Background/Objectives: Since April 2006, smoking cessation treatment has been included in public health insurance coverage, although conditionally. The tobacco control program usually takes 12 weeks or so. When it comes to the form of treatment, most medical care facilities adopt nicotine replacement therapy (NRT) at their outpatient ward. The cessation success rates are considered not so high as before. In stead of treating nicotine-addict outpatients individually, our hospital has been offering a stop-smoking program all its own since 1999. This study was designed to examine the results of our efforts in the last six years retrospectively.Subjects/Methods: Enrolled for this study were 232 patients who had participated in our six-month smoking cessation program between 1999 and 2005. A non-smokingsupport team made up of a physician, pharmacist(s), nurses, dietitian(s) and physical therapist(s) takes care of groups of participating patients, each group consisting of 10 or less. The patients undergo behavior therapy throughout the 6-month period and NRT in the first eight weeks. Under the program, nutrition guidance is offered regularly by dietitians for weight control and physical exercises by physical therapists for relief from the stress due to abstinence from smoking. We took a questionnaire survey of all the subjects and worked out the ratios of those persons who had remained abstinent up to one year after they stopped smoking to the total.Results: The rates of abstinence maintained eight weeks, six months and one year after the start of cessation were 78.4%, 70.3% and 64.7%, respectively. Of those who were still abstinent, 78.0% replied that they found it easy to resist the urge to smoke cigarette thanks to the smoking cessation program.Conclusion: Our six-month participatory tobacco control program was found effective as high cessation rates were maintained.
Cessation of smoking ; seconds ; month ; week ; Smoking

Objective: In order to assess usefulness, applicability and problems of aromatherapy in the modern medical practice.
Method: We conducted a questionnaire survey on the recognition and utilization of complementary and alternative medicine (CAM) and medical aromatherapy in a professional school of acupuncture and Judo-therapy in Osaka City. The respondents were 866 students at the school.
Results: We found that 97.1% of the respondents had experienced at least one CAM therapy and 25.8% had aromatherapy. Compared to male students, more female students used aromatherapy. Perceived effectiveness of aromatherapy for purpose of the use ranged between 73.8% and 89.2%. Approximately 70.0% of the respondents were interested in medical aromatherapy, and 89.4% expected this therapy for psychosomatic/mental diseases. Main problems pointed out were collecting more scientific evidence and reducing the costs.
Conclusion: The results suggest that aromatherapy may become more widespread and one of the options to make the current clinical practice more satisfactory for patients.

Objective: It has been reported that essential oils used in aromatherapy effect the nervous, immune and endocrine systems. The purpose of this study was to assess the effects of essential oils on the cardiovascular system in healthy human subjects.
Methods: Rosemary essential oil, which reportedly has a vasopressor-like effect, and lavender essential oil which reportedly has a depressor-like effect, were administered to sixty subjects divided into rosemary, lavender, or control groups. Blood pressure and heart rate were measured after two-minutes of smelling. Data were compared among the three groups.
Result: Heart rate increased in the rosemary group. In addition to blood pressure and heart rate increased in subjects who expressed a negative impression from smelling a specific essential oils.
Conclusion: The results suggest that fragrance preference affects the therapeutic effects of aromatherapy.

Nutritional profiles in middle-aged trained and untrained women were compared both before and after menopause. Subjects were assigned to one of four groups : (1) pre-menopausal trained (Pre-T: n=14, aged 43±5 years, running distance 56±27 km/week, Vo₂max 49±4ml/ kg/min, mean±SD), (2) pre-menopausal untrained (Pre-UT: n=25, 42±5 years, 34±5 ml/kg/ min), (3) post-menopausal trained (Post-T: n=19, 53±3 years, 49±17 km/week, 42±6 ml/ kg/min), (4) post-menopausal untrained (Post-UT: n=26, 54±3 years, 31±3 ml/kg/min) . There were no significant differences in hematocrit (range 38.7 to 39.3%), hemoglobin (12.8 to 13.1 g/dl) and total protein (6.9 to 7.1 g/dl) among the four groups. Serum iron concentrations in the post-menopausal women (Post-T: 97±30μg/dl, Post-UT: 106±29μg/dl) were relatively higher than in the pre-menopausals (Pre-T: 85±35 pg/dl, Pre-UT: 78±33 pg/dl) . Mean total iron binding capacity in Post-UT (326 pg/dl) was lower than other groups (352 to 361 pg/dl) . Higher serum ferritin levels were observed in the post-menopausal women (Post-T : 35.8±27.5 ng/ml, Post-UT : 60.4±47.1 ng/ml) than the pre-menopausals (Pre-T: 18.3±13.1 ng/ml, Pre-UT: 16.6±10.7ng/ml) . Intake levels of the four groups with regard to the major nutrients were sufficient as compared with the recommended dietary allowance appropriate for age, sex and physical activity level. Intakes of calcium, iron and vitamins B₁, B₂ and niacin were higher in the trained groups than in the untrained. Regularly performed endurance exercise resulted in higher protein and iron intakes associated with higher energy intakes both before and after menopause. These results suggest that nutritional status of middle-aged women who regularly perform vigorous endurance running could be adequate for maintaining their health in a good state.

