今早為Asian Medical Students Association Hong Kong (AMSAHK)的新一屆執行委員會就職典禮作致詞分享嘉賓,題目為「疫情中的健康不公平」。
感謝他們的熱情款待以及為整段致詞拍了影片。以下我附上致詞的英文原稿:
It's been my honor to be invited to give the closing remarks for the Inauguration Ceremony for the incoming executive committee of the Asian Medical Students' Association Hong Kong (AMSAHK) this morning. A video has been taken for the remarks I made regarding health inequalities during the COVID-19 pandemic (big thanks to the student who withstood the soreness of her arm for holding the camera up for 15 minutes straight), and here's the transcript of the main body of the speech that goes with this video:
//The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, continues to be rampant around the world since early 2020, resulting in more than 55 million cases and 1.3 million deaths worldwide as of today. (So no! It’s not a hoax for those conspiracy theorists out there!) A higher rate of incidence and deaths, as well as worse health-related quality of life have been widely observed in the socially disadvantaged groups, including people of lower socioeconomic position, older persons, migrants, ethnic minority and communities of color, etc. While epidemiologists and scientists around the world are dedicated in gathering scientific evidence on the specific causes and determinants of the health inequalities observed in different countries and regions, we can apply the Social Determinants of Health Conceptual Framework developed by the World Health Organization team led by the eminent Prof Sir Michael Marmot, world’s leading social epidemiologist, to understand and delineate these social determinants of health inequalities related to the COVID-19 pandemic.
According to this framework, social determinants of health can be largely categorized into two types – 1) the lower stream, intermediary determinants, and 2) the upper stream, structural and macro-environmental determinants. For the COVID-19 pandemic, we realized that the lower stream factors may include material circumstances, such as people’s living and working conditions. For instance, the nature of the occupations of these people of lower socioeconomic position tends to require them to travel outside to work, i.e., they cannot work from home, which is a luxury for people who can afford to do it. This lack of choice in the location of occupation may expose them to greater risk of infection through more transportation and interactions with strangers. We have also seen infection clusters among crowded places like elderly homes, public housing estates, and boarding houses for foreign domestic helpers. Moreover, these socially disadvantaged people tend to have lower financial and social capital – it can be observed that they were more likely to be deprived of personal protective equipment like face masks and hand sanitizers, especially during the earlier days of the pandemic. On the other hand, the upper stream, structural determinants of health may include policies related to public health, education, macroeconomics, social protection and welfare, as well as our governance… and last, but not least, our culture and values. If the socioeconomic and political contexts are not favorable to the socially disadvantaged, their health and well-being will be disproportionately affected by the pandemic. Therefore, if we, as a society, espouse to address and reduce the problem of health inequalities, social determinants of health cannot be overlooked in devising and designing any public health-related strategies, measures and policies.
Although a higher rate of incidence and deaths have been widely observed in the socially disadvantaged groups, especially in countries with severe COVID-19 outbreaks, this phenomenon seems to be less discussed and less covered by media in Hong Kong, where the disease incidence is relatively low when compared with other countries around the world. Before the resurgence of local cases in early July, local spread of COVID-19 was sporadic and most cases were imported. In the earlier days of the pandemic, most cases were primarily imported by travelers and return-students studying overseas, leading to a minor surge between mid-March and mid-April of 874 new cases. Most of these cases during Spring were people who could afford to travel and study abroad, and thus tended to be more well-off. Therefore, some would say the expected social gradient in health impact did not seem to exist in Hong Kong, but may I remind you that, it is only the case when we focus on COVID-19-specific incidence and mortality alone. But can we really deduce from this that COVID-19-related health inequality does not exist in Hong Kong? According to the Social Determinants of Health Framework mentioned earlier, the obvious answer is “No, of course not.” And here’s why…
In addition to the direct disease burden, the COVID-19 outbreak and its associated containment measures (such as economic lockdown, mandatory social distancing, and change of work arrangements) could have unequal wider socioeconomic impacts on the general population, especially in regions with pervasive existing social inequalities. Given the limited resources and capacity of the socioeconomically disadvantaged to respond to emergency and adverse events, their general health and well-being are likely to be unduly and inordinately affected by the abrupt changes in their daily economic and social conditions, like job loss and insecurity, brought about by the COVID-19 outbreak and the corresponding containment and mitigation measures of which the main purpose was supposedly disease prevention and health protection at the first place. As such, focusing only on COVID-19 incidence or mortality as the outcomes of concern to address health inequalities may leave out important aspects of life that contributes significantly to people’s health. Recently, my research team and I collaborated with Sir Michael Marmot in a Hong Kong study, and found that the poor people in Hong Kong fared worse in every aspects of life than their richer counterparts in terms of economic activity, personal protective equipment, personal hygiene practice, as well as well-being and health after the COVID-19 outbreak. We also found that part of the observed health inequality can be attributed to the pandemic and its related containment measures via people’s concerns over their own and their families’ livelihood and economic activity. In other words, health inequalities were contributed by the pandemic even in a city where incidence is relatively low through other social determinants of health that directly concerned the livelihood and economic activity of the people. So in this study, we confirmed that focusing only on the incident and death cases as the outcomes of concern to address health inequalities is like a story half-told, and would severely truncate and distort the reality.
