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2019年12月10日 20:02:36

Treating mental illness心理疾病治疗Body and soul身体与灵魂A professional schism hinders Britains mental-health system一个专业性的分裂阻碍英国心理健康系统THE day after Mandy Peck tried to electrocute herself in the bath her family took her to a mental-health centre in Chelmsford and asked for help. They were told that there were no beds available and sent home. Two days later Ms Peck jumped to her death from a multi-storey car park. She left a daughter behind.在曼迪·派克试图在浴室用电击自杀的第二天,她的家人将她送至且切姆斯福德的一家心理健康中心寻求帮助。他们被告知中心没有空余床位,随即回家。两天之后,派克于一个多层停车场跳楼自杀。她死后还留下了一个女儿。Ms Peck would not have been turned away had she arrived at hospital with a broken leg. Yet the National Health Service (NHS) often fails those suffering from a broken spirit. The numbers are fuzzy, but about one Briton in four suffers a mental-health problem at some time in their life, ranging from mild anxiety to severe schizophrenia. Less than a third of those receive treatment. That is in part because many sufferers are ashamed to seek help, but it is also due to funding gaps and disorganisation within the NHS. The result is a system in crisis, says Sue Bailey, a former president of the Royal College of Psychiatrists.如果派克到达医院时是腿部骨折的话,她就不会被医院拒收了。然而英国的国民医疗保健制度(NHS)总是放弃了那些饱受残缺心灵折磨的人们。尽管没有确切数据,但平均每四个英国人中就有一个人在他们生命中的某个时期受到心理健康问题的困扰,这些问题小到轻微的焦虑症,大到严重的精神分裂。可是不到三分之一的人选择接受心理治疗。因为从某种程度来讲很多病人都羞于寻求这方面的帮助,但这也归咎于NHS内部的资金缺口和杂乱无章。英国皇家精神科医学院的前任院长苏·贝利称这样的结果使整个制度陷入危机。This failure is costly. Mental-health problems cause more suffering in Britain than physical illness, poverty or unemployment, according to Richard Layard, an economist and author of a book on happiness. People with severe mental illnesses have higher rates of physical illness than the general public. According to the Kings Fund, a think-tank, this costs the NHS between £8 billion ( billion) and £13 billion each year. Sufferers are also more likely to commit crime; mental illness has become the most common reason to claim disability benefits. Researchers at the OECD, a club of rich countries, reckon getting mentally-ill people back to work could increase employment in Britain by nearly 5%.这个失败的代价很高。据著有一本关于幸福的书的经济学家理查德·莱亚德称,心理健康问题在英国给人们带来的痛苦多过生理疾病、贫困或失业。有严重心理疾病的人们比一般人有更高的生理疾病得病率。据智囊团君主基金分析,这个每年耗费了NHS80亿英镑(约合130亿美元)到13亿英镑。同时患有心理疾病的患者犯罪几率更高;心理疾病已经成为索赔伤残补助的最常见的理由。经合组织(OECD,发达国家组成的俱乐部)的研究人员估算如果将那些有心理疾病的人送回去工作,那么英国的就业率可以提高将近5%。Part of the problem is money. The consequences of mental illness cost the British economy over £100 billion a year, according to the Centre for Mental Health, a think-tank, yet the NHS spends just £11.3 billion on the problem. Some, like Mr Layard, see misplaced priorities. Doctors spend about £3.5 billion a year treating the depression and anxiety disorders suffered by some 6m British adults—a vast amount less than is spent treating the physical ailments of roughly 500,000 patients in the last year of their lives.这问题有一部分原因是因为钱。根据智囊团心理健康中心调查,心理疾病致使英国经济一年花费至少1000亿英镑,但NHS为此只花费了113亿。一些像莱亚德一样的人了解其中的轻重缓急。一些医生一年花费35亿英镑治疗大约600万患有抑郁和情绪障碍的英国成年人,这巨额费用中大部分都用来治疗50万弥留病人的生理疾病。