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尼古丁 (Nicotine))  For many Americans, the tobacco industry’s disingenuousness became a matter of public record during a Congressional hearing on April 14, 1994. There, under the withering glare of Representative Henry A. Waxman, Democrat of California, appeared the chief executives of the seven largest American tobacco companies.   In the 1930s and 1940s, cigarettes were either healthy because they were implicitly endorsed by a kindly doctor, or sexy. Each executive raised his right hand and solemnly swore to tell the whole truth about his business. In sequential testimony, each one stated that he did not believe tobacco was a health risk and that his company had taken no steps to manipulate the levels of nicotine in its cigarettes. 追尋煙草的歷程:從性感到致命 霍華德·馬克爾,醫學博士 對許多美國人來說,煙草業的不誠信記入了公眾檔案始于1994年4月14日的一次國會聽證會。在加州民主黨代表亨利·A·韋克斯曼的怒視下,美國七大煙草巨頭的首席執行官出現在這次聽證會上。 在20世紀30和40年代,香煙要么意味著健康——因為有一位仁慈的醫生含蓄地推薦它;要么就意味著性感。 每位總裁舉起右手,鄭重宣誓要對從事的業務實話實說。在隨后的證詞中,每個人都陳述自己不相信煙草會給健康帶來風險,而且自己的公司從未采取措施來操縱香煙中尼古丁的含量。 Thirty years after the famous surgeon general’s report declaring cigarette smoking a health hazard, the tobacco executives, it seemed, were among the few who believed otherwise. But it was not always that way. Allan M. Brandt, a medical historian at Harvard, insists that recognizing the dangers of cigarettes resulted from an intellectual process that took the better part of the 20th century. He describes this fascinating story in his new book, The Cigarette Century: The Rise, Fall and Deadly Persistence of the Product that Defined America (Basic Books). In contrast to the symbol of death and disease it is today, from the early 1900s to the 1960s the cigarette was a cultural icon of sophistication, glamour and sexual allure — a highly prized commodity for one out of two Americans. 30年前,一位衛生局長就發布了關于抽煙危害健康的著名報告。 如今看來,煙草業總裁們屬于不相信該報告的極少數人的行列。 但事實并非始終如此。哈佛大學醫學史專家艾倫·M·布蘭特堅持認為,對香煙危害的認識源于持續了大半個20世紀的一個智力過程。在新書《香煙的世紀:界定美國的產品的興衰和死命的堅持》,他講述了這個引人入勝的故事。 雖說當今香煙是死亡和疾病的象征,但從20世紀初到20世紀60年代,香煙在文化上象征著成熟練達、魅力和性感誘惑——是當時半數美國人大為追捧的商品。 Many advertising campaigns from the 1930s through the 1950s extolled the healthy virtues of cigarettes. Full-color magazine ads depicted kindly doctors clad in white coats proudly lighting up or puffing away, with slogans like “More doctors smoke Camels than any other cigarettes.” Early in the 20th century, opposition to cigarettes took a moral rather than a health-conscious tone, especially for women who wanted to smoke, although even then many doctors were concerned that smoking was a health risk. The 1930s were a period when many Americans began smoking and the most significant health effects had not yet developed. As a result, the scientific studies of the era often failed to find clear evidence of serious pathology and had the perverse effect of exonerating the cigarette. 從20世紀30年代到50年代,許多廣告運動都頌揚香煙的健康品質。在全彩的雜志廣告中,身穿白大褂的仁慈的醫生驕傲地點起香煙或是吞云吐霧,上面還寫著“更多醫生選擇駱駝牌香煙。”之類的廣告語。 20世紀初期,對香煙的抵制帶著道德的口吻,而不是出于對健康的關注。對想抽煙的女性更是如此,不過即使在當時,許多醫生已經關注到吸煙會給健康造成風險。 