The Effect of Aroma Hand Massage Therapy for People with Dementia.

OBJECTIVES: Clinical aromatherapy is a complementary therapy that may be very helpful for elderly dementia care. Aromatherapy may reduce the behavioral and psychological symptoms of dementia (BPSD), improve quality of care, and thus improve the quality of life for people with dementia. In this pilot study, aroma hand massage therapy was used for elderly patients in a medical institution in Japan. The study assessed the effectiveness and safety of clinical aromatherapy as part of routine integrative care among people with dementia in a clinical care setting. INTERVENTIONS: The randomized, crossover pilot trials were performed among 14 patients with mild-to-moderate dementia older than age 65 years living in a nursing home in Nara, Japan. Participants were divided into two groups and offered, alternately, control therapy and clinical aromatherapy 3 times a week for the 4-week trials. The effects on BPSD and activities of daily living (ADLs) were evaluated quantitatively before and after the study and 4 weeks after the study ended as a follow-up. Observation records were also collected to obtain qualitative data. RESULTS: The quantitative data showed that neither therapy significantly improved the BPSD or ADL results. The qualitative data were classified into four main categories-mood, behavior, verbal communication, and nonverbal communication-reflecting the positive experiences of participants during both therapies. No harmful reactions or changes in medication occurred during the study. CONCLUSIONS: This pilot study demonstrated that clinical aromatherapy was clinically safe but did not lead to statistically significant improvements in BPSD or ADL among people with dementia. Further research on therapeutic effects is needed to develop high-quality care with clinical aromatherapy for elderly patients with dementia in Japan and to fully establish evidence for effective and safe practice in health care institutions.

The importance of socio-environmental and personal factors related with smoking among high school seniors in western Kanagawa Prefecture, Japan.

OBJECTIVES: The purpose of this study was to identify socio-environmental and personal variables associated with high school students smoking behavior by applying multilevel analyses. METHODS: A cross-sectional survey of the first-year students of five public senior high schools in western Kanagawa Prefecture, Japan was conducted using multilevel logistic regression analyses with students at level 1 and schools at level 2. Self-administered questionnaires were returned by 517 out of 597 enrolled students, and information was collected regarding the prevalence of previous and current smoking and socio-environmental, educational and personal variables. RESULTS: The rates of past and current smoking were found to be 25.2% and 12.6% in males and 16.9% and 5.2% in females, respectively. Maternal smoking, having friends or older school-mates who smoked and lower probabilities of high school academic achievement potential were significantly associated with both past (adjusted ORs of 2.37, 4.28 and 2.98, respectively) and current (adjusted ORs 2.46, 5.57 and 3.02) smoking. CONCLUSIONS: It is recommended that health professionals in charge of school-based educational programs should tailor the teaching methods to fit the students' backgrounds and specific vulnerabilities. Educational programs for smoking prevention focusing on the students' mothers and classmates or students in high schools with reduced academic achievement potential should be developed.

[Factors associated with successful smoking cessation among adolescent smokers undergoing a smoking cessation program involving nicotine replacement therapy].

OBJECTIVE: To identify factors associated with successful smoking cessation among adolescent smokers in a smoking cessation program involving nicotine replacement therapy. METHODS: We recruited adolescent smokers who were prepared to quit smoking and participated in the smoking cessation program in Kanagawa prefecture. All participants fulfilled a questionnaire beforehand, covering gender, age at the beginning of the study, age at onset of smoking, the number of quit attempts, the number of cigarettes per day and the smoking status of their families and friends. Seven nicotine patches (nicotine 52.5 mg/day) were given to them free of charge for daily use. Their smoking status and the use of nicotine patches were confirmed by telephone or postcard at the 1 and 6 month follow-ups. The relationships between successful smoking cessation and different factors among eligible participants were analyzed using the Fisher's exact test and the Mann-Whitney U test. RESULTS: The subjects included 39 adolescent smokers (mean 16.4 years). The mean age at onset of smoking and the mean duration of smoking were 13.3 years and 2.3 years, respectively. The average daily number of cigarettes smoked was 12.8. Of 39 eligible participants at the one month follow up, 14 (35.9%) were found to be abstaining from smoking. The subjects treated with nicotine patches were significantly more likely to be abstinent than those without them (P<0.05). However, no significant associations with other factors were found. Of 39 participants at the six months follow up, 10 (25.6%) were still abstinent but there were no significant associations with any of the factors, including use of nicotine patches. Subjects living with smokers were significantly less likely to be successful in their efforts to quit than those living with non-smokers (P< 0.05). There were no significant associations with other factors, including using nicotine patches. No adverse events relating to the use of the nicotine patches were encountered during the study period. CONCLUSION: The smoking cessation program involving NRT provided for adolescent smokers appeared effective at the one month follow up. Those adolescents living with smokers had more difficulties in quitting smoking than those with non-smokers at the 6 month follow up. In order to increase the number of adolescent smokers in the smoking cessation study, the need to obtain parental consent might be considered as a barrier to be overcome. Additionally, more effective follow-up procedures should be considered for the purpose of avoiding dropouts during the study.

[Predictors of abstinence from smoking among participants in a smoking cessation program in a health center in Japan].

PURPOSE: To identify predictors of successful smoking abstinence. METHOD: A prospective analysis was conducted of a group of 687 individuals (mean age +/- SD 49.5 +/- 14.6 years, range 20 to 81 years) comprising 518 males and 169 females, who attempted to stop smoking by participating in smoking cessation programs provided by Kamakura Health Center in Japan from September 2002 to September 2003. They were provided with free nicotine patches and referred to medical clinics for follow-up. Baseline characteristics such as age, gender, program settings, daily cigarette consumption and time to the first cigarette of the day were recorded at the start of the program. Smoking status was confirmed at the one-year follow up. In addition, the participants were asked whether they had used free nicotine patches or follow-up nicotine patches and gum. The relationships between characteristics used to assess smoking abstinence rates were first analyzed using a chi2 test. Logistic regression analysis was then employed to identify independent predictors of smoking abstinence at the one-year follow up. RESULTS: A total of 687 smokers who participated in the program were registered at the start of this study. Out of these, 528 (76.9%) were eligible because their smoking status could be confirmed at the one-year follow up. The rate of smoking abstinence at the one-year follow up was 39.2%. No significant differences were observed in the rates of smoking abstinence among the participants at the one-year follow up based on gender, daily cigarette consumption or time to the first cigarette of the day. When participants were over fifty years of age (abstinence rate 47.0%), were provided with the program conducted at the Health Center (abstinence rate 50.3%), used free nicotine patches (abstinence rate 50.7%) and received follow-up nicotine replacement therapy (abstinence rate 57.7%). they were significantly more likely to have stopped smoking than the reference groups. With the above-mentioned four predictors, adjusted odds ratios of smoking abstinence observed in the logistic regression analysis were 1.68, 1.80, 2.01 and 1.79, respectively. CONCLUSION: We found a 39.2% smoking abstinence rate at one-year follow up among smokers who were treated with free nicotine patches in the smoking cessation program by the Kamakura Health Center. It was indicated that predictors of smoking abstinence are age (over fifty years), location (at the Health Center), use of free nicotine patches and receipt of follow-up nicotine replacement therapy.