Step by Step2000 第三册 Unit 5 Health and Medicine

Unit 5 Health and Medicine

Part I Warming up

A1

1. This news item is about a successful brain tissue transplant carried out by a South African surgeon.

2. This news item is about the discovery of a new way to increase the effectiveness of chemotherapy.

3. This news item is about the discovery of a new way to treat glaucoma.

4. This news item is about a new research on writing which shows that writing can result in clinically meaningful outcomes.

or

This news item is about a new research on writing which shows that writing can help people with chronic illnesses improve their health.

5. This news item is about the theory and function of acupuncture.

A2

1. The surgery was performed a week ago on a patient suffering from Parkinson's disease.

2. The effectiveness of chemotherapy can be increased by inhibiting a natural defense mechanism employed by cancer cells.

3. Glaucoma involves the death of brain cells.

4. The study adds to the growing amount of scientific literature suggesting that meeting patients’ psychological needs produces physical health benefits.

5. One of the key benefits of acupuncture is that it has few side effects and that when used with standard drug treatment it allows physicians to cut back on medication.

Tapescript:

1. The world's leading transplant surgeon, Dr Christopher Bernard, has carried out one of the most difficult brain tissue transplants yet attempted. The South African surgeon has succeeded in transplanting tissues into the human brain in what is thought to be the first operation of its kind. The surgery was performed a week ago on a patient suffering from Parkinson's disease. A portion of the patient's adrenal gland was implanted into a part of the patient's brain, an operation which has previously been performed only on rats and monkeys.

2. Approximately a-third of all people develop cancer at one point in their lives. Chemotherapy has its limitations, but it is one of the major treatment options. Some American scientists have discovered they can increase the effectiveness of chemotherapy by inhibiting a natural defense mechanism employed by cancer cells.

3. Glaucoma is responsible for blindness in an estimated 67 million people around the world. Until now, treatments have focused exclusively on the eyes. But that may change in the next few years, following the discovery that glaucoma involves the death of brain cells.

4. New research shows that the simple act of writing down thoughts about a stressful event can help people with chronic illnesses improve their health. This is the first study to show that writing can result in clinically meaningful outcomes for chronically-ill patients. The study adds to the growing amount of scientific literature suggesting that meeting patients' psychological needs produces physical health benefits.

5. Traditional Chinese medicine says that good health is associated with the balance of qi. Qi can be hindered or helped by yang and yin. According to traditional theory, the goal of acupuncture is to promote the flow of qi by keeping yin and yang in balance- and this is done by inserting needles at various points along primary channels and meridians that crisscross the body. One of the key benefits of acupuncture is that it has few, if any, side-effects; and that when used with standard drug treatment --in anesthesia, for example it allows physicians to cut back on medication, delivering the same level of benefit with fewer negative effects.

B.

Tapescript.

l. GMO & GE

Basically, genetic modification is when a scientist removes a gene that carries particular instructions for a particular characteristic from the DNA of one organism and inserts that gene into the DNA of another (sometimes very different) organism. The result is called a genetically modified organism or GMO. This technology is also referred to generally as genetic engineering or GE.

2. Organic, Semi-organic

Organic generally refers to farming using no artificial fertilizers or pest control chemicals, and the food produced by this fanning method. Semi-organic means farming using as little artificial fertilizers, etc. as possible. "Semi" means "half."

3. Transgenic organisms

Transgenic organisms are created when a short section of genetic material from an unrelated species is introduced into another species, for example, animal genes to a plant. "Trans" means "going across."

4. Pharming

A pun on the word for farming. It means using farm animals such as cows, goats and pigs, that have been genetically changed, to produce pharmaceutical drugs. Pharming beginning with a "ph" is pronounced the same as farming beginning with an ,,f. ,,

5. Frankenstein

Frankenstein refers to the novel of that name by Mary Wollstonecraft Shelley (1797- 1851). The novel is about a scientist who creates a subhuman creature that ends up destroying him. So Frankenstein means any "creation that ends up destroying the creator."

C.

1. Your 21st century future

The future is determined by the actions of the present day. The responsibility we have for the future begins when we recognize that we ourselves create the future- that the future is not something imposed upon us by fate or other forces beyond our control.

2. Your 21st century doctor

More and more doctors will use computers for medical diagnosis and treatment instead of their textbooks. Computers in your home will enable you to answer interactive questions about your health and show the alternative results which will affect you if you act in a certain way.

3. Your 21st century brain

Your brainwaves may be used to check out whether you are busy, tired, or doing your work properly. Bosses could measure brain activity through the scalp and tell whether a worker is performing well, working hard, or too tired to do the job properly. Ongoing computer analysis could tell whether a worker is seeing all the activity they have to monitor clearly enough.

