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HeartAttack IntheUnitedStatesandespeciallyinbigcitiesandruralareastensofthousandsofpeoplewithheartsthatshouldbegood【51】tokeepthemalivedieeachyearforlackofadequatefirstaid.InNewYorkCityforexampleanewstudyhasshownthatonlyonepersonin100outsideofhospitals【52】aftertheheartsuddenlystopspumping.IncontrastinSeattlethesurvival【53】aftersuchheartattacksisoneinfive. Thedifferencecanbetraced【54】theeffectivenessofthechainofsurvivalDr.JosephP.Ornatosaid.Eachlinkinthe【55】mustbestrongenoughformanylivestobe【56】. Thechainbeginswithanimmediatetelephone【57】foremergencyhelpandthestartwithinfourminutesoftheprocessneededforrestartingthe【58】workingbyafamilymemberorbystander旁观者. Itcontinueswiththepromptarrival-------withineight【59】tenminutesofarescuerequippedwithaspecialinstrumentthatcanshocktheheartbacktoanormalrhythm.Anditendswiththeadministration给予实施ofadvanced先进emergencycarebynursestomaintaintheheart’’sabilitytosurviveuntilthedoctorsatthehospitalscantake【60】Whenoneormorelinksinthischainfailorfunctiontooslowlythe【61】ofavictimsurvivingheartattackfallsrapidly.Becauseofwidespreadweaknessesinthechainof【62】expertsinemergencyheartcareestimatethat20000to80000people【63】needlesslyofheartattackeachyearanumbercomparabletothe55000killedannuallyinautomobile【64】. OneexpertsaysSendinganemergencyvehicletoaheartattackvictim【65】thespecialequipmentislikehavingpolicemenwithgunsbutnobullets.Theymayputonagoodshowbuttheylacktheweaponneededtogetthejobdone.
Itishisassumptionofafalsetheorythatmadehimpayahighprice.
CommunicationProblems After20yearsofresearchmycolleaguesandIhavediscoveredthatallcommunicationinvolvesourbodiessometimesprofoundly.Whilewespeakwithwordswealsospeakwitheveryfiberofourbeing.Thislanguageoftheheartisintegraltothehealthandemotionallifeofallofus. Wefoundthatevenapleasantchatabouttheweathercanaffectthecardiovascular心血管性的systemparticularlybloodpressure.Thetraditionalwayoftakingbloodpressure—withastethoscope听诊器—meantthatthepatienthadtokeepsilentandthissilencepreventedcliniciansfromdiscoveringthelinkbetweencommunicationandbloodpressure. Thebreakthroughinourstudiesoccurredin1977whenwemetEdatypicalhypertensivepatientwhocametotheUniversityofMaryland’’sPsychophysiologyCenterfortreatment.WehookedupEdtoanewcom?puterthatcouldcontinuouslymonitorbloodpressure.Wefoundthathispressureimmediatelyincreasedeverytimehespokeevenifhewasdiscussingthemostneutraltopic.WhatwasmoresurprisingwasthatEdwasunawareofthesechanges. Thisfindingsointrigueduswebegantestingothers.Theresultswerethesame.Bloodpressureandheartrateroserapidlywheneverpeopletalked.Weaskedstudentstoreadaloudfromabland乏味的text.Theirbloodpressureandheartrateroserapidlyeverytime.Wetested38deaf-mutevolunteers.Whenthesepeoplesignedtheirbloodpressurealsoincreased.Thisconfirmedoursuspicionthatitwastheactofcommunicationnotjusttalkingthatledtothesechanges. Mostnormaltalkisaseesaw一上一下的动作.Therisingofbloodpressurewhenonetalksisbalancedbyarapidloweringofpressurewhenonelistens.Buttherhythmisoutofsynclinalhypertensives.Theyfluentlyfailtolisten;theyareonguarddefensive.Sotheirpressurestaysup. ThebenefitsoflisteningareseenintheorientingreflexdiscoveredbyPavlov.Whenadoghearsasoundorseesmovementitwillstopallactivityandcockitshead.AnotherRussianscientistE.N.Soklornoticedthatthedog’’sheartrateslows. Asimilarresponseoccursinpeopletoo—anditlowersbloodactivities:readingoutloudstaringatablankwallandwatchingfishinatank.Bloodpressurewashingtestwhenthepeoplespoke.Butitwaslowestwhentheywatchedthefishratherthanwhentheysimplysatandrelaxed.Whetherwatchingfishorlisteningtoanotherpersonattendingcalmlytotheworldoutsideyourselfhelpslowerbloodpressure.WhenIgothypertensivestolistenundefensivelytheirbloodpressureoftenfelldramatically. Whydosomepeoplefindtalkingsostressfulandlisteningsodifficult?Itestedsomehealthynewborns.Whentheycriedtheirbloodpressureoftendoubled.Webeganthinkingaboutpressuresurgesinhypertensivesassimilartothechangeswhenababycries.Thoughcalmonthesurfacewhiletalkingtheirbodiesarescreamingtobeheard.Forthesepeoplecommunicationbecomesadesperatebuthiddenstruggle.Insidetheiradultbodiesisababycryingterrifiedbecausenoonecanhearit. Sohowcanweenjoyconversationyetkeepbloodpressuredown?Bylisteningmorebybreathingregularlywhiletalkingbyalternatingbetweentalkingandpayingattentiontowhattheotherpersonissaying.Butwhatcanhypertensivesdo?Treatmentsthatteachthemtofocusontheirrelationshipandhowtocommunicateinarelaxedwaycanbeastarttowardhealth. Wecanunderstandandcopewithillnessonlywhenweviewourselvesaspartofacomplexworldbeyondtheconfinesofourownindividualskin.Theresponseofourheartsbloodvesselsandmuscleswhenwecommunicatewithspousechildrenfriendsandcolleaguesisasvitaltoourcardiovascularhealthasisexerciseordiet. IntheninthparagraphthesentenceTheyfrequentlyfailedtolistenmeans______.
