Hints for Prevention: Parent’s Role on Health Promoting Schools 防患未然小錦囊家長角色 Professor Albert Lee Director of Centre for Health Education and Health Promotion Professor (Head of Family Medicine) Department of Community and Family Medicine The Chinese University of Hong Kong Honorary Consultant of Family Medicine 李大拔教授 香港中文大學醫學院健康教育及促進健康中心主任 香港中文大學醫學院社區及家庭醫學系教授 ( 家庭醫學主管 ) 家庭醫學榮譽顧問

課程改革有哪七個學習宗旨？ 其中包括 - 健康生活方式 - 責任感 資料來源： 課程發展處教育統籌局

Why is it Important to Promote Health at Schools? 為何在校推廣健康是如此的重要 ?  Health Status Learning Outcomes 健康狀況 學習成效  Both health and education are linked to the economic performance and social cohesion of modern industrialized society  在現代化的城市裏，健康及教育均與經濟成就和 社會團結有莫大關係

Substantial evidence indicates that health is a major factor affecting the learning capacity of a person 不少証據顯示，健康是影響人們 學習能力的主要因素 Substantial evidence indicates that health is a major factor affecting the learning capacity of a person 不少証據顯示，健康是影響人們 學習能力的主要因素 (WHO, 1997; Ziglio, 1997; Lavin et al., 1992; World Bank, 1993; WHO, 1995)

In line with Curriculum Reform In line with Curriculum Reform 配合課程改革  Enable students to develop healthy living model 確立學生的健康生活模式  Promote self esteem 提升自信  Cultivate correct values and concepts of life 培養正確的價值觀

In line with Health Care reform 配合醫護改革  Strengthen the implementation of preventive medicine 加強預防醫學的實踐與推行  Empower the concept and skills of self help and self care. 增加自我照護的概念及技巧

 There has not been any new case of SARS reported in Hong Kong since June 2003 but we have to prepare on the assumption that this will return.  自從 2003 年 6 月，本港雖再沒有 SARS 新症， 然而我們須嚴陣以待，假設它會回來。 Timely issue: will SARS come back? 最新話題︰ SARS 會回來嗎？

Related websites 相關網站 Checklist of measures to combat SARS -e.pdf -e.pdf

構成傳染病的 〝 三種 〞要素 傳染原 (Infections Agent) ↓ 傳染途徑 (Mode of spread) 易 受病者 (Susceptible host ) 切斷 這三種要素之間任何二者的關係，便能控制 傳染病的傳播 Infectious prevention and control in school 學校傳染病預防及控制的方法

Norwalk-like Viruses

 In developed countries, acute diarrheal illness remains an important cause of morbidity among both children and adults  在已發展的國家，由急性肚瀉帶來的身 體不適是引致兒童和成人發病的主要因 素 Viral Gastroenteritis 病毒性腸胃炎

 Two distinct groups of viruses – the rotaviruses and the enteric caliciviruses, such as Norwalk virus – as well as a variety of bacterial pathogens have emerged as important etiologic agents of gastroenteritis  包括兩類明顯的病毒 – 1) 輪狀病毒和 2) Enteric caliciviruses, 例如：諾沃克病毒 – 和不 同種類的細菌病原體皆顯露出是腸胃炎的主要 致病原 Viral Gastroenteritis 病毒性腸胃炎

 Rotavirus infection occurs worldwide  By the age of 3 years, virtually every individual has been infected by rotaviruses at least once  輪狀病毒感染可以是全球性發生  由三歲開始, 事實上每個人皆有致少感染過一次 輪狀病毒的可能性 Viral Gastroenteritis 病毒性腸胃炎

 In areas with a temperate climate, rotavirus infection is seasonal, occurring in the cooler winter months  於溫帶地區，輪狀病毒感染是季節性發 生，和多出現於較寒冷的冬季 Viral Gastroenteritis 病毒性腸胃炎

