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Why Hospitals Should Let You Sleep 為什麼醫院應該讓你好眠?

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讀紐時學英文
2019/03/01 第253期 訂閱/退訂看歷史報份
 
 

紐時周報精選 Why Hospitals Should Let You Sleep 為什麼醫院應該讓你好眠?
Can We Grow More Food on Less Land? 人類可以用更少的土地 生產更多糧食嗎?

紐時周報精選
 

Why Hospitals Should Let You Sleep 為什麼醫院應該讓你好眠?
文/Austin Frakt
譯/李京倫

If part of a hospital stay is to recover from a procedure or illness, why is it so hard to get any rest?

如果住院的部分原因是要從手術或疾病康復,為什麼想要歇息片刻會這麼難?

There is more noise and light than is conducive for sleep. And nurses and others visit frequently to give medications, take vitals, draw blood or perform tests and checkups — in many cases waking patients to do so.

噪音和光線多(或強)到足以讓人難以入眠。護理師等人頻繁前來給藥、量取生命徵象、抽血或進行檢測,許多時候是叫醒病人來做。

Some monitoring is necessary, of course. Medication must be given; some vital signs do need to be checked. And frequent monitoring is warranted for some patients — such as those in intensive care units. But others are best left mostly alone. Yet many hospitals don’t distinguish between the two, disrupting everyone on a predefined schedule.

當然,有的監測有其必要。藥一定要給;有些生命徵象必須檢查。頻繁的監測對某些病人而言也是必要的,例如加護病房的病人,其他病人則最好少去打擾,然而許多醫院並未將二者加以區分,照著預定時程打擾每個病人。

Peter Ubel understands the problem as both a physician and patient. When he spent a night in the hospital recovering from surgery in 2013, he was interrupted multiple times by blood draws, vital sign checks, other lab tests, as well as by the beeping of machines. “Not an hour went by without some kind of disruption,” said Ubel, a physician with Duke University. “It’s a terrible way to start recovery.”

既是醫師又當過病人的伍柏了解這個問題。2013年他為了從手術恢復而住院一晚,當晚他被抽血、生命徵象檢查、其他檢驗和機器嗶嗶聲打擾多次。現為美國杜克大學內科醫師的伍柏說:「沒有一小時沒受到某種打擾,這是展開復原過程的可怕方式。」

It’s more than annoying — such disruptions can harm patients. Short sleep durations are associated with reduced immune function, delirium, hypertension and mood disorders. Hospital conditions, including sleep disruptions, may contribute to “posthospital syndrome” — the period of vulnerability to a host of health problems after hospitalization that are not related to the reason for that hospitalization.

這樣的干擾不只惱人,還可能傷害病人。睡眠期間短暫與免疫功能下降、譫妄、血壓高和情感疾患有關。醫院的環境,包括睡眠干擾,可能導致「出院症候群」,就是病人出院後有一段期間容易出現許多健康問題,而這些問題跟住院原因無關。

“In addressing a patient’s acute illness, we may inadvertently be causing harm by ignoring the important restorative powers of a healing environment,” said Harlan Krumholz, a Yale University physician who has been calling attention to posthospital syndrome for several years. “The key to a successful recovery after illness may be a less stressful, more supportive, more humane experience during the hospitalization.”

耶魯大學醫師克朗霍茲呼籲重視出院症候群已有多年,他說:「在治療病人的急性疾病時,我們可能忽視了有治療功用的環境重要的幫助復原力量,因而在無意中造成傷害。病後順利復原的關鍵,或許正是少點壓力、多點支持、而且更人道的住院經驗。」

It’s an environment that, all too often, seems set up for everyone else’s convenience but the patient’s. To help patients deal with the stresses of hospitalization, sedatives are often prescribed. These medications, including opioids, carry their own risks, such as addiction.

醫院的環境往往似乎是為所有其他人的方便而設,獨獨忽視了病人的方便。為了幫助病人應付住院的壓力,醫師通常會開鎮靜劑。這些藥劑,包括鴉片類藥物,帶有風險,譬如使人上癮。

“Instead, we could make the environment more conducive to rest and reduce the use of sedatives,” Ubel said.

伍柏說:「我們大可讓醫院環境更有助於休息,並減少鎮靜劑的使用。」

Solutions aren’t hard to fathom. Ubel listed some in 2013. Hospital workers could coordinate so that one disruption serves multiple needs: a blood draw and a vitals check at the same time instead of two hours apart.

解決方法並不難懂。伍柏2013年列舉過一些。醫院人員可以協調,使一次打擾滿足多種需求:同時抽血和測量生命徵象,而不是隔兩小時分開做。

Or they could allow patients’ needs to guide schedules. If a patient is at low risk and can go six or eight hours without a vitals check, for example, perhaps don’t do that check once every four hours.

或者他們可以根據病人的需求安排時程。比方說,如果病人屬於低危險群,可以連續6或8小時無須測量生命徵象,也許就不用每4小時測一次。

※說文解字看新聞

本文指出,美國醫院院方太常打擾住院病人,導致病人無法好眠,不利於康復。

interrupt跟disrupt在本文中都是「打擾」,只是交替使用,但其實含意有別。interrupt是打斷正在進行的活動,disrupt則是「以造成混亂的方式」打斷活動。例如,一個小孩在課堂上插話提問是interrupt討論過程,大哭大鬧則是disrupt討論過程;電話鈴響interrupt一場撲克牌遊戲,一個玩家發火掀翻牌桌,則是disrupt這場遊戲。

fathom跟understand在本文中也都是「了解」,同義字互換使用,但fathom其實比較文謅謅。fathom當名詞是「英尋」,相當於1.83公尺,用來指水深,當及物動詞是「用測深索測量」,引申為「深入了解、透徹理解」,所以fathom一般是指「理解了比較複雜難懂的事物」,譬如相對論,但如果你懂得「行人過馬路要走斑馬線」,就不能用fathom,要用understand。

另外,fathom還有「估量」的意思,例如I could not fathom the depth of his hate.這句的fathom如果換成understand,雖然也可以,但就沒有fathom精準。

 

Can We Grow More Food on Less Land? 人類可以用更少的土地 生產更多糧食嗎?
文/Brad Plumer
譯/陳韋廷

If the world hopes to make meaningful progress on climate change, it won’t be enough for cars and factories to get cleaner. Our cows and wheat fields will have to become radically more efficient, too.

