譴責暴力

法國啟蒙時代思想家伏爾泰曾說過一句很有名的話：「我雖然不同意你說的話，但是我誓死維護你說這話的權利。」

(I disapprove of what you say, but I will defend to the death 

your right to say it.)



與大家共勉。嚴正譴責林正杰的暴力行為。

早上喝咖啡 小心心臟病

很多人喜歡在早上起床來一杯香醇的咖啡，讓一天有個清醒的開始。但是根據研究發現，這或許不是個好主意。請看下面來自路透社的報導。



Cup of coffee linked to heart attack in some

Tue Aug 22, 2006 6:35 PM BST

NEW YORK (Reuters Health) - That morning cup of coffee may be enough to trigger a first-time heart attack in vulnerable people, a study suggests.

Researchers found that among middle-aged and older adults, light to moderate coffee drinkers had an elevated risk of heart attack in the hour after having a cup of coffee.

This was particularly the case when a coffee drinker got little regular exercise or had three or more risk factors for heart disease -- such as diabetes(糖尿病), high blood pressure(高血壓) and smoking(抽煙).

On the other hand, there was no risk of having a heart attack among people who were heavy coffee drinkers, downing four or more cups per day. The difference, according to the researchers, may be that these coffee devotees(咖啡愛好者) build up a tolerance to the cardiovascular(侵襲心血管的) effects of caffeine.

The findings suggest that light or moderate coffee drinkers who are already at risk of heart attack should consider giving up the beverage, according to lead study author Dr. Ana Baylin.

For them, that morning cup could become "the straw that broke the camel's back,"(壓倒駱駝的最後一根稻草) Baylin, of Brown University in Providence, Rhode Island, said in a statement.

The findings, published in the journal Epidemiology(流行病學期刊), will likely add to the confusion that's been brewing about the health effects of coffee.

For example, a recent large study of U.S. adults found no association between heavy consumption of coffee -- at least the filtered kind -- and heart disease. But another study suggested that the heart effects of coffee might depend on genetics(遺傳學); researchers found an elevated heart attack risk only among coffee drinkers with a particular variant of a gene that helps metabolize caffeine.

The current study included 503 adults from Costa Rica who suffered a first heart attack between 1994 and 1998. Baylin and her colleagues questioned them about their coffee intake and overall diet in the hours and days before the heart attack. They also collected information on patients' medical history, background and lifestyle habits.



The researchers found that among those who typically drank less than one cup of coffee a day, the risk of heart attack in the hour after drinking a cup was four times higher than would be expected.

Similarly, moderate coffee drinkers -- those who had two or three cups per day -- showed a 60 percent higher-than-expected risk.

According to Baylin's team, that jolt of caffeine may boost nervous system activity and blood pressure enough to rupture a pre-existing fatty deposit(脂肪堆積), or plaque(血小板), on the artery walls(動脈內壁). When this happens, blood flow to the heart can be obstructed, causing a heart attack.

The researchers do acknowledge the limitations of their study, including the fact that patients were asked to recall their coffee intake in relation to the heart attack. In addition, it's well known that heart attack risk naturally rises in the morning, a time when most coffee drinkers have at least one cup.

However, Baylin and her colleagues note, that would not explain why heavy coffee drinkers seem immune to the effects. Instead, they suspect that heavy consumers develop a complete tolerance to the short-term cardiovascular effects of caffeine, whereas light to moderate drinkers remain susceptible.

SOURCE: Epidemiology, September 2006.



自由時報的中文編譯



早上喝咖啡 心臟病發機率高

〔編譯陳成良／路透紐約二十三日電〕美國一項最新研究警告，不常喝咖啡的中老年人，早上喝一杯咖啡就可能提高心臟病發的機率。

研究指出，平常不常喝咖啡又不常固定運動的中老年人，若同時又有三項或更多的心臟病風險因子，如糖尿病、高血壓和抽菸，更不適合一早就喝杯咖啡。不過，一天喝四杯咖啡以上的重度咖啡飲者，心臟病發機率提高與否就與喝咖啡無關。研究認為，這可能是後者已對咖啡因對心血管的影響有了一定容忍度。

主持這項研究的布朗大學貝林博士建議，已是心臟病危險群的中度或輕度咖啡飲者應考慮戒掉咖啡，因為喝咖啡可能成為「壓倒駱駝的最後一根稻草」。

貝林的研究小組以五○三名曾在一九九四至九八年首次心臟病發作的哥斯大黎加人為研究對象，調查他們心臟病發前數小時和數天的咖啡飲用量、飲食習慣、病史及生活習慣等背景資料，結果發現，平時一天喝不到一杯咖啡的人，早上喝一杯咖啡後一小時心臟病發機率比平常提高四倍；一天喝兩、三杯的中度飲者，早上一杯咖啡後的心臟病發機率也比平常增加六十％。

