ABSTRACT We established a rapid method for the identification of influenza A and B virus strains: the peroxidase-antiperoxidase (PAP) staining method with two subtype-specific murine monoclonal antibodies, C179 (H1 and H2 specific) and F49 (H3 specific), and an anti-influenza B virus rabbit polyclonal serum. The types and subtypes of 160 strains were examined, and 158 strains were identified to be the same by the hemagglutination-inhibition (HI) test and the PAP method. In contrast to the results by the HI test, two strains were revealed to be a mixture of two subtypes (H1 and H3) by the PAP method, which was confirmed by plaque cloning. We further analyzed clinical specimens by the PAP method by directly inoculating specimens into Madin-Darby canine kidney cells in microplates. After 40 h of incubation, the types and subtypes of viruses in 52 of 152 specimens were clearly identified. Since the reactivities of the two monoclonal antibodies are not influenced by the antigenic drift of influenza virus, the newly developed method should be applicable not only for rapid diagnosis but also for the epidemiological study of influenza.
In July-August in 2000 or 2001, using females living in Shiga Prefecture, investigations were conducted on the actual conditions of beverage-drinking habits by drinking occasions. Investigations were also conducted on images toward beverages drunk in chatting time and served to visitors. The results of the investigation are as follows.1) The drinking green tea increased with age, and there was the significant difference between students and females over 40-years old. Barley tea and oolong tea were consumed frequently among females under 39-years old.For breakfast, coffee and milk were consumed among all age groups. In females over 60-years-old, before sleeping, many females drink water or milk.2) Students like black tea than coffee. The preference for black tea decreased with age and the preference for coffee increased with age. In females over 40-years old, both the drinking rate of green tea and the preference for green tea were high and those of black tea were low.3) Regarding beverages in chatting time, no difference in image for green tea among all females was observed. The image for black tea decreased and for green tea increased with a rise in age.4) Regarding beverages for visitors, the image for black tea was strong in young females and green tea was strong in older females.
Infant mortality, the rate at which babies and children of less than one year of age die, is the most fundamental measure of infant health. In OECD countries, around two-thirds of the deaths that occur during the first year of life are neonatal deaths (i.e. during the first four weeks). Birth defects, prematurity and other conditions arising during pregnancy are the main factors contributing to neonatal mortality in developed countries. For deaths beyond a month (post-neonatal mortality), there tends to be a greater range of causes – the most common being SIDS (sudden infant death syndrome), birth defects, infections and accidents.
Health care coverage, through government schemes and private health insurance, provides financial security against unexpected or serious illness. However, the percentage of the population covered by such schemes does not provide a complete indicator of accessibility, since the range of services covered and the degree of cost-sharing applied to those services also affects access to care.
A 25-year-old woman with an extensive travel history developed chronic cough and multiple lung nodules. The lung biopsy revealed lymphoid interstitial pneumonia. The patient later developed cervical lymphadenopathy, arthritis and livedo reticularis, then systemic lupus erythematosus was diagnosed with positive double-stranded DNA and low complement. The patient’s symptoms responded to prednisolone and azathioprine.
The High-Level Commission on Health Employment and Economic Growth released its report to the United Nations Secretary-General in September 2016. It makes important recommendations that are based on estimates of over 40 million new health sector jobs by 2030 in mostly high- and middle-income countries and a needs-based shortage of 18 million, mostly in low- and middle-income countries. This paper shows how these key findings were developed, the global policy dilemmas they raise, and relevant policy solutions. Regression analysis is used to produce estimates of health worker need, demand, and supply. Projections of health worker need, demand, and supply in 2030 are made under the assumption that historical trends continue into the future. To deliver essential health services required for the universal health coverage target of the Sustainable Development Goal 3, there will be a need for almost 45 million health workers in 2013 which is projected to reach almost 53 million in 2030 (across 165 countries). This results in a needs-based shortage of almost 17 million in 2013. The demand-based results suggest a projected demand of 80 million health workers by 2030. Demand-based analysis shows that high- and middle-income countries will have the economic capacity to employ tens of millions additional health workers, but they could face shortages due to supply not keeping up with demand. By contrast, low-income countries will face both low demand for and supply of health workers. This means that even if countries are able to produce additional workers to meet the need threshold, they may not be able to employ and retain these workers without considerably higher economic growth, especially in the health sector.
