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福州去哪家医院治疗胎停育比较好同城分享

2019年08月21日 18:03:37|来源:国际在线|编辑:导医社区
Britain 英国Reforming the NHS 改革国民医保系统Bitter medicine良药苦口Competition is not the cause of the NHSs problems竞争不是导致国民医保系统问题的原因LIKE patients shrinking from needles, many doctors fear politicians pushing market-oriented health policies. For more than two decades governments of all shades have injected small doses of competition into Englands publicly funded health system. Reforms passed by the coalition government in 2012 provided the most recent jab. They have left many people feeling queasy.正如病人害怕打针一样,许多医生害怕政客推进以市场为导向的健康政策。20多年来,历届政府向英格兰公费医疗系统注入了一些竞争因素。联邦政府于2012年通过的改革措施则加速了近期的竞争力度,令许多人感到惶恐不安。David Cameron, the prime minister, had hoped to see nearly all of the NHSs contracts awarded through competitive bidding. In the end, his new rules acknowledged that non-competitive contracting is sometimes the best choice if the process is transparent, unbiased, and clearly benefits patients. But the local groups responsible for purchasing care (known as Clinical Commissioning Groups, or CCGs) complain that they have received mixed messages. Some of the doctors that run CCGs say they fear legal challenges from health providers if they do not tender all of their contracts competitively. In February Andy Burnham, the shadow health secretary, said CCGs had spent 5m (.4m) on competition lawyers during the previous year. Sir David Nicholson, former head of the NHS, said that the service is “bogged down in a morass of competition law”.英国首相戴维·卡梅伦曾希望能够看到所有的医保合同通过竞标获利。最后,卡梅伦发布的新政策承认非竞争性的医保合同有时也是最好的选择,前提是这一过程透明、公正、惠及病人。但是当地负责购买保险的团体(又称作临床调试组或CCGs)抱怨他们收到的信息杂乱不堪。有些运行CCGs的医生说如果不对医保合同进行竞标,他们担心会受到医务人员的控诉。2月份,影子卫生部长安迪·伯纳姆表示,去年CCGs在竞标律师身上花费了500万英镑(840万美元)。前英国国民保健系统的首脑大卫·尼克松说,该系统“深陷竞争法的沼泽”。The health regulator, Monitor, tacitly concedes that the rules could be clearer. It is busy tutoring CCGs on what they actually mean. If they honour common sense and put patients interests first “theyre 95% there”, says Andrew Taylor, former head of the NHSs Co-operation and Competition panel.卫生监管部门,Monitor,心照不宣地承认这些规则可以更明确。教导人们了解CCGs的真实意思非常费事。前国民医保系统的合作与竞争委员会首脑,安德鲁·泰勒表示如果他们尊敬常识、将病人的利益放在第一位,“病人利益至上,占95%”。And CCGs are probably wrong to believe that the coalitions most recent reforms will mean their decisions get challenged more often through the courts. In truth, health providers have been growing more combative for years. In 2011 the Royal Brompton hospital in London went to court in the hope of reversing a plan to consolidate paediatric heart surgery in other hospitals. (It lost, but the case had a “signalling effect”, says Mr Taylor.) In fact by beefing up Monitors role, the governments reforms have provided a means of resolving disputes outside the courts.CCGs可能误以为联邦政府最近的改革意味着其决议将在法院受到更多的挑战。事实上,医务人员多年来变得越来越好斗。2011年,伦敦的英国皇家布鲁顿学院提起起诉,希望能够取消一项在其他医院巩固儿科心脏手术的计划(泰勒说,起诉失败,但是引起了“信号传递效应”)。事实上,通过加强Monitor的角色的重要性,政府改革为解决法庭外的争端提供了方法。The reforms will probably have a bigger effect on hospital mergers. The government made it clear that the Competition Act—which prohibits anti-competitive agreements and the abuse of a dominant market position—should be applied to the NHS. In October two cash-strapped hospitals in Dorset were blocked from joining up on the grounds that it would give patients too few choices. This was controversial because the hospitals argued that their agreement would result in better care, a difficult thing to gauge. Some doubt the competition authorities can get the cost-benefit analysis right.改革可能对医院合并产生更大的影响。政府清楚地表明:竞争法令——禁止反竞争合同和滥用市场垄断地位——应用于国民医保系统。10月份,多赛特的两所债务深重的医院被禁止合并,因为病人的选择范围太小。这充满了争议,因为医院辩解说他们的合并将带来更好的治疗条件,而这是很难衡量的。有些人怀疑竞争权威部门可能有成本效益分析权。