研究小組指出，咖啡因可能激化神經系統活動，血壓也升高到足以造成血管壁上累積的脂肪脫落，阻礙流向心臟的血液，造成心臟病發。不過報告也承認，他們的研究還不夠精確，包括是靠患者事後回憶咖啡飲用量，以及早上心臟病發機率本來就較高。

發表在「病理學」期刊的這項新研究，可能增加了有關喝咖啡與健康關係的爭論。最近美國一項大型研究便提出，成人喝咖啡與心臟病無關；另一項研究則指出，喝咖啡對心臟病的影響要看個人基因。

 

 

羞愧！這是我們的媒體

五隻小豬之歌

五隻小豬之歌 Five Little Pigs (1942)



一隻小豬上市場，

一隻小豬待在家，

這隻小豬吃烤牛，

那隻小豬餓肚皮，

還有一隻小豬嗷嗷叫。



很有趣的書名吧，這還是Agatha Christie的作品。故事敘述十六年前轟動一時的名畫家奎雷被謀殺案。



當時所有的證據都不利於阿瑪斯˙奎雷的妻子卡羅琳˙奎雷，然而整起事件因為小女孩卡拉˙洛曼荃的長大，而開啟了為母親洗刷謀殺親夫罪名的契機。



這本書又是以赫丘勒˙白羅為主角。他透過「五隻小豬」寫下對當時案件發生時的印象和對人物性格的看法而破解了這宗嫁禍他人的謀殺案。



不錯，故事的結局有點讓人意想不到。



這個暑假還看了高爾夫球場命案(The murder on the Links,1923)、瑪波小姐的完結篇(Miss Marple's Final Cases,1979)。

台灣之光王建民登上紐時

Yankees' Wang Finds His Place on the Mound and in the World

　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　Lucy Nicholson/Reuters

Chien-Ming Wang has become a hero in Taiwan and a stalwart in the Yankees’rotation.

進入The New York Times的網站，在最左邊的選單中挑選Sports這個項目，映入眼簾的，是這則新聞！台灣之光王建民確實在洋基隊、投手丘和世界舞台上都找到了自己的位置！



在這則報導中，非常詳實地介紹王建民，網站上還有一段很精采的專訪影片，實在值得一看！以下就是這則報導和翻譯。

By TYLER KEPNER

Published: August 13, 2006

He pitches with a sense of purpose and responsibility. For the Yankees’Chien-Ming Wang, celebrity and earning potential grow with every ground ball. The better he pitches, the better he can take care of his family in Taiwan.



他投球時，讓人感覺很有目標、背負著責任。對洋基隊的王建民而言，每一顆滾地球都為他帶來名氣和潛在的財富增加。他投的越好，相對地，他能帶給台灣的家人更好的生活。



Wang, who is scheduled to start at Yankee Stadium today against the Los Angeles Angels, has become more than the best ground-ball pitcher in the American League. At 26, he is a national hero in his home country, where he endorses computers and potato chips.



王建民，今天表定要在洋基主場對上洛杉磯天使隊。他已經變成美國聯盟的最佳滾地球投手。二十六歲的他，是祖國的全民英雄，在那裡，他甚至為代言電腦和洋竽片代言。

“When I used to go back to Taiwan, there weren’t that many events to go to,” Wang said through an interpreter before a game in Chicago last week. “Starting last year, there have been more events, and going out is not as convenient.”



「就之前回台灣的時候，就是沒有那麼多……像要做什麼活動之類的。王建民上星期在芝加哥的一場球賽前透過一個翻譯表示：「就從去年開始，就蠻多一些活動的。出門也不太方便。」

The kinds of events he attends are telling. “Going to orphanages,” Wang said, “and events for premature babies.”



他參加一些類似孤兒院或是王建民說：「還有為早產兒舉辦的活動之類的。」

Wang started playing baseball in fourth grade, as a pitcher, first baseman and outfielder. He attended high school in Taipei, on the north side of the island of Taiwan. His home, Tainan, is in the south. It was through baseball that he learned an important part of his personal story.



王建民從小學四年級開始玩棒球，他當過投手、一壘手和外野手。雖然他的家鄉在台南（位居台灣的南部），但是他高中到台北（位於台灣的北部）求學。透過了棒球，他學到人生中最重要的一部分！

“We were going out to a competition and needed our personal documents,” Wang said, explaining that meant the names, relationships and birthdates of family members. “When I got my documents, I learned who my biological parents were. My parents didn’t tell me.”