Recent cuts to health spending have fallen hardest on mental-health care, just as doctors say demand is rising. The number of NHS beds for patients with mental illness has declined by over 30% since 2003. Many facilities are now full. As a result patients are having to travel long distances or wait months for care. To free up room, a mental-health centre in London has discharged patients to bed-and-breakfasts. Others are not so lucky: sufferers picked up by police are often diagnosed in jail cells. This week Norman Lamb, the minister for care, said that services for young people are “stuck in the dark ages”.最近健康消费的削减使心理健康护理的境况跌入谷底,正如医生所说,人们对于心理健康的需求正在提升。NHS提供给心理疾病患者的床位自2003年起已经减少了至少30%。很多设备现在也没有空余的了。因此病人必须长途跋涉去别的地方或者排队等待数月来寻求治疗。为了腾出空间,伦敦一家心理健康中心向出院病人提供住宿和早餐。其他的病人就没那么幸运了。一些病人经常碰到警察,被带回监狱诊断。本周医疗部长诺曼·兰布称,对于年轻人来讲,心理健康务“仍就停留在黑暗时期”。A second challenge arises from the way the NHS is structured. Mental-health care is staffed and funded separately from physical care—treatment is focused on the mind or body, but rarely on both at once. Yet research shows depressed people are more likely than others to develop heart and lung disease, and to suffer from strokes. Mental illness also appears to make diseases more lethal. On average men with mental-health problems die 20 years earlier than those without them (most from causes other than suicide), says the British Medical Association.第二个挑战来自NHS的制度结构。心理健康保健的提供和资助都与生理健康保健是分开的。因为治疗通常针对精神或身体,但鲜少两者兼顾。但研究显示抑郁的人比其他人更易患心脏和肺部的疾病,且更易患中风。患上心理疾病似乎也更易患上绝症。通常患上心理疾病的人比那些没有患心理疾病的人少活20年(大多心理疾病会导致患者死于除自杀之外的原因)。英国医学会如是说。The government is alive to these problems. Britains spending on mental health may be inadequate, but it compares favourably with that of other rich countries. From April ministers have promised to limit the long waiting times that prevent many people using mental-health services. And in 2012 the government pledged to give mental health care equal priority to physical care, enshrining this principle as part of the Health and Social Care Act. But critics complain that the promise has yet to deliver much practical change.政府已经意识到这些问题。英国对于心理健康的出或许不够,但与其它富有国家相比算是不错的了、自4月部长们已经承诺会限制阻止很多人使用心理健康务的长时间等待。2012年政府保给予心理健康保健与生理保健平等优先权,并将这一原则作为健康与社会保健法案的一部分。但批评家们抱怨承诺并未带来很多实际变化。Reform advocates would like better integration between mental- and physical-health care. “Liaison psychiatry” involves placing mental-health specialists in hospitals to work alongside doctors. The Centre for Mental Health found that one such initiative in Birmingham reduced the length of hospital stays and the number of missions and improved the health and well-being of patients. The centre calculated that the programme saved four times its costs. Yet such services are often meagre.改革倡议者想要心理和生理保健更好的一体化。“联络精神病学”涉及到心理健康专家在医院和医生一起工作。心理健康中心发现,伯明翰的一项此类实验减少了病人住院时间长度和再次入院的次数,并且提高病人的健康和幸福感。中心计算得出这项计划花费只占成本四分之一,但这类务还不完善。