奈良学園大学

ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) is associated with reduced physical function and quality of life and has a substantial impact on employment. In Japan, employment rates among patients with COPD are particularly low. Although airflow limitation and comorbidities have been linked to employment status, the role of exercise tolerance remains unclear. Objectives: This study aimed to investigate the characteristics of working men with stable COPD and to identify factors associated with employment status, with a focus on exercise tolerance. Methods: A total of 240 men with stable COPD were included in this cross-sectional study. The measurements included respiratory function, grip strength, knee extension strength, peripheral oxygen saturation, pulse rate (PR), degree of dyspnea (chest), and lower limb fatigue (leg) during the 6-min walk test (6MWT), respiratory rate, 6-min walk distance (6MWD), and Nagasaki University Respiratory Disease ADL Questionnaire. Independent two-sample tests, multivariate logistic regression analysis, and receiver-operating characteristic analysis were used to examine the relationship between employment status and each indicator, with a significance level set at 5%. Results: The analysis included 20 and 115 individuals from the working and nonworking groups, respectively. Propensity score matching was performed with age as a covariate, resulting in the selection of 20 individuals from the nonworking group. The working group showed significantly higher values than the nonworking group in forced expiratory volume in 1 s (FEV1.0) ( P = 0.037), FEV1.0% (P = 0.05), %FEV1.0 ( P = 0.035), maximum PR during the 6MWT (PR max; P = 0.005), and 6MWD ( P = 0.016). In addition, the 6MWD was identified as a factor associated with employment status (odds ratio = 1.007, confidence interval: 1.001–1.013, P = 0.023). Moreover, the area under the curve was 0.73 ( P = 0.013), and the cutoff value for the 6MWD was 224.5 m. Conclusion: The study suggests that the 6MWD is associated with employment status in men with COPD.

IMPORTANCE:The optimal duration of occupational therapy after distal radius fracture remains uncertain. Occupational therapy practitioners focus on objective indicators such as range of motion and grip strength, whereas patients prioritize subjective daily activity difficulties. OBJECTIVE:To identify objective and subjective factors influencing decisions to continue occupational therapy from therapists' and patients' perspectives. DESIGN:Prospective observational cohort study. SETTING:Multicenter. PARTICIPANTS:Patients (N = 143) who underwent open reduction and internal fixation for distal radius fracture were enrolled. The number of participants analyzed at Postoperative Weeks 4, 8, 12, and 24 was 143, 138, 114, and 82, respectively, because of attrition and incomplete data. OUTCOMES AND MEASURES:Objective assessments included range of motion and grip strength, whereas patient-reported outcomes were assessed using the Hand20 questionnaire. Therapists and patients evaluated the necessity for continued occupational therapy. Statistical analyses included Cohen's κ for agreement, Lasso regression for variable selection, and generalized linear models for significance testing. RESULTS:Therapists prioritized objective measures (range of motion, grip strength), whereas patients emphasized subjective difficulties with daily activities. At Postoperative Week 8, Hand20 scores significantly affected the decisions of both groups, more closely aligning with perceptions. By Postoperative Week 12, therapists reverted to objective measures, renewing discrepancies. CONCLUSIONS AND RELEVANCE:Discrepancies exist between therapists' objective assessments and patients' subjective recovery requirements regarding therapy continuation. With limited evidence supporting therapy beyond 12 wk, integrating patient-reported outcomes into shared decision-making may enhance functional recovery and satisfaction, particularly during the first 8 wk postoperation. Plain-Language Summary: This study investigated how patients and occupational therapists decide whether to continue or discontinue therapy after a wrist fracture. Therapists focus on movement and strength, whereas patients care more about how their hand feels during daily activities. Early after surgery, their views were different; however, by 8 weeks, similarities were observed. Subsequently, differences reemerged. The results suggest that listening to patients' experiences, especially during the first 8 weeks, may improve therapy plans and recovery outcomes.

OBJECTIVE:This cross-sectional study investigated physical factors associated with dyspnea-related work productivity loss among employed individuals with respiratory diseases, estimating annual economic loss. METHODS:Fifty-one employed individuals undergoing respiratory rehabilitation at our Hospital (April 2023-August 2024) were enrolled. The Quantity and Quality method assessed work productivity. Physical function was evaluated through pulmonary tests, grip and knee extension strength, SpO₂, pulse rate, respiratory rate, 6-minute walk distance (6MWD), recovery time, and Borg scale ratings. RESULTS:Twenty-nine participants were analyzed. Reduced work productivity correlated with decreased FEV₁/FVC, decreased Nagasaki University Respiratory Activities of Daily Living scores, decreased 6MWD, and extended recovery time. Annual productivity loss averaged 42%. 6MWD independently predicted productivity loss, with ≤220 m strongly indicating risk. CONCLUSION:6MWD predicts dyspnea-related productivity loss; monitoring exercise tolerance may help maintain work productivity in respiratory disease.

Background and Purpose: As the workforce ages, facilitating the integration of medical care and occupational activities is a key concern for individuals with chronic obstructive pulmonary disease. Although dyspnea is associated with reduced work productivity, the relationship between employment status and the effects of pulmonary rehabilitation remains unclear. This study examined whether changes in exercise capacity and dyspnea following pulmonary rehabilitation differed according to employment status in individuals with chronic obstructive pulmonary disease. Methods: This exploratory prospective cohort study included 34 individuals with chronic obstructive pulmonary disease who participated in a 3-month outpatient pulmonary rehabilitation program. Participants were classified as employed (n = 6) or unemployed (n = 28). To evaluate changes following pulmonary rehabilitation, a two-way repeated-measures analysis of covariance (ANCOVA) was performed. Time (pre- and post-intervention) was treated as a within-subject factor, while employment status served as a between-subject factor, with age incorporated as a covariate. The primary endpoints were functional exercise capacity, evaluated using the 6 min walk distance, and dyspnea severity, assessed using the modified Medical Research Council scale. Results: For functional exercise capacity, neither the time × employment status interaction nor the main effect of time was statistically significant (p = 0.165 and p = 0.062, respectively). For dyspnea, the time × employment status interaction was not statistically significant (p = 0.567), whereas a significant main effect of time (p = 0.020) and a significant time × age interaction (p = 0.014) were observed. Exploratory within-group comparisons did not detect significant changes in either employment group. Discussion: No statistically significant differences in changes in exercise capacity or dyspnea were detected between employment groups. The significant main effect of time for dyspnea should be interpreted in light of the significant time × age interaction. Given the small and markedly unequal group sizes, particularly the limited number of employed participants, these findings should be regarded as exploratory and hypothesis-generating. Larger prospective studies are required to determine whether employment-related factors modify responses to pulmonary rehabilitation.

Harada conjectured that the product of the sizes of all conjugacy classes is divided by the product of the degrees of all irreducible characters for any finite group. When the group is the symmetric group Sand the alternating group A , this conjecture is presented by the hook length properties of the Young diagram (cf. [1]). We show the conjecture for the covering groups S-n and A(n) (n >= 4).