擴大校園尿篩 防青少年染毒

新興混合式毒品逐漸在年輕族群間流行，常被巧妙包裝咖啡包、奶茶包、果凍和軟糖，引誘「染毒」，彰化縣政府決定編列預算，擴大尿篩，提醒家長若發現孩子有疑似藥物濫用，或擔憂在不知情況下誤食，可簽署同意書請學校實施尿篩，「及時拉一把！」。

驗出毒品人數大降

彰化縣國、高中校園，每年2次定期和假期過後不定期抽檢學生是否濫用毒品，國中、高中學生總人數約7萬人，前年定期共檢測2552人、去年1768人，驗出毒品反應分別4.09％和1.76％，至於不定期抽檢，前年和去年，分別是646人和660人，檢出0.08％。

彰化縣長魏明谷表示，毒品危害層出不窮，五花八門的毒品，常以精美包裝以假亂真，防制藥物濫用問題已刻不容緩。擴大尿篩最主要目是保護青少年，如果沾染了毒品，縣府也期望能拉他們一把，透過用心輔導，讓孩子們有改過向上的機會，同時呼籲家長平時多關心孩子的生活狀況。

輔導中輟生見成效

學生校外會督導謝孟椒說，校外會一直強化對中輟生、在校高關懷學生等巡迴輔導，舉辦展翅計畫，從縣內學生染毒比例下降的數據來看，發揮相當的成效，擴大尿篩，是為了擴大預防。

教育處長鄧進權說，尿篩試劑1成本約65元，今年編列450萬元經費，必要時可追加，執行擴大尿篩，並不是意味學生都是可疑分子，而是要做到「一個都不能放棄！」要盡所有力量，即時拉染毒學生一把，並提醒所有家長一起關心。

23歲的小珍，因近期分泌物增多且顏色異常，至婦產科就醫，原以為是單純的感染，沒想到經檢查後竟是罹患子宮頸癌，安安婦幼醫院廖倖玲醫師提醒，子宮頸癌罹癌已逐漸年輕化，且女性一生有高達8成機率會感染HPV病毒。

子宮頸癌是國內婦女的致命殺手，根據衛福部統計，發生率及死亡率均排名在前七名！隨著性行為發生的年齡下降，感染HPV （人類乳突病毒）的患者比例也越來越年輕化，日前知名美妝部落客大饅也分享罹患子宮頸癌前病變。台灣目前共核准3款子宮頸癌疫苗，包括2價、4價及9價類型，但接種人口卻不到百分之十。安安婦幼醫院廖倖玲醫師表示，反覆感染到HPV病毒，就有機會從「病」變成「癌」，一般抹片只能提早發現異常，卻不能做到完整預防，建議年輕女生及早施打。 

廖倖玲醫師也表示，預防子宮頸癌除了定期做子宮頸抹片，追蹤身體狀態之外，因初夜年齡逐年下降，建議女性應在尚未發生性行為前就先施打子宮頸癌疫苗，能產生比較有力的抗體預防，減低感染HPV病毒、甚至是病變罹癌的危險。 

針對人類乳突病毒的預防疫苗，施打後維持的效果，普遍大眾認知模糊，廖倖玲醫師說明，2價疫苗涵蓋HPV16、 HPV18，四價則增加HPV6、 HPV11型別的保護效果，這兩種疫苗經由臨床證實，至少有10年的保護力；至於近兩年新推出的九價疫苗，涵蓋的高度致癌病毒型別更廣，除了上述四款病毒型別以外，更新增5種病毒，其中囊括了台灣人感染最多的HPV52與58型，可有效將防範子宮頸癌病變的機率從7成提升到9成，是普遍醫師認可預防最完善的疫苗。

雖然大部分HPV病毒感染會自動代謝清除，但只要發生過性行為，就有高達99%的機率會感染致癌病毒，轉變成子宮頸癌。通常子宮頸癌的前兆並不明顯，廖倖玲醫師分析臨床案例，提醒女性平常應養成觀察陰道分泌物的習慣，一旦「白帶」分泌量變多，或者顏色帶血、偏黃，產生惡臭異味以及陰道搔癢時，就應該要立刻到婦產科做檢查，不必擔心內診尷尬，千萬不能拖延，以免錯過最佳的黃金治癒期間。

