1.Employment Aspirations of Individuals with Advanced or Terminal Cancer and the Role of Occupational Therapists: A Nationwide Survey of Designated Cancer Care Hospitals in Japan
Hiroyuki ASE ; Takuro SAKURAI ; Hinako SEKIHARA ; Akira TANUMA ; Toshiyuki FUJIWARA
Palliative Care Research 2025;20(4):251-258
Objective: This study aimed to clarify the current practices of occupational therapy (OT) in addressing the employment aspirations of individuals with advanced or terminal cancer. Methods: A web-based questionnaire survey was administered to occupational therapists (OTs) working at designated cancer care hospitals across Japan. Data were analyzed using descriptive statistics and a qualitative descriptive approach. Results: A total of 278 OTs responded to the survey, of whom 119 (43%) had experience supporting employment in this patient population. The purposes of employment aspirations were categorized as financial reasons, social roles and responsibility to others, and self-realization or self-fulfillment. Agreed-upon goals included full-time return to work (32 cases, 27%) and part-time or reduced-hours return to work (38 cases, 32%). In addition, some goals did not lead to actual employment but reflected patients’ wishes, such as life review (7 cases, 6%) and simulated activities (7 cases, 6%). Conclusion: Employment aspirations in patients with advanced or terminal cancer are rooted in diverse psychosocial factors beyond economic motivations. OTs play a vital role in supporting these patients by respecting their wishes and helping set realistic goals that enhance quality of life.
2.Survey on the Effectiveness of the “Let's Become a Physiatrist” Seminar
Fumihito KASAI ; Dai FUJIWARA ; Mari KAKITA ; Akira YOSHIDA ; Hidetsugu MATSUMOTO ; Michiyuki KAWAKAMI ; Takumi IKEDA ; Takashi HIRAOKA ; Fumihiro TAJIMA
The Japanese Journal of Rehabilitation Medicine 2023;60(3):248-252
Objective:Only 44 of the 82 university medical schools in Japan have rehabilitation medicine departments, although rehabilitation medicine is one of the 19 basic specialties recognized by the Japanese Medical Specialty Board, and many medical doctors are concerned regarding selecting rehabilitation medicine as a basic specialty without sufficient education in the field. The “Let's Become a Physiatrist” Seminar has been organized since 2017 to eliminate such concerns, and this study aimed to investigate how these results are manifested in the number of majors.Methods:We examined the number of past attendees and tracked how many of them became rehabilitation medicine majors.Results:The number of seminar attendees over a 5-year period was 589. The number of on-demand viewers in FY2020 and FY2021, which were held via the web, was 554. A total of 116 of the 471 physicians who began specialty training in rehabilitation medicine after the seminar was planned attended or web viewed the seminar accounting for 24.63%.This percentage has been increasing each year, with 36.81% of the majors who applied in 2022 attending the seminar, and the number of multiple attendees also increased. The number of majors has increased significantly doubling to 144 in 2022 compared with 74 in 2018.Conclusion:In many cases, the seminar helped the attendees learn more about physiatrists and develop their thoughts while attending multiple times. Thus, they started their majors. Five years have passed since we started planning this seminar, and we believe that the results are now coming to fruition.
3.Survey on the Effectiveness of the “Let's Become a Physiatrist” Seminar
Fumihito KASAI ; Dai FUJIWARA ; Mari KAKITA ; Akira YOSHIDA ; Hidetsugu MATSUMOTO ; Michiyuki KAWAKAMI ; Takumi IKEDA ; Takashi HIRAOKA ; Fumihiro TAJIMA
The Japanese Journal of Rehabilitation Medicine 2023;():22040-
Objective:Only 44 of the 82 university medical schools in Japan have rehabilitation medicine departments, although rehabilitation medicine is one of the 19 basic specialties recognized by the Japanese Medical Specialty Board, and many medical doctors are concerned regarding selecting rehabilitation medicine as a basic specialty without sufficient education in the field. The “Let's Become a Physiatrist” Seminar has been organized since 2017 to eliminate such concerns, and this study aimed to investigate how these results are manifested in the number of majors.Methods:We examined the number of past attendees and tracked how many of them became rehabilitation medicine majors.Results:The number of seminar attendees over a 5-year period was 589. The number of on-demand viewers in FY2020 and FY2021, which were held via the web, was 554. A total of 116 of the 471 physicians who began specialty training in rehabilitation medicine after the seminar was planned attended or web viewed the seminar accounting for 24.63%.This percentage has been increasing each year, with 36.81% of the majors who applied in 2022 attending the seminar, and the number of multiple attendees also increased. The number of majors has increased significantly doubling to 144 in 2022 compared with 74 in 2018.Conclusion:In many cases, the seminar helped the attendees learn more about physiatrists and develop their thoughts while attending multiple times. Thus, they started their majors. Five years have passed since we started planning this seminar, and we believe that the results are now coming to fruition.