It would be better and cheaper to keep sufferers out of hospital altogether, says Emma Stanton, who runs Beacon UK, a mental-health consultancy. Ms Stanton recommends treatment at home through teams of doctors, nurses and social workers. Instead of swallowing antidepressants, health bosses would like sufferers of mild conditions to receive help under a programme called Improving Access to Psychological Therapies (IAPT), which aims to expand the use of treatments such as cognitive behavioural therapy. This helps individuals challenge the gloomy thinking that can lead to anxiety and depression. The National Institute for Health and Care Excellence (NICE), which evaluates treatments, considers it good value. Yet David Clark, an adviser for IAPT, says it reaches only a fraction of those who need it. He would like its budget doubled.心理健康咨询公司英国灯塔的运营者艾玛·斯坦顿称,将患者在院外集中是个更好且更实惠的方法。斯坦顿推荐在家通过治疗团队的医生、护士以及社会工作者治疗的方法。与用抗抑郁药相比卫生官员们更希望中等程度的病患接受一个名为“使更多人获得心理治疗”(IAPT)的项目的帮助。这个项目旨在扩大认知行为疗法的使用。这能帮助个人挑战可能会导致焦虑和抑郁的悲观想法。国家健康和护理研究所(NICE)评估此项治疗并且认为物有所值、但IAPT的顾问大卫·克拉克称项目预算只够一小部分需要它的人接受治疗。他希望预算可以翻倍。Convincing politicians to cough up more funds will be tough. Some critics fear that beefing up treatment of the most common mental-health problems risks saddling the system with overwhelming costs. Fortunately there is a lot that can be achieved without more cash. Many mental-health services still do not meet the standards recommended by NICE, and communication between services is poor. Elaborate therapies are not always necessary—one effective treatment for those suffering mental illness is keeping them in a job. Other types of therapy, say advocates, should pay for themselves by saving health-care costs and increasing productivity. Improving Britons mental health is not only humane, but economical.说政客们挤出更多的资金是艰难的。一些批评家担心加强治疗最常见的心理健康问题会有成本过高使体系不堪重负的风险。幸运的是有很多事情无需更多金钱便可做到。很多心理健康务不符合NICE推荐的标准,并且务之间的交流也很贫乏。复杂的治疗并不总是必要的——对于病患来说,一个有效的治疗方法就是让他们保持工作。提倡者称,其他的治疗方式应该通过节约健康保健成本和提高生产力来为病患付。提高英国心理健康不仅是关乎人道,也关系到经济。 译者:邵夏沁 校对:张娣 译文属译生译世 /201507/385857哈尔滨做人流大约多少钱A servileance camera at an Idaho high school appears to have caught evidence of a ghost.爱达荷州一所高中的监控摄像头似乎拍下了鬼Later,officials examined the milky white image and concluded it was just another resident of Idaho.稍后 官方检查了乳白色的图像 得出结论称 不过是一位普通的爱达荷州居民Thats Steve.This is crazy.This never happens anymore.This is a strange story.是史蒂夫啊 疯狂的消息 前所未闻 奇怪的消息On Monday,a Delta flight from Cleveland to New York took off with just two passengers.周一 一架从克利夫兰飞往纽约的西北航空飞机载着两名乘客就起飞了Two passengers on the whole plane.Yet somehow they spent the whole flight fighting over the arm rest.As if they wouldnt sit together,but they did.整架飞机只有两名乘客 但他们一路上却都在为扶手打架 按理说他们不会坐在一起呢 但偏偏就坐一起了Everyones ok,everyones ok.But instead of sending his kid to school with his lunch,a man sent him to school with 18,000 dollars worth of drugs and knives.人都没事 但一名男子送孩子去学校的时候给他带的不是午饭 而是价值18,000美元的毒品和刀The kid was 3 years old,sent to him school with drugs and knives.孩子才3岁 给他拿了一堆毒品和刀就送他去学校了The man is in jail and the 3 year old has cornerd the cookie and juice market.男子被送入监狱 他3岁的儿子压制了饼干饮料的销售Dont mess with that kid.He will cut your face.别惹那孩子啊 他会砍伤你的脸Weird story,a man who fell overboard off a royal Caribbean cruise ship was rescued hours later by a Disney cruise ship.