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Review For2015students Justforreference 2020 3 18 1 Doyouagreethatitissheerneuronoverloadonthedoctorsidethatleadstothecomplaintthatdoctorsdon tlisten Pre 1 NeuronoverloadPatients highexpectationsMistrustandmisunderstandingbetweenthepatientsandphysician Unit1TextA 2020 3 18 2 PleaselistMrs Osorio scondition Pre 2 A56 year oldwomanSomewhatoverweightReasonablywell controlleddiabetesandhypertensioncholesterolonthehighsidewithoutanymedicationsforthisNotasmuchexerciseassheshouldThinningofherbonesonlastDEXAscanStressfulbutgoodaboutkeepingherappointmentsandgettingherbloodtestsGenerallyhealthy 2020 3 18 3 WhatthingsaboutMrs Osorio sconditionsrunthroughtheauthor smind Pre 3 GoodThingsBloodtestsdoneGlucosealittlebetterHerbloodpressuregoodbutnotgreatBadThingsHerweightalittleupHerbonesalittlethinontheDEXA 2020 3 18 4 DoyouagreethatParagraph4justillustratesthatonestrayrequestfromMrs Osoriosendsthedelicatelybalancedthree ringcircustumblingdown Pre 4 2020 3 18 5 Thekeyisinpara 4 Theauthorwasinmoderatestateofpanic jugglingsomanythoughtsaboutMrs Osorio sconditionsandtryingtoresolvethemallbeforetheclockrandownMrs Osoriomadeatrivialrequest notsoimportantascomparedtoherconditionsMrs Osorioseemedtocareonlyabouther innocent andcompletelyjustified request theformsignedbyherdoctorThedoctortriedtooratleastpretendtopayattentiontothepatientswhilecompletingdocumentationComplaintsthatdoctorsdon tlistenmighthaveotherreasonsthanjustdoctors neuronoverload 2020 3 18 6 See Paras 7 8 Howcanyoucomparemultitaskinginhumanbeingsandcomputers pre 5 2020 3 18 7 Multitaskingoriginatedincomputerscience Microprocessorsinfactlinear actuallyperformonlyonetaskatatime Multitaskingseemsjustasanillusionbothincomputerandhumans Atbest ManjugglesonlyahandfulofthoughtsinthismannerThemorethoughtswejuggle thelessweareabletoattunefullytoanygiventhought Socanwesaymultitaskingisarecipefordisaster How 2020 3 18 8 Whatistheuseofthenumbers Usethesenumberstojustifythatitisthejugglingmindthatkeepsdoctorsawakeatnight pre 6 Whatarethereasonswhydoctorskeptawakeatnight Aretheythereasonsoftheirneuronoverload Pre 6 2020 3 18 9 7medicalissuestoconsider5separatethoughts atleast foreachissue7X5 35thoughts10patientsthatafternoon35X10 3505residentsundertheauthor ssupervision4patientsseenbyeachresidents10thoughts atleast generatedbyeachpatients5X4X10 200350 200 550thoughtstobehandledintotalIfthedoctordoesagoodjobjuggling98 ofthetime thatstillleavestenthoughtsthatmightgetlostintheprocess 2020 3 18 10 Explainthelastsentenceofthisparagraph page5 Arethoseproposedsolutions likecomputer generatedreminders casemanagers ancillaryservices capableofsolvingtheauthor sproblemofoverload Pre 7 2020 3 18 11 Unit2TextA Whatdoestheauthorimplybymentioningtwochoices para 1 Pre 1 Whatfollowedeversincetheheadydaysofvictorydeclarations para 4 Pre 2 Whatdoesthejoinedbattlereferto Andelaborateonit paras 5 12 pre 3 2020 3 18 12 Thefirstquestionhassomethingtodowith ornot People sinadequateconsciousnessabouttheconsequenceofneglectingtheemergingandreemerginginfectiousdiseases Unjustifiabilityofpeople scomplacencyaboutthepreventionandcontroloftheinfectiousdiseases Unfinishedwaragainstinfectiousdisease Aboveall