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《HOPE English 希平方》服務條款關於個人資料收集與使用之規定

隱私權政策
上次更新日期:2014-12-30

希平方 為一英文學習平台,我們每天固定上傳優質且豐富的影片內容,讓您不但能以有趣的方式學習英文,還能增加內涵,豐富知識。我們非常注重您的隱私,以下說明為當您使用我們平台時,我們如何收集、使用、揭露、轉移及儲存你的資料。請您花一些時間熟讀我們的隱私權做法,我們歡迎您的任何疑問或意見,提供我們將產品、服務、內容、廣告做得更好。

本政策涵蓋的內容包括:希平方 如何處理蒐集或收到的個人資料。
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我們所收集的個人資料, 將用於通知您有關 希平方 最新產品公告、軟體更新,以及即將發生的事件,也可用以協助改進我們的服務。

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上次更新日期:2013-09-09

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兒童及青少年之保護 兒童及青少年上網已經成為無可避免之趨勢,使用網際網路獲取知識更可以培養子女的成熟度與競爭能力。然而網路上的確存有不適宜兒童及青少年接受的訊息,例如色情與暴力的訊息,兒童及青少年有可能因此受到心靈與肉體上的傷害。因此,為確保兒童及青少年使用網路的安全,並避免隱私權受到侵犯,家長(或監護人)應先檢閱各該網站是否有保護個人資料的「隱私權政策」,再決定是否同意提出相關的個人資料;並應持續叮嚀兒童及青少年不可洩漏自己或家人的任何資料(包括姓名、地址、電話、電子郵件信箱、照片、信用卡號等)給任何人。

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上次更新日期:2013-09-16

希平方 內所有資料之著作權、所有權與智慧財產權,包括翻譯內容、程式與軟體均為 希平方 所有,須經希平方同意合法才得以使用。
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「Alyson McGregor:藥物為什麼常對女性有危險副作用」- Why Medicine Often Has Dangerous Side Effects for Women


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We all go to doctors. And we do so with trust and blind faith that the test they are ordering and the medications they're prescribing are based upon evidence—evidence that's designed to help us. However, the reality is that that hasn't always been the case for everyone. What if I told you that the medical science discovered over the past century has been based on only half the population?

I'm an emergency medicine doctor. I was trained to be prepared in a medical emergency. It's about saving lives. How cool is that? Okay, there's a lot of runny noses and stubbed toes, but no matter who walks through the door to the ER, we order the same tests, we prescribe the same medication, without ever thinking about the sex or gender of our patients. Why would we? We were never taught that there were any differences between men and women.

A recent Government Accountability study revealed that 80 percent of the drugs withdrawn from the market are due to side effects on women. So, let's think about that for a minute. Why are we discovering side effects on women only after a drug has been released to the market? Do you know that it takes years for a drug to go from an idea to being tested on cells in a laboratory, to animal studies, to then clinical trials on humans, finally to go through a regulatory approval process, to be available for your doctor to prescribe to you? Not to mention the millions and billions of dollars of funding it takes to go through that process. So why are we discovering unacceptable side effects on half the population after that has gone through? What's happening? Well, it turns out that those cells used in that laboratory, they're male cells, and the animals used in the animal studies were male animals, and the clinical trials have been performed almost exclusively on men.

How is it that the male model became our framework for medical research? Let's look at an example that has been popularized in the media, and it has to do with the sleep aid Ambien. Ambien was released on the market over 20 years ago, and since then, hundreds of millions of prescriptions have been written, primarily to women, because women suffer more sleep disorders than men. But just this past year, the Food and Drug Administration recommended cutting the dose in half for women only, because they just realized that women metabolize the drug at a slower rate than men, causing them to wake up in the morning with more of the active drug in their system. And then they're drowsy and they're getting behind the wheel of the car, and they're at risk for motor vehicle accidents. And I can't help but think, as an emergency physician, how many of my patients that I've cared for over the years that were involved in a motor vehicle accident possibly could have been prevented if this type of analysis was performed and acted upon 20 years ago when this drug was first released. How many other things need to be analyzed by gender? What else are we missing?

World War II changed a lot of things, and one of them was this need to protect people from becoming victims of medical research without informed consent. So some much-needed guidelines or rules were set into place, and part of that was this desire to protect women of childbearing age from entering into any medical research studies. There was fear: what if something happened to the fetus during the study? Who would be responsible? And so the scientists at this time actually thought this was a blessing in disguise, because let's face it—men's bodies are pretty homogeneous. They don't have the constantly fluctuating levels of hormones that could disrupt clean data they could get if they had only men. It was easier. It was cheaper. Not to mention, at this time, there was a general assumption that men and women were alike in every way, apart from their reproductive organs and sex hormones. So, it was decided. Medical research was performed on men, and the results were later applied to women.

