Friday, February 13, 2009

當銅臭味壓過藥水味


【記者韋麗文/特稿】
檢討醫界的聲浪接踵而至,一切向錢看的氣氛卻在醫界越來越濃。健保總額制度之下,點值日益縮水,各醫院為了另闢財源,廣開自費門診,明顯往營利傾斜,醫師也連帶失去理想性;不管連續劇「白色巨塔」的劇情是否真人實事,但台灣已可預見,一場白色風暴才剛要開始。

過去若有醫師完成高難度、國內第一例的手術,或是論文被刊登在國際期刊上,這等光耀門楣的醫生,醫院無不立即召開記者會昭告天下。如今卻全都噤聲,就怕名聲弄得太響亮,萬一病人來得太多,在健保合理門診量制度之下,多做又不會多賺錢,醫院都選擇別太張揚。

從健保局口袋掏錢困難,醫院乾脆直接訴諸民眾,創造疾病需求。從醫學中心到診所,各種自費門診不斷擴張,健康檢查、睡眠中心、植牙、雷射美容、減肥門診等,唯有會賺錢的話題才是好話題。

在醫院明顯往營利傾斜,醫生也失去理想性的時代,醫院管理凌駕在醫師專業之上,以利益的觀點壓縮醫療人力、踢病人,醫護人員被迫配合或主動迎合,做了有違醫德的行為,好醫生不再被褒揚,只能逐漸沉默。

在一切向錢看的環境下,醫師開藥時,哪一種藥最適合病患已經不是首要考量,醫師心中盤算的是本月額度用完沒 開藥會不會被健保局核刪 「醫者父母心」已成鳳毛鱗角,「利字當頭」卻司空見慣,醫病衝突將日益增多,病患如何安心把性命交給醫生。

>>>>2006/09/03 聯合晚報

十大抗氧化食物 給你青春 【聯合晚報╱韋麗文】

2008.11.23 02:43 pm

病從口入,但食物也能成為青春的良方。醫師指出,綠茶、番茄、蘋果、杏仁、蔓越莓、花椰菜、深海魚類、地瓜、小麥胚芽、黃豆是十大青春食物,可以多多攝取。

榮新診所副院長丁綺文指出,常吃抗氧化食物的人,比較不會罹患癌症、心臟病和老年痴呆等老化疾病,而且熱量低,經常攝取也不容易胖。

近年來,歐美國家也開始流行喝茶,但歐美人士只喝紅茶,不像華人、日本人懂得欣賞綠茶。綠茶屬於未發酵茶,含多種生物類異黃酮,其中兒茶素為強力抗氧化物質,可以阻止壞的膽固醇氧化,因此不會堆積在血管壁變成斑塊。

花椰菜是十字花科蔬菜,十字花科還包括包心菜、甘藍菜、高麗菜、高麗菜苗、芥藍、芥菜、大頭菜、油菜、蘿蔔等,所含的抗癌成分,能幫助男女性荷爾蒙正常代謝,預防乳癌、子宮頸、攝護腺癌。

愛斯基摩人每天攝食大量的魚類,心臟及癌症罹患率很低,因其中含有大量的優良omega-3油,可以減少血管阻塞,防止心臟病發,所以又稱「血管的清道夫」。

但鮪魚、鮭魚可能蓄積大量的重金屬,宜適量食用,體型 一公斤 左右的深海魚是最佳選擇。

番茄含有抗氧化物茄紅素,能保護植物不受陽光、空氣汙染傷害,所以番茄越曬越紅、越漂亮,茄紅素像是防護罩,避免紫外線激發自由基。同理,人類攝取之後,也可以利用茄紅素的抗氧化作用,對抗老化產生的疾病,甚至防癌的目的。