在20世紀30年代這一時期,許多美國人變成了煙民,而抽煙對健康最為顯著的危害尚未顯現出來。因此,這一時期的科學研究無法從嚴肅的病理學上找到清晰的證據,竟起到了為香煙開脫的反效果。 The years after World War II, however, were a time of major breakthroughs in epidemiological thought. In 1947, Richard Doll and A. Bradford Hill of the British Medical Research Council created a sophisticated statistical technique to document the association between rising rates of lung cancer and increasing numbers of smokers. The prominent surgeon Evarts A. Graham and a medical student, Ernst L. Wynder, published a landmark article in 1950 comparing the incidence of lung cancer in their nonsmoking and smoking patients at Barnes Hospital in St. Louis. They concluded that “cigarette smoking, over a long period, is at least one important factor in the striking increase in bronchogenic cancer.” Predictably, the tobacco companies — and their expert surrogates — derided these and other studies as mere statistical arguments or anecdotes rather than definitions of causality. 然后,到了二戰后,流行病學思想取得了不少重大突破。1947年,英國醫學研究會的理查德·多爾和A·布拉德福德·希爾創立了一種復雜的統計方法,以記錄肺癌上升率和煙民增加之間的聯系。 著名外科醫生埃瓦茨·A·格雷厄姆和醫學專業學生歐內斯特·L·溫德爾于1950年發表了一篇極為重要的論文,比較了圣路易斯市巴恩斯醫院內煙民和非煙民患者中肺癌的發生幾率。在結論中,他們認為“長期抽煙至少是支氣管癌發病率飆升的重要因素之一。” 不難想象,煙草公司以及他們的專家代言人們嘲笑這些以及其它研究,稱這些僅僅是統計上的論據或趣聞軼事,根本不能確定其因果關系。 Dr. Brandt, who has exhaustively combed through the tobacco companies’ internal memorandums and research documents, amply demonstrates that Big Tobacco understood many of the health risks of their products long before the 1964 surgeon general’s report. He also describes the concerted disinformation campaigns these companies waged for more than half a century — simultaneously obfuscating scientific evidence and spreading the belief that since everyone knew cigarettes were dangerous at some level, smoking was essentially an issue of personal choice and responsibility rather than a corporate one. In the 1980s, scientists established the revolutionary concept that nicotine is extremely addictive. The tobacco companies publicly rejected such claims, even as they took advantage of cigarettes’ addictive potential by routinely spiking them with extra nicotine to make it harder to quit smoking. And their marketing memorandums document advertising campaigns aimed at youngsters to hook whole new generations of smokers. 在詳細梳理了煙草公司的內部備忘錄和研究文檔后,布蘭特博士用充足的證據證明,早在1964年的衛生局長報告發表前,各大煙草巨頭就已了解了自家產品對健康造成的諸多風險。 他還描述了這些公司在半個多世紀以來,一直合謀炮制假消息,同時混淆科學證據,散布這種論調:既然大家都知道香煙在一定程度上有危害,抽煙與否從根本上說是個人的選擇和責任問題,責任不在煙草公司。 在20世紀80年代,科學家們建立了一種革命性的觀念,即尼古丁具有極強的上癮性。雖說煙草公司公開否認這些說法,但當時他們已經利用香煙的致癮性來賺錢了,他們加大尼古丁含量,將煙民勾住,使得戒煙愈發困難。在他們的營銷備忘錄中,記錄了他們針對青少年發動的廣告運動,旨在誘惑一代代的新煙民。 In 2004, Dr. Brandt was recruited by the Department of Justice to serve as its star expert witness in the federal racketeering case against Big Tobacco and to counter the gaggle of witnesses recruited by the industry. According to their own testimony, most of the 29 historians testifying on behalf of Big Tobacco did not even consult the industry’s internal research or communications. Instead, these experts focused primarily on a small group of skeptics of the dangers of