Preventive medicine a-introduction-nepal-10.8.21
新健康的英语作文带翻译
Title: The Importance of Maintaining Good Health
健康的重要性
Introduction:
Good health is crucial for a happy and fulfilling life. In today's fast-paced world, it is becoming increasingly important to prioritize our physical and mental well-being. This essay will delve into the significance of maintaining good health, providing examples, templates, and sample essays to help you express your thoughts effectively in English.
降低压力水平：
保持良好健康有助于降低压力水平。参与瑜伽、冥想等身体活动，并过上健康的生活方式可以促进放松，减轻焦虑。这使个体能够有更好的心理清晰度和改善的决策能力。
3. Case Study: The Japanese Approach to Healthy Living
案例研究：日本人健康生活的方法
4. Essay Template: Discussing the Importance of Good Health
Introduction:
- Introduce the topic of good health and its significance.
- Mention the physical and mental benefits of maintaining good health.
预防医学相关英语
预防医学相关英语Title: Preventive Medicine in HealthcareIntroduction:Preventive medicine plays a crucial role in maintaining and promoting public health. It focuses on preventing diseases, injuries, and other health-related issues rather than simply treating them. By implementing preventive measures, individuals and communities can reduce healthcare costs, improve quality of life, and minimize the burden on healthcare systems. This article aims to explore various aspects of preventive medicine and its significance in healthcare.I. Importance of Preventive Medicine:1.1. Disease Prevention:Preventive medicine emphasizes the importance of immunizations, screenings, and early detection to prevent the development and progression of diseases such as cancer, cardiovascular diseases, and diabetes. Regular check-ups, vaccinations, and health screenings can identify potential health risks and allow for timely interventions.1.2. Lifestyle Modifications:Promoting healthy behaviors is a key component of preventive medicine. Encouraging individuals to adopt a balanced diet, engage in regular physical activity, maintain a healthy weight, and avoid smoking and excessive alcohol consumption can significantly reduce the risk of chronic diseases. Health education programs and awareness campaigns play a vital role in empowering individuals to make informed choices.1.3. Environmental Health:Preventive medicine also addresses environmental factors that contribute to health issues. Ensuring clean air, safe drinking water, proper waste management, and reducing exposure to harmful substances are essential in preventing respiratory diseases, waterborne illnesses, and occupational hazards.II. Strategies for Preventive Medicine:2.1. Primary Prevention:Primary prevention focuses on eliminating or reducing the risk factors associated with diseases. It includes health promotion activities, such as education, awareness campaigns,and policy interventions. For example, implementing smoking bans in public places has proven effective in reducing the prevalence of smoking-related illnesses.2.2. Secondary Prevention:Secondary prevention aims to detect diseases at an early stage when interventions are most effective. Regular health screenings, such as mammograms, Pap smears, and colonoscopies, enable early detection and treatment of conditions before they progress.2.3. Tertiary Prevention:Tertiary prevention focuses on minimizing the impact of diseases and preventing complications. It involves managing chronic conditions and providing rehabilitation services to enhance quality of life. Disease management programs and specialized healthcare services are vital components of tertiary prevention.III. Benefits of Preventive Medicine:3.1. Cost Savings:Preventive medicine can significantly reduce healthcare costs by preventing expensive treatments and hospitalizations.Investing in preventive measures can yield substantial long-term savings for individuals, healthcare systems, and society as a whole.3.2. Improved Quality of Life:By preventing diseases and promoting healthy lifestyles, preventive medicine improves overall quality of life. It enables individuals to live longer, healthier lives, free from the burden of chronic illnesses and their associated complications.3.3. Enhanced Healthcare System:Emphasizing preventive medicine helps relieve the strain on healthcare systems. By reducing the demand for acute care services, resources can be allocated more efficiently to provide better care for those in need.Conclusion:Preventive medicine is a vital component of healthcare, focusing on disease prevention, lifestyle modifications, and environmental health. By implementing strategies such as primary, secondary, and tertiary prevention, individuals and communities can enjoy the benefits of improved health, reduced healthcare costs, and enhanced quality of life.Prioritizing preventive medicine in healthcare policies and practices is essential for creating a healthier and more sustainable future.。
泰山医学院预防医学本科专业人才培养方案
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2 公共关系学
Public Relationship
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3 管理学概论
Introduction To Management
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4 经济学概论
Introduction To Economics
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5 计算机应用技术 Technology Of Computer Application 1.5 32 16 16 16
三、主干学科和核心课程
主干学科：基础医学、临床医学、预防医学 核心课程：基础化学、有机化学、系统解剖学、生理学、生物化学、医学 微生物学、医学免疫学、组织学与胚胎学、病理学、病理生理学、药理学、诊 断学、内科学、外科学总论、妇产科学、儿科学、传染病学、卫生统计学、卫 生化学、卫生微生物学、流行病学、环境卫生学、营养与食品卫生学、职业卫 生与职业医学、儿童少年卫生学、毒理学基础、卫生经济学、健康教育学、突 发公共卫生事件处理等。
医学史、哲学社会学、文献检索、 公共卫生英语、医学学术英语阅读 等
计算机应用技术、信息时代的科学 技术革命 卫生统计学、流行病学、社会医 学、SPSS 软件应用、SAS 统计软 件应用等 基础化学、有机化学、系统解剖 学、生理学、生物化学、医学微生 物学、医学免疫学、组织学与胚胎 学、病理学、病理生理学、药理 学、诊断学、内科学、外科学总 论、妇产科学、儿科学、传染病 学、卫生统计学、卫生化学、卫生 微生物学、流行病学、环境卫生 学、营养与食品卫生学、职业卫生 与职业医学、儿童少年卫生学、毒 理学基础、卫生经济学、健康教育 学、突发公共卫生事件处理等 系统解剖学、生理学、生物化学、 医学微生物、病理生理学、药理 学、病理学、诊断学、内科学、外 科学、妇产科学、儿科学、皮肤病 科学、眼科学、精神病学、传染病
就业规划当医生的英语作文
就业规划当医生的英语作文When parents mention the "good major" in their mind, medicine is an indispensable existence. The employment risk of many jobs has been greatly increased, and the medical major is firmly on the list of popular majors for examination. However, we have entered a misconception. In fact, studying medicine is not equal to becoming a doctor, and different categories face different employment conditions and salary conditions. The following is a brief introduction to the employment prospects of different medical majors under the guidance of a small editor, so that you can have a more thorough idea of your career planning and development. Basic medicine tends to medical research. Most of the work is done in schools, medical institutions, life science research institutions, pharmaceutical enterprises, etc. There are a wide range of choices, but there is also a great degree competition.In addition, scientific research generally requires high-level and high-level talents. If you want to be professional, you need to consider going to graduate school or studying abroad for further study. According to the statistics of the Sunshine College Entrance Examination Information Platform, the employment rate of clinical medicine is85%~90%. However, with the expansion of medical school enrollment, the job applications of big cities+big hospitals are also gradually changing. Medical doctors generally do not worry about employment, but many doctoral students feel that the cost performance ratio is low; It is still difficult to obtain direct employment for undergraduates, and most of them can only choose to take the postgraduate entrance examination. If they do not take the postgraduate entrance examination, they are only likely to engage in other medical related jobs or change careers directly. Small suggestion: if you want to graduate and get employed, targeted distribution may be a good choice.The employment field of stomatologists