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晋安区看妇科大约多少钱福州博爱中医院检查男性精子质量怎么样And, if that wasnt bad enough, of course,如果这还不算太糟糕的话,当然all of this is rapidly progressing towards the fact that我们很快可以看到另一个数据many of you, in fact, about one in 10 of you at this point,很多人,事实上,大约10个人当中就有1个will die in intensive care.会死在ICU中。In the U.S., its one in five.而在美国,这个数字是每5个人当中有1个。In Miami, its three out of five people die in intensive care.在迈阿密,这个数字是每5个人当中有3个。So this is the sort of momentum这就是我们目前所看到的that weve got at the moment.发展势头。The reason why this is all happening is due to this,事情会变成这个样子主要是因为这个。and I do have to take you through what this is about.而我要带领大家去一起探讨一下其原因。These are the four ways to go. 21世纪主要有四种死亡形式。So one of these will happen to all of us.我们所有人都会以其中的一种形式死去。The ones you may know most about are the ones人们最熟知的死亡方式that are becoming increasingly of historical interest:也是越来越引起我们关注的一种死亡方式sudden death.猝死。Its quite likely in an audience this size在我们这样的观众群中,this wont happen to anybody here.可能不会有这种死亡。Sudden death has become very rare.猝死现在已经很少见了。The death of Little Nell and Cordelia and all that sort of stuff像Little Nell或Condelia那样猝死的案例just doesnt happen anymore.现在已经很少了。The dying process of those with terminal illness现在因为患绝症而死亡的病人that weve just seen正如我们刚才看到的一样,occurs to younger people.在年轻人中的发病率越来越高了。By the time youve reached 80, this is unlikely to happen to you.到你80岁,这也不可能发生在你身上。Only one in 10 people who are over 80 will die of cancer.现在80岁年龄层中只有10%的人死于癌症。The big growth industry are these.而造成死亡最多的因素主要在以下几个方面。What you die of is increasing organ failure,越来越多的人死于器官功能衰竭with your respiratory, cardiac, renal,如呼吸和心、肾功能衰竭等等。whatever organs packing up. Each of these不管以上那个器官出了问题would be an admission to an acute care hospital,病人都要紧急送院治疗,at the end of which, or at some point during which,到最后,或者在治疗过程中的某一时间上somebody says, enough is enough, and we stop.直到有人对我们说不用治了,我们才放弃。And this ones the biggest growth industry of all,这是我们见得最多的案例,and at least six out of 10 of the people in this room每10个在这里听演讲的人中就会有6个will die in this form, which is将会以这种方式结束我们的一生,the dwindling of capacity这是因为功能的缺失with increasing frailty,造成的生命的脆弱,and frailtys an inevitable part of aging,而脆弱是老龄化不可避免的进程,and increasing frailty is in fact the main thing而脆弱事实上就是that people die of now,现代人死亡的主要原因,and the last few years, or the last year of your life你生命的最后一年或几年时间is spent with a great deal of disability, unfortunately.你都会在能力缺失中度过,这太不幸了。Enjoying it so far?你们还承受得住么?Sorry, I just feel such a, I feel such a Cassandra here.对不起,我怎么成了一个卡珊德拉式的预言家了呢。What can I say thats positive? Whats positive is但积极的一面是that this is happening at very great age, now.这只发生在老年人当中。We are all, most of us, living to reach this point.我们大家也都会经历这一时期的。You know, historically, we didnt do that.要知道,以住要活到这么长的人不多的。This is what happens to you这种死亡方式when you live to be a great age,只会发生在那些高龄人身上,and unfortunately, increasing longevity does mean不幸的是,寿命的延长more old age, not more youth.延长的不是青春,而是老年的时光。Im sorry to say that.很遗憾这样说。What we did, anyway, look, what we did,不管怎么说,我们所做的we didnt just take this lying down我们并不仅仅指那些at John Hunter Hospital and elsewhere.在John Hunter医院逝去的人或在其它地方死去的人。