Truth be told, health inequality does not only appear after the pandemic outbreak of COVID-19, it is a pre-existing condition in countries and regions around the world, including Hong Kong. My research over the years have consistently shown that people in lower socioeconomic position tend to have worse physical and mental health status. Nevertheless, precisely because health inequality is nothing new, there are always voices in our society trying to dismiss the problem, arguing that it is only natural to have wealth inequality in any capitalistic society. However, in reckoning with health inequalities, we need to go beyond just figuring out the disparities or differences in health status between the poor and the rich, and we need to raise an ethically relevant question: are these inequalities, disparities and differences remediable? Can they be fixed? Can we do something about them? If they are remediable, and we can do something about them but we haven’t, then we’d say these inequalities are ultimately unjust and unfair. In other words, a society that prides itself in pursuing justice must, and I say must, strive to address and reduce these unfair health inequalities. Borrowing the words from famed sociologist Judith Butler, “the virus alone does not discriminate,” but “social and economic inequality will make sure that it does.” With COVID-19, we learn that it is not only the individuals who are sick, but our society. And it’s time we do something about it.
Thank you very much!//
Please join me in congratulating the incoming executive committee of AMSAHK and giving them the best wishes for their future endeavor!
Roger Chung, PhD
Assistant Professor, CUHK JC School of Public Health and Primary Care, @CUHK Medicine, The Chinese University of Hong Kong 香港中文大學 - CUHK
Associate Director, CUHK Institute of Health Equity
同時也有2部Youtube影片,追蹤數超過5萬的網紅Gobby Hong,也在其Youtube影片中提到,Nominate 我的中學排球女團《6魔女》... Facebook我會tag返大家啦,不用擔心,我會提你地找數~ ^3^ 大家有錢出錢,有力出力~!!! 最緊要多認識,關心關注! 肌萎縮性脊髓側索硬化症Wiki: http://zh.wikipedia.org/wiki/%E8%82%8C%E8...
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#朋友分享給我的訊息
#我的常備藥品日本eve止痛藥就是布洛芬成分
台灣人很多人去日本必買這款止痛藥,但是卻不知道成分是什麼(盒子上都寫日文),我也是到德國後被問這藥成分才去查,以前都是吃有用就好,沒在管成分
昨天陽先生才在叫我不要吃布洛芬止痛藥,今天朋友就分享一樣的訊息給我,趕快分享給大家參考
#最近先暫停吃布洛芬成分
#日本eve止痛藥就是布洛芬成分
📣主題:若您是COVID-19患者不建議使用ibuprofen
建議大家在家感冒發燒等,可以先使用其他抗發炎藥物 (還是先問藥師喔怕您有慢性疾病,不是每一種抗發炎藥都可以用)
❌暫時先不要使用布洛芬ibuprofen成分❌
手邊發燒退燒藥有這個成分的
先收起來吧!!