is relatively wide. They can not only work in stomatology in large hospitals, but also set up private clinics, and can engage in facial surgery and beauty in beauty salons. After graduation, students majoring in stomatology can engage in work related to medical education, scientific research and clinical practice. However, the stomatological medical talents in big cities are gradually saturated. If they still aspire to big cities+big hospitals, they still need to further improve their academic qualifications. The employment prospects of public health and preventive medicine may be wider than those of basic medicine and clinical medicine. Moreover, the industries contacted after employment are more abundant than basic medicine and clinicalmedicine. Preventive medicine plays an important role in the national public health management and research. The employment direction mainly includes hospitals, Centers for Disease Control and Prevention, Chinese health supervision units, entry-exit inspection and quarantine bureaus, food and drug administrations, health administrative departments, etc. Students of this major have the ability to develop in various directions, but their income level is somewhat lower than that of clinical medicine and stomatology. After graduation, students majoring in traditional Chinese medicine can engage in clinical medical work and scientific research of traditional Chinese medicine in TCM hospitals, TCM research institutions and general hospitals at all levels. Jobs: beautician, traditional Chinese medicine doctor, traditional Chinese medicine doctor, traditional Chinese medicine doctor, beauty tutor, traditional Chinese medicine, traditional Chinese medicine doctor, traditional Chinese medicine doctor, medical sales representative, traditional Chinese medicine physiotherapist, nurse, etc. Traditional Chinese medicine has no advantage over western medicine. However, with the improvement of people's health awareness and the country's strong advocacy of traditional culture, the demand for TCM in society is long-term.。
有关医疗卫生人员职衔职称的英文翻译
有关医疗卫生人员职衔职称的英文翻译医士 Assistant Doctor主任药师 Professor of Pharmacy 主管药师 Pharmacist-in-charge 药师 Pharmacist药士Assistant Pharmacist主任护师 Professor of Nursing 主管护师 Nurse-in-charge护师Nurse Practitioner护士Nurse主任技师 Senior Technologist主管技师Technologist-in-charge技师 Technologist 技士Technician主治医师 Doctor-in-charge外科主治医师 Surgeon-in-charge 内科主治医师 Physician-in-charge 眼科主治医师 Oculist-in-charge 妇科主治医师 Gynaecologist-in-charge 牙科主治医师 Dentist-in-charge医师 Doctor儿科主任医师 主任医师（讲课）Professor of Medicine主任医师（医疗）Professor of TreatmentProfessor of Paediatrics中英文大学课程对照表：应用生物学Applied Biology 医学技术Medical Technology 细胞生物学Cell Biology 医学Medicine 生物学Biology 护理麻醉学Nurse Anesthesia 进化生物学Evolutionary Biology 口腔外科学Oral Surgery 海洋生物学Marine Biology 口腔/ 牙科科学Oral/Dental Sciences微生物学Microbiology 骨科医学Osteopathic Medicine 分子生物学Molecular Biology 耳科学Otology 医学微生物学Medical Microbiology 理疗学Physical Therapy 口腔生物学Oral Biology 足病医学Podiatric Medicine寄生物学Parasutology 眼科学Ophthalmology 植物生物学Plant Physiology 预防医学Preventive Medicine心理生物学Psychobiology 放射学Radiology放射生物学Radiation Biology 康复咨询学Rehabilitation Counseling 理论生物学Theoretical Biology 康复护理学Rehabilitation Nursing野生生物学Wildlife Biology 外科护理学Surgical Nursing 环境生物学Environmental Biology 治疗学Therapeutics 运动生物学Exercise Physiology 畸形学Teratology 有机体生物学Organismal Biology 兽医学Veterinary Sciences 生物统计学Biometrics 牙科卫生学Dental Sciences 生物物理学Biophysics 牙科科学Dentistry生物心理学Biopsychology 皮肤学Dermatology 生物统计学Biostatistics 内分泌学Endocrinology 生物工艺学Biotechnology 遗传学Genetics 生物化学Biological Chemistry 解剖学Anatomy 生物工程学Biological Engineering 麻醉学Anesthesia 生物数学Biomathematics 临床科学Clinical Science 生物医学科学Biomedical Science 临床心理学Clinical Psychology细胞生物学和分子生物学Celluar and Molecular Biology 精神病护理学Psychiatric Nursing个人资料词汇name 姓名alias 别名pen name 笔名date of birth 出生日期 birth date 出生日期 born 出生于 birth place 出生地点 age 年龄 native place 籍贯 province 省 city 市 autonomous region 自治区 prefecture 专区 county 县 nationality 民族，国籍 citizenship 国籍 duel citizenship 双重国籍address 地址 current address目前地址 present address 目前地址 permanent address 永久地址postal code 邮政编码 home phone 住宅电话 office phone 办公电话 business phone 办公电话 Tel. 电话 sex 性另U male 男 female 女 height身高 weight 体重 marital status 婚姻状况 family status 家庭状况 married 已婚 single/unmarried未婚 divorced 离异 separated 分居 number of children子女人数 none 无 street 街lane 胡同，巷 road 路 district 区 house number 门牌 health 健康状 况 health condition 健康状况 blood type 血型 short-sighted 近视 far-sighted 远视 color-blind 色盲ID card No.身份证号码date of availability可到职时间available 可到职 membership 会员，资格 president 会长 vice-president 畐廿会长 director 理事 standing director常务理事 secretarygeneral 秘书长 society 学会 association 协会 research society 研究会教育程度词汇education 学历 educational background 教育程度 educational history 学历 curriculum 课程 major 主修 minor 畐廿修 educational highlights 课程重点部分 curriculum included课程包括 specializedcourses 专门课程 courses taken 所学课程 courses completed所学课程 special training特另U 训练social practice 社会实践 part-time jobs 业余工作 summer jobs 暑期工作 vacation jobs 假期工作 refresher course进修课程 extracurricular activities课夕卜活动 physical activities体育活动 recreational activities 娱乐活动 academic activities 学术活动 social activities社会活动rewards 奖励 scholarship 奖学金 "Three Goods" student 三好学生 excellent League member 优秀团员 excellent leader优秀干部 student council 学生会 off-job training 脱产培训 in-job training学制 academic year 学年 semester 学期（美） term 学期 （英） president 校长 vice-president畐廿校长 dean 院长 assistant deansupervisor 论文导师 principal 中学校长（美）headmaster 中学校长（英）master 小学校长 （美）dean在职培训 educational system 畐院长academic dean 教务长 department chairman 系主任 professor 教授 associate professor 副教授guest professor客座教授lecturer 讲师 teaching assistant助教 research fellow研究员 research assistant 助理研究员of studies 教务长dean of students 教导主任dean of students 教导主任teacher 教师probation teacher 代课教师tutor 家庭教师governess 女家庭教师intelligence quotient 智商pass 及格fail 不及格marks 分数grades 分数scores 分数examination 考试grade 年级class 班级monitor 班长vice-monitor 畐廿班长commissary in charge of studies 学习委员commissary in chargeof entertainment 文娱委员commissary in charge of sports 体育委员commissary in charge ofphysical labor 劳动委员Party branch secretary 党支部书记League branch secretary 团支部书记commissary in charge of organization 组织委员commissary in charge of publicity 宣传委员degree学位post doctorate 博士后doctor （Ph.D）博士master 硕士bachelor 学士student 学生graduate student 研究生abroad student 留学生returned student 回国留学生foreign student 夕卜国学生undergraduate 大学肄业生senior 大学四年级学生；高中三年级学生Junior 大学三年级学生；高中二年级学生sophomore大学二年级学生；高中一年级学生freshman 大学一年级学生guest student 旁听生（英）auditor 旁听生（美）government-supported student 公费生commoner 自费生extern 走读生day-student 走读生intern 实习生prize fellow 奖学金生boarder 寄宿生classmate 同班同学schoolmate 同校同学graduate 毕业生工作经历词汇accomplish 完成（任务等）achievements 工作成就，业绩adapted to 适应于adept in 善于administer管理advanced worker 先进工作者analyze 分析appointed 被任命的assist 辅助authorized 委任的；核准的be promoted to 被提升为be proposed as 被提名为；被推荐为behave 表现breakthrough 惊人的进展，关键问题的解决break the record 打破记录business background 工作经历business experience 工作经历business history 工作经历conduct 经营，处理control 控制cost 成本；费用create 仓U造decrease 减少demonstrate 证明，示范design 设计develop 开发，发挥devise 设计，发明direct 指导double 加倍，翻一番duties 职责earn 获得，赚取effect 效果，作用eliminate 消除employment experience 工作经历employment record 工作经历employment 工作enlarge 扩大enliven 搞活enrich 使丰富establish 设立（公司等）；使开业；确立evaluation 估价，评价excellent League member 优秀团员excellent Party member 优秀党员execute 实行，实施expand 推广；扩大expedite 加快；促进experience 经历exploit 开发（资源，产品）export 出口found 仓U立generate 产生good at 擅长于guide 指导；操纵implement 完成，实施import 进口improve 改进，提高increase 增力口influence 影响initiate 创始，开创innovate 改革，革新inspired 受启发的；受鼓舞的install 安装integrate 使结合；使一体化introduce 采用，引进invent发明invest 投资job title 职位justified 经证明的;合法化的launch 开办（新企业）lead 领导lengthen 延长lessen 减少（生产成本）level 水平localize 使地方化maintain 保持；维修make制造manage管理，经营manufacture 制造mastered 精通的modernize 使现代化motivate 促进，激发negotiate 谈判nominated 被提名的；被任命的occupational history 工作经历operate 操作，开动（机器等），经营（厂矿）organize 组织originate 创始，发明overcome 克服（困难等）participate in 参加perfect 使完善；改善perform 执行，履行plan 计划position 职位professional history 职业经历professional 职业经历profit 禾U润promote 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预防医学绪论 第一章