Weve started a whole series of projects我们已经开始一系列的项目to try and look about whether we could, in fact, involve尝试去了解我们能否让更多的人people much more in the way that things happen to them.参与到那些可能发生到他们身上去的事。But we realized, of course, that we are dealing然而,我们当然意识到with cultural issues,我们要应对一些文化层面的问题,and this is, I love this Klimt painting,我喜欢这张克里姆特的画,because the more you look at it, the more you kind of get这是因为,你越看它,the whole issue thats going on here,你越能了解发生在这里的一切,which is clearly the separation of death from the living,而这明显是一种死与生,and the fear.Like, if you actually look,和恐惧的分隔。比如说,如果你仔细看的话,theres one woman there你会发现有个女人who has her eyes open.她的眼睛是睁着的。Shes the one hes looking at,他在看着她,and shes the one hes coming for. Can you see that?他就是冲着她来的。你们看到了吗?She looks terrified.她看起来很惊恐。Its an amazing picture.这是一幅很不错的画。Anyway, we had a major cultural issue.另外,我们还有一个主要的文化层面的问题。201507/388184三明市精子检查那家医院最好 He even said,what if they see mistakes and sue us? 他甚至说,如果他们看到错误并起诉我们怎么办?What I saw behind every excuse was deep fear,and what I learned was that to become a doctor,we have to put on our white coats,put up a wall, and hide behind it. 我看到的是每个借口后面深深的恐惧,我学到的是去成为一个医生,我们不得不穿上白大褂,筑起一道墙, 并藏在后面。Theres a hidden epidemic in medicine.这其实是一种在医学领域里隐藏的风气。Of course, patients are scared when they come to the doctor.当然, 患者会害怕当他们去看医生的时候。Imagine you wake up with this terrible bellyache,you go to the hospital,youre lying in this strange place, youre on this hospital gurney,youre wearing this flimsy gown,strangers are coming to poke and prod at you. 想象你因肚子痛而醒来,你去医院,你躺在一个一个陌生的地方, 你在医院的轮床上,你穿着单薄的病人,陌生人过来对你一通摆弄,You dont know whats going to happen.你不知道将发生什么。You dont even know if youre going to get the blanket you asked for 30 minutes ago.你甚至不知道你会不会 拿到你30分钟前要的毛毯。But its not just patients who are scared;doctors are scared too.但是这不仅仅是患者害怕;医生也一样害怕,Were scared of patients finding out who we are and what medicine is all about.我们害怕患者找出我们是谁和医学是关于什么的。And so what do we do?所以我们做什么呢?We put on our white coats and we hide behind them.我们穿上我们的白大褂并藏在后面,Of course, the more we hide,the more people want to know what it is that were hiding. 当然, 我们越是想隐藏,人们就越想知道我们隐藏的是什么.The more fear then spirals into mistrust and poor medical care.越多的害怕就会造成医患之间不信任, 以及贫乏的医疗救助。We dont just have a fear of sickness,we have a sickness of fear. 我们不仅仅有着对疾病的害怕,我们也患上了恐惧病。Can we bridge this disconnect between what patients need and what doctors do?我们能在患者需求和医生之间的这种隔阂搭建桥梁吗?Can we overcome the sickness of fear?我们能克这种恐惧吗?Let me ask you differently:让我换种方式问你:If hiding isnt the answer, what if we did the opposite?如果隐藏并不是解决问题的, 假使我们反方向而行之了呢?What if doctors were to become totally transparent with their patients?如果医生和患者之间变得完全透明呢?Last fall, I conducted a research study to find out what it is that people want to know about their healthcare.去年秋天, 我做了一个研究学习去找出人们想知道关于他们医疗保健的哪些事情。I didnt just want to study patients in a hospital,but everyday people. 我不仅是想了解医院病人们的想法,而是所有人。So my two medical students, Suhavi Tucker and Laura Johns,literally took their research to the streets. 所以我的两个实习生, 苏诃毗?塔克和劳拉约翰,到街上做了这个研究。They went to banks, coffee shops, senior centers,Chinese restaurants and train stations. 他们去了医院, 咖啡店, 老人中心,中餐厅和火车站。What did they find?他们发现了什么呢?Well, when we asked people.当我们问他们。