Kansai University of Nursing and Health Sciences (関西看護医療大学, Kansai kango iryō daigaku) is a private university in Awaji, Hyōgo, Japan. The school was established in 2006 as Junshin-kai University of Nursing and Health. The school adopted the present name in 2008..
The hotel industry, with labor-intensive nature, conflicts with persistent challenges of labor shortages and inefficiencies. Furthermore, the issue of existing disparity between the workforce competencies prioritized by hotel practitioner and academia experts remains. With the rapid advancement of cutting-edge technologies, this study, in consideration of the literacy of AI application as one of the pivotal employability metrics, aims to scrutinize the discrepancies in the perceptions of upscale hotel practitioners and hospitality management educators regarding workforce competencies, leverage the practical demands of hotel industry as a benchmark, identify the prioritized criteria, propose suggestions to academics for effectively cultivating the potential employees, enhance workforce efficacy, and ameliorate the labor insufficiency. Furthermore, the issue of integrating smartization into upscale hotel industry and considering AI proficiency one of the employability indicators is a relatively innovative research field; thus, the expert system was applied for data collection. To overcome the problems of indeterminant, fuzzy and biased information generated by the natural semantic expressions of the experts, identify the discrepancies in perceptions of hotel workforce employability between practitioners and educators, and prioritize and rank these criteria, a novel hybrid Multiple Attribute Decision Making (MADM) research approach, combining the dynamic Z-number method, Fuzzy Delphi Method (FDM), and Best-Worst Method (BWM) was employed. The Dynamic Z-number approach is employed to capture uncertainty and inconsistency inherent in the decision-making process; FDM is utilized to aggregate expert consensus and construct the core indicator framework; BWM is applied to perform pairwise comparisons for the derivation of indicator weights. The research results benefit three stakeholders: allowing educational institutions to tailor their curricula to more effectively with industry demands, enhancing the employability of students, and ultimately, alleviating the problem of deficient workforce for upscale hoteliers.
Background Previous studies that examined Parkinson's disease (PD) mortality were mostly conducted in Western countries. Objects We compared mortality rates and causes of death in PD patients and persons without PD from Taiwan over 15 years of follow-up. Methods Within the National Health Insurance database, we followed 50,290 incident PD patients (2003–2016) and 201,153 matched non-PD participants (controls) until 31/12/2018. We used multivariable Cox proportional-hazards regression models to compare mortality rates and causes of death in PD patients and controls. Due to non-proportionality, we performed stratification by follow-up duration (≤5/>5 years). We examined interactions between PD status participants’ characteristics for all-cause mortality. Results PD patients had higher all-cause mortality than controls (HR = 1.40, 95% CI = 1.37–1.42); the association was stronger ( p < 0.0001) after the first 5 years of follow-up (HR = 1.49 [1.46–1.53]) than before (HR = 1.34 [1.31–1.37]). The strongest associations were observed for suicide (HR = 1.79 [1.52–2.10]), dementia (HR = 1.69 [1.47–1.93]), and pneumonia (HR = 1.57 [1.49–1.65]). The association between PD and death decreased as age increased, and was stronger in patients without comorbidities, depression, and dementia than in those with. Conclusions Taiwanese PD patients have reduced life expectancy throughout the course of disease with a stronger association after the first 5 years of follow-up. PD had a stronger impact on mortality in younger persons and in those without comorbidities. Prevention of pneumonia and suicide, and appropriate management of dementia and comorbidities would help reduce PD-related mortality. Our findings may help health authorities allocate resources to improve the management of PD patients in order to address PD-related mortality.