地的社会、经济、文化、卫生和环境条件，以及有关的政策 等。
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第二节 三级预防策略
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• 2.健康的作用 • 健康的组成是从健康的3个维度获取资源，并把它应用到
日常的生活中。
• 好的健康可以使我们完成所需的活动，可以使人们的每个 生活阶段经历丰富多彩的生活。
• 保证健康可以提高整个国民素质，避免疾病造成的直接和 间接的经济损失，减少社会医疗费用的支出，使社会收入 再分配能够向高层次需求和提高生活质量转移，有利于促 进社会的良性循环和经济的快速发展。
• 通过本课程的学习，结合在基础医学和临床医学所
学到的知识和技能，使自己真正成为一名防治结合 的五星级医生。
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第11页，共75页。
第一节 预防医学概念与健康生态学模型
• 一、预防医学的定义、内容和特点 • 定义：预防医学是医学的一门应用学科，它以个
体和确定的群体为对象，目的是保护、促进和维 护健康，预防疾病、失能和早逝。 • 工作模式：它以“健康生态学模型”作为其工作 模式，强调环境与人群的相互依赖、相互作用和 协调发展，并以健康为目的。
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• 健康生态学模型：
作为一种思维方式，它是总结和指导预防医学和
公共卫生实践的重要理论模型。
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该模型的结构可分为5层:
•第一层，核心层：是先天的个体特质如年龄、性别、种族和其
药物的英文名称
药物的英文名称medicine; drug; remedy: 药sleeping pill: 安眠药contraceptive drugs: 避孕药tonic: 补药a medicine for colds: 感冒药expectorant: 化痰药anti-cancer drugs; cancer-fighting drugs: 抗癌药anti-tuberculous drug: 抗结核药oral contraceptive; pill: 口服避孕药good medicine; a good remedy:良药laxative: 轻泻药antipyretic: 退热药for oral administration: 内服药specific medicine; specific: 特效药for external use: 外用药preventive medicine; prophylactic: 预防药sedative: 镇静药take medicine: 服药change dressings:换药decoct herbal medicine: 煎药fill a prescription: 配药have a prescription made up(filled):（患者）抓药medicinal materials; crude drugs: 药材medicinal herbs: 药草tablet: 药片medicines and chemical reagents: 药品medicine bottle: 药瓶remedies: 药石liquid medicine; medicinal liquid: 药水lotion: 洗液pill: 药丸bolus: 大药丸herbal medicines in a prescription: 药味（中药方中的药）flavor of a drug: 药味（药的味道或气味）medicines; pharmaceuticals; medicaments: 药物heal with drugs: 药物医治drug allergy: 药物过敏materia medica: 药物学drug poisoning: 药物中毒(medicinal)powder: 药粉ointment; salve: 药膏apply a plaster: 上药膏。
Preventive Medicine Integrative Medicine and the Health of the Public
PREVENTIVE MEDICINE, INTEGRATIVE MEDICINE & THE HEALTH OF THE PUBLICDavid L. Katz, M.D., M.P.H., FACPM, FACPAther Ali, N.D., M.P.H.Commissioned for the IOM Summit onIntegrative Medicine and the Health of the PublicFebruary, 2009The responsibility for the content of this paper rests with the authors and does not neces-sarily represent the views or endorsement of the Institute of Medicine or its committees and convening bodies. The paper is one of several commissioned by the Institute of Medicine. Reflective of the varied range of issues and interpretations related to integra-tive medicine, the papers developed represent a broad range of perspectives.Katz and Ali ABSTRACT The fields of preventive medicine and public health share the objec-tives of promoting general health, preventing specific diseases, and applying the concepts and techniques of epidemiology toward these goals. The purview of pre-ventive medicine as a discipline has traditionally been described to encompass primary, secondary, and tertiary prevention levels. This paper explores the over-lap and potential synergies of integrative medicine and preventive medicine in the context of these levels of prevention, acknowledging the relative deficiency of re-search on the effectiveness of practice-based integrative care.The holistic approach of integrative medicine overcomes the traditional wall of silence between complementary and alternative medicine (CAM) and conven-tional practice, reducing the risk of adverse interactions or gaps in care. At the level of primary prevention, an array of integrative modalities can be effective in health promotion, including lifestyle counseling, dietary guidance, stress mitiga-tion techniques, interventions to improve sleep quality, and use of nutriceuticals and herbal supplements for health promotion. At the level of secondary preven-tion, stress management and nutritional supplementation can reduce risk factors for chronic disease. At the level of tertiary prevention, the full range of CAM mo-dalities pertains to such goals as pain management, symptom control, stress re-lief, disease management, and risk reduction. Integrative medicine offers knowledgeable guidance to tailored therapies across the full spectrum of both conventional and CAM practice, thereby providing any given patient more op-tions—and more opportunities for success—in the pursuit of personal health. This must be weighed against the inherent risks in making use of therapeutic practices for which the scientific evidence base is often at best incomplete.The goal of integrative medicine should be to make the widest array of appro-priate options available to patients, ultimately blurring the boundaries between conventional care and CAM. Both disciplines should be subject to rigorous scien-tific inquiry so that interventions that work are systematically distinguished from those that do not. The case is made that responsible use of science and respon-siveness to the needs of patients that persist when the data from randomized con-trolled trials have been exhausted can be reconciled. Integrative medicine is a framework for this reconciliation, and practiced judiciously, offers the promise of better patient outcomes.2Katz and AliINTRODUCTIONPreventive MedicinePreventive medicine encompasses both the care of individual patients, and public health practice, and as is evident in the name, focuses on the prevention of disease rather than treatment, per se. The fields of preventive medicine and public health share the objectives of promoting general health, preventing specific dis-eases, and applying the concepts and techniques of epidemiology toward these goals.While preventive medicine seeks to enhance the lives of individuals by help-ing them improve their own health, public health attempts to promote health in populations through the application of organized community efforts. Although preventive medicine and public health are often discussed somewhat separately, there is a seamless continuum among the following: the practice of preventive medicine by physicians and other health professionals (clinical preventive ser-vices); the attempts of individuals and families to promote their own health and the health of loved ones; and the efforts of governments and voluntary agencies to achieve the same health goals for populations. The dividing line between preven-tive medicine and public health practice is thus far from distinct, as is that be-tween prevention and treatment. The purview of preventive medicine as a discipline has traditionally been described to encompass primary, secondary, and tertiary prevention (so-called “Leavell’s levels”) (Jekel et al., 2007). Only the first of these is nominally the exclusive purview of “preventive” as opposed to other disciplines of medicine.In the construct developed, or at least popularized, by Leavell (Leavell and Clark, 1965),all physician and other health professional activities have the goal of prevention. What is to be prevented depends on the context, and the patient’s po-sition on the spectrum from health to disease. Primary prevention keeps the dis-ease process from becoming established by eliminating causes of disease or increasing resistance to disease. Secondary prevention interrupts the disease process before it becomes symptomatic. Tertiary prevention limits the physical and social consequences of symptomatic disease.Primary Prevention and PrediseasePrimary prevention refers to health promotion, which fosters wellness in gen-eral and thus reduces the likelihood of disease, disability, and