學(xué)術(shù)英語(醫(yī)學(xué))課后問題答案

Unit1

1、Somefactorsthatmayleadtothecomplaint:

·Neuronoverload

·Patients*highexpectations

·Mistrustandmisunderstandingbetweenthepatientandthedoctor

2、Mrs.Osorio’scondition:

·A56-year-oldwoman

·Somewhatoverweight

·Reasonablywell-controlleddiabetesandhypertension

·Cholesterolonthehighsidewithoutanymedicationsforit

·Notenoughexercisessheshouldtake

·HerbonesalittlethinonherlastDEXAscan

3、Goodthings:

·Bloodtestsdone

·Glucosealittlebetter

·HerbloodpressurealittlebetterbutnotsogreatBadthings:

·Cholesterolnotsogreat

·Herweightalittleup

·HerbonesalittlethinonherlastDEXAscan4

4、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

3、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

·Reductionoffoodallergiesandtoxicload

5、Casesmentionedinthetext:

·Increasedmercurystoresinthebrainsofpeoplewithdentalfillings

·HighlevelsoftheherbicideatrazineinprivatewellsinIowa

·Thestrongassociationbetweenpesticideexposureandneurodegeneration

·Theassociationofsinglenucleotidepolymorphismsinvolvingmetabolismofsulfurand/orBvitamins

·Inefficientclearingoftoxins

With70%to90%oftheriskfordiabetes,heartdisease,cancer,andautoimmunitybeingduetoenvironmentalfactorsotherthanthegenes,wecantakemanyhealthproblemsandthehealthcarecrisisunderourcontrol,forexample,optimizingournutritionandreducingourtoxicload.

Unit4

1、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,massageandTaiChihaveshedlightonsomeofthetheoriesandpracticesofTCM

3、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

·Anincreasingnumberofphysicianacupuncturists

5、

·Appropriateusesofherbsdependonproperguidance:

?ProperTCMdiagnosisofthezhengofthepatient

?Correctselectionofthecorrespondingtherapeuticstrategiesandprinciplesthatguidethechoiceofherbsandherbalformulas

·Digressionfromeitheroftheaboveguidencewillleadtomisusesofherbs,andwillresultincomplicationsinpatient

6、

·Randomizedcontrolledtrials

Advantages:

?Eliminationofthepotentialbiasintheallocationofparticipantstotheinterventiongrouporcontrolgroup

?Tendencytoproducecomparablegroups

?Guaranteedvalidityofstatisticaltestsofsignificance

Limitations:

?Difficultyingeneralizingtheresultsobtainedfromtheselectedsamplingtothepopulationasawhole

?Apoorchoiceforresearchwheretemporalfactorsareanissue

?Extremelyheavyresources,requiringverylargesamplegroups

?Quasi-experiments

Advantages:

?Controlgroupcomparisonspossible

?Reducedthreatstoexternalvalidityasnaturalenvironmentsdonotsufferthesameproblemsofartificialityascomparedtoawell-controlledlaboratorysetting.

?Generalizationsofthefindingstobemadeaboutpopulationsincequasiexperimentsarenaturalexperiments

Limitations：

?Potentialfornon-equivalentgroupsasquasi-experimentaldesignsdonotuserandomsamplinginconstructingexperimentalandcontrolgroups.

?Potentialforlowinternalvalidityasaresultofnotusingrandomsamplingmethodstoconstructtheexperimentalandcontrolgroups

?Cohortstudies

Advantages:

?Clearindicationofthetemporalsequencebetweenexposureandoutcome

?Particularuseforevaluatingtheeffectsofrareorunusualexposure

?Abilitytoexaminemultipleoutcomesofasingleriskfactor

Limitations:

?Larger,longer,andmoreexpensive

?Pronetocertaintypesofbias

?Notpracticalforrareoutcomes

?Case-controlstudies

Advantages:

?Theonlyfeasiblemethodinthecaseofrarediseasesandthosewithlongperiodsbetweenexposureandoutcome

?Timeandcosteffectivewithrelativelyfewersubjectsascomparedtootherobservationalmethods

Limitations：

?Unabletoprovidethesamelevelofevidenceasrandomizedcontrolledtrialsasitisobservationalinnature

?Difficulttoestablishthetimelineofexposuretodiseaseoutcome

?“N=1”trials

Advantages

?Easytomanage

?Inexpensive

Limitations：

?Findingsdifficulttobegeneralizedtothewholepopulation

?Weakestevidenceduetothenumberofthesubject

7、

?Synthesisofevidenceiscompletelydependenton:

?Thecompletenessoftheliteraturesearch(unavailableforforeignstudies)

?Theaccuracyofevaluation

·TherearesituationsinwhichnoanswercanbefoundforthequestionsofinterestinRCTsanddatabaseanalyses.

