A small bedside agent for preventing falls has been developed. It talks to a person on a bed to prevent them from getting out of bed abruptly, until a care worker arrives. This paper describes the user-oriented design process of the agent system. The development process involving users, such as nurses and caregivers, as well as older adults is described. First, hardware design, such as the outer shape, size, and function of the agent was reviewed by nurses and caregivers, mainly from a safety viewpoint. The prototype agent incorporating improvements based on their opinions was used experimentally by older adults after several review processes. Second, the software design of the agent, such as the content of voice call, was studied through multiple experiments to improve its acceptability. Lastly, the integrated model was introduced into care facilities and hospitals to investigate the practical serviceability of the system.

1. Developmental process of caring for demented elders: the case of family caregivers consists of the beginning process (stage 1 through 4) and the awakening process (stage 5 through 7). 2. In the beginning process, the caregiver is unaware of the interaction between him/her and the demented family member, relies on conventional, general-purpose methods of care and on verbal communication, and consider care in terms of training and discipline of the person cared for. 3. The caregiver in the awakening process has realized that there is interaction between him/her and the demented family member, reflects on the nonverbal signs shown by the elder in order to improve their care, and provide warm and considerate care by making the most of nonverbal communication.

These quality indicators represent the first attempt to develop a best practices approach toward improving the quality of elderly end-of-life care in nursing.

Aim: The aim of this study was to examine a causal model of self-care agency by exploring the relationship between the structure of "body self-awareness" and the structure of the Instrument of Diabetes Self-Care Agency (IDSCA). Methods: The participants were 353 patients with diabetes. The internal consistency of the six items for body self-awareness was examined by calculating the factor structure using principal factor analysis and Cronbach's alpha. In order to examine the relationship between the seven factors in the IDSCA, a path analysis was conducted. Results: With regard to the factor structure, the factor loading of these five items was 0.511-0.743 (α = 0.739). In the path analysis, "body self-awareness" was influenced by the "ability to acquire knowledge" and had a direct effect (0.33) on the "motivation to self-manage", while "motivation to selfmanage" had an effect (−0.32) on the "ability to self-manage". The Goodness-of-Fit Index was 0.974. Conclusion: "Body self-awareness" plays a part in the self-care operation process and serves as an intermediary factor to enable the performance of self-care operations by making the most use of self-care agency. Moreover, striking a proper balance between self-management that is focused on the treatment of diabetes and a person's ability for self-management of diabetes was found to be important.

The purpose of this paper is to describe current cultural issues in Japanese health-care services that have resulted from the increased immigration. Also described is the establishment of a new academic research centre that will focus on culturally appropriate nursing care. There are many health-care issues in Japan caused by a shortage of health-care workers and disparities in access to health care. The major issues are an increase in the number of foreign patients, foreign nurses and care workers. Despite the occurrence of similar issues in other countries, Japan's situation and the causes are different. In response to dynamic demographic and health-care changes in Japan, we launched the Asian Research & Collaboration Center for Nursing & Cultural Studies at Chiba University Graduate School of Nursing.