「那一天好像是、好像要出去比賽，需要那戶籍謄本、戶口名簿那種……」王建民說，戶口名簿是記載著他們一家的名字、關係和出生年月日。「那時候拿到的時候才看到，因為他們沒有跟我講。」

Wang found out then that his biological father was the man he knew as his uncle, Ping-Yin Wang. Wang’s parents had no children of their own and offered to raise him. They later had a daughter, Hsiu-Wen Wang, who is two years younger.



王建民發現，他的生父竟是他平時熟知的三叔，王炳穎。當時，因為王建民的父母並沒有小孩，所以將王建民過繼給哥哥。然而，之後，他們有了一個女兒，比王建民小兩歲。

It must have been a startling revelation, but Wang betrayed no emotion when talking about it. 



這必定是一個令人震驚的真相，但是王建民講到這個時，並沒有顯示任何的情緒。

“I didn’t feel anything in particular,” he said. “I felt it was all right, like I had two fathers.”



「那時候就想說也不錯。」他說：「有兩個爸爸。對啊，也不會感覺到什麼。」



If anything, Wang said, he became even more serious about succeeding as a pitcher.



如果要說有什麼的話，那就是讓王建民更認真地想成為一位成功的投手



“I felt I had to work even harder in order to help two sets of parents,” he said, adding later, “Most of my money I send home to let my parents manage. The rest I use for living expenses in America.” 



「就想要以後更努力啊，就要幫助兩個爸爸媽媽。」稍後，他補充道：「除了在美國的生活費之外，其他的錢都寄回家交給爸媽處理。」

In the off-season, Wang and his wife, Chia-Ling, live with the parents who raised him. He loves his mother’s cooking, he said, but the overriding reason is cultural.



在球季以外的時間，王建民和他的妻子吳嘉姈會回到台灣和父母住在一起。他說他喜歡媽媽的廚藝，不過真正的原因其實是在於文化上面。

His parents, who manufactured metal products like spoons and lunch boxes, have been retired for about 10 years. In Taiwan, Wang explained, it is customary for sons to stay at home and take care of their parents. Long after learning his personal background, Wang remains very close with the parents who raised him.



他的雙親已經退休達十年之久，之前是從事金屬產品的製造。王建民解釋道，在台灣小孩和父母同住並且照顧雙親是很平常的事。即使得知他自己的背景，王建民仍然和養父母非常的親近。

“In Taiwan there’s a saying: ‘Raising a child is more important than giving birth. Raising a child is greater,’ ” Wang said.



「台灣人講：就養你的就比較偉大啊，對啊。」王建民表示。

No Taiwanese player had played in the major leagues until outfielder Chin-Feng Chen joined the Los Angeles Dodgers in 2002. (Wang’s childhood idol was Roger Clemens.)



到外野手陳金峰在2002年加盟洛杉磯道奇隊以前，從來沒有台灣人站上大聯盟的舞台。(王建民童年時期的偶像是火箭人Roger Clemens)



He attended a sports college, Taipei Ti Wu University, and was signed by the Yankees for about $2 million in 2000, with a hard, straight fastball as his primary weapon. Shoulder injuries sidelined him for all of 2001 and part of 2003, but by 2004 he was a star for the Chinese Taipei Olympic team and, by late August, the top starter for Class AAA Columbus.



他在2000年的時候，正就讀台北體院，就被洋基隊以一紙大約兩百萬的合約簽下。當時，他的主要武器是球質硬的快速直球。然而因為肩部的受傷，使得他在2001年以及2003部分時候無法上場。但是就在2004年奧運，小王成為台灣隊中的一顆閃耀的球星。到了八月，他成了3A球隊的王牌先發。



The timing of his surge was significant. Had Wang blossomed in the spring of 2004, rather than the late summer, he might have attracted the attention of the Arizona Diamondbacks, who aggressively scouted the Yankees’ farm system before the July 31 nonwaiver trading deadline.



王建民的崛起時間點極具意義。如果他開花結果的時間不是在2004年夏末，而提前於早春「綻放」，那麼當時他很有可能會引起亞利桑那響尾蛇隊的注意。它們在731大限到來之前，正虎視眈眈地盯著洋基農場。

The Yankees wanted badly to trade for Randy Johnson and made all of their prospects available to the Diamondbacks. Arizona assigned the scout Bryan Lambe to evaluate several players, including Robinson Canó, Melky Cabrera and Dioner Navarro.



