Background: Nurses' oral assessment and dental referral performance for inpatients are important to provide appropriate oral care services in hospitals. The purpose of this study was to investigate the knowledge, attitudes, and performance of oral assessments and dental referrals for their inpatients among nurses and to identify factors associated with that performance to promote oral health care in hospitals. Methods: All nurses (n = 919) who worked at five hospitals in Japan were recruited as responders. A questionnaire regarding their performance of oral assessments and dental referrals was distributed to the subjects in each hospital. The data were collected from August 2018 to September 2018. Results: A total of 757 (82.4%) nurses (82 males and 675 females) responded to the questionnaire. With respect to each of the 8 oral assessment categories, 16.2-41.2% of the nurses performed oral assessments for more than 50% of their inpatients, and 20.3-29.9% had encouraged more than one inpatient to see a dentist within the previous 3 months. Significant differences were found by ward and hospital in their performance of oral assessments for inpatients. Additionally, their oral assessment performance, knowledge of the usage of oral assessment tools, wards, and hospitals were significantly associated with their dental referral performance. Conclusions: The performance of oral assessment and dental referral was not developed sufficiently in the hospitals. Thus, oral health professionals should support oral assessment education for nurses, including usage of assessment tools, to promote dental referral by nurses. These results may contribute to promotion of dental referral performance by nurses and provision of oral health care by oral health professionals for hospital inpatients.

Aim: This study aimed to identify the experiences and feelings of difficulty during international humanitarian aid of Japanese relief workers based on the length of the mission. Methods: This cross-sectional study was conducted from August through December 2015. Participants were 167 Japanese healthcare workers who participated in an overseas disaster relief mission and were asked to complete a self-administered questionnaire. Feelings of difficulty during the international humanitarian aid were assessed using the Humanitarian Aid Difficulty Scale. Scores on this instrument were evaluated based on mission duration using analysis of covariance with adjustment for sociodemographic status and disaster reliefrelated status. Results: Of the instrument's five subscales, the highest score for all mission duration was for "Culture and Custom". Higher "Culture and Custom" scores and "Cooperation" scores were associated with longer mission duration (p trend: 0.02 and 0.004, respectively). Additionally, the "Infrastructure" score for a medium mission duration was higher than that for a long mission duration (p = 0.001), and the "Cooperation" score for a long mission duration was higher than for a short mission duration (p = 0.02). Conclusions:The mission duration may be independently associated with an increase or decrease in the negative experiences of Japanese relief workers at an overseas disaster site. Results suggest that it is necessary for Japanese relief workers, who participate in international aid, to further enrich their cross-cultural understanding through education. Moreover, relief organizations should provide comprehensive support that addresses difficulty-related feelings depending on the mission duration.

Objectives: This study aimed to clarify factors related to Japanese nurses' tolerance toward Indonesian nurse trainees.Methods: We conducted a self-administered questionnaire survey from May 21, 2015 to June 13, 2015 targeting Japanese nurses in a hospital accepting Indonesian nurse trainees.Results: We received responses from 97 of the 109 participants (collection rate: 89%, valid response rate: 100%). "Length of education," "overseas travel experience," "number of countries traveled," "length of stay," and "foreign language learning experience" were significantly related to tolerance and this supported results from previous research targeting residents. Foreign language learning experience had a significantly greater influence on increasing tolerance compared to agreement with policies on introducing foreign nurses. These are important findings when considering future nurse education and smooth cooperation with foreign nurses. Although no research thus far exists on Japanese nurses working alongside foreign nurses in Japan, research on accepting foreign nurses has begun in Japan after the EPA signing. However, most of this research was on the original countries' nursing education and nursing systems, and were surveys of Japanese nurses and nursing students on the positives and negatives of accepting foreign nurses.Writing about Japan's acceptance of foreigners, Kozakai states that although Japan welcomes information and concepts from different cultures, it also rejects the actual people who create and bring those things (Kozakai, 1996). Previous research has also shown that most nurses have negative feelings toward foreign nurses (Kawaguchi, 2009;Takahashi, 2014). Considering Japan's declining birthrate, aging population, and nurse shortage, as well as the global trend of cross-border nurse expansion, it is predicted that opportunities to work alongside foreign nurses will increase in the future. Therefore, it is essential to work together to minimize friction between those from different cultural backgrounds.Yasuda reports that tolerance of people who are different is important in promoting cooperation, building trust, and generating smooth business conduct with foreigners when accepting foreign workers of different cultural backgrounds into the Japanese workplace (Yasuda, 2009). Tolerance among people in the accepting majority is thought to lead to intercultural adjustment for foreigners and understanding on both sides (Adachi, 2008).The relationships between tolerance of foreigners and "age," "academic background,"and "experience with foreigners and different cultures" have been widely reported within the domestic and foreign sociology and social psychology fields. Tolerance of foreigners is DOI: http://dx.doi.org/10.14391/ajhs.11.1 Asian Journal of Human Services, VOL.11 1-17 3 Services Human generally greater the younger someone is (Tanabe, 2001;Matsumoto, 2004; Hirota, Machimura, Tajima et al., 2006;Mori, 2006;Ito, 2011;Nukaga, 2006;Ohtsuki, 2006;Mazumi, 2015;Bettelheim, 1949; Quillian,1995)...