cigarettes during the 1950s, many of whom had or would eventually have ties to the tobacco industry. “I was appalled by what the tobacco expert witnesses had written,” Dr. Brandt said in a recent interview. “By asking narrow questions and responding to them with narrow research, they provided precisely the cover the industry sought.” Apparently, the judge, Gladys Kessler of Federal District Court for the District of Columbia, agreed. Last August, she concluded that the tobacco industry had engaged in a 40-year conspiracy to defraud smokers about tobacco’s health dangers. Her opinion cited Dr. Brandt’s testimony more than 100 times. 2004年,布蘭特博士被司法部聘請為重要專家,在指控煙草巨頭的聯邦欺詐案件中作證,并與煙草業雇傭來的一伙證人進行對質。根據為煙草巨頭們出庭作證的29位歷史學家們自己的供述,他們中大多數甚至沒有參看過煙草業內部的研究或交流文檔。相反,這些專家主要關注的是20世紀50年代的一小撮對香煙危害的懷疑論者,他們中的大部分人要么就是當時就與煙草業有勾結,要么最終也會同煙草業勾結起來。 布蘭特博士在近期一次專訪中說:“這些專家證人寫下的言論令我感到震驚。他們靠問一些片面的問題,并用片面的研究來解答,從而為煙草業提供了他們恰好需要的擋箭牌。” 顯然,哥倫比亞特區聯邦地方法庭法官格拉迪絲·凱斯勒同意這一看法。去年八月,她總結認為,煙草業策劃了一場長達40年的陰謀,向煙民隱瞞煙草對健康的危害。她的觀點中引用布蘭特博士的證詞達100多次。 Dr. Brandt acknowledges that there are pitfalls in combining scholarship with battle against the deadly pandemic of cigarette smoking, but he says he sees little alternative. “If one of us occasionally crosses the boundary between analysis and advocacy, so be it,” he said. “The stakes are high, and there is much work to be done.” 布蘭特博士承認,將學術研究和與抽煙這種致命的世界性傳染病作斗爭結合起來,這當中會有陷阱,但他說他幾乎看不到有別的選擇。 “如果我們中有人偶然跨過了分析和倡導之間的邊界,那就跨過吧。”他說。“風險很大,還有很多工作要做。” summary First stage In contrast to the symbol of death and disease it is today, from the early 1900s to the 1960s the cigarette was a cultural icon of sophistication, glamour and sexual allure — a highly prized commodity for one out of two Americans.The 1930s were a period when many Americans began smoking and the most significant health effects had not yet developed. 雖說當今香煙是死亡和疾病的象征,但從20世紀初到20世紀60年代,香煙在文化上象征著成熟練達、魅力和性感誘惑——是當時半數美國人大為追捧的商品。 在20世紀30年代這一時期,許多美國人變成了煙民,而抽煙對健康最為顯著的危害尚未顯現出來。 Second stage The years after World War II, however, were a time of major breakthroughs in epidemiological thought. In 1947, Richard Doll and A. Bradford Hill of the British Medical Research Council created a sophisticated statistical technique to document the association between rising rates of lung cancer and increasing numbers of smokers. The prominent surgeon Evarts A. Graham and a medical student, Ernst L. Wynder, published a landmark article in 1950 comparing the incidence of lung cancer in their nonsmoking and smoking patients at Barnes Hospital in St. Louis. They concluded that “cigarette smoking, over a long period, is at least one important factor in the striking increase in bronchogenic cancer.” 著名外科醫生埃瓦茨·A·格雷厄姆和醫學專業學生歐內斯特·L·溫德爾于1950年發表了一篇極為重要的論文,比較了圣路易斯市巴恩斯醫院內煙民和非煙民患者中肺癌的發生幾率。在結論中,他們認為“長期抽煙至少是支氣管癌發病率飆升的重要因素之一。” Third stage In the 1980s, scientists established the revolutionary concept that nicotine is extremely addictive. And their marketing memorandums document advertising campaigns aimed at youngsters to hook whole new generations of smokers. Tobacco industry the tobacco industry had engaged in a 40-year conspiracy to defraud smokers about tobacco’s health dangers. 