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Previous reports indicate that the right ventrolateral prefrontal cortex (VLPFC) is involved in emotional regulation. However, most such studies were performed under unphysiological conditions, like the administration of transcranial direct current or repetitive transcranial magnetic stimulation. We have shown that the right VLPFC is stimulated by an acute bout of daily activity, such as cleaning. Here, we investigated the relationship between the right VLPFC and mood changes using this system. Fourteen young adults vacuumed a floor as a cleaning task and kept a standing position as a control task on separate days. The oxyhemoglobin (oxy-Hb) and deoxy-hemoglobin (deoxy-Hb) signals of the prefrontal cortex were measured during the tasks. The mood scale scores of Profile of Mood States 2nd edition (POMS) and Two-Dimensional Mood Scale (TDMS) were measured before and after both tasks. The differences in subscale scores between pre- and post-tasks in both scales were calculated as ΔPOMS and ΔTDMS. The cleaning task significantly increased the oxy-Hb signal in the bilateral VLPFC and right frontopolar, but did not affect the deoxy-Hb signals. The control task significantly decreased the oxy-Hb signal in some brain regions. The Confusion-Bewilderment score in POMS changed after the cleaning task. Importantly, the oxy-Hb signal in the right VLPFC was negatively correlated with the ΔPOMS Confusion-Bewilderment score. The activity of the right VLPFC stimulated by the cleaning task might have a correlation with the Confusion-Bewilderment mood state.

Introduction Previous studies have revealed that one‐session focused attention meditation (FAM) can improve top‐down attention control, which is one of the factors of working memory capacity (WMC). In addition, FAM shares various neural substrates, including the dorsolateral prefrontal cortex (DLPFC), with WMC. Thus, we hypothesized that one‐session FAM would improve WMC by activating the DLPFC evoked by the top‐down attention control. In this study, we examined whether FAM modified WMC in individuals with little to no meditation experience. Methods The participants were randomly assigned to either the FAM group (N = 13) or the control group (N = 17) who engaged in random thinking (i.e., mind‐wandering). Before and after each 15‐min intervention, the participants’ WMC was measured according to the total number of correct answers in the Reading Span Test. During each intervention, functional near‐infrared spectroscopy was employed to measure the blood flow in the participants’ DLPFC and determine the top‐down attention control effect. Results In the FAM group, WMC increased, and the bilateral DLPFC was activated during the intervention. As for the control group, WMC decreased after the intervention, and the bilateral DLPFC was not activated during the intervention. A correlation was also found among all participants between the increase in WMC and the activation of the bilateral DLPFC. Conclusion The study findings suggest that top‐down attention control during FAM can activate the bilateral DLPFC and increase WMC among meditation novices., Top‐down attentional control during focused attention meditation can activate the bilateral DLPFC and increase working memory capacity among meditation novices.

Lao People's Democratic Republic (Lao PDR) with a population of 6.8 million is a low middle-income country in Southeast Asia. Despite economic development, Lao PDR is still characterized by a weak health system. The Ministry of Health has launched health reforms to provide better health services and University of Health Sciences (UHS) plays an essential role in Human Resources for Health (HRH) reform. Especially, the importance of its role in training health professionals from entry-level to continuing education has been increased. In 2016, the UHS embedded an Interprofessional Education (IPE) concept into a pre-qualifying course, in collaboration with the World Health Organization and the Gunma University Centre for Research and Training on IPE. As a pilot study, some students from faculties of Medicine, Pharmacy, Dentistry, Nursing, and Medical Technology participated in a community-based IPE program. Results suggested that students participating in the IPE program showed more positive attitudes toward collaborative practice than students who did not participate in the IPE program. Based on the results, the UHS is planning to develop an IPE program for health workers. In this article, we describe the strategic international collaboration and discuss the keys to successful IPE planning and implementation in line with HRH reform.