奇怪的新闻 一名男子从一艘皇家加勒比邮轮上坠海 几小时后 他被一艘迪士尼的游轮救了起来The Disney ship was playing the ;Frozen; Soundtrack,so he immediately jumped back overboard.迪士尼船上在播放《冰雪奇缘》的原声碟 所以他立刻又跳海了Hes dead.I dont know why youre that happy.He died in the frigid waters.他都死了 真不知道你们为什么这么开心 他死在冰冷的水里201609/466400黑龙江省哈尔滨市三院可以做人流吗Patient data病人数据Caring and sharing关爱和分享A controversial NHS database will benefit patients—eventually颇有争议的英国国民保健务数据库将最终惠及病人NESTLED among offers for tree trimmers, cleaners and slankets, the English may have noticed a leaflet with “important information” about their health records last month. More likely, they did not. Though the National Health Service says it sent one to every household, over 70% of the public do not remember getting it. Those who did pick it off the carpet learned of a plan to collect patient data from GPs. Slated to begin in April, it has now been shelved for six months so that a more robust campaign can be mounted to convince the public of its merits.上个月,从事修剪树木、清洁工作或是居家的英国人可能会注意到有一张传单记录着他们健康情况的重要信息。更多的是,他们可能没有注意到这一现象。尽管英国国民保健务机构称他们给每户家庭都送了一张健康信息单,超过70%的公众不记得收到过。那些在门口的垫子上捡到健康信息单的人们了解到,需要通过全科医生收集病人数据。尽管既定4月份开始启动,这一计划现在已经被搁置了6个月,因此,可能会利用一场更加激烈的活动让公众认识到该信息单的优越性。The programme, called care.data, attracted little attention when it was set up as part of the Health and Social Care Act of 2012. Many patients now feel it has been thrust upon them with little consultation. Critics have stoked fears that the database might be hacked or misused by businesses or other third parties, which can petition the government for access. Despite safeguards to keep identifiable data confidential, GPs worry patients will withhold information from them. Many will likely opt out of the scheme, which almost two-thirds of the public opposes.这一项目称为关爱数据,最初作为2012年健康和社会保健法案设立时并未引起人们的关注。许多病人现在认为这项法案没有咨询他们的意见就强加在了他们的身上。家们担心该数据库被黑客窃取或者被滥用于商业以及被第三方所利用,因为这些公司或第三方可以向政府申请访问权限。尽管保护措施确保可识别的数据非常隐秘,但是全科医生担心病人将从中撤走其个人信息。几乎有三分之二的公众反对该项目,很多人可能决定从中退出。The NHS certainly has a public-relations problem, but its central case is strong. Data on patients in hospital are aly collected by the health service—and have never been seriously breached, say officials. These have helped it to allocate funds and keep accurate books. The information has also helped to save lives, says Tim Kelsey, the NHS director for patients and information. In Bristol, data showed an unusually high death rate during paediatric surgeries in the early 1990s, a problem since corrected. In Mid Staffordshire the numbers signalled a catastrophic breakdown in care between 2005 and , leading to a government inquiry, though not before hundreds of patients died.国民保健务有处理公众关系的问题,但是其核心案例非常强大。保健务系统已经搜集了医院的病人数据—官员说并未遇到非常强烈的反对情况。这些案例帮助该务系统筹集资金,并保有关书籍的正确性。国民保健务的病人与信息部主任蒂姆·凯尔西称,这一也有利于挽救病人的生命。在布里斯托尔收集的数据表明,20世纪90年代早期,儿科手术的死亡率非常高,自从改正后就出现了这个问题。斯塔福德郡中部的数据显示2005年至年,社会关爱遭受了灾难性的崩溃,成百上千的病人去世,从而引起政府政府关注进行调查。