原标题: 于都县第二人民医院治疗性功能障碍哪家医院最好好医解答
“Has the person become agitated, aggressive, irritable, or temperamental?” the questionnaire asks. “Does she/he have unrealistic beliefs about her/his power, wealth or skills?”“人有变得焦躁不安、具攻击性、易怒、情绪起伏不定吗?”这份调查表问到。“她/他有对自己的能力、财富或技能抱着妄信吗?”Or maybe another kind of personality change has happened: “Does she/he no longer care about anything?”又或许,她/他的个性有了另一种转变:“对任何事都漠不关心?”If the answer is yes to one of these questions — or others on a new checklist — and the personality or behavior change has lasted for months, it could indicate a very early stage of dementia, according to a group of neuropsychiatrists and Alzheimer’s experts.如果对上述问题之一的回答是肯定的,或对这份新检查清单上的其他问题有肯定的回答,且这些性格或行为的转变已经持续数月,那么根据一群神经心理学家与阿尔茨海默氏症专家的说法,这可能意味着某人正处于失智症(痴呆症)极早期阶段。They are proposing the creation of a new diagnosis: mild behavioral impairment. The idea is to recognize and measure something that some experts say is often overlooked: Sharp changes in mood and behavior may precede the memory and thinking problems of dementia.这些学者在提倡一种新的诊断类别——轻度行为障碍(mild behavioral impairment, M.B.I.),旨在辨认与测量某些专家认为常遭忽视的面向:心情与行为的急剧变化,可能在失智症造成的记忆与思考困难之前出现。The group made the proposal on Sunday at the Alzheimer’s Association International Conference in Toronto, and presented a 34-question checklist that may one day be used to identify people at greater risk for Alzheimer’s.该研究团队上周日于多伦多的阿尔茨海默氏症国际年会(Alzheimer#39;s Association International Conference)发表了这份提案,并提出一个列有34个问题的检查清单。或许这份清单有天能用来识别较易罹患阿尔茨海默氏症的人。“I think we do need something like this,” said Nina Silverberg, the director of the Alzheimer’s Disease Centers program at the National Institute on Aging, who was not involved in creating the checklist or the proposed new diagnosis.“我认为这样的诊断工具确实有需要,”在美国国家老龄化研究所(National Institute on Aging)主持阿尔茨海默氏症中心计划(Alzheimer#39;s Disease Centers program)的妮娜#8231;席维伯格(Nina Silverberg)表示。她并未参与这份检查清单的设计或提出这个新诊断类别。“Most people think of Alzheimer’s as primarily a memory disorder, but we do know from years of research that it also can start as a behavioral issue.”“大多数人都认为阿尔茨海默氏症主要是记忆方面的毛病,不过我们从多年的研究中的确得知,这种病症初发时,也可能从行为开始出问题。”Under the proposal, mild behavioral impairment (M.B.I.) would be a clinical designation preceding mild cognitive impairment (M.C.I.), a diagnosis created more than a decade ago to describe people experiencing some cognitive problems but who can still perform most daily functions.这份提案指出,临床上应该先进行轻度行为障碍诊断,再进行轻度认知障碍(mild cognitive impairment, M.C.I.)诊断。轻度认知障碍是十多年前创造出来的诊断类别,用来描述有些人有点认知问题,但日常生活功能大抵正常。Dr. Zahinoor Ismail, a neuropsychiatrist at the University of Calgary and member of the group proposing the new diagnosis, said studies and anecdotes suggested that emotional and behavioral changes were “a stealth symptom,” part of the dementia disease process, not separate from it.札希努#8231;伊斯梅尔(Zahinoor Ismail)士是加拿大卡尔加里大学(University of Calgary)的神经心理学家,也是提出这个新诊断类别的研究团队成员。他表示,各项研究与生活轶事都表明,情绪与行为的转变是”神不知鬼不觉的征候”,属于失智症发展过程,不应与失智症分开视之。