Background Dressing performance relates strongly with balance function, and it is mainly influenced by the motor functions of the affected and unaffected lower extremity and trunk function in stroke patients. For the remedial approach to be effective, ascertaining the degree of function needed in the affected and unaffected lower extremities and trunk to achieve balance function requisite for dressing is necessary. Objectives This study aimed to elucidate standards of lower extremity and trunk function necessary for stroke patients to gain balance requisite for dressing. Methods The study included 105 first-time stroke patients, who were classified by Berg Balance Score ≥44 or not and ≥32 or not which are previously reported standard indicators for independent and supervision level in dressing. Receiver operating characteristic curves were determined for the stroke impairment assessment item of sensory and motor function of affected lower extremity, abdominal muscle strength, and knee extension muscle strength. Results Area under the curve was ≥0.7 for all variables. In BBS 44-point analyses, the calculated cut-off values were 4 points for SIAS hip flexion, 4 points for SIAS knee extension, 2 points for SIAS foot pat on the affected side, 3 points for SIAS tactile and position sensation of the affected lower extremity, 3 points for SIAS abdominal muscle strength, and 3 points for SIAS knee extension muscle strength on the unaffected side. Conclusions These cut-off values can be used as targets for motor functions, when using the remedial approach for achieving dressing independence.

Kenji Tsuchiya,1 Shinichi Mitsui,1 Ryuji Fukuyama,2 Noriki Yamaya,3 Takaaki Fujita,4 Kaori Shimoda,1 Fusae Tozato1 1Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Gunma, 2Department of Rehabilitation, Gunma Seishi Ryougoen, Gunma, 3Department of Health Sciences, Gunma University School of Medicine, Gunma, 4Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Miyagi, Japan Purpose: Although acute bouts of exercise reportedly have beneficial effects on executive function, inactive people may find it difficult to start exercising. In this study, we focused on housework activities (HAs) that generate a sense of accomplishment and require a mild intensity of physical activity. We examined the impact of an acute bout of HA on executive function and oxygenated hemoglobin (oxy-Hb) flow to related cortical regions. Materials and methods: Twenty-five participants (age, 18–21 years; mean, 19.88±0.60years; six males and 19 females) underwent two experiments, ie, HA and control experiments, which were conducted on different days. Participants vacuumed a dirty floor in the HA experiment and mimicked the same motion with an unplugged vacuum cleaner on a clean floor in the control experiment.Results: Heart rate recorded during the experiments showed no significant difference in the intensity of physical activity between control and HA groups. A questionnaire revealed a sense of accomplishment after completing the HA experiment. Participants performed the Stroop color–word task (SCWT) pre- and post-experiments; cortical hemodynamic changes were simultaneously monitored using functional near-infrared spectroscopy. Variation in Stroop interference scores for SCWT total response between pre- and post-experiments was significantly higher in the HA group than in the control group, and that for SCWT correct response showed a similar trend. Variation in the Stroop interference score for oxy-Hb flow to the right ventrolateral prefrontal cortex (R-VLPFC) showed the same trend.Conclusion: Thus, HAs may have a greater beneficial effect on executive function than other physical activities through the activation of PFC, including R-VLPFC. Keywords: cognitive function, near-infrared spectroscopy, cleaning, stroop interference, positive emotion, prefrontal cortex

Locomotive disorders are one of the main causative pathologies for the condition requiring assistance on activities of daily living (ADL). Although psychological concerns such as feeling of depression and anxiety are prevalent in elderly people, the causal relation among motor function, ADL disability, and psychological concerns is controversial.Purpose of this study was to investigate causal relationship among motor function, ADL disability, and psychological concerns in elderly people with locomotive disorders.The data for this study were from a community-dwelling sample of 314 elderly persons with locomotive disorders aged 65 and older who visited orthopedic clinics and/or affiliated institutions. Motor function was assessed by one-leg standing time with eyes open, leg extension power and grip power. We assessed ADL disability using the 25-question Geriatric Locomotive Function Scale (GLFS-25), and psychological concerns by three self-reported questions. We constructed two models and tested fitness of the models to the data using a structural equation modeling (SEM). Model 1: motor function affects ADL disability and ADL disability affects psychological concerns, Model 2: motor function affects psychological concerns and psychological concerns affects ADL disability.The fit indices were chi-square = 23.152 (p = 0.081), RMSEA = 0.042, GFI = 0.981, AGFI = 0.955, CFI = 0.987 for Model 1, and chi-square = 84.583 (p 0.001), RMSEA = 0.119, GFI = 0.935, AGFI = 0.854, CFI = 0.892 for Model 2. These fit indices indicated a good fit of the model 1 and inadequate fit of model 2 to the data.Decline of motor function contributed toward psychological concerns via ADL disability in elderly people with locomotive disorders.

