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Ano: 2018 Banca: VUNESP Órgão: SÃO CAMILO Prova: VUNESP - 2018 - SÃO CAMILO - Processo Seletivo - 2º Semestre de 2018 - Medicina |
Q1798990 Inglês
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The challenge of doctor-patient relations in the internet age



     “Let me do some research and I’ll get back to you,” my patient said. My patient, a 19-year-old student, had already taken time off from school because of her anxiety. I was her psychiatrist, with over two decades of experience treating university students, and had just explained my diagnostic impressions based on a lengthy evaluation. I’d recommended that she try a medicine I expected would help. I’d also laid out the risks and benefits of other treatment options. 
      “Do you have additional questions I can answer?” I asked. I wanted to let her know that’s why I was there, to cull the research, to help make sense of it. “No, I like to go online and look for myself,” she said.
     More and more, I see students turning away from the expertise that a live person can offer and instead turning to the vast and somehow more objective-seeming “expertise” of the digital world.
     In an age when journalism we don’t like can be dismissed as “fake news,” suggesting that the information we do like is most credible, regardless of its source, it’s not hard to understand why young people do this. The medical profession itself, under managed care, has played a role as well, providing less time for doctor-patient interactions and undermining the chances that a personal relationship and trust can develop. Under the guise of efficiency, medical test results are now often released directly to patients, sometimes before or even without the benefit of any interpretation.
     But there’s danger in trusting data over people, as there is in thinking the expertise of all people is equivalent. When it comes to health, digital natives may not be learning how to navigate effectively. And the consequences could be harmful.
    The availability of health data on the internet has its benefits. Online, for example, we can find explanations and solutions for symptoms we might be too embarrassed, or afraid, to discuss with another person, in person. Or, for lifethreatening diseases, we can locate clinical trials our doctors may not be aware of.
     However, there’s also a lot of misleading information, and information that’s simply untrue. The internet is full of people selling things – supplements, treatment regimens that have not been rigorously tested, even prescription medications – and making false promises that have not been scrutinized by regulatory agencies. Sometimes, as in the case of some websites that promote “an anorexic diet” for “aggressive” weight loss, the information can encourage life-threatening behavior.
      Years ago, when we discussed paternalism versus patient autonomy in my medical school ethics class, I came down strongly in favor of autonomy. Who but the patient could best decide what was right for him or her? But years of clinical – and personal – experience have taught me that information in and of itself is insufficient. Judgment is also indispensable, especially in complex situations, and the capacity for good judgment rests within people, not data sets.

(Doris Iarovici is a psychiatrist at Harvard University’s Counseling and
Mental Health Services and the author of Mental Health Issues and the
University Student. www.nytimes.com, 01.03.2018. Adaptado.)
No terceiro parágrafo, o termo “expertise” está entre aspas para
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Ano: 2016 Banca: UNICENTRO Órgão: UNICENTRO Prova: UNICENTRO - 2016 - UNICENTRO - Vestibular - PAC - 1ª Etapa |
Q1798889 Inglês


NOGUEIRA, Salvador. Translated by Marina Della Valle. Disponível em: < www1folha.uol.com.br/internacional/em/scienceandhealth/2016/03/ 1755511-russia-will-install-telescope-in-brazil..shtml>. Acesso em: 27 set. 2016.

Considerando o uso gramatical da língua no texto, é correto afirmar:
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Ano: 2019 Banca: VUNESP Órgão: SÃO CAMILO Prova: VUNESP - 2019 - SÃO CAMILO - Processo Seletivo - 2º Semestre de 2019 - Medicina |
Q1798252 Inglês
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Worshiping the false idols of wellness




     Before we go further, I’d like to clear something up: wellness is not the same as medicine. Medicine is the science of reducing death and disease, and increasing long and healthy lives. Wellness used to mean a blend of health and happiness. Something that made you feel good or brought joy and was not medically harmful — perhaps a massage or a walk along the beach. But it has become a false antidote to the fear of modern life and death.
    The wellness industry takes medical terminology, such as “inflammation” or “free radicals,” and polishes it to the point of incomprehension. The resulting product is a “Do It Yourself” medicine for longevity that comes with a confidence that science can only aspire to achieve.
     Let’s take the trend of adding a pinch of activated charcoal to your food or drink. While the black color is strikingly unexpected and alluring, it’s sold as a supposed “detox.” Guess what? It has the same efficacy as a spell from the local witch. Maybe it’s a matter of aesthetics. Wellness potions in beautiful jars with untested ingredients of unknown purity are practically packaged for Instagram.
     Medicine and religion have long been deeply intertwined, and it’s only relatively recently that they have separated. The wellness-industrial complex seeks to resurrect that connection. It’s like a medical throwback, as if the idyllic days of health were 5,000 years ago. Ancient cleansing rituals with a modern twist — supplements, useless products and scientifically unsupported tests.
     The dietary supplements that are the backbone of wellness make up a $30 billion a year business despite studies showing they have no value for longevity (only a few vitamins have proven medical benefits, like folic acid before and during pregnancy and vitamin D for older people at risk of falling). Modern medicine wants you to get your micronutrients from your diet, which is inarguably the most natural source.
     Yet the wellness-industrial complex has managed to pervert that narrative and make supplements a necessary tool for nonsensical practices, such as boosting the immune system or fighting the war on inflammation. The resulting fluorescent yellow urine from multivitamins may provide a false sense of efficacy, but it’s a fool’s gold (and the consequence of excessive B2 that couldn’t possibly be absorbed). So what’s the harm of spending money on charcoal for non-existent toxins or vitamins for expensive urine? Here’s what: the placebo effect or “trying something natural” can lead people with serious illnesses to postpone effective medical care. However, I admit that doctors can learn something from wellness. It’s clear that some people are looking for healers, so we must find ways to serve that need that are medically ethical.