HeartAttack IntheUnitedStatesandespeciallyinbigcitiesandruralareastensofthousandsofpeoplewithheartsthatshouldbegood【51】tokeepthemalivedieeachyearforlackofadequatefirstaid.InNewYorkCityforexampleanewstudyhasshownthatonlyonepersonin100outsideofhospitals【52】aftertheheartsuddenlystopspumping.IncontrastinSeattlethesurvival【53】aftersuchheartattacksisoneinfive. Thedifferencecanbetraced【54】theeffectivenessofthechainofsurvivalDr.JosephP.Ornatosaid.Eachlinkinthe【55】mustbestrongenoughformanylivestobe【56】. Thechainbeginswithanimmediatetelephone【57】foremergencyhelpandthestartwithinfourminutesoftheprocessneededforrestartingthe【58】workingbyafamilymemberorbystander旁观者. Itcontinueswiththepromptarrival-------withineight【59】tenminutesofarescuerequippedwithaspecialinstrumentthatcanshocktheheartbacktoanormalrhythm.Anditendswiththeadministration给予实施ofadvanced先进emergencycarebynursestomaintaintheheart’’sabilitytosurviveuntilthedoctorsatthehospitalscantake【60】Whenoneormorelinksinthischainfailorfunctiontooslowlythe【61】ofavictimsurvivingheartattackfallsrapidly.Becauseofwidespreadweaknessesinthechainof【62】expertsinemergencyheartcareestimatethat20000to80000people【63】needlesslyofheartattackeachyearanumbercomparabletothe55000killedannuallyinautomobile【64】. OneexpertsaysSendinganemergencyvehicletoaheartattackvictim【65】thespecialequipmentislikehavingpolicemenwithgunsbutnobullets.Theymayputonagoodshowbuttheylacktheweaponneededtogetthejobdone.
TheGeneIndustry Majorcompaniesarealreadyinpursuitofcommercialapplicationsofthenewbiology.Theydreamofplacingenzymesintheautomobiletomonitorexhaustandsenddataonpollutiontoamicroprocessorthatwillthenadjusttheengine.TheyspeakofwhattheNewYorkTimescallsmetal—hungrymicrobesthatmightbeusedtominevaluabletracemetalsfromoceanwater.Theyhavealreadydemandedandwontherighttopatentnewlifeforms. Nervouscriticsincludingmanyscientistsworrythatthereiscorporatenationalinternationalandinter-scientificrivalryintheentirebiotechnologicalfield.Theycreateimagesnotofoilspillsbutofmicrobespillsthatcouldspreaddiseaseanddestroyentirepopulations.Thecreationandaccidentalreleaseofextremelypoisonousmicrobeshoweverisonlyonecauseforalarm.Completelyrationalandrespectablescientistsaretalkingaboutpossibilitiesthatstaggertheimagination. Shouldwebreedpeoplewithcow-likestomachssotheycandigestgrassandhaytherebyrelievingthefoodproblembymodifyingustoeatlowerdownonthefoodchain?Shouldwebiologicallyalterworkerstofitthejobrequirementforexamplecreatingpilotswithfasterreactiontimesorassembly-lineworkersdesignedtodoourmonotonousworkforus?Shouldweattempttoeliminateinferiorpeopleandbreedasuper-race?Hitlertriedthisbutwithoutthegeneticweaponrythatmaysoonissuefromourlaboratories.Shouldweproducesoldierstodoourfighting?Shouldweusegeneticforecastingtopre-eliminateunfitbabies?Shouldwegrowreserveorgansforourselveseachofushavingasitwereasavingsbankfullofsparekidneyliversorhands? Wildasthesenotionsmaysoundeveryonehasitsadvocatesandopposersinthescientificcommunityaswellasitsstrikingcommercialapplication.AstwocriticsofgeneticengineeringJeremyRifkinandTedHowardstateintheirbookWhoShouldPlayGod?BroadScalegeneticengineeringwillprobablybeintroducedtoAmericamuchthesamewayasassemblylinesautomobilesvaccinescomputersandalltheothertechnologies.Aseachnewgeneticadvancebecomescommerciallypracticalanewconsumerneedwillbeexploitedandamarketforthenewtechnologywillbecreated. Accordingtothepassagetheexhaustfromacarenginecouldprobablybecheckedby______.
HeartAttack IntheUnitedStatesandespeciallyinbigcitiesandruralareastensofthousandsofpeoplewithheartsthatshouldbegood【51】tokeepthemalivedieeachyearforlackofadequatefirstaid.InNewYorkCityforexampleanewstudyhasshownthatonlyonepersonin100outsideofhospitals【52】aftertheheartsuddenlystopspumping.IncontrastinSeattlethesurvival【53】aftersuchheartattacksisoneinfive. Thedifferencecanbetraced【54】theeffectivenessofthechainofsurvivalDr.JosephP.Ornatosaid.Eachlinkinthe【55】mustbestrongenoughformanylivestobe【56】. Thechainbeginswithanimmediatetelephone【57】foremergencyhelpandthestartwithinfourminutesoftheprocessneededforrestartingthe【58】workingbyafamilymemberorbystander旁观者. Itcontinueswiththepromptarrival-------withineight【59】tenminutesofarescuerequippedwithaspecialinstrumentthatcanshocktheheartbacktoanormalrhythm.Anditendswiththeadministration给予实施ofadvanced先进emergencycarebynursestomaintaintheheart’’sabilitytosurviveuntilthedoctorsatthehospitalscantake【60】Whenoneormorelinksinthischainfailorfunctiontooslowlythe【61】ofavictimsurvivingheartattackfallsrapidly.Becauseofwidespreadweaknessesinthechainof【62】expertsinemergencyheartcareestimatethat20000to80000people【63】needlesslyofheartattackeachyearanumbercomparabletothe55000killedannuallyinautomobile【64】. OneexpertsaysSendinganemergencyvehicletoaheartattackvictim【65】thespecialequipmentislikehavingpolicemenwithgunsbutnobullets.Theymayputonagoodshowbuttheylacktheweaponneededtogetthejobdone.