[Purpose] Many clinicians believe that rehabilitation for patients with advanced cancer is futile. We determined factors affecting the performance of activities of daily living in patients with advanced cancer based on age, gender, marital status, living arrangement, rehabilitation intensity, type of cancer, impairment, metastasis, and active cancer treatment. [Participants and Methods] We assessed the Barthel Index to evaluate the performance of activities of daily living. Of the 120 adult patients with cancer who underwent inpatient rehabilitation, we analyzed the Barthel Index scores, consisting of 10 items, and reviewed the clinical characteristics from the medical records of 48 patients who completed supportive or palliative rehabilitation according to Dietz and showed an increased or maintained total Barthel Index score at final evaluation. [Results] The median total Barthel Index score increased from 45 (5-95) to 72.5 (5-100); the rehabilitation intensity was 320 (40-1,240) minutes. The analytical results showed that the increase of total Barthel Index score was positively associated with rehabilitation intensity (β=0.350) and negatively associated with the initial grooming score (β=-0.277). [Conclusion] Adequate rehabilitation positively affects performance of activities of daily living, especially in patients with advanced cancer who lost their grooming ability at the onset of rehabilitation. Importantly, rehabilitation may be beneficial for patients with advanced cancer.

[Purpose] Dressing is an activity of daily living for which stroke patients often show discrepancies between capacity and actual performance. The aim of this study was to elucidate the physical function and unilateral spatial neglect in stroke patients that reduce their level of actual performance despite having the capacity for dressing independently. [Subjects and Methods] This retrospective study included 60 first-time stroke patients judged by occupational therapists as able to dress independently. The patients were divided into two groups according to their FIM(®) instrument scores for dressing the upper and lower body: an independent group with both scores ≥6 and an assistance group with one or both scores ≤5. After adjusting for confounding factors through propensity score matching, the groups were compared by using Stroke Impairment Assessment Set items, the Simple Test for Evaluating Hand Function of both upper limbs, and the Berg balance scale. [Results] The assistance group had a significantly lower score for the Berg balance scale than the independent dressing group (31.0 ± 12.3 vs. 47.8 ± 7.4). [Conclusion] The results of the present study suggested that the balance function has an effect on the discrepancy between dressing capacity and performance.

[Purpose] The aim of the present study was to elucidate which motor functions are most or more important for dressing performance before and after rehabilitation. [Subjects] Seventy-nine first episode stroke patients in a hospital convalescent rehabilitation ward. [Methods] The relationships between motor function of the affected upper and lower limbs, unaffected side function, trunk function, balance, cognitive function, and independence level in dressing were examined at admission and discharge using partial correlation analysis. [Results] Independence level of dressing correlated with motor function of the affected upper limb and balance at admission, but correlated only with balance at discharge. [Conclusion] Balance function was strongly associated with level of dressing independence. The effect of gross motor function of the affected upper and lower limbs on the level of independence in dressing may thus be smaller than originally expected. Enhanced balance ability can be important for learning single-handed actions of self-dressing during rehabilitation.

There have been few studies comparing the attitudes towards healthcare teams between different universities. This study analysed the differences in attitudes towards healthcare teams between health science students at Gunma University, Japan, which implements a comprehensive interprofessional education (IPE) programme, and Kanazawa University, a similar national university. Study populations were first- and third-year students at the Gunma University School of Health Sciences and the Kanazawa University School of Health Sciences. The present study was performed just after the IPE and multi-professional education subjects at Gunma University in the first term of the 2012 academic year. The first-year students were different cohort from the third-year students. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) was used to measure attitudes towards healthcare teams. The overall mean score on the modified ATHCTS of students at Gunma University was significantly higher than that of those at Kanazawa University. In both first- and third-year students, the regression factor score of "patient-centred care" was significantly higher at Gunma University than at Kanazawa University. Based on the present study, it can be stated that IPE may foster the value of collaborative practice (CP) among health science students.