premature death in a nonspecific manner, as well as specific protection against the inception of dis-3Katz and Ali ease. Examples of the former include the promotion of physical activity and pru-dent dietary practices; smoking avoidance or cessation; and the mitigation of stress. Immunization is a clear example of the latter.Most noninfectious diseases can be seen as having an early stage, during which the causal factors will start to produce physiologic abnormalities. In athero-sclerosis, for example, there may be dyslipidmia and endothelial dysfunction (Jiamsripong et al., 2008), but no overt signs of atheroma during the predisease stage. The goal of a health intervention at this time is to modify risk factors in a favorable direction. Life- modifying activities (e.g., changing to a diet low in satu-rated and trans fat, pursuing a consistent program of aerobic exercise, and ceasing to smoke cigarettes), are considered to be methods of primary prevention because they are aimed at keeping the pathologic process and disease inception from oc-curring.Health promotion Health-promoting activities usually contribute to the prevention of a variety of diseases as well as enhancing a positive feeling of health and vitality. They consist of nonmedical interventions, such as changes in lifestyle, nutrition, and the environment. Such activities may require structural improvements in society to enable the majority of people to take part in them. Structural improvements imply societal changes that make healthful choices easier. For example, dietary modification may be difficult unless a variety of wholesome, tasty and nutrient-rich foods are available in stores at a reasonable cost. Exercise will be more difficult if bicycling or jogging is a risky activity because of automobile traffic or the threat of violence. Even more basic to health promotion is the assurance of the basic necessities of life, including freedom from poverty, environmental pollution, and assault, suggesting the ties between preventive medicine and public health. Principles of health promotion apply both to noninfectious and infectious diseases.Specific protection When the means are available, and/or when health-promoting changes in environment, workplaces, and health-related behaviors are not fully effective, methods of specific protection against a disease may be warranted. This form of primary prevention is targeted at a specific disease or type of injury. Examples include immunization against poliomyelitis; pharmacologic treatment of hypertension to prevent subsequent end-organ damage; use of ear-protecting devices in loud working environments, such as around jet airplanes; and use of seat belts, air bags, and helmets to prevent bodily injuries in automobile and motorcycle crashes. Some measures provide specific protection while also contributing to the more general goal of health promotion. Fluoridation of water4Katz and Ali supplies, for example, not only helps to prevent dental caries, but is also a nutritional intervention that promotes stronger bones and teeth.Secondary Prevention and Latent DiseaseSecondary prevention refers to the detection and management of presympto-matic disease, and the prevention of its progression to symptomatic disease. Screening is the dominant practice in this space, exemplified by cancer screening (e.g., mammography, colonoscopy), and cardiac risk screening (e.g., lipid testing, blood pressure screens). The margins between primary and secondary prevention can at times blur, depending on definitions used for diseases, their risks, and their antecedents. If hypertension is defined as a disease, its treatment is secondary prevention; if defined as a risk factor for coronary disease that does not yet exist, it is primary prevention.Presymptomatic diagnosis and treatment through screening programs is re-ferred to as secondary prevention, because it is the secondary line of defense against disease. Although it does not prevent a root cause from initiating the dis-ease process, it may delay or obviate progression to the symptomatic stage. Tertiary Prevention and Symptomatic DiseaseTertiary prevention refers to the treatment of symptomatic disease in an effort to prevent its progression to disability, or premature death. The overlap with treatment is self-evident, and perhaps suggests that preventive medicine has gran-diose territorial ambitions. Be that as it may, there is a legitimate focus on preven-tion even after disease develops, such as the prevention of early cancer from metastasizing, or the prevention of coronary disease from inducing a myocardial infarction or heart failure. This domain also encompasses rehabilitation, the pur-pose of which is to preserve or restore functional ability, and thus prevent its de-generation. As with the other stages of prevention, the terminology here is subject to interpretation at the margins. If coronary artery disease is the disease in ques-tion, its treatment to prevent progression to myocardial infarction is tertiary pre-vention; if myocardial infarction is the disease, then the treatment of coronary atherosclerosis is secondary prevention. The net benefit to the patient of this en-deavor pursued successfully is the same, of course, however the terminology is applied.Disability limitation describes medical and surgical measures aimed at cor-recting the anatomic and physiologic components of disease in symptomatic pa-tients. Most care provided by physicians meets this description. It may be5Katz and Ali considered prevention because its goal is to halt the disease process and thereby prevent or limit resultant impairment or disability. An example is the surgical re-moval of a tumor, which may prevent the spread of disease locally or by metasta-sis to other sites.Discussions about a patient’s disease may provide an opportunity (a “teach-able moment”) to convince the patient to begin health promotion techniques de-signed to delay disease progression (e.g., to begin exercising and improving the diet and to stop smoking after a myocardial infarction). The use of interaction os-tensibly dedicated to the treatment of established disease as an opportunity for overall health promotion begins to suggest the potential interface between integra-tive and preventive medicine.Rehabilitation falls under the rubric of preventive medicine because it may mitigate the effects of disease and thereby prevent some of the social and func-tional disability that would otherwise occur. For example, a person who has been injured or who has suffered a stroke may be taught how to care for him/herself in the activities of daily living(e.g., feeding, bathing). This may enable him/her to avoid the adverse sequelae associated with prolonged inactivity (e.g., increasing muscle weakness).By traditionally focusing on the diagnosis and treatment of disease, conven-tional medical education and practice have tended to obscure the importance, sci-entific basis, and clinical process of promoting the overall health of individuals. Diagnosis and treatment of disease will always be important aspects of health care, but increasing emphasis is also being placed on the preservation and en-hancement of health. There are specialists who undertake research, teaching, and clinical practice in the field of preventive medicine, but prevention is no more the exclusive province of preventive medicine specialists than, for example, the care of older people is limited to geriatricians. On the contrary, prevention should be incorporated into the practice of all physicians and other health care professionals. Expanding the medical model to encompass prevention as well as treatment of active pathology shares much with the expansion of intervention modalities atten-dant