内なる国際化に向けたﾎﾃﾙの人材ﾏﾈｰｼﾞﾒﾝﾄ

本稿は､九州地域にあるﾌﾙ･ｻｰﾋﾞｽ型ﾎﾃﾙのﾋｱﾘﾝｸﾞ調査を通じて､観光立国に必要な人材ﾏﾈｰｼﾞﾒﾝﾄの在り方を考察するものである｡大都市圏を中心に飛躍的に増加する外国人旅行者数と現内閣が掲げる更なる倍増の目標は､宿泊産業にとって明るい材料となっている｡今後､地方にその流れを呼び込むためには､内なる国際化という新たな環境に適合する人材を質量共に育成し､受入体制を強化する必要がある｡ﾀﾞｲﾅﾐｯｸに雇用が流動し､国内外から有為で多様な人材が地域の宿泊産業に集まる体制が早く構築されることが期待される中､日本に固有な雇用ｼｽﾃﾑが変革の壁になっているとも言われる｡国内系･外資系大手ﾎﾃﾙの人材ﾏﾈｰｼﾞﾒﾝﾄの違いを対比し､併せてﾎﾃﾙ産業先進国の米国の例を参考に､今後の課題を考察する｡Based on interviews with seven Human Resources managers who are working for full-service upscale hotels in the Kyusyu district, this article explores what local hotels should do for HR management to support Japan to become a Tourism Nation. The lodging industry in Japan, especially in big cities, is expecting a bright forecast due to the expanding number of inbound tourists and based on indications from the Abe cabinet that numbers will double by 2020. To attract this market more toward smaller cities, it will be crucial for hotels to develop talent who can take care of a wide variety of guests from overseas. There is a huge gap between the way of HR management in Japan and other countries, and it has been a challenge for Japanese companies in general to diversify their corporate culture. This article intends to compare the way of HR management among 7 hotels which consist of 5 well known Japanese hotel operators and 2 global hotel operators in Kyusyu. In addition, this article attempts to show a sample career path of a Hotel General Manager in the US as a global HR practice

「欧州型」リゾートをモデルとした地域観光の在り方―長崎県におけるMICEによる観光の可能性―

観光庁の資料によれば、1990年に年間324万人だった訪日外国人旅行者数は、2018年に3,119万人となり、今後さらに高い数量目標が掲げられている。大阪、横浜などの大都市が区域認定を目指して立候補を表明する中で、長崎、和歌山などの地方都市が認定レースに名乗りを挙げ、IR が地域にもたらす巨大な経済効果に期待が集まっている。政府が掲げる「観光立国」ビジョンの切り札として、現在国による準備が進められているのが統合型リゾート（IR）計画である。IR の開発については、カジノの是非と経済効果を天秤にかけるような議論に話題が集中しがちである。しかしながら、開発した IR の永続性を考えるとカジノ外の中核施設である（MICE1）によるビジネスツーリズムについても注視すべきである。MICE がもたらす訪問者の滞在日数は長期化する傾向にあり、その結果観光消費額の向上につながる。この消費額拡大への取り組みは、大都市中心の観光客数量という指標から、地域における付加価値の高い観光地化という質へのシフトという極めて重要な意味を持つ。本研究は、持続可能な観光の先進地であり、MICE 需要を取り込む欧州型リゾートの滞在型観光地経営の在り方を通して、地方都市である長崎県における現状と今後の可能性をとりあげ、地域ならではの持続可能な観光地経営についての考察と今後研究すべき課題について示したものである

