|
考研英语阅读题源来源广泛,取自《经济学人》、《纽约时报》、《新闻周刊》、《卫报》、《Nature》、《华盛顿邮报》、《The Scientist》等等【了解更多题源】,因此考生可以多关注一下此类文章。下面新东方在线分享一些考过的题源文章,并附上详细解析,本阶段复习,大家可以看看。
From The New York Times
By Kate Murphy
Apr.17, 2007
Teaching Doctors to Teach Patients about Lifestyle
Everybody knows that diet, exercise and other aspects of lifestyle play a
significant role in health. But the specifics are less well understood.
To what extent does lifestyle cause or contribute to disease and
disability? And what exactly is a healthy lifestyle anyway? There is much
confusion about what type of diet or exercise is best, not to mention how much
sleep, stress or sex is ideal. Nor is it clear how best to motivate people to
change their habits.
This lack of clarity has inspired a growing movement to inform health
professionals and patients about the importance of lifestyle in preventing and
treating disease. Its aims are to disseminate scientific research about what it
means to live well and to encourage doctors and other providers to incorporate
this knowledge into their practices.
Two years ago, a group of doctors founded an organization with the goal of
making lifestyle medicine a credentialed clinical specialty and a part of basic
medical training. Symptomatically treating disease without assessing patients'
lifestyles or offering them guidance on how to change is "irresponsible and
bordering on neglect," said Dr. John H. Kelly Jr. , president of the fledgling
organization, the American College of Lifestyle Medicine.
A professor of preventive medicine at the Loma Linda University School of
Medicine in California, Dr. Kelly said the group was formed because of people
like his uncle.
Given a diagnosis of heart disease, the uncle had a stent surgically
implanted to open a clogged artery but received no advice on how he might change
his lifestyle, even though research shows that diet, exercise and stress
management could greatly improve his condition.
Dr. Kelly says lifestyle medicine is essential in fighting the national
epidemics of obesity, diabetes and cardiovascular disease. "We cannot solve the
health problems of society unless we change our focus from acute, episodic care
to health promotion and wellness-lifestyle medicine," he said.
The Centers for Disease Control and Prevention reports that 1.7 million
Americans die and 25 million are disabled each year by chronic diseases caused
or made worse by unhealthy lifestyles. And a 2005 study in The New England
Journal of Medicine predicted that average life expectancy in the United States
would decline in the next 20 years as a result of unhealthy lifestyles,
reversing a trend dating to the 1850s. The American College of Lifestyle
Medicine has 150 members in a wide array of specialties-nutritionists,
ophthalmologists, gastroenterologists and oncologists, among others. Helping
their cause is a new publication, The American Journal of Lifestyle Medicine,
which appears every other month with peer-reviewed research on the way daily
habits affect health.
"Bottom line is we want to promote the science, education and practice of
lifestyle medicine,'' Dr. Kelly said.
Lifestyle medicine proponents include researchers and clinicians from the
fields of medicine and public health. While they agree on the importance of
questioning patients about their lifestyles and giving tailored advice on how to
make improvements, there remains disagreement about who should provide such
counseling and with what sort of training. Nor is there a widely accepted
prescriptive approach for encouraging patient compliance.
“We know lifestyle interventions can be very powerful, often more effective
than drugs or surgery," said Dr. JoAnn Manson, a professor of epidemiology at
Harvard's School of Public Health and a member of the editorial board of the new
journal. “But we need to provide the scientific evidence an how to incorporate
that knowledge into practice."
Doctors may vaguely recommend that patients lose weight or get more sleep,
for example, but they do not necessarily, know how to help them do it.
Moreover, many physicians themselves have unhealthy habits that may prevent
them from offering advice.
"Sleep-deprived doctor who scarf candy bars for lunch tend to feel
inhibited in counseling others when they aren't exactly setting an example,"
said Dr. Walter Willett, chairman of the department of nutrition at the Harvard
School of Public Health and a member of the lifestyle medicine college's board
of advisers.
"Primary caregivers at least should have extensive training in lifestyle
medicine," Dr. Willett said. “And it's reasonable for there to be a medical
specialty" so patients can consult a trained practitioner who is certified as an
expert in the field.
Others say lifestyle medicine should be incorporated into every facet of
health care.
"I don't think it's appropriate to segment it off," said Dr. Thomas W.
Rowland, chief of pediatric cardiology at Baystate Medical Center in
Springfield, Mass., who routinely counsels children and parents on how to adopt
health lifestyles. "it needs to be a fundamental part of every doctor's practice
and therefore a part of every medical school's core curriculum."
Still, he acknowledges that there are significant obstacles, because
lifestyle consuming is time-consuming and is seldom compensated by Medicare or
health insurers.
Reimbursement is a chief concern of the American College of Lifestyle
Medicine. The group plans to lobby Congress to that end. And it wants Congress
to require that patients be informed about the relative effectiveness of
lifestyle changes before receiving certain medications--including blood
pressure, acid reflex and cholesterol drugs-and before undergoing procedures
like back surgery, bypass surgery and stent placement.
But first, Dr. Kelly said, patients and insurers need to be assured of the
professionalism of lifestyle medicine providers.
Some doctors say the movement suffers from fringe elements that advocate
unproven strategies like strict vegan diets and daily saunas .
“Lifestyle medicine has to be scientifically base to distinguish it from
all the quackery out there," said David R. Brown, senior behavioral scientist in
the division of nutrition and physical activity at the disease control
center.
Dr. Kelly agreed. "We need to have a certification process in place with
rigorous, evidence- based standards," he said.
Proponents of lifestyle medicine are quick to distinguish it from
alternative medicine. “This
is mainstream medicine supported by mainstream medical research," said Dr.
James M. Rippe, associate professor of cardiology at Tufts University School of
Medicine and the editor of The American Journal of Lifestyle Medicine. "The
lifestyle medicine movement is not an anti- procedure, anti-medication
movement."
Rather, he said, it advocates that lifestyle interventions become part of
doctor’s arsenal in fighting disease: "For too long we’ve ignored out most
powerful weapon when it should be our first line of defense.”
|
|