Human resources for health have been recognized as essential to the development of responsive and effective health systems. Low- and middle-income countries seeking to achieve universal health coverage face human resource constraints - whether in the form of health worker shortages, maldistribution of workers or poor worker performance - that seriously undermine their ability to achieve well-functioning health systems. Although much has been written about the human resource crisis in the health sector, labour economic frameworks have seldom been applied to analyse the situation and little is known or understood about the operation of labour markets in low- and middle-income countries. Traditional approaches to addressing human resource constraints have focused on workforce planning: estimating health workforce requirements based on a country's epidemiological and demographic profile and scaling up education and training capacities to narrow the gap between the "needed" number of health workers and the existing number. However, this approach neglects other important factors that influence human resource capacity, including labour market dynamics and the behavioural responses and preferences of the health workers themselves. This paper describes how labour market analysis can contribute to a better understanding of the factors behind human resource constraints in the health sector and to a more effective design of policies and interventions to address them. The premise is that a better understanding of the impact of health policies on health labour markets, and subsequently on the employment conditions of health workers, would be helpful in identifying an effective strategy towards the progressive attainment of universal health coverage. Les ressources humaines du secteur de la santé sont essentielles au développement de systèmes médicaux efficaces et réactifs. Les pays à revenu faible et moyen qui cherchent à obtenir une couverture maladie universelle souffrent de restrictions en matière de ressources humaines - que ce soit sous forme de pénurie d'agents de santé, de mauvaise répartition ou de faibles performances des travailleurs - qui compromettent sérieusement leur capacité à créer un système de santé optimal. Même si on a beaucoup écrit au sujet de la crise des ressources humaines dans le secteur de la santé, des cadres économiques de travail ont rarement été appliqués pour analyser la situation, et on connaît ou on comprend peu de choses sur le fonctionnement des marchés du travail dans les pays à revenu faible et moyen. Les approches traditionnelles dans le but de répondre aux restrictions en matière de ressources humaines accordent de l'importance à la planification des effectifs : estimer les besoins en matière de travailleurs de la santé par rapport au profil démographique et épidémiologique d'un pays, et intensifier les capacités de formation et d'enseignement pour réduire l'écart entre le nombre de travailleurs "nécessaire" et le nombre réel. Toutefois, cette approche néglige d'autres facteurs importants qui influent sur la capacité des ressources humaines, notamment les dynamiques du marché du travail et les réponses et préférences comportementales des travailleurs de la santé. Ce document explique comment l'analyse du marché du travail peut aider à mieux comprendre les facteurs qui sont à l'origine des restrictions en matière de ressources humaines dans le secteur de la santé, mais aussi à mettre en oeuvre des politiques et des interventions plus efficaces pour y remédier. L'hypothèse initiale est qu'une meilleure compréhension de l'impact des politiques de santé sur les marchés du travail de la santé et, par ailleurs, sur les conditions d'emploi des travailleurs de la santé, serait utile pour pouvoir identifier une stratégie efficace et progressivement mettre en place une couverture maladie universelle.El papel de los recursos humanos en el sector sanitario se considera esencial para el desarrollo de sistemas sanitarios eficaces y con capacidad de respuesta. Los países de ingresos bajos y medianos