Whatever is eroding memory and thinking skills in the dementia process may also affect the brain’s systems of emotional regulation and self-control, he said.伊斯梅尔表示,不论在失智症中损害记忆与思考能力的因素是什么,都可能影响脑部调节情绪与自制的系统。If two people have mild cognitive impairment, the one with mood or behavior changes develops full-blown dementia faster, he said. Alzheimer’s patients with those symptoms “do much worse over time”; after death, autopsies have shown they had more brain damage.他表示,如果拿两个都有轻度认知障碍的人相较,出现心情或行为转变的那个人,失智症会更快全面发作。有这些心情与行为征候的阿尔茨海默氏症患者,“随着时间过去,病情会变得比其他人严重得多”。死亡之后的尸检也显示他们的脑部受损更厉害。Of course, not everyone experiencing mood swings with age is suffering warning signs of dementia. Dr. Ismail emphasized that, to be considered M.B.I., a symptom should have lasted for at least six months and be “not just a blip in behavior, but a fundamental change.”当然了,不是每个随年龄增长心情也起伏不定的人就是在为失智症的警讯所苦。伊斯梅尔士强调,要确定有轻度行为障碍,某个症状必须持续至少六个月,“不仅仅是行为偶尔失常而已,而是彻底的改变。”Still, some experts worry that naming and screening for such an early-stage syndrome might end up categorizing large numbers of people, making some of them concerned they will develop Alzheimer’s when there are not yet effective treatments for the disease.然而还是有些专家担心,为这么早期的症状定名并进行筛检,最终可能会把一大群人列入某个分类里,导致其中一些人担心在阿尔茨海默氏症尚无有效治疗手段的时候会患上这种病。“There’s the potential benefit of early diagnosis, identifying people more likely to decline,” said Dr. Kenneth Langa, a professor of internal medicine at the University of Michigan. But “the flip side is overdiagnosis, labeling someone and getting people in the clinical cascade, where you start doing the test and people start doing more brain imaging and being at the doctor’s more and getting more concerned.“早期诊断、辨认出那些更可能患病的人或许有好处,”芝加哥大学(University of Michigan)内科教授肯尼斯#8231;兰加(Kenneth Langa)士表示。不过“从另一面来看,这也是过度诊断、给人贴标签、让人陷入没完没了的临床程序。当你开始做检测,民众就要开始做更多脑部显影扫描、更常看医生,也会产生更多担心”。“If it becomes a routine practice, that’s a huge amount of dollars.”“要是这成了例行工作,得花上很一大笔钱。”Dr. Langa, who has written about M.C.I., cited the experience with that designation. Many people given an M.C.I. diagnosis do not develop full-blown dementia even a decade later, and as many as 20 percent have later been deemed cognitively normal, he said.兰加医师曾撰文探讨轻度认知障碍,并在文中援引了使用这个诊断类别的经验。他表示,许多被诊断出有轻度认知障碍的人,甚至在诊断十年后都没有完全发展成失智症,其中还有多达20%的人的认知功能稍后又被判为正常。That could be because on the day they were screened, their cognitive function was lower than usual, possibly a result of stress or medications they were taking for other conditions.这可能是因为他们在做筛查那天的认知功能有失水平,或许是出于压力,又或许是他们因其他健康问题所用的药物所致。“That’s one of the things that makes me think twice” about creating M.B.I., said Dr. Langa, who recommended the checklist be tested by researchers before doctors began using it.“那正是我三思的原因之一,”兰加谈到创立轻度行为障碍时这么说。他建议医师在开始使用这份核查清单之前,应该先把它交由研究人员进行测试。Others are more enthusiastic.其他人的看法则较为乐观。