The purpose of this study was to investigate the circulation responses (heart rate (HR), systolic blood pressure (SBP) and second derivative of photoplethysmogram waveform index (|d/a|)) during 90 seconds continuous isometric contraction on trunk muscle. Subjects were 10 healthy male (22±1 years). Subjects performed 90 seconds continuous isometric contraction on Rectus Abdominus. Contraction intensity was 55.4±13.8% maximal voluntary contraction.HR and SBP were a significant increase after contraction beginning, immediately. |d/a| (one of the peripheral blood vessel contraction index) was a significant increase at 60 seconds after contraction beginning. After that, HR was an increase more, |d/a| showed a decline tendency. But, SBP was an increase more.The followings are suggestive by these results. When the contraction beginning, HR was increased immediately by central command, muscle mechano reflex and so on. The other hand, the peripheral blood vessel contraction was late by the accumulation of metabolism product from active muscle was late. When the prolong contraction time, the peripheral blood vessel was extension. But, SBP was increased more by increasing the cardio output, muscle tension and so on.

　This study examined the cases of the difficult encounters with problematic students that academic administrative staffs in the health professions education institutons faces. 185 cases were obtained from the 143 administrative staffs who participated in the training program for academic administrative staffs training from 2013 to 2015. Although there are 136 cases (73.5%) related to the problem students, some cases existed which problems were from the system or faculty members. In order to dealing with difficult encounters appropriately in the health care professional training institutions, the cooperation between teachers and academic administrative staffs is indispensable.

　　The establishment of a sustainable healthcare system based on residents’ needs is an urgent issue in a rural region. For this purpose, considering the structure of a healthcare system, such as the numbers of beds, doctors, and nurses is important. In addition, the study of healthcare utilization using the date gathered through geographic information systems (GIS) would be very helpful in building such a healthcare system. In Japan, however, there are few published studies available on how health services are utilized. The aim of this paper was to review articles of GIS research on healthcare utilization. We conducted a systematic search of published peer-reviewed literature on PubMed. We found 38 articles that satisfied our inclusions criteria for review. Of them, 12 articles had a map for understanding health needs or demands, 23 articles carried analyses of distance and time for health utilizations, and seven articles had a buffer or database for analyses of healthcare utilization. Most of these articles have dealt with pediatric care and emergency care. Given the aging population in a rural region, we concluded that a more evidence-based approach should be taken to rural health focussing on lifestyle-related diseases.

  Emotional intelligence and empathy are crucial in patient–physician relationships and clinical outcomes. It has been reported that both emotional intelligence and empathy decrease as students advance through medical school. This study aimed to validate Japanese versions of the Trait Emotional Intelligence Questionnaire–Short Form （TEIQue–SF）, developed by Petrides and Furnham （2001）, and the Jefferson Scale of Physician Empathy （JSPE）, developed by Hojat et al. （2001）.
1）The TEIQue–SF and JSPE were translated and administered to 370 medical students. Valid responses were obtained from 321 students（88%）.
2）Cronbach’s alpha for internal reliability was high for both the TEIQue–SF （0.87） and the JSPE （0.89）. All item total score correlations were positive for both the TEIQue–SF （range, 0.29 to 0.64） and the JSPE （range, 0.27 to 0.72）.
3）Cronbach’s alpha was smaller if an item was deleted than if all items were included for both the TEIQue–SF （0.84–0.85） and the JSPE （0.81–0.86）.
4）Factor analysis of both the TEIQue–SF and the JSPE revealed that the Japanese versions had some structural differences from the original versions. However, criterion–related analysis showed that the TEIQue–SF and the JSPE were highly correlated with the NEO–Five Factor Inventory, a measure of the Big Five personality traits.
5）These findings provide support for the construct validity and reliability of the Japanese versions of the TEIQue–SF and the JSPE when used for medical students. Further investigation is needed.