藍莓及蔓越莓含高量的花青素。蔓越莓可預防泌尿道感染,藍莓則可以增強視力,對於老年人常患的白內障、黃斑部退化和視網膜病變都有療效。

金黃色的地瓜有很高的抗氧化物—β胡蘿蔔素,能延緩老化過程及減少癌症的危險。地瓜沒有脂肪且含有高纖,一顆小地瓜僅有54卡。

蘋果有優質的果膠來源,果膠是可溶性纖維,可降低血中膽固醇及血糖。新鮮的蘋果還含有保護細胞免於傷害的抗氧化物—維他命C,可以幫助鐵及葉酸的吸收,也是膠原蛋白形成所需的元素。

最早吃黃豆製品的應該是中國人,但是把黃豆用來養生最成功的卻是日本人。黃豆可以預防心血管疾病、抑制癌細胞生長、減緩更年期症狀和預防骨質疏鬆。

小麥胚芽是小麥的營養精華,含高量的維生素E、蛋白質、纖維及少許脂肪。除了小麥胚芽外,其他麥類及全穀製品也比精製白米、麵粉好,雜糧麵包、全麥吐司或五穀飯都是良好的選擇。

杏仁含有纖維、維他命B2、鎂、鐵、鈣。杏仁還含有大量的維他命E,也提供很好的植物性蛋白,有益心臟。而杏仁含的油脂是單元不飽和脂肪酸,是一種好的脂肪酸,可以降低血中膽固醇,可以多喝杏仁茶。

【2008/11/23 聯合晚報】

衛星相撞 機率10億分之一

國家太空中心副主任吳岸明說,衛星相撞機率非常小,撞擊影響要看碎片多寡,再計算是否影響其他衛星和太空站。

每個衛星都有地面站控制運作,國際組織也有規定同一軌道中每個衛星間的距離。

吳岸明說,目前約有五千顆衛星在軌道上運行,衛星高度都是用公里計算,衛星大小則以公尺為單位,公尺是公里的千分之一,再加上太空是三度空間,撞到機率約為十億分之一,美俄衛星會相撞,相當令人意外。

他指出,過去多認為擔心衛星相撞或小行星撞地球是杞人憂天,這次衛星相撞或許會讓科學家更加注意這些問題。

吳岸明表示,衛星造價昂貴,不會有人故意拿衛星去撞毀另顆衛星,要毀掉衛星,直接用飛彈打就好了,去年中國就曾發射飛彈摧毀衛星。如果真如外傳俄羅斯衛星是報廢的衛星,這顆衛星應已不受控制,被美國衛星撞上,應純屬意外。

人造衛星運行的軌道可分地球同步和太陽同步。地球同步軌道高度約距離地面約3萬6千公里;太陽同步軌道則是繞著地球南北極方向轉,主要分布在1千公里以下的高空。台灣的福衛2號就屬此類衛星。

【2009/02/13 聯合報

Sunday, February 8, 2009

猜法美女部長孩子的爸 十指不夠數

一本新書說,阿拉伯國家卡達的司法部長馬理,是法國阿拉伯裔美女司法部長達蒂新生女嬰的父親。這是達蒂今年1月出席部長會議後,踏出總統府的神情。
歐洲圖片新聞社
誰才是法國43歲的美女司法部長拉希妲.達狄(Rachida Dati)「孩子的爸」?最新謎底是44歲的卡達司法部長馬理。

法國記者達蒙(Michael Darmon)與狄亥(Yves Derai)出版新書說,達狄有時一個月赴卡達多達3次,而已有家室的馬理也常到巴黎度周末;兩人曾被目擊在巴黎共進晚餐。

馬理的履歷顯示,他曾就讀巴黎索邦大學,並被頒授法國榮譽軍團司令勳章這項法國最高的平民榮譽。達蒙與狄亥在《密友》(Belle-Amie)一書中引述一名法國外交官的話說:「他是很崇拜法國人,是個為達目的不惜使出渾身解數的人。」