que aspiran a alcanzar la cobertura sanitaria universal se enfrentan a las limitaciones en materia de recursos humanos, sea por escasez de personal sanitario, la distribución ineficaz del personal o el desempeño ineficiente del mismo, factores que socavan gravemente la capacidad para lograr sistemas sanitarios con un funcionamiento adecuado. Aunque se ha vertido mucha tinta acerca de la crisis de recursos humanos en el sector sanitario, rara vez se han aplicado los marcos económicos laborales para analizar la situación y poco se sabe o entiende sobre el funcionamiento de los mercados laborales en los países de ingresos bajos y medianos. Los enfoques tradicionales para hacer frente a las limitaciones en materia de recursos humanos se han centrado en la planificación del personal, mediante el cálculo de las necesidades de personal sanitario basada en el perfil epidemiológico y demográfico del país y la ampliación de los recursos educativos y formativos para reducir la brecha entre el número «necesario» de personal sanitario y el número real. Sin embargo, este enfoque deja de lado otros factores importantes que influyen en la capacidad de los recursos humanos, como la dinámica del mercado de trabajo, las respuestas de comportamiento y las preferencias del personal sanitario. Este informe describe cómo el análisis del mercado laboral pretende mejorar la comprensión de los factores que explican la escasez en materia de recursos humanos en el sector sanitario y ofrecer un diseño más eficaz de las políticas e intervenciones para abordarlos. La premisa para ello es que una mejor comprensión del impacto de las políticas sanitarias en el mercado laboral sanitario, y por consiguiente, en las condiciones laborales del personal sanitario, sería de gran ayuda en la identificación de una estrategia eficaz para alcanzar la cobertura sanitaria universal de forma progresiva.تم الاعتراف بضرورة الموارد البشرية الصحية لتطوير أنظمة صحية فعالة وسريعة الاستجابة. وتواجه البلدان المنخفضة والمتوسطة الدخل التي تسعى لتحقيق التغطية الصحية الشاملة قيوداً تتعلق بالموارد البشرية – سواء أكانت في شكل نقص في العاملين الصحيين أو سوء توزيع للعاملين أو الأداء الضعيف لهم – والتي تضعف بشكل خطير من القدرة على إنشاء أنظمة صحية تعمل بشكل جيد. ورغم وجود أبحاث كثيرة حول أزمة الموارد البشرية في القطاع الصحي، إلا انه كان من النادر تطبيق أطر العمل الاقتصادية للعمالة لتحليل الموقف، ولا يوجد سوى القليل من المعرفة والفهم حول تشغيل أسواق العمالة في البلدان المنخفضة والمتوسطة الدخل. وركزت النهج التقليدية للتعامل مع قيود الموارد البشرية على تخطيط قوة العمل: تقدير متطلبات قوة العمل الصحية استناداً إلى الحالة الوبائية والسكانية للبلد والتوسع في نطاق القدرات التعليمية والتدريبية لتضييق الفجوة بين العدد "المطلوب" من العاملين الصحيين والعدد الموجود. ومع ذلك، يهمل هذا الأسلوب عوامل أخرى هامة تؤثر على قدرة الموارد البشرية، بما في ذلك القوى المحركة لسوق العمالة والاستجابات السلوكية وتفضيلات العاملين الصحيين أنفسهم. ويصف هذا البحث كيفية إسهام تحليل سوق العمالة في التوصل إلى فهم أفضل للعوامل التي تقف وراء قيود الموارد البشرية في القطاع الصحي وإلى تصميم أكثر فعالية للسياسات والتدخلات للتعامل معها. وتقوم الفرضية على أن الفهم الأفضل لتأثير السياسات الصحية على أسواق العمالة الصحية، ومن ثم على ظروف توظيف العاملين الصحيين، سيساعد في تحديد إستراتيجية فعالة باتجاه الإدراك المتدرج للتغطية الصحية الشاملة.卫生人力资源被公认为发展灵敏有效的卫生系统不可或缺的一环。努力实现全民医疗保障制度的中低收入国家面临着人力资源限制的问题——或是缺乏卫生工作者，或是卫生工作者配置不合理，或是卫生工作者绩效差——这些问题严重削弱了实现完善卫生系统的能力。尽管有关卫生部门人力资源危机的论述为数众多，却很少有研究应用劳动经济框架分析这种状况，人们对中低收入国家劳动力市场的运作了解或认识得非常少。解决人力资源限制问题的传统方法将重点放在劳动力规划上：基于国家的流行病学和人口统计学特征估计卫生工作人员需求，升级教育培训实力来缩短“需要”卫生工作者数量和现有数量之间的差距。但是，这种方法忽略了影响人力资源容量的其他重要因素，包括劳动力市场动力和卫生工作者自身的行为反应和偏好。本文描述了劳动力市场分析对更好理解卫生部门人力资源限制因素的作用，以及对制定更有效应对政策和干预措施的作用。其论述的前提是：更好地理解卫生政策对卫生劳动力市场的影响，继而对卫生工作者就业状况的影响，将有助于识别出逐步实现全民医保的有效战略。