“We have to improve our ability to identify people at risk,” said Arthur Toga, a neuroscientist at University of Southern California. Eventually “there will be an effective treatment,” he said, “and there’s too much unknown about this disease anyway.”“我们必须提升辨识风险族群的能力,”南加州大学(University of Southern California)的神经学家阿瑟#8231;托加(Arthur Toga)表示。假以时日,“一定会出现有效治疗手段,”他说道。“毕竟,这种病有太多未知之处了。”Dr. Toga said that his mother exhibited frustration and other emotional changes in her 70s, years before she developed Alzheimer’s. He believes her moods stemmed from dismay felt by his mother, a retired teacher, while trying to hide something family members had not yet noticed: “her ever decreasing cognitive capacity with words.”托加士表示,他的母亲是退休教师,在七十多岁时出现了挫折感以及其他情绪变化,比她最后患上阿尔茨海默氏症的时间早上好几年。他认为母亲情绪欠佳,是因为她在试图掩饰家人尚未注意到的事情,并因此感到气馁,此事就是“她对言谈的认知能力每况愈下”。Indeed, Dr. Langa and others said, memory tests are not always able to detect early problems because some people, especially highly educated ones, may be skilled enough at taking tests that their scores do not reflect the full extent of their cognitive slippage.兰加士与其他学者表示,记忆测验的确不能每次都侦测到早期问题,因为有些人可能很会应付考试(尤其是那些教育程度很高的人),以至于测出来的分数无法反映出认知能力下降到何种程度。Dr. Mary Ganguli, a professor of psychiatry, neurology and epidemiology at the University of Pittsburgh, said people often came in reporting that they or a family member had stopped doing something they always enjoyed, like baking a certain Thanksgiving dessert or tinkering with the lawn mower in springtime.玛莉#8231;冈古力(Mary Ganguli)士是匹兹堡大学(University of Pittsburgh)的精神病学、神经病学和流行病学教授,她表示人们常在就诊时表示,自己或某位家人不再从事他们向来喜爱的某项活动了,像是烘焙某种感恩节点心,或是春天的时候对除草机修修弄弄。Even the patient may not know why, she said. They may be uninterested in the activity because “they couldn’t figure out how to do it anymore.”她表示,就连病人自己可能都不明白原因何在。他们可能因为“不再知道该怎么做”而对某件事失去兴趣。Usually, when Dr. Ganguli asks if the patient is having trouble remembering things, “They will say, ‘Yes, but it’s not the biggest problem,’” she said. “But if I assess them, I find memory problems.”通常当冈古力询问病人是不是记不住事情的时候,“他们会说:‘是啊,可是没啥大不了的。’”她说,“不过要是我做检测,就会发现他们的记忆有问题。”Some experts supporting the new diagnosis said that unlike most cognitive problems, some mood and behavior symptoms could be treated with therapy and medication. “We can make them sleep better, we can take the edge off depression, we can help the family learn how to manage the problems,” Dr. Ganguli said.持前述新诊断类别的一些专家表示,有些情绪与行为症状能通过治疗手段或药物改善,这与大多数的认知障碍不同。“我们可以让当事人睡得更好、减轻他们的沮丧程度、帮助家属学习处理各种问题,”冈古力医师表示。Dr. Ismail said apathy was a common symptom, but he has seen starker changes. One patient in her 70s became so sexually uninhibited, she “went from prude to promiscuous,” he said. Another, a law-abiding 67-year-old woman, suddenly “started smoking crack.” Both later developed dementia.伊斯梅尔士则表示,漠然无感是常见的症状之一,不过他也见识过截然不同的转变。有位女性病人在七十多岁时变得性欲勃发,“从老古板变成豪放女”。另一位奉公守法的67岁女性则突然“开始抽强效可卡因”。这两位不久都患上了痴呆症。Mood and behavior changes have long been recognized as early-warning signs of frontotemporal dementia, which accounts for about 10 percent of dementias.