somethingtodowithmoney budget 2020 3 18 13 Whatfollows Out of expectationoutcomeAppearanceofnewdiseasessuchasAIDSandEbola Comebackoftheoldafflictions DiphtheriaintheformerSovietUnion TBinurbancenterslikeNewYorkCity RisingGroupAstreptococcalconditionslikescarletfever Thefearofapowerfulnewflustrainsweepingtheworld 2020 3 18 14 Elaborateonthejoinedbattle Pre 3 WHO establishmentofanewdivisiondevotedworldwidesurveillanceandcontrolofemergingdiseaseinOct 1995CDC launchingpreventionstrategyin1994Congress raisingfundfrom 6 7millionin1995to 26millionfor1997 2020 3 18 15 Justify therealizationthatworldhealthisindivisible Pre 4 AttentiontothehealthconditionsoftheglobebeforesatisfyingOURmostparochial 地方范围的 needsMeaninglessnessofborderstopathogenic 致病的 microbesWith24hoursoftime fromacrowdedmarketplaceinKikwit ZairetoaNewYorkCitysubway 2020 3 18 16 Exemplifythestatementthat Everyreturning pre 5 Examples 1 TBPrisonsandhomelesssheltersasidealvenuesforTBspreadDevelopmentofdrug resistantstrainsorevenmulti drug resistantstrainArideontheHIVwagonbyattackingtheimmunocompromised 免疫功能不全的 2020 3 18 17 Examples 2 GroupAstrepAchangeinvirulence 毒性 Mutationintheexteriorofthebacteriumfleshing eatingbacteriaof1994rheumaticfeverscarletfeverfluConstantchangesinitscoat surfaceantigens表面抗原 andresultantchangesinitslevelofvirulenceLooming 逼近 nextflupandemicasbadasthatof1918 2020 3 18 18 Whyarevaccinationpracticesattheheartofthemostinfectiousdiseases Useexamplestoproveit Pre 6 WhatarethefourareasoffocusaccordingtoBobHoward Pre 7 2020 3 18 19 Examples WaningimmunitySeriousdiphtheriasituationintheformerSovietUnionDeteriorationinsomeAmericancitiesIncreasedreportsofmalaria 2020 3 18 20 Thefourareasoffocus NeedforsurveillanceUpdatedsciencecapableofdealingwithdiscoveriesinthefieldAppropriatepreventionandcontrolStrongpublichealthinfrastructure 2020 3 18 21 Oldenemiesneverdie Justifyitmedically 2020 3 18 22 DiscussingIstherea100 solutionforeveryproblem Istherea100 cureforeveryailment Whatdoesthetile TheSeventyPercentSolution mean Pre 6 Unit3TextA 2020 3 18 23 With70 to90 oftheriskfordiabetes heartdisease cancer andautoimmunitybeingduetoenvironmentalfactorsotherthangenetics wecanprovidetherealsolutiontomanyhealthproblemsandthehealthcarecrisisbychangingourenvironment forexample optimizingournutritionandreducingourtoxicload Whatdoesthetile TheSeventyPercentSolution mean Pre 6 Accordingtotheauthor 2020 3 18 24 HowwasTerry slifebeforeshewasdiagnosedwithMS Pre 1 HowmuchdoyouknowaboutMSandautoimmunedisease Pre 2 2020 3 18 25 Causeasmentionedbytheauthortheassaultofimmunecellsonthebrain withpossibleoriginingeneticmake upor andcombinationofenvironmentalfactorsTreatmentasmentionedbytheauthorinterferonandcopolymer 1 HowmuchdoyouknowaboutMSandautoimmunedisease Pre 2 http en wikipedia org wiki Autoimmune disease o http en wikipedia org wiki Multiple sclerosis 2020 3 18 26 Beginherownstudyoftheliterature readingarticleafterarticleonPubMed Relearnbasicsciencesuchascellularphysiology biochemistryandneurophysiology LookforrecentarticlestestingnewMSdrugsinanimalmodelsandreadarticlesconcerningneurodegenerationofalltypes dementia Parkinson sdisease Huntington s andLouGehrig sdisease WhatdidTerrydobeforesheself experimented Pre 