欧宝娱乐

Drinking artificially "activates" the brain's reward system....increasing the release of the neurotransmitter dopamine which is central to feelings of pleasure and reward. Over time...the brain develops what are known as "compensatory adaptations"to all the artificial revving up: in an effort to bring its own chemistry back into its natural equilibrium, it works overtime to decrease dopamine, ultimately leaving those same pleasure/reward circuits depleted. A vicious cycle ensues: by drinking too much, you basically diminish your brain's ability to manufacture feelings of well-being and calm on its own, and you come to depend increasingly on the artificial stimulus - alcohol - to produce those feelings.

"One of the most commonly cited statistics on recidivism comes from the Course of Alcoholism: Four Years after Treatment, a January 1980 report by the Rand Corporation and the most extensive and comprehensive study of its kind today. This study tracked a group of 900 alcoholic men over a period of 4 years. Of those, only 28% remained free of alcohol problems both at 18 months and at 4 years after entering treatment; only 15% were in continuous remission for the entire 4 years. Once you've crossed the line into alcoholism, the percentages are not in your favour; there appears to be no safe way to drink again, no way to return to normal, socially controlled drinking."

Cited as the most frequent bad listening behaviours

*Interrupting
*Responding vaguely or illogically to what was just said.
*Looking at a phone, watch, looking around the room, or otherwise away from the speaker.
*Fidgeting (tapping on the table, frequently shifting position, clicking a pen, etc)



Foetuses can recognise human voices

We begin to listen even before we are born. Foetuses respond to sound at just sixteen weeks' gestation and, during the last trimester of pregnancy, can clearly distinguish between language and other sounds. An unborn child can be soothed by a friendly voice and startled by an angry outburst.

Attachment Theory

If we don't attach well with our carers when we are babies, we can form dysfunctional attachments not only as children, but also when we are older.

Our ability to listen and connect with people as adults is shaped by how well our parents listened and connected with us as children.

Attentive and responsive care givers set you up to have a secure attachment style, which is characterised by an ability to listen empathetically and this for functional, meaningful and mutually supportive relationship.

On the other hand, children whose parents were not dependably attentive typically grow up to be adults with an insecure anxious attachment style, which means they tend to worry and obsess about relationships. They do not listen well because they are so concerned about losing people's attention and affection. This preoccupation can lead them to be overly dramatic, boastful, or clingy. They might also pester people, rather than allowing them to have their space.

An insecure avoidant attachment style comes from growing up with care givers who were mostly inattentive - or perhaps overly attentive, to the point of smothering. People raised this way are often bad listeners because they tend to shut down or leave relationships whenever things get too close. They resist listening because they don't want to be disappointed or overwhelmed.

Finally people who have an insecure disorganised attachment style display both anxious and avoidant behaviours in an illogical and erratic manner. This is often the result of growing up with a care giver who was threatening or abusive. Intimacy can feel scary or frightening.

Of course not everyone fits neatly into one of these categories . Most people land somewhere along a continuum from secure to insecure.

Several programmes have emerged in the last decade to teach parents of young children how to listen and respond to their babies and toddlers, before dysfunctional neural patterns get grooved into their developing brains.

To listen well

To listen well is to figure out what's on someone's mind and demonstrate that you care enough to want to know.

Listening is not about teaching, shaping, critiquing, appraising or showing how it should be done.

Listening requires, more than anything, curiosity.

In How to Win Friends and Influence People, Dale Carnegie wrote, "You can make more friends in two months by becoming interested in other people that you can in two years by trying to get other people interested in you"

While you might think you'd be more likely to listen to a loved one than a stranger, in fact, the opposite is often true.

Things that help us talk to people.

The person shows interest.
They ask the right questions.
They were less judging
They didn't interrupt.