洋基隊當時即想得到藍迪˙強森(Randy Johnson )的加盟，所以對於響尾蛇隊的所有指望通接受。響尾蛇隊派出球探Bryan Lambe評估了幾名選手，包括了Robinson Canó, Melky Cabrera 和Dioner Navarro。



They never mentioned Wang to Lambe, and the teams did not make a deal until after the season. Wang was not in the trade.



洋基並沒有對Lambe提到王建民，而直到球季結束才完成交易，王建民沒有列入交易名單之內。

“I’d like to say I never saw him, but I did, maybe for a game or at least a part of a game,” said Lambe, who now scouts for the Mets. “He pitched well, but not like now. He didn’t have that velocity or that kind of sink. Natural maturity took care of the velocity, but somebody fine-tuned him, because that sinker is as good as anybody’s.



「我很想說我從未見過小王，但是，事實上我有。或許是在一場或至少幾局的球賽裡。」現在是大都會隊球探的 Bryan Lambe 說道：「他投得很好，但不像現在這麼好。當時他沒有這種球速和下沉尾勁。球速也許來自天賦，但是某人對他的改造，使得他的伸卡球不輸給任何人。」



“He’s winning because of that hard sinker. You can hit it on the screws, and if it’s sinking, you’ve hit a nice, hard ground ball. It takes a lot of ground balls to win.”



「他的勝利和他的硬質伸卡球有很大的關係。你可以在它在作螺旋轉動時打到它，但是只要他的球開始往下沉，就會造成一記強勁的滾地球。滾地球的大量製造為他帶來勝利。」

To throw the sinker, Wang holds the ball with his index and middle fingers along the seams framing the ball’s sweet spot. There is a dark callus to the right of the nail on his index finger, which he places just off the left seam. When he releases the ball, Wang pushes off the seam with his index finger, creating diving, downward movement toward the shins of a right-handed hitter.

The pitch may end up out of the strike zone, but hitters find it hard to resist before it shifts course.

“All you can do is hit the top of the ball,” said the Yankees’ Nick Green, who faced Wang eight times when he played for the Tampa Bay Devil Rays. “Every time it comes in, it looks like a strike. It’s easy to tell yourself to lay off it from watching it on TV, but it’s hard to do.”

Wang, who has not lost since July 3, has produced 3.36 ground outs for every fly out this season, the best ratio in the league. Because he induces contact so regularly, he has only 49 strikeouts, tied for the fewest in the majors among pitchers who qualify for the earned-run-average title.

Wang credits his sinker to Neil Allen, his pitching coach at Columbus in 2004, and Sal Fasano, who caught him then.

“He’s got that unique ability that whatever you teach him, he can throw with almost immediate success,” said Fasano, now the Yankees’ backup catcher. “But that’s why you have to be careful.”

In Columbus, Wang threw six pitches, which Fasano said he considered too many. Wang took to the sinker so quickly, Fasano said, that it made sense to master that pitch and throw it roughly 90 percent of the time.

The trick was not to throw it too hard. Wang can throw a four-seam fastball around 96 miles an hour. The sinker — or two-seamer — comes in two or three miles an hour slower, but has more movement.

When Wang threw 103 pitches in beating the Devil Rays on July 8, catcher Jorge Posada said he called only sinkers. But Ron Guidry, the pitching coach, said Wang also throws a changeup, slider and four-seam fastball.

When right-handers protect against the sinker, Guidry said, Wang can throw a slider or four-seamer to the outside corner, where they cannot reach. But mostly, Guidry conceded, Wang gets outs with the sinker.

“It’s like hitting a shot put,” Guidry said. “It’s harder than most sinkers, and it’s got late movement.”

Wang leads the team with 161 innings pitched, and he is 13-4 with a 3.69 earned run average. Beyond his ability, Wang’s personality has endeared him to teammates.

Reliever Mike Myers, who sometimes runs with Wang before batting practice around the concourse level of road ballparks, said Wang’s smile drew people in, and the language barrier fell later.

“Once you get him to open up, he’s fine,” Myers said. “But you’ve got to get him to open up.”

The Yankees provided Wang with a personal interpreter when he first came to the United States in 2000, but the interpreter was soon fired. Wang said he would rather not worry about the possibility of losing another interpreter, so he has not asked for one since.

“This year is better than last year,” Wang said. “Last year the other players didn’t talk to me very much. They figured I couldn’t speak English. In my second year, more people are talking to me, chatting with me.”

Wang’s English is improving, and he speaks well enough to convey basic points to the news media after games. Rick Cerrone, the Yankees’ media relations director, has suggested that Wang group three distinct ideas in each answer, and Wang has been quoted more often lately.