Человеческие ресурсы в сфере здравоохранения были признаны необходимым фактором для развития оперативной и эффективной системы здравоохранения. Страны с низким и средним уровнем доходов, стремящиеся обеспечить всеобщий охват населения медико-санитарными услугами, сталкиваются с нехваткой человеческих ресурсов в виде либо нехватки работников здравоохранения, либо неравномерного распределения работников, либо низкой эффективности труда работников, что серьезно подрывает способность данных стран обеспечить хорошее функционирование систем здравоохранения. Хотя уже много написано на тему кризиса человеческих ресурсов в секторе здравоохранения, для анализа ситуации редко применялись экономические концепции, касающиеся труда, и о функционировании рынков труда в странах с низким и средним уровнем дохода мало что известно или мало кто понимает, как они функционируют. Традиционные подходы к решению проблем нехватки человеческих ресурсов были направлены на планирование трудовых ресурсов, то есть на оценку потребности в трудовых ресурсах в сфере здравоохранения на основе эпидемиологического и демографического профиля страны и пропорциональном наращивании возможностей образования и подготовки с целью сократить разрыв между «необходимым» и имеющимся количеством работников здравоохранения. Однако такой подход не учитывает других важных факторов, которые влияют на человеческие ресурсы, в том числе динамику рынка труда и поведенческие реакции и предпочтения самих работников здравоохранения. В этой статье описывается то, как анализ рынка труда может способствовать лучшему пониманию факторов, обуславливающих нехватку человеческих ресурсов в секторе здравоохранения, и разработке более эффективной политики и мероприятий по устранению данных факторов. Исходной посылкой является то, что лучшее понимание влияния политики в области здравоохранения на рынки труда в данной сфере и, соответственно, на условия труда работников здравоохранения может оказаться полезным при выборе эффективной стратегии по постепенному достижению всеобщего охвата населения медико-санитарными услугами.
Belimumab (BE) has been shown to decrease disease activity, glucocorticoid (PSL) intake, and flare rates, thereby suppression of damage progression, and also has been included in the 2023 EULAR recommendations on SLE management as an approved biological drug to be used in patients with a refractory response to a standard of care regimen.
Objectives:
We have previously examined the effect of belimumab on immunological activities, disease activities (DA), activities of daily living score (AS)1 in patients with SLE. We summarized the data from three centers for rheumatology concerning about patients with SLE using BE to clarify the effects on each immunological activities such as anti-ds DNA, RNP, Sm, SS-A and SS-B antibodies, and the association between improvement of AS and factors such as immunological activities, dose of PSL, DA. and AS.
Methods:
We selected 69 cases (F/M 55/14) from 2018 to 2023 in patients with SLE treated with belimumab (BE) to clarify the effect of BE on immunological data, disease activities (SLEDAI), daily living score (AS) and doses of PSL after treatment for 6 months (M), 12 M and 24M. Statiscal analyses such as correlation coefficient and anlyses of variance were performed by JMP12.2.0.
Results:
Mean BMI age and duration of disease were 20.9±3.7 kg/m2, 45.5±17.1 and 15.7±13.8 years. After treatment with BE for 6M, 12M and 24M anti-dsDNA antibodies (AU/ml) were significantly decreased for 6M, 12 M and 24 M, respectively (p<0.05, before 60±146, 6M 21±38, 12M 17±20, 24M 18±18), and C3, C4 and CH50 (U/ml) were significantly increased. Levels of SLEDAI score were significantly decreased (p<0.001, before 11±7, 6M 6±3, 12 M 5±3, 24M 5±4 and Doses of PSL (mg) were significantly decreased (p<0.001, before 15.6±14.2, 6 M 7.2±5.0, 12 M 5.9±3.9, 24M5.7±3.8). AS scores were also significantly improved (p<0.001-0.05, before 25.7±14.4, 6M 17.6±12.3, 12M12.5±12.9, 24 M 12.8±11.9). Anti-SS-A, SS-B and Sm antibodies were tend to be decreased, but not anti-RNP antibody. No significant relationship between changes of AS and each improved factor by BE treatment were observed.
Conclusion:
Effects of BE on clinical results, and induction of clinical remission and maintenance treatment were useful without major adverse effects in patients with SLE. BE-induced Improvement of AS might be independent factor.