We are more open with people we don't know well

In an in-depth study of a cohort of 38 graduate students and confirmed in a large online survey of 2,000 people representative of all Americans, Harvard sociologist Mario Luis Small found that slightly more than half the time, people confided their most pressing worrisome concerns to people with whom they had weaker ties, even people they encountered by chance, rather than to those they had previously said were closest to them - like a spouse, family member or dear friend. In some cases, the subjects actively avoided telling the people in their innermost circle because they feared unkindness, judgement, blowback or drama.

The Closeness Communication bias

Also people in long term relationships tend to lose their curiosity about one another. They become convinced that they know the other person better than they do. They don't listen, because they think they know what the other person will say. This is called The Closeness Communication bias.

Nurturing Relationships

One of the most widely cited researchers on the topic of human relations is British anthropologist and evolutionary psychologist Robin Dunbar. He says that a primary way we maintain friendships is through "everyday talk" That means asking "How are you?" and actually listening to the answer. Dunbar stresses that there are hierarchical layers of friendship determined by how much time you spend with the person. Without consistent contact, friendships can easily fall into the realm of acquaintance. At this point, you are friendly, but not really friends, because you've lost touch with who they are, which is always evolving. An exception might be friends with whom you feel like you can pick up right where you left off, even though you haven't talked to them for ages. According to Dunbar, these are usually friendship forged through extensive and deep listening at some point in your life, usually during an emotionally wrought time, like a personal crisis.

Prying

Prying is the the quickest way to lose someone's confidence. In Notes from Underground, Fyodor Dostoyevsky wrote, "Every man has some reminiscences which he would not tell to everyone but only to his friends. He has other which he would not reveal even to his friends, but only to himself, and that in secret. But finally there are still others which a man is even afraid to tell himself, and every decent man has a considerable number of such things stored away"

We never understand one another fully

Daniel Flores, a Roman Catholic bishop in Texas, believes that expecting complete understanding is the root of many troubled relationships. "We all long to express ourselves to another, but if we thing there will be the perfect person who will be able to receive it all, we will be disappointed. Not that we shouldn't always try to communicate and give one another the gift of listening, for that is love, even if we aren't always able to understand.

Reflecting/paraphrasing is not enough, we need to display understanding

Research by Graham Bodie, a professor of integrated marketing communication at the University of Mississippi, shows that people are more likely to feel understood if a listener responds not by nodding, parroting, or paraphrasing, but by giving descriptive and evaluative information. Contrary to the idea that effective listening is some sort of passive exercise, Bodie's work reveals it requires interpretation and interplay. We want someone to respond in a thoughtful, feeling way. People want to the sense you get why they are telling you the story and what it means to them.

Active listening goes beyond just listening to the facts. You want to pick up the mood of the person who is speaking, how they feel about what they are saying.

You already know about you.
You miss out on opportunities when you don't take a breath and listen. Talking about yourself doesn't add anything to your knowledge base. You already know about you.

3 Questions to ask yourself after a conversation

When you leave a conversation ask yourself:
* What did I just learn about that person?
* What was most concerning to that person today?
* How did that person feel about what we were talking about?
If you can't answer those questions, you probably need to work on your listening.

Keep an open mind. You may be wrong

Disagreements and sharp differences of opinion are inevitable in life whether they are over political ideology, ethical issues, business dealings, or personal matters. When engaged in any kind of dispute, the father of listening studies, Ralph Nichols, advised listening for evidence that you might be wrong rather than listening to poke hole in the other person's argument, much less plugging your ears or cutting someone out of your life entirely. If you remain open to the possibility that you might be wrong, or at least not entirely right, you'll get far more out of the conversation.

This approach is backed up by science. The amygdala in our brain is what activates when we sense a threat, and the more the amygdala is activated the less we are able to listen. It also clouds judgement, rendering us unthinking and irrational.

To listen doesn't mean you agree with someone. It simply means you accept the legitimacy of the other person's point of view, and that you might have something to learn from it. It also means that you embrace the possibility that there might be multiple truths and understanding them might lead to a larger truth.