Information gleaned from GPs would help the NHS administer the system better. But the greatest potential lies in linking the two datasets. People tend to think of health care as a one-off episode, says John Appleby of the Kings Fund, a health-policy think-tank. But most care is consumed by people with chronic conditions, like diabetes, who move between GPs offices and hospital wards. Without data from family doctors it is impossible to track patients and figure out which treatments produce the best long-term results.通过全科医生收集的信息可帮助国民保健务更好地管理这一系统。但是最大的潜力是连接两大数据组。卫生政策智囊团——国王基金——的约翰·阿普比人们常认为健康保健是一次性事件,但是大多数的医疗关怀都用在了患有慢性疾病的人身上(如糖尿病患者),他们往返于全科医生办公室和医院病房之间。没有来自家庭医生的数据资料,就没法跟踪病人并了解哪种治疗方式能够产生最佳的长期的治疗效果。Few countries do this well, but Britains NHS numbers, which are assigned to each patient, give it an advantage. Indeed, within its own (present) borders it has a model worth emulating. Scotland gathers all data on diabetes patients into a central database and shares it around. One result has been a 40% drop in amputation rates. The Scots are now looking to keep diabetes patients out of hospital, where they cost over £300m (0m) a year. Put another way, they want to know what is and is not working in GPs offices.很少有国家能够在这一领域取得成绩,但是英国的国民保健务数据指定到每个病人,也是有其优势的。确实,在其范围之内,这一模式值得仿效。苏格兰收集了糖尿病患者的所有数据输入到中心数据库中,并和其他地区分享。其中之一的结果就是截肢率下降了40%。苏格兰人现在希望能让糖尿病患者离开医院,因此他们每年需要耗费3亿英镑(5亿美元)。但是另一方面,他们也想知道全科医生办公室的优点和缺点。The more data collected, the more useful it is, but not everyone will be persuaded to hand their information to the NHS. Some patients will no doubt conclude that the potential benefits of care.data do not trump their concerns. Either way they will get a healthy debate.收集的信息越多越有用,但是不是能够说所有人都同意将其信息交给国民保健务机构。有些病人会毫不犹豫地断定关爱数据的潜在福利不会解决他们的顾虑。换句话来说,他们将进行一场关于健康的辩论。 译者:毛慧 校对:王红兵 译文属译生译世 /201510/405097Air safety飞行安全Pressing on高压A spate of accidents will not put Asians off air travel事故连绵不绝,但不会阻止亚洲人乘坐飞机ON DECEMBER 30th Indonesian officials said they had discovered debris and bodies from AirAsia flight QZ8501, which had vanished two days previously, floating in shallow seas near the south-west coast of Borneo. The airliner lost contact with air-traffic controllers while passing through rough weather on a short journey between the Indonesian city of Surabaya and Changi airport in Singapore. The plane was carrying 162 people, most of them Indonesians. As The Economist went to press, no survivors had been found.印尼官员12月30日表示,已经发现在婆罗洲西南海岸周边的浅海中,漂浮着两天前消失的亚航QZ8501航班的残骸与尸体。这趟短途航班原定从印尼泗水飞往新加坡樟宜机场,在穿越气象条件恶劣的空域时与航空管制失去了联系。机上载有162人,多数为印尼人。截至本期《经济学人》付梓前,没有找到任何幸存者。The crash, most probably an accident, comes at the end of a particularly tragic year in South-East Asias aviation history. Search parties have not yet found the remains of Malaysia Airlines flight MH370, which plunged into the Indian Ocean nine months ago killing all 239 people on board. In September pro-Russian rebels shot down another Malaysia Airlines plane, MH17, over Ukraine, killing another 298.这场空难的原因最有可能是事故。这一年是东南亚航空史上悲剧之年,以空难结尾。9个月前,马航MH370栽入印度洋,机上239人死亡。搜索小组至今仍没找到其残骸。9月另一家马航客机MH17在乌克兰上空被亲俄叛军打下,又有298人死亡。