Predictably, teammates ply Wang with amusing phrases. On a recent flight, he greeted Larry Bowa, the boisterous third-base coach, by saying, “What’s up, Meat?”

“They’re teaching him new stuff, and he’s testing it on me,” Bowa said. “He does have a good sense of humor.”

That was the first thing Andy Phillips mentioned when asked to explain Wang’s personality. Wang parrots phrases, for sure, but he usually knows when he is being set up, and he has keen comic timing.

“He’s very, very funny,” Phillips said. “He’s pretty quiet, and then all of a sudden he’ll say something or ask a question at a random time, and it’s just hilarious.”

Phillips and Wang were teammates in the minors, and they eat together on the road sometimes. On one of their first trips in the majors, they had rooms on the same floor. When they got there, Wang sheepishly asked Phillips, “Where’s my luggage?”

Phillips explained that a bellman would bring the bags. Any rookie could have asked the same question, but it reminded Phillips of the adjustments Wang still has to make.

“When you think about all the little things we do every day just to be able to get to the field and do our work, that can be quite a challenge,” Phillips said. “But his personality is so laid back that he doesn’t let those challenges affect him.”

From absorbing the true story of his own beginning to mastering opposing lineups, Wang has handled it all.

王建民接受紐約時報精采的專訪(video)



紐時原始報導

陽光燦爛的集集小鎮

從綠色隧道開始，

就這麼步入了別具古樸之美的集集小鎮。









傳統印象中，

假日的集集總是有很多民眾騎著自行車欣賞著小鎮的風光。

現在，又多了坐馬車這個有趣的選擇。









鐵道集集線，

是西部縱貫鐵路的三條支線之一。

因為歷史悠久，這裡，總是能讓人尋回從前的許多寶貴回憶。









車站前，老伯奏起悅耳的樂音，

街頭藝術的美也可以在這裡看到。









這是武昌宮，

它在九二一大地震的天搖地晃之下，嚴重受損。

至今仍然保存災後的面貌，讓人記憶歷史，做個有記憶的人！









返途再看一次綠色隧道！

蜿蜒的鐵道、筆直清翠的綠樹，這小鎮還真美！





→更多《集集小鎮》的淳樸之美！

美容紫外線 UVA 今起預報

我們常常有一個概念，就是早上10點到下午3點左右出門是紫外線影響最劇烈的時候。但是這指的是UVB，對我們皮膚影響更大的往往卻是UVA。接著來看看一些實用的小常識。



紫外線是什麼？

紫外線是一種短波長的電磁輻射，具有高能量，按波長大小可分類為兩種：



1.UVA

波長介於320~375nm間(註：1nm=10負九次方m)。能穿透皮膚層，   曬黑皮膚，抑制免疫系統，讓皮膚「老化」，引起皺紋。



2.UVB

波長介於280~320間。穿透力小於UVA。但其能量較大，會灼傷皮膚，引發自由基的產生而破壞DNA，一旦皮膚的防禦系統及修護機制受UVB攻擊時，便易造成皮膚癌；除此又能分解眼球內的過氧化氫而形成氫氧自由基，導致眼球白內障。



那市面上看到琳琅滿目的防曬乳又該如何挑選？

首先要先釐清一些重要的標示係數。



UVA的標示通常採取PA+﹙Protection Grade of UVA﹚

用來阻斷紫外線UVA，可分為PA+、PA++、PA+++，越多+代表防止A光的功能也就越強。PA+表示可以延緩皮膚曬黑的時間倍數為2-4倍；PA++指的是可延緩4-8倍；PA+++表示可延緩8倍以上。



其他還有其中PFA（Protection Factor of UVA）、PPD - Persistent Pigment Darkening及IPD - Immediate Pigment Darkening等方法來表示防曬品對UVA的防禦能力。



而UVB的表示法，則是一般常見的SPF。

SPF = Sun Protection Factor ，歐洲系統則以IP（Indicia Protection，防護指標）表示，與SPF之間的轉換為：IP X 1.5 = SPF。



至於要選擇怎樣的防曬乳比較適合？其實，在日常生活不過度曝曬的一般情形下，選擇SPF 20 左右和 PA ++ 就可以了。因為要特別注意的，一般上班或上學往往只有在早上和傍晚才曬到太陽，如此，UVA的防護更顯重要。從事其他活動或到海邊等地方則又另當別論囉。