David Bennett of Monitor believes some of the hand-wringers are more interested in ending, not improving, the current competition regime. Mr Burnham admits as much, but his options are limited even if Labour wins the next election. His proposal to favour NHS hospitals and clinics for contracts may turn out to be illegal under European law.Monitor的大卫·班尼特相信悲观主义者对结束当前的竞争政权更感兴趣,而并非改善情况。勃汉姆承认,即使工党赢得了下一届选举,他的选择也跟现在一样受限。他建议持的NHS系统下签合同的医院和诊所可能在欧洲法案下是违法的。The NHSs new boss, Simon Stevens, seems keen on competition. Patients will benefit if he can convince critics of its merits. Two studies at English hospitals found that competition saved lives without increasing costs. Another study showed that family doctors located close to rival practices performed better. The medicine is working. Time to increase the dosage.国民医保系统的新老大,西门·斯蒂文斯似乎非常热衷于竞争。如果他能让家确信其优点,病人也能从中获益。关于英国医院的两项研究表明,竞争同样可以拯救生命而不会提高成本。另一研究表明,离竞争对手近的家庭医生表现更好。药物有效,是适合下一剂猛料了。译者:毛慧 校对:邵夏沁 译文属译生译世 /201509/398273Public-information films公共信息电影广告Dont stop, dont look, dont listen莫停留,莫张望,莫听信Scary adverts dont work, yet they are everywhere骇人的广告如同鸡肋却无处不在CHATTERING schoolchildren don colourful anoraks; clutching hands, they depart for a woodland picnic. Elsewhere a young man leaps into his car and speeds off to work. Moments later he careers off the road and his spinning car kills each one of the cheery youngsters. The camera lingers on their dead hands and the now-empty classroom. A grim voice explains that they represent the children killed as a result of speeding in Northern Ireland since 2000.冻得瑟瑟发抖的孩子们穿着鲜艳的厚夹克,手拉手去森林野餐。在另一处一个年轻人跳上车加速行驶赶去工作。片刻之后道路上猛冲的车子失去控制撞向了那一群孩童,孩子们在这场车祸中无一幸免。镜头停留在他们毫无生命力的小手上以及如今空荡荡的教室里。一个恐怖的声音解释道,他们呈现的是自2000年起北爱尔兰因超速受害的儿童。British road-safety adverts are more shocking than those broadcast in America, says Anne McCartt of the Insurance Institute for Highway Safety, an independent research group there. The British penchant for horror might reflect the nations long tradition of public-service broadcasting, which seeks to entertain and inform at once. But do the ads work?英国道路安全广告比在美国道路安全广告效果要震撼的多,当地一家独立研究机构——公路安全保险学会的安妮·麦克卡特如是说。倾向于使用恐怖元素的英国广告或许反映了国家公共务广播的悠久传统,即能立刻起到兼信息发布的作用。但这真的有用吗?Though gory, shocking public-information films linger in peoples heads, they seem not to alter behaviour much. If the consequences seem too extreme, the threat may seem too far-fetched, says Josh Bullmore, who has both made and studied such adverts. Few may believe that disaster could befall them or adjust their behaviour accordingly. Tessa Langley of the University of Nottingham has compared the impact of smoking campaigns that showed tumours erupting disgustingly out of cigarettes with more positive ones that also urged people to quit. The former proved more memorable, but the latter led more people to ring the national smoking helpline.尽管血淋淋的、震撼人心的公共信息电影广告停留在观众脑海里挥散不去,但人们似乎并没有从中受到多大教育。如果这些电影广告的结局太过极端,那么广告所起到的教育震慑作用就显得过于牵强附会了,乔希·布尔莫如是评价。他也曾参与制作和学习这类广告片。没几个人会相信灾难会降临到自己头上,他们也不会真的通过广告片来审视自己的行为。诺丁汉大学的泰萨·朗利将两种反吸烟运动的影响进行对比,一种是展示出因香烟造成的恶性肿瘤,另一种也是积极的却说人们戒烟。前者被实更加难忘,但后者则引导了更多人拿起电话拨打全国戒烟热线。The budget for public-information films is shrinking. The Central Office of Information, the governments marketing department, was closed in 2011. In 2008-09 the Department for Transport (DfT) spent almost £3m on its drink-drive advertising campaign. In 2013-14 spending fell to less than £1m. Unable to afford as many spots on television, the scaremongers hope their films will be shared on social media. And that is encouraging them to churn out the gory kind. In a recent advert from the DfT, men washing their hands in a pub toilet are startled by the face of a mannequin smashing bloodily through the mirror. The ad suggests a hashtag, publooshocker, for online sharing. Less shocking adverts might work better, but fewer people would see them.公共信息电影广告的预算正在缩水。中央信息办公室,即政府的市场营销部门,早在2011年就关闭了。