(Jen Gunter. www.nytimes.com, 01.08.2018. Adaptado.)
According to the first paragraph, medicine and wellness
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Ano: 2015 Banca: VUNESP Órgão: UNIFESP Prova: VUNESP - 2015 - UNIFESP - Prova de Língua Portuguesa e Língua Inglesa |
Q1797724 Inglês

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    Poverty may hinder kids’ brain development, study says

    Reduced gray matter, lower test scores reported for poor children

July 20, 2015



    Poverty appears to affect the brain development of children, hampering the growth of gray matter and impairing their academic performance, researchers report. Poor children tend to have as much as 10 percent less gray matter in several areas of the brain associated with academic skills, according to a study published July 20 in JAMA Pediatrics. “We used to think of poverty as a ‘social’ issue, but what we are learning now is that it is a biomedical issue that is affecting brain growth,” said senior study author Seth Pollak, a professor of psychology, pediatrics, anthropology and neuroscience at the University of Wisconsin-Madison.

   The results could have profound implications for the United States, where low-income students now represent the majority of kids in public schools, the study authors said in background information. Fifty-one percent of public school students came from low-income families in 2013.

    Previous studies have shown that children living in poverty tend to perform poorly in school, the authors say. They have markedly lower test scores, and do not go as far in school as their well-off peers.

    To see whether this is due to some physical effect that poverty might have on a child’s brain, Pollak and his colleagues analyzed MRI scans of 389 typically developing kids aged 4 to 22, assessing the amount of gray matter in the whole brain as well as the frontal lobe, temporal lobe and hippocampus. “Gray matter contains most of the brain’s neuronal cells,” Pollak said. “In other words, other parts of the brain – like white matter – carry information from one section of the brain to another. But the gray matter is where seeing and hearing, memory, emotions, speech, decision making and self-control occur.”

    Children living below 150 percent of the federal poverty level – US$ 36,375 for a family of four – had 3 percent to 4 percent less gray matter in important regions of their brain, compared to the norm, the authors found. Those in families living below the federal poverty level fared even worse, with 8 percent to 10 percent less gray matter in those same brain regions. The federal poverty level in 2015 is US$ 24,250 for a family of four. These same kids scored an average of four to seven points lower on standardized tests, the researchers said.

    The team estimated that as much as 20 percent of the gap in test scores could be explained by reduced brain development. A host of poverty-related issues likely contribute to developmental lags in children’s brains, Pollak said. Low-income kids are less likely to get the type of stimulation from their parents and environment that helps the brain grow, he said. For example, they hear fewer new words, and have fewer opportunities to read or play games. Their brain development also can be affected by factors related to impoverishment, such as high stress levels, poor sleep, crowding and poor nutrition, Pollak said.

    This study serves as a call to action, given what’s already known about the effects of poverty on child development, said Dr. Joan Luby, a professor of child psychiatry at Washington University School of Medicine in St. Louis. “The thing that’s really important about this study in the context of the broader literature is that there really is enough scientific evidence to take public health action at this point,” said Luby, who wrote an editorial accompanying the study. “Poverty negatively affects brain development, and we also know that early interventions are powerfully effective,” Luby said. “They are more effective than interventions later in life, and they also are cost-effective.”


(www.nlm.nih.gov. Adaptado.)

Segundo o texto, a pesquisa publicada no periódico JAMA Pediatrics aponta que a pobreza
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Q1797670 Inglês
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The fantastic appeal of fantasy


The fantasy genre starts where science ends

     Few things can brighten up a dark morning in a Scottish seaside resort during an Atlantic storm. Yet while sheltering in a bookshop from the rain, I had a moment of sunny revelation. Stacked almost as high as my 11-year-old self were copies of The Lord of the Rings, with a cover illustration that promised mystery and magic. That chance discovery started a lifelong love of the fantasy genre1 , both as reader and writer. 
   The fantasy genre has had more and more success, but today we’re in the middle of an unprecedented fantasy boom. Sales continue to rise and it is now the biggest genre in publishing. The more rational the world gets, with super-science all around us, the more we demand the irrational in our fiction.
     Fantasy is not simply a case of swords2 and sorcery3 . Yes, there is that by the shelf. But the genre is as broad as the imagination. The genre starts where science ends.
    “In these modern times, where most of us sit at computers, fantasy books offer a chance to break out of mundane moments,” says Mark Newton, an editor with the genre. “People like to explore themes that go beyond the limited palette that literary fiction claims to offer.” 
     A search for the origins of fantasy will usually have academics muttering about Beowulf or Homer’s The Iliad, but they come from a time when all stories were fantasy: gods and monsters and supernatural artefacts with humanity caught in the middle. The first modern fantasy writer is usually considered to be William Morris, in the late 19th Century. But it was the early 20th Century where fantasy really started to gain status.
     Fantasy fiction has always been about visionary ideas. You can get artful words in plenty of literary fiction, but being able to see beyond the boundaries4 of the world around us — now that’s a special skill.
     I don’t write fantasy fiction simply to provide a trapdoor5 from the real world. For me, the genre is about the reality. But instead of coming up against it, fantasy maps the unconscious aspirations of our modern society through allegory in story- -forms as old as humanity. It’s about turning off the mobile phone and the computer and remembering who we are in the deepest parts of ourselves.

(Mark Chadbourn. www.telegraph.co.uk, 12.04.2008. Adaptado.)

1genre: gênero. Categoria distintiva de composição literária, como romance, poesia etc.
2sword: espada.
3sorcery: feitiçaria.
4boundary: fronteira.
5trapdoor: alçapão
O trecho sublinhado em “the genre is as broad as the imagination” (3° parágrafo) expressa uma
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66: A
67: D
68: D
69: C
70: C