Today's one of the most important problems both in the industrial hygiene and the community health care is the health protection of farmers who are working in factories. There are many such farmers in the San'in rural districts. We surveyed the working conditions of 370 factories in Shimane Prefecture and found that they had many problems to be solved. The problems in the factories, mostly small-scale factories, are summarized as aging of workers, long working hours, insufficient rest, harmful work and night work.
Even in Sada-cho, where the local government is promoting the comprehensive community health care and encouraging the health care activity of inhabitants, the health care for factory workers is performed insufficiently. Some factories do not carry out even a periodical health examination of the workers.
We established the Sada-cho Occupational Health Association in cooperation with the local government, Izumo Health Center, Shimane Labor Standard Inspection Office and the factories in Sada-cho for the purpose of promoting the unified activity of the industrial hygiene and the community health care.

In order to analyze the influence of thyrotropin releasing hormone (TRH) on rehabilitation process of stroke Patients, the comparison of functional gain and length of hospital stay was made between eight patients treated with TRH (TRH group) and 11 age and sex matched ones without TRH (control group). Using Social Maturation Scale (Takenshiki, SMS) and Motor Age Test for trunk and lower extremities (MoA), the patients were assessed at the admission, 2 and 3 months after the admission and the discharge, respectively. TRH of 2mg was administered once a day by intravenous drip injection for 10 days between 2 and 3 months after the admission. The gain of SMS score between 2 and 3 months after the admission was larger in the TRH group than in the control group, especially that of interpersonal skills. The gain of MoA score was not different between the two groups. Compared to the control group (5.3 months), the length of hospital stay was significantly short in the TRH group (4.2 months). However, functional gain during inpatient-rehabilitation was not different between the two groups. It is assumed that TRH is effective to shorten the course of stroke rehabilitation.

Actual conditions of the health care of school personnel in rural districts of Shimane Prefecture were investigated, concentrating our attention on the structure of diseases, the contents of health examination, factors impeding health, and so forth.
As a result of our investigation we found that the incidence of adult diseases among school personnel is considerably high. Health examinations with complete contents should be practised in the near future.
Further, the establishment of health care system in the work place, the improvement of working conditions considering sufficiently the peculiarity of mental work and of femininity, the independence of school nurses as specialist should be realized on the basis of the understanding of actual problems, which are obtained by examinations of health care conditions at each work place including epidemiological examination.

The recent urbanization of rural communities and the associated changes of the living environments influenced the health conditions of children in rural districts of Shimane Prefecture, Japan. It obliged therefore to review the usual school health approach and to evaluate the care system to new trends of critical health problems of children.
A questionnaire was sent to school nurses asking their worries and problems about each step of the scientific school health procedure to recognize the health needs, to analyse the health problems, to plan the appropriate counterplans, to practice and to evaluate.
As a result of our investigations, the following remedies were necessary for the development of rural school health activities.
Firstly, the specialization of school nurses should be established without delay, and their working conditions should be more improved.
Secondary, school nurses should strengthen the contacts with teachers, parents and other school staffs to organize the developed school health system.
Finally, school nurses should make their efforts to delop the community-based school health care which connected the comprehensive community health care.

The rise of the average age of the population in Shimane Prefecture has become more and more conspicuous in these years. According to the estimation of the future population the aging phenome-non in Shimane Prefecture is going about fifteen years ahead of the average of Japan. Therefore it is significant to perform a community experiment of the comprehensive health care for the elderly in this prefecture, in the sense that its results will offer many useful experiences to other districts of Japan, where the aging of the population is proceeding a little more slowly.
We carried out an experiment called “the Service Package System for the Bedridden Elderly”, in Sada-cho, Shimane Prefecture in cooperation with Sada-cho, Izumo Health Center and Izumo Medical Association. It is an improvement on the health care system for the bedridden elderly and their family, which has been performed in Scandinavian countries.
The results of our experiment obviously showed the existence of many problems stemming from the lack of integration among different fields such as health care, medical care, social welfare, working and cultural life. To establish the comprehensivehealth service system for the elderly and their family the integration of these fields is most urgently demanded.

In order to develop the health care system for the elderly we need to analyse fundamentally the phenomenon that the average age of population in each community is rapidly becoming older, as well as we have to grasp life conditions and health needs of old people. We investigated the rate of increase or decrease of population, rate of the elderly living by themselves and the index of the aging of population of each community, classified these communities into several types, and presented the points necessary to develop a community-based comprehensive health care for the elderly as to each type by considering the meanings the indices of health care, medical care and social welfare of the communities disclose.

Recently, while the medical technology developed remarkably on the one hand, the soscial need for preventive medicine largely increased on the other. In Japan, it is an urgent problem of the medical education how to create effective methodology and technology of the preventive medicine that can attract students who generally prefer to become professionals in clinical medicine.
Since 1978 we have practiced an educational programme in which each student looks after one family picked up from the agricultural district for one year, caring for the health of the family members and helping them out of health problems, if there are any. In this way students can learn primary health care and community health of their own will.
Compared with the traditional method, this method is effective in making the students understand with real interest the meanings of comprehensive primary health care through concerning themselves in the health care of a family as “a socio-economical-psycho-complex”.

In a farm village of Shimane Prefecture we conducted an investigation on the difference of nutrition between young, middle-aged and old generations. The result showed that nutrition was below the necessary level in the old generation, with many foods being scantily taken. Irrespective of generation the diet was of Japanese style. It will be necessary to guide people to the improvement of dietary life according to generations.
The dietary life of bedridden people and of those who attend to them was the worst of all. Some social measures to improve the situation, as well as the repletion of primary health care for old people are urgently required.
Women in rural communities generally have concrete demands for improvement of the dietary life. It is important to carry out the improvement in harmony with the actual condition of life in the community and the demand of inhabitants.

We treated two elderly patients who contracted amebiasis in a foreign country. They ate a watermelon in Peking, the People's Republic of China. From their account, the watermelon was considered the most probable source of infection.
In Case 1, the patient complained of acute nausea, vomiting, diarrhea and unconsciousness following severe dehydration. The trophozoites of Entamoeba histolytica were found by stool examination. The treatment with metronidazole was not so effective in Case 1 patient with fulminating amebic colitis. In Case 2, he had no subjective symptoms, but the cysts of Entamoeba histolytica were found by stool examination.
Recently, traveling abroad has become popular. The number of travelers has been increasing in Japan from not only urban districts but also rural districts. Therefore, it is necessary to exercise strict rigilance over the imported protozoan parasites and possible mass outbreak of amebiasis in tour groups.