Introduction: The purpose of this study was to clarify the issues for nurses in neurology departments of medical clinics in building a comprehensive community care system based on the implementation status of regional cooperation and individual support for hospitalized patients. We selected neurology as the subject of our study because patients who visit the neurology department are in the medical clinic for an extended period, and we believe that regional cooperation and individual support are implemented more than in other departments.Methods: A self-administered questionnaire survey was conducted by mail in February 2020 among nurses at 1,052 clinics, which were randomly selected from 2,104 clinics with neurology departments among medical institutions designated for intractable diseases.Results: We collected 174 responses (16.5% collection rate), 164 of which were valid (15.5% valid response rate). The regional cooperation rate was 71.3% and individual support by nurses was implemented at 29.9% of the clinics in the past year. Clinical physicians often sought "patient support in collaboration with related parties" and "patient guidance". Free descriptions included five categories such as [strengthening the awareness and abilities of nurses who are responsible for community healthcare] and [training nurses who can promote comprehensive community care].Conclusion: Regional cooperation and individual support are necessary as nursing activities linked to the functions of family physicians.

Introduction: The purpose of this study was to clarify factors related to recognition of the possibility of end-of-life care at home (hereafter referred to as end-of-life care) among middle-aged and elderly people living in heavy snowfall and depopulated areas.Methods: Residents aged 40~69 years in town B, prefecture A were surveyed by mail using a self-administered, unmarked questionnaire. Analysis methods were: (1) a reliability analysis of survey items, (2) basic statistics, (3) tests for differences in composition ratios, (4) tests of differences between the two groups for each item, and (5) binomial logistic regression analysis. Recognition of the possibility of end-of-life care was used as the objective variable, and sex, age, and 18 indicators significant in (3) and (4) were used as explanatory variables.Results: There were 63 in the positive group for end-of-life care, 239 in the negative group, and 120 in the unknown group (Response rate: 44.1%). Factors related to perception of the possibility of end-of-life care were positively related to "existence of a community hospital, " "positive image of end-of-life care, " and "trust in people in the community. "Conclusion: In depopulated areas, it is necessary to consider specific measures to promote the three factors that raise awareness of the possibility of end-of-life care.

Backgroud
Sri Lanka is a developing and multiracial country, located in the Indian ocean near the equator, with a population of approximately 20 million. It has a parliamentary democratic system of government and over 80% of hospitals belong to government and medical services are free of charge. Literacy rate of Sri Lanka is higher than the neighbouring countries of the region, and the government's health policies, based on the promotion of Maternal & Child and Geriatric health, are on the way to success.
According to the Health Master Plan (HMP) by the Ministry of Healthcare & Nutrition (MOH&N) ,the health problems in this country are classified into three categories based on epidemiological and medical economics:
i) Continuing Problems such as dengue fever, ii) Emerging Problems such as HIV/AIDS, and iii) Evolving Problems such as lifestyle-related diseases.
It is apprehensive thatthe health conditions and economics of individual Sri Lankan and Nation's economics will be compelled to face the multiple burdens in the near future.
JICA's Technical Support (JTS)
JTS on the first prevention against non-communicable diseases (NCDs) has been already startedby JICA after receiving the request by the government of Sri Lanka in order to avoid the catastrophic situations pointed out by HMP. Futhermore, the trend analyses on the data of inpatients suffered 59 types of communicable or NCDs from 1983 to 2003 were performedto propose the tagets and contents of the new JTS. As a result, ffifteen diseases were statistically significant, and nine out of the above15 cases were NCDs.
Because lifestyle-related diseases such as ischemic heart disease, cardiovascular diseases occupy four positions out of five leading causes of death in recent past of Sir Lanka, new model system which combines the first prevention and screening of high-risk persons and early treatment system was proposed to MOH&N.
The flow of the basic model projiect, composed of two screening steps to detect thespecific persons having high-risks such as obesity, hypertension, high cholesterol, etc., is classified into three groups to receive optimum healthcare sevices at the nearby hospitals.
Fortunately, MOH&N made a request for the new JTS based on this proposal to the government of Japan. Consequently, the budget of this project proposal was approved and is now under the practical arrangements by JICA.

OBJECTIVE: This study was conducted to validate the Advanced Test of Attention (ATA) of the visual attention version of Japanese children with attention deficit/hyperactivity disorder (ADHD) and to evaluate the efficacy of methylphenidate (OROS-MPH) and atomoxetine medications. METHODS: To assess pharmacotherapy efficacy, the visual version of ATA was administered to 42 children with ADHD. Results were assessed using discriminant analysis, ANOVA for indices of ATA before and after medication treatment, and correlation analysis between the improvement of indices of ATA and clinical symptoms during medication treatment. RESULTS: Discriminant analysis showed that 69.0% of ADHD children were assigned correctly. The T score of commission errors increased as the trial progressed on the medication-off condition. T scores of commission errors and standard deviation of response times on medication-on condition were low compared to the medication-off condition. A few significant correlations were found between the improvements of indices of ATA and ADHD-Rating Scale (RS) during treatment. CONCLUSION: The performance of the visual version of ATA on medication-off condition reflected the features of ADHD. Furthermore, the medication treatment effects were confirmed sufficiently. In addition, results suggest that indices of ATA reflected aspects of ADHD symptoms that are difficult to elucidate for ADHD-RS. For assessing symptoms and effects of medical treatment in children with ADHD, ATA might be a useful assessment tool.
Asian Continental Ancestry Group ; Attention Deficit Disorder with Hyperactivity ; Child* ; Drug Therapy ; Humans ; Japan* ; Methylphenidate* ; Reaction Time ; Atomoxetine Hydrochloride