151 research outputs found

    Lessons learned from the history of postgraduate medical training in Japan: from disease-centred care to patient-centred care in an aging society.

    Get PDF
    BACKGROUND: Health workers, the core of health service delivery and a key driver of progress towards universal health coverage, must be available in sufficient numbers and distributed fairly to serve the entire population. In addition, the planning and management of the health workforce must be responsive to the changing needs of society, including changes in age structure and epidemiology. Considering these issues, this paper examines in historical perspective the evolution of postgraduate medical training and practice in Japan, from the late nineteenth century to the present. MAIN TEXT: When the first medical schools were established in the country towards the end of the nineteenth century, Japan was a largely agrarian society, with a population of about 30 million and an average life expectancy of 30-40 years. During the twentieth century, life expectancy and the national population continued to increase in a context of rapid economic growth. Since the 1980s, another demographic transition has occurred: low fertility rates and an aging society. As a result, the inputs and skills required from health professionals have changed considerably over time, posing new challenges to the national health sector and the management of human resources for health. CONCLUSIONS: The case of Japan offers valuable lessons for other countries experiencing a rapid epidemiological and demographic transition. To provide medical care that meets health priorities in the communities, we must consider not only the training of specialists, but also ensure the availability of a large cadre of physicians who possess basic skills and can provide patient-centred care. Furthermore, the Japanese experience shows that a highly hierarchical system and organisational culture are ill-suited to respond quickly to the changing demands of society

    Phylogenetic Relationships of Eublepharid Geckos (Reptilia: Squamata): A Molecular Approach

    Get PDF
    Phylogenetic analyses were carried out for representatives of all eublepharid genera and afew other gekkonoid taxa using sequence data for 879 base pairs of mitochondrial 12S and 16S ribosomalRNA genes. Neighbor-joining (NJ) distance analysis of the data suggested independent great divergencesof Coleonyx and Aeluroscalabotes, and monophyly of the remainder within Eublepharidae (bootstrap proportion[BP]=76%). Of the latter, the two African genera, Hemitheconyx and Holodactylus, were almost certainlymonophyletic altogether (BP=99%), whereas their sister-group relationship with Eublepharis received a weaker,but still substantial support (BP=68%). Within Goniurosaurus kuroiwae, G. k. splendens first diverged fromthe remainder (BP=100%), followed by G. k. kuroiwae from the northern part of Okinawajima (BP=100%): G.k. kuroiwae from the southern part of Okinawajima and G. k. orientalis, differing from each other at onlyseven bases, diverged finally (BP=99%). Parsimony analysis yielded results consistent with those of NJanalysis with respect to the monophyly of the two African genera and relationships within G. kuroiwae, butretained the other relationships within Eublepharidae unresolved. Our results, while showing no seriousdiscrepancies with the relationships among eublepharid genera hypothesized from morphological data, casta serious doubt to the currently accepted population systematics within G. kuroiwae. Furthermore, results ofboth analyses suggested a closer affinity of Diplodactylinae (as represented by Rhacodactylus trachyrhynchus)with Eublepharidae, rather than with Gekkoninae. Our study lends a robust support to the Laurasian origin ofthe family Eublepharidae

    For more than money : willingness of health professionals to stay in remote Senegal

    Get PDF
    The study was funded through a Research Grant for International Health, H25-11, from the Ministry of Health, Welfare and Labour, Japan (http://www.ncgm.go.jp/kaihatsu/), and undertaken as part of the project Réseau Vision Tokyo 2010, funded by the Japan International Cooperation Agency. Acknowledgement The authors would like to express their profound gratitude to the fieldwork team and to the health professionals who responded to the survey questionnaire. Thanks also to four reviewers whose comments have improved the paper. The datasets used and/or analysed in the study are available from the corresponding author on reasonable request.Peer reviewedPublisher PD

    Phylogenetic Relationships of the Flying Lizards, Genus Draco (Reptilia, Agamidae)

    Get PDF
    Phylogenetic relationships among 12 species of the genus Draco were inferred from 779 base pairs of mitochondrial 12S and 16S rRNA genes and allozymes for 20 presumptive loci. Results indicated the presence of at least four distinct lineages within the genus. The first lineage consists of D. volans and D. cornutus, whereas the second only of D. lineatus, which exhibits a great genetic divergence between two subspecies. The third is monotypic with D. dussumieri, the only species distributed in southern India. The fourth included all the remaining species. The third and fourth lineages are supposed to exclusively share a common ancestor. It is likely that the common ancestor of whole Draco originally diverged into three groups, the ancestors of the first, second, and third and fourth lineages, by vicariance. In the fourth lineage, D. blanfordii, D. haematopogon, D. melanopogon, D. obscurus and D. taeniopterus are likely to be exclusively close to each other. The resultant phylogenetic tree contradicts the dichotomous relationships previously hypothesized on the basis of morphological characters

    Evolution of Asian and African Lygosomine Skinks of the Mabuya Group (Reptilia: Scincidae): A Molecular Perspective

    Get PDF
    Phylogenetic relationships among Asian and African lygosomine skinks of the Mabuya group were inferred from 825 base pairs of DNA sequences of mitochondrial 12S and 16S rRNA genes. Results indicated the presence of two distinct lineages within this group, of which one consisted of Lamprolepis and Lygosoma, and the other of Apterygodon, Dasia, and Asian and African Mabuya. Within the latter, African species of Mabuya first diverged from the remainder, leaving the Asian congeners together with the Apterygodon-Dasia clade. Our results, while suggesting the non-monophyly of the genus Mabuya, do not support the currently prevailing phylogeographical hypothesis which assumes the independent origins of Lamprolepis and Lygosoma from the Asian Mabuya-like stock. On the other hand, our results suggest that morphological and karyological similarities between the Apterygodon-Dasia clade and Lamprolepis are attributable to symplesiomorphy, while their ecological similarity to convergence. Morphological and karyological character states unique to Apterygodon are supposed to have evolved from those exhibited by Dasia

    High-throughput screening of cell death inducible short peptides from TNF-related apoptosis-inducing ligand sequence

    Get PDF
    AbstractTherapeutic peptides and small molecules, rationally designed to trigger cell death have attracted strong attention. Cell death inducible peptides were screened from amino acid sequence of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Using Fmoc solid phase synthesis, cellulose membrane-bound octameric peptide library of TRAIL scan was prepared and cell viability assay was directly performed on peptide disk with Jurkat cells. Six peptide sequences that could induce cell death were found. Peptide sequence with RNSCWSKD (TRAIL227–234) that exist in the zinc-binding site revealed high cell death inducible activity. Apoptotic cell death was observed when cells were treated with soluble synthesized peptide
    corecore