[全球衛生] 修課筆記20200929

Facultative/Obligate/Coprozic(spurious)

Symbiosis/Mutualism/Commensalism/Zoonosis

Toxocara Canis 犬蛔蟲

Toxoplasma gondii 弓漿蟲

Nematode 線蟲

Cestode/Scolex 絛蟲

Trematode 吸蟲 可雌雄同體

Protozoae/ Plasmodium falciparum, vivax, malaria, ovale

Medical Arthoropoda

Clonorchis sinensis中華肝吸蟲 雌雄同體 Opisthorchis sinensis (trematoda)

Egg,intermidaite host, cercaria, second intermidate host, metacercaria, reservoir host/human, adult

1758雙名法Ascaria lumbricoides

1902三名法Trypanosoma brucei gambiense

Ascaris lumbricoides, large roundworm

Loelffer syndrome

Albendazole, Mebendazole, Ivermectin

Necator americanmus

Ancylostoma duodenale, caninum, braziliense, ceylanisum

Bursa, male

Hookworm, Eggshell

Filaria

Trichuris trichiura

albendazole

[全球衛生] 修課筆記20200928

Tobacco Use Among Undergraduates in South-Western Nigeria: a Cross-Sectional Study

International Journal of Mental Health and Addiction (2020)

Tobacco use in tertiary institutions has continued to receive increased attention, especially in developing countries. This is not unconnected with the intensification of efforts by the tobacco industry to appeal to young people, many of whom are domiciled in higher institutions of learning. In describing the burden of tobacco use and advocating for stronger tobacco control efforts, this study aimed to explore the prevalence of tobacco use among undergraduates in two universities in Ibadan, Southwestern Nigeria. This study was a cross-sectional study that used interviewer-assisted questionnaires to obtain information from 1200 undergraduates via a multistage sampling technique. Data were analyzed using SPSS version 23. The analysis included descriptive as well as chi-square statistics and p < 0.05 was taken as statistically significant. There were 646 (53.8%) males and 554 (46.2%) females, with a male–female ratio of 1.16 to 1.0. Their mean age was 21.6 (± 3.1) years with a range of 16–43 years. The prevalence rate of current smoking was significantly (X 2 = 11.64, p = 0.001) lower among medical students (0.5%) compared with other students (9.4%). The mean age at initiation of smoking among respondents was 16 (+ 2.4) years (range 8–25 years). Furthermore, 73.9% of current smokers had started smoking by their eighteenth birthday. Respondents smoked 7.7 (± 4.2) cigarettes daily, with a range of 1–21 cigarettes per day. There was a significant association between sex, level of study, and current smoking status. In the private university, more males 20.9% were current smokers than the females 4.3% (p < 0.001). Similarly, in the public university, more males 12.9% were current smokers than females 2.6% (p < 0.001). There is the need to be proactive and initiate primary prevention interventions in early adolescence while continuing to intensify tobacco control efforts within tertiary institutions to reduce the morbidity and mortality from tobacco-related illnesses, in Nigeria.

[全球衛生] 進修筆記 20200923

SPAR

全名為IHR States Parties Self-Assessment Annual Reporting

Global Health Threat

Health Risks in a Globalizaed world, facing multiple health challenges

Global public health security

the activity required to prevent and respond to threats that endanger the collective health of people across different regions and nations

Quarantine, sanitation, vaccination, IHR

Plague-Quaranine 14th century 40days

Cholera-sanitation; MDG/SDG

Smallpox, Variola virus, air droplets; UN

IHR 1969; WHO 1948

IHR 2005: quickly tackle any outbreak at its source; infectious diseases, chemical, radioactive, microorganism(food-borne, zoonotic); Detect, Assess, Report, Respond; in active 2007

GHSA: prevent

5-year strategic plan; 13th general programme of work 2018-2023

focuses on a triple billion target

1 billion more pople benefit from UHC

1 billion more people are protected from health emergencies

1 billion more people enjoy etter health and well-being

Air pollution and climate change

Noncommunicable diseases.

Global influenza pandemic. H1N1 1918; H2N2 1957; H3N2 1968; H1N1 2009(1st PHEIC)

Fragile and vulnerable settings.

Antimicrobial resistance.

Ebola and other high-threat pathogens.

Weak primary health care.

Vaccine hesitancy.