最後看看2006.08.07的報紙相關報導。

早上10點前 下午3點後 紫外線UVA是UVB的400倍

〔記者鍾麗華／台北報導〕非正午時段，別以為紫外線少就掉以輕心。學者發現，早上十點前、下午三點後，紫外線ＵＶＡ的輻射量可達ＵＶＢ的四百倍，最好塗上兼具ＵＶＡ、ＵＶＢ的防曬產品。

紫外線（ＵＶ）依波長不同，分為ＵＶＡ、ＵＶＢ及ＵＶＣ。ＵＶＡ波長最長，可穿透臭氧層到達地表，是輻射量最多的紫外線；ＵＶＢ僅一％會到達地球，但近年因臭氧破洞而增強；ＵＶＣ波長最短，大多被高層臭氧吸收，不會到達地表。

台大全球變遷中心主任柳中明說，ＵＶＡ俗稱「美容（白）紫外線」或「年齡紫外線」，會穿透到較深層的真皮層，導致皮膚老化、皺紋、長黑斑，甚至誘發皮膚癌與眼睛白內障等病變。不過，與ＵＶＢ短時間曝曬造成傷害不同的是，ＵＶＡ屬於長期累積性影響。

三總皮膚科主任醫師趙昭明說，老人皮膚癌比過去增加一％到二％，從臉上的斑與色素沈澱很明顯就是ＵＶＡ惹的禍。

柳中明說，太陽最強的時候約在上午十點到下午三點間，ＵＶＡ與ＵＶＢ都很強，應同時注意ＵＶＡ與ＵＶＢ；上下班時段及冬天、陰天，陽光不烈，ＵＶＢ輻射量低，但不可忽略ＵＶＡ，一樣要做好防曬。

柳中明與環境品質文教基金會昨天共同公布學界研發的ＵＶＡ預報系統，民眾可上網查詢http://cats.gcc.ntu.edu.tw/UVA/Welcome.html。

建議民眾每天最好塗抹防曬係數SPF20或PA++的防曬產品，上下班前、中午外出吃飯，最好都能塗抹一次。(2006.08.07自由時報)



美容殺手紫外線A 今起預報 

【記者薛荷玉／報導】愛美的女性注意了。環保團體與學界合作，從今天開始發布俗稱「美容紫外線」或「年齡紫外線」的紫外線A(UVA)預報，而紫外線A據信正是皮膚老化的關鍵；台大大氣系教授柳中明指出，下午四、五點時太陽不強，但紫外線A仍高，因此，女性在下班前宜補擦防曬乳。

根據環境品質文教金會及台灣大學全球變遷研究中心合作發布的紫外線A預報，今天全台各地的紫外線A多在「過量級」以上，達到「危險級」的地區包括基隆市、苗栗縣、彰化市、台南市、高雄市、屏東縣、台東市、台東縣、花蓮市，金馬等離島的紫外線A更是全面亮紅燈。民眾要查詢每天的紫外線A預報，可上網到：http://cats.gcc.ntu.edu.tw/UVA/Welcome.html查詢。

目前環保署及中央氣象局預報的紫外線指數，主要是針對紫外線B(UVB)，過度暴露會造成皮膚曬紅、曬傷，長期還會導致皮膚癌、黑色素瘤及白內障病變。

環品會董事長劉銘龍表示，該會所預報的紫外線A傷害力比較弱，但量卻是UVB的百倍，且因其波長較長，可到達並損傷真皮層的彈性纖維，並傷害皮膚微血管，是皮膚形成皺紋、老化、長黑斑的關鍵，且也有誘發皮膚癌與白內障病變的可能，不得不防。

柳中明分析，過去環保署所發布的紫外線指數發現，UVB主要在上午十時點到下午二時之間發威，但UVA的影響時間卻更長，從早上九時就開始，到中午升至最高，但直到下午四、五時左右，許多地區的U-VA都還在「中量級」以上。

且以冬天的高雄為例，往往環保署紫外線預報為「低量級」，但UVA卻可能高達「中量級」與「過量級」，因此，柳中明認為，民眾有必要另外參考紫外線A的預報。

劉銘龍表示，歐盟執委會研究發現，UVA除了會引起皮膚提早老化，還會讓免疫系統出現問題；而一般防曬乳標示的防曬係數(SPF)卻主要在防止引起曬傷的UVB，因此，歐盟正在研發一套針對UVA的防曬標示及產品規範，預計於2007年開始實施。 (2006.08.07 民生報)