Itisalevelthatmustextendbeyondpurelybiologicalneedsto{{U}}comprise{{/U}}asetofindispensablemachinesandsocialinteractions.
MostAdultsinU.S.HaveLowRiskofHeartDisease Morethan80percentofUSadultshavealessthan10percentriskofdevelopingheartdiseaseinthenext10yearsaccordingtoareportintheJournaloftheAmericanCollegeofCardiology.Just3percenthaveariskthatexceeds20percent. IhopethatthesenumberswillgivephysiciansresearchershealthpolicyanalystsandothersabetterideaofhowcoronaryheartdiseaseisdistributedintheUSpopulationleadauthorDr.EarlS.FordfromtheCentersforDiseaseControlandPreventioninAtlantasaidinastatement. Thefindingsarebasedonanalysisofdatafrom13769subjectsbetween20and79yearsofagewhoparticipatedintheThirdNationalHealthandNutritionExaminationSurveyfrom1988to1994. Overall82percentofadultshadariskoflessthan10percent15percenthadariskthatfellbetween10to20percentand3percenthadariskabove20percent. Theproportionofsubjectsinthehighestriskgroupincreasedwithadvancingageandmenweremorelikelythanwomentobeinthisgroup.Bycontrastraceorethnicityhadlittleeffectonriskdistributions. Althoughthereportsuggeststhatmostadultshavealow10-yearriskofheartdiseasealargeproportionhaveahighorimmediateriskDr.DanielS.BermanfromCedars-SinaiMedicalCenterinLosAngelesandDr.NathanD.WongfromtheUniversityofCaliforniaatIrvinenoteinarelatededitorial. Aggressivetreatmentmeasuresandpublichealthstrategiesareneededtoshifttheoverallpopulationriskdownwardtheyadd. Elderlypeoplehaveahigherriskofheartdiseasethanyoungerpeople.
HeartAttack IntheUnitedStatesandespeciallyinbigcitiesandruralareastensofthousandsofpeoplewithheartsthatshouldbegood【51】tokeepthemalivedieeachyearforlackofadequatefirstaid.InNewYorkCityforexampleanewstudyhasshownthatonlyonepersonin100outsideofhospitals【52】aftertheheartsuddenlystopspumping.IncontrastinSeattlethesurvival【53】aftersuchheartattacksisoneinfive. Thedifferencecanbetraced【54】theeffectivenessofthechainofsurvivalDr.JosephP.Ornatosaid.Eachlinkinthe【55】mustbestrongenoughformanylivestobe【56】. Thechainbeginswithanimmediatetelephone【57】foremergencyhelpandthestartwithinfourminutesoftheprocessneededforrestartingthe【58】workingbyafamilymemberorbystander旁观者. Itcontinueswiththepromptarrival-------withineight【59】tenminutesofarescuerequippedwithaspecialinstrumentthatcanshocktheheartbacktoanormalrhythm.Anditendswiththeadministration给予实施ofadvanced先进emergencycarebynursestomaintaintheheart’’sabilitytosurviveuntilthedoctorsatthehospitalscantake【60】Whenoneormorelinksinthischainfailorfunctiontooslowlythe【61】ofavictimsurvivingheartattackfallsrapidly.Becauseofwidespreadweaknessesinthechainof【62】expertsinemergencyheartcareestimatethat20000to80000people【63】needlesslyofheartattackeachyearanumbercomparabletothe55000killedannuallyinautomobile【64】. OneexpertsaysSendinganemergencyvehicletoaheartattackvictim【65】thespecialequipmentislikehavingpolicemenwithgunsbutnobullets.Theymayputonagoodshowbuttheylacktheweaponneededtogetthejobdone.
Thedoctorshaveabandonedthehopetorescuetheoldman.
Thesynergyofhumanssocietyandmachinesisthefundmentalcauseofthe{{U}}unparalleled{{/U}}materialprosperityofmanynations.
MostAdultsinU.S.HaveLowRiskofHeartDisease Morethan80percentofUSadultshavealessthan10percentriskofdevelopingheartdiseaseinthenext10yearsaccordingtoareportintheJournaloftheAmericanCollegeofCardiology.Just3percenthaveariskthatexceeds20percent. IhopethatthesenumberswillgivephysiciansresearchershealthpolicyanalystsandothersabetterideaofhowcoronaryheartdiseaseisdistributedintheUSpopulationleadauthorDr.EarlS.FordfromtheCentersforDiseaseControlandPreventioninAtlantasaidinastatement. Thefindingsarebasedonanalysisofdatafrom13769subjectsbetween20and79yearsofagewhoparticipatedintheThirdNationalHealthandNutritionExaminationSurveyfrom1988to1994. Overall82percentofadultshadariskoflessthan10percent15percenthadariskthatfellbetween10to20percentand3percenthadariskabove20percent. Theproportionofsubjectsinthehighestriskgroupincreasedwithadvancingageandmenweremorelikelythanwomentobeinthisgroup.Bycontrastraceorethnicityhadlittleeffectonriskdistributions. Althoughthereportsuggeststhatmostadultshavealow10-yearriskofheartdiseasealargeproportionhaveahighorimmediateriskDr.DanielS.BermanfromCedars-SinaiMedicalCenterinLosAngelesandDr.NathanD.WongfromtheUniversityofCaliforniaatIrvinenoteinarelatededitorial. Aggressivetreatmentmeasuresandpublichealthstrategiesareneededtoshifttheoverallpopulationriskdownwardtheyadd. Only3percentofUSadultshaveamorethan10percent10-yearriskofheartdisease.