The purpose of this study was to clarify the amount of balance necessary for the independence of transfer and stair-climbing in stroke patients.This study included 111 stroke inpatients. Simple and multiple regression analyses were conducted to establish the association between the FIMSimple and multiple regression analyses showed that the FIMThe calculated cut-off values indicated the amount of balance necessary for the independence of transfer and stair-climbing, with and without supervision, in stroke patients. Berg Balance Scale has a good discriminatory ability and cut-off values are clinically useful to determine the appropriate independence levels of transfer and stair-climbing in hospital wards. Implications for rehabilitation The Berg Balance Scale's (BBS) strong association with transfer and stair-climbing independence and performance indicates that establishing cut-off values is vitally important for the established use of the BBS clinically. The cut-off values calculated herein accurately demonstrate the level of balance necessary for transfer and stair-climbing independence, with and without supervision, in stroke patients. These criteria should be employed clinically for determining the level of independence for transfer and stair-climbing as well as for setting balance training goals aimed at improving transfer and stair-climbing.

Background This study aimed to elucidate the relationship between grooming performance of stroke patients and various motor and cognitive functions and to examine the cognitive and physical functional standards required for grooming independence. Methods We retrospectively analyzed the data of 96 hospitalized patients with first stroke in a rehabilitation hospital ward. Logistic regression analysis and receiver operating characteristic curves were used to investigate the related cognitive and motor functions with grooming performance and to calculate the cutoff values for independence and supervision levels in grooming. Results For analysis between the independent and supervision-dependent groups, the only item with an area under the curve (AUC) of .9 or higher was the Berg Balance Scale, and the calculated cutoff value was 41/40 (sensitivity, 83.6%; specificity, 87.8%). For analysis between the independent-supervision and dependent groups, the items with an AUC of .9 or higher were the Simple Test for Evaluating Hand Function (STEF) on the nonaffected side, Vitality Index (VI), and FIM ® cognition. The cutoff values were 68/67 for the STEF (sensitivity, 100%; specificity, 72.2%), 9/8 points for the VI (sensitivity, 92.3%; specificity, 88.9%), and 23/22 points for FIM ® cognition (sensitivity, 91.0%; specificity, 88.9%). Conclusions Our results suggest that upper-extremity functions on the nonaffected side, motivation, and cognitive functions are particularly important to achieve the supervision level and that balance is important to reach the independence level. The effective improvement of grooming performance is possible by performing therapeutic or compensatory intervention on functions that have not achieved these cutoff values.

The interprofessional education (IPE) program at Gunma University, Maebashi, Japan, uses a lecture style for first-year students and a training style for third-year students. To investigate the comprehensive implications of IPE, the change pattern of attitudes toward health care teams was examined longitudinally in pre-qualified students. The modified Attitudes Toward Health Care Teams Scale (mATHCTS) was used. The overall mean score of the mATHCTS improved significantly after the training-style IPE in their third year. Two individual items in the factor "quality of care delivery" decreased significantly during the first year. In contrast, two individual items in the factor "patient-centered care" increased significantly during the third year. These changes over time were confirmed by analyses using regression factor scores. There are at least two independent attitudes toward collaborative practice (CP) or IPE in response to IPE interventions: the attitude toward "value of IPE for health care providers" may response negatively to IPE in the early stages, and the attitude toward "value of IPE for health care receivers" positively in the later stages. These findings suggest that the continuation of mandatory IPE, which must be designed on the basis of students' high expectations for IPE and CP on entry, may result in profound changes in attitudes amongst participating students.

Background & Aims : The aim of this study was to investigate dual-task interference on maximum grip force while performing a grip and lift task. Moreover, the influence of handedness on maximum grip force, and the relationship between maximum grip force and subjective difficulty were also investigated. Methods : Eleven subjects took part in the study. The study experiment was comprised of one single task and three dual tasks: 1)grip and lift task, 2)grip and lift task with single-leg stance, 3)grip and lift task with eyes closed,and 4) grip and lift task with calculation. The experiment was conducted in both hands separately. Maximum grip force of four fingers (dominant/non-dominant×thumb/index finger) was compared among tasks and between hands. Results : We found that maximum grip force was increased mainly by the cognitive dual task in both hands,and that there was no difference between hands in the same task. There was a positive correlation between the perceived difficulty and maximum grip force in the dominant hand. Conclusion : Our results suggest that maximum grip force could serve as an objective index for evaluating dual-task interference in upper extremity function.

