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Purpose The study purpose was to investigate whether years of clinical experience and experience of encountering heart failure affect perceptions of the need for physical assessment, and the nature of the association between perceptions and years of clinical experience. Methods: This study was survey‐based. Of hospitals in Japan with ≥200 beds, 298 hospitals were randomly selected as candidate research sites. Ultimately, 44 hospitals agreed to participate in this study. A self‐administered questionnaire measuring 48 physical assessment skills was developed and distributed to nurses. The questionnaire rated the perceived need for 48 skills assessing acute progression of heart failure. Results: Of 1,113 nurses sampled, 373 (33.5%) responded. Of these, 347 completed questionnaires (response rate: 93.0%). Nurses' perceived need for skills involving systematic or cardiovascular system assessment decreased with clinical experience. Nurses' perceived need for skills involving cardiovascular symptoms and circulatory failure assessment increased with clinical experience. We found four patterns of change for nurses' perceptions of physical assessment skills according to clinical experience. Conclusions: The findings showed that differences in nurses' perceived need for physical assessment skills were associated with differences in clinical experience. Nurses with more experience selected more suitable skills for detecting acute progression of heart failure. Nurses' perceptions of the need for specific skills were proportional to years of clinical experience, and there may be a threshold value of years of experience. [ABSTRACT FROM AUTHOR]

To determine whether maximum bite force ( MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios ( HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [ CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively ( P for trend = .01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women. [ABSTRACT FROM AUTHOR]

Background and Objectives: Arterial stiffness is a leading cause of cardiovascular disease (CVD), and it is considered to be affected by dietary intake. However, few studies have examined the relationship between major dietary patterns and brachial-ankle pulse wave velocity (baPWV) among Japanese middle-aged subjects. We studied whether major dietary patterns were associated with baPWV in this population.Methods and Study Design: Between 2009 and 2012, 70 Japanese middle-aged subjects (39 men and 31 women) with no history of stroke, coronary heart disease, or cancer were studied. Dietary intake was documented using a validated food-frequency questionnaire, and dietary patterns were generated using factor analysis. Correlational analyses were performed between baPWV and identified dietary patterns and between baPWV and individual risk factors (total cholesterol, triglyceride, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non- HDL-C, LDL/HDL ratio, and augmentation index).Results: Two dietary patterns were identified: a rice-rich pattern (high in rice, breads, oils and fats, meats, and confectionery) and a vegetable-rich pattern (high in vegetables, fruit, fish, and seaweed). The rice-rich pattern was not associated with baPWVor other risk factors. A significant inverse correlation was found between baPWV and the vegetable-rich dietary pattern (p<0.05).Conclusions: Our findings suggest that a dietary pattern characterized by high consumption of vegetables, seafood, seaweed, fruit, and pulse is inversely associated with arterial stiffness measured by baPWV. This diet offers an additional nutritional approach to the prevention and treatment of arterial stiffness. [ABSTRACT FROM AUTHOR]

Background. Despite increasing attention toward forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was focused on elucidating the health benefits of forest walking on cardiovascular reactivity. Methods. Within-group comparisons were used to examine the cardiovascular responses to walking in forest and urban environments. Forty-eight young adult males participated in the two-day field research. Changes in heart rate variability, heart rate, and blood pressure were measured to understand cardiovascular reactivity. Four different questionnaires were used to investigate the changes in psychological states after walking activities. Results. Forest walking significantly increased the values of ln(HF) and significantly decreased the values of ln(LF/HF) compared with the urban walking. Heart rate during forest walking was significantly lower than that in the control. Questionnaire results showed that negative mood states and anxiety levels decreased significantly by forest walking compared with urban walking. Conclusion. Walking in the forest environment may promote cardiovascular relaxation by facilitating the parasympathetic nervous system and by suppressing the sympathetic nervous system. In addition, forest therapy may be effective for reducing negative psychological symptoms. [ABSTRACT FROM AUTHOR]