 The majority of rotavirus infections are subclinical or cause mild gastrointestinal illness that do not require hospitalization  The onset of illness is usually abrupt  大多數的輪狀病毒感染都沒有臨床症狀，或會 引致溫和的腸胃炎不適，而不需要住院治療  通常是突發性病發 Viral Gastroenteritis 病毒性腸胃炎

 More than 80 percent of affected children develop vomiting followed by diarrhea  About one-third of hospitalized children have a temperature of greater than 39°C (102.2°F)  多過八成的受感染兒童會出現嘔吐過後接著是 肚瀉的症狀  大概有三分之一的住院兒童會出現發燒大過 39°C (102.2°F) 的情況 Viral Gastroenteritis 病毒性腸胃炎

 Gastrointestinal symptoms usually last between 2 and 6 days  Immunity is not complete  腸胃炎症狀一般維持 2 至 6 日  暫時未有疫苗注射 Viral Gastroenteritis 病毒性腸胃炎

 Norwalk infection occurs year-round and is common  More than 70 percent of adults in both developed and less developed countries have antibodies to this virus  諾沃克病毒感染是普遍和每年皆發生  於已發展和將近發展的國家中，多過七成的成人 對此病毒已有抗體 Norwalk-like viruses 諾沃克類病毒

 Antibody acquisition occurs at a younger age among children in less developed countries than among those in developed areas  於將近發展國家的年幼兒童比起已發展國家的 年幼兒童較容易產生抗體 Norwalk-like viruses 諾沃克類病毒

 Norwalk virus is spread by the fecal-oral route  In developed countries, the virus is responsible for one-third of all epidemics of nonbacterial gastroenteritis  諾沃克病毒的傳播媒介是經口或糞便  在已發展國家中，此病毒佔有全部非細菌性腸胃 炎爆發的三分之一 Norwalk-like viruses 諾沃克類病毒

 The virus is a common cause of waterborne epidemics of gastroenteritis and has been shown to be the etiologic agent in nursing home, cruise ship, and institutional (summer camp and school) outbreaks  此病毒正是導致經由飲水而感染腸胃炎的主要 原因  而且，當腸胃炎發生在家居護理、遊輪及公共 團體時 ( 如夏令營和學校 ) ，皆顯示出此病毒便 是致病原 Norwalk-like viruses 諾沃克類病毒

 Norwalk illness has an incubation period of between 18 and 72 h.  Disease is characterized by the abrupt onset of nausea and abdominal cramps followed by vomiting and/or diarrhea  諾沃克病毒疾病的潛伏期為 18 至 72 小時  其發病的特色主要是突發性的作嘔、腹痛、接 著是嘔吐和 / 或肚瀉 Norwalk-like viruses 諾沃克類病毒

 Vomiting is reported more frequently for children than for adults  Low-grade fever [above 37.5°C (99.5°F)] develops in about half of affected individuals  報告指出，兒童出現嘔吐的情況比成人多  低溫發燒 [ 大概 37.5°C (99.5°F)] 出現於過半數的 受感染者 Norwalk-like viruses 諾沃克類病毒

 Headache, myalgias, and abdominal pain are common  The illness is usually mild and self-limited, lasting 24 to 48 h.  一般症狀包括：頭痛、肌痛和腹痛  此疾病通常是溫和和自限的，維持 24 至 48 小時 Norwalk-like viruses 諾沃克類病毒

 Most people do not develop long-term resistance  多數人沒有產生長期抗性 Norwalk-like viruses 諾沃克類病毒

Reference 相關資訊 衛生署熱線︰ 教統局︰預防傳染病在學校擴散 CM03310C.pdf CM03310C.pdf 衛生署：預防病毒性腸胃炎 衛生署：學校預防傳染病指引