HeartAttack IntheUnitedStatesandespeciallyinbigcitiesandruralareastensofthousandsofpeoplewithheartsthatshouldbegood【51】tokeepthemalivedieeachyearforlackofadequatefirstaid.InNewYorkCityforexampleanewstudyhasshownthatonlyonepersonin100outsideofhospitals【52】aftertheheartsuddenlystopspumping.IncontrastinSeattlethesurvival【53】aftersuchheartattacksisoneinfive. Thedifferencecanbetraced【54】theeffectivenessofthechainofsurvivalDr.JosephP.Ornatosaid.Eachlinkinthe【55】mustbestrongenoughformanylivestobe【56】. Thechainbeginswithanimmediatetelephone【57】foremergencyhelpandthestartwithinfourminutesoftheprocessneededforrestartingthe【58】workingbyafamilymemberorbystander旁观者. Itcontinueswiththepromptarrival-------withineight【59】tenminutesofarescuerequippedwithaspecialinstrumentthatcanshocktheheartbacktoanormalrhythm.Anditendswiththeadministration给予实施ofadvanced先进emergencycarebynursestomaintaintheheart’’sabilitytosurviveuntilthedoctorsatthehospitalscantake【60】Whenoneormorelinksinthischainfailorfunctiontooslowlythe【61】ofavictimsurvivingheartattackfallsrapidly.Becauseofwidespreadweaknessesinthechainof【62】expertsinemergencyheartcareestimatethat20000to80000people【63】needlesslyofheartattackeachyearanumbercomparabletothe55000killedannuallyinautomobile【64】. OneexpertsaysSendinganemergencyvehicletoaheartattackvictim【65】thespecialequipmentislikehavingpolicemenwithgunsbutnobullets.Theymayputonagoodshowbuttheylacktheweaponneededtogetthejobdone.
Hecouldneverbecontentuntilhecouldaffordtobuythatbeautifulcar.
Inaworldinwhichhungerremains{{U}}prevalent{{/U}}machinesandorganizationsholdthekeytoproducingmorefoodanddistributingitequitably.
Euthanasia:aHeatedlyDebatedTopic Wemustn’’tdelayanylonger...?swallowing吞咽isdifficult...andbreathingthat’’salsodifficult.Thosemusclesareweakeningtoo...wemustn’’tdelayanylonger. ThesewerethewordsofDutchman荷兰人CeesvanwendeldeJoodeaskinghisdoctortohelphimdie.AffectedwithaseriousdiseasevanVendelwasnolongerabletospeakclearlyandheknewtherewasnohopeofrecoveryandthathisconditionwasrapidlydeteriorating. VanVenderslastthreemonthsoflifebeforebeinggivenafinallethalinjectionbyhisdoctorwerefilmedandfirstshownontelevisionlastyearintheNetherlands.Theprogrammehassincebeenboughtby20countriesandeachtimeitisshownitstartsanationwidedebateonthesubject. TheNetherlandsistheonlycountryinEuropewhichpermitseuthanasia安乐死althoughitisnottechnicallylegalthere.HoweverdoctorswhocarryouteuthanasiaunderstrictguidelinesintroducedbytheDutchParliament议会twoyearsagoareusuallynotprosecuted.Theguidelinesdemandthatthepatientisexperiencingextremesufferingthatthereisnochanceofacureandthatthepatienthasmaderepeatedrequestsforeuthanasia.Inadditiontothisaseconddoctormustconfirm证实thatthesecriteriahavebeenmetandthedeathmustbereportedtothepolicedepartment. Shoulddoctorsbeallowedtotaketheliveofothers?Dr.WilfredVanOijenCeesvanVendel’’sdoctorexplainshowhelooksatthequestion: Wellit’’snotasifIinplanningtomurderacrowdofpeoplewithamachinegun.InthatcasekillingistheworstthingIcanimagine.Butthat’’sentirelydifferentfrommyworkasadoctor.IcareforpeopleandItrytoensurethattheydon’tsuffertoomuch.That’’sverydifferentthing. Manypeoplethougharetotallyagainstthepracticeofeuthanasia.Dr.AndrewFergusonChairmanoftheorganizationHealthcareopposedtoEuthanasiasaysthatinthevastmajorityofeuthanasiacaseswhatthepatientisactuallyaskingforissomethingelse.Theymaywantahealthprofessionaltoopenupcommunicationforthemwiththeirlovedonesorfamily—there’’snearlyalwaysanotherquestionbehindthequestion. Britainalsohasastrongtraditionofhospices—specialhospitalswhichcareonlyforthedyingandtheirspecialneeds.CicelySaundersPresidentoftheNationalHospiceCouncilandafoundermemberofthehospicemovementarguesthateuthanasiadoesn’’ttakeintoaccountthattherearewaysofcaringforthedying.Sheisalsoconcernedthatallowingeuthanasiawouldunderminetheneedforcareandconsiderationofawiderangeofpeople;It’’sveryeasyinsocietynowfortheelderlythedisabled伤残的andthedependenttofeelthattheyareburdensandthereforethattheyoughttoopt脱离out.Ithinkthatanythingthatlegallyallowstheshorteningoflifedoesmakethosepeoplemorevulnerable脆弱的. Manyfindthisprohibitionofanindividual’’srighttothepaternalistic家长式的.Althoughtheyagreethatlifeisimportantandshouldberespectedtheyfeelthatthequalityoflifeshouldnotbeignored.Dr.VanOijenbelievesthatpeoplehavethefundamentalrighttochooseforthemselvesiftheywanttodie:Whatthosepeoplewhoopposeeuthanasiaaretellingmeisthatdyingpeoplehaven’ttheright.Andthatwhenpeopleareveryillweareallafraidoftheirdeath.Buttherearesituationswheredeathisafriend.Andinthosecaseswhynot? Butwhynot?isaquestionwhichmightcausestrongemotion.ThefilmshowingCeesVanVendel’’sdeathwasbothmovingandsensitive.Hisdoctorwasclearlyafamilyfriend;hiswifehadonlyherhusband’’sinterestsatheart.Somehoweverwouldarguethatitwouldbedangeroustousethisparticularexampletosupportthecaseforeuthanasia.Notallpatientswouldreceivesuchahighlevelofindividualcareandattention. WhentheauthorsaysButwhynot?isaquestionmightcausestrongemotionthelastpara.hemaymean______.