在2008至年间交通部门(DfT)在它的反酒驾广告运动上花费了近300万英镑。而在2013至2014年间在此花费却不到100万英镑。这种广告的制作商由于无法负担过多电视频道的费用,从而希望他们的电影广告可以通过社会媒体传播。并且那也促使他们大量炮制这种骇人的广告。DfT最近的一部广告中,人们在一个酒吧的洗手间洗手时被打碎镜子、满脸是血的人体模型的脸吓到。这个广告在线上分享时带有一个标签酒吧洗手间惊魂。少一些血腥元素的广告或许更有用,但那就没什么人会去看了。译者:邵夏沁 校对:周晓婷 译文属译生译世 /201501/354571Criminal justice in Japan日本的刑事司法Forced to confess屈打成招Suspects in Japanese police cells are far too vulnerable to abuse日本监狱里的政治嫌犯极其脆弱,易受欺凌ON THE face of it Japans system of criminal justice looks as if its gets a lot right. Crime rates are lower in Japan than almost anywhere else—the murder rate is less than a tenth of Americas. Those arrested for minor wrongdoing are treated with exceptional leniency. Less than one in 20 Japanese deemed to have committed a penal offence go to prison, compared with one in three of those arrested in America, where the average jail term is much longer. In Japan the emphasis is on rehabilitation, especially of young offenders. The rates of recidivism are admirably low, partly because the state is adept at involving families in reforming those who stray.日本的刑事司法体系表面看来是挺公正的。日本的犯罪率比大多数国家都要低得多——谋杀率连美国的十分之一都不到。那些由于轻微违法行为而入狱的人通常会得到特殊的宽大处理。犯了刑事罪的人中只有不到二十分之一的会进监狱,而这个比例在美国则是三分之一,且刑期也比日本长得多。日本注重的是对罪犯,尤其是对年轻罪犯的改造。惯犯的比例也是极其的低,部分原因在于日本在改造这些迷失自我的人时善于融入家庭的力量。Yet the states benign paternalism has a dark side. The chief reason the system looks good is that Japan is a remarkably safe society. And where once police worked closely with local communities to solve crimes, now they struggle to catch criminals. The system relies on confessions, which form the basis of nine-tenths of criminal prosecutions. Many confessions are extracted under duress. Some of those who admit guilt are plainly innocent, as recent exonerations have shown. The extraordinary lack of safeguards for suspects in Japanese interrogation cells is a stain on the whole system, failing victims as well as those wrongly convicted.但日本家长式作风有利有弊。日本司法体系看起来运作良好,主要是由于日本是一个非常安全的社会。曾经,为了破案警民密切合作,而现在,警方想要抓住罪犯却困难重重。日本司法体系的根基依赖于招供——90%的刑事起诉案件即是如此。很多人是在胁迫之下承认了罪行。最近的无罪声明显示,在承认罪行的人中,有些明显是无辜的。日本审讯室中的嫌疑犯极其缺乏安全保障,这是日本司法体系的一个污点,也让受害者以及那些蒙冤者失望至极。Say you did it, even if you didnt欲加之罪 何患无辞In a country more inclined than the West to think of itself as a big family collective, admission of guilt is often seen as the first step to mission into society. It is also the surest route to a conviction. Prosecutors and police are thus under immense pressure to make suspects talk, and have powerful tools to encourage them to do so.相比西方国家,日本社会更像一个集体式的大家庭,在这个国家里,承认犯罪通常被视为洗心革面重回社会的第一步。同时这也意味着定罪。日本检方和警方因此不得不在巨大的社会压力下逼嫌犯招供,而他们也有这个本事。Common criminal suspects may be held in detention for 23 days without charge. Many have only minimal contact with a lawyer. Few interrogations are recorded, and then not in their entirety, so there is not much to stop interrogators piling in. Physical torture is rare, but sleep deprivation, which is just as effective, is common. So are various other forms of psychological coercion. Some interrogators use moral blackmail (“Think of the shame you are bringing on your family”). A few, if they are convinced that the suspect is guilty, simply fabricate a confession and press the suspect into signing it.如果不经控告,一般嫌犯可能会被拘留23天。许多嫌犯与律师取得联系的机会微乎其微。审讯一般都不会被记录下来,即便记录也非全部,因此阻止审讯员介入,无太多可为。身体上折磨少有,而与之同效力的剥夺睡眠却十分见。因此形成了多种心理逼供。一些审讯员用精神压迫进行逼供(“比如,想想你给你家人带来的耻辱”)。如果他们确信犯罪嫌疑人有罪,一些审讯员甚至会捏造一份认罪书然后逼迫嫌犯签字画押。