英语问题和答案.doc

Unit1
1、Do you agree that it is sheer neuron overload on the doctor side that leads to the complaint that doctors do not listen?
2、Describe Mrs. Osorio's condition.
3、What are the good and bad things about Mrs. Osorio's conditions that run through the author s mind?
4、Describe the situation when Mrs. Osorio might send the authors delicately balanced three-ring circus tumbling down.
5、Compare multitasking in human beings and computers.
6、Use numbers to justify that it is the juggling mind that keeps doctors awake at night.
7、What are possible solutions to the impossible high-wire act of juggling competing details and panicking about slipping a critical one?

Unit2
1、 What does the author imply by mentioning two choices?
2、 Describe the heady days of victory declarations and what followed ever since.
3、 Elaborate on the joined battle.
4、 Justify “the realization that world health is indivisible”.
5、 Exemplify the statement that “Every returning condition marches to the beat of a different drum.”
6、 Vaccination practices are at the heart of the most infectious diseases. Use examples to prove it.
7、 What are the four areas of focus according to Bob Howard?
8 “Old enemies never die.” Justify it medically.

Unit3
1、 How was Terry s life before she was diagnosed with MS?
2、 What are the symptoms of MS and autoimmune disease?
3、 What did Terry do before she self-experimented?
4、 What approaches did Terry mainly use to deal with neurodegeneration?

5、 Give one example to illustrate the correlation between toxic load and diseases.
6、 What does the title “The Seventy Percent Solution” mean?

Unit4
1、 Give a brief explanation of the two concepts: complementary medicine and alternative medicine.
2、 To what extent do you agree with the authors opinion on traditional Chinese medicine as being “affordable，low tech, safe, and effective”？
3、 Summarize the clinical uses of acupuncture.
4、 Do you think the author is overoptimistic in predicting a wider future use of acupuncture in the U.S
5、 Explain how inappropriate uses of herbs may result in complications.
6、 Various approaches to herbal study are mentioned in the text. Choose one to discuss the advantages and limitations.
7、 What are the difficulties in investigating herbal therapies?
8、 What are the factors to consider when we integrate Eastern and Western medicine

Unit5
1、 Clarify the differences between disease and dis-ease.
2、 Share your personal understanding about the claim that health is a multi-dimensional experience of body, mind and spirit.
3、 Illustrate the relationship between life on automatic pilot and
4、 Describe the time of great confusion we live in.
5、 Comment on 4 a culture that values thinking more than feeling and emphasizes reason over intuitive awareness and knowing .
6、 Explain the process where we change from ^playing full-out to play it safe, or play not to lose”.
7、 Explain how wellness can be established
8、 Make a list of tips on how to become a fully integrated human being.

Unit6
1、 How has the end-of-life care changed over time?
2、 What is said about George?
3、 What advantages does a hospital have over a nursing home for end-of-life care?
4、 What is the role of family and friends when the patient is cared for at home?
5、 What needs to be considered to make comfort care available at home?
6、 How has the meaning of palliative care changed?
7、 What might be one of the misconceptions about choosing a hospice？

Uint7
1、 What difficult situation is the young doctor facing?
2、 What is paternalistic decision-making in medicine
3、 In what way can patient empowerment be good for the patient?
4、 Why does the author say too much physician restraint may not be that good for the patient?
5、 What kind of considerations may have prevented doctors from making decisions for their patients?
6、 Do you agree that doctors should be prepared to make any decisions together with their patients