目前很多國家說這藥物會加重COVID-19新冠狀病毒的嚴重性
只是數據還不多 尤其老年人要特別注意
📺相關新聞報導:https://www.cbc.ca/news/health/ibuprofen-covid-19-novel-coronavirus-1.5501496
🔍圖片是3/11/2020醫學期刊針對是高血壓跟糖尿表
🔹醫生簡述:
ACE INHIBITOR/ARB本來就是用在高血壓糖尿病人心臟病人身上
其他的疾病 很少用
文章說用CCB鈣離子阻斷劑治療血壓不會增加ACE2受體的表現
但如果長期使用CCB會失去ACEI/ARB帶來的血管保護的好處
📺相關新聞報導:
世衛組織現在正式建議避免服用布洛芬治療COVID-19症狀(但是還未公開發表喔)
新聞時間:AFP17 2020年3月
🔹Google翻譯中文
世界衛生組織週二建議,在法國官員警告說抗炎藥可能會使這種病毒的作用惡化後,患有COVID-19症狀的人避免服用布洛芬。
法國衛生部長奧利維爾·韋蘭(Olivier Veran)發出的警告是根據《柳葉刀》醫學雜誌上的一項最新研究得出的。
當被問及這項研究時,世衛組織發言人克里斯蒂安·林德梅爾在日內瓦對記者說,聯合國衛生機構的專家正在“對此進行研究,以提供進一步指導”。
他說:“與此同時,我們建議使用撲熱息痛,而不是使用布洛芬作為自我藥物。這很重要。”
他補充說,如果布洛芬是“醫護人員開的處方,那當然取決於他們”。
在Veran發推文警告說,布洛芬和類似的抗炎藥的使用可能是COVID-19感染的“加重因素”之後,他發表了上述評論。
他寫道:“在發燒的情況下,服用撲熱息痛。”
法國部長強調,已經接受抗炎藥治療的患者應向醫生諮詢。
撲熱息痛必須嚴格按照推薦劑量服用,因為過量會損害肝臟。
COVID-19大流行已在全球感染了190,000人,並殺死了7,800多人,在大多數人中引起輕微症狀,但可能導致肺炎,在某些情況下還可能導致嚴重疾病,導致多器官衰竭。
甚至在大流行之前,法國當局就因使用布洛芬而引起的嚴重“傳染性並發症”發出了警報,布洛芬以Nurofen和Advil等各種品牌出售,還使用了其他抗炎藥。
製造Nurofen的英國製藥公司Reckitt Benckiser的發言人在一封電子郵件聲明中表示,該公司已經意識到對“使用類固醇和非甾體抗炎(NSAIDs)產品(包括布洛芬)進行緩解的關注” COVID-19症狀。”
發言人說:“消費者安全是我們的首要任務,”他強調說:“布洛芬是一種行之有效的藥物,已被安全地用作自保發熱和減輕疼痛的藥物,包括病毒性疾病已使用了30多年。 ”
聲明說:“我們目前不認為有任何可靠的科學證據將非處方布洛芬的使用與COVID-19的惡化聯繫起來。”
該發言人表示,瑞吉特·本克塞(Reckitt Benckiser)正在“與世界衛生組織,歐洲藥品管理局(EMA)和其他地方衛生當局合作”,並將在進行任何此類評估後提供“任何有關安全使用我們產品的必要信息或指導。 ”
📺新聞出處:http://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms
結語:目前狀態是歐盟藥品管理局週三表示,目前尚無證據表明服用布洛芬會使冠狀病毒引起的疾病惡化。
英國藥理學會同意,但建議暫時不要使用它們。
該協會主席穆尼爾·皮爾穆罕默德(Munir Pirmohamed)說:“隨著更多證據的收集,我們將持謹慎態度。”
“除非我們有更多信息,否則人們應該服用撲熱息痛來治療冠狀病毒的症狀,除非醫生告訴他們撲熱息痛不適合他們。”
多倫多大學臨床藥理學系主任戴維·尤爾林克(David Juurlink)表示,對布洛芬的擔憂“似乎並不是基於大量的充分證據。”
各國專家對於這方面的確數據還不夠多 大家就謹慎使用藥物 若有疑似症狀還是先到醫院做檢查比較安全喔
大多數死於COVID-19的人都是老年人和患有諸如心血管疾病等基本健康狀況的人 若家中有這類族群患者就要特別注意使用藥用
health condition中文 在 Mark mak Facebook 的最佳貼文
各位,明天早上11點我和鄺俊宇會到長沙灣政府合署漁護署總部,就「錯誤殺死泰國家狗事件」遞交聯署及請願信,促請漁護署
1.)詳細交待殺狗理據。
2.)向狗主及全香港市民道歉!(因為令香港人蒙羞!)
3.) 立即檢討人道毀滅機制,停止殺害任何健康的動物!
明早,大家會抽一個小時來為動物討個公道嗎?
11點,漁護署見!
