To be culturally competent, nurses need to understand their own world views and those of the patients. This cultural competence allows you to see the entire picture and improves the quality of care and health outcomes.
Cultural competence means to really listen to the patients, to find out and learn about the patients' beliefs with regards to health and illness, to provide culturally appropriate care, and to understand culturally influenced health behavior.
Since the viewpoint of diseases and their causes varies from culture to culture, these individual preferences affect the approaches to health care. Culture also influences how people seek health care and how they behave towards health care providers. Health care providers must possess the ability and knowledge to communicate and understand health behavior influenced by culture. Thus, to deliver culturally competent care, related policies, practices and procedures should be developed.
CR Meyer, the author of the book, Medicine's Melting Pot, describes four major challenges in health care .The first is the challenge of recognizing clinical(临床的) differences among people of different racial groups. The second is communication. This deals with everything from the need for translators to the differences in words in various languages. Some patients, even in Western cultures don't want to talk about personal matters. The third challenge is ethics(道德规范). Respect for the belief systems of others and the effects of those beliefs on well-being are very important to competent care. The final challenge involves trust. For some patients, authoritative figures are immediately mistrusted, sometimes for good reason. Having been victims of accidents at the hands of authorities in their homelands, many people are as cautious of caregivers themselves as they are of the care.
As individuals, nurses and health care providers, we need to learn to ask questions skillfully and show respect for different cultural beliefs. Most importantly, we must listen to our patients carefully. The main source of problems in caring for patients from diverse cultural backgrounds is the lack of understanding.
81. According to the passage, what can lead to the improvement of the quality of health care?
(No more than 2 words ) (2 marks)
______________________________________________________________________________________
82. Why are people from different countries likely to have different approaches to health care?
(No more than 13 words) (2 marks)
______________________________________________________________________________________
83. According to CR Meyer, why are many people cautious of both caregivers and the care?
( No more than 16 words ) (3 marks)
_______________________________________________________________________________________
84. How can the care providers avoid the problems caused by the lack of understanding?
(No more than 17 words) (3 marks)
_______________________________________________________________________________________
81. Cultural competence.
82. Because the viewpoint of diseases and their causes varies from culture to culture.
/ Because of their various viewpoint of disease and their causes.
83. Because they used to be victims of accidents at the hands of authorities in their homelands.
84. By asking questions skillfully, showing respect for different cultural beliefs and listening to the patients carefully.
科目：高中英语 来源：2013届江苏省扬州中学高三12月质量检测英语试卷（带解析） 题型：阅读理解
Homeownership has let us down. For generations, Americans believed that owning a home was undoubtedly good. Our political leaders hammered home the point. Franklin Roosevelt held that a country of homeowners was “unconquerable.” Homeownership could even save babies, save children, save families and save America. A house with a lawn and a fence wasn’t just a nice place to live in or a risk-free investment; it was a way to shape a nation. No wonder leaders of all political types wanted to spend more than $100 billion a year on subsidies（补助）and tax breaks to encourage people to buy.
But the dark side of homeownership is now all too apparent: Indeed, easy lending stimulated（刺激）by the cult of homeownership may have triggered（引起）the financial crisis. Housing remains a drag on the economy. Existing-home sales in April dropped 27% from the previous month, worsening fears of a double-dip. And all that is just the obvious tale of a housing bubble and what happened when it popped. The real story is deeper and darker still.
For the better part of a century, politics, industry and culture lined up to create a fetish of the idea of buying a house. Homeownership has done plenty of good over the decades; it has provided stability to tens of millions of families. Yet by idealizing the act of buying a home, we have ignored the downsides. In the bubble years, lending standards slipped dramatically, allowing many Americans to put far too much of their income into paying for their housing. And we ignored longer-term phenomena too. Homeownership contributed to the hollowing out of cities and kept renters out of the best neighborhoods. It fed America’s overuse of energy and oil. It made it more difficult for those who had lost a job to find another. Perhaps worst of all, it helped us become casually self-deceiving: By telling ourselves that homeownership was a pathway to wealth and stable communities and better test scores, we avoided dealing with these frightening issues head-on.
Now, as the U.S. recovers from the biggest housing bust（破产）since the Great Depression, it is time to rethink how realistic our expectations of homeownership are—and how much money we want to spend chasing them. Many argue that homeownership should not be a goal pursued at all costs.
【小题1】Political leaders wanted to spend money encouraging people to buy houses because______.
| A．owning a home was undoubtedly good |
| B．homeownership could shape a country |
| C．houses could save families and America |
| D．homeownership was unconquerable |
| A．homeownership has quite a lot of bad effects |
| B．there might be another housing breakdown in the U.S. |
| C．the existing-home sales will keep decreasing in the U.S. |
| D．the result of homeownership is much worse than it appears |
| A．Americans choose to live out of urban areas |
| B．it is the way to wealth to have one’s own house |
| C．it is hard for Americans to get a home loan |
| D．homeownership has made many people out of work |
| A．Cautious. | B．Ambiguous. | C．Favorable. | D．Optimistic. |
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科目：高中英语 来源：2014届浙江象山普通高中高三第二次模拟英语卷（解析版） 题型：阅读理解
McDonald's is the world single biggest food provider with annual sales of around $12.4bn. And the company's symbol Ronald McDonald is now （or so the company claims） the world's most recognized person after Santa Claus.