Tapescript:

1. Your 21st century future

The future will not determine itself. The future is determined by the actions of the present day. Edward Cornish, the editor of The Futurist magazine published by the World Future Society, says, "The responsibility we have for the future begins when we recognize that we ourselves create the future--that the future is not something imposed upon us by fate or other forces beyond our control."

2. Your 21st century doctor

More and more doctors will use computers for medical diagnosis and treatment.

You will visit your doctor, and find that he uses a computer screen and visual information about your condition instead of his textbooks.

Computers in your home will enable you to answer interactive questions about your health and show the alternative results which will affect you if you act in a certain way.

3. Your 21st century brain

Your brainwaves may be used to check out whether you are busy, tired, or doing your work properly.

Psychologist Arthur F. Kramer, at the University of Illinois, tested volunteers working on arithmetic problems. He found that he could predict their performance from the strength of the brain's electrical activity. This is measured through the scalp.

The future? Bosses could measure brain activity through the scalp and tell whether a worker is performing well, working hard, or too tired to do the job properly. Ongoing computer analysis could tell whether a worker, such as an air traffic controller, is seeing all the activity they have to monitor clearly enough.

Part II Frankenstein food to feed the world?

A.

Outline

I. Possible functions of GE

A. To repair a genetic "defect"

B. To make a characteristic already natural to that organism even better

C. To improve resistance to disease or outside damage

D. To make the organism do something it would not normally do

II The pros

A. Reducing chemical inputs to the land

B. Helping the environment

C. Increasing the possibility of growing crops in difficult geographic areas

D. Improving nutritional qualities of food

III. The cons

A. Upsetting the complex environmental balance

B. Creating many new non-reversible ecological problems

C. Increasing the dominance of major corporations

D. Disadvantaging small farmers

E. Causing damage to the human immune system

F. Causing cancer

Tapescript

You will be aware of the controversy in Europe and the United States over food that has been genetically modified. But why should our scientists want to do this?

Well, genetic engineering could be used to repair a genetic "defect" as with the current scientific trials of gene therapy in humans; to make a characteristic already natural to that organism even better, for example, to increase the growth rate of a crop; to improve resistance to disease or outside damage, for example, crop disease or resistance to cold or drought; to make the organism do something it would not normally do, for example, getting a tomato to ripen without going soft--this can be done simply by taking one of its own genes, turning its "pattern" upside down and putting it back again!

It sounds like an amazing new technology, but opinions differ greatly on the pros and cons of genetically engineered food (GE food).

Supporters of GE food say that GE crops will reduce chemical inputs to the land, help the environment, increase the possibility of growing crops in difficult geographic areas; improve nutritional qualities of food.

Opponents of GE food say that GE crops may upset the complex environmental balance, create many new non-reversible ecological problems, increase the dominance of major corporations and disadvantage small farmers, as these rich corporations will control seed varieties, at the worst, cause damage to the human immune system and cause cancer.

At the moment, there is much controversy surrounding GE food.

Some people claim GE food is safe for humans and safe for the environment and will benefit everyone.

Some say they support research into GE food because they recognize the possible benefits for economic food supply in the future.

But many also say that nothing has yet been proved for this new technology and the risks are so great, that it is wise to go slow. None of the GE foods so far produced are at all necessary. So why are they being sold? Why not wait longer until more scientific trials are carried out?

Some say no to GE foods. They are not worth the risk to the environment and our health. They say organic or semi-organic farming is the answer to feeding the world. This type of farming needs lots of labor, but needs no debt and no large corporations.

Others are angry that GE food is already being sold and that there is no way for consumers to know if they are consuming food made from plants that have had their genes altered in a laboratory. They feel that they have been tricked by big corporations and they do not like being human guinea pigs for this new GE food. They insist on clear labeling on food packaging to show whether GE food products are present.

It is a brave new world we are facing in the twenty-first century. As the molecular biologist Michael Antoniou says: "Genetic Engineering and conventional breeding are worlds apart. )' What Nature has done for us for millions of years is now suddenly out-of-date. Today's scientists face huge problems in deciding whether the benefits of the new technology are worth the risks. It is your future that is being decided here. It might be worth offering the scientists some guidance.

B.

1. When did people begin breeding wild plants and animals?

10,000 years ago

2. What kind of traits of plants and animals are preferred by human beings?

Fatter, easier to handle, more milk, bigger fruit

2. What are the four molecules that all genes are made from?

A, T,C; and G

4, What have the scientists done with breeding over the centuries?