HeartAttack IntheUnitedStatesandespeciallyinbigcitiesandruralareastensofthousandsofpeoplewithheartsthatshouldbegood【51】tokeepthemalivedieeachyearforlackofadequatefirstaid.InNewYorkCityforexampleanewstudyhasshownthatonlyonepersonin100outsideofhospitals【52】aftertheheartsuddenlystopspumping.IncontrastinSeattlethesurvival【53】aftersuchheartattacksisoneinfive. Thedifferencecanbetraced【54】theeffectivenessofthechainofsurvivalDr.JosephP.Ornatosaid.Eachlinkinthe【55】mustbestrongenoughformanylivestobe【56】. Thechainbeginswithanimmediatetelephone【57】foremergencyhelpandthestartwithinfourminutesoftheprocessneededforrestartingthe【58】workingbyafamilymemberorbystander旁观者. Itcontinueswiththepromptarrival-------withineight【59】tenminutesofarescuerequippedwithaspecialinstrumentthatcanshocktheheartbacktoanormalrhythm.Anditendswiththeadministration给予实施ofadvanced先进emergencycarebynursestomaintaintheheart’’sabilitytosurviveuntilthedoctorsatthehospitalscantake【60】Whenoneormorelinksinthischainfailorfunctiontooslowlythe【61】ofavictimsurvivingheartattackfallsrapidly.Becauseofwidespreadweaknessesinthechainof【62】expertsinemergencyheartcareestimatethat20000to80000people【63】needlesslyofheartattackeachyearanumbercomparabletothe55000killedannuallyinautomobile【64】. OneexpertsaysSendinganemergencyvehicletoaheartattackvictim【65】thespecialequipmentislikehavingpolicemenwithgunsbutnobullets.Theymayputonagoodshowbuttheylacktheweaponneededtogetthejobdone.
Theprojectfordevelopinglocalindustrieswasevaluatedforitsusefulnessfeasibilityandeasinessofexecution.
Wethoughtthearrangementwas{{U}}permanent{{/U}}butapparentlyitwasn't.
TheGeneIndustry Majorcompaniesarealreadyinpursuitofcommercialapplicationsofthenewbiology.Theydreamofplacingenzymesintheautomobiletomonitorexhaustandsenddataonpollutiontoamicroprocessorthatwillthenadjusttheengine.TheyspeakofwhattheNewYorkTimescallsmetal—hungrymicrobesthatmightbeusedtominevaluabletracemetalsfromoceanwater.Theyhavealreadydemandedandwontherighttopatentnewlifeforms. Nervouscriticsincludingmanyscientistsworrythatthereiscorporatenationalinternationalandinter-scientificrivalryintheentirebiotechnologicalfield.Theycreateimagesnotofoilspillsbutofmicrobespillsthatcouldspreaddiseaseanddestroyentirepopulations.Thecreationandaccidentalreleaseofextremelypoisonousmicrobeshoweverisonlyonecauseforalarm.Completelyrationalandrespectablescientistsaretalkingaboutpossibilitiesthatstaggertheimagination. Shouldwebreedpeoplewithcow-likestomachssotheycandigestgrassandhaytherebyrelievingthefoodproblembymodifyingustoeatlowerdownonthefoodchain?Shouldwebiologicallyalterworkerstofitthejobrequirementforexamplecreatingpilotswithfasterreactiontimesorassembly-lineworkersdesignedtodoourmonotonousworkforus?Shouldweattempttoeliminateinferiorpeopleandbreedasuper-race?Hitlertriedthisbutwithoutthegeneticweaponrythatmaysoonissuefromourlaboratories.Shouldweproducesoldierstodoourfighting?Shouldweusegeneticforecastingtopre-eliminateunfitbabies?Shouldwegrowreserveorgansforourselveseachofushavingasitwereasavingsbankfullofsparekidneyliversorhands? Wildasthesenotionsmaysoundeveryonehasitsadvocatesandopposersinthescientificcommunityaswellasitsstrikingcommercialapplication.AstwocriticsofgeneticengineeringJeremyRifkinandTedHowardstateintheirbookWhoShouldPlayGod?BroadScalegeneticengineeringwillprobablybeintroducedtoAmericamuchthesamewayasassemblylinesautomobilesvaccinescomputersandalltheothertechnologies.Aseachnewgeneticadvancebecomescommerciallypracticalanewconsumerneedwillbeexploitedandamarketforthenewtechnologywillbecreated. WhatdoseJeremyRifkinandTedHoward’sstatementimply?