In a court system without an adversarial approach to establish innocence and guilt, judges too rarely question whether confessions really are voluntary. Yet time and again innocent people have been shown to confess to crimes in the hope of a more lenient sentence—or simply to make the interrogation stop. In October a mother convicted of killing her daughter for the insurance money was released after a crime reconstruction proved her innocence. Last year Iwao Hakamada was freed after 46 years on death row when a judge declared that his conviction was unsafe (among other things, he appears to have been tortured at the time of his arrest). One lawyer estimates that a tenth of all convictions leading to prison are based on false confessions. It is impossible to know the true figure, but when 99.8% of prosecutions end in a guilty verdict, it is clear that the scales of justice are out of balance.在没有抗辩制度确认无罪或有罪的法庭中,法官很少质疑被告人悔罪是否出于自愿。然而屡次无辜者曾被指示:供出罪行便有希望获得较轻处罚——或者仅仅只为终止审问。十月,一位曾被指控为谋保险金而杀死自己女儿的母亲,在案卷重审后得意无罪释放。去年,经历了46年死囚生涯的Iwao Hakamada也被释放,因为法官宣布据不足,不能认定他有罪(从其他方面,他似乎在被抓捕期间已经备受折磨)。据一位律师估计,所有获罪入狱的罪犯中有十分之一是基于不实的供认。虽不可能了解这背后的真实数据,但是99.8%的起诉案件最后都是认定犯罪嫌疑人有罪。由此可见,司法公正已明显荡然无存。As a step towards restoring due process, all interrogations should be filmed from start to finish. Suspects should have y access to defence counsel, to whom prosecutors should also disclose all evidence. Interrogations should be much shorter; suspects should be properly rested. Investigators who fabricate evidence should be put in the dock themselves. Prosecution cases should rely more on detective work, and less on self-incrimination. Such reforms would not improve conditions in Japans psychologically brutal prisons (see article). But they would give the innocent a better chance of keeping their liberty.为了进一步恢复法定诉讼程序,应将审讯从始至终都拍摄下来并记录在案。嫌犯应有权诉诸于辩护律师,检察官也应向其辩护律师公开所有据。此外,还应缩短审讯时间、妥善安置嫌犯。对于编造供词的审讯员也应使其接受讯。起诉案件的处理应当更多地依赖于侦察工作,而非自我控告。这样的改革并不能改善日本监狱中心理逼供的残忍状况(见文章)。但是他们将会为无辜者提供一个更好的机会以维系自由。翻译:邓小雪 amp; 颜琪琳 校对:王丹培 译文属译生译世 /201603/430843

Most birds flap their wings up and down, but hummingbirds move their wings in a figure-eight pattern.大多数的鸟是上下拍打翅膀飞行,但蜂鸟不一样,它是以八字形移动翅膀。With each flap they twist their wings one-hundred-eighty degrees so that they create a downwardthrust on both the forward and backward strokes.蜂鸟每次拍打翅膀都会旋转180度,以便为前后的拍打创造一个推力。If each loop of the wings is of the same strength, they hover.如果每次翅膀旋转的力度一样,蜂鸟就会盘旋在空中。They can go forward, backwards, orsideways by tilting their wings in the direction they want to go.它们只要往想去的方向倾斜翅膀,就可以前进,后退,或横向移动。Kind of like a helicopter.Exactly.就像直升机一样。是的。In order to hover, hummingbirds have to be really strong.要盘旋在空中,蜂鸟必须得很强壮。Their wing muscles are thirty percent oftheir total weight.它们翅膀的肌肉重量占身体整个体重的三分之一。When a small hummingbird hovers it flaps its wings about eighty times persecond.一只小蜂鸟盘旋在空中时,翅膀的震动频率约为每秒80次。Hummingbirds have to eat close to fifty percent of their weight in food everyday to keep up theirstrength.蜂鸟每天吃的东西是它们体重的二分之一,这样才能维持体力。They eat things that are packed with calories and produce lots of reusable energy, likeseeds, nuts, fruit, and nectar.它们吃的东西都是高热量食物,能产生大量可重复使用的能量,像种子,坚果,水果和花蜜。 201410/336587

The American Lung Association’s 2016 State of the Air report claims that 52% of Americans live in counties with dangerous levels of particle or ozone pollution. 美国肺脏协会的2016年国家空气报告称,52%的美国人生活在有颗粒或臭氧污染的县郡。Thats 166 million people. National President and CEO of the association, Harold P. Wimmer, says that this percentage is actually an improvement, but he did add that climate change is making it more difficult to put a dent in the numbers. 那是1亿6,600万人。协会总裁兼首席执行官哈罗德·温默表示,这个比例其实是一个进步,但他补充道,气候变化正使数量更难削减。Ozone pollution, which is mainly caused by cars and factory emissions, can cause serious conditions, including chest pain, coughing, and throat irritation. 臭氧污染主要是由汽车和工厂排放造成的,可能会导致严重的情况,包括胸痛,咳嗽,喉咙发炎。The 2016 State of the Air report examined data from 2012 to 2014. Six of the top ten most polluted counties were in California, with Los Angeles topping the list at number one.2016年国家空气报告调查了2012年到2014年的数据。十个污染最严重的县中有六个在加利福尼亚,洛杉矶排名第一。译文属。201604/438800

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