upon the transition from conventional to integrative care models.Integrative MedicineIntegrative medicine, a term first introduced in the mid 1990s and now clearly gaining adherents and traction, refers to the fusion—by various means, and to varying degrees—of conventional medical practice and some of the practices that fall under the complementary and alternative medicine (CAM) rubric. Integrative medicine thus offers, in theory at least, the opportunity to combine the “best” of both conventional medicine and CAM, and thereby produce better patient out-6Katz and Ali comes, measured in terms of symptom relief, functional status, patient satisfac-tion, and perhaps cost-effectiveness. Integrative medicine is necessarily “holistic” in the sense that somatic, emotional, and spiritual health are considered integral to overall health (Goldstein et al., 1988). These definitions are inherently problem-atic; what exactly comprises spiritual health, or whether this is the appropriate realm of the physician, is debated (Luster and Hines, 2005; Scheurich, 2003). Fur-ther, holistic medicine proponents are accused of creating a forced dichotomy be-tween holistic medicine incorporating CAM and “good conventional medicine.”A rationale for integrative medicine depends largely on a rationale for CAM, since CAM tends to be the limiting element in efforts to advance integrative care. The health care system in the United States, and the associated reimbursement mechanisms, are closely allied to conventional medical practices. The expansion of integrative care models depends in part on establishing both a clinical and fi-nancial case for CAM in conjunction with conventional medicine.CAM is one among the numerous designations for diverse medical practices not routinely taught in conventional medical schools (NCCAM, 2007a). Each of the terms applied to such practices is limited or objectionable in some way. Alter-native implies both that such practices are defined by what they are not and that they are exclusive of conventional medical care. Complementary implies that such practices are supplemental to mainstream medicine. The inconsistency in suggest-ing that such practices are both alternative and complementary to conventional care has been noted (Druss and Rosenheck, 1999; Katz, 2000). There is also ob-jection to the label as it is an intrinsically somewhat pejorative designation, denot-ing what it is by referring to what it is not; it is “complementary” or “alternative” to something, and that something is the conventional medical practices that pre-dominate.Such challenges to the nomenclature notwithstanding, CAM is the most widely used appellation, its primacy conveyed by its incorporation into the title of the National Institutes of Health National Center for Complementary and Alterna-tive Medicine (NCCAM). NCCAM provides the following definition of the area over which its management extends:CAM is a group of diverse medical and health care systems, prac-tices, and products that are not presently considered to be part ofconventional medicine. Conventional medicine is medicine aspracticed by holders of MD (medical doctor) or DO (doctor of os-teopathy) degrees and by their allied health professionals, such asphysical therapists, psychologists, and registered nurses.NCCAM groups CAM practices into four domains, recognizing there can be some overlap. In addition, NCCAM studies CAMwhole medical systems, which cut across all domains.7Katz and Ali1. Whole medical systems are built upon complete systems oftheory and practice. Often, these systems have evolvedapart from and earlier than the conventional medical ap-proach used in the U.S.2. Mind-body medicine uses a variety of techniques designedto enhance the mind's capacity to affect bodily function andsymptoms. Biologically based practices in CAM use sub-stances found in nature, such as herbs, foods, and vitamins.3. Manipulative and body-based practices in CAM are basedon manipulation and/or movement of one or more parts ofthe body.4. Energy therapies involve the use of energy fields. Biofieldtherapies are intended to affect energy fields that purport-edly surround and penetrate the human body. Bioelectro-magnetic-based therapies involve the unconventional use ofelectromagnetic fields, such as pulsed fields, magneticfields, or alternating-current or direct-current fields(NCCAM, 2007a).This definition conveys something of the breadth of CAM, and by extension, integrative medicine, and thus begins to suggest the expansive potential overlap with preventive medicine. CAM practices encompass a broad range of approaches to health care that include whole medical systems, such as naturopathic medicine, chiropractic, homeopathy, world medical traditions such as traditional Chinese medicine and Ayurveda, as well as specific techniques, such as acupuncture, mind-body medicine, and massage. Traits widely shared by CAM approaches in-clude an emphasis on the individualization of care, the devotion of time and atten-tion to each patient, a reliance on or faith in the healing powers of the body, and a preference for natural remedies. Other than these prevailing characteristics, CAM is in fact an extremely heterogeneous array of practices, ranging from those well supported by scientific evidence to those that defy any plausible scientific expla-nation, and it is delivered by providers of widely diverse training and credentials (Katz, et al., 2003a). Some self-professed CAM practitioners have no formal training and are subject to no formal credentialing. At the other extreme, naturo-pathic physicians require the same 4 years of postgraduate training for their ND (Doctor of Naturopathic Medicine) degree as MDs do for theirs. The naturopathic scope of practice is regulated by the states (Houghet al., 2001).Some distinctions among medical disciplines are captured in their names. Conventional medicine is often labeled as allopathic medicine, in which allo means different from and path refers to disease. The mainstay of allopathic ther-apy is to attack disease states with therapies that are unrelated to the condition8Katz and Ali being treated: treating by “the other.” By analogy, this approach douses fire with water. In contrast, homeopathic medicine relies on treatments that supposedly in-duce the same or similar (homeo) symptoms as those being addressed, with the belief that the body will eradicate the disease by responding to minute doses of the remedy. By analogy, homeopathy espouses to fight fire with fire. Of note, the term allopathy was coined as a pejorative term by Samuel Hahnemann, the nine-teenth-century German physician credited for founding homeopathy. Naturo-pathic medicine obviously relies on natural treatments in its approach to treatment and healing.Interest in and use of CAM has remained constant in recent years (Barneset al., 2008) after a rise in use between 1990 and 1997 (Eisenberg et al., 1998). Nearly 40 percent of the adult population and 12 percent of children have used at least one CAM therapy (Barneset al., 2008). Visits to CAM practitioners in 1997 exceeded visits to all primary care physicians (Eisenberg et al. 1998). The major-ity of patients seek CAM approaches to complement rather than substitute for conventional care most often for pain and chronic musculoskeletal conditions (Barnes et al., 2008).Particularly revealing about the popularity of CAM is the fact that the magni-tude of the demand for these therapies continues despite the lack of insurance coverage for such services in most instances. Americans spent an estimated $21.2 billion out-of-pocket for visits to alternative providers in 1997, an increase of 45 percent from 1990. The majority—58 percent—of those surveyed who used CAM did so for disease