The purpose of this study was to elucidate the developmental changes in joint attention and the effects of joint attention on child development. The subjects were 35 mothers and their infants. Mother-Infants' play sessions were observed and recorded on videotape in their homes when the infants were 13, 18 and 24 months old. Joint attention was categorized into coordinated joint attention (CJA) and passive joint attention (PJA). The Kyoto Scale of Psychological Development (KSPD) was used to assess child development. The main findings were as follows.
1) There were no differences in CJA according to the age of the child, but PJA increased significantly with the age of the child.
2) Joint attention when the child was 13 and 18 months old was positively correlated with KSPD when the child was 24 months old.
The results of this study on joint attention using Japanese mothers and infants as subjects differed both qualitatively and quantitatively from those obtained from studies performed in USA. The results of this study suggest that subsequent child development can be predicted by the degree of joint attention during infancy.

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To identify the structure and predictors of empowerment among public health nurses, a questionnaire survey was conducted among 470 such nurses.
There were 191 replies, from which the following (40.6% response rate) results were obtained.
1) Using factor analysis, these 4 factors were identified as an integral part of empowerment: the ability to encourage family self-help, the ability to develop autonomy in others, the positive influence on communities, and an affirmative attitude toward work.
2) A principal component analysis of each factor was made, and three sub scales, namely encouraging family self-help, autonomy and community influence, made up the empowerment scale.
3) For developing greater skills in encouraging family self-help, the most apparent factors were frequent consultations with workers in related occupations, and strong motivation for self-fulfilment.
4) For autonomy, the most apparent factors were lower populations under their jurisdiction, more experience as a public health nurse, frequent consultations with workers in related occupations, high levels of work-life satisfaction and strong motivation.
5) The factors enhancing community influence were older age and motivation for self-fulfilment.
From the above results,the empowerment of public health nurses is promoted by age and years of experience. It is also increased by the individual personalities of public health nurses who are more satisfied with their work and are more strongly motivated to succeed. For greater empowerment of public health nurses, this study suggests that it is also necessary to improve the workplace so that public health nurses can easily relate to workers in similar occupations.

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This study evaluated the effectiveness of nurses' discharge education and post-discharge patient problem prediction for hospitalized patients experiencing neurological problems. A sample of 21 nurses providing discharge education and 107 patients who received the education at a university-based hospital was studied using survey methodology. Eleven patient problem areas were identified and questionnaires investigated three issues for each area: 1) discharge education; 2) post-discharge patient problem prediction, and 3) actual post-discharge patient problems. Results revealed that the effectiveness of discharge education and the accuracy of patient problem prediction varied according to the problem areas. Activities of daily living (ADL) skills were frequently taught and ADL problems were accurately predicted. However, a significant number of patients continued to experience ADL problems. Information about medical procedures and medication was frequently provided and few patients experienced problems in these areas after discharge. Disease management, anxiety, family dynamics, living environment and social and recreational activities were less frequently discussed in discharge education, were predicted inaccurately and many patients experienced post-discharge problems in these areas. Financial problems were rarely predicted but many patients experienced such difficulties. Generally, patients who received education about social services did not experience problems in accessing them while those who had not received such information had significant related problems. This research highlights a need for nurses to focus discharge education and problem prediction on holistic concerns and not limit it to medical procedures and medication.

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Purpose: This study assessed the need for in-service education by comparing staff development educator's needs with staff nurse's learning needs. Educational/learning needs were identified by focusing on_??_?The Professional Nursing Competencies_??_?, based on the Competency Model Method.
Subjects & Methods: 48 educators and 240 staff nurses in 7 N-affiliated hospitals were the subjects of this analysis. A needs assessment questionnaire consisting of 9 categories was developed and used for data collection.
Results:
1. A review of the data indicated a gap in needs between educators and staff nurses. Educator's needs showed significantly higher scores than staff nurse's needs for Teaching, Management, Research-based Practice,and Decision-Making. By contrast, the staff nurse's needs yielded somewhat higher scores for both Understanding Clients and Clinical Skills.
2. The learning needs of staff nurses were influenced by years of nursing experience and self-directed learning.
(1) We discovered significant differences in Understanding Clients, Clinical Skills, Nursing Process, Counseling, and Decision-Making according to duration of nursing experience. Nurses who had worked for more than 4 years had lower scores than the others.
(2) Nurses who had continued self-directed learning had a significantly higher score for Research based Practice and Teaching than the others.
3. Concerning the timing of continuing education, educator's needs tended to be concentrated within the first 3 years after graduation. However, analysis of the priority of learning needs showed that nurses tended to have wider interests in continuing education after 4 years experience.
Conclusion: These findings suggest that education for professional nurses should be on a continuing basis.

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