學(xué)術(shù)英語(yǔ)(醫(yī)學(xué))課后問(wèn)題答案

Unit11、Somefactorsthatmayleadtothecomplaint:·Neuronoverload·Patients*highexpectations·Mistrustandmisunderstandingbetweenthepatientandthedoctor2、Mrs.Osorio’scondition:·A56-year-oldwoman·Somewhatoverweight·Reasonablywell-controlleddiabetesandhypertension·Cholesterolonthehighsidewithoutanymedicationsforit·Notenoughexercisessheshouldtake·HerbonesalittlethinonherlastDEXAscan3、Goodthings:·Bloodtestsdone·Glucosealittlebetter·HerbloodpressurealittlebetterbutnotsogreatBadthings:·Cholesterolnotsogreat·Herweightalittleup·HerbonesalittlethinonherlastDEXAscan44、Thesituation:·Theauthorwasinamoderatestateofpanic:jugglingsomanythoughtsaboutMrs.Osorio’sconditionsandtryingtoresolvethemallbeforetheclockrandown.·Mrs.Osoriomadeatrivialrequest,notsoimportantascomparedtoherconditions.·Mrs.Osorioseemedtocareonlyabouther“innocent—andcompletelyjustified—request”：theformsignedbyherdoctor.·Thedoctortriedtooratleastpretendedtopayattentiontothepatientwhilecompletingdocumentation.5、Similarities:·Incomputermultitasking,amicroprocessoractuallyperformsonlyonetaskatatime.Likemicroprocessors,wehumanbeingscarftactuallyconcentrateontwothoughtsatthesameexacttime.Multitaskingisjustanillusionbothincomputersandhumanbeings.Differences:·Theconceptofmultitaskingoriginatedincomputerscience.·Atbest,humanbeingscanjuggleonlyahandfulofthoughtsinamultitaskingmanner,butcomputerscandomuchbetter.·Themorethoughtshumanbeingsjuggle,thelesshumanbeingsareabletoattunefullytoanygiventhought,butcomputerscandomuchbetter.6、·7medicalissuestoconsider·5separatethoughts,atleast,foreachissue·7x5=35thoughts·10patientsthatafternoon·35x10=350thoughts·5residentsundertheauthorssupervision·4patientsseenbyeachresident·10thoughts,atleast,generatedfromeachpatient·5x4x10=anther200thoughts·350+200=550thoughtstobehandledintotal·Ifthedoctordoesagoodjobjuggling98%ofthetime,thatstillleavesabout10thoughtsthatmightgetlostintheprocess.7、Possiblesolutions:·Computer-generatedreminders·Casemanagers·Ancillaryservices·Thesimplestsolution:timeUnit21、Theauthorimplies:?Peoplesinadequateconsciousnessabouttheconsequenceofneglectingthere-emerginginfectiousdiseases·Unjustifiabilityofpeoplescomplacencyaboutthepreventionandcontroloftheinfectiousdiseases·Unfinishedwaragainstinfectiousdiseases2、Victorydeclarations:·SurgeonGeneralWilliamStewart'shyperbolicstatementofclosing“thebookoninfectiousdisease”.·Astringofimpressivevictoriesincurredbyantibioticsandvaccines·ThethoughtthatthewaragainstinfectiousdiseaseswasalmostoverWhatfollowedeversince:·AppearanceofnewdiseasessuchasAIDSandEbola·Comebackoftheoldafflictions:?DiphtheriaintheformerSovietUnion?TBinurbancenterslikeNewYorkCity?RisingGroupAstreptococcalconditionslikescarletfever·Thefearofapowerfulnewflustrainsweepingtheworld3、Elaborateonthejoinedbattle:·WHOestablishedanewdivisiondevotedtoworldwidesurveillanceandcontrolofemergingdiseaseinOctober1995.·CDClaunchedapreventionstrategyin1994.·Congressraisedfundfrom$6.7millionin1995to$26millionin1997.4、Thebordersaremeaninglesstopathogenicmicrobes,whichcantravelfromonecountrytoanotherremotecountryinaveryshorttime.5、TB:·PrisonsandhomelesssheltersasidealplacesforTBspread·Emergingofdrug-resistantstrainorevenmulti-drug-resistantstrain·ArideontheHIVw^onbyattackingtheimmunocompromisedGroupAstrep:·Achangeinvirulence·MutationintheexteriorofthebacteriumFlu:Constantchangesinitscoat(surfaceantigens)andresultantchangesinitslevelofvirulence6、Examples:·ExperimentinEnglandisseeingthewaningimmunitybecauseofnovaccination.