What do you want to know about your healthcare?你们想知道关于你们的医疗保健的什么?people responded with what they want to know about their doctors,because people understand health care to be the individual interaction between them and their doctors. 人们回应他们想知道 关于他们的医生的信息,因为人们知道医疗保健是他们和他们医生之间的个人互动。When we asked, What do you want to know about your doctors?当我们问, 你们想知道关于医生的什么?people gave three different answers.人们给了三个不同的回答。Some want to know that their doctor is competent and certified to practice medicine.一些人想知道他们的医生是有能力和资格去行医。Some want to be sure that their doctor is unbiased and is making decisions based on evidence and science,not on who pays them. 一些人想确定他们的医生公正的做决定是基于科学依据,而不是谁给他们付钱。Surprisingly to us,many people want to know something else about their doctors.令我们惊讶的是,许多人想知道关于医生的其他事情。Jonathan, a 28-year-old law student,says he wants to find someone who is comfortable with LGBTQ patients and specializes in LGBT health.乔纳森, 一个28岁的法律学生,说他想找一些愿意为同性 双性恋及跨性别患者治疗,而且是这一类别相关疾病的专家。Serena, a 32-year-old accountant,says that its important to her for her doctor to share her values when it comes to reproductive choice and womens rights.塞丽娜, 一个32岁的会计,说她的医生分享她的价值观在生育选择上和女性权力上 对她说是重要的。Frank, a 59-year-old hardware store owner,doesnt even like going to the doctor and wants to find someone who believes in prevention first,but who is comfortable with alternative treatments. 弗兰克, 一个59岁的五金店老板,甚至不喜欢去看医生只是想找以预防为先,而且愿意进行替代疗法的医生。One after another, our respondents told us that that doctor-patient relationship is a deeply intimate one that to show their doctors their bodies and tell them their deepest secrets,they want to first understand their doctors values.一个接一个的, 我们的回应者告诉我们医生和患者之间的关系是紧密到可以让他们的医生去看他们的身体,并可以告诉他们最深秘密的。他们想先了解他们的医生的价值观。Just because doctors have to see every patient doesnt mean that patients have to see every doctor.仅仅是因为医生可以去看每一个患者并不代表每个患者就不得不去看每个医生。People want to know about their doctors first so that they can make an informed choice.人们想先了解他们的医生所以他们可以在知情情况下做出选择,As a result of this, I formed a campaign.通过这个结果, 我组织一个活动。Whos My Doctor?我的医生是谁?that calls for total transparency in medicine.来呼吁医疗界的透明化。Participating doctors voluntarily disclose on a public website not just information about where we went to medical school and what specialty were in,but also our conflicts of interest. 自愿参与的医生公开信息在一个公共网站上,不仅仅我们上了哪家医学我们的专业是什么,而且还有我们的经济利益冲突。We go beyond the Government in the Sunshine Act about drug company affiliations,and we talk about how were paid. 我们已经超出了政府关于制药从属公司的阳光行动,我们讨论了我们是如何得到报酬的。Incentives matter.诱因很重要。If you go to your doctor because of back pain,you might want to know hes getting paid 5,000 dollars to perform spine surgery versus 25 dollars to refer you to see a physical therapist,or if hes getting paid the same thing no matter what he recommends. 如果你去看医生因为背痛,你可能想知道, 他做一个脊柱手术就能拿到5000美金,而引荐你去看物理治疗只能拿到25美金。或者说不管他推荐你什么, 他得到的付都是一样的。201503/365864When I was young, there was an amazing publication called The Whole Earth Catalogue, which was one of the bibles of my generation.当我还很年轻的时候,有一本刊物名叫《环球百科目录》。它是我那一代人必读的圣典之一。It was created by a fellow named Stuart Brand not far from here in Menlo Park, and he brought it to life with his poetic touch.它是由一个叫 Stuart Brand 的人在距此不远的 Menlo Park 出版的。