CommunicationProblems After20yearsofresearchmycolleaguesandIhavediscoveredthatallcommunicationinvolvesourbodiessometimesprofoundly.Whilewespeakwithwordswealsospeakwitheveryfiberofourbeing.Thislanguageoftheheartisintegraltothehealthandemotionallifeofallofus. Wefoundthatevenapleasantchatabouttheweathercanaffectthecardiovascular心血管性的systemparticularlybloodpressure.Thetraditionalwayoftakingbloodpressure—withastethoscope听诊器—meantthatthepatienthadtokeepsilentandthissilencepreventedcliniciansfromdiscoveringthelinkbetweencommunicationandbloodpressure. Thebreakthroughinourstudiesoccurredin1977whenwemetEdatypicalhypertensivepatientwhocametotheUniversityofMaryland’’sPsychophysiologyCenterfortreatment.WehookedupEdtoanewcom?puterthatcouldcontinuouslymonitorbloodpressure.Wefoundthathispressureimmediatelyincreasedeverytimehespokeevenifhewasdiscussingthemostneutraltopic.WhatwasmoresurprisingwasthatEdwasunawareofthesechanges. Thisfindingsointrigueduswebegantestingothers.Theresultswerethesame.Bloodpressureandheartrateroserapidlywheneverpeopletalked.Weaskedstudentstoreadaloudfromabland乏味的text.Theirbloodpressureandheartrateroserapidlyeverytime.Wetested38deaf-mutevolunteers.Whenthesepeoplesignedtheirbloodpressurealsoincreased.Thisconfirmedoursuspicionthatitwastheactofcommunicationnotjusttalkingthatledtothesechanges. Mostnormaltalkisaseesaw一上一下的动作.Therisingofbloodpressurewhenonetalksisbalancedbyarapidloweringofpressurewhenonelistens.Buttherhythmisoutofsynclinalhypertensives.Theyfluentlyfailtolisten;theyareonguarddefensive.Sotheirpressurestaysup. ThebenefitsoflisteningareseenintheorientingreflexdiscoveredbyPavlov.Whenadoghearsasoundorseesmovementitwillstopallactivityandcockitshead.AnotherRussianscientistE.N.Soklornoticedthatthedog’’sheartrateslows. Asimilarresponseoccursinpeopletoo—anditlowersbloodactivities:readingoutloudstaringatablankwallandwatchingfishinatank.Bloodpressurewashingtestwhenthepeoplespoke.Butitwaslowestwhentheywatchedthefishratherthanwhentheysimplysatandrelaxed.Whetherwatchingfishorlisteningtoanotherpersonattendingcalmlytotheworldoutsideyourselfhelpslowerbloodpressure.WhenIgothypertensivestolistenundefensivelytheirbloodpressureoftenfelldramatically. Whydosomepeoplefindtalkingsostressfulandlisteningsodifficult?Itestedsomehealthynewborns.Whentheycriedtheirbloodpressureoftendoubled.Webeganthinkingaboutpressuresurgesinhypertensivesassimilartothechangeswhenababycries.Thoughcalmonthesurfacewhiletalkingtheirbodiesarescreamingtobeheard.Forthesepeoplecommunicationbecomesadesperatebuthiddenstruggle.Insidetheiradultbodiesisababycryingterrifiedbecausenoonecanhearit. Sohowcanweenjoyconversationyetkeepbloodpressuredown?Bylisteningmorebybreathingregularlywhiletalkingbyalternatingbetweentalkingandpayingattentiontowhattheotherpersonissaying.Butwhatcanhypertensivesdo?Treatmentsthatteachthemtofocusontheirrelationshipandhowtocommunicateinarelaxedwaycanbeastarttowardhealth. Wecanunderstandandcopewithillnessonlywhenweviewourselvesaspartofacomplexworldbeyondtheconfinesofourownindividualskin.Theresponseofourheartsbloodvesselsandmuscleswhenwecommunicatewithspousechildrenfriendsandcolleaguesisasvitaltoourcardiovascularhealthasisexerciseordiet. Fromthearticlewecanconcludethat______.
MostAdultsinU.S.HaveLowRiskofHeartDisease Morethan80percentofUSadultshavealessthan10percentriskofdevelopingheartdiseaseinthenext10yearsaccordingtoareportintheJournaloftheAmericanCollegeofCardiology.Just3percenthaveariskthatexceeds20percent. IhopethatthesenumberswillgivephysiciansresearchershealthpolicyanalystsandothersabetterideaofhowcoronaryheartdiseaseisdistributedintheUSpopulationleadauthorDr.EarlS.FordfromtheCentersforDiseaseControlandPreventioninAtlantasaidinastatement. Thefindingsarebasedonanalysisofdatafrom13769subjectsbetween20and79yearsofagewhoparticipatedintheThirdNationalHealthandNutritionExaminationSurveyfrom1988to1994. Overall82percentofadultshadariskoflessthan10percent15percenthadariskthatfellbetween10to20percentand3percenthadariskabove20percent. Theproportionofsubjectsinthehighestriskgroupincreasedwithadvancingageandmenweremorelikelythanwomentobeinthisgroup.Bycontrastraceorethnicityhadlittleeffectonriskdistributions. Althoughthereportsuggeststhatmostadultshavealow10-yearriskofheartdiseasealargeproportionhaveahighorimmediateriskDr.DanielS.BermanfromCedars-SinaiMedicalCenterinLosAngelesandDr.NathanD.WongfromtheUniversityofCaliforniaatIrvinenoteinarelatededitorial. Aggressivetreatmentmeasuresandpublichealthstrategiesareneededtoshifttheoverallpopulationriskdownwardtheyadd. Therewasagreaterproportionofmenthanwomeninthesurvey.
HeartAttack IntheUnitedStatesandespeciallyinbigcitiesandruralareastensofthousandsofpeoplewithheartsthatshouldbegood【51】tokeepthemalivedieeachyearforlackofadequatefirstaid.InNewYorkCityforexampleanewstudyhasshownthatonlyonepersonin100outsideofhospitals【52】aftertheheartsuddenlystopspumping.IncontrastinSeattlethesurvival【53】aftersuchheartattacksisoneinfive. Thedifferencecanbetraced【54】theeffectivenessofthechainofsurvivalDr.JosephP.Ornatosaid.Eachlinkinthe【55】mustbestrongenoughformanylivestobe【56】. Thechainbeginswithanimmediatetelephone【57】foremergencyhelpandthestartwithinfourminutesoftheprocessneededforrestartingthe【58】workingbyafamilymemberorbystander旁观者. Itcontinueswiththepromptarrival-------withineight【59】tenminutesofarescuerequippedwithaspecialinstrumentthatcanshocktheheartbacktoanormalrhythm.Anditendswiththeadministration给予实施ofadvanced先进emergencycarebynursestomaintaintheheart’’sabilitytosurviveuntilthedoctorsatthehospitalscantake【60】Whenoneormorelinksinthischainfailorfunctiontooslowlythe【61】ofavictimsurvivingheartattackfallsrapidly.Becauseofwidespreadweaknessesinthechainof【62】expertsinemergencyheartcareestimatethat20000to80000people【63】needlesslyofheartattackeachyearanumbercomparabletothe55000killedannuallyinautomobile【64】. OneexpertsaysSendinganemergencyvehicletoaheartattackvictim【65】thespecialequipmentislikehavingpolicemenwithgunsbutnobullets.Theymayputonagoodshowbuttheylacktheweaponneededtogetthejobdone.