·Duetopoorvaccinationefforts,thediphtheriasituationintheformerSovietUnionisserious.'?ThevaccinationratesaredroppinginsomeAmericancities,anditwillleadtomorediphtheriaandwhoopingcough.7、Thefourareasoffocus:·Theneedforsurveillance·Updatedsciencecapableofdealingwithdiscoveriesinthefield·Appropriatepreventionandcontrol·Strongpublichealthinfrastructure8、TheinfectiousdiseasessuchasTB,flu,diphtheriaandscarletfeverwillneverreallygoaway,andthewaragainstthemwillneverend.Unit31、Terry'slifebefore·ShelovedpracticingTaeKwonDo·Shelovedthesurgeofadrenalinethatcamewiththecontrolledcombatoftournaments.·Shecompetednationally,evenwonbronzemedalinthetrialsforthePanAmericanGames.·Sheattendedmedicalschool,practicedasaninternalmedicineresident,andbecameanacademicgeneralinternist.·Shegotmarriedandgotasonandadaughter.2、ThesymptomsofMSandautoimmunedisease:·Lossofstaminaandstrength·Problemswithbalance·Boutsofhorrificfacialpain·Dipsinvisualacuity3、Terrydidthefollowingbeforesheself-experimented:·Shestartedinjections.·Sheadoptedmanypharmacotherapies.·Shebeganherownstudyofliterature:?ShereadarticlesonwebsitessuchasPubMed.?ShesearchedforarticlestestingnewMSdrugsinanimalmodels.?Sheturnedtoarticlesconcerningneurodegenerationofalltypes—dementia，Parkinson'sdisease,Huntington'sdisease,andLouGehrig'sdisease.?Sherelearnedbasicsciencessuchascellularphysiology,biochemistry,andneurophysiology.4、ApproachesTerrymainlyused:·Self-experimentationwithvariousnutrientstoslowneurodegenerationbasedonliteraturereportsonanimalmodels·Self-experimentationwithneuromuscularelectricalstimulationwhichisnotanapprovedtreatmentforMS·Onlinesearchtoidentifythesourcesofmicronutrientsandhavinganewdiet·Reductionoffoodallergiesandtoxicload5、Casesmentionedinthetext:·Increasedmercurystoresinthebrainsofpeoplewithdentalfillings·HighlevelsoftheherbicideatrazineinprivatewellsinIowa·Thestrongassociationbetweenpesticideexposureandneurodegeneration·Theassociationofsinglenucleotidepolymorphismsinvolvingmetabolismofsulfurand/orBvitamins·Inefficientclearingoftoxins6、With70%to90%oftheriskfordiabetes,heartdisease,cancer,andautoimmunitybeingduetoenvironmentalfactorsotherthanthegenes,wecantakemanyhealthproblemsandthehealthcarecrisisunderourcontrol,forexample,optimizingournutritionandreducingourtoxicload.Unit41、Twoconcepts:·Complementarymedicinereferstotheuseofconventionaltherapiestogetherwithalternativetreatmentssuchasusingacupunctureinadditiontousualcaretohelplessenpain.ComplementaryandalternativemedicineisshortenedasCAM.·Alternativemedicinereferstohealingtreatmentsthatarenotpartofconventionaltherapies—likeacupuncture,massagetherapy,orherbalmedicine.Theyarecalledsobecausepeopleusedtoconsiderpracticesliketheseoutsidethemainstream.2·TCMdoesnotrequireadvanced,complicated,andinmostcases,expensivefacilities.·TCMemploysneedles,cups,coins,tomentionbutafew.·MostproceduresandoperationsofTCMarenoninvasive.·Thesubstancesusedasmedicinearerawherbsorabstractsfromthem,andtheyareindeedallnatural,fromnature.·TCMhasbeenpracticedaslongastheChinesehistory,sotheefficiencyisprovenandensured.