Questões de Inglês - Grammar

Reducing preventable harm in hospitals

Each year, in the United States, millions of patients are harmed while receiving care in hospitals.
They get infections, experience adverse reactions to drugs, develop dangerous bedsores or come
down with pneumonia from the very ventilators meant to help them breathe.
The estimates of the number of people who die each year as a result of hospital errors have ranged
[5] from as many as 98,000 in a landmark Institute of Medicine report from 1999 to as many as 440,000
in a 2013 study.
It’s believed that most of these deaths could be prevented if health care providers always adhered
to evidence-informed practices. In recent years, the Centers for Medicare and Medicaid Services,
have sought to drive improvements by linking payments to hospital performance, including patient
[10] safety.
Amid the complexity, the chaotic pace and the increasing need for coordination, how can hospitals
do better to improve patient safety? How can they ensure, for example, that every single time a
patient receives a medication, precautions are taken to reduce the risks of an adverse drug reaction?
The big challenge is not just designing systems with better defenses; it is gaining acceptance for
[15] them, and properly implementing them. Over the past decade, for example, many hospitals have
adopted a key feature of aviation safety − checklists − to improve safety in areas where standard
protocols can save many lives, such as inserting central line catheters, using ventilators and while
performing surgery and assisting childbirth.
When the checklists are well implemented, the results of their use have been stunning. However,
[20] as checklists have proliferated, the results have been inconsistent, often because front-line
practitioners rejected them or adopted them halfheartedly. The devotion to protocol that pilots
see as integral to their professionalism is derided by some doctors as “cookbook medicine”. Atul
Gawande, a surgeon and contributor to The New Yorker, has said that the high value that physicians
place on autonomy and independence makes them reluctant to submit to checklists.
[25] So the big question is: how can health systems be made safer when success means changing the
attitudes and habits of health care professionals at a time when many are overwhelmed and deeply
frustrated by all of the demands being made on them? What does it take to get them to embrace,
with urgency, new ways of working?

opinionator.blogs.nytimes.com

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Apple manufacturing plant workers complain of long hours and militant culture

  Chengdu, China (CNN) — Miss Chen (we changed her name for this story), an 18-year-old student from a village outside of the southern megacity of Chongqing, is one of more than one million factory workers at a Chinese company that helps manufacture products for Apple Inc.’s lucrative global empire, which ranked in a record $46.3 billion in sales last quarter. They work day or night shifts, eating and sleeping at company facilities, as they help build electronics products for Apple and many other global brand names, such as Amazon’s Kindle and Microsoft’s Xbox.

  As a poor college student with no work experience, looking for a job in China’s competitive market is an uphill battle. So when Chen was offered a one-month position at Foxconn with promises of great benefits and little overtime, she jumped at the chance. But when she started working, she found out that only senior employees got such benefits.

  “During my first day of work, an older worker said to me, ‘Why did you come to Foxconn? Think about it again and leave right now’,” said Chen, who plans to return to her studies at a Chongqing university soon.

  Foxconn recently released a statement defending its corporate practices, stating its employees are entitled to numerous benefits including access to health care and opportunities for promotions and training. In response to questions from CNN, Apple also released a statement: “We care about every worker in our worldwide supply chain. We insist that our suppliers provide safe working conditions, treat workers with dignity and respect, and use environmentally responsible manufacturing processes wherever Apple products are made. Our suppliers must live up to these requirements if they want to keep doing business with Apple.”

  After three weeks of applying more than 4,000 stickers a day onto iPad screens by hand and working 60 hours a week in an assembly line, Chen says she’s ready to go back to school and study hard so she’ll never have to return to Foxconn. “It’s so boring, I can’t bear it anymore. Everyday is like: I get off from work and I go to bed. I get up in the morning, and I go to work. It is my daily routine and I almost feel like an animal,” said Miss Chen. When asked why humans do machine-like work at Foxconn, she responds, “Well, humans are cheaper.”

Adaptado de http://edition.cnn.com, consulta em 06/02/2012

Read the text to answer question.

