Development of a World Health Organization International Reference Panel for different genotypes of hepatitis E virus for nucleic acid amplification testing.

Globally, hepatitis E virus (HEV) is a major cause of acute viral hepatitis. Epidemiology and clinical presentation of hepatitis E vary greatly by location and are affected by the HEV genotype. Nucleic acid amplification technique (NAT)-based assays are important for the detection of acute HEV infection as well for monitoring chronic cases of hepatitis E. The aim of the study was to evaluate a panel of samples containing different genotypes of HEV for use in nucleic NAT-based assays. The panel of samples comprises eleven different members including HEV genotype 1a (2 strains), 1e, 2a, 3b, 3c, 3e, 3f, 4c, 4g as well as a human isolate related to rabbit HEV. Each laboratory assayed the panel members directly against the 1 World Health Organization (WHO) International Standard (IS) for HEV RNA (6329/10) which is based upon a genotype 3 a strain. The samples for evaluation were distributed to 24 laboratories from 14 different countries and assayed on three separate days. Of these, 23 participating laboratories returned a total of 32 sets of data; 17 from quantitative assays and 15 from qualitative assays. The assays used consisted of a mixture of in-house developed and commercially available assays. The results showed that all samples were detected consistently by the majority of participants, although in some cases, some samples were detected less efficiently. Based on the results of the collaborative study the panel (code number 8578/13) was established as the "1st International Reference Panel (IRP) for all HEV genotypes for NAT-based assays" by the WHO Expert Committee on Biological Standardization. This IRP will be important for assay validation and ensuring adequate detection of different genotypes and clinically important sub-genotypes of HEV

World Health Organization International Standard to Harmonize Assays for Detection of Hepatitis E Virus RNA

Nucleic acid amplification technique–based assays are a primary method for the detection of acute hepatitis E virus (HEV) infection, but assay sensitivity can vary widely. To improve interlaboratory results for the detection and quantification of HEV RNA, a candidate World Health Organization (WHO) International Standard (IS) strain was evaluated in a collaborative study involving 23 laboratories from 10 countries. The IS, code number 6329/10, was formulated by using a genotype 3a HEV strain from a blood donation, diluted in pooled human plasma and lyophilized. A Japanese national standard, representing a genotype 3b HEV strain, was prepared and evaluated in parallel. The potencies of the standards were determined by qualitative and quantitative assays. Assay variability was substantially reduced when HEV RNA concentrations were expressed relative to the IS. Thus, WHO has established 6329/10 as the IS for HEV RNA, with a unitage of 250,000 International Units per milliliter. Hepatitis E virus (HEV) is a nonenveloped, singlestranded RNA virus belonging to the family Hepeviridae (1,2). In developing countries, HEV is a major cause of acute hepatitis, transmitted by the fecal–oral route and associated with contamination of drinking water. In industrialized countries, reports of HEV infection have been uncommon but are being reported more frequently; some cases are imported after travel to HEV-endemic areas, but reports of autochthonous cases are also increasing, and infection with HEV appears to be more prevalent than originally believe

園内研修初期段階における保育実践の変容とその諸相 : 特別に配慮を必要とする子どもへの注目を契機として

園内研修初期段階において特別に配慮を必要とする子どもへの注目が具体的な子どもの姿や保育者の子どもへの関わりの姿をより鮮明に浮かび上がらせる契機となった。保育実践変容の要因として,次の3点が明らかになった。1)指導計画の環境図に子どもの姿を書き入れることで子ども理解が深まり,自分(保育者)が子どもとどのように関わっているのかが客観化された。2)子どもに対する配慮の違いを通じて保育者の持っている暗黙の保育観・子ども観に違いがあることが確認された。3)「保育後記録」を書き,保育の省察を行うことが,保育実践の変容を導き出す原動力となった。The attention paid to pre-schoolers in need of special care during the early stage of our training program brought a light to the state of each pre-schooler, and also to the relationship between the pre-schooler and the teachers. During this process, 3 things became evident.1.By having the teachers expect where each pre-schooler would play each day, the understanding towards each pre-schoolers deepened. It also helped the teachers see their relationships with the pre-schoolers more objectively. 2.Through the differences of attitudes towards the pre-schoolers, it became clear to the teachers that each of them had a different view on Early Childhood Care and Education and children.3.Keeping a record of what happened each day and the reflection of it helps create a change in the action