·There'stherequirementofusinglessstringentinformationratherthan“harddata”

8、

·Assessmentoftheintrinsicvalueoftraditionalmedicineinsociety

·Researchandeducation

·Political,economic,andsocialfactors

Unit5

1、

·Dis-easereferstotheimbalancearisingfrom：

?Continuousstress

?Pain

?Hardships

·Diseaseisahealthcrisisascribabletovariousdis-eases.

·Promptingeliminationofdis-easescanalleviatesomediseases.

2、

·Wellnessisastateinvolvingeveryaspectofourbeing:body,mindandspirit.

·Manifestationsofahealthyperson:

?Energyandvitality

?Acertainzipingait

?Awarmfeelingofpeaceofheartseenthroughbehavior

3、

·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,denialanddisconnectionfromourbodiesandfeelingsbecomean

unconscious,self-protectivehabit,akindofdefaultresponsetolife.

7

·Amulti-facetedprocess:

?Lookingforrootsofandresolutionsfortheissuesindifferentdimensions

?Buildingourwellnesstoolboxslowly

?Picturingourwholestateofbeing

·Attentiontothelittlestuff:

?Examiningourliveshonestlyandsettingclearintentionstochange

?Strivingtomaintainabalanceofourmind,bodyandspirit

?Takingsmallstepsinthewaytoperceiveandresolveconflict

8

·Trytoawakenandevolveinordertolivemoreconsciously.

·Getintouchwithourgenuinefeelingsandemotions.

·Cometotermswiththetoxicemotions

Unit6

Inthepast,mostpeoplediedathome.Butnow,moreandmorepeoplearecaredinhospitalsandnursinghomesattheirendoflife,whichofcoursebringsanewsetofquestionstoconsider.

·Sixty-fouryearsoldwithahistoryofcongestiveheartfailure

·Decidingtodoeverythingmedicallypossibletoextendhislife

·Availabilityofaround-the-clockmedicalservicesandafullrangeoftreatmentchoices,tests,andothermedicalcare

·Relaxedvisitinghours,andpersonalitemsfromhome

Availabilityofaround-the-clockmedicalresources,includingdoctors,nurses,andfacility.

·Takingonajobwhichisbigphysically,emotionally,andfinancially

·Hiringahomenurseforadditionalhelp

·Arrangingforservices(suchasvisitingnurses)andspecialequipment(likeahospitalbedorbedsidecommode)

5、

·Healthinsurance

·Planningbyaprofessional,suchasahospitaldischargeplaimerorasocialworker

·Helpfromlocalgovernmentalagencies

·Doctor'ssupervisionathome

6、

·Traditionally,itisonlyaboutsymptomcare.

·Recently,itisacomprehensiveapproachtoimprovingthequalityoflifeforpeoplewhoarelivingwithpotentiallyfataldiseases.

7、

·Stoppingtreatmentspecificallyaimedatcuringanillnessequalsdiscontinuingalltreatment.

·Choosingahospiceisapermanentdecision.

Unit7

1、

·Adyingpatient

·Decisionwhethertowithdrawlife-supportmachinesandmedicationandstartcomfortmeasures

·Thefamily'srefusaltomakeanydecisionorwithdrawanytreatments

2、

·Thedoctorasexclusivedecision-maker

·Thepatientasparticipantwithlittlesayinthefinalchoice

3、

·Respectforthepatient,especiallythepatientsautonomy

·Patient-centeredcare

·Thepatientasdecision-makerbasedontheinformationprovidedbythedoctor

4、

·Patientsareforcedtomakedecisionstheyneverwantto.

·Patients,atleastalargemajorityofthem,prefertheirdoctorstomakefinaldecisions.

·Shiftingresponsibilityofdecision-makingtopatientswillbringaboutmorestresstopatientsandtheirfamilies,especiallywhenthebestoptionforthepatientisuncertain.

Doctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression.

·Shoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionsontheirown.

·Balancingbetweenpaternalismandrespectforpatientsautonomyconstitutesalargepartofmedicalpractice.

Unit8

1、

·Research:

Anactivitytotesthypothesis,topermitconclusionstobedrawn,andtherebytodeveloporcontributetogeneralizableknowledge

·Practice:

Interventionssolelytoenhancethewell-beingofanindividualpatientorclientandthathaveareasonableexpectationofsuccess

·Blurreddistinction:

?Cooccurrenceofresearchandpracticelikeinresearchdesignedtoevaluatea