衛生署：病毒性腸胃炎討論會簡報 _gastroenteritis/Chinese/download/vgs.ppt _gastroenteritis/Chinese/download/vgs.ppt 衛生署：諾沃克類病毒感染 衛生署：預防傳染病資訊集 食環署：諾沃克類病毒知多少？ norwalkc.html norwalkc.html Reference 相關資訊

Health Promotion (by WHO) 世界衛生組織將健康促進定義為  The process of enabling people to increase control over, and to improve their health 增強人們掌控及改善自己健康的能力  To ensure sustained positive changes 確保能持續地作出正面的改善  To address the interwined social, educational, psychological, and health needs of school children 配合學童在社會、教育、心理和健康上的多種需要 Health Promoting Schools 健康促進學校

Hong Kong Healthy Schools Award Scheme 香港健康學校獎勵計劃

The Hong Kong Subsidized Secondary Schools Council 香港津貼中學議會 the Subsidized Primary Schools Council 津貼小學議會 World Health Organisation 世界衛生組織 the Hong Kong Special Schools Council 香港特殊學校議會 the Centre for Health Education and Health Promotion of the Faculty of Medicine of The CUHK 香港中文大學醫學院 健康教育及促進健康中心 Education and Manpower Bureau 教育統籌局

Quality school health programmes Formal curriculum 正規課程 The environment 學校環境 Health services 健康服務 Partnerships 伙伴關係 School policies 學校政策

面對不同疾病對我們和下一代的威脅，作 為家長的您可擔當什麼角色？ You as parents are taking what kind of roles while you and your children are facing the threat of different diseases?

School Health Policies 學校健康政策  As an advisor, monitor & reviewer  作為顧問、監察及檢討過程的諮詢者  Example: Health eating policy 健康飲食政策 Infectious control policy 傳染病控制政策

 Understand the goal & content of health education  明白健康教育的目的及內容 Health Education Curriculum 健康教育課程  Provide home environment to sustain children personal health skills: Reinforcement  提供理想的家庭環境，強化孩 子在學校所學的健康生活技能

 Modeling e.g. Personal Hygiene, Civil Responsibility  以身作則，例如注重個人衛生、重視公民 責任 Health Education Curriculum 健康教育課程

Health Services 健康服務  Provide accurate health information of children to school  提供準確的學生健康資料予學校 e.g. SARS: Temperature 例如 SARS ︰個人體溫

Health Services 健康服務  Report any kinds of infectious disease that your child suffer, e.g. Hand foot mouth.  向學校報告孩子任何患上的傳染病，例︰ 手足口病  Keep your child at home accordingly for rest  讓孩子在家休息

Health Services 健康服務  Collaborate with health services providing organization, e.g. DH Student Health Services  配合現存的健康服務，例如衛生署的學童保健 計劃

Environment 學校環境  Take part in school cleaning and beautifying activities  參與校園清潔及美化工作

Not just keeping school environment clean…but 不但保持學校環境衛生 … 也能 1.Improve relationships between parent, children & school 增進親子關係及與學校之關係 2.Increase the sense of belonging in students to school 提昇學生對學校的歸屬感 3.Let your child putting civic and moral education into practice through the school cleaning & beautiful activities 透過參與校園清潔及美化工 作，提供孩子一個公民教育實踐的機會

Partnership 伙伴關係  As human resource to school parent volunteer, e.g. SARS  為學校義工隊，成為學校的人力資源，例 如 SARS 期間的工作  Provide professional input, e.g. medical, nursing  提供專業意見，例如醫療或護理的意見

Health Promotion Programmes needing support from parents 健康推廣計劃需要家長的支持 /hygiene_charter.htm giene_charter/movie/movie.html

 TEAM CLEAN objectives  全城清潔策劃小組目標  a Pledge Day to act in each September  每年九月舉行「承諾日」

Summary of Features of this Project 計劃總結  create a culture of healthy habit and healthy living environment  建立健康的文化和一個健康的生活環境 Healthy School 健康學校 Healthy Community 健康社區 Healthy future generation 健康的新一代

Thank you!