3 2020 3 18 27 self experimentationwithvariousnutrientstoslowneurodegenerationbasedonliteraturereportsonanimalmodelsself experimentationwithneuromuscularelectricalstimulationstillbasedonliteratureonlinesearchtoidentifythesourcesofmicronutrientsreductionoffoodallergyandtoxicload WhatapproachesdidTerrymainlyusetodealwithneurodegeneration Pre 4 2020 3 18 28 With70 to90 oftheriskfordiabetes heartdisease cancer andautoimmunitybeingduetoenvironmentalfactorsotherthangenetics wecanprovidetherealsolutiontomanyhealthproblemsandthehealthcarecrisisbychangingourenvironment forexample optimizingournutritionandreducingourtoxicload Oneexampletoillustratethecorrelationbetweentoxicloadanddisease Pre 5 2020 3 18 29 Unit4TextA Giveabriefexplanationofthetwoconcepts complementarymedicineandalternativemedicine pre 1 Towhatextentdoyouagreewiththeauthor sopinionontraditionalChinesemedicineasbeing affordable lowtech safe andeffective pre 2 2020 3 18 30 Theclinicalusesofacupuncture Pre 3 Anadjuncttreatment anacceptablealternativeforpost operativechemotherapyinducednauseaandvomitingpost operativedentalpainaddictionstrokerehabilitationheadachemenstrualcrampstenniselbow fibromyalgia myofascialpain osteoarthritis lowbackpain carpaltunnelsyndrome andasthma 2020 3 18 31 DoyouthinktheauthorisoveroptimisticinpredictingawiderfutureuseofacupunctureintheUS Pre 4 Moreintense Higher Greater Stronger Anincreasingnumberof research adoptionofacupuncture interestofhealthinsuranceindustries pushforcoverage physicianacupuncturists 2020 3 18 32 Explainhowinappropriateusesofherbsmayresultincomplications Pre 5 AppropriateusesofherbsdependonproperguidanceProperTCMdiagnosisofthezhengofthepatientCorrectselectionofthecorrespondingtherapeuticstrategiesandprinciplesthatguidethechoiceofherbsandherbalformulasDigressionfromeitheroftheaboveconditions misusesofherbs willresultincomplicationsinpatient 2020 3 18 33 Variousapproachestoherbalstudyarementionedinthetext Pickonetodiscusstheadvantagesandlimitations Pre 6 RandomizedcontrolledtrialsQuasi experimentscohortstudiescase controlstudies 1 trials 2020 3 18 34 Whatarethedifficultiesininvestigatingherbaltherapies Pre 7 DependenceofsynthesisofevidenceonThecompletenessoftheliteraturesearch Unavailableforforeignstudies TheaccuracyofevaluationNoanswerstobefoundforthequestionsofinterestRequirementofusinglessstringentinformationratherthan harddata 2020 3 18 35 Whatarethefactorstoconsiderwhenweintegrateeasternandwesternmedicine Pre 8 AssessmentoftheintrinsicvalueoftraditionalmedicineinsocietyResearchandeducationPolitical economicandsocialfactors 2020 3 18 36 Unit5TextA Clarifythedifferencesbetweendiseaseanddis ease Pre 1 Dis easereferstotheimbalancearisingfromacontinuousstresspainhardshipsDiseaseisahealthcrisisascribabletovariousdis easesPrompteliminationofdis easescanalleviatesomediseases 2020 3 18 37 YourpersonalunderstandingabouttheclaimthatHealthisamultidimensionalexperienceofbody mindandspirit Pre 2 Wellnessasastateinvolvingeveryaspectofourbody body mind andspiritManifestationsofahealthypersonEnergyandvitalityAcertainzipingaitAwarmfeelingofpeaceofheartseenthroughbehaviour 2020 3 18 38 Illustratetherelationshipbetweenlifeonautomaticpilotandwellness Pre 3 Constantmessages