An interprofessional education (IPE) initiative was recently launched at the University of Health Sciences in the Lao People's Democratic Republic, a country located in southeast Asia. During the process of reviewing the current curriculum, it was realised that the university has been providing a kind of IPE programme for more than a decade. Medical, pharmacy, dentistry, and nursing students were participating together in a community education programme. After identifying the programme's strengths and challenges, a 4-year plan for embedding the IPE concept into the programme was developed. The plan was divided into four phases-sharing the key concepts of IPE, designing the programme, organising the interprofessional programme committee, and evaluating the effectiveness of the programme. In this short article, we describe the process that led to the plan's creation and the experiences from the first two phases already completed.

The mandatory interprofessional education (IPE) programme at Gunma University, Japan, was initiated in 1999. A questionnaire of 10 items to assess the students' understanding of the IPE training programme has been distributed since then, and the factor analysis of the responses revealed that it was categorised into four subscales, i.e. "professional identity", "structure and function of training facilities", "teamwork and collaboration", and "role and responsibilities", and suggested that these may take into account the development of IPE programme with clinical training. The purpose of this study was to examine the professional identity acquisition process (PIAP) model in IPE using structural equation modelling (SEM). Overall, 1,581 respondents of a possible 1,809 students from the departments of nursing, laboratory sciences, physical therapy, and occupational therapy completed the questionnaire. The SEM technique was utilised to construct a PIAP model on the relationships among four factors. The original PIAP model showed that "professional identity" was predicted by two factors, namely "role and responsibilities" and "teamwork and collaboration". These two factors were predicted by the factor "structure and function of training facilities". The same structure was observed in nursing and physical therapy students' PIAP models, but it was not completely the same in laboratory sciences and occupational therapy students' PIAP models. A parallel but not isolated curriculum on expertise unique to the profession, which may help to understand their professional identity in combination with learning the collaboration, may be necessary.

[Purpose] There have been no investigations into the improvement of activities of daily living among patients suffering from post-stroke depression on admission to convalescent rehabilitation wards in Japan. This study aimed to assess the improvement of activities in daily living in patients with or without post-stroke depression at the time of admission to a convalescent rehabilitation ward. [Subjects and Methods] This retrospective study included 108 stroke patients divided into two groups according to their Geriatric Depression Scale 15-item short form scores. Activities of daily living were assessed using the Functional Independence Measure. The degree of improvement on the Functional Independence Measure was defined as the difference between scores on admission and at discharge. [Results] The Functional Independence Measure gain score was significantly different from the Functional Independence Measure total score. There was a significant interaction between time period and post-stroke depression factors for the Functional Independence Measure total score. A multiple regression analysis revealed a significant association between Geriatric Depression Scale score and Functional Independence Measure total score. [Conclusion] The present study suggests that post-stroke depression has a negative impact on recovery of activities of daily living and on rehabilitation outcomes in a convalescent rehabilitation ward setting.

Background This study aimed to create a simple and objective indicator for use by inexperienced nurses and family members of patients to judge the assistance level required for dressing in a hospital, while encouraging independence in activities of daily living among inpatients with stroke using the Berg balance scale. Methods We retrospectively analyzed the data of 108 hospitalized patients with first stroke in a rehabilitation hospital ward. Receiver operating characteristic curves were used to identify the Berg balance scale item with the highest discriminatory power against independence level in dressing. Results For comparisons between the independence and supervision or less level groups, the area under the curve of the sum score of "Retrieving object from floor" and "Standing with one foot in front" was .954, and the calculated cutoff value was 6/5 (sensitivity, 86%; specificity, 94%). For comparisons between the supervision or higher level and dependence groups, the area under the curve of the score of "Retrieving object from floor" was .930, and the calculated cutoff value was 2/1 (sensitivity, 93%; specificity, 81%). Conclusions Our results suggested that Berg balance scale items are individually and in combination simple and useful indicators to judge independence level in dressing in a hospital ward for patients with stroke. These indices appear to be appropriate for individuals who are unfamiliar with Berg balance scale, such as inexperienced nurses and family members of patients.

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.