睡多睡少都不好

睡太多或是睡太少都不好，

根據國外研究，睡眠時間長期多於9小時或是少於5小時，

都會增加罹患糖尿病的機率。



以下是節錄自2006.08.07《自由時報》的相關報導：

睡太多睡太少 都易得糖尿病

〔記者胡清暉／台北報導〕國外研究指出，若睡眠時間長期多於九小時或少於五小時，可能增加罹患糖尿病的機率。國內醫師分析，糖尿病與代謝症候群密切相關，若有睡眠問題，會影響體內經由肝、腎排泄的代謝，確實可能增加罹病機率。

國內糖尿病患者約有百萬人，去年死亡人數破萬，名列國人十大死因，糖尿病衛教學會昨天舉辦十週年年會暨學術研討會，呼籲各界正視糖尿病對健康的威脅。

研討會中有多位醫師針對糖尿病與睡眠問題進行報告。台大醫院內科部代謝內分泌科主治醫師楊偉勛根據國外流行病學研究，指出睡眠時間太多及太少，可能增加罹患糖尿病的機率，但原因並不十分明確。

此外，國外實驗也發現，健康年輕人的睡眠若持續六天被干擾，胰島素分泌不足，部分受試者狀態會有些像是初期的糖尿病患。

國軍北投醫院精神科主任李光輝認為，若有睡眠問題，會影響體內經由肝、腎排泄的代謝，確實有可能增加罹病機率，然而，不少糖尿病患者因為失眠問題，因而影響睡眠品質，因此，糖尿病、睡眠障礙之間的因果關係很難分析。

另外，國外有研究表示，糖尿病患者二成八有難以入睡的問題，三成二甚至要靠安眠藥才能入睡，國內也有類似情況。楊偉勛援引二○○三年的健保給付資料，指出國內最常使用安眠藥的前三名疾病，分別是失眠、自發性高血壓及糖尿病，顯見不少糖尿病患者都有睡眠上的困擾。

楊偉勛說，夜半低血糖狀態會讓患者醒過來覓食，而且糖尿病患者尿多，經常導致睡眠中斷，此外，一旦患者的血糖控制不好，白天會昏昏欲睡，晚上則是失眠。

楊偉勛也提醒，糖尿病患者愈肥胖，身體質量指數（ＢＭＩ值）愈高，愈容易睡眠困難。

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睡多久才夠？ 醫師︰與年齡體質有關

一個人一天要睡多久才夠？國軍北投醫院精神科主任李光輝指出，受到基礎代謝率、褪黑激素的影響，睡眠時間多寡與年齡有關，三至六歲的幼兒要睡九至十小時，六至二十歲的兒童及青少年時間較不固定，二十至六十歲的民眾平均睡六至八小時，六十歲以上的老年人則睡九小時。

不過，李光輝強調，睡眠多寡有時也要看個人體質，以往民間認為，睡得少可能會短命，但研究證明並非如此，而且有許多長壽者睡眠時間並不長。

台灣睡眠醫學學會理事長李宇宙建議，若民眾有睡眠問題，最好求助精神科醫師，並按時服藥。至於安眠藥的服用，李宇宙形容，「當用則用，能省則省」。（記者胡清暉）

當我擁有愈多時，我願意給的竟然愈少

當我擁有愈多時，



我願意給的竟然愈少!

在雲林急診的最後一個夜班，想不到病人竟像知道我要離開似的如潮水般從各處湧入。



晚上9 點多，門診醫生轉介來一位病人溫先生。他發燒、嘔吐，右下腹有明顯的壓痛及反彈痛，看來就像是盲腸炎。我幫他作了簡單的身體檢查，告訴他和他的妻子我的猜測以及可能需要開刀。

『醫生，能不能更確定一點? 』溫太太猶豫地追問。

『好吧，』由於來診病人很多，我說，『等一下抽血結果出來我再進一步和你們討論』。

一小時後，抽血的結果顯示白血球上昇、發炎指數也升高。

『有八成的機會是盲腸炎了，』我說：『我會請外科醫生來和你們討論開刀的事』。只見溫太太又遲疑了：『八成? 能不能肯定是或不是? 』



我有點生氣的回答道：『當然還有可能是憩室炎、腹腔內膿瘍等等的可能。我也可以很武斷地只告訴妳就是盲腸炎，反正開刀下來醫生也會告訴你『是有一點發炎』而妳也不會知道真相。只是醫學上本就沒有百分之百確定的事，我希望你能夠了解，也尊重你知道各種可能的權利。而且臨床上已經這麼像了，等待進一步檢查可能會有盲腸破裂引發敗血症的危險。』



溫先生始終不發一語，溫太太似乎不喜歡台北來的醫生這種多重可能的解釋方式。

在雲林我還是第一次遇到這麼龜毛的病人；我替他打上抗生素，並且安排電腦斷層(CT),然後轉身回到淹滿病患的來診區繼續處理其他病人。心裡直嘀咕健保局審查員若是抽到這本病歷一定會刪我 CT 檢查費六十萬元，然後附上一句『要放大100倍以嚴懲浪費』。

一小時後，斷層片洗出來，果然在盲腸附近有發炎腫脹的跡象。『現在盲腸炎的可能性有九成以上了，』我指著片子對溫太太說：『少數的病人可以只用抗生素注射治癒，但大多數的情況下開刀還是最好的選擇(我還是維持我的說明方式)。』

想不到她竟然回我一句：『醫生，能不能帶藥回家吃就好?』。

這回換我生氣了!