长久以来,心情与行为变化都被视为额颞叶痴呆的早期警讯,它在全部痴呆症中约占10%。Palmer Posvar, a patient of Dr. Ganguli’s, was in her 50s when she started taking food off other people’s plates, asking to borrow money from friends and trying to pawn heirloom jewelry, said her husband, Wesley. At 54, she was found to have frontotemporal dementia. Now 64, Mrs. Posvar can no longer speak and she falls so frequently that she was recently moved from their house in Fox Chapel, Pa., to a nursing home.冈古力的病人帕尔玛#8231;波斯瓦(Palmer Posvar)的丈夫韦斯利(Wesley)说,帕尔玛在五十多岁的时候开始拿别人盘子里的东西来吃、向朋友借钱,还想把家传珠宝拿去典当。她在54岁时被诊断出患有额颞叶痴呆。现年64岁的波斯瓦太太已丧失语言能力,而且时常跌倒,所以近来从宾州福克斯查普尔的住处送去了养老院。Still, “early diagnosis is a double-edged sword,” Mr. Posvar said when asked about creating a mild behavioral impairment category.然而,“早期诊断是把双刃剑。”当我们询问波斯瓦先生对创造“轻微行为障碍”这个诊断类别有什么看法,他如此表示。The upside is that “there are medications which help manage mood and behavior,” and clinical trials that these patients might qualify for, he said. But “does that become part of your health record that’s accessible by insurance companies” or employers, he wondered.他说,好处是“有药物能协助控制心情与行为举止”,此外病人或许能参加一些他们符合资格的临床试验。不过他怀疑“受测纪录会列入你的个人健康史,保险公司可以调阅”,雇主可能也会查看。“And do you really want to know? Because there’s no cure yet.”“而且你真想知道么?这种病目前还没法治疗。”Some experts said they believed the benefits of the new diagnosis outweighed the drawbacks.一些专家表示,他们相信这种新诊断类别的利大于弊。“We should not be ignoring them, waiting for the cognitive manifestations to appear,” Dr. Ganguli said, “because we may be missing the opportunity.”“我们不应该无视这些征候、坐等认知障碍出现,”冈古力表示,“我们可能会因此错失治疗契机。” /201607/456954Data taken from leaked internal documents has suggested that some Uber drivers in the US are making less than their state#39;s minimum wage. According to a report, Detroit drivers make just .10 an hour – 40 cents less than the state#39;s minimum wage.近日,优步公司流出的内部文件数据表明,美国国内一些优步司机的收入尚未达到其所在州的最低工资标准。据一份报告显示,底特律地区优步司机的时薪仅为8.10美元,比该州的最低工资少了40美分。Despite these initial calculations, a Washington Post report lowered the meagre earnings figures further. As Uber drivers are technically independent contractors and not direct employees of the online taxi service, the drivers also pay out twice the amount of standard tax for usual workers.除初步估算之外,《华盛顿邮报》的算法则令司机的收入数据进一步降低。由于优步司机属于独立运营商,不属于优步公司的员工,因此缴纳的标准税额是普通工人的两倍。After factoring this into its calculations – as well as the average hourly mileage costs for travelling to a pick-up spot without a passenger – Detroit#39;s drivers were estimated to earn .60 an hour, with Houston and Denver following at .43 and .21 respectively.如果再减去税额和司机接乘客途中的空车费,底特律的司机的时薪变为6.60美元,休斯敦和丹佛的司机的时薪则分别为8.43美元和11.21美元。The paper spoke to an anonymous Uber representative regarding the initial report, who said ;It would be wrong, or at least very challenging, to calculate expenses with such a diverse clientele.;《华盛顿邮报》采访了优步公司的一位匿名代表,该代表对此发表了看法:“优步公司面对的是多种多样的乘客,这样的计算方式存在问题,或者至少会引起争议。”