学术英语(医学)课后问题答案_第1页
学术英语(医学)课后问题答案_第2页
学术英语(医学)课后问题答案_第3页
学术英语(医学)课后问题答案_第4页
学术英语(医学)课后问题答案_第5页
已阅读5页,还剩45页未读 继续免费阅读

下载本文档

版权说明:本文档由用户提供并上传,收益归属内容提供方,若内容存在侵权,请进行举报或认领

文档简介

学术英语(医学)课后问题答案学术英语(医学)课后问题答案学术英语(医学)课后问题答案学术英语(医学)课后问题答案编制仅供参考审核批准生效日期地址:电话:传真:邮编: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—requesttheformsignedbyherdoctor.·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.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.Unit3Terry'slifebefore·ShelovedpracticingTaeKwonDo·Shelovedthesurgeofadrenalinethatcamewiththecontrolledcombatoftournaments.·Shecompetednationally,evenwonbronzemedalinthetrialsforthePanAmericanGames.·Sheattendedmedicalschool,practicedasaninternalmedicineresident,andbecameanacademicgeneralinternist.·Shegotmarriedandgotasonandadaughter.2、ThesymptomsofMSandautoimmunedisease:·Lossofstaminaandstrength·Problemswithbalance·Boutsofhorrificfacialpain·Dipsinvisualacuity3、Terrydidthefollowingbeforesheself-experimented:·Shestartedinjections.·Sheadoptedmanypharmacotherapies.·Shebeganherownstudyofliterature:»ShereadarticlesonwebsitessuchasPubMed.»ShesearchedforarticlestestingnewMSdrugsinanimalmodels.»Sheturnedtoarticlesconcerningneurodegenerationofalltypes—dementiaParkinson'sdisease,Huntington'sdisease,andLouGehrig'sdisease.»Sherelearnedbasicsciencessuchascellularphysiology,biochemistry,andneurophysiology.4、ApproachesTerrymainlyused:·Self-experimentationwithvariousnutrientstoslowneurodegenerationbasedonliteraturereportsonanimalmodels·Self-experimentationwithneuromuscularelectricalstimulationwhichisnotanapprovedtreatmentforMS·Onlinesearchtoidentifythesourcesofmicronutrientsandhavinganewdiet·Reductionoffoodallergiesandtoxicload5、Casesmentionedinthetext:·Increasedmercurystoresinthebrainsofpeoplewithdentalfillings·HighlevelsoftheherbicideatrazineinprivatewellsinIowa·Thestrongassociationbetweenpesticideexposureandneurodegeneration·Theassociationofsinglenucleotidepolymorphismsinvolvingmetabolismofsulfurand/orBvitamins·InefficientclearingoftoxinsWith70%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.·CometotermswiththetoxicemotionsUnit6Inthepast,mostpeoplediedathome.Butnow,moreandmorepeoplearecaredinhospitalsandnursinghomesattheirendoflife,whichofcoursebringsanewsetofquestionstoconsider.·Sixty-fouryearsoldwithahistoryofcongestiveheartfailure·Decidingtodoeverythingmedicallypossibletoextendhislife·Availabilityofaround-the-clockmedicalservicesandafullrangeoftreatmentchoices,tests,andothermedicalcare·Relaxedvisitinghours,andpersonalitemsfromhomeAvailabilityofaround-the-clockmedicalresources,includingdoctors,nurses,andfacility.·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.Doctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression.·Shoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionsontheirown.·Balancingbetweenpaternalismandrespectforpatientsautonomyconstitutesalargepartofmedicalpractice.Unit81、·Research:Anactivitytotesthypothesis,topermitconclusionstobedrawn,a

温馨提示

  • 1. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
  • 2. 本站的文档不包含任何第三方提供的附件图纸等,如果需要附件,请联系上传者。文件的所有权益归上传用户所有。
  • 3. 本站RAR压缩包中若带图纸,网页内容里面会有图纸预览,若没有图纸预览就没有图纸。
  • 4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
  • 5. 人人文库网仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对用户上传分享的文档内容本身不做任何修改或编辑,并不能对任何下载内容负责。
  • 6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
  • 7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。

评论

0/150

提交评论