地域の「稼ぐ力」を促進するDMOの在り方―米国カリフォルニア州ナパ・バレー DMO の事例から―

日本版DMO（Destination Management/Marketing Organization）候補法人の登録が開始されてから3年が経過した。DMOの役割・機能は非営利的な活動が主であるが、DMOが成果として期待されることは、観光を通じて地域の「稼ぐ力」を引き出し、地域に継続的な経済効果を産むことにある。また、DMOは、独立した法人としての自律的・継続的な活動のための安定的な運営資金を確保することが必要となる。そこで、本稿は、米国の先進事例として、米国カリフォルニア州ナパ・バレーのVisit Napa Valley（公式DMO）を取り上げ、その公表データにより概要と戦略を把握することを目的とした。Visit Napa Valleyは“プレミア”な地域としての有り様と目標を示しながら、ラグジュアリー・トラベラー（富裕層の旅行者）に対する戦略を行なっていること、地域のマーケティング活動などにかかる独自財源の安定的な確保する仕組みであるTID（Tourism Improvement District）で運営資金を確保し、同組織の活動の結果を広く公開して成果を明示していることがわかった。今後の日本版 DMOの方向性を示す指針となると考えられる

Efficacy and safety of nintedanib in Japanese patients with progressive fibrosing interstitial lung diseases : Subgroup analysis of the randomised, double-blind, placebo-controlled, phase 3 INBUILD trial

Background: The efficacy of nintedanib in progressive fibrosing interstitial lung diseases (ILDs) was demonstrated in the randomised, double-blind, placebo-controlled INBUILD trial. This subgroup analysis evaluated the efficacy and safety of nintedanib in the Japanese population. Methods: Patients with progressive fibrosing ILDs (evaluated by physicians within 24 months of screening) were randomised (1:1) to twice-daily 150-mg nintedanib or placebo; treatment continued until the last patient completed 52 weeks. The primary endpoint was the annual rate of decline in forced vital capacity (FVC) over 52 weeks. Time-to-first acute ILD exacerbation or death and time-to-death up until the last patient had completed the week 52 visit were evaluated. This subgroup analysis included 108 Japanese patients. Results: The adjusted annual rates of FVC decline (mL/year) over 52 weeks for Japanese patients were −148.31 (nintedanib) and −240.36 (placebo), adjusted difference: 92.05 (95% CI: −10.69–194.80) and for non-Japanese patients were −67.41 (nintedanib) and −177.65 (placebo), adjusted difference: 110.24 (95% CI: 64.97–155.52). No heterogeneity in treatment effect between Japanese and non-Japanese subgroups was observed (treatment-by-subgroup interaction, p = 0.75). The risks of “acute exacerbation or death” (hazard ratio, 0.30 [95% CI: 0.10–0.91]) and mortality (hazard ratio, 0.54 [95% CI: 0.14–2.11]) in Japanese patients were numerically lower for nintedanib than placebo. There were no new or unexpected safety findings. Conclusions: In Japanese patients, nintedanib slowed ILD progression, evidenced by a reduction in the annual rate of decline in FVC vs placebo. The efficacy and safety of nintedanib in Japanese patients were consistent with the overall INBUILD population

Age is not a limiting factor for brachytherapy for carcinoma of the node negative oral tongue in patients aged eighty or older

<p>Abstract</p> <p>Background</p> <p>To examine the role of brachytherapy for aged patients 80 or more in the trend of rapidly increasing number.</p> <p>Methods</p> <p>We examined the outcomes for elderly patients with node negative oral tongue cancer (T1-3N0M0) treated with brachytherapy. The 21 patients (2 T1, 14 T2, and 5 T3 cases) ranged in age from 80 to 89 years (median 81), and their cancer was pathologically confirmed. All patients underwent definitive radiation therapy, with low dose rate (LDR) Ra-226 brachytherapy (n = 4; median 70Gy), with Ir-192 (n = 12; 70Gy), with Au-198 (n = 1) or with high dose rate (HDR) Ir-192 brachytherapy (n = 4; 60 Gy). Eight patients also underwent external radiotherapy (median 30 Gy). The period of observation ranged from 13 months to 14 years (median 2.5 years). We selected 226 population matched younger counterpart from our medical chart.</p> <p>Results</p> <p>Definitive radiation therapy was completed for all 21 patients (100%), and acute grade 2-3 mucositis related to the therapy was tolerable. Local control (initial complete response) was attained in 19 of 21 patients (90%). The 2-year and 5-year local control rates were 91%, (100% for T1, 83% for T2 and 80% for T3 tumors after 2 years). These figures was not inferior to that of younger counterpart (82% at 5-year, n.s.). The cause-specific survival rate was 83% and the regional control rate 84% at the 2-years follow-up. However, 12 patients died because of intercurrent diseases or senility, resulting in overall survival rates of 55% at 2 years and 34% at 5 years.</p> <p>Conclusion</p> <p>Age is not a limiting factor for brachytherapy for appropriately selected elderly patients, and brachytherapy achieved good local control with acceptable morbidity.</p