單身的達狄曾說孩子她爸「經常旅行」,而1月2日出生的貝比左拉的眼睛像極了父親。

報導並稱,去年4月在一項記者會中,達狄大大誇獎馬理一番,說「兩人經常交換意見」,讓她在反恐與打擊組織犯罪工作上如魚得水。

孩子她爸是誰,上月生下女嬰的達狄不說就是不說。媒體對這位播種人大猜謎,入幕之賓皆為達官貴人,連同馬理,兩隻手快要不夠數。西班牙前總理阿茲納與法國 春天百貨集團執行長皮諾特,都曾被點名,但都否認。法國總統沙克吉一度也是「嫌犯」,後來甚至有媒體說沙克吉一家三兄弟,他的兄長與胞弟都有可能。

另外,媒體也說,真正的播種人是縱橫全球商界的威立雅環境集團總裁普羅格里奧與超級豪華Barriere酒店集團負責人戴西格尼。後來又有媒體說,真正的父親是法國電視台台長兼製片人亞瑟。

隨著人選增加,真相也愈來愈迷離、愈糾纏不清。有一說是達狄告訴沙克吉,孩子她爸是阿茲納。阿茲納否認後,有人認為是沙克吉擔心達狄成為巴斯克恐怖集團攻擊的對象,才放出這種風聲。最新出版的書說,阿茲納是個煙幕彈,目的是掩護馬理。

【2009/02/09 聯合報】

Saturday, February 7, 2009

日皇太子妃雅子之父 被選為國際法院院長

日本各大媒體報導,位於荷蘭海牙的國際法院(ICJ)昨天在15位法官的互選之下,選出日本皇太子妃雅子的父親、76歲的小和田恒擔任院長。

日本外務省宣布,小和田恒昨天在位於荷蘭海牙的國際法院的法官會議上,被選為院長。任期3年。這是日本人首度擔任該院院長,日本外務大臣中曾根弘文已表示肯定之意。

小和田是皇太子妃雅子的父親,1955年進入外務省,1999年退休。退休後,曾在美國哈佛大學、哥倫比亞大學等擔任客座教授,教授國際法。2003年2月起,擔任國際法院的法官。

國際法院是根據1945年生效的「國際法院規約」,於1946年成立的聯合國司法裁決機構。主要功能是對各國所提交的案件做出仲裁,或是在聯合國大會及聯合國安全保障理事會的請求下,提供諮詢性的司法建議。

目前國際法院規定的當事國為192國。法官共15人,任期9年,可連任。15位法官必須來自不同的國家。院長、副院長任期3年,由法官互選。

國際法院要開庭的話,必須由當事國雙方同意才行。例如,日本與韓國之間的竹島(韓國稱「獨島」)主權紛爭,日本希望交付國際法院審理,但韓方拒絕,因此未能開庭。

本月3日,國際法院就羅馬尼亞與烏克蘭黑海海域邊界劃分問題做出判決,羅國表示歡迎。

格達費翻身 從狂人到非盟主席

圖為格達費聆聽「非洲聯盟」發言,深思的表情。
(路透)
利比亞領導人格達費靠軍事政變起家,曾出面承擔泛美客機遭恐怖攻擊墜毀案的責任,並公開承認發展大規模毀滅性武器,不過他既沒有像賓拉丹般被列為國際頭號通緝犯,更未如伊拉克總統海珊般被絞死,反而在2日當選了「非洲聯盟」的主席。

「非洲聯盟」成立於2002年7月,是繼歐盟之後第二個重要的地區國家聯盟,旨在促進、維護非洲大陸的和平穩定,推行掃貧策略,實現非洲的發展和復興,有53個成員國。

「非洲聯盟」第12屆元首高峰會2日在衣索匹亞舉行。聯盟發言人梅吉瑞雪克宣布:「格達費在閉門會議上被與會領袖選為主席,任期一年。」

1969年,格費費發動軍事政變,一夕之間以上校軍階成為三軍統帥。在強人極權領導下,利比亞被西方列為支持恐怖主義的「流氓國家」,美國前總統雷根更稱之為「中東地區的一隻瘋狗」。

格達費獲選為「非洲聯盟」主席,志得意滿。
(歐洲圖片新聞社)
利比亞恐怖分子主導1988年的「洛克比事件」,震驚全球。該年12月21日,美國泛美航空一架班機在英國蘇格蘭洛克比上空爆炸墜毀,造成機上259名乘客、機組人員全部喪生,並波及地面無辜民眾11人,合計270人罹難。

