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. Osorios 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 Stewarts 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 won 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. Du e 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、Terrys 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 medici