prevention, whereas 42 percent used such services for actual medical problems. The use of CAM is more prevalent among female, better-educated, higher-income populations (Barnes et al., 2008; Eisenberg et al., 1998). Although the use of CAM is greatest among people aged 50 to 59 years, use among older patients between 60 to 69 years of age is nearly the same (44.1 per-cent vs. 41.0 percent, respectively) (Barneset al., 2008) and is likely to increase with the growing prevalence of chronic illnesses as populations age. The use of CAM has been found to be especially high in patients with Alzheimer’s disease, multiple sclerosis, rheumatic diseases, cancer, AIDS, back problems, anxiety, de-pression, headaches, head colds, and chronic pain (Barnes et al., 2004; Astin, 1998). Several of these imply the intersection of CAM and the priorities of pre-ventive medicine.Predictors of CAM use include poorer health status, a holistic philosophical orientation to health and life, a chronic health condition, classification in a cul-tural group identifiable by its commitment to environmentalism or its commit-ment to feminism, and an interest in spirituality and personal growth psychology (Astin, 1998). Although research findings vary somewhat, common reasons that people choose CAM include: an interest in combining conventional medicine with CAM; dissatisfaction with the ability of conventional medicine to adequately treat9Katz and Ali chronic illnesses; a desire to avoid the harmful side effects of conventional medi-cine and treatments; an interest in and greater knowledge of how nutritional, emo-tional, and lifestyle factors affect health; and a broader focus on disease prevention and overall health (Barnes et al., 2004; Eisenberg et al., 1998; Astin, 1998).Thus, access to CAM modalities affords patients a greater opportunity to ob-tain care that is consistent with their beliefs and preferences. The availability of CAM treatments may therefore be considered an important means of patient em-powerment. In this way, the provision of CAM options and a patient-centered ap-proach to care may be seen as fundamentally interrelated.Despite the significant increase in the use of CAM over recent decades, fewer than 40 percent of alternative medicine users disclose such information to their primary care provider, which reveals an important disconnect between the prefer-ences of patients and their willingness to share these views with their doctors (Eisenberg et al., 1993, 1998; Astin 1998; Elder et al., 1997; Feldman, 1990; McKee, 1988). This important deficiency in provider-patient communication (Elderet al., 1997; Feldman, 1990; McKee, 1988) may reflect patient dissatisfac-tion with the conventional medical system (Astin, 1998), distrust, or simply an accurate assessment of conventional providers’ receptivity.There is widespread reticence about (if not outright opposition to) CAM prac-tices among conventional physicians. Those most opposed argue that CAM thera-pists do not have the extensive knowledge required to properly diagnose an illness, and they often cite the lack of evidence of the efficacy of CAM (Astin, 1998). The latter is the most heatedly debated among ardent proponents of evi-dence-based medicine, but the claim that conventional medicine is unfailingly supported by scientific evidence is invalid, thus belying evidence as a reliable dis-criminator between conventional practice and CAM.A decade ago, the Office of Technology Assessment of the U.S. Congress es-timated that fewer than 30 percent of the procedures currently used in mainstream medicine had been rigorously tested (Dalen, 1999). One reason why most CAM therapies are not robustly evidence based is that the majority were introduced prior to the advent of the randomized controlled clinical trial (RCT)—now the gold standard for examining clinical effectiveness. Such limitations are evident in conventional medicine as well; however, they are often overlooked because of the apparent or established effectiveness of a particular treatment. For example, the common and accepted use of antithrombotic agents for cardiovascular diseases and their complications (e.g., myocardial infarction, stroke, and pulmonary embo-lism) supports this contention. Three of the agents prescribed by conventional physicians for millions of patients every day—warfarin, aspirin, and heparin—were introduced prior to the era of randomized clinical trials and therefore had not been exposed to the rigorous research standards in effect today (Dalen, 1998).10Katz and Ali Few physicians would consider these drugs unconventional treatments, despite the fact that they were not put through RCTs at the time they were introduced. Con-versely, many CAM interventions are indeed supported by methodologically rig-orous trials (Ornish et al., 1998; Perlman et al., 2006; Katz et al. 2003b). Disparities in evidence between conventional and CAM practices do exist—and are likely to persist—because of great discrepancies in the availability of funds to support definitive clinical trials (Tufts Center for the Study of Drug Development, 2008).Thus, a case may be made for the responsible guidance of patients to CAM therapies both on the basis of patient interest, and in accordance with the prevail-ing standards of scientific evidence. Since this guidance should by no means sup-plant conventional treatments, a de facto argument for integrative medicine emerges: patients should receive expert guidance across the full expanse of avail-able treatments and modalities that offer them the promise of better health.The overlap of integrative medicine with preventive medicine is noteworthy. At the level of primary prevention, an array of modalities vouchsafes a meaning-ful contribution to health promotion. Minimally, these encompass lifestyle coun-seling, dietary guidance, stress mitigation techniques, interventions to improve sleep quality, and use of nutriceuticals and herbal supplements for health promo-tion. At the level of secondary prevention, CAM modalities such as stress man-agement and nutrient supplements for management of high blood pressure are germane, as are interventions that facilitate use of conventional therapies for risk attenuation; the use of coenzyme Q10 to mitigate myalgia associated with statin use is an example (Marcoff and Thompson, 2007). At the level of tertiary preven-tion, the full range of CAM modalities pertain to such goals as pain management, symptom control, stress relief, disease management, and risk reduction. The fu-sion of these modalities with conventional care is integrative medicine.To some extent, a conventional medical system that has emphasized the diag-nosis and treatment of disease with ever increasing degrees of specialization has marginalized both preventive medicine, and the holistic view that is central to in-tegrative medicine. The importance of disease prevention/health promotion is gaining increasing recognition, due in part to economic forces molding the evolu-tion of modern health care (McGinnis et al., 2002; Hu and Reuben, 2002; Freeman et al., 2008). Integrative medicine offers the promise of more expansive means to achieve the desired ends of preventive medicine, but also imposes the challenges of assessing evidence across that broader expanse. There are, thus, pit-falls to avoid in the pursuit of promise fulfilled.This paper explores the overlap and potential synergies of integrative medi-cine and preventive medicine, using the framework of Leavell’s levels of preven-tion to lend structure and clarity to the exploration. Integrative medicine will be seen to have much potential in the areas of primary and tertiary prevention, rather11。
Preventive Medicine (1)
