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

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 Dr. 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,” Dr. 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. Dr. 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。

原文參照：
https://www.nytimes.com/2018/12/03/upshot/why-hospitals-should-let-you-sleep.html

2019-02-17 聯合報．D4．紐約時報賞析 李京倫

說文解字看新聞 李京倫

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。

North Korea Frowns Upon Rising Sway Of Its Phones
北韓告誡人民 提防智慧手機
By Choe Sang-Hun

K-pop. Cheating on exams. Even pornography.
南韓流行音樂。考試作弊。甚至色情。

North Korea recently warned against the disruptive influence it said smartphones could have on its isolated population, as the devices have begun to expose young people in particular to information and trends from the outside world.
北韓當局日前提醒人民，智慧手機可能對與世隔絕的北韓人民造成破壞性影響，當下北韓人民已開始透過智慧手機接觸外部世界的資訊與趨勢，尤其是年輕人。

In the hermetically sealed North, South Korean officials estimate that the number of mobile phones has risen to 6 million since 2008, when cellular phone service began as a joint venture between the Egyptian telecommunications firm Orascom and the North’s communication ministry. The country has a population of 25 million.
南韓官員估計，在與外界完全隔絕的北韓，自從2008年埃及電信公司Orascom與北韓通訊部合資開辦行動電話業務以來，手機數量已成長到600萬支。北韓人口2500萬。

The North’s main state-run newspaper, Rodong Sinmun, published an article listing what it called “negative repercussions” from the introduction of smartphones in schools around the world, including the use of phones during classes, cheating during exams and the circulation of pornographic material.
北韓最大國營報紙「勞動新聞」刊出一篇文章，列舉勞動新聞所謂將智慧手機引入學校在全球各地造成的「負面影響」，包括上課滑手機、考試作弊和色情素材流傳。

“This proves that mobile phones have become an avenue to instill students with unhealthy ideology,” it said. “Most educators and parents around the world believe that various corrupt and reactionary cultures spreading through mobile phones are confusing students as they shape their lives’ values.”
文章寫道：「這證明手機已成了灌輸學生不健康意識形態的管道。世界各地絕大多數的教育工作者和父母都認為，透過手機散播的各式各樣腐敗和反動文化，會在學子塑造人生價值觀時混淆他們的心智。」

“More serious is the fact that erotic messages, novels and video files, as well as electronic games with violent content, are spreading unlimited through mobile phones,” the article said.
文章中說：「更嚴重的是，色情訊息、小說和影片檔案與含有暴力內容的電玩，正透過手機不受限制地散播。」

The article did not say what actions, if any, North Korea planned to take.
文章並未提到北韓打算採取什麼措施（如果有的話）。

With smartphones proliferating, North Korean authorities have struggled to maintain their tight control over what information the population receives, even as the country’s leader, Kim Jong Un, has helped to encourage the use of the devices, according to North Korean defectors and South Korean officials.
根據脫北者和南韓官員的說法，隨著智慧手機激增，北韓政府奮力維持對人民所能接收資訊的嚴密控管，這恰恰是在北韓領導人金正恩鼓勵使用智慧手機的時候。

North Korea still walls off its computers and smartphones from global communications networks, including the internet, and rigs all radio and TV sets so they can receive only propaganda-filled government broadcasts.
北韓仍然用高牆阻絕國內電腦和智慧手機與全球通訊網路的連結，包括網際網路，並操縱所有收音機和電視機，使之只能收到充斥宣傳的政府節目。

Such information control is seen as key to maintaining Kim’s grip on totalitarian power and the personality cult surrounding his family, which has ruled the North since its founding at the end of World War II.
這樣的資訊管控被認為是維持金正恩極權權力和對金家個人崇拜的關鍵，金家從二戰結束北韓建國以來就統治北韓。

Nevertheless, North Koreans have begun using their phones to watch outside entertainment smuggled in from China, including South Korean TV dramas. The files are shared between smartphones and other mobile devices through tiny memory chips, or the wireless data-exchange technology Bluetooth.
不過，北韓人已開始用手機觀看從中國大陸偷帶進來的國外娛樂節目，包括南韓電視劇。這些節目檔案透過迷你記憶體晶片或無線資料傳輸技術藍牙，在智慧手機與其他行動裝置之間分享。

原文參照：
https://www.nytimes.com/2018/12/18/world/asia/north-korea-smartphones.html

2019-02-17 聯合報．D4．紐約時報賞析 李京倫