「洛克比事件」被查出為利比亞恐怖分子所為,格達費在2003年亦首度表明為此事件負責,並承諾放棄發展大規模毀滅性武器。自此之後,利比亞與西方國家的關係開始解凍。

2006年4月,美國布希總統宣布放寬對利比亞之經濟制裁;同年5月15日,美國宣布將利比亞從支持恐怖活動國家名單中剔除,同時恢復全面外交關係,設立大使館;2007年10月,利比亞更獲選為聯合國安理會非常任理事國。

儘管格達費似已浪子回頭,卻也有人認為,格達費向西方傾斜只是權宜之計,為的是自保,避免步上海珊的後塵,並挽救利國經濟、避免被孤立,他狂傲的本質並沒有改變。

【2009/02/07 聯合報】@ http://udn.com

Sunday, February 1, 2009

Nadal Defeats a Tearful Federer at Australian Open


MELBOURNE, Australia — It was not quite another tennis masterpiece. The much-anticipated rematch between Rafael Nadal and Roger Federer lacked the consistent quality and, above all, the crescendo finish of their five-act drama in fading light at Wimbledon last year.

But this Australian Open final was certainly epic entertainment, too. It also lasted five sets and more than four hours. It also featured plenty of abrupt reversals of fortune and unexpected breaks of serve, and it also ended with Nadal triumphant and Federer devastated.

Federer, the 27-year-old Swiss star, needed just one more victory to match Pete Sampras’s all-time record of 14 Grand Slam singles titles. But he faded badly in the final set on Sunday night and was then unable to keep his composure after Nadal’s 7-5, 3-6, 7-6 (3), 3-6, 6-2 victory.

In the post-match ceremony, Federer choked up after receiving the runner’s-up plate from one of his idols, Rod Laver, and was unable to get more than a few sentences into his speech to the crowd before he began to cry in earnest.

"God it’s killing me," he said, eventually backing away from the microphone.

But this historic rivalry, one of the best in any sport, is also a friendly rivalry, despite all the power and spin these two well-mannered young men employ against each other when they are on opposite sides of a net. And so it was no surprise that Nadal, the first Spanish player to win the Australian championship, was soon putting his left arm around Federer, putting his head against Federer’s and helping him pull himself back together just long enough to finish the speech.

"I don’t want to have the last word; this guy deserves it," Federer said. "So Rafa, congratulations. You played incredible. You deserve it man."

It is difficult to argue with that last sentence. To even reach the final, the top-seeded Nadal had to win the longest match in Australian Open history in the semifinals: a five-set, 5-hour-14-minute classic against his compatriot Fernando Verdasco. He then had one day less than the second-seeded Federer to prepare for the 19th installment of their rivalry: undergoing intense physical therapy in an attempt to recover the freshness of mind and body required to repulse a man on a mission.

"I knew it was not going to affect him a lot," Federer said of Nadal’s abbreviated preparation. "It did not have any role to play in it, so I was ready for that."

Nadal was not nearly so certain that he would be in fine shape. After getting to sleep at 5 a.m. Saturday following his Friday night marathon with Verdasco, he woke at 1 p.m. He practiced lightly that afternoon and again on Sunday afternoon.

"I was having a bit of trouble practicing," he said. "I felt a little light-headed when I practiced yesterday and today. I was pretty concerned, not being sure whether I could be at my best. It’s tough feeling that way when it’s your first final in Australia and you’re not sure you’re going to be 100 percent. But in the end everything worked out well for me."

It was hardly a straightforward process. Nadal would need 4 hours 23 minutes to finish off Federer, who actually won one more point than the Spaniard. Nadal would need to rally from 2-4 down in the first set, breaking Federer in the following game with the help of two phenomenal winners on the run. He would need to save all six break points he faced in the third set: the same set when he twice received changeovers on treatment for a right thigh that was feeling ominously tight.