INTRODUCTION:The therapeutic advantages of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in diabetes management have been demonstrated. However, their potential association with autoimmune diseases remains unknown. Using a comprehensive real-world dataset, this study compared GLP-1 RAs against dipeptidyl peptidase-4 inhibitors (DPP-4is) with respect to the incidence of autoimmune diseases. METHODS:This retrospective cohort study, with an active-comparator and new-user design, analyzed data from the TriNetX US Collaborative Network. We identified 4,841,560 patients aged over 18 years with type 2 diabetes from 1 January 2015 to 31 December 2022. Finally, 412,021 and 383,415 patients were included in the GLP-1 RAs and DPP-4is groups, respectively. Propensity score matching was used to balance baseline characteristics, and hazard ratios (HRs) were estimated with Cox regression models over an eight-year follow-up. RESULTS:After propensity score matching, each group included 290,770 patients. The analysis revealed that patients receiving GLP-1 RAs exhibited significantly higher risks of certain autoimmune conditions, including ulcerative colitis (HR, 1.11; 95 % CI, 1.04-1.19), rheumatoid arthritis (HR, 1.08; 95 % CI, 1.03-1.12), autoimmune thyroiditis (HR, 1.30; 95 % CI, 1.24-1.38), ankylosing spondylitis (HR, 1.30; 95 % CI, 1.13-1.51), and psoriasis (HR, 1.17; 95 % CI, 1.12-1.22), compared to those on DPP-4is. Moreover, sensitivity analyses consistently revealed a significant link between GLP-1 RAs use and autoimmune diseases. CONCLUSIONS:This study suggests that compared with DPP-4is, the use of GLP-1 RAs is linked to increased risks of certain autoimmune diseases. Careful monitoring might be required among patients on GLP-1 RAs.
Background Numerous studies have explored the role of acupuncture-related treatments in alleviating chemotherapy-induced peripheral neuropathy (CIPN) and improving the quality of life for patients with cancer, resulting in mixed findings. This umbrella review aimed to synthesize existing systematic reviews (SRs) to deliver an updated assessment of the certainty of evidence concerning the effects of acupuncture-related treatments on CIPN and quality of life among a diverse group of patients with cancer. Methods This umbrella review considered eligible SRs published on one of nine electronic databases between inception and August 2024. It included adult patients with cancer of any stage who were undergoing chemotherapy. Interventions encompassed acupuncture, either alone or with electrical stimulation or moxibustion, and transcutaneous electrical acupoint/nerve stimulation (TEAS). The outcomes analyzed were changes in CIPN, nerve conduction velocity (NCV), and quality of life. Results The outcomes were evaluated using data obtained from 14 SRs that demonstrated moderate to high methodological and reporting quality. The findings showed that acupuncture (either alone or combined with electrical stimulation) and TEAS effectively alleviated CIPN symptoms, reduced CIPN pain, improved NCV, and enhanced quality of life. Conclusion The findings of this umbrella review indicate that these benefits were usually noticeable by the second week of treatment, persisted until the sixth week, and then gradually declined. Sensory nerve recovery occurred more rapidly than motor nerve recovery, often within 1.5 weeks. Although acupuncture combined with moxibustion or acupressure also enhanced patient outcomes, there was insufficient information available for further study analysis.
Patients with diabetes-related foot ulcers may require hospitalization and face an increased risk of amputation, which can significantly impact their quality of life. One potential solution is exercise, which can regulate blood glucose levels, improve wound healing, and enhance overall well-being. This randomized controlled trial aimed to evaluate the impact of a lower limb resistance training program combined with breathing-regulation techniques on glycemic control, wound healing, and quality of life in patients with diabetes-related foot ulcers. Patients hospitalized for type 2 diabetes-related foot ulcers were recruited from a single medical center and randomly divided into two groups. The control group (n = 31) received standard treatment, while the exercise group (n = 28) received standard treatment along with lower limb resistance training and breathing-regulation techniques. Assessments of fasting blood glucose levels, hemoglobin A1c (HbA1c) levels, wound healing, and quality of life were carried out at the start of the study and week 4, week 8, and week 12 of the intervention. The exercise group demonstrated significant improvements in fasting blood glucose and HbA1c levels, as well as in physical health, psychological well-being, social relationships, and environmental aspects of quality of life over the 12 weeks compared to both the control group and the baseline (p < .05). However, no significant change was observed in wound healing (p > .05). The resistance training program for the lower limbs, combined with breathing-regulation techniques, is recommended for improving blood glucose levels and quality of life over 12 weeks.