在20世紀80年代,科學家們建立了一種革命性的觀念,即尼古丁具有極強的上癮性。在他們的營銷備忘錄中,記錄了他們針對青少年發動的廣告運動,旨在誘惑一代代的新煙民。煙草業策劃了一場長達40年的陰謀,向煙民隱瞞煙草對健康的危害。 Tobacco culture Tobacco health warnings appear on packs of cigarettes and are among the strongest defences against the global epidemic of tobacco. WHO particularly approves of tobacco health warnings that contain both pictures and words because they are the most effective at convincing people to quit. Such pictorial warnings appear in more than a dozen countries. 煙草健康警告出現在香煙盒上,是抵御全球煙草流行的最有力的防御措施之一。誰特別贊成煙草健康警告,包含圖片和文字,因為他們是最有效的說服人們戒煙。這種圖案的警告出現在十幾個國家。 On World No Tobacco Day 2009, and throughout the following year, WHO will encourage governments to adopt tobacco health warnings that meet all the criteria for maximal effectiveness, including that they cover more than half of the pack, appear on both the front and back of the pack and contain pictures. The WHO Framework Convention on Tobacco Control obligates its more than 160 countries parties to require "health warnings . describing the harmful effects of tobacco use" on packs of tobacco and their outside packaging and recommends that the warnings contain pictures. 在世界無煙日2009,并在接下來的一年,他將鼓勵各國政府通過煙草健康警示,滿足所有的標準的最大效用,包括他們支付一半以上的包,出現在正面和背面包裝和包含圖片。WHO煙草控制框架公約規定的160多個國家締約方要求“健康警告描述的有害影響,煙草使用對煙草及其外包裝袋和建議警告包含圖片。  WHO works through its Tobacco Free Initiative department to help the parties to meet their obligation, providing technical and other assistance. As WHO Director General Margaret Chan says, “We hold in our hands the solution to the global tobacco epidemic that threatens the lives of one billion men, women and children during this century.” Tobacco health warnings are a big part of the solution about which Dr Chan speaks    誰通過其煙草自由行動部門的工作,以幫助各方滿足他們的義務,提供技術和其他援助。正如世界衛生總干事Margaret Chan說的那樣,“我們掌握了全球煙草流行的解決方案,威脅到本世紀十億名男性、女性和兒童的生命。”煙草健康警告是Chan博士講話的一大組成部分。 The theme of World No Tobacco Day  Tobacco or health, please choose  Women and tobacco  Teenagers do not smoke   Don't smoke in public places and public transport   No smoking in the workplace 1993 The health department and health workers are against smoking   1994 Mass media campaign against smoking 1995 Tobacco and economy 1996 Smoke free style 1997 The United Nations and the relevant agencies object to smoking 1998 Growing up in a non tobacco environment 1999 Quit smoking: never late 2000 Do not use sports promotion tobacco 2001 Clean the air and refuse to smoke 1994年; 大眾傳播媒介宣傳反對吸煙 1995年: 煙草與經濟 1996年: 無煙的文體活動 1997年: 聯合國和有關機構反對吸煙 1998年: 在無煙草環境中成長 1999年: 戒煙:永不言遲 2000年: 不要利用文體活動促銷煙草 2001年: 清潔空氣,拒吸二手煙 2002 Smoke free sports -Clean game 2003 No tobacco, film and fashion action 2004 Control smoking and reduce poverty. 2005 Health professionals against tobacco 2006 Tobacco devour life 2007 Smoke free inside 2008 Tobacco-free youth 2002年:  無煙體育—清潔的比賽 2003年:  無煙草影視及時尚行動 2004年:  控制吸煙,減少貧困 2005年:  衛生工作者與控煙 2006年:  煙草吞噬生命 2007年:  創建無煙環境 2008年:  無煙青少年

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