廖倖玲醫師也呼籲女性，因國內青少年性經驗年齡逐年下降，女性應該要學習愛自己且保護自己，謹記預防勝於治療，透過定期做「疫苗接種」與「抹片篩檢」，雙重防治子宮頸癌，才能降低感染率。

針對子宮頸癌疫苗的安全性，廖倖玲醫師最後補充，提醒年輕女性，注射子宮頸癌疫苗與其他疫苗一樣，注射後部位可能引起輕微紅疹，或者暈眩的症狀，但時間短暫、通常隔天就恢復正常，對於身體健康影響不大，女性不該因噎廢食，做好完善的預防，才能避免癌症找上門！

新聞網址：http://health.ettoday.net/news/821702

青少年得糖尿病 過重是主因

　　全台年逾廿歲糖尿病友約有一七二萬人，再過廿年將達二三○萬人。醫師指出，台灣第二型糖尿病有年輕化趨勢，國家衛生研究院發現，體重過重是青少年罹病主因。

　　台大醫院內科部主治醫師王治元指出，青少年第二型糖尿病患者比率已超過第一型，根據一九九二年到二○○○年全台國中、小學童尿液篩檢報告，糖尿病童中有百分之五十四點二為第二型糖尿病。

　　他表示，飲食西化使年輕人體重過重、肥胖，增加罹患糖尿病的機率，但傳統觀念認為糖尿病是中老年人疾病，多數年輕患者不易發現自己罹病。

　　王治元解釋，十到十七歲就罹患第二型糖尿病的年輕病友，除了肥胖，也與遺傳有關，若父母一方罹病，遺傳機率為百分之卅到四十，雙親皆有糖尿病，則達百分之七十。

　　不少青少年糖友父母礙於外界眼光，加上第二型糖尿病幾乎沒有症狀，沒有帶孩子接受治療，每當發現時，往往因為血糖問題身在急診。

　　王治元說有糖尿病家族史、家人曾有早發性心血管疾病、或ＢＭＩ介於卅至卅五，甚至超過卅五者，皆為糖尿病易發族群，學童可提早做篩檢，也建議一般人在卅五歲至四十歲間檢查。此外，王治元也說，均衡飲食控制、每日運動卅分到一小時，研究指女性每天睡眠超過七小時，皆會降低第二型糖尿病罹患機會。

新聞來源：

http://health.udn.com/health/story/5974/1300586

廣州青少年染愛滋年增逾四成 七成半經男男同性傳播

　　廣州市疾病預防控制中心表示，廣州青少年感染愛滋病的數目以年均46.37%的速度增長，截至去年底，累計學生感染個案達231宗，引發當局關注。根據發布的防治工作方案目標，初中以上學校的愛滋病健康教育開課率要達到100%，初中6課、高中4課，並納入日常或衛生工作年度考核內容之一。

　　廣州疾控中心印發《廣州市全國第三輪愛滋病綜合防治示範區青少年學生愛滋病防控專項工作方案(2015-2018年)》（方案），文件稱，廣州市青少年愛滋病防治形勢日益嚴峻，報告病例以年均增長46.37%的速度快速上升，自2002年發現首宗青少年感染病例以來，截至去年年底，累計學生感染個案達231宗，廣州學生所佔病例的比例由2002年的0.74%升至2014年的3.91%。方案又提到，在231宗病例中，有165例可以獲得其學校信息，分別有74間省內外大學、7間中學及29間職業技術學校，其中54間學校位於廣州市內，主要分佈在天河區、番禺區和白雲區，當中有4間廣州學校累計超過10宗感染個案。

　　方案又提到，青少年主要因性接觸感染病毒，「男男同性傳播」比例更高達74.76%，主要發現途徑為自願諮詢檢測，佔41%，其他發現途徑包括性病門診和術前檢測（佔19%）、專題調查（佔17%）等。分析認為，學生對愛滋病防治知識認識較少，性觀念亦變得開放，在進行性行為時沒有做好防護措施而感染，而青年學生發生性行為的比例由2011年的6.48%升到去年的16.35%，當中有1.21%試過「商業性行為」。

　　據了解，廣州進行「男男性行為」的學生超過​​5000人，他們存在多種高危性行為，包括多性伴侶（最多達100人）、安全套使用率低（近半年安全套每次使用率為29.6%）、性病感染（15.3%的人近一年出現過性病相關症狀）、群交（4.4%）和濫藥（19.9%​），同時他們的HIV檢測率低，不足30%，令愛滋病感染和傳播風險增加。

新聞來源：

http://news.mingpao.com/ins/instantnews/web_tc/article/20151110/s00004/1447133025342

The Center for Epidemiologic Studies Depression Scale (CES-D)

http://counsellingresource.com/quizzes/cesd/index.html

one of the most common screening tests for helping an individual to determine his or her depression quotient. The quick self-test measures depressive feelings and behaviours during the past week.