此人以他富于诗意的工作为这份刊物注入了生命。This was in the late Sixties, before personal computers and desktop publishing.那是在60年代末,个人电脑和桌面出版发明之前。So it was all made with typewriters, scissors, and Polaroid cameras.因此这本刊物完全是由打字机、剪刀和拍立得相机做出来的。It was sort of like Google in paperback form thirty-five years before Google came along.它就像平装本的 Google,不过是在 Google 诞生的35年前。It was idealistic, overflowing with neat tools and great notions.一样是那么的理想主义,充满着简洁的工具和了不起的洞见。Stuart and his team put out several issues of the The Whole Earth Catalogue, and then when it had run its course.Stuart 和他的团队出版了数期《环球百科目录》,随后刊物的生命走到了尽头。They put out a final issue.他们就出版了最后的一期。It was the mid-Seventies and I was your age.那是在70年代中期了,我正是你们这个年纪。On the back cover of their final issue was a photograph of an early morning country road.最后一期的封底,是一幅清晨乡村公路的照片。The kind you might find yourself hitchhiking on if you were so adventurous.假如你搭便车上路探险,就会看到这种景色。Beneath were the words, ;Stay hungry, stay foolish;在照片下方写着这样的话,;求知若饥,虚心若愚;。It was their farewell message as they signed off. ;Stay hungry, stay foolish;.这是他们停止了发刊的告别语,;求知若饥,虚心若愚;。And I have always wished that for myself.我一直希望自己能做到这样。And now, as you graduate to begin a new, I wish that for you.现在,在你们即将毕业,开始新的历程的时刻,我用这句话来祝福你们。Stay Hungry, Stay Foolish.求知若饥,虚心若愚。Thank you all, very much.非常感谢大家。201412/347374三明市造影大约多少钱

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福州博爱医院宫腔镜手术多少钱 American leadership美国领导In each of these cases, we should not expect change to happen overnight所有这些情况下 我们都不应当指望变化在一夜间实现Thats why we form alliances not just with governments, but also with ordinary people正因为如此 我们才同政府 甚至普通民众建立起联盟For unlike other nations, America is not afraid of individual empowerment we are strengthened by it同其它国家不同 美国并不害怕个人拥有太大权力相反 个人赋权让我们更强大Were strengthened by civil society公民社会让我们更强大Were strengthened by a free press新闻出版自由让我们更强大Were strengthened by striving entrepreneurs and small businesses奋力拼搏的企业家和创业者让我们更加强大Were strengthened by educational exchange and opportunity for all people and women and girls教育交流以及所有人的平等机会让我们更加强大包括女性Thats who we are. Thats what we represent这就是我们 这就是我们所代表的I saw that through a trip to Africa last year我去年在一次去非洲的访问中看到where American assistance has made possible the prospect of an AIDS-free generation while helping Africans care themselves for their sick美国援助在帮助非洲人解决看病问题的同时正让没有艾滋病的未来变得不那么遥不可及Were helping farmers get their products to market to feed populations once endangered by famine我们正在帮助农民将农产品销往市场为曾被饥荒威胁生命的人提供粮食We aim to double access to electricity in sub-Saharan Africa so people are connected to the promise of the global economy我们计划将非洲撒哈拉以南地区的电力供应提高一倍让人们能够更好地分享世界经济的成果And all this creates new partners and shrinks the space for terrorism and conflict所有这些努力都会为我们赢得新的伙伴让恐怖主义无机可乘 压缩冲突发生的空间Now, tragically, no American security operation can eradicate the threat posed by an extremist group like Boko Haram the group that kidnapped those girls悲剧的是 美国的安全行动并没能根除科圣地这类极端主义组织的威胁正是该组织绑架了那些尼日利亚女孩And thats why we have to focus not just on rescuing those girls right away but also on supporting Nigerian efforts to educate its youth因此 我们不应只将注意力集中在营救那些女孩上我们还应帮助尼日利亚教育年轻人201506/381377南平宫腹腔镜宁德哪里可以检查精子活性



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