　Modern medical education stresses the importance of staff／faculty development and its evaluation. The Medical Education Development Center of Gifu University has been accredited by the Ministry of Education, Culture, Sports, Science and Technology as a National Collaboration Center and has held Seminar and Workshop on medical education 50 times over 14 years towards achieving the mission of staff／faculty development in Japan. Through the analysis of the characteristics of participants and the topics of the workshops and seminars held by the Medical Education Development Center, the history and future of staff／faculty development were examined. The key points suggested to predict the direction of staff／faculty development in the education of health professionals were: acquisition of comprehensive teaching competence, various learning strategies, the importance of work place and practicality, collaborative learning beyond boundaries, scholarly discussion to integrate international and domestic evidence, continuing professional development, and evaluation based on learning stage.

　This paper reports how Gifu University has been developing an extracurricular course for interprofessional education (IPE) in collaboration with multi-institutions for three years. Since the planning and implementation of such an IPE course have not been described exhaustively, we summarize our experience and the outcomes based on the analysis of a questionnaire survey involving the participants, including students and faculty members.

Since the Infection Control Team (ICT) was organized in 1999, our hospital has been engaged in evidence-based operations against nosocomial infections. The ICT's major activities included guidance in preventive measures against infections, surveillance involving continuous environmental monitoring, proposition as regards prescription of antibacterial medicines, and consultation with clinicians about prophylaxis. The team comprising physicians, nurses, pharmacists and clinical laboratory technicians has made expert propositions to clinicians. To be concrete, the team members, with the liaison clerk playing a central role, met with physicians in charge or with other staff members of the hospital, studied the infection cases in question, and presented the study findings to the clinicians. Fundamentally, therefore, it is not that the ICT intervenes in the affairs of the clinical department by way of directions but that it presents clinicians with the ideas gained through discussion between ICT members and physicians and other hospital staffers. While cementing a relationship of mutual trust between hospital employees, the ICT is expected to engage in nosocomial infection prevention activities by joining forces transdeoartmentally.
Clinical ; Hospitals ; Infection Control ; seconds ; Prophylactic

Clinical clerkships in medical school requires an educational approach that integrates medical students into the medical team and progressively assigns medical tasks to them based on their competencies. However, it is challenging for supervisors to delegate tasks to medical students gradually while considering medical safety. This paper outlines the design of an emergency department clinical clerkship program based on the Four Component Instructional Design (4C/ID) model. This model enables students to learn complex task performance skills in stages while developing a schema, considering the cognitive load involved in learning complex tasks. The 4C/ID model is anticipated to be an effective instructional design for constructing clinical clerkship programs.

Objective：Studies on upper extremity functional interventions for patients with spinal cord infarction are limited, and the effectiveness of the interventions for upper limb paresis in such patients have not been elucidated. This case report describes evidence-based spinal cord injury interventions that improved upper extremity function in a patient with spinal cord infarction.Methods：A man in his 60s presented with mild right hemiplegia because of right anterior spinal artery infarction in the C5 medullary segment. Upon admission, the patient had an American Spinal Injury Association Impairment Scale of D, lacked cognitive impairment, and demonstrated independence indoors with ambulation. The intervention included a combination of robotic therapy and electrical stimulation, adherence-enhancing behavioral strategies (Transfer Package), and typical occupational therapy. We recorded the following upper extremity functional scores：①Active Range of Motion of the shoulder, ②Passive Range of Motion of the shoulder, ③Manual Muscle Test, ④Grip strength, ⑤Pinch strength, ⑥Action Research Arm Test, ⑦Simple Test for Evaluating Hand Function, and ⑧Motor Activity Log.Results：After intervention therapy for 39 days, upper extremity function and the degree and quality of arm use in daily activities improved.Conclusion：These results suggest that evidence-based interventions for spinal cord injury could improve upper extremity function and the degree and quality of arm use in daily activities in patients with cervical spinal cord infarcti.