Applicability of radiocolloids, blue dyes and fluorescent indocyanine green to sentinel node biopsy in melanoma

Patients with primary cutaneous melanoma underwent sentinel node (SN) mapping and biopsy at 25 facilities in Japan by the combination of radiocolloid with gamma probe and dye. Technetium-99m (99mTc)-tin colloid, 99mTc-phytate, 2% patent blue violet (PBV) and 0.4% indigo carmine were used as tracers. In some hospitals, 0.5% fluorescent indocyanine green, which allows visualization of the SN with an infrared camera, was concomitantly used and examined. A total of 673 patients were enrolled, and 562 cases were eligible. The detection rates of SN were 95.5% (147/154) with the combination of tin colloid and PBV, 98.9% (368/372) with the combination of phytate and PBV, and 97.2% (35/36) with the combination of tin colloid or phytate and indigo carmine. SN was not detected in 12 cases by the combination method, and the primary tumor was in the head and neck in six of those 12 cases. In eight of 526 cases (1.5%), SN was detected by PBV but not by radiocolloid. There were 13 cases (2.5%) in which SN was detected by radiocolloid but not by PBV. In 18 of 36 cases (50%), SN was detected by radiocolloid but not by indigo carmine. Concomitantly used fluorescent indocyanine green detected SN in all of 67 cases. Interference with transcutaneous oximetry by PVB was observed in some cases, although it caused no clinical trouble. Allergic reactions were not reported with any of the tracers. 99mTc-tin colloid, 99mTc-phytate, PBV and indocyanine green are useful tracers for SN mapping.ArticleJOURNAL OF DERMATOLOGY. 39(4):336-338 (2012)journal articl

Early administration of IL-6RA does not prevent radiation-induced lung injury in mice

<p>Abstract</p> <p>Background</p> <p>Radiation pneumonia and subsequent radiation lung fibrosis are major dose-limiting complications for patients undergoing thoracic radiotherapy. Interleukin-6 (IL-6) is a pleiotropic cytokine and plays important roles in the regulation of immune response and inflammation. The purpose of this study was to investigate whether anti-IL-6 monoclonal receptor antibody (IL-6RA) could ameliorate radiation-induced lung injury in mice.</p> <p>Methods</p> <p>BALB/cAnNCrj mice having received thoracic irradiation of 21 Gy were injected intraperitoneally with IL-6RA (MR16-1) or control rat IgG twice, immediately and seven days after irradiation. Enzyme-linked immunosorbent assay was used to examine the plasma level of IL-6 and serum amyloid A (SAA). Lung injury was assessed by histological staining with haematoxylin and eosin or Azan, measuring lung weight, and hydroxyproline.</p> <p>Results</p> <p>The mice treated with IL-6RA did not survive significantly longer than the rat IgG control. We observed marked up-regulation of IL-6 in mice treated with IL-6RA 150 days after irradiation, whereas IL-6RA temporarily suppressed early radiation-induced increase in the IL-6 release level. Histopathologic assessment showed no differences in lung section or lung weight between mice treated with IL-6RA and control.</p> <p>Conclusions</p> <p>Our findings suggest that early treatment with IL-6RA after irradiation alone does not protect against radiation-induced lung injury.</p