Preventive Medicine （1）Preventive medicine is an essential branch of medicine that focuses on preventing diseases or illnesses from occurring. Unlike curative medicine, which is often aimed at treating the symptoms of diseases after they have already arisen, preventive medicine utilizes various strategies to ward off illnesses before they can affect people. These strategies typically involve lifestyle modifications and health interventions, such as vaccination and screening, which can be used to identify and mitigate potential health problems before they cause serious harm.There are many reasons why preventive medicine is important. First and foremost, preventing diseases is often easier and more cost-effective than treating them after they have already occurred. By focusing on prevention, we can reduce the demand for medical services, lower healthcare costs, and improve overall quality of life. Preventive medicine is particularly effective in addressing chronic diseases, such as heart disease, obesity, and diabetes, which are major contributors to global morbidity and mortality. These diseases often arise from modifiable behaviors, such as poor diet and lack of physical activity, which can be targeted through lifestyle interventions and education campaigns.One of the most effective strategies for preventing diseases is vaccination. Vaccines work by stimulating the immune system to create immunity to specific pathogens, such as viruses or bacteria, which can cause serious illness. This immunity helps to protect individuals from developing the diseases that the vaccines are designed to prevent. Vaccination has been hugely successful in eradicating or greatly reducing the prevalence of many infectiousdiseases, such as polio, measles, and smallpox. In recent years, there has been some debate around the safety and efficacy of vaccines, but the overwhelming consensus among health experts is that vaccines are an essential tool for preventing disease and promoting public health.Another key component of preventive medicine is screening. Various screening programs can identify individuals who are at risk of developing certain diseases before they become symptomatic. For example, breast cancer screening can detect tumors in their earliest stages, enabling earlier treatment and potentially better outcomes. Similarly, screenings for conditions such as diabetes and high blood pressure can identify individuals who are at higher risk of developing these diseases, allowing for earlier intervention and potentially better outcomes.Lifestyle interventions are also an important tool for preventing diseases. Encouraging healthy behaviors, such as regular exercise, healthy eating, and adequate sleep, can help to reduce the risk of a wide range of diseases, including cardiovascular disease, obesity, and certain types of cancer. While changing behavior is often difficult, there is a growing body of evidence that suggests that targeted lifestyle interventions, such as personalized coaching or group-based interventions, can be effective in promoting healthy behaviors.Preventive medicine is a rapidly evolving field, and new strategies and interventions are constantly being developed and tested. Emerging technologies, such as mobile health apps and wearable devices, are being used to track and monitor various healthindicators, enabling individuals to take a more proactive approach to their own health. Precision medicine, which seeks to tailor medical interventions to individual patients based on their genetics, lifestyle, and other factors, is also showing great promise in preventing diseases.Despite the many benefits of preventive medicine, there are some challenges to implementing these strategies on a large scale. For example, there is often a lack of access to healthcare services, particularly in low-income communities, which can make it difficult to implement screening programs and other interventions. Additionally, changing behavior is often difficult, and many people may need ongoing support and encouragement to adopt healthy habits. Moreover, there are often social and environmental factors, such as poverty and pollution, that are beyond the control of individuals and can be major contributors to disease.In conclusion, preventive medicine is a critical component of modern healthcare and plays a crucial role in reducing the prevalence of disease and improving overall health outcomes. While there are certainly challenges to implementing these strategies on a large scale, there is also much cause for optimism, as new technologies and interventions continue to emerge. By focusing on prevention, we can create a healthier, more resilient society, and ensure that individuals are able to live longer, healthier, and more fulfilling lives.Preventive medicine is a proactive approach to healthcare that recognizes the importance of identifying and addressing risk factors for disease before they lead to symptoms or complications. This approach encompasses a wide range of strategies, including education, vaccination, screening,lifestyle interventions, and precision medicine.Education is an essential component of preventive medicine, as it empowers individuals to make informed decisions about their health. Education campaigns can provide information on risk factors for disease, such as smoking, alcohol consumption, and poor diet, and can promote healthy behaviors, such as regular exercise and healthy eating. By educating individuals about the importance of prevention, we can help them to take ownership of their health and make positive changes that can reduce their risk of developing chronic diseases.Vaccination is perhaps the most well-known and widely used strategy for preventing disease. Vaccines work by introducing a small, harmless dose of a pathogen into the body, which stimulates the immune system to generate an immune response. This response creates immunity to the pathogen, which can provide lifelong protection against certain diseases. Vaccinations have been extremely effective at preventing diseases such as measles, mumps, and rubella, and have contributed to the eradication of diseases such as smallpox.Screenings are another important strategy for preventive medicine, as they can help to identify individuals who are at high risk for developing certain diseases. For example, screenings for prostate cancer can detect tumors in their early stages, allowing for earlier treatment and potentially better outcomes. Similarly, colonoscopies can detect precancerous polyps and remove them before they become cancerous. Screenings can also identify risk factors for other diseases, such as high blood pressure and high cholesterollevels, which can be treated with lifestyle modifications and medication.Lifestyle interventions, such as the promotion of healthy behaviors, are an increasingly important tool in preventive medicine. A healthy lifestyle can reduce the risk of developing many chronic diseases, including heart disease, diabetes, and certain types of cancer. Such interventions may include personalized coaching and support, as well as group-based programs that target specific populations. Lifestyle modifications can be particularly effective when combined with other preventive interventions, such as vaccination and screening.Precision medicine is another emerging field that holds great promise for the future of preventive medicine. Precision medicine seeks to tailor medical interventions to individual patients based on their genetics, lifestyle, and other factors. This approach recognizes that there is no "one-size-fits-all" approach to preventive medicine, and that different individuals may require different interventions based on their unique needs and risk factors. Precision medicine is still in its early stages, but it is already showing