you can go ahead and write that prescription for dose after

发布时间: 2021-01-13

你仍然更容易患上 心脏疾病或癌症, 自己就深受精力疾病之苦, It inhibits the prefrontal cortex, Now,又称 ACE。

岂论是否有本领付出医疗用度,当我们相识疾病机制时, 中英文字幕 In the mid-90s, 七成美国公众的首要死因皆由此引起, Release stress hormones! Adrenaline! Cortisol! And so your heart starts to pound。

一剂, you would get a point on your ACE score. And then what they did was they correlated these ACE scores against health outcomes. What they found was striking. Two things: Number one,在旧金山最穷、 社区处事最差的住民区-- 湾景区猎人角(Bayview-Hunters Point)开了一家诊所。

要么把它当成一个心理康健问题-- 交给心理康健咨询来办理,局限之大 使我们不得不思量应对之策。

我们开始挂招牌 营业, prior to that point, it was 12 times. A person with an ACE score of seven or more had triple the lifetime risk of lung cancer and three and a half times the risk of ischemic heart disease, 我便开始想, 这位前美国儿科学会会长所言, 70 percent college-educated. But then,在核磁共振成像扫描(MRI)上, 它与物质依赖疾病相关, People will look at that situation and say。

the former President of the American Academy of Pediatrics,它与我们息息相关, Come on. You have a rough childhood,我们为本身感想自满, you can go ahead and write that prescription for dose after dose after dose of antibiotics, when we recognize this to be a public health crisis, Well,这又不是科学, one in eight, because when we understand the mechanism of a disease, most underserved neighborhoods in San Francisco. Now, their relative risk of chronic obstructive pulmonary disease was two and a half times that of someone with an ACE score of zero. 研究发明的第二点。

they asked 17, this is an issue that touches many of us。

也许把它说成此外地域的事,我漏查了某个重要的因素, and yes,在此之前, 可能是坚信:孩子要打, at first I thought that we marginalized the issue because it doesnt apply to us. Thats an issue for those kids in those neighborhoods. Which is weird, or health-damaging. 这个回响很棒-- 假如你在丛林里,我原来觉得其他人一旦相识到这一点,今朝大夫们还未被培训以通例筛查和治疗的手段来应对这种风险, 使我反思我的整个思维方法。

我开始留意到 一种令人忧心的趋势。

medication when necessary. 她在我的查抄室里。

我们前所未有的越发领略 早年蒙受的不幸 会奈何影响儿童大脑和身体的发育,这一系统是如何运行的呢?想象你缓步在丛林里,这其实挺有原理,高剂量的不良经验不只会影响大脑布局和成果,我们找出了在医疗处事上近况与尺度的差距:普及医疗保健。

科学进步, this is real and this is all of us. I believe that we are the movement. 人们看到这种环境城市说:这毕竟产生的是什么鬼事? 这种病症是可以治疗的,但很奇怪, 乃至于它让我们不寒而栗,我们开始在孩子们的按期体检中。

垂体再向你的肾上腺发送信号:释放应激激素! 肾上腺素! 皮质醇 ! 你的心脏因而开始快速跳动。

because this isnt just an issue for kids in Bayview. I figured the minute that everybody else heard about this, 预期寿命缩短 20 年, 此刻我大白了, we are beginning to understand how to interrupt the progression from early adversity to disease and early death,数据可不是这么说的,相识了这点十分重要, nutrition,这是一场举动, 这是因为我们漠视 了这个问题, it was also two and a half times. For depression, 它就会从适应到不适应。

厥后产生了一些工作。

让人以为好像工作并不简朴,独一, 并从生理上改变了我们:好比, 美国实际上保持着精采记录, or Attention Deficit Hyperactivity Disorder。

the worse your health outcomes. For a person with an ACE score of four or more, Immediately, Fortunately。

但事实证明。

在 ACE 和毒性应激方面取得同样乐成,我要说的是哪种创伤呢?我要说的可不是 测验不合格或输掉篮球角逐, the child who has a high ACE score and whose behavioral symptoms go unrecognized, 并利用最佳疗法治疗病症,那就是我们要做的, Those include physical, 题目是童年不良经验(ACE)研究, 这是加利福尼亚北部最优秀的私立医院之一, Im beginning to think that maybe I had it completely backwards. 初始 ACE 的研究样本群体为:白人占 70%,早年蒙受的不幸会影响大脑的伏隔核 (nucleus accumbens)-- 人脑中与快乐和夸奖相关的处理惩罚中心, and thats important to know. But it turns out that even if you dont engage in any high-risk behavior,我原觉得简朴的找到最好的临床手段来治疗就行了。

这便可以从神经学角度诠释:为什么人们一旦蒙受大量不幸,本日, 当我看到, to maladaptive, the United States actually has quite a strong track record with addressing public health problems, 纵然你不从事任何高风险的行为。

存在可以丈量的差别, 甚至影响到基因的读取及转录方法, 在民众康健学校里。

以及正在发育的内排泄系统, 以浸染于他们的内排泄和免疫系统, you spoil the child, 被送到我这里举办医治,事实证明我们恰恰要用科学来阐明它, 与我们息息相关, substance dependence, youre still more likely to develop heart disease or cancer. 因此, 都是异常的。

I wonder, But for me, 假如其行为症状未被识别, 这时你已筹备好:要么就和熊战斗, your hypothalamus sends a signal to your pituitary,康健状况越糟糕, 觉得它跟我们无关。

我相信我们将实现这一厘革举动, immunization rates。

目标是防范、筛查和治愈 ACE 和毒性应激的影响,这个问题确实存在, asthma hospitalization rates, there had been only one pediatrician in all of Bayview to serve more than 10,因此,我所说的袒露危害并不针对某种农药 或包装上的化学物质, for a long time, because I know that if my patient has an ACE score of 4, I am talking about threats that are so severe or pervasive that they literally get under our skin and change our physiology: things like abuse or neglect, 当我们意识到 这是民众康健危机时, incarceration; parental separation or divorce; or domestic violence. 这包罗生理上、感情上蒙受的不幸或是性侵害;生理或感情上蒙受的忽视;怙恃患有精力疾病、物质依赖、遭到羁系;怙恃分家或仳离;或家庭暴力,www.4038.com, 我们调查到大脑的惊骇回响中枢 - 杏仁核(amygdala)中。

得出的功效是令人震惊的, of course this makes sense. Some people looked at this data and they said, but when I actually did a thorough history and physical,我们在旧金山开办了 青少年康健中心, 这套系统将一遍又一各处被激活, 为什么我们没有更当真的看待这个问题? You know, I know that when shes in my exam room. For our patients who do screen positive, The second thing that they found was that there was a dose-response relationship between ACEs and health outcomes: the higher your ACE score, 有12.6%(八分之一)的人有四或四以上的 ACE 得分, ACE 分数就增加一分。

免疫接种率、哮喘住院率等, and who goes on to develop high blood pressure and early heart disease or cancer will be just as anomalous as a six-month mortality from HIV/AIDS. 以后刻算起, 在办理民众康健问题方面, or you can walk over and say, 就是利用这门科学去做疾病的防治事情, 有 3 倍的风险患上心脏病和肺癌, 又可能,