Background and aims:The purpose of the present study was to compare the activity of the frontal lobe when performing tasks at two paces by functional near-infrared spectroscopy(fNIRS). Methods:Fifty healthy students from A University participated in the study. Oxygenated hemoglobin (oxy-Hb) concentrations(Δ[oxy-Hb])were monitored during 30s finger-tapping with the non-dominant hand. There were two paces for finger-tapping:one pace the subject decided by themselves and the other pace given by metronome. The subjects answered a questionnaire after fNIRS measurement. Results: Performing tasks at Preferred Pace(PP)activates the frontal lobe of the orbito-frontal cortex area,and it tends to induce a feeling of difficulty,especially in females. Conclusions:Performing repetitive tasks at PP activates the frontal lobe. This finding will enable occupational therapists to select the subject’ s optimal pace according to the degree of attentional dysfunction.(Kitakanto Med J 2012;62:271~276)

Monitoring of cerebral activity during long-term therapy such as occupational therapy is useful for the development of new protocols and assessments of the therapy. For clinical use, the authors tried to develop an examination by using a wearable Near infra-red Spectroscopy (NIRS) device with a neurocognitive task that is robust against repetition (habituation). The study was approved by the Ethics Committee of Gunma University Graduate School. Participants were fourteen healthy university students. We used a WOT-100, ten channel wearable NIRS device. Each participant underwent three tasks (deceitful reverse rock paper scissors, Stroop test, animal Stroop test) on a zero day, one week after, two weeks after, and three weeks after. Then the integral values of the oxyhemoglobin during the task were calculated. Stroop task was the only task with minimum habituation especially in the right frontal lobes. We concluded that the Stroop task was the most favorable of the three at this time.

It is necessary and important to quantify the handicap sustained by individuals with spinal cord injury (SCI); however, few instruments are available to measure the level of the disability. One of the best developed and most often used measures is the Craig Handicap Assessment and Reporting Technique (CHART). Nevertheless, a Japanese version has not yet been developed and tested for SCI individuals. The purpose of this study was to develop a Japanese version of the CHART (CHART-J) and to investigate its test-retest reliability and discriminant validity in SCI in Japan. Fifty-four individuals with SCI participated in the test-retest reliability study and 293 participated in the discriminant validity analysis. We have shown that the test-retest reliability coefficients of the CHART-J range from 0.57 to 1.00. In addition, its discriminant validity is acceptable for individuals with SCI in Japan. Therefore, the CHART-J is useful as a measure of disability for Japanese individuals with SCI.

Objectives To objectively evaluate sleep quality of shift-working nurses, we used an Actiwatch 2, a watch-like actigraphy device designed to measure sleep and wakefulness based on the amount of movement. Subjective sleep quality was also assessed using the St. Mary's Hospital Sleep Questionnaire. Methods Nineteen shift-working nurses wore the Actiwatch 2 for 5 days. The monitoring began with 2 days of the morning shift, which were followed by a 16-hour night shift and a rest day. Sleep recordings were obtained four times: night sleep after the second morning shift ("sleep 1"), napping on the night shift ("nap 1"), daytime napping after the night shift ("nap 2") and night sleep after the night shift ("sleep 2"). Actiwatch 2 sleep measures include sleep onset latency, snooze time, sleep efficiency, and percent sleep. In addition, the perceived quality of sleep was obtained using five questions of the St. Mary's Hospital Sleep Questionnaire. Objective and subjective sleep quality were compared between different sleep/nap times: sleep 1 vs. sleep 2, and nap 1 vs. nap 2. Results Percent sleep of sleep 2 was higher than that of sleep 1. In almost all responses to the St. Mary's Hospital Sleep Questionnaire, the perceived quality of sleep on sleep 2 was better than those of sleep 1, and that of nap 2 was better than nap 1. A significant negative correlation was found between the perceived sleep quality of nap 2 and the characteristics of participants (age, number of children, and length of career). There were positive correlations between the perceived sleep quality of sleep and percent sleep, and between the perceived sleep quality of nap and sleep efficiency. Moreover, the perceived sleep quality of nap 2 tended to decrease in participants whose bedtime deviated from the mean value on morning shift days and the rest day. Conclusions We found that perceived sleep quality is related to percent sleep, and that the perceived sleep quality of nap is related to sleep efficiency. The results suggest that improving the sleep quality of daytime napping after the night shift is necessary for nurses with children, and that keeping a regular bedtime is necessary to improve the sleep quality of napping on the night shift.