These earlier calamities nibbled at South-East Asias popularity among tourists, especially among sightseers from China. But they have done little to dampen booming demand for air travel among South-East Asians themselves. The region is one of the worlds fastest-growing aviation markets. Its 50-odd carriers are awaiting delivery of 1,600 new planes, about the same number as are in their fleets today. Boeing, an American planemaker, thinks regional airlines will need to order more than 3,000 new aircraft over the next 20 years.东南亚在游客中的口碑为这些天灾人祸一点点侵蚀,尤其是中国的游客很受影响。但这些灾祸并没有抑制住东南亚地区间快速增长的航空需求。东南亚地区是全世界增长最快的航空市场。这里有五十多家航空公司,他们已订购的新客机有1600架,等待交付使用。这一数字与现有客机数量持平。美国飞机制造商波音认为,未来20年东南亚本地航线需要购置超过3000架新飞机。This growth partly reflects the rapid rise of South-East Asias middle classes, who are eager to shell out for more convenient ways to navigate the continents archipelagoes. It has been nudged along by the regions governments, who have promised to liberalise aviation as part of plans for greater economic co-operation.航空市场增长部分反映出东南亚中产阶级的快速兴起,该地群岛斑驳,他们很愿意为更舒适的交通方式埋单。东南亚各国政府也提供了助力,他们保实行航空自由化以推进彼此更深入的经济合作。Yet it also reflects growing confidence in airline safety, despite recent disasters. In much of the region rutted roads and fickle seas are a far bigger worry. A recent study of 160 ferry accidents since 2000, costing nearly 17,000 lives, showed that Indonesia and the Philippines were among the most lethal places to board a boat (only Bangladeshi vessels were more deadly). Images of grieving families in Singapore and Surabaya have horrified Indonesians, and the world. But journeys are still safer in the skies.尽管最近发生了些许天灾人祸,但航空市场发展也反映出对飞行安全不断增长的自信。在东南亚大多数地方,坑洼的道路与变幻的海域远比飞行安全更让人忧虑。近些年有人做过研究,2000年后共发生过160起渡轮事故,其中17000人丧生,而其中印尼与菲律宾的渡轮是最危险的(只有孟加拉国的轮船更容易沉)。新加坡与泗水那些悲伤的空难家属让印尼国民以及整个世界为之战栗。但相比之下空中旅行仍然是更安全的。译者:周鼎烨 校对:李童译文属译生译世 /201504/371577哈尔滨做个人流手术现在多少钱

黑龙江第三人民医院门诊专家预约哈尔滨市道外区妇幼保健所检查白带多少钱I know I know,But it definitely might, they keep me grounded and stay humble,Its great,Yeah我知道 我知道 但是这确实会 他们让我不骄不躁 保持谦逊 这很好 是的Well thats hard to keep you humble because you are so great at everything但是要让你保持谦逊很难 因为你实在是太有才华了I dont know how anybody could even,cause I mean, if I were around you all the time我不知道会有人 我是说 如果我们俩经常在一起I will just be telling you how great you are,I would not be healthy for you我会对你赞不绝口 这可能对你的成长不利I will just constantly say god you are gorgeous我会一刻不停地对你说 你太棒了god you are great god you are talented god you are amazing,Thank you 你太伟大了 你太有才了 你太不可思议了 谢谢Thats Ill do all day, you cant concern yourself with,people always do that我会整天在你耳边唠叨这些 你不能有这种思想 大家会一直夸你Because then you just start believing that stuff否则你就可能会飘到天山去了I need people to say that was you shouldnt do that or that wasnt good,Right我希望大家对我说的话是 你不应该这样做 这是不对的 没错Or tell me when I perform you know you have to work on this like或者告诉我表演的时候应该在这方面下功夫I need that in my life,Because if I just have people saying that Im just so good at everything then itll just我的生活需要这种警示 因为如果我身边的人 整天对我说 你太有才了Yeah you need people to challenge you and I have a feeling you challenge yourself是的 你需要有人鞭策 我感觉你在挑战自己But we have to take a break, well talk more about you and your and Ill tell you things you do wrong但是我们要休息一下 回来之后 我们要深入探讨一下你的 我会指出你的错误Well be back我们马上回来 /201606/451022哈尔滨做人流得花多少钱黑龙江维多利亚医院贴吧

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