·Ongoingresearcharoundtheworldonacupuncture,herbs,massageandTaiChihaveshedlightonsomeofthetheoriesandpracticesofTCM3、Itmaybeusedasanadjuncttreatment,analternative,orpartofacomprehensivemanagementprogramforanumberofconditions:post-operativeandchemotherapyinducednauseaandvomiting,post-operativedentalpain,addiction,strokerehabilitation,headache,menstrualcramps,tenniselbow,fibromyalgia,myofascialpain,osteoarthritis,lowbackpain,carpaltunnelsyndrome,andasthma.4、Awell-justifiedNO:·Moreintenseresearchtouncoveradditionalareasfortheuseofacupuncture·Higheradoptionofacupunctureasacommontherapeuticmodalitynotonlyintreatmentbutalsoinpreventionofdiseaseandpromotionofwellness·Explorationandperfectionofinnovativemethodsofacupuncturepointstimulationwithtechnologicaladvancement·Improvedunderstandingofneuroscienceandotheraspectsofhumanphysiologyandfunctionbybasicresearchonacupuncture·Greaterinterestbystakeholders·Anincreasingnumberofphysicianacupuncturists5、·Appropriateusesofherbsdependonproperguidance:?ProperTCMdiagnosisofthezhengofthepatient?Correctselectionofthecorrespondingtherapeuticstrategiesandprinciplesthatguidethechoiceofherbsandherbalformulas·Digressionfromeitheroftheaboveguidencewillleadtomisusesofherbs,andwillresultincomplicationsinpatient6、·RandomizedcontrolledtrialsAdvantages:?Eliminationofthepotentialbiasintheallocationofparticipantstotheinterventiongrouporcontrolgroup?Tendencytoproducecomparablegroups?GuaranteedvalidityofstatisticaltestsofsignificanceLimitations:?Difficultyingeneralizingtheresultsobtainedfromtheselectedsamplingtothepopulationasawhole?Apoorchoiceforresearchwheretemporalfactorsareanissue?Extremelyheavyresources,requiringverylargesamplegroups?Quasi-experimentsAdvantages:?Controlgroupcomparisonspossible?Reducedthreatstoexternalvalidityasnaturalenvironmentsdonotsufferthesameproblemsofartificialityascomparedtoawell-controlledlaboratorysetting.?GeneralizationsofthefindingstobemadeaboutpopulationsincequasiexperimentsarenaturalexperimentsLimitations：?Potentialfornon-equivalentgroupsasquasi-experimentaldesignsdonotuserandomsamplinginconstructingexperimentalandcontrolgroups.?Potentialforlowinternalvalidityasaresultofnotusingrandomsamplingmethodstoconstructtheexperimentalandcontrolgroups?CohortstudiesAdvantages:?Clearindicationofthetemporalsequencebetweenexposureandoutcome?Particularuseforevaluatingtheeffectsofrareorunusualexposure?AbilitytoexaminemultipleoutcomesofasingleriskfactorLimitations:?Larger,longer,andmoreexpensive?Pronetocertaintypesofbias?Notpracticalforrareoutcomes?Case-controlstudiesAdvantages:?Theonlyfeasiblemethodinthecaseofrarediseasesandthosewithlongperiodsbetweenexposureandoutcome?TimeandcosteffectivewithrelativelyfewersubjectsascomparedtootherobservationalmethodsLimitations：?Unabletoprovidethesamelevelofevidenceasrandomizedcontrolledtrialsasitisobservationalinnature?Difficulttoestablishthetimelineofexposuretodiseaseoutcome?“N=1”trialsAdvantages?Easytomanage?InexpensiveLimitations：?Findingsdifficulttobegeneralizedtothewholepopulation?Weakestevidenceduetothenumberofthesubject7、?Synthesisofevidenceiscompletelydependenton:?Thecompletenessoftheliteraturesearch(unavailableforforeignstudies)?Theaccuracyofevaluation·TherearesituationsinwhichnoanswercanbefoundforthequestionsofinterestinRCTsanddatabaseanalyses.·There'stherequirementofusinglessstringentinformationratherthan“harddata”8、·Assessmentoftheintrinsicvalueoftraditionalmedicineinsociety·Researchandeducation·Political,economic,andsocialfactorsUnit51、·Dis-easereferstotheimbalancearisingfrom：?Continuousstress?Pain?Hardships·Diseaseisahealthcrisisascribabletovariousdis-eases.·Promptingeliminationofdis-easescanalleviatesomediseases.2、·Wellnessisastateinvolvingeveryaspectofourbeing:body,mindandspirit.·Manifestationsofahealthyperson:?Energyandvitality?Acertainzipingait?Awarmfeelingofpeaceofheartseenthroughbehavior3、·Constantmessages,positiveandnegative，aresenttoourmindaboutthehealthofourbody.