Because recent changes in medical care security policy have made clinical skills training difficult, even in teaching hospitals, training with suitable models and simulators is becoming essential for medical students to acquire clinical skills. On the basis of these changes, we performed a nationwide survey on the prevalence and application of clinical skills laboratories for clerkships in Japan. Registered questionnaires were sent to all medical schools in Japan （n＝80） in December 2012. The response forms were filled out by clinical instructors and by the staff responsible for the skills laboratory. The response rate was 94% （75 of 80 schools）. Seventy-one schools （95%） have already installed clinical skills laboratory; however, floor area and availability varied greatly among schools. Floor space ranged from 24 to 2,250 m2 （median, 214 m2）. The number of uses of the facility by medical students in the 2011 school year ranged from less than 100 to more than 10,000 （median, 1,402）. Forty-two schools （59%） had a resident director for the skills laboratory. Simulators of most universities （> 90%） were venopuncture simulators, lung-sound simulators, basic life support mannequins, heart-sound simulators, surgical suture trainers, and automated external defibrillator trainers, and all were frequently used. These results suggest considerable differences among schools in simulation-based learning environments during clinical clerkships. Although most medical schools in Japan have their own clinical skills laboratories, their size, service, and frequency of use vary greatly.

Many people have been killed or physically disabled during twenty-year internal conflict in Cambodia. People still get injured due to remained land mines and unexplosive ordnances, even a decade after the cease-fire. This paper aims to examine the situation of the physically disabled and assistance programs in Cambodia by analyzing published documents and visiting activity sites, and to discuss future challenges. In this paper, the physically disabled mainly implies adults and children with orthopedic impairments.
The major causes of physical disability are: land mines; unexplosive ordnances; traffic accidents; occupational accidents such as falling down from palm trees; infectious diseases, etc. Casualties of land mines and unexplosive ordnances were 50,915 (13,686 were dead) between 1979 and 2000. Recently, the number of land mine accidents has been declining, while that of traffic accidents has been increasing.
Since 1980s, many international NGOs have assisted land mine victims through providing with artificial limbs, prostheses and rehabilitation services. However, the assistance for the disabled people of other categories has been neglected. The international NGOs provide services based on their own interests, therefore, the participation of the disabled people and their family in the assistance programs has been limited. The government plays only limited roles to endorse the activities of the international NGOs, and has not had any specific strategies to prepare for the future withdrawal of the NGOs.
Disabled people require assistance not only for health, but also for education, employment, etc. On the other hand, it is also very important to empower and build capacity of them, so that they can contribute to the development of the Cambodian society. Additionally, means of prevention should be considered as one of the key perspectives. Sustainable supporting systems should be established by the government and domestic NGOs through participation of the disabled themselves.

Many young mothers get nervos when their children in hospital fret or cry at night. This problem has been regarded as a result, at least in part, of a deficiency in nursing time and experience of child care in this age of nuclear family or dualincome family. We thought, that it would be possible to reduce their anxiety if they were trained and had personal experience getting contact with other children and nurses.
By way of acting out this idea, we invited them to participate in creative play such as “origami”(the craft of paper folding) and evaluated how it worked based on a questionnaire obtained from 50 mothers. The results indicated that they became able to take care of thier children properly according to the health condition of each child after having relationships with other children, mothers and nurses through the group play. Such experience has naturally helped the mothers to gain knowledge and skill in child care. In the present surrey, 96% of the respondents said that they were happy to be together with their children in a hospital, and all acknowledged that they had learned many things through communication with other children and mothers. We conclude that this way of learning by experience through creative play is effective in relieving the anxiety of mothers about child care in a pediatric hospital.

Objective: At Kitasato Institute Hospital, Kitasato University (henceforth, the hospital), the first edition of an antimicrobial use guidebook (henceforth, the guidebook) was produced in 2000.  This time, the Pharmaceutical Department’s members on the hospital’s Infection Control Committee (ICC) took the lead and revised the guidebook so that it better conforms to clinical conditions and assessed the guidebook they created.
Methods: A Working Group (WG) consisting of two ICC Pharmaceutical Department members and two members of the Medical Products Information Office staff examined the items to be listed in the guidebook.  These items were approved by the ICC and then assigned to physicians and pharmacists to be written up.  A questionnaire survey was conducted on the physicians and pharmacists in the hospital as to their assessment of the content and the conditions of use of the guidebook created.
Results: In the revised edition, “Antimicrobials PK/PD,” “TDM,” “Empiric Therapy for Infections in Each Department,” etc. have been added, the physicians wrote “Empiric Therapy for Infections in Each Department” and everything else was written by the WG.  The return rate of the questionnaire was 65.7% (N=99), and the guidebook utilization rate was 75.4%.  Frequently viewed items were “List of Antimicrobials Used In-Hospital,” “How to Administer Medication during Decreased Renal Function,” “Empiric Therapy for Infections in Each Department,” etc. by the internal medicine physicians, “List of Antimicrobials Used In-Hospital” and “How to Administer Medication during Decreased Renal Function,” etc. by the surgeons, and “Classification of Antimicrobials,” “List of Antimicrobials Used In-Hospital,” “When Renal Function is Decreased,” “TDM,” and “Empiric Therapy for Infections in Each Department,” etc. by the residents.  Furthermore, there were no items deemed “not necessary for inclusion” for a clear reason.  As to be expected in this guidebook, 72.3% of all respondents mentioned it was “a source of information on basic antimicrobial use” and next, “a source of information for treating infections outside one’s area of specialty.”
Conclusion: The items listed in the guidebook are thought to be appropriate, and its usage conditions are also good.  As they are specialists on antimicrobials, the pharmacists playing a central role while cooperating with the physicians on the ICC led to the creation of a highly useful guidebook.