如果這個世界希望在氣候變遷上取得有意義的進展,只靠汽車與工廠變得更乾淨是不夠的。我們的牛隻與小麥田也必須從根本上提高效率。

That’s the basic conclusion of a sweeping new study issued by the World Resources Institute, an environmental group. The report warns that the world’s agricultural system will need drastic changes in the next few decades in order to feed billions more people without triggering a climate catastrophe.

環境組織「世界資源研究所」發表了一份包容廣泛的新研究報告,獲致以上基本結論,該報告提醒世人,未來幾十年世界農業系統需要徹底改變,方足以在不引起氣候災難的情況下養活多出了數十億的人口。

The challenge is daunting: Agriculture already occupies roughly 40 percent of the world’s vegetated land and is responsible for about a quarter of humanity’s greenhouse gas emissions. But with the global population expected to grow from 7.2 billion people today to nearly 10 billion by 2050, and with many millions of people eating more meat as incomes rise, that environmental impact is on pace to expand dramatically.

這是嚴酷的挑戰:農業已占用世界約40%有植被的土地,溫室氣體排放量也約達人類總排放量的四分之一,但隨著全球人口料將自目前的72億人成長至2050年的近100億人,並伴隨數以百萬計的人因收入增加而食用更多的肉,環境承受的這種衝擊正在急劇擴大。

Based on current trends, the authors calculated, the world would need to produce 56 percent more calories in 2050 than it did in 2010. If farmers and ranchers met that demand by clearing away more forests and other ecosystems for cropland and pasture, as they have often done in the past, they would end up transforming an area twice the size of India.

報告的作者們預測,依照目前趨勢,世界2050年時須較2010年時多生產56%的卡路里。若農牧從業人員一仍舊例,透過清除更多森林與其他生態系統來滿足農田和牧場的需求,他們最終改造的面積將是印度的兩倍大。

That, in turn, could make it nearly impossible to stay below 2 degrees Celsius of global warming, the agreed-upon international goal, even if the world’s fossil-fuel emissions were rapidly phased down. When forests are converted into farmland, the large stores of carbon locked away in those trees is released into the atmosphere.

果若如此,即便全球化石燃料的溫室氣體排放量迅速遞減,國際上一致同意的目標,亦即讓全球升溫低於攝氏兩度,也幾乎不可能達成。當森林被改造成農田時,鎖在那些樹木中的大量碳會釋放到大氣中。

“Food is the mother of all sustainability challenges,” said Janet Ranganathan, vice president for science and research at the World Resources Institute. “We can’t get below 2 degrees without major changes to this system.”

世界資源研究所負責科學和研究的副所長珍妮·藍佳納森說:「糧食是所有永續問題挑戰之母。這個系統不做重大變革,我們無法壓到兩度以下。」

The new study, the result of six years’ worth of modeling work conducted in partnership with French agricultural researchers, is hardly the first to warn that feeding the world sustainably will be a formidable task. But the authors take a different view of the most plausible solutions.

這份新研究報告是跟法國農業研究人員合作,進行為期六年模擬工作的結果,稱不上是警告永續養活世人十分艱難的第一份報告,但作者們對最合理的解決方法持不同的看法。

In the past, researchers who have looked at the food problem have suggested that the key to a sustainable agriculture system is to persuade consumers to eat far less meat and waste far less of the food that’s already grown.

糧食問題的研究人員過去認為,農業系統得以永續的關鍵,在於說服消費者大幅減少肉食量,以及對已經種植出來的糧食的浪費。

The new report, however, cautions that this could prove difficult in practice. The authors do recommend that the biggest consumers of beef and lamb, such as those in Europe and the United States, could cut back their consumption by about 40 percent by 2050, or down to about 1.5 servings a week on average.

不過,這份新報告警告說,這可能很難落實。報告的作者們的確提出了他們的建議,牛肉與羊肉的最大消費者,像是歐洲和美國人,到2050年時可將消耗量減少約40%,或減至每個禮拜平均約1.5份。

※說文解字看新聞

農業為文化之母,許多文化發源地都是農業發生最早地區,而agriculture恰好就是由意指「農田、土地」字根agri跟culture組成,而culture(文化)則是源自代表「種植、栽培」意思的動詞cultivate。

此外,文中多次出現單字feed意指「餵食、養活」,餵嬰兒或動物喝奶也用此字,偶爾也能用來展現幽默表示「人吃飯」,當名詞用時則為「動物飼料」,而若要將人或是動物養壯養肥,這時要用動詞片語feed up,如feed up the pigs(將豬養肥)。

最後,sustainable可說是全文最關鍵字彙,文中譯為「永續的」,由代表「在下面的」字首sus跟具有「拿、握」意思字根tain以及形容詞字尾able所組成,動詞型式則為sustain。值得注意的是,sustainable跟sustained的區別為,前者意指「可持續的、能維持的」,後者則是「持續的、持久的」意思。

 

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