This study aims to evaluate the effectiveness of teaching START (Simple Triage and Rapid Treatment) to nursing students using videos. To this end, we conducted a study from October 1, 2016 to March 31, 2018, instructing nursing students to view a video of 30 simulated cases and to perform triage exercises both before and after START training. Subjects included 57 freshmen and 56 seniors. We calculated the accuracy rate for each case and examined those where students were most likely to make mistakes. We found that after START training, both freshmen and senior students did significantly better on the triage exercises. Before the training, seniors treated an average (± standard error (SE)) of 23.5 ± 0.7 out of 30 patients correctly, while after the training, this number increased to 29.3 ± 0.2 (p < 0.001). For freshmen, the increase was even more drastic, increasing from 17.4 ± 0.6 correct before the training to 29.1 ± 0.3 after (p < 0.001). While freshmen initially answered far fewer questions correctly, after the training, there was no significant difference in the performance of freshmen and seniors: both groups had an overall accuracy rate of 95% or higher. The drastic performance increase even of freshmen with little medical knowledge suggests that this program may even be effective for the general public, making our results relevant for developing better disaster medical care in the future.

START is a system of primary triage performed on casualties at the scene of a mass-casualty incident. START is an acronym for "Simple Triage and Rapid Treatment" by which casualties are sorted into four triage categories. After conducting the triage simulation exercises, the authors realized that some students repeated the same errors despite having completed the triage classes. The purpose of this study is retrospectively to examine some mis-categorized cases to identify causes of triage errors, and thereby inform the future design of courses for triage education.Subjects were 115 fourth-year nursing students at a university in Kyushu, Japan who completed a two-day disaster nursing course. Nursing students were asked to fill out an answer sheet in the first session (hereafter referred to as "pre-intervention") and again in the second session held a week later (hereafter referred to as "post-intervention"). Many of those were about mis-categorizing "green" casualties as "yellow" and vice versa, which implied that students had difficulty in making triage decisions between the "walking wounded/minor" and "delayed" categories.The results of the study showed that most students were likely to answer the triage questions largely based on their perception of visual information (such as video images) rather than on triage criteria. A number of studies have reported on the effectiveness of simulation education, including field training exercise, both in Japan and abroad (Powers, 2007;Howard，2014;Donatelli ， 2012;Nesbitt, 2015). Although the field training exercise at the above-mentioned university was also proven to be effective, it was difficult for the university to continue to organize a field training exercise for nursing students every year.In an effort to complement desktop learning, the university introduced a triage simulation exercise using video content to allow the students to practice triaging casualties. After conducting the triage simulation exercises, the authors realized that some students repeated the same errors despite having completed the triage classes, and in addition, multiple students gave the same wrong answers to certain questions. The authors had predicted that the students would have difficulty in making triage decisions between the "yellow" and "red" categories most probably because they would be unable fully to understand the levels of severity for those categories. Contrary to that prediction, students' test records indicate that they wavered most between the "green" and "yellow" categories, both before and after the triage classes. revealed the difficulty students find in distinguishing patients in the "green" category from those in the "yellow" category. The authors believe that it is important to identify factors behind such difficulty for the future advancement of disaster medical response.The purpose of this study is retrospectively to examine some mis-categorized cases to identify causes of triage errors. Ⅱ. Subjects and Methods Subjects and ProceduresParticipants: 115 fourth-...