* At one car factory in India 580 robots produce one complete motor care every 30 seconds!

* The 'ASUS Zenbo' is a 62cm tall personal bot which trundles around your home, switching lights off, streaming video calls and performing other simple tasks. Its *face* is a touchscreen depicting a face with a range of 24 different emotions. :O)*

* A robot coffee-maker called Ella, can work 5 times faster than a human barista, making up to 15 different coffees and recognising regular customer's faces - AND recalling their favourite hot drink.

* The PRECEYES Surgical System helps surgeons work inside the human eye, to reattach retinas and perform other operations with incredible precision. The robot moves the surgical tools to within 0.02mm - just 1/4 the width of a human hair.

* A Robot-Rx can dispense 6,000 - 7,000 prescriptions a day, saving human pharmacists 90% of their time.

*Some wards of the Covid-19 field hospital in Wuhan were largely staffed by robots, which took temperatures, instructed patients, delivered medicine and food and sprayed disinfectant.

*Japan has three troops of 32 cheerleading robots called 'Murata', capable of performing choreographed routines. They use gyroscopic sensors to stay balanced and upright.

*Sony's AIBO robot dog comes with a bone it will hunt for, a ball to play with, and the ability to learn lots of new tricks. It can also patrol a home as a security guard, seeking out faces it recognises and those it doesn't. It recognises more than 50 voice commands.

* Robotic exoskeletons are just one of the robots used to help people during rehabilitation from injury or illness. They can support a patient's weight and assist their movement until they can build up the strength to do exercises fully for themselves. This can help patients strengthen their muscles, or improve their heart and lung fitness.

* In 2018 the Smithsonian started using robots as tour guides. They lead visitors around the exhibits, answering questions and providing commentaries. During Covid, some robots travelled around closed galleries and museums, providing filmed tours which people could stream and enjoy from home.

* PARO is a robot modelled on a baby harp seal, and is used to provide company for elderly people who suffer with loneliness or anxiety. It moves its head and flippers, blinks and makes facial expressions and sounds to provide company and comfort. Sensors embedded in its fur react to touch. In 2018 there were 5,000 in use, 3,000 of them in Japan.

* The most popular robots in the world are Roomba vacuum cleaners and Braava robot floor moppers.

(Linear accelerators) are triumphs of physical science and high-tech engineering, which have taken decades and thousands of scientists and engineers to create. A magnetron - just as in your microwave oven-generates radio frequency waves (streams of photons). An electrongun (usually a heated tungsten filament) fires electrons down 'the wave-guide' - a long tube which lies within the radiofrequency waves. The electrons, steered by surrounding magnets, surf the waves, and are accelerated close to the speed of light to slam into a tungsten target. The target spits out photons as the high-speed electrons react with the tungsten atoms. The photons are then filtered and focused and shaped into a narrow beam, like the light from a torch, and fired into the cancer (and whatever else surrounds it.) By firing the photon beam in a rotating arc, and modulating its intensity, as well as its shape, a high dose of X-rays is delivered to the tumour and a relatively low dose to the surrounding body.

Children and language

The brain is sculpted by experience, cutting away connections that are not being used. Until the age of two, for instance, children in all cultures can discriminate between all the basic sounds of all languages, but from then on, they can only recognise the phonemes of their mother tongue.

Compassion

After I had been diagnosed with advanced prostate cancer and became a patient myself, I was surprised to keep on remembering more and more patients whom I had completely forgotten - some were cases going back more than thirty years. Now that I was so anxious and unhappy, feeling abandoned, I realised how anxious and unhappy so many of my patients must have been, and yet how I had chosen to turn a blind eye to this. My former patients became reproachful ghosts who came to punish me....I thought of how I would be a much better doctor if I could start all over again. How I would be full of the compassion and understanding that I lacked when I was younger. But would this then leave me unable to enter the operating theatre, pull on my gloves, and cut into my patients' heads? I simply don't know, although I do know that the arthritis I am starting to suffer from in my hands makes it all a nonsense anyway.....