Unit8
1、 How are research and practice related to each other?
2、 What is the principle of respect for persons?
3、 What is the principle of beneficence?
4、 How is the principle of beneficence related to Hippocratic Oath?
5、 What concrete examples can be given to illustrate the principle of justice?
6、 What is informed consent and its application?
7、 What are the considerations involved in selection of human subjects in research？
Unit1
1、Some factors that may lead to the complaint:
·Neuron overload
·Patients* high expectations
·Mistrust and misunderstanding between the patient and the doctor
2、 Mrs. Osorio’s condition:
·A 56-year-old woman
·Somewhat overweight
·Reasonably well-controlled diabetes and hypertension
·Cholesterol on the high side without any medications for it
·Not enough exercises she should take
·Her bones a little thin on her last DEXA scan
3、 Good things:
·Blood tests done
·Glucose a little better
·Her blood pressure a little better but not so great Bad things:
·Cholesterol not so great
·Her weight a little up
·Her bones a little thin on her last DEXA scan 4
4、The situation:
·The author was in a moderate state of panic: juggling so many thoughts about Mrs. Osorio’s conditions and trying to resolve them all before the clock ran down.
·Mrs. Osorio made a trivial request, not so important as compared to her conditions.
·Mrs. Osorio seemed to care only about her “innocent — and completely justified —request”： the form signed by her doctor.
·The doctor tried to or at least pretended to pay attention to the patient while completing documentation.
5、Similarities:
·In computer multitasking, a microprocessor actually performs only one task at a time. Like microprocessors, we human beings carft actually concentrate on two thoughts at the same exact time. Multitasking is just an illusion both in computers and human beings.
Differences:
·The concept of multitasking originated in computer science.
·At best, human beings can juggle only a handful of thoughts in a multitasking manner, but computers can do much better.
·The more thoughts human beings juggle, the less human beings are able to attune fully to any given thought, but computers can do much better.
6、
·7 medical issues to consider
·5 separate thoughts, at least, for each issue
·7 x 5 = 35 thoughts
·10 patients that afternoon
·35 x 10 = 350 thoughts
·5 residents under the authors supervision
·4 patients seen by each resident
·10 thoughts, at least, generated from each patient
·5 x 4 x 10 = anther 200 thoughts
·350 + 200 = 550 thoughts to be handled in total
·If the doctor does a good job juggling 98% of the time, that still leaves about 10 thoughts that might get lost in the process.
7、Possible solutions:
·Computer-generated reminders
·Case managers
·Ancillary services
·The simplest solution: time

Unit2
1、The author implies:
• Peoples inadequate consciousness about the consequence of neglecting the re- emerging infectious diseases
·Unjustifiability of peoples complacency about the prevention and control of the infectious diseases
·Unfinished war against infectious diseases

2、Victory declarations:
·Surgeon General William Stewart's hyperbolic statement of closing “the book on infectious disease”.
·A string of impressive victories incurred by antibiotics and vaccines
·The thought that the war against infectious diseases was almost over What followed ever since:
·Appearance of new diseases such as AIDS and Ebola
·Comeback of the old afflictions:
» Diphtheria in the former Soviet Union
» TB in urban centers like New York City
» Rising Group A streptococcal conditions like scarlet fever
·The fear of a powerful new flu strain sweeping the world

3、Elaborate on the joined battle:
·WHO established a new division devoted to worldwide surveillance and control of emerging disease in October 1995.
·CDC launched a prevention strategy in 1994.
·Congress raised fund from $6.7 million in 1995 to $26 million in 1997.

4、 The borders are meaningless to pathogenic microbes, which can travel from one country to another remote country in a very short time.

5、TB:
·Prisons and homeless shelters as ideal places for TB spread
·Emerging of drug-resistant strain or even multi-drug-resistant strain
·A ride on the HIV w^on by attacking the immunocompromised
Group A strep:
·A change in virulence
·Mutation in the exterior of the bacterium
Flu:
Constant changes in its coat (surface antigens) and resultant changes in its level of virulence

6、Examples:
·Experiment in England is seeing the waning immunity because of no vaccination.
·Due to poor vaccination efforts, the diphtheria situation in the former Soviet Union is serious. '
• The vaccination rates are dropping in some American cities, and it will lead to more diphtheria and whooping cough.

7、The four areas of focus:
·The need for surveillance
·Updated science capable of dealing with discoveries in the field
·Appropriate prevention and control
·Strong public health infrastructure

8、The infectious diseases such as TB, flu, diphtheria and scarlet fever will never really go away, and the war against them will never end.

Unit3
1、 Terry's life before
·She loved practicing Tae Kwon Do
·She loved the surge of adrenaline that came with the controlled combat of tournaments.
·She competed nationally, even won bronze medal in the trials for the Pan American Games.
·She attended medical school, practiced as an internal medicine resident, and became an academic general internist.
·She got married and got a son and a daughter.