·Physicalsymptomsaresuppressedbypeoplewhogothroughlifeonautomaticpilot.·Beingwellequalstobeingdisease-orillness-freeinthemindsofthem.·Theyconfusedwellnesswithanabsenceofsymptoms.4、·People'smindsareinfectedbyspin:?Half-truth?Fearfulfictions?Blatantdeceit:someasaformofself-deceit·Spinisaresultofunconsciousliving.·Thekindoffalsenessispandemic.5·Ourbodyintelligenceissuppressedordormantfromalackofuse.·Therearetremendousamountofstressonadailybasis.·Ourbodiesareeasilyignoredforyearsbecauseofalackofrecreationtime.·Limiting,self-defeatingandevenself-destructivebehaviorsundermineourwellbeingandkeepthemfromachievingourfullpotential.6·Wegrowmorereluctanttotakerisks.·Welosetheabilitytofeelandacknowledgeourdeepestfeelingsandthecouragetospeakourtruth.·Wecontinuetodenyandrepressourfeelingstoprotectourselves.·Fear,denialanddisconnectionfromourbodiesandfeelingsbecomeanunconscious,self-protectivehabit,akindofdefaultresponsetolife.7·Amulti-facetedprocess:?Lookingforrootsofandresolutionsfortheissuesindifferentdimensions?Buildingourwellnesstoolboxslowly?Picturingourwholestateofbeing·Attentiontothelittlestuff:?Examiningourliveshonestlyandsettingclearintentionstochange?Strivingtomaintainabalanceofourmind,bodyandspirit?Takingsmallstepsinthewaytoperceiveandresolveconflict8·Trytoawakenandevolveinordertolivemoreconsciously.·Getintouchwithourgenuinefeelingsandemotions.·CometotermswiththetoxicemotionsUnit61、Inthepast,mostpeoplediedathome.Butnow,moreandmorepeoplearecaredinhospitalsandnursinghomesattheirendoflife,whichofcoursebringsanewsetofquestionstoconsider.2、·Sixty-fouryearsoldwithahistoryofcongestiveheartfailure·Decidingtodoeverythingmedicallypossibletoextendhislife·Availabilityofaround-the-clockmedicalservicesandafullrangeoftreatmentchoices,tests,andothermedicalcare·Relaxedvisitinghours,andpersonalitemsfromhome3、Availabilityofaround-the-clockmedicalresources,includingdoctors,nurses,andfacility.4、·Takingonajobwhichisbigphysically,emotionally,andfinancially·Hiringahomenurseforadditionalhelp·Arrangingforservices(suchasvisitingnurses)andspecialequipment(likeahospitalbedorbedsidecommode)5、·Healthinsurance·Planningbyaprofessional,suchasahospitaldischargeplaimerorasocialworker·Helpfromlocalgovernmentalagencies·Doctor'ssupervisionathome6、·Traditionally,itisonlyaboutsymptomcare.·Recently,itisacomprehensiveapproachtoimprovingthequalityoflifeforpeoplewhoarelivingwithpotentiallyfataldiseases.7、·Stoppingtreatmentspecificallyaimedatcuringanillnessequalsdiscontinuingalltreatment.·Choosingahospiceisapermanentdecision.Unit71、·Adyingpatient·Decisionwhethertowithdrawlife-supportmachinesandmedicationandstartcomfortmeasures·Thefamily'srefusaltomakeanydecisionorwithdrawanytreatments2、·Thedoctorasexclusivedecision-maker·Thepatientasparticipantwithlittlesayinthefinalchoice3、·Respectforthepatient,especiallythepatientsautonomy·Patient-centeredcare·Thepatientasdecision-makerbasedontheinformationprovidedbythedoctor4、·Patientsareforcedtomakedecisionstheyneverwantto.·Patients,atleastalargemajorityofthem,prefertheirdoctorstomakefinaldecisions.·Shiftingresponsibilityofdecision-makingtopatientswillbringaboutmorestresstopatientsandtheirfamilies,especiallywhenthebestoptionforthepatientisuncertain.5、Doctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression.6、·Shoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionsontheirown.·Balancingbetweenpaternalismandrespectforpatientsautonomyconstitutesalargepartofmedicalpractice.Unit81、·Research:Anactivitytotesthypothesis,topermitconclusionstobedrawn,andthereby