To move genes around within a species

5. What are the scientists doing now?

To take genes from different species and put them into each other

6. What kind of problems may turn up in people and agriculture?

Possible new allergies in some people / possible resistance to pesticide in some pests

7. What is the advice given to us by the scientists?

To learn about the great benefits, but to proceed carefully

Tapescript:

Unnatural genetic modification of food has been around since the beginning of civilization.

Ten thousand years ago, we began breeding wild plants and animals to get more of the traits we like. Fatter, easier to handle, more milk, bigger fruit, which we later learned came from changes in their genes.

So for centuries now, most food we've eaten was genetically modified. Here's what's different. Scientists have discovered the four molecules all genes, plant and animal, are made from--A, T, C and G. And they now know how to manipulate them (and) move them around. What's more, they have crossed a natural barrier.

What we did over the centuries with breeding was simply to move genes around within a species. All dogs are variations on the wolf species. All our apple varieties are variations on the one old Eurasian apple. Now that's changing.

"Now we can take genes from fish, from bacteria, and from humans and put them into each other. '

Dangerous? Not necessarily. Millions of people eat such genetically manipulated food with no apparent trouble.

But testing has only begun, and a few problems already are turning up. In people, for example, soybeans with genes added from Brazil nuts to make them more nutritious, can trigger dangerous allergies in people allergic to Brazil nuts. In agriculture, genes from bacteria are added to vegetables to act as a built-in pesticide. But scientists worry that insects may evolve resistance to that and thus become super pests.

"Our lack of understanding might lead to a risk that right now we can't even predict.'

Scientists we talked to say there may be great benefits, but that moving genes across the species barrier is a step into the unknown and we should proceed carefully.

Part III Medical emergency 911

A

( 4 ) a. How SYSCOM operates

( 3 ) b. Purpose of SYSCOM

( 1 ) c. Treatment by ambulance workers

( 2 ) d. Response to shooting accident

B.

1. What happens in Maryland when there is a serious accident?

2. What response is made to the accident reported to 9117 What does Lieutenant Mike Fahey do?

3. What do the ambulance paramedics do for this patient?

4. What is SYSCOM? What does it do?

5. What is the purpose of this system?

C

1. How does this system help if you have a serious accident?

a. Know where and when an accident happens

b. Immediate action / life-saving care

2. How is this system activated?

By dialing 911

3. Where is your call forwarded?

To fire department's emergency rescue service / then to

nearest help / depending on information given

4. In this report, what kind of accident has happened?

Shooting accident

5. Who responds first? How long docs it take to respond?

Paramedic supervisor / 9 min.

6. How docs Lt. Fahey act? What effect docs he have on the

patient?

Deliberately / calmly / calm patient down

7. What condition is the patient in when he is put in the ambulance?

In shock

8. What has everyone agreed to do for this man? Why?

Send him to the regional shock trauma center / center is 6 min. away by land / available / equipped for his injury

9. What is SYSCOM?

Statewide System communication Center

10. What important function docs SYSCOM serve?

Dispatch point for helicopters

11. What can SYSCOM do for paramedics?

Connect them by radio to hospitals and emergency specialists

12. According to Dr R. Adams Cowley, what needs to be done in order to save a person's life?

Stop bleeding and restore blood pressure within an hour of accident

Tapescript

Maryland may be a small state, but it's a major player in developing emergency medical services. There are 49 hospitals that have 24-hour emergency departments. Nine of those hospitals are specially designated shock trauma centers, and there's a sophisticated communication center that links the state's ambulances, helicopters, and the hospitals.

"A serious accident happens. Pre-hospital staff --paramedics, emergency medical technicians--through a sophisticated communication system know where and when the accident happened, and they are summoned immediately to provide the initial, quick, life-saving care."

That's Dr Philip Militello. He's head of trauma surgery for the state system. If you have a serious injury anywhere in Maryland, this system will get you the right treatment with the least delay. What kind of help do you need? Where's the closest hospital? Should you go by ambulance or by helicopter? The answers to these questions come through sophisticated communications. The system springs into action with a telephone call to 911, your local emergency number anywhere in the state.

"Fire and rescue.”'

If you're injured, your call is forwarded to the fire department's emergency rescue service. Based on the information you give them, they send a radio call for the nearest available help.

"He has been shot. Hold on while I dispatch an ambulance."

A man has shot himself. The nearest available shock trauma ambulance is twenty minutes away. But a paramedic supervisor with some emergency medical equipment in his car responds to the radio call and arrives on the scene within nine minutes. The supervisor, Lieutenant Mike Fahey, is a nationally certified paramedic. He quietly talks to the patient while he bandages the bullet hole. Finding the patient's blood pressure alarmingly low, he immediately starts intravenous blood plasma. His movements are deliberate and his voice is calm.