Euthanasia:aHeatedlyDebatedTopic Wemustn’’tdelayanylonger...?swallowing吞咽isdifficult...andbreathingthat’’salsodifficult.Thosemusclesareweakeningtoo...wemustn’’tdelayanylonger. ThesewerethewordsofDutchman荷兰人CeesvanwendeldeJoodeaskinghisdoctortohelphimdie.AffectedwithaseriousdiseasevanVendelwasnolongerabletospeakclearlyandheknewtherewasnohopeofrecoveryandthathisconditionwasrapidlydeteriorating. VanVenderslastthreemonthsoflifebeforebeinggivenafinallethalinjectionbyhisdoctorwerefilmedandfirstshownontelevisionlastyearintheNetherlands.Theprogrammehassincebeenboughtby20countriesandeachtimeitisshownitstartsanationwidedebateonthesubject. TheNetherlandsistheonlycountryinEuropewhichpermitseuthanasia安乐死althoughitisnottechnicallylegalthere.HoweverdoctorswhocarryouteuthanasiaunderstrictguidelinesintroducedbytheDutchParliament议会twoyearsagoareusuallynotprosecuted.Theguidelinesdemandthatthepatientisexperiencingextremesufferingthatthereisnochanceofacureandthatthepatienthasmaderepeatedrequestsforeuthanasia.Inadditiontothisaseconddoctormustconfirm证实thatthesecriteriahavebeenmetandthedeathmustbereportedtothepolicedepartment. Shoulddoctorsbeallowedtotaketheliveofothers?Dr.WilfredVanOijenCeesvanVendel’’sdoctorexplainshowhelooksatthequestion: Wellit’’snotasifIinplanningtomurderacrowdofpeoplewithamachinegun.InthatcasekillingistheworstthingIcanimagine.Butthat’’sentirelydifferentfrommyworkasadoctor.IcareforpeopleandItrytoensurethattheydon’tsuffertoomuch.That’’sverydifferentthing. Manypeoplethougharetotallyagainstthepracticeofeuthanasia.Dr.AndrewFergusonChairmanoftheorganizationHealthcareopposedtoEuthanasiasaysthatinthevastmajorityofeuthanasiacaseswhatthepatientisactuallyaskingforissomethingelse.Theymaywantahealthprofessionaltoopenupcommunicationforthemwiththeirlovedonesorfamily—there’’snearlyalwaysanotherquestionbehindthequestion. Britainalsohasastrongtraditionofhospices—specialhospitalswhichcareonlyforthedyingandtheirspecialneeds.CicelySaundersPresidentoftheNationalHospiceCouncilandafoundermemberofthehospicemovementarguesthateuthanasiadoesn’’ttakeintoaccountthattherearewaysofcaringforthedying.Sheisalsoconcernedthatallowingeuthanasiawouldunderminetheneedforcareandconsiderationofawiderangeofpeople;It’’sveryeasyinsocietynowfortheelderlythedisabled伤残的andthedependenttofeelthattheyareburdensandthereforethattheyoughttoopt脱离out.Ithinkthatanythingthatlegallyallowstheshorteningoflifedoesmakethosepeoplemorevulnerable脆弱的. Manyfindthisprohibitionofanindividual’’srighttothepaternalistic家长式的.Althoughtheyagreethatlifeisimportantandshouldberespectedtheyfeelthatthequalityoflifeshouldnotbeignored.Dr.VanOijenbelievesthatpeoplehavethefundamentalrighttochooseforthemselvesiftheywanttodie:Whatthosepeoplewhoopposeeuthanasiaaretellingmeisthatdyingpeoplehaven’ttheright.Andthatwhenpeopleareveryillweareallafraidoftheirdeath.Buttherearesituationswheredeathisafriend.Andinthosecaseswhynot? Butwhynot?isaquestionwhichmightcausestrongemotion.ThefilmshowingCeesVanVendel’’sdeathwasbothmovingandsensitive.Hisdoctorwasclearlyafamilyfriend;hiswifehadonlyherhusband’’sinterestsatheart.Somehoweverwouldarguethatitwouldbedangeroustousethisparticularexampletosupportthecaseforeuthanasia.Notallpatientswouldreceivesuchahighlevelofindividualcareandattention. Whoisagainsteuthanasia?
Mothertoldmetotakeanumbrellawithme;itmight{{U}}comeinhandy{{/U}}shesaid.
