アンナ も ジュリア も,イエス の 言葉 が 正しい こと を 実感 し まし た。アンナ は こう 言い ます。「クリスチャン の 活動 に 参加 し て いる と,自分 の 抱える 問題 で は なく,他 の 人 の こと を 考える よう に なり ます。いつも そう できる わけ で は ない けど,以前 より は ずっ と 前向き に なり まし た」。ジュリア は,祈っ たり 聖書 を 読ん だり する こと で 心 が いや され,こう 述べ て い ます。「祈っ て,自分 の 思い を 神様 に 打ち明ける と,気持ち が 楽 に なり ます。聖書 を 読む と,神様 が わたし の こと を 大切 に 思い,本当 に 見 て い て くれる こと が 分かり ます。将来 に 対し て も ポジティブ に なれ ます」。
Primary health care is the foundation of universal health coverage. It is an approach that embraces all of society for better health and wellbeing, centred on the needs and preferences of individuals, families and communities. It focuses on the essential package of care needed for physical, mental and social health and wellbeing, from promotion of health and prevention of disease and ill health, to treatment, rehabilitation and end-of-life care, in accessible settings where people live or work.
UHC and primary health care recognise that health is a fundamental human right. They put people at the centre, and empower individuals, families and communities with knowledge and care to optimize their health. This requires stakeholders to work together across sectors to address the social, economic, environmental and commercial factors that influence health and wellbeing (the determinants of health). A health system strengthened through UHC and primary health care is resilient and copes better with natural disasters and emergencies.

On February 11 2019, the WHO Kobe Centre, along with the Hyogo Prefectural Board of Education and Osaka University, organized the WKC forum “Think Global Agenda with High School Students” at the Kobe Fashion Mart Hall. About 500 students and teachers participated, mainly from high schools in Hyogo prefecture, and shared their views of how we can contribute to achieve Sustainable Development Goals.

The WHO’s Centre for Development is strategically placed in Kobe to conduct research for health systems of the future accelerate progress towards UHC. We work with researchers across the globe to explore best practices and how they can help other countries achieve UHC. Our work focuses on innovative solutions that strengthen health and the delivery of healthcare solutions, especially for rapidly ageing populations.
A new publication sharing the results of the Kobe Expert Meeting on health emergency and disaster risk management (Health EDRM) was published in the International Journal of Environmental Research and Public Health. The meeting convened members of the WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network.  The meeting identified research questions in five major areas for Health EDRM: health data management, psychosocial management, community risk management, health workforce development, and research methods and ethics. Funding these key research questions is essential to accelerate evidence-based actions during emergencies and disasters.

本レビューに、24,308例の参加者を対象にした79件のRCT(関連性のある比較90件)を選択した。バイアスリスクの点で研究は多様であった。 主要解析の結果、Collaborative careモデルを用いて治療を受けた成人うつ病患者のうつ病アウトカムは、短期(SMD -0.34、95%CI -0.41~-0.27;RR 1.32、95%CI 1.22~1.43)、中期(SMD -0.28、95%CI -0.41~-0.15;RR 1.31、95%CI 1.17~1.48)、長期(SMD -0.35、95%CI -0.46~-0.24;RR 1.29、95%CI 1.18~1.41)いずれにおいても、有意な改善がみとめられた。しかし、これらの有意な有益性は、超長期では示されなかった(RR 1.12、95%CI 0.98~1.27)。 また、Collaborative careモデルによる治療を受けた成人不安障害患者の不安アウトカムにおいても、短期(SMD -0.30、95%CI -0.44~-0.17;RR 1.50、95%CI 1.21~1.87)、中期(SMD -0.33、95%CI -0.47~-0.19;RR 1.41、95%CI 1.18~1.69)、長期(SMD -0.20、95%CI -0.34~-0.06;RR 1.26、95%CI 1.11~1.42)で、有意な改善が示された。超長期の不安アウトカムに対する本介入の効果を検討した比較はなかった。 薬剤使用、精神保健上の生活の質、患者満足度などの副次アウトカムにおいて有益であるというエビデンスがみられたが、身体的生活の質に対する有益性のエビデンスはみられなかった。

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