《沉冤待雪》(最新加入泰文版本)
感謝各位熱心人,《促漁護署交代「處決」泰小狗事件》聯署,截止14/3晚上九時,已超過一萬人參與,促漁護署交代事件及立即歸還泰小狗遺體予主人,另泰國方面開始有不少人加入聯署,令聯署數字不斷上升,感謝泰國動物保護組織Watchdog的協助。
我們決定明早(15/3,星期五)十一時,向漁護署位於長沙灣政府合署的辦公室遞交第一波的聯署,歡迎市民到場聲援。
聯署繼續收集中,請各位務必在今晚再廣傳聯署表格,已加入泰文版本,方便泰國的朋友了解事件。
據知漁護署今日再發出新聞稿,指泰小狗於被帶走的即晚(12/3)已被「人道毀滅」,若屬實,情況就更離譜,漁護署更需要清楚交代為何在不足24小時的情況下就殺泰小狗。
以下是中文、英文及泰文的聯署,請各位幫忙廣傳。
(Please scroll down for English)
一隻狗狗誤闖一艘由泰國開來香港的船上,於昨天來港後,被香港漁護署帶走。其後於泰國的主人得知消息,喜極想盡快接狗狗回家,今早立法會議員鄺俊宇去信香港漁護署署長促「刀下留狗」,正當大家期待這隻不自知「偷渡」的狗狗能回國,與主人重聚之時,豈料相隔不足一日,進展竟然是「香港漁護署證已『人道處理』」,換言之,即香港漁護署於昨天接走狗隻後不足一日,狗狗就已經遭「人道毀滅」。
事件令不少市民震驚,狗狗只是不小心上船,越洋過海後遭香港漁護署帶走,署方卻連事情都未搞清楚,就立即將狗隻處決,甚至連人道毀滅本身需等待四天的程序也不依,冷血程度令人咋舌。據知其泰國的主人已計劃來港接狗狗回家,卻驚聞惡耗,香港漁護署卻只是草草回應事件,指沒發現狗狗身上有植入晶片,及牠並沒有任何健康證明文件或醫療紀錄,故「以人道方式」處理有關狗隻。
這是何等的諷刺?若狗狗到的是其他國家或地方,都不會於不足一日的時間內就被人道毀滅,香港漁護署無疑在制造國際醜聞,若香港漁護署不公開交代事件,難以向心痛的主人及關注事件的市民交代。
若你也願意出一分力,請參與以下聯署,促香港漁護署公開交代事件及道歉。
「促香港漁護署交代『處決』誤闖來港的泰國狗狗事件」聯署行動:
https://bit.ly/2HrPOhc
謝謝你,請替無辜的狗狗發聲。
A dog was mistakenly sailed from Thailand to Hong Kong. As it arrived Hong Kong on the 12th March, the Agriculture Fisheries and Conservation Department of Hong Kong received the dog. The owner of the dog soon knew that the dog was found and was ready to travel to Hong Kong and bring it home. Legislator Roy Kwong immediately contacted the AFCD expressing concern to ensure the dog is safe. Yet the AFCD replied today (13th March) that the dog was euthanised within 1 day.
The AFCD did not conduct any investigation and soon decided to kill the dog, ignoring the criteria and guidelines of animal euthanasia. The decision shows how cruel the AFCD is. According to the department, there is no microchip found in the dog. They are unable to retrieve any information about the health condition nor medical record of the dog. It doesn’t take them long to decide the fate of the dog.
We believe that if the dog traveled to any other cities in the world, none of them would come up with the decision as the one made in Hong Kong. The AFCD was creating an international scandal in this case. We urge the AFCD to apologise for this irresponsible and ridiculous action taken and give an account of such issue to the public.
Please sign and share this petition, we need to speak up for the poor dog.
Petition:https://bit.ly/2HrPOhc
สุนัขตัวหนึ่งหลงมากับเรือจากประเทศไทยไปฮ่องกง ซึ่งเดินทางมาถึงวันที่ 12 มีนาคม กรมประมงและการอนุรักษ์ของฮ่องกง หรือ AFCD ได้รับสุนัขเอาไว้ เมื่อเจ้าของสุนัขทราบว่าสุนัขหลงมากับเรือ เขาก็พร้อมที่จะเดินทางไปฮ่องกงและนำสุนัขกลับบ้านทันที Roy Kwong สมาชิกสภานิติบัญญัติ ได้ติดต่อกับ AFCD ทันทีเพื่อให้แน่ใจว่าสุนัขปลอดภัย แต่ทาง AFCD ได้ตอบกลับในวันนี้ (13 มีนาคม) ว่าสุนัขถูกการุณยฆาตภายในหนึ่งวันหลังจากที่มาถึง
โดยปกติแล้ว สุนัขหรือแมวที่เข้ามาอยู่ในความดูแลของ AFCD จะถูกกักตัวเป็นเวลา 4 วันเพื่อเปิดโอกาสให้เจ้าของมารับกลับ แต่ในกรณีนี้ ทาง AFCD ไม่ได้ทำการสอบสวน หรือกักตัวสุนัขแต่อย่างใด และตัดสินใจอย่างรวดเร็วที่จะกำจัดสุนัขโดยไม่คำนึงถึงหลักเกณฑ์และกฎของ AFCD ในการทำการุณยฆาต การตัดสินใจนี้แสดงให้เห็นว่า AFCD โหดร้ายเพียงใด เพียงเพราะสุนัขไม่มีไมโครชิป และไม่สามารตรหาข้อมูลเกี่ยวกับสุขภาพและบันทึกทางการแพทย์ของสุนัขได้ ทาง AFCD ใช้เวลาไม่นานในการตัดสินชะตากรรมของสุนัข