positiveandnegative senttoourmindaboutthehealthofourbodyPhysicalsymptomssuppressedBeingwellequaledtobeingdiseaseorillnessfreeWellnessconfusedwithanabsenceofsymptoms 2020 3 18 39 Describethetimeofgreatconfusionwelivein Pre 4 People smindinfectedbyspinhalf truthfearfulfictionsblatantdeceit someasaformofself deceitSpinasaresultofunconsciouslivingPandemicfalsenessShowinguponeveryfrontinsocietyandthemediaSpreadingtoallcornersoftheglobeDeeplyembeddedinourminds 2020 3 18 40 Commenton aculturethatvaluesthinkingmorethanfeelingandemphasizesreasonoverintuitiveawarenessandknowing Pre 5 OurbodyintelligencesuppressedanddormantTremendousamountofstressonadailybasisLimiting self defeating andevenself destructivebehaviorsthatunderminesourwell beingandkeepsthemfromachievingourfullpotential 2020 3 18 41 Explaintheprocesswherewechangefrom playingfull out to playitsafe orplaynottolose Pre 6 MorereluctanttotakerisksLossofabilitytofeelandacknowledgeourdeepestfeelingsandthecouragetospeakourtruthContinuingdenialandrepressionofourfeelingtoprotectthemselvesAnunconsciousandself protectivehabit adefaultresponsetolife fear denial anddisconnectionfromourbodiesandfeeling 2020 3 18 42 EverythingcomesfinallydowntoHOW Explainhowwellnesscanbeestablished Pre 7 Amulti facetedprocessIssuesrootedandresolvedindifferentdimensionsBuildingourwellnesstoolboxslowlyPicturingourwholestateofbeingAttentiontothelittlestuffWellnessnotagoalbutaprocessMaintenanceofabalanceofourmind body andspirit 2020 3 18 43 Makealistofthetipsonhowtobecomeafullyintegratedhumanbeing Pre 8 TrytoawakenandevolveinordertolivemoreconsciouslyGetintouchwithourgenuinefeelingsandemotionsCometotermswith Makepeacewiththetoxicemotions 2020 3 18 44 Unit6TextA Howhastheend of lifecarechangedovertime pre 1 2020 3 18 45 Whatadvantagesdoesahospitalhaveoveranursinghomeforend of lifecare Pre 3 Availabilityofmedicalresources includingdoctors nursesandfacilityaroundtheclockAnythingelseyoucanaddtothat AdvantagesofNursingHomePrearrangedplansforend of lifecareEstablishmentofarelationshipbetweenthestaffandfamilyMorepersonalizedcarePrivacyarrangement timealone 2020 3 18 46 What stheroleoffamilyandfriendswhenthepatientiscaredathome Pre 4 Takingonajobwhichisbigphysically emotionally andfinancially Hiringahomenurseforadditionalhelp Arrangingforservices suchasvisitingnurses andspecialequipment likeahospitalbedorbedsidecommode 2020 3 18 47 Whatneedstobeconsideredtomakecomfortcareavailableathome Pre 5 HealthinsurancePlanningbyaprofessional suchasahospitaldischargeplannerorasocialworkerHelpfromlocalgovernmentalagenciesDoctorsupervisionathome 2020 3 18 48 Howhasthemeaningofpalliativecarechanged Pre 6 onlysymptomcare closetohospicecare 2020 3 18 49 Whatmightbeoneofthemisconceptionsaboutchoosinghospice Pre 7 StoppingtreatmentspecificallyaimedatcuringanillnessequalsdiscontinuingalltreatmentAgoodexample AnolderpersonwithcancerDiscontinuationofchemotherapybutcontinuationofmedicationforhypertension 2020 3 18 50 Whatmightbeoneofthemisconceptionsaboutchoosinghospice Pre 7 ChoosinghospiceisapermanentdecisionDeloresasanexampleEighty twowithfailingkidneysBeginninghospicecarenotwantingtogothroughdialysis soDeloresChanginghermindandbeginningdialysisinthehopesofonedayholdingherfirstgreat