    There’s something faintly embarrassing about the 50th anniversary of the first moonwalk. It was just so long ago. It’s no longer “we” who put a man on the moon, it’s “they” who put a man on the moon. So why can’t “we” do it? It’s hard not to feel that for all the technological advances of the last halfcentury, America has lost something — the ability to unite and overcome long odds to achieve greatness.

    At one level, this is silly. The U.S. stopped going to the moon because Americans stopped seeing the point of it, not because they stopped being capable of it. Still, the historic Mercury, Gemini, and Apollo programs do have something to teach us. Months before the moon landing, the journal Science wrote that the space program’s “most valuable spin-off of all will be human rather than technological: better knowledge of how to plan, coordinate and monitor the multitudinous and varied activities of the organizations required to accomplish great social undertakings.” So, here, lessons the Apollo has left behind.

    1.                        President John Kennedy simplified NASA’s job with his 1961 address to Congress committing to “the goal, before this decade is out, of landing a man on the moon and returning him safely to Earth.” From then on, any decision was made by whether it would aid or impede the agency in meeting that deadline. Experiments that were too heavy were shelved, however valuable they might have been. Technologies that were superior but not ready for deployment were set aside. Having a North Star to pursue was essential, because skeptics and critics abounded. Amid protests over the Vietnam war and race riots, NASA engineers kept their heads down and their slide rules busy.

    2. Harness incongruence. In any large organization there is pressure to suppress dissent. That can be deadly, as it was for NASA in the two space shuttle failures — Challenger and Columbia — each of which killed all seven crew members. Leading up to both tragedies, the fact that engineers grew concerned about a technical problem they did not fully understand, but they could not make a quantitative case; and were consequently ignored.

    After the bad years of the shuttle disasters, the practice of harnessing incongruence, and learning from mistakes, has staged something of a revival at NASA, which has since successfully sent unmanned craft to Mars, Jupiter and Saturn. Says Adam Stelzner, a NASA engineer, “Listen to all that the problem has to say, do not make assumptions or commit to a plan of action based on them until the deepest truth presents itself”.

    3. Delegate but decide. NASA realized early on that it needed help. About 90% of Apollo’s budget was spent on contractors from the most varied places. NASA itself was, therefore, more of a confederation than a single agency.

    With so many players involved, turf wars were unavoidable. NASA Administrator James Webb coined the phrase Space Age Management to describe how he tried to manage conflicts and ensure final decisions were made by headquarters. Unfortunately, Webb’s mastery of the complex network was not as thorough as he believed. The death of three astronauts during a routine test in 1967 was traced to deficiencies Webb had been unaware of. Failure, in this case, was as instructive as success.

    4. Effectiveness and elegance. Aesthetically, the Apollo mission was poor. The module that touched down on the moon looked like an oversize version of a kid’s cardboard science project, all right angles and skinny legs. Apollo’s return to Earth was equally unglamorous. The spaceship that left the launch pad was awesome; what was, by plan, to be rescued from the Pacific Ocean was a stubby cone weighing just 0.2% of the majestic original. But what looks clunky and awkward to an outsider may appear elegant to an engineer. Engineering inelegance, by contrast, would be redesigning a machine without fully anticipating the consequences.

    Most of the people alive today had not yet arrived on the planet when Armstrong, Aldrin and Commander Michael Collins returned to it after their historic voyage. Never mind, though. The moon landing was a victory for all of the human race, past, present, and future.

(Peter Coy. Bloomberg Businessweek, 22.07.2019. Adapted.)

5 Reasons Why Artificial Intelligence Won’t Replace Physicians

    Although many signs are pointing towards
the fact that A.I. will completely move the world of
medicine, and many other technologies will also have
a transformative effect on the industry, stating that the
[5] majority of medical professionals will disappear, is
fearmongering and irresponsible.
    According to a report by Carl Benedikt Frey and
Michael A. Osborne from the University of Oxford,
medical transcriptionists, medical records and health
[10] information technicians and medical secretaries are
the most likely jobs to be computerized in the future,
but physicians and surgeons have a 0.42 percent
chance for their professions being automated.
    Moreover, A.I. will transform the meaning of what
[15] it means to be a doctor: some tasks will disappear,
while others will be added to the work routine. However,
there will never be a situation where the embodiment
of automation, either a robot or an algorithm will take
the place of a doctor. Let me tell you five reasons why.