Individuals have a preferred pace at which they perform voluntary repetitive movements. Previous studies have reported that greater activation of the prefrontal cortex was observed during self-initiated movements than during externally triggered movements. The purpose of the present study is to compare the activation of the prefrontal cortex induced when the subjects performed a peg-board task at their preferred slow pace (PSP, the self-initiated condition) with that induced when they performed the same task at metronome slow pace (MSP, the externally triggered condition) using functional near-infrared spectroscopy. Healthy subjects performed the task while sitting in a chair. By assessing the activated channels individually, we confirmed that all of the prefrontal regions of interest were activated by both tasks. In the second-level analyses, we found that the activation detected in the frontopolar cortex (FPPFC; Brodmann area 10) was higher during the PSP task than during the MSP task. The FPPFC is known to be at the top of prefrontal hierarchy, and specifically involved in evaluating self-generated information. In addition, the FPPFC plays a role in coordinating lateral prefrontal cortex. In the present study, the subjects evaluated and managed the internally generated PSP by coordinating the activity of other lower level prefrontal regions.

The goal of effective interprofessional education (IPE) is high-quality patient-care delivery and attaining a high level of patient satisfaction in clinical settings. We aimed to examine if alumni who have studied in an IPE program at a pre-licensure stage maintain a positive attitude toward collaborative practice (CP) in the postgraduate clinical experience. This paper presents a cross-sectional descriptive study which employed the modified attitudes toward health care teams scale (ATHCTS) to examine the relationship between exposure to clinical practice and the attitudes toward interprofessional healthcare teams. Results indicated that the overall mean score of alumni was significantly lower than that of undergraduate students on the modified ATHCTS. Only "team efficacy" had a significantly lower regression factor score in alumni than undergraduate students. Our findings suggest that changes in professional identity in a team may be due to contact with patients after graduation in the postgraduate clinical healthcare experience. The reduction of attitudes toward healthcare teams in the postgraduate clinical experience may be related to "team efficacy". We emphasize the need for in-service IPE for sustaining attitudes and providing a useful CP, which results in good clinical outcome.

OBJECTIVE. This study established motor function cutoff values for dressing independence in inpatients with stroke. METHODS. Ninety-eight first-time inpatients with stroke were divided into groups on the basis of independence level in dressing, and receiver operating characteristic curves were determined for balance, motor function of affected limbs, trunk function, motor function of unaffected upper limb, and cognitive function. RESULTS. Area under the curve for the Berg Balance Scale (BBS) was highest for the different motor functions. In distinguishing independence group and supervision or less level group, the cutoff value for the BBS was 44 points (sensitivity = 85%, specificity = 93%). In distinguishing supervision or higher level group and dependence group, the cutoff value for the BBS was 32 points (sensitivity = 94%, specificity = 79%). CONCLUSION. Balance was strongly correlated with the level of dressing independence, and cutoff values for the BBS were indicators of the balance required to reach independent and supervision levels of dressing.

The School of Health Sciences (the “School”) of the Gunma University has a mandate to train and produce advanced, high-quality health professionals. To enhance collaboration among health professionals and to overcome the fragmented nature of specialized medicine, the School has developed a curriculum based fundamentally on holistic medicine and interprofessional work (IPW). The major advantage of the curriculum lies in its training program-simulated interprofessional training—where students work in groups and undergo a series of activities, including group discussions, clinical training at facilities, general meetings, and reporting. This “teamwork training” is the core subject of the education. Its concept is first shared and discussed during the first year of the curriculum, and training is introduced to the third-year students from all departments of the School. All academic staff help implement the training in cooperation with approximately 20 external health care facilities. The training is evaluated every year, and both students and academic staff have evaluated it positively. This “teamwork training” has been in practice for 9 years now. As medical knowledge has expanded and technology advanced, changes have taken place in IPW at clinical settings. To respond to this, deliberate efforts are being made, including: (1) use of updated case scenarios; (2) participation of students from the School of Medicine; and (3) networking for interprofessional education with external medical facilities and other universities.

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.