5.Randomized phase III trial comparing pegylated liposomal doxorubicin (PLD) at 50 mg/m2 versus 40 mg/m2 in patients with platinum-refractory and -resistant ovarian carcinoma:the JGOG 3018 Trial
Takashi MOTOHASHI ; Akira YABUNO ; Hiroshi MICHIMAE ; Tetsuro OHISHI ; Miwa NONAKA ; Masashi TAKANO ; Shin NISHIO ; Hiroyuki FUJIWARA ; Keiichi KEIICHI ; Eiji KONDO ; Toru SUGIYAMA ; Tsutomu TABATA
Journal of Gynecologic Oncology 2021;32(1):e9-
Objective:
The standard dose for pegylated liposomal doxorubicin (PLD) is 50 mg/m2 every 4 weeks. While 40 mg/m2 has recently been used in clinical practice, evidence supporting this use remains lacking.
Methods:
This phase III randomized, non-inferiority study compared progressionfree survival (PFS) for patients with platinum-resistant ovarian carcinoma between an experimental arm (40 mg/m2 PLD) and a standard arm (50 mg/m2 PLD) until 10 courses, disease progression or unacceptable toxicity. Eligible patients had received ≤2 prior lines.Stratification was by performance status and PFS of prior chemotherapy (<3 months versus ≥3 months). The primary endpoint was PFS and secondary endpoints were overall survival (OS), toxicity profile, clinical response and tolerability. The total number of patients was 470.
Results:
The trial was prematurely closed due to slow recruitment, with 272 patients randomized to the experimental arm (n=137) and standard arm (n=135). Final analysis was performed with 234 deaths and 269 events for PFS. In the experimental arm vs. standard arm, median PFS was 4.0 months vs. 4.0 months (hazard ratio [HR]=1.065; 95% confidence interval [CI]=0.830–1.366) and median OS was 14.0 months vs. 14.0 months (HR=1.078; 95% CI=0.831–1.397). Hematologic toxicity and oral cavity mucositis (≥grade 2) were more frequent in the standard arm than in the experimental arm, but no difference was seen in ≥grade 2 hand-foot skin reaction.
Conclusion
Non-inferiority of 2 PLD dosing schedule was not confirmed because the trial was closed prematurely. However, recommendation of dose reduction of PLD should be based both on efficacy and safety.
7.Endoscopic Biopsy Technique using an Alcohol Swab to Prevent Transmission through the Instrument Channel in the COVID-19 Era
Shusei FUKUNAGA ; Taku MANABE ; Mitsuhiro KONO ; Tadashi OCHIAI ; Akira HIGASHIMORI ; Masaki OMINAMI ; Yasuaki NAGAMI ; Yasuhiro FUJIWARA
Clinical Endoscopy 2021;54(5):771-773
8.The analysis of venous blood flow velocity increase during ankle exercise
Minami FUJIWARA ; Takayuki MURAKAMI ; Yuki YANO ; Atsuki KANAYAMA ; Mayuka MINAMI ; Toshimitsu OHMINE ; Saki YAMAMOTO ; Yasuo IRIE ; Akira IWATA
Japanese Journal of Physical Fitness and Sports Medicine 2021;70(5):327-335
Ankle exercises are useful for preventing deep vein thrombosis, as they increase venous blood flow velocity. The cause for the increased venous blood flow velocity during ankle exercises may be the skeletal-muscle pump, but the mechanism is not clearly understood. The purpose of this study was to investigate the effects of the dorsiflexion angle and gastrocnemius muscle contraction on venous blood flow velocity during ankle exercises and to investigate the mechanism of the increase in venous blood flow velocity. The blood flow velocity in the popliteal vein, ankle joint angle, and surface electromyographic activity of the gastrocnemius muscle were measured at rest and during ankle exercises in the prone position in young healthy volunteers. The significant increase in venous blood flow velocity was observed during dorsiflexion phase, max dorsiflexion and during planter flexion phase. The peak venous blood flow velocity was different in each subject and classified into four types. The correlations of venous blood velocity to ankle joint angle and with the surface electromyographic activity of the gastrocnemius muscle were not statistically significant. These findings suggest that venous blood flow velocity increases not only during plantar flexion and dorsiflexion.
10.Endoscopic Biopsy Technique using an Alcohol Swab to Prevent Transmission through the Instrument Channel in the COVID-19 Era
Shusei FUKUNAGA ; Taku MANABE ; Mitsuhiro KONO ; Tadashi OCHIAI ; Akira HIGASHIMORI ; Masaki OMINAMI ; Yasuaki NAGAMI ; Yasuhiro FUJIWARA
Clinical Endoscopy 2021;54(5):771-773


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