great promise in identifying individuals who are at high risk for certain diseases, such as heart disease, stroke, and certain types of cancer.Despite the many benefits of preventive medicine, there are still some challenges that must be overcome in order to implement these strategies on a large scale. One of the biggest challenges is ensuring equal access to healthcare services for all individuals, regardless of their income or social status. In many low-incomecommunities, there may be limited access to healthcare services, which can make it difficult to implement screening programs and other interventions. Disparities in access to healthcare services can also lead to disparities in health outcomes, as individuals who do not have access to preventive care are more likely to develop chronic diseases and experience poorer health outcomes.Another challenge is changing behavior, which can be difficult even when individuals are aware of the benefits of healthy behaviors. Many people may need ongoing support and encouragement to adopt healthy habits, and social and environmental factors, such as poverty and pollution, can be major contributors to disease. Addressing these underlying factors requires a multidisciplinary approach that involves healthcare providers, public health officials, and policymakers, as well as community leaders and organizations.In conclusion, preventive medicine is an essential component of modern healthcare that offers many benefits to individuals, communities, and society as a whole. By focusing on prevention, we can reduce the prevalence of chronic diseases, improve overall health outcomes, and promote a healthier, more resilient society. While there are certainly challenges to implementing these strategies on a large scale, there is also much cause for optimism, as new technologies and interventions continue to emerge. With continued investment in preventive medicine and a commitment to promoting healthy behaviors and environments, we can create a healthier, more equitable, and more vibrant future for all.。
美国医学执照考试第二步的临床理论部分 (USMLE Step2 CK)
美国医学执照考试第二步的临床理论部分（USMLE Step2 CK）USMLE Step2是关于临床知识与技能的考试。
考试的宗旨是评估考生是否能够运用医学知识与技能，理解相关的临床医学科学，从而有能力在上级医生的监督指导下对病人实施医疗。
其中包括强调提高医疗卫生水平以及疾病防治。
USMLE Step2考试要求并保证考生对安全有效行医所基于的临床医学原理以及以病人为中心的基本临床技能予以足够的重视。
USMLE Step2考试分为临床理论（Clinical Knowledge, CK）和临床技能（Clinical Skills, CS）两个部分。
考试形式与USMLE Step1考试相同，Step2 CK以选择题的形式出现。
考试时间９小时，大约有370道选择题，分8个Blocks 进行，每个Block 60分钟。
考生可以在中国国内参加考试。
考试内容USMLE Step2 CK考试内容领域包括:◇内科学（internal medicine）◇妇产科学（obstetrics and gynecology）◇儿科学（pediatrics）◇预防医学（preventive medicine）◇精神病学（psychiatry）◇外科学（surgery）◇在上级监督下行医有关的其他领域（other areas relevant to provision of care under supervision）USMLE Step2 CK考试的大部分题目向你描述一个临床背景，要求你对以下一个或几个方面作出回答：△诊断（a diagnosis）△预后（a prognosis）△疾病的机制（an indication of underlying mechanisms of disease）△下一步治疗方法，包括预防措施（the next step in medical care, including preventive measures）USMLE Step2 CK考试是一个涉及面广，要求所学知识融汇贯通的考试。
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issues.
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Lifestyle
While many people indulge in high fat ， high sugar, high salt, low fiber diets, millions of others in the world suffer from vitamin deficiency diseases. Overindulgence in some rich areas causes health problems(such as high cholesterol), instead of the starvation found in other areas of the globe.
measures are not required.
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Lifestyle
Lifestyle affects people’s health in many ways.
For eห้องสมุดไป่ตู้ample, little sleep and rest can reduce our resistance
to infections. Proper lifestyle can give you an excellent body, but a poor diet, insufficient exercise, as well as smoking and drinking, may lead to a poor health .
improving the health and well-being of all people.
Describe Specifically
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The Difference Between Health Care and Public Health
• Health Care = Individual Health • Public Health = Population Health
child developed streptococcal infections and did not get medical care, he or she could have developed a rheumatic heart condition. If a youngster broke a limb and did not receive proper medical care, he or she could have developed a deformed arm or leg.
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Medical Care
Two main aspects of health care affect everyone.
One is technology, which has been in the limelight
for several decades. For example, the computerized axial tomograph.
7
Environment
Some estimates, based on morbidity and mortality
statistics, indicate that the impact of the environment
on health is as high as 80 percent.
The mission of public health is defined as ―the fulfillment
of society’s interest in assuring the conditions in which people can be healthy‖
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Public Health
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Lifestyle
Moving sidewalks, escalators, elevators, cars, buses, and other means of transportation may be leading many people to an early demise. The heart muscle, like all muscles, will waste away if not used vigorously. Realizing this, and considering the frequency of high fat,high cholesterol diets, it is easy to see why heart disease is the NO.1 killer in many countries .
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What is public health?
Definition: The science and art of preventing disease, prolong life and promoting health and efficiency through organized community effort. (WHO,1952)
In all determinants, lifestyle is the easiest one to control.
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Medical Care
Another factor that determines our health is the medical
care that we receive during our lifetime. For example, if a
Preventive medicine
School of Public Health
1
This class we will mainly study Introduction of preventive medicine
2
Objectives
Master the definition of public heath and preventive medicine; the three levels of prevention; aims of the specialty of preventive medicine. Understand the definition of health and disease; ten Major Public Health Issues; Public Health Achievements;
note
3
What is health?
• Please take a minute to think about the concept before studying. • If you are very strong in body, can that show you are in perfect health?
artificial organs, monitoring instruments for fetus, and
electrocardiograph devices worn by patients to detect an oncoming heart attack, etc..
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computerized axial tomograph
But in reality, public health is for all of us. Like the public library, public schools, public utilities. . .
public health has the mission of protecting and
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Lifestyle
In less developed countries, infectious diseases dominate health problems, whereas, in some rich areas, diseases associated with lifestyle are the leading killers.
people have also acquired intelligence, knowledge,and expertise that allow them to make significant changes in the environment, and create conditions to lessen the likelihood of disease.
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Environment
The environment more strongly affects people’s health than any of the other determinants. For example, the water we drink, the food we eat. the air we breathe, become part of our body. In the past, due to poor environmental management, many people have died from environmentally-related diseases such as typhoid fever.
sophisticated equipment for kidney patients
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Medical Care
The second trend in health care is the increased interest in medical self-help on the part of the public. These emphasize self-examination of the skin, breasts, mouth, eyes,and nails etc.. .