TheGeneIndustry Majorcompaniesarealreadyinpursuitofcommercialapplicationsofthenewbiology.Theydreamofplacingenzymesintheautomobiletomonitorexhaustandsenddataonpollutiontoamicroprocessorthatwillthenadjusttheengine.TheyspeakofwhattheNewYorkTimescallsmetal—hungrymicrobesthatmightbeusedtominevaluabletracemetalsfromoceanwater.Theyhavealreadydemandedandwontherighttopatentnewlifeforms. Nervouscriticsincludingmanyscientistsworrythatthereiscorporatenationalinternationalandinter-scientificrivalryintheentirebiotechnologicalfield.Theycreateimagesnotofoilspillsbutofmicrobespillsthatcouldspreaddiseaseanddestroyentirepopulations.Thecreationandaccidentalreleaseofextremelypoisonousmicrobeshoweverisonlyonecauseforalarm.Completelyrationalandrespectablescientistsaretalkingaboutpossibilitiesthatstaggertheimagination. Shouldwebreedpeoplewithcow-likestomachssotheycandigestgrassandhaytherebyrelievingthefoodproblembymodifyingustoeatlowerdownonthefoodchain?Shouldwebiologicallyalterworkerstofitthejobrequirementforexamplecreatingpilotswithfasterreactiontimesorassembly-lineworkersdesignedtodoourmonotonousworkforus?Shouldweattempttoeliminateinferiorpeopleandbreedasuper-race?Hitlertriedthisbutwithoutthegeneticweaponrythatmaysoonissuefromourlaboratories.Shouldweproducesoldierstodoourfighting?Shouldweusegeneticforecastingtopre-eliminateunfitbabies?Shouldwegrowreserveorgansforourselveseachofushavingasitwereasavingsbankfullofsparekidneyliversorhands? Wildasthesenotionsmaysoundeveryonehasitsadvocatesandopposersinthescientificcommunityaswellasitsstrikingcommercialapplication.AstwocriticsofgeneticengineeringJeremyRifkinandTedHowardstateintheirbookWhoShouldPlayGod?BroadScalegeneticengineeringwillprobablybeintroducedtoAmericamuchthesamewayasassemblylinesautomobilesvaccinescomputersandalltheothertechnologies.Aseachnewgeneticadvancebecomescommerciallypracticalanewconsumerneedwillbeexploitedandamarketforthenewtechnologywillbecreated. WhichofthefollowingnotionsisNOTmentioned?
IcyroadsandpoorvisibilityarefamiliarhazardsintheMidwest.
Theteamusuallywearshirtswithredandwhite{{U}}vertical{{/U}}stripes.
Thechairmanproposedthatweshouldstopthemeeting.
Euthanasia:aHeatedlyDebatedTopic Wemustn’’tdelayanylonger...?swallowing吞咽isdifficult...andbreathingthat’’salsodifficult.Thosemusclesareweakeningtoo...wemustn’’tdelayanylonger. ThesewerethewordsofDutchman荷兰人CeesvanwendeldeJoodeaskinghisdoctortohelphimdie.AffectedwithaseriousdiseasevanVendelwasnolongerabletospeakclearlyandheknewtherewasnohopeofrecoveryandthathisconditionwasrapidlydeteriorating. VanVenderslastthreemonthsoflifebeforebeinggivenafinallethalinjectionbyhisdoctorwerefilmedandfirstshownontelevisionlastyearintheNetherlands.Theprogrammehassincebeenboughtby20countriesandeachtimeitisshownitstartsanationwidedebateonthesubject. TheNetherlandsistheonlycountryinEuropewhichpermitseuthanasia安乐死althoughitisnottechnicallylegalthere.HoweverdoctorswhocarryouteuthanasiaunderstrictguidelinesintroducedbytheDutchParliament议会twoyearsagoareusuallynotprosecuted.Theguidelinesdemandthatthepatientisexperiencingextremesufferingthatthereisnochanceofacureandthatthepatienthasmaderepeatedrequestsforeuthanasia.Inadditiontothisaseconddoctormustconfirm证实thatthesecriteriahavebeenmetandthedeathmustbereportedtothepolicedepartment. Shoulddoctorsbeallowedtotaketheliveofothers?Dr.WilfredVanOijenCeesvanVendel’’sdoctorexplainshowhelooksatthequestion: Wellit’’snotasifIinplanningtomurderacrowdofpeoplewithamachinegun.InthatcasekillingistheworstthingIcanimagine.Butthat’’sentirelydifferentfrommyworkasadoctor.IcareforpeopleandItrytoensurethattheydon’tsuffertoomuch.That’’sverydifferentthing. Manypeoplethougharetotallyagainstthepracticeofeuthanasia.Dr.AndrewFergusonChairmanoftheorganizationHealthcareopposedtoEuthanasiasaysthatinthevastmajorityofeuthanasiacaseswhatthepatientisactuallyaskingforissomethingelse.Theymaywantahealthprofessionaltoopenupcommunicationforthemwiththeirlovedonesorfamily—there’’snearlyalwaysanotherquestionbehindthequestion. Britainalsohasastrongtraditionofhospices—specialhospitalswhichcareonlyforthedyingandtheirspecialneeds.CicelySaundersPresidentoftheNationalHospiceCouncilandafoundermemberofthehospicemovementarguesthateuthanasiadoesn’’ttakeintoaccountthattherearewaysofcaringforthedying.Sheisalsoconcernedthatallowingeuthanasiawouldunderminetheneedforcareandconsiderationofawiderangeofpeople;It’’sveryeasyinsocietynowfortheelderlythedisabled伤残的andthedependenttofeelthattheyareburdensandthereforethattheyoughttoopt脱离out.Ithinkthatanythingthatlegallyallowstheshorteningoflifedoesmakethosepeoplemorevulnerable脆弱的. Manyfindthisprohibitionofanindividual’’srighttothepaternalistic家长式的.Althoughtheyagreethatlifeisimportantandshouldberespectedtheyfeelthatthequalityoflifeshouldnotbeignored.Dr.VanOijenbelievesthatpeoplehavethefundamentalrighttochooseforthemselvesiftheywanttodie:Whatthosepeoplewhoopposeeuthanasiaaretellingmeisthatdyingpeoplehaven’ttheright.Andthatwhenpeopleareveryillweareallafraidoftheirdeath.Buttherearesituationswheredeathisafriend.Andinthosecaseswhynot? Butwhynot?isaquestionwhichmightcausestrongemotion.ThefilmshowingCeesVanVendel’’sdeathwasbothmovingandsensitive.Hisdoctorwasclearlyafamilyfriend;hiswifehadonlyherhusband’’sinterestsatheart.Somehoweverwouldarguethatitwouldbedangeroustousethisparticularexampletosupportthecaseforeuthanasia.Notallpatientswouldreceivesuchahighlevelofindividualcareandattention. Dr.WilfredVanOijenmayagreethat______.
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