[20]     1) We cannot replace empathy
    Even if the array of technologies will offer brilliant
solutions, it would be difficult for them to mimic
empathy. Why? Because at the core of empathy, there
is the process of building trust: listening to the other
[25] person, paying attention to their needs, expressing
the feeling of compassion and responding in a manner
that the other person knows they were understood.
    At present, you would not trust a robot or a
smart algorithm with a life-altering decision or even
[30] with a decision whether or not to take painkillers, for
that matter. But we might never be able to imagine
healthcare without human empathy. We will need
doctors holding our hands while telling us about a
life-changing diagnosis, their guide through therapy
[35] and their overall support. An algorithm cannot replace
that. Ever

    2) Physicians have a non-linear working
method
    There was an episode in House M.D. where
[40] the team couldn’t figure out how a young boy could
have been poisoned. They considered many options:
drugs, food poisoning, pesticide poisoning. For
every possible diagnosis, they suggested a different
treatment option. Each one of them made the patient
[45] worse – until they figured out, by accident, that the
boy picked up phosmet, a type of insecticide from the
jeans that he bought from a street vendor who kept
the trousers in a truck. The boy didn’t wash the piece
of clothing before wearing it, that’s how his skin could
[50] absorb the poison.

    No algorithm could have made that diagnosis.
Although data, measurements and quantitative
analytics are a crucial part of a doctor’s work, setting
up a diagnosis and treating a patient are not linear

[55] processes. It requires creativity and problem-solving
skills that algorithms and robots will never have.
    3) Complex digital technologies require
competent professionals
    More and more sophisticated digital health
[60] solutions will require the competence of qualified
medical professionals, no matter whether it’s
about robotics or A.I. Take the example of the most
commonly known surgical robot, the da Vinci Surgical
System. It features a magnified 3D high-definition
[65] vision system and tiny wristed instruments that bend
and rotate far greater than the human hand. However,
surgeons have to learn how to operate it, and it takes
practice to master it.
    Likewise, look at IBM Watson. Its unique program
[70] for oncologists provides clinicians evidence-based
treatment options. Nonetheless, it’s only doctors
together with their patients who can choose the
treatment, and only physicians can evaluate whether
the smart algorithm came up with potentially useful
[75] suggestions. No robot or algorithm could clearly
interpret complex, multi-layered challenges —
involving the psyche. While they will provide the data,
interpretation will always remain a human territory

    4) There will always be tasks algorithms and
[80] robots can never complete
    Physicians, nurses and other members of the
medical staff have plenty of cumbersome monotonous
and repetitive tasks to complete every single day.
However, there are responsibilities and duties which
[85] technologies cannot perform. While IBM Watson can
sift through millions of pages of documents in seconds,
it will never be able to do the Heimlich maneuver.
There will always be tasks where humans will be
faster, more reliable — or cheaper than technology.
[90]     5) It has never been tech vs. human
    The consistent and constant enemy image
building should stop once and for all. It has never
been technology versus humans since technological
innovations always serve the purpose to help people.
[95] We are playing on the same team. No matter whether
it’s A.I., robotics, augmented or virtual reality, we
should accept that they have a massive influence on
the way healthcare operates, and then start utilizing
their power.
[100]     Collaboration between humans and technology is
the ultimate response. The Medical Futurist believes
that this is the perfect example for the coming decades.
Technology will help bring medical professionals
towards a more efficient, less error-prone and more
[105] seamless healthcare. Our team insists on the usage
of digital tools as we are confident that if utilized in
the right way — ethical and legal concerns NOT set
aside — the physician will have more time for the
patient, the doctor can enjoy his work and healthcare
[110] will move into an overall positive direction.

Available at: http://medicalfuturist.com/5-reasons-artifi cial- -intelligence-wont-replace-physicians. Retrieved on: June 30, 2018. Adapted