Washington Post also spoke to Lawrence Mishel, the president of the Economic Policy Institute, a DC-based think tank. Mishel stated: ;Uber likes to play it both ways. It claims that it#39;s the future of work, while it also emphasises that most of the drivers work less than 10 or 12 hours a week. They want to be the wave of the future, but they also want to picture themselves and their drivers earning [extra] money.;《华盛顿邮报》还采访了位于华盛顿特区的经济政策研究所的主任劳伦斯·米舍尔。米舍尔表示:“优步希望向外界展示自己在两方面的优势。优步一方面声称这样的工作方式才是未来的工作方式,另一方面则称优步司机每周的工作时间还不到10小时或12小时。优步希望这能成为未来的潮流,但同样希望令世人相信,公司和旗下司机确实在挣钱。”While the calculations are only applicable to Uber drivers in the US, this isn#39;t the first time accusations of low levels of pay has been levelled at the app-based taxi firm. In February, IBTimes UK spoke to James Farrar and Lucas Malec – two UK-based drivers disillusioned by Uber#39;s commission rates and overall support. Farrar in particular estimated that after expenses he earned just 5.03pounds an hour – well below the 7.20 pounds for UK workers over the age of 25.尽管上述估算仅适用于美国,但是外界对优步司机收入较低的质疑却由来已久。今年2月份,IBTimes的英国分站采访了两位司机,詹姆斯·法勒和卢卡斯·马拉克。二人对优步付的佣金和总体持政策深感沮丧。法勒表示,在交纳各项费用后自己的时薪仅为5.03英镑,远低于英国25岁以上工人7.20英镑的时薪。While Uber has recently settled two class-action lawsuits in the US in Massachusetts and California, this was followed by further legal challenges claiming that the company violated the Fair Labor Standard Act.优步近日在马塞诸塞州和加利福尼亚州的两起集体诉讼中和原告达成了和解。随后美国又陆续出现了对优步违反《公平劳动标准法》的指控。 /201607/454429

When photographer Christopher Cline moved from Virginia to Minnesota, he was feeling homesick and “sliding into a sad place in life.” But then his girlfriend brought him Juji. Though the photographer wasn’t keen on getting a dog at first, the adorable Goldendoodle not only became his best friend, he brought his inspiration back.  克里斯多夫·克莱恩是名摄影师,从弗吉尼亚搬到明尼苏达后,他非常想家,”陷入了悲伤的人生境地“。但后来, 女友把朱吉带到他身边。尽管这位摄影师一开始并不怎么喜欢养,但可爱的金毛贵宾犬不但成了他的好伙伴,还把灵感带回他身边。  Now Cline creates amusing Photoshop manipulations featuring the giant Juji and Cline himself taking all sorts of adventures together. He wants his photos to have a “kids’ book feel.” “I immediately fell in love with him,” said Cline. “He has turned my life completely around and we are now absolutelyinseparable. I have found a new outlook on life and in my artwork and I owe it all to him.”  现在克莱恩用Photoshop手法创作好玩的照片,大朱吉和他自己作主角,拍了各色各样一起历险的相片。他希望自己的照片有“儿童读物的感觉”。“我立马就喜欢上朱吉了,”克莱恩说,“它完全改变了我的生活,我们现在完完全全密不可分。我对生活和我的艺术创作有了全新的看法,这都是它的功劳。” /201604/434642

Reaching for the top shelf too often could lead you to looking down on women.经常把手伸到货架顶部会让你看不起女人。Psychologists have found that too much soft-core pornography may be lixed to a lower view of women and leads to people becoming desensitised to provocative images.心理学家发现观看软核色情的男性可能对女性更可能具有消极看法并导致人们对挑逗性的图像反应麻木。Previous studies have shown lixs between hard-core pornography and increased sexual deviance including sex offences negative attitudes to intimate relationships and acceptance of rape myths.之前的研究表明了硬核色情和性异常行为增加之间的关系,包括性犯罪,对亲密关系持负面态度以及接受强奸之类的鬼话。