2、The symptoms of MS and autoimmune disease:
·Loss of stamina and strength
·Problems with balance
·Bouts of horrific facial pain
·Dips in visual acuity

3、Terry did the following before she self-experimented:
·She started injections.
·She adopted many pharmacotherapies.
·She began her own study of literature:
» She read articles on websites such as PubMed.
» She searched for articles testing new MS drugs in animal models.
» She turned to articles concerning neurodegeneration of all types — dementia， Parkinson's disease, Huntington's disease, and Lou Gehrig's disease.
» She relearned basic sciences such as cellular physiology, biochemistry, and neurophysiology.

4、Approaches Terry mainly used:
·Self-experimentation with various nutrients to slow neurodegeneration based on literature reports on animal models
·Self-experimentation with neuromuscular electrical stimulation which is not an approved treatment for MS
·Online search to identify the sources of micronutrients and having a new diet
·Reduction of food allergies and toxic load

5、Cases mentioned in the text:
·Increased mercury stores in the brains of people with dental fillings
·High levels of the herbicide atrazine in private wells in Iowa
·The strong association between pesticide exposure and neurodegeneration
·The association of single nucleotide polymorphisms involving metabolism of sulfur and/or B vitamins
·Inefficient clearing of toxins

6、 With 70% to 90% of the risk for diabetes, heart disease, cancer, and autoimmunity being due to environmental factors other than the genes, we can take many health problems and the health care crisis under our control, for example, optimizing our nutrition and reducing our toxic load.

Unit4
1、Two concepts:
·Complementary medicine refers to the use of conventional therapies together with alternative treatments such as using acupuncture in addition to usual care to help lessen pain. Complementary and alternative medicine is shortened as CAM.
·Alternative medicine refers to healing treatments that are not part of conventional therapies — like acupuncture, massage therapy, or herbal medicine. They are called so because people used to consider practices like these outside the mainstream.

2
·TCM does not require advanced, complicated, and in most cases, expensive facilities.
·TCM employs needles, cups, coins, to mention but a few.
·Most procedures and operations of TCM are noninvasive.
·The substances used as medicine are raw herbs or abstracts from them, and they are indeed all natural, from nature.
·TCM has been practiced as long as the Chinese history, so the efficiency is proven and ensured.
·Ongoing research around the world on acupuncture, herbs, massage and Tai Chi have shed light on some of the theories and practices of TCM

3、It may be used as an adjunct treatment, an alternative, or part of a comprehensive management program for a number of conditions: post-operative and chemotherapy induced nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.
4、A well-justified NO:
·More intense research to uncover additional areas for the use of acupuncture
·Higher adoption of acupuncture as a common therapeutic modality not only in treatment but also in prevention of disease and promotion of wellness
·Exploration and perfection of innovative methods of acupuncture point stimulation with technological advancement
·Improved understanding of neuroscience and other aspects of human physiology and function by basic research on acupuncture
·Greater interest by stakeholders
·An increasing number of physician acupuncturists

5、
·Appropriate uses of herbs depend on proper guidance:
» Proper TCM diagnosis of the zheng of the patient
» Correct selection of the corresponding therapeutic strategies and principles that guide the choice of herbs and herbal formulas
·Digression from either of the above guidence will lead to misuses of herbs, and will result in complications in patient

6、
·Randomized controlled trials
Advantages:
» Elimination of the potential bias in the allocation of participants to the intervention group or control group
» Tendency to produce comparable groups
» Guaranteed validity of statistical tests of significance

Limitations:
» Difficulty in generalizing the results obtained from the selected sampling to the population as a whole
» A poor choice for research where temporal factors are an issue
» Extremely heavy resources, requiring very large sample groups
• Quasi-experiments
Advantages:
» Control group comparisons possible
» Reduced threats to external validity as natural environments do not suffer the same problems of artificiality as compared to a well-controlled laboratory setting.
» Generalizations of the findings to be made about population since quasiexperiments are natural experiments
Limitations：
» Potential for non-equivalent groups as quasi-experimental designs do not use random sampling in constructing experimental and control groups.
» Potential for low internal validity as a result of not using random sampling methods to construct the experimental and control groups