Perceptions and practices of Japanese nurses regarding tobacco intervention for cancer patients.

BACKGROUND: We investigated the perceptions and practices regarding tobacco intervention among nurses, as improvement of such practices is important for the management of patients who smoke. METHODS: Self-administered questionnaires were delivered by hospital administrative sections for nursing staff to 2676 nurses who were working in 3 cancer hospitals and 3 general hospitals. Of these, 2215 (82.8%) responded. RESULTS: Most nurses strongly agreed that cancer patients who had preoperative or early-clinical-stage cancer but continued to smoke should be offered a tobacco use intervention. In contrast, they felt less need to provide tobacco use intervention to patients with incurable cancer who smoked. Most nurses felt that although they assessed and documented the tobacco status of cancer patients, they were not successful in providing cessation advice, assessing patient readiness to quit, and providing individualized information on the harmful effects of tobacco use. In multivariate analysis, nurses who received instruction on smoking cessation programs during nursing school were more likely to give cessation advice (odds ratio, 1.61; 95% confidence interval, 1.15-2.26), assess readiness to quit (1.73, 1.09-2.75), and offer individualized explanations of the harmful effects of tobacco (1.94, 1.39-2.69), as compared with nurses who had not received such instruction. CONCLUSIONS: The perceptions of Japanese nurses regarding tobacco intervention for cancer patients differed greatly by patient treatment status and prognosis. The findings highlight the importance of offering appropriate instruction on smoking cessation to students in nursing schools in Japan.

Smaller brain size likely in young adults (<40 years old) with depressive symptoms compared to healthy controls: a retrospective study.

PURPOSE: The aim of this study was to determine whether the brain size of young patients with depressive symptoms is smaller than that of healthy controls using magnetic resonance imaging (MRI). MATERIALS AND METHODS: We retrospectively evaluated brain size by calculating the ratio of the brain area to that of the skull (the brain-to-skull ratio) on routine MRI scans including the splenium of the corpus callosum obtained from 19 patients <40 years old with depressive symptoms in 2009. The controls were 12 healthy individuals <40 years old who underwent MRI for medical examinations. RESULTS: The mean brain-to-skull ratio of the control group was 0.850 ± 0.022 (range 0.822-0.889), and that of the patient group was 0.819 ± 0.041 (range 0.756-0.878). An unpaired t-test showed a significant difference in the brain-to-skull ratios between these groups (P = 0.011). In particular, in 7 of the 19 patients with longer duration of illness and more severe symptoms, the brainto-skull ratio was 89%-92% of the mean ratio of the control group. CONCLUSION: The brain size of young patients with depressive symptoms appears to be smaller than that of healthy controls.