05; ΔLF/HF, underweight P < 0.05 and overweight P < 0.01). ΔHF in the overweight group was significantly lower than in the normal weight group (normal weight P < 0.05). CONCLUSION: The effect on the cardiovascular and autonomic nervous systems by movements simulating washing of the lower limbs differed according to body type.

Changes in attitudes toward interprofessional health care teams and education in the first- and third-year undergraduate students.

The interprofessional education (IPE) program at Gunma University, Maebashi, Japan, implements a lecture style for the first-year students and a training style for the third-year students. Changes in the scores of modified Attitudes Toward Health Care Teams Scale (ATHCTS) and those of modified Readiness of health care students for Interprofessional Learning Scale (RIPLS) at the beginning and the end of the term were evaluated in the 2008 academic year. Two hundred and eighty-five respondents of a possible 364 completed the survey. In both the scales, the overall mean scores declined significantly after the lecture-style learning in the first-year students, while the scores improved significantly after the training-style learning in the third-year students. Exploratory factor analysis revealed that the modified ATHCTS was composed of three subscales, and the modified RIPLS two subscales. Analyses using regression factor scores revealed that the scores of "quality of care delivery" subscale in the modified ATHCTS and those of "expertise" subscale in the modified RIPLS declined significantly in the first-year students. Consequently, IPE programs may be introduced early in the undergraduate curriculum to prevent stereotyped perceptions for IPE, and comprehensive IPE curricula may result in profound changes in attitudes among participating students.

Systematic inclusion of mandatory interprofessional education in health professions curricula at Gunma University: a report of student self-assessment in a nine-year implementation.

BACKGROUND: The mandatory interprofessional education programme at Gunma University was initiated in 1999. This paper is a statistical evaluation of the programme from 1999 to 2007. METHODS: A questionnaire of 10 items to assess the achievement levels of the programme, which was developed independently of other assessment systems published previously, was distributed, as well as two or three open-ended questions to be answered at the end of each annual module. A multivariate analysis of variance model was used, and the factor analysis of the responses was performed with varimax rotation. RESULTS: Over all, 1418 respondents of a possible 1629 students completed the survey, for a total response rate of 87.1%. Cronbach's alpha of 10 items was 0.793, revealing high internal consistency. Our original questionnaire was categorized into four subscales as follows: "Role and responsibilities", "Teamwork and collaboration", "Structure and function of training facilities", and "Professional identity". Students in the Department of Occupational Therapy reached a relatively lower level of achievement. In the replies to the open-ended questions, requests for the participation of the medical students were repeated throughout the evaluation period. CONCLUSION: The present four subscales measure "understanding", and may take into account the development of interprofessional education programmes with clinical training in various facilities. The content and quality of clinical training subjects may be remarkably dependent on training facilities, suggesting the importance of full consultation mechanisms in the local network with the relevant educational institutes for medicine, health care and welfare.