RESUMO
BACKGROUND: India has ratified with the United Nations Convention on the Rights of Persons with Disabilities and has passed the Rights of People with Disabilities Act in 2016. There is need for training healthcare professionals in disability competencies as people with disabilities are many and marginalized. Disability competencies were introduced in the foundation course of revised competency based medical curriculum for Indian medical graduates by the Medical Council of India (MCI) just prior to the rollout of the programme. We intend describing our center's experience in implementing the same. METHODS: FC 4.5.1 TO 4.5.8 of MCI foundation course guidelines were resource material. Eight faculty members participated. Setting was the lecture theatre. The suggested and actual teaching learning methods are compared for each competency. Notes made from delivering disability competencies, photographs, videos and reflections from students were source of data. RESULTS: We used sensitizing lectures of 15 min each for FC 4.5.1, 4.5.2 and 4.5.4 [cognitive] with interesting set induction, student narratives of family members with disability, buzz groups for interaction and self-directed learning activity using mobile phones. We facilitated FC 4.5.3 and 4.5.5 [skill/affective domain] demonstrating unacceptable and acceptable disability etiquettes using standardized patients and role play. We conducted a forum theatre of the oppressed for FC 4.5.6. We introduced our learners to universal design in our campus for teaching 4.5.7. As a part of the principle of inclusivity we involved two staff members with motor disabilities for delivering FC 4.5.8 in an interview. We assessed the learners using written reflections and obtained feedback on a rating scale.
RESUMO
Background A significant relationship has been documented in the literature between the autonomic nervous system imbalance and cardiovascular mortality. In patients with autonomic failure, water ingestion has been shown to increase blood pressure (BP), induce bradycardia, and cause low heart rate variability (HRV). A few studies showed the altered HRV as an acute effect of ice water intake in healthy subjects. None of the studies have shown light on the relationship of BP and HRV to ice water intake in obese and overweight subjects. The present study is aimed to correlate BP and HRV with body mass index (BMI) after ice water ingestion. Methods This cross-sectional study included a total of 60 subjects of both sexes aged between 18 and 24 years old. Subjects were assigned into three groups based on their BMI: normal, overweight, and obese. Before and after ice water ingestion, BP and HRV parameters were recorded and compared between the groups. Statistically data were analyzed by Student's paired t-test and one-way analysis of variance. Results Basal HF was significant (p<0.05) in all three groups after ice water ingestion [F(2, 27), 44.1; p-value, 0.02]. After ice water ingestion, all HRV values were significant (p<0.001) in the three groups. The post-hoc Tukey HSD test demonstrated the less mean score for mean RR interval, standard deviation of all NN interval, standard deviation of differences between adjacent, HF and high for HR, LF, and LHR in overweight and obese subjects. Conclusions Because of the effective buffering system, healthy subjects showed increased HR and unchanged BP. Overweight and obese subjects showed decreased HR and increased BP.