But the effects of soft porn including images found in tabloid newspapers and websites are less well studied.但软色情的影响,包括在小报报纸和网站上发现的图片,都没有进行过深入研究。 They found that people who were frequently exposed to soft-core images were desensitised to them and were less likely to describe them as #39;pornographic#39; than people with lower levels of exposure.他们发现,经常接触软核女性形象的人对这些形象不敏感,与较少接触软核女性形象的人相比,他们也更不愿意把这些形象描绘成“色情的”,In addition the study showed that people who viewed soft-core images often were less likely to hold positive views of women.此外研究发现,经常观看软核女性形象的人对女性更不易有正面的看法。However the researchers add that it#39;s unclear whether the habit drives the attitude or vice versa.尽管如此,研究者们补充说,还不清楚是习惯驱动了态度,还是正好相反。 /201606/449647President Obama and his family will move into an 8,200-square-foot (790sqm), red-brick home about two miles (3.2km) from his current address after he leaves office in January.在明年一月卸任后,奥巴马总统及其家人将搬到一幢占地8200平方英尺(约合790平米)、由红砖建造的新家里,该处距白宫2英里(约合3.2公里)。The Obama family still own a home in Chicago, however, the president has said he would remain in Washington until his 14-year-old daughter, Sasha, graduates from the Sidwell Friends School in 2018.但是,奥巴马一家人还在芝加哥拥有一套房子。总统此前曾表示,自己将继续待在华盛顿,直到2018年其14岁大的女儿--莎夏--从西德维尔友谊中学毕业。Mr Obama#39;s new home, which is valued around m, is near Embassy Row in the Kalorama section of the district. The president will count French ambassador Gerard Araud, the embassy of Oman and the European Union ambassador to the US as his new neighbours.据悉,奥巴马的新家价值高达600万美元,位于华盛顿科络拉玛的使馆区附近。在挑选新邻居方面,奥巴马将会在法国大使杰勒德·阿劳德、阿曼大使和欧盟驻美国大使之间权衡。Bart Gordon, a former Democratic congressman from Tennessee, also lives next door to the soon-to-be Obama residence.来自田纳西州的前民主党议员戈登也住在奥巴马新家的隔壁。;I think it#39;s a brilliant stroke for them to move here, they#39;re surrounded by a lot of people who are still politically active,; said Susan Harreld, a Kalorama resident who lives nearby. ;It#39;s a very family-oriented neighbourhood, which is great for Sasha, but also a very private neighbourhood.;科络拉玛附近一位居民苏珊·哈罗德表示:“我认为他们(奥巴马一家)搬到这里来是一个很明智的决定。在他们的邻居里,很多人仍然在政坛上十分活跃。这是一个以家庭为主的街区,这对莎夏来说很好。但同时,这也是一个非常私人的街区。”Mr Obama will rent the home, which is unoccupied, from Joe Lockhart, a former press secretary and senior adviser to Bill Clinton. Mr Lockhart and his wife, Giovanna Gray Lockhart, moved to New York City after he became the vice president of communications for the National Football League.这幢房屋目前尚无人居住,而奥巴马将从比尔·克林顿的前任新闻秘书、高级顾问乔·洛克哈特手中租下他的新家。在担任美国国家橄榄球联盟通信副总裁之后,洛克哈特和他的妻子--乔瓦娜·格雷·洛克哈特--一起搬到了纽约。But Mr Obama will not be the first president to reside in the prominent community. Woodrow Wilson, William Howard Taft, Warren Harding, Franklin D Roosevelt and Herbert Hoover also called Kalorama home at different points in their lives.不过奥巴马并不是首位在这个著名街区里居住的美国总统。许多美国总统都曾在科络拉玛的各地段拥有居所,比如伍德罗·威尔逊、威廉·霍华德·塔夫脱、沃伦·哈定、富兰克林·罗斯福和赫伯特·胡佛。 /201606/448499

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