As a doctor, you could not do the work if you were truly empathetic..... Empathy, like exercise, is hard work, and it is normal and natural to avoid it. You have to practise instead a limited form of compassion, without losing your humanity in the process. While I was still working, I thought that I had achieved it, but now, looking back, and as a patient myself, I was full of doubt."

Mistakes

He mentions the time he operated on the problem of a trapped nerve, but he operated on the wrong side of the man's neck. The man was incredibly understanding and said he understood, he installed kitchens for people and said he knew how easy it was to make a mistake. Marsh ends by saying that nowadays the pressure on him to lie would have been far greater, as if the mistake had happened today he would probably have been dismissed. (He also says that this happened in the time before the introduction of checklists, although in this instance that probably wouldn't have helped.)

Surgeons and experience

Marsh stresses that the question we need to find out about surgeons doing our operations is how experienced they are in doing these types of procedures.

The Private Finance Initiative

"The building was built under the private finance initiative (PFI), and it was owned by a private, highly profitable company that rented the building to the NHS. PFI was supposed to be a cheaper and more efficient way of building hospitals and schools than direct government funding, but as many warned at the time, the opposite was true. PFI was a con, little short of an economic crime, for which nobody has been held to account."

The pleasures of working in a small hospital

He writes about the pleasure he had working in a small hospital - Atkinson Morley's Hospital in Wimbledon. "It had tall ceilings and high windows, the emphasis being on fresh air and light. It was built before hospitals became machines for healing, and when Wimbledon was still surrounded by fields and gardens. The hospital had its own stables, and laundry and staff residences. When I worked there it was only three stories high, and it had a staff of fewer than 200. It was built on a human scale. I knew all the staff - not just the other doctors, but the nurses, the physios, the porters and the cleaners. I think all of us, at all levels, had a real sense of belonging and personal responsibility for what happened to our patients. The hospital was famously efficient - I would get through three or four major surgical cases a day, something unimaginable now.

We are tribal animals - we are happiest in relatively small groups."


FreeWill

Given that nerve cells act over space and time, perhaps we should not be surprised that scientific experiments show some strange effects. Some of the earliest, and most famous, were Benjamin Libet's experiments in America in the 1980s. These showed (and have been confirmed subsequently many times) that the conscious decision to move your hand comes a few milliseconds after electrical activation of the brain's hand area, as revealed by electrodes placed over the scalp. Libet's experiments have inevitably added to the already excessive literature about 'freewill'.....
Studies have shown that a remarkably high proportion of violent offenders in prison have a history of previous head injury, or an abusive childhood, or both. In my work I often saw patients with physical brain damage, typically to the frontal lobes from accidental trauma. This often causes personality change, almost invariably for the worse. They were almost always unaware of this themselves, but it could be quite terrible for their families. Such experiences make it very hard indeed to believe that thought and feeling, and consciousness itself, are not generated by physical processes in our brains. Free will might be a legal necessity for an ordered society, but it is an illusion. Our decisions are determined by our past..... But that doesn't mean that pain isn't painful, or that difficult decisions are not difficult. It just means we don't understand how our brains work.

AI
I am not worried about super-intelligent AI in some way replacing us in the foreseeable future, although it may well render large numbers of people unemployed. (Most economists argue that this does not usually happen with the introduction of new labour-saving technology, and instead new jobs are created.) But I am deeply worried about the way AI will be used in a malign way by my fellow human beings, and especially by despotic governments. The loss of anonymity, for instance, that comes with omnipresent CCTV and facial-recognition software puts enormous power in the hands of a few people.

Establishing trust with your patients

You should always be seated.
You should never appear to be in a hurry.

The curse of good medicine

Although scientific medicine has brought great and wonderful blessings, it has also brought a curse - dying, for many of us, has become a prolonged experience, even if severe pain is now only rarely a problem.