Dengue

HIV

Scope and Definition of Security

Schistosoma mansoni

Schistosoma japonicum

Schistosoma haematobium

Health system strengthening/PHC/UHC

MDG

消滅極端貧窮和飢餓

實現普及初等教育

促進性別平等並賦予婦女權力

降低兒童死亡率

改善產婦保健

與愛滋病毒/愛滋病、瘧疾以及其他疾病對抗

確保環境的永續性

全球合作促進發展

SDG

1. 消除各地一切形式的貧窮

2. 消除飢餓，達成糧食安全，改善營養及促進永續農業

3. 確保健康及促進各年齡層的福祉

4. 確保有教無類、公平以及高品質的教育，及提倡終身學習

5. 實現性別平等，並賦予婦女權力

6. 確保所有人都能享有水及衛生及其永續管理

7. 確保所有的人都可取得負擔得起、可靠的、永續的，及現代的能源

8. 促進包容且永續的經濟成長，達到全面且有生產力的就業，讓每一個人都有一份好工作

9. 建立具有韌性的基礎建設，促進包容且永續的工業，並加速創新

10. 減少國內及國家間不平等

11. 促使城市與人類居住具包容、安全、韌性及永續性

12. 確保永續消費及生產模式

13. 採取緊急措施以因應氣候變遷及其影響

14. 保育及永續利用海洋與海洋資源，以確保永續發展

15. 保護、維護及促進陸域生態系統的永續使用，永續的管理森林，對抗沙漠化，終止及逆轉土地劣化，並遏止生物多樣性的喪失

16. 促進和平且包容的社會，以落實永續發展；提供司法管道給所有人；在所有階層建立有效的、負責的且包容的制度

17. 強化永續發展執行方法及活化永續發展全球夥伴關係

[全球衛生] 修課筆記 20200917

*Discriptive vs inferential Statistics *COVID-19 到底在全球增加多少死亡率? 頂多1.X%而已 死亡大多是老年、共病症(糖尿病,高血壓,...) 但是因為菸害死亡的人數遠遠多過COVID-19 *GYTS:Global youth tobacco survey https://www.hpa.gov.tw/Pages/List.aspx?nodeid=1489

[全球衛生] 修課筆記20200916

PHEIC: Public Health Emergency of International Concerns 國際關注衛生緊急事件 https://pansci.asia/archives/178771 其中，至少要有兩個要件能被明顯判斷，疫情才有可能被視為「國際」社會中的「緊急」事件，而且若當事國覺得自己判斷不了，也可以尋求世衛的意見，進行磋商。這四個主要考慮因素包括： 該事件對公共健康影響的嚴重性。 該事件是否不尋常或屬意料之外。 該事件是否具跨國傳染的高風險。 該事件是否危險到應該限制旅遊或貿易 IHR 2005 https://www.who.int/ihr/publications/9789241580496/zh/ “以針對公共衛生風險，同時又避免對國際交通和貿易造成不必要干擾的適當方式，預防、 抵禦和控制疾病的國際傳播，並提供公共衛生應對措施” Detect, Assess, Report, Respond Highly Pathogenic Asian Avian Influenza (HPAI) H5N1 https://www.cdc.gov/flu/avianflu/h5n1-virus.htm PIP Framework 2011 Pandemic Influenza Preparedness Frame work 2006年 H5N1爆發且印尼拒絕提供病毒樣本 GHSA 2014 Global Health Security Agenda endorsed by G7. linking GHSA to IHR2005 JEE: Joint External Evaluation 2016

[眼睛保健] 建議眼底篩檢的對象與頻率

篩檢工具有: 眼科醫師檢查(不散瞳or有散瞳)、眼底攝影(一般)、超廣角眼底攝影(Optos) 1.高度近視(超過五百度/即使曾經接受近視雷射手術) 高度近視容易產生視網膜破洞/剝離、青光眼、黃斑病變。 若無視力改變、飛蚊閃電，可以半年~一年檢查一次。 2.糖尿病 若尚無視網膜病變，或是視力尚未有影響，一年檢查一次 若已有視力改變，就會建議盡快檢察。 3.飛蚊症 若無增加，可以半年到一年檢查一次；若有突然增加或有看到閃電，則建議1~3天內一定要散瞳檢查 眼底攝影可以初步頻估，但是若想檢察視網膜邊緣的破洞/剝離，仍建議到眼科散瞳檢查 4.有家族青光眼病史、或有眼睛脹痛、頭痛、噁心嘔吐感、視野缺損 此類民眾有較高機會罹患青光眼，建議可以主動篩檢，且若暫時無病灶、兩到三年再主動追蹤。 5.超過五十歲以上 五十歲以上可能會有老年黃斑部病變、黃斑部皺摺、黃斑部裂孔(分層與全層) 但若是很輕微，眼底攝影未必能夠看出，需要光學斷層掃描(OCT)才能診斷出來 6. 最近有視力/視野改變者 超廣角眼底攝影(Optos)有一定優於眼底攝影(一般)嗎? 不一定，因為超廣角攝影的影像經過軟體重組拼接，所以顏色會有略微差異，對於眼科醫師判讀不一定是容易的。