"Come in. Take control of the situation. Remain calm. Chaos is contagious, and so is the calm that you have. When the patient looks up at you and you're calm, then you're reassuring. Then they calm down."

The paramedic ambulance with advanced life support equipment arrives twelve minutes later, and Fahey's patient is loaded on a stretcher, ready to go. But the patient is in shock. If he stays in shock, he has a poor chance of survival. Inside the ambulance, they start another line of plasma and apply medical anti-shock trousers. Those are rubberized trousers to squeeze the blood from the legs back to the brain and other vital organs. Through radio communication everyone has agreed to send him by ambulance to the regional shock trauma center. It's only six minutes by land; it's available; and the regional center is equipped for his particular injury.

"They're putting on the trousers now. As soon as they get that, they'll be able to start going down the highway. '

"If we can get the patient to the trauma center within twenty minutes, we go by land. If it's going to be longer than twenty minutes, we try to go by air."

Captain Linda Sterling. She's Mike Fahey's boss at the local emergency medical service. When one of her paramedics needs a medevac helicopter, the request goes quickly to the SYSCOM, the statewide System Communication Center. Throe large screens dominate the darkened room at SYSCOM. The right screen shows which hospital can take what kind of injury. The center screen shows the location of all medevac helicopters. And the one on the left shows the helicopter landing pad at the main shock trauma center. SYSCOM operations chief Andy Polavski tells us what's happening.

"Part of the operation here is the SYSCOM operation: system communications. They serve as the coordinators of the medevac activity in the state. This is the dispatch point for the State Police helicopters and the U.S. Park Police helicopters."

SYSCOM can also connect by radio any paramedic in the state with any hospital or any emergency specialist. In shock trauma injuries, minutes can mean life or death. Maryland's communication system saves precious time by connecting citizens, ambulances, helicopters, and hospitals. Dr R. Adams Cowley, founder of the system, said, "If I can get you and stop your bleeding and restore your blood pressure within an hour of your accident, then I can probably save your life. '

Part IV Doctors on the Internet

B. Tapescript:

"Is there a doctor in the house?" The answer is always yes if you have a computer and a modem at home.

Did you forget to ask your doctor an important question on your last visit? Has another issue come up? No problem. You can get in touch with a doctor via the Internet at any hour of the day or night. In just the past few months, hundreds of doctors have gone on line 24 hours a day, seven days a week.

Owings Mills, Maryland in the Washington DC suburbs is the headquarters of "America's Doctor Online." Forty-two primary care doctors as well as dieticians and pharmacists provide free information to callers with health questions. The firm's founder is Dr Scott Rifkin.

"We are not trying to practice medicine. We are trying to give consumers good information on their various health care issues. We are not going to diagnose. We are not going to prescribe. We are going to listen to the consumer, and have them ask us questions and then give them information that they most need. The idea is to give them directed information that's usable to the consumer."

Dr Rifkin told ABC News that America's Doctor Online acts as a clearing house for the hundreds of thousands of responses a web browser might turn up in answer to a question. The online health professionals don't diagnose or treat medical conditions. And they don't charge for their service. They are not known by their names but by Amdoc Number 3 or 4 or whatever.

"Our physicians are very carefully trained to not practice medicine and to always refer their consumer back to their own physician or to their local resources, their local hospitals."

Unlike Dr Rifkin, Florida emergency care physician, Dr Tom Caffrey, has founded a website of board-certified doctors who do practice medicine. They make "virtual house calls" at about fifty dollars a visit and diagnose, advise and prescribe medicine to hundreds of patients daily.

"We are the only site on the Internet where you can pick a doctor who is board certified, see his credentials, know who you're speaking with. And we're there 24 hours a day, seven days a week. It's the return of a house call. This time it's electronic."

Dr Caffrey believes that Internet medicine is inevitable and provides a useful service.

"I am very comfortable with what we're doing. We want to help set the standard for this because it is coming. You can't stop this. It is going to happen."

There is anecdotal information about other online doctors prescribing harmful drugs and giving bad advice. And the President of the American Medical Association, Dr Thomas Reardon, believes that doctors simply should not practice medicine over the Internet.

"I don't think it's ethical. I think it's unethical to diagnose and prescribe over the Internet without having a patient-physician relationship."

Drugs carry cautionary labels. Perhaps these websites should carry warning labels, also, such as. "Check out the doctor's credentials." "Protect your privacy with secure sites. ' "Share what you learn with your own doctor." "Never go online in a medical emergency."

And the big question remains unanswered--whether Internet doctors should practice medicine or only advise.