The third annual meeting of Primary Care Research (PCR) Connect was the start of the Special Interest Group (SIG) initiative addressing research on the social determinants of health. The SIG is important for building networks among researchers to promote primary care research on complex systems.

We, a group of four delegates from Japan, participated in the fifth Japan-UK Primary Care Exchange Programme and visited the UK in October of 2018. This report highlights some differences between the UK and Japanese healthcare systems, such as working conditions for GPs and requirements for GP trainers, and what the Japan Primary Care Association can learn from them. We propose that the Japan Primary Care Association create opportunities to discuss and exchange views with other healthcare professionals, strengthen training programs for future GP trainers and define competencies for GP trainers in Japan.

　A 34-year-old woman with cerebral palsy was admitted to our hospital because of increased spasticity. She showed spastic quadriparesis with partially inhibited range of motion of the lower limbs. Her modified Ashworth Score (MAS) was 2 for the upper limbs and 3 for the lower limbs. Radiography showed mild scoliosis, but magnetic resonance imaging did not show any compression of the spinal cord. An abdominal computed tomography scan revealed urinary retention and a large bladder diverticulum. A urological assessment was performed, and an indwelling catheter was placed in the bladder. In addition to urological management, non-invasive spasticity management was performed, and her MAS was reduced to 1＋and 2 for the upper and lower limbs, respectively. After these treatments, the patient was able to resume self-care activities.

The purpose of this study was to determine the effects of supine floating on rectal temperature and cardiac autonomic nervous system activity after exercise. Seven healthy males volunteered for this study. Subjects performed supine position for 30 minutes in both control condition (C-condition) and water condition (W-condition) after exercise with a cycle ergometer for 15 minutes. Exercise intensity was high (80%VO₂max) and moderate (60%VO₂max). Water temperature was 30 degrees Celsius. Rectal temperature of post exercise showed no significant differences under the W-condition, as compared to the C-condition. Delta rectal temperature (point 0-0 was end of exercise) was significantly reduced (p<0.05) under the W-condition, as compared to the C-condition. Log HF was significantly increased (p<0.05) under the W-condition, as compared to the C-condition. These data suggested that supine floating after high and moderate intensity exercise could promote recovery of rectal temperature and increased in cardiac parasympathetic nervous system activity.