เราเชื่อว่าหากสุนัขเดินทางไปยังเมืองอื่นๆ ในโลก เหตุการนี้จะไม่เกิดขึ้นเหมือนที่ AFCD ในฮ่องกงได้กระทำลงไป AFCD ได้สร้างเรื่องอื้อฉาวระหว่างประเทศ เราขอเรียกร้องให้ AFCD ออกมากล่าวขอโทษต่อการกระทำที่ไร้ความรับผิดชอบและไร้สำนึกนี้ต่อสาธารณชน
กรุณาลงชื่อและแชร์คำร้องนี้ เพื่อที่เราจะได้เป็นกระบอกเสียงให้กับสัตว์ที่พูดไม่ได้
คำร้อง: https://bit.ly/2HrPOhc
health condition中文 在 Gobby Hong Youtube 的精選貼文
Nominate 我的中學排球女團《6魔女》... Facebook我會tag返大家啦,不用擔心,我會提你地找數~ ^3^ 大家有錢出錢,有力出力~!!! 最緊要多認識,關心關注!
肌萎縮性脊髓側索硬化症Wiki:
http://zh.wikipedia.org/wiki/%E8%82%8C%E8%90%8E%E7%BC%A9%E6%80%A7%E8%84%8A%E9%AB%93%E4%BE%A7%E7%B4%A2%E7%A1%AC%E5%8C%96%E7%97%87
Anthony的ALS Ice Bucket Challenge冰桶挑戰影片(中文字幕版):
https://www.youtube.com/watch?v=d77TzcndRzU#t=126
https://www.youtube.com/watch?v=h07OT8p8Oik&feature=youtu.be
朋友們捐款可選:
美國ALSA http://www.alsa.org/
香港肌健協會 http://www.hknmda.org.hk/index.php
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health condition中文 在 HimeChar 曉玲 Youtube 的最佳解答
First, I'd like to state that I'm against 1. the challenge to donate structure, 2. the waste of water, and 3. ALS Association doing animal testing.
Raising awareness through creativity and fun is good, but it's becoming more of a contest and joke at times. It's a horrible disease and shouldn't be portrayed as anything like fun. My own father is a cancer survivor, if I were to see the disease in the social media this way, I would be f*ing pissed. Do the ends justify the means? How many celebs recorded the video and donated without putting much thought? How many of you have been watching those viral videos, had a good laugh, but not donating to any charity?
Therefore, I wouldn't be recording this video if I was not challenged by a fellow streamer friend. Hopefully you may get to understand ALS as a disease, like any other fundraising campaigns in need of public attention. I won't be naming anyone in particular, as I believe donations should NOT be a challenge or a hype. It's a selfless habit and one should take his own time to consider the causes that he cares most about.
Here are more information on different causes that you could help out:
ALS Association: http://alsa.pub30.convio.net/
Animal Rescue Team Taiwan: http://www.savedogs.org/english/
World Vision for children: http://www.worldvision.org/
Charity: Water: http://www.charitywater.org/
Sorry, I'm so serious.
May we all have a little more love for each other in this big big world.
我中文可能表達不當,請包涵。首先,我是反對1.捐助是挑戰的形式、2.浪費水、3.漸凍人研究採動物實驗。這樣的創意與好玩引起社會大眾注意確實是達到了,可是它很多時候變得扭曲像競賽像玩笑。這個病症是殘酷的,一點都不該是這樣的媒體形象。試問有多少公眾人物錄了影片、捐了也沒認識它太多?有多少觀眾看了很多冰桶挑戰影片,笑了,卻沒有捐助任何慈善團體?為了達到目的,就可以不擇手段嗎?所以如果不是被友善的實況主點名,我不會錄這個影片。或許我的觀眾因此而認識這個病症,開始了解其他需要被關注的募款。我不會點名任何人,因為捐助該是自發的習慣,無須挑戰或流行。每一個人都有能力去捐助這個世界,多一點愛與關懷,花一點時間選擇你想要支持的目標。抱歉我太嚴肅~
____________________________________
#himechar #video #icebucketchallenge #IBC #ALS #water #donation #charity #animaltesting #animalrescue
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