"Winning the third was vital," Nadal said. "It would have gotten very complicated if I had lost that set."

He would also need Federer, a three-time Australian Open champion, to serve much less convincingly than usual. The Swiss put only 52 percent of his first serves in play on Sunday, which was by far his lowest percentage of the tournament. One of the most remarkable statistics from this remarkable match was that Federer managed to win the second set with a first-serve percentage of just 37 percent.

"Perhaps I should not have been out there in the fifth set at all," said Federer, still red-eyed an hour after the match. "I should have won the first set and the third. The rest of the story, we all know it."Nadal, the swashbuckling 22-year-old from the Spanish island of Majorca, was considered a clay court specialist early in his career. But he is now well on his way to becoming one of the game’s great multi-surface champions. He has won the last four French Opens on clay, last year’s Wimbledon title on grass and has now won his first Grand Slam title on a hard court.

"It is a dream to win here," Nadal said. "I’ve worked very hard the last, well, all my life to improve the tennis outside of clay."

Nadal also has helped win tennis’s premier team competition, the Davis Cup, for Spain as well as last year’s Olympic gold medal in singles on a hard court in Beijing. The only major title he is missing is the United States Open, where he was beaten in the semifinals last year.

But Nadal, for all the fire and brimstone in his flashy left-handed game, is also a self-effacing champion: one who has continued to affirm that Federer is the greatest player of all time even as he continues to build on his career edge against him.

Once he took the microphone himself on Sunday, with the trophy in his hands, his first words were for his opponent. "Well, first of all, sorry for today," he said, turning to face Federer. "I really know how you feel right now. It’s really tough. Remember you are a great champion. You are the best in history."

Nadal then said that he was convinced Federer would beat Sampras’s record.

Perhaps Federer will, but for now, the younger man — however respectful — who keeps blocking his path is Nadal. The Spaniard has won five of the seven Grand Slam finals they have played, including the last three. His career edge overall against Federer stands at 13-6 and the only surface on which Federer continues to hold a statistical advantage is on grass, where the Swiss has won two of their three matches.

"I don’t think there’s any trick to it; I’m not that smart," Nadal said. ’We’ve played many matches. I’ve won some. He’s won some. One of us has always been number one when we play, so the matches are always tough. I always have tried to go on court believing I can win and giving my best, thinking that if I don’t give my best and play my best I’m not going to beat a player like Roger."

This final was the first to go five sets at the Australian Open since 1988, when Mats Wilander beat Pat Cash. But the roar that was heard in Rod Laver Arena when Federer held serve to even the match at two sets apiece was soon replaced by the groans and awkward silences that accompany an anticlimax.

Federer, suddenly looking sluggish and off rhythm, was broken in the fourth game of the final set, blowing a 30-0 lead on his serve by losing four straight points: three with unforced errors from the baseline and another with a double fault.

That gave Nadal a 3-1 edge that he would never surrender. Federer won just two points on Nadal’s final two service games as he kept missing returns with his one-handed backhand, a shot that blew hot and cold throughout the match.

Serving to stay in the final at 2-5, Federer quickly fell behind 15-40. Though he would save two match points as Nadal made uncharacteristic backhand errors, he could not build on that brief reprieve.

At deuce, Nadal hit a backhand winner, with Federer appearing distracted by a shout of "out" from the crowd earlier in the rally. Pascal Maria, the French chair umpire, reminded the crowd to refrain from such behavior, but the point, in such cases, is not replayed.

On the next and final point, Federer knocked a forehand long and Nadal dropped immediately on his back: never more of a true number one.

But as Nadal gradually began to grasp the degree of Federer’s emotional distress, his moment of triumph also became a moment of reflection.

"Of course it can happen to all of us," he said of Federer’s breakdown during the ceremony. "It was an emotional moment, and I think this also lifts up sport, to see a great champion like Federer expressing his emotions. It shows his human side. But in these moments, when you see a rival, who is also a comrade, feeling like this, you enjoy the victory a little bit less."