grandchild 2020 3 18 51 Whatmightbeoneofthemisconceptionsaboutchoosinghospice Pre 7 ChoosinghospiceisapermanentdecisionArtBuchwaldasanotherexampleeighty onereal lifehumoristandWashingtonPostcolumnistDecidedagainstthekidneydialysissuggestedbyhisdoctorBignewswithstabilizedconditionLeavinghospicewithoutthreatofdeath 2020 3 18 52 Whatdifficultsituationistheyoungdoctorfacing Pre 1 AdyingpatientDecisionwhethertowithdrawlife supportmachinesandmedicationandstartcomfortmeasuresThefamily srefusaltomakeanydecisionorwithdrawanytreatments Unit7TextA 2020 3 18 53 DoctorsasexclusivedecisionmakerPatientsasparticipantswithoutlittlesayinthefinalchoiceThewaydoctorsandpatientsapproachmedicaldecisionshaschangedsharplyoverthelast50years Whatispaternalisticdecision makinginmedicine Pre 2 2020 3 18 54 Respectforthepatient especiallythepatient sautonomyPatient centeredcareThePatientsasdecisionmakerbasedontheinformationprovidedbythedoctor Inwhatwaycanpatientempowermentbegoodforthepatient Pre 3 2020 3 18 55 Thepatientsareforcedtomakedecisionstheyneverwantto Patients atleastalargemajority prefertheirdoctorstomakefinaldecisions Shiftingresponsibilityofdecisionmakingtothepatientswillbringaboutmorestresstothepatientsandtheirfamilies especiallywhenthebestoptionforthepatientisuncertain Whydoestheauthorsaythattoomuchphysicianrestraintmaynotbethatgoodforthepatient Pre 4 2020 3 18 56 Doctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression Doctorsmaybegrapplingwiththeirownsetofworries WhoamItopresumetoknowwhatmypatientsneed Whatkindofconsiderationsmayhavepreventeddoctorsfrommakingdecisionsfortheirpatients Pre 5 2020 3 18 57 Doyouagreethatdoctorsshouldbepreparedtomakeanydecisionstogetherwiththeirpatients Pre 6 Shoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionontheirownalone Balancingbetweenpaternalismandrespectforpatient sautonomyconstitutesalargepartofmedicalpractice 2020 3 18 58 Howareresearchandpracticerelatedtoeachother Pre 1 BlurreddistinctionbetweenpracticeandresearchCooccurrenceofresearchandpracticeasinresearchdesignedtoevaluateatherapyNotabledeparturesfromstandardpracticeas experimental withtheterms experimental and research arecarelesslydefined 2020 3 18 59 Howareresearchandpracticerelatedtoeachother Pre 1 Practice interventionssolelytoenhancethewell beingofanindividualpatientorclientandthathaveareasonableexpectationofsuccess toprovidediagnosis preventivetreatmentortherapytoparticularindividuals 2020 3 18 60 Howareresearchandpracticerelatedtoeachother Pre 1 Research anactivitytotesthypothesis permitconclusionstobedrawn andtherebytodeveloporcontributetogeneralizableknowledgeexpressedintheories principles andstatementsofrelationships 2020 3 18 61 Whatistheprincipleofrespectforpersons Pre 2 InDiagramP194 principleofrespectofpersons protectionofpersonswithdiminishedautonomy involvementofprisonersassubjectsofresearch 2020 3 18 62 Whatistheprincipleofbeneficence Pre 4 Donoharm asafundamentalprincipleofmedicalethicsOneshouldnotinjureonepersonregardlessofthebenefitsthatmightcometoothers Butbenefitsandrisksasaset duet inbothmedicalpracticeandresearchExposuretotherisksintheprocessesoflearningwhatisharmfulorbenefi
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