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Most patients respond to the awareness that they have a terminal illness with the statement, "Oh no, this can"t happen to me. " After the first shock, numbness, and need to deny the reality of the situation, the patient begins to send out cues that he is ready to "talk about it". If we, at that point, need to deny the reality of the situation, the patient will often feel deserted, isolated, and lonely and unable to communicate with another human being what he needs so desperately to share. Most patients who have passed the stage will become angry as they ask the question, "Why me" Many look at others in their environment and express envy, jealousy, anger, and rage toward those who are young, healthy, and full of life. These are the patients who make life difficult for nurses, physicians, social workers, clergymen, and members of their families. Without justification they criticize everyone. What we have to learn is that the stage in terminal illness is a blessing, not a cure. These patients are not angry at their families or at the members of the helping professions. Rather, they are angry at what these people represent; health and energy. Without being judgmental, we must allow these patients to express their anger and dismay. We must try to understand that the patients have to ask, "Why me" and that there is no need on our part to answer this question concretely. Once a patient has ventilated his rage and his envy, then he can arrive at the bargaining stage. During this time, he" s usually able to say, "Yes, it is happening to me—but". The"but" usually includes a prayer to God; "If you give me one more year to live, I will be a good Christian. " How many stages can a patient with terminal illness pass through in facing death
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下列属于会计软件数据最基本的输出形式是______。
Charles Paul and his wife, Hazel, stopped using the motor home they bought several years ago; it sits idle behind their house in Richardson, Texas. Travel is just one sacrifice they made to pay for the cost of their prescriptions, more than a dozen medications for the two of them. They found relief by switching drugstores, to one in nearby McKinney. A prescription for Paul" s diabetes had cost $ 89. 88 when he got it from a national chain but dropped down to $ 58 from McKinney" s Smith Drug. Smith, which claims to be the oldest drugstore in Texas, has been getting a lot of attention since a Dallas newspaper touted its astoundingly low prices. The overwhelming response from the public has been " a little scary," says co-owner Kaylei Mosier. She says the store simply marks each prescription up enough to cover its costs, but for many prescriptions that" s a lot lower than at other stores. The Smith Drug story has highlighted a little-known fact: prescription prices vary from city to city and block to block, and a little research can save consumers hundreds or thousands of dollars. Insurance copays can make these differences invisible, but they" re a huge deal to the 45 million uninsured Americans. Why the price swings Howard Schiff, executive director of the Maryland Pharmacists Association , explains that pharmacies generally buy their drugs from a wholesaler, who doesn" t sell to every drugstore at the same price. Once the drug is in the pharmacy, each owner chooses how much to mark it up. Because fewer than 10 percent of consumers comparison-shop for prescriptions the way they might for a quart of milk—and drug prices generally are not advertised—pharmacies don" t worry that higher prices will drive people away, says Stanford economist Alan Scorensen. There is a downside to hopping from drugstore to drugstore. If people price-shop, they" re going to lose some protection that comes from having one pharmacy track all your medications. Going to many pharmacies keeps one pharmacist from noticing potentially harmful interactions between prescriptions. Comparison-shopping is further complicated because pharmacies that have the best price on one drug don" t usually have the lowest prices across the board, so finding a good price on one drug at a pharmacy does not guarantee a cheaper total bill. The word "downside" used in the last paragraph refers to______.
Researchers have recently found a connection between disease and stressful situations. To test this theory, psychologists are trying to find a link between the brain and the immune system. The immune system in our bodies fights the bacteria and viruses which cause disease. Therefore , whether or not we are likely to get various diseases depends on how well our immune system works. Biologists used to think that the immune system was a separate, independent part of our bodies. Recently, however, they have found that our brain can affect our immune system. This discovery indicates that there may be a connection between emotional factors, such as stress or depression, and illness. Although many doctors in the past suspected a connection between emotional factor and disease, they had no proof. Scientists have only recently discovered how the brain and the immune system function. Before this, no one could see a link between them. As a result, medical science never seriously considered the idea that psychological factors could cause disease. Several recent studies showed a connection between stress and illness, for example, researchers went to an American military school to study the students. They found that the sick students there had a lot of academic pressure and wanted to achieve, but they were not very good students. In a similar study, researchers studied a group of student nurses and found that the nurses who developed cold sores were the ones who described themselves as generally unhappy people. In addition to these results, which support their theory, researchers are also looking for proof that stress can damage the immune system. Researchers studied recently bereaved people, i. e. , people whose loved ones have just died, because they are more likely to become ill or die. By examining the immune system of recently bereaved people, the researchers made an important discovery. They examined some white blood cells which are an important part of the immune system. They were not functioning properly. The fact that they were not working correctly indicates that severe psychological stress, such as a loved one" s death, may damage an important part of our immune system. There is still no positive proof of a connection between the immune system and psychological factors. Researchers also say that the results of the studies on bereaved people could have a different explanation. For example, bereaved people often sleep and eat less than normal, or may drink alcohol or take medication. These factors can also affect the immune system. More research is needed to clearly establish the connection between the immune system and psychological factors. In the past,many doctors______.
Scientists have developed a slimming drug that successfully suppresses appetite and results in a dramatic loss of weight without any apparent ill effects. The drug interferes with appetite control and prevents the build-up of fatty tissue. More importantly, the drug appears to prevent a serious decline in metabolic rate-causing tiredness and lethargy—which is typically associated with living on a starvation diet. As a result, mice taking the drug lost 45 percent more weight than mice fed the same amount of food, which compensate for the lack of food by becoming more sluggish. The scientists, from the Johns Hopkins University in Baltimore, said that C 75 is likely to produce a similar effect on humans because appetite control in the brain is thought to be based largely on the same chemical pathways as those in mice. " We are not claiming to have found the fabled weight-loss drug. What we have found, using C 75, is a major path way in the brain that the body uses naturally in regulating appetite at least in mice," said Francis Kuhajda, a pathologist and senior team member. "We badly need effective drugs for weight loss. Obesity is a huge problem. We"re hoping to explore the possibilities of this new pathway," he said. Discovering a biochemical pathway in the brain that controls appetite raises new prospects for developing slimming aids. Research on leptin, a hormone produced in fatty tissue for controlling fat deposits, has so far failed to produce the expected slimming drug break-through. The latest study, published in the journal Science, showed that even moderate doses of C 75 produced a significant loss of appetite, which returned to normal after a few months. The scientists believe that C 75, which they produced synthetically in the laboratory, binds to an enzyme called fatty acid sythase, which is involved in storing excess food intake as fat. Inhibiting the enzyme causes a build-up of a chemical in the liver which acts as a precursor to fat deposition. This precursor is thought to have an indirect effect on the brain, causing appetite suppression. Normally, when animals fast, a hormone called neuropeptide Y increases sharply in the appetite control centers of the brain, stimulating the desire for food. However, when animals are given C 75, levels of this hormone fall, leading to a loss of interest in food. Dr Kuhajda said discovering that C 75 has no effect on metabolic rate is one of the most significant findings of the study. "If you try to lose weight by starving, your metabolism slows down after a few days," he said. " It" s a survival mechanism that sabotages many diets. We see this in fasting mice. Yet metabolic rate in the C 75-treated mice doesn"t slow at all. " Further animals studies will be needed before C 75 could be tested on humans. Living on a starvation diet may result in______ .
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