Screening Major Depressive Disorder in Children and Adolescents

The U.S. Preventive Services Task Force now recommends screening adolescents 12-18 years of age for clinical depression only when systems are in place to ensure accurate diagnosis, treatment and follow-up. (B recommendation) The Task Force found insufficient evidence to assess the balance of benefits and harms of screening children 7-11 years of age for clinical depression. (I statement) The Task Force reviewed new evidence on the benefits and harms of screening children and adolescents for clinical depression, the accuracy of screening tests administered in the primary care setting and the benefits and risks of treating clinical depression using psychotherapy and/or medications in patients 7 and 18 years of age.

The recommendations are published in the April issue of Pediatrics and are available on the AHRQ Web site at http://www.ahrq.gov/clinic/uspstf/uspschdepr.htm

Release Date: March 2009

Summary of Recommendations / Supporting Documents

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This recommendation updates the Task Force's 2002 recommendation on Screening for Depression. In that year, the Task Force found the evidence insufficient to recommend for or against routine screening of children or adolescents. An updated recommendation on Screening for Depression in Adults will be published in the next several months.

Summary of Recommendations

• The USPSTF recommends screening of adolescents (12-18 years of age) for major depressive disorder (MDD) when systems are in place to ensure accurate diagnosis, psychotherapy (cognitive-behavioral or interpersonal), and follow-up.
  Grade: B recommendation.
• The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening of children (7-11 years of age).
  Grade: I statement.

Grade Definitions After May 2007

What the Grades Mean and Suggestions for Practice The U.S. Preventive Services Task Force (USPSTF) has updated its definitions of the grades it assigns to recommendations and now includes "suggestions for practice" associated with each grade. The USPSTF has also defined levels of certainty regarding net benefit. These definitions apply to USPSTF recommendations voted on after May 2007. Grade Definition Suggestions for Practice A The USPSTF recommends the service. There is high certainty that the net benefit is substantial. Offer or provide this service. B The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. Offer or provide this service. C The USPSTF recommends against routinely providing the service. There may be considerations that support providing the service in an individual patient. There is at least moderate certainty that the net benefit is small. Offer or provide this service only if other considerations support the offering or providing the service in an individual patient. D The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. Discourage the use of this service. I Statement The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. Read the clinical considerations section of USPSTF Recommendation Statement. If the service is offered, patients should understand the uncertainty about the balance of benefits and harms. Levels of Certainty Regarding Net Benefit Level of Certainty* Description High The available evidence usually includes consistent results from well-designed, well-conducted studies in representative primary care populations. These studies assess the effects of the preventive service on health outcomes. This conclusion is therefore unlikely to be strongly affected by the results of future studies. Moderate The available evidence is sufficient to determine the effects of the preventive service on health outcomes, but confidence in the estimate is constrained by such factors as: The number, size, or quality of individual studies. Inconsistency of findings across individual studies. Limited generalizability of findings to routine primary care practice. Lack of coherence in the chain of evidence. As more information becomes available, the magnitude or direction of the observed effect could change, and this change may be large enough to alter the conclusion. Low The available evidence is insufficient to assess effects on health outcomes. Evidence is insufficient because of: The limited number or size of studies. Important flaws in study design or methods. Inconsistency of findings across individual studies. Gaps in the chain of evidence. Findings not generalizable to routine primary care practice. Lack of information on important health outcomes. More information may allow estimation of effects on health outcomes. * The USPSTF defines certainty as "likelihood that the USPSTF assessment of the net benefit of a preventive service is correct." The net benefit is defined as benefit minus harm of the preventive service as implemented in a general, primary care population. The USPSTF assigns a certainty level based on the nature of the overall evidence available to assess the net benefit of a preventive service.