What did this do to the notion of women's health? Women's health became synonymous with reproduction: breasts, ovaries, uterus, pregnancy. It's this term we now refer to as "bikini medicine." And this stayed this way until about the 1980s, when this concept was challenged by the medical community and by the public health policymakers when they realized that by excluding women from all medical research studies, we actually did them a disservice, in that apart from reproductive issues, virtually nothing was known about the unique needs of the female patient.

Since that time, an overwhelming amount of evidence has come to light that shows us just how different men and women are in every way. You know, we have this saying in medicine: children are not just little adults. And we say that to remind ourselves that children actually have a different physiology than normal adults. And it's because of this that the medical specialty of pediatrics came to light. And we now conduct research on children in order to improve their lives. And I know the same thing can be said about women. Women are not just men with boobs and tubes. But they have their own anatomy and physiology that deserves to be studied with the same intensity.

Let's take the cardiovascular system, for example. This area in medicine has done the most to try to figure out why it seems men and women have completely different heart attacks. Heart disease is the number one killer for both men and women, but more women die within the first year of having a heart attack than men. Men will complain of crushing chest pain—an elephant is sitting on their chest. And we call this typical. Women have chest pain, too. But more women than men will complain of "just not feeling right," "can't seem to get enough air in," "just so tired lately." And for some reason we call this atypical, even though, as I mentioned, women do make up half the population.

And so, what is some of the evidence to help explain some of these differences? If we look at the anatomy, the blood vessels that surround the heart are smaller in women compared to men, and the way that those blood vessels develop disease is different in women compared to men. And the test that we use to determine if someone is at risk for a heart attack, they were initially designed and tested and perfected in men, and so aren't as good at determining that in women. And then if we think about the medications—common medications that we use, like aspirin. We give aspirin to healthy men to help prevent them from having a heart attack, but do you know that if you give aspirin to a healthy woman, it's actually harmful?

What this is doing is merely telling us that we are scratching the surface. Emergency medicine is a fast-paced business. How many life-saving areas of medicine, like cancer and stroke, are there important differences between men and women that we could be utilizing? Or even, why is it that some people get those runny noses more than others? Or why the pain medication that we give to those stubbed toes work in some and not in others?

The Institute of Medicine has said every cell has a sex. What does this mean? Sex is DNA. Gender is how someone presents themselves in society. And these two may not always match up, as we can see with our transgendered population. But it's important to realize that from the moment of conception, every cell in our bodies—skin, hair, heart and lungs—contains our own unique DNA, and that DNA contains the chromosomes that determine whether we become male or female, man or woman.

It used to be thought that those sex-determining chromosomes pictured here—XY if you're male, XX if you're female—merely determined whether you would be born with ovaries or testes, and it was the sex hormones that those organs produced that were responsible for the differences we see in the opposite sex. But we now know that that theory was wrong—or it's at least a little incomplete. And thankfully, scientists like Dr. Page from the Whitehead Institute, who works on the Y chromosome, and Doctor Yang from UCLA, they have found evidence that tells us that those sex-determining chromosomes that are in every cell in our bodies continue to remain active for our entire lives and could be what's responsible for the differences we see in the dosing of drugs, or why there are differences between men and women in the susceptibility and severity of diseases. This new knowledge is the game-changer, and it's up to those scientists that continue to find that evidence, but it's up to the clinicians to start translating this data at the bedside, today. Right now. And to help do this, I'm a co-founder of a national organization called Sex and Gender Women's Health Collaborative, and we collect all of this data so that it's available for teaching and for patient care. And we're working to bring together the medical educators to the table. That's a big job. It's changing the way medical training has been done since its inception.

But I believe in them. I know they're going to see the value of incorporating the gender lens into the current curriculum. It's about training the future health care providers correctly. And regionally, I'm a co-creator of a division within the Department of Emergency Medicine here at Brown University, called Sex and Gender in Emergency Medicine, and we conduct the research to determine the differences between men and women in emergent conditions, like heart disease and stroke and sepsis and substance abuse, but we also believe that education is paramount.

We've created a 360-degree model of education. We have programs for the doctors, for the nurses, for the students, and for the patients, because this cannot just be left up to the health care leaders. We all have a role in making a difference. But I must warn you: this is not easy. In fact, it's hard. It's essentially changing the way we think about medicine and health and research. It's changing our relationship to the health care system. But there's no going back. We now know just enough to know that we weren't doing it right.
Martin Luther King, Jr. has said, "Change does not roll in on the wheels of inevitability, but comes through continuous struggle." And the first step towards change is awareness. This is not just about improving medical care for women. This is about personalized, individualized health care for everyone. This awareness has the power to transform medical care for men and women. And from now on, I want you to ask your doctors whether the treatments you are receiving are specific to your sex and gender. They may not know the answer—yet. But the conversation has begun, and together we can all learn. Remember, for me and my colleagues in this field, your sex and gender matter.

Thank you.

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