來診護士一直在叫有新病人新病人快來處理，這對夫妻竟然還這麼多意見纏著我。我說：『如果早要這樣就不需要這麼多檢查了!你不信任我們，我可以把你轉到其他醫院開刀，但要回去我不會同意。』他倆靜默不語。

我於是說：『要不然你們就簽自動出院吧，有事我們不負責!』。

想不到一直不說話的溫先生竟然開口道：『簽就簽吧!反正我爛命一條。』



我心頭一驚，只見溫太太低下頭說：『江醫師，我們不是不想治療或住院，只是我們一點錢也沒有。他每天作捆工領現，三個小孩才有飯吃。現在要是他開刀住院…』。

我突然對剛才言語的魯莽感到抱歉，想了一想說：『我覺得你還是開刀才能最快復原。我找外科醫師下來看看? 錢的事明天一早我會照會社工室來協助你們。』

外科醫師也真好心，他算一算開腹腔鏡復原的最快，只要住院兩天，不過要自費兩萬多元；開傳統術式住院日數稍長，要花三千多塊；用抗生素治療則可能要住院一週以上。



『真是一毛錢逼死英雄好漢 !』他搖搖頭道。

溫太太想等隔天早上社工確定補助金額後再決定治療方式，於是溫先生就先在急診打了一晚上的點滴與抗生素，溫太太則是回家哄小孩睡覺後，半夜又來陪先生到天亮。

我在晨間會議時向鄰座的蘇醫師提到了這個病人。『想不到雲林真的有這麼窮的病人，在台北從來不會遇到… 』我說。

可是他竟然皺起眉回我一句：『你怎麼可以讓他在急診待這麼久?盲腸炎會有破裂併發敗血症的危險! 』

『我當然知道啊，可是… 』



我想反駁，可是他接下來的話卻讓我啞口無言：『我們可以讓病人因病而死，卻不能讓病人因貧而死 ! 』『你應該先讓他去開刀，錢的事再想辦法，大不了就幫他出嘛 !』

我腦中一陣昡暈，不是因為一晚沒睡的關係，而是他突然把我的心敲開了一道刺眼的光，像住院醫師放映在投影幕上的燈一樣亮。我想到十年前的一個晚上，俊貿提議我們去認養貧童，我立刻就答應。那時我的薪水還不到現在的一半，卻對這樣的事毫不猶豫；更早的時候靠公費過活，還能捐出一個月的家教費並且和俊貿在補習街挨家挨戶募款。而現在，『付出』這樣的想法竟已不自覺地被排除在我行為反應的選項之外!幾千塊對現在的我來說，不過是節慶一場吃飯錢；對溫先生來說，卻是一家人命之所繫。『我怎麼沒有想到? 』我懊惱驚覺：『當我擁有愈多時，我願意給的竟然愈少 』。

我一面想一面走出會議室，遇見社工說他們是登記有案的低收入戶，可以補助大多數的費用。我走到病床邊，看到 護士小姐已經幫溫先生換好手術衣。我向溫先生解釋手術後大約要休養時間，然後拉上圍簾，把五千元放在他的手中，他原本不說一語的漠然態度，突然轉為羞赧，溫太太則在一旁說不要不要。我硬是把他手握成拳，說道：『沒關係啦，急診加住院要幾千塊，你開完刀還要一個星期不能工作。三個小孩總要呷飯啊! 』

溫 太太幾乎快哭了，溫先生終於說道：『醫師，我們雖不認識，可是，謝謝你對我們這麼好。我之後工作有錢，再慢慢還你。』

我揮揮手道：『沒關係，互相幫助而已。我要下班了，你還是要好好休養，不要急著出院，之後的復原才不會受影響。』



我經過忙碌的看診台，向喚醒我赤子之心的蘇醫師道謝；他一頭霧水。走出雲林急診的大門，門外清晨的陽光似乎更耀眼了。



(本文轉錄自ptt share版)

(作者:台大醫院急診科江文莒醫師)