The first McDonald's restaurant was opened in San Bernardino, California, in 1948 by brothers Mac and Richard “Dick” McDonald. Mac ran the restaurant side; Dick was the marketing genius. He had already invented the drive-in laundry and had been the first person to use neon lights in advertising. Now he spotted the gap in the post-war, baby-boom market for cheap, family-orientated restaurants with simple menus, standardized food and efficient service.
After a slow start, business began to boom. By 1954, the brothers were joined by another entrepreneur, a kitchen equipment salesman called Ray A Kroc who owned the franchise to the Multimixer, milk shake maker used throughout the McDonald's chain. A year later, Kroc had bought the McDonald brothers' chain of 25 franchises for the equivalent of around $70m（￡44m）. Dick remained with the company until the Seventies, when he and Kroc fell out over Kroc's claim that the chain was his creation.
Today, an almost Stalinist cult of personality surrounds Kroc （who died in 1984） at McDonald's, while the brothers who gave the company its name have all but been written out of its history. But though Kroc did not found McDonald's, he was certainly responsible for the empire-building philosophy which led to its world domination. He ushered in such essential contributions to international cuisine as the Big Mac （1968） and the Egg McMuffin （1973）; and helped launch Ronald McDonald —— “in any language he means fun” —— on to television in 1963.
Every three hours, a new McDonald's franchise opens somewhere in the world; it can be found in more than 100 countries including India （vegetarian-only to avoid offending the non-beef-eating populace） and Israel （non kosher, despite fierce local objection）. McDonald's chain embodied the thrusting, can-do spirit of Fifties America with staff mottoes such as “If you've got time to lean, you've got time to clean.”
1.McDonald's was founded _____.
A. by a kitchen equipment salesman
B. in California
C. by a marketing genius called Dick McDonald
D. after the first World War
2.What do we know about McDonald's brothers?
A. They were not McDonald's founders although they named the restaurant.
B. Their business was still in depression after several years.
C. They had clear job separation on business.
D. They sold their restaurant to a salesman in 1954.
3.Which is not Kroc's contribution to McDonald's ?
A. He launched the restaurant image Ronald McDonald on to television.
B. Under his lead, international cuisine as the Big Mac and the Egg McMuffin earned worldwide fame
C. He spotted the gap in postwar market for cheap, family-orientated restaurants.
D. He built McDonald's empire with a philosophy which led to its world domination.
4.Which statement is true according to the passage?
A. The single biggest food provider was however, not named after its founder
B. The international cuisine as the Big Mac, a beef hamburger, is provided every chain restaurant in the world.
C. Employees in McDonald's have no time to lean.
D. The symbol Ronald McDonald, means fun in any language, is said to the world most recognized person after Santa Claus.
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科目：高中英语 来源：2014届浙江东阳南马高级中学高三9月月考英语卷（解析版） 题型：阅读理解
McDonald's is the world single biggest food provider with annual sales of around $12.4bn. And the company's symbol Ronald McDonald is now （or so the company claims） the word's most recognized person after Santa Claus.
The first McDonald's restaurant was opened in San Bernardino, California, in 1948 by brothers Mac and Richard “Dick” McDonald. Mac ran the restaurant side; Dick was the marketing genius. He had already invented the drive-in laundry and had been the first person to use neon lights in advertising. Now he spotted the gap in the post-war, baby-boom market for cheap, family-orientated restaurants with simple menus, standardized food and efficient service.
After a slow start, business began to boom. By 1954, the brothers were joined by another entrepreneur, a kitchen equipment salesman called Ray A Kroc who owned the franchise to the Multimixer, milk shake maker used throughout the McDonald's chain. A year later, Kroc had bought the McDonald brothers' chain of 25 franchises for the equivalent of around $70m（￡44m）. Dick remained with the company until the Seventies, when he and Kroc fell out over Kroc's claim that the chain was his creation.
Today, an almost Stalinist cult of personality surrounds Kroc （who died in 1984） at McDonald's, while the brothers who gave the company its name have all but been written out of its history. But though Kroc did not found McDonald's, he was certainly responsible for the empire-building philosophy which led to its world domination. He ushered in such essential contributions to international cuisine as the Big Mac （1968） and the Egg McMuffin （1973）; and helped launch Ronald McDonald —— “in any language he means fun” —— on to television in 1963.
Every three hours, a new McDonald's franchise opens somewhere in the world; it can be found in more than 100 countries including India （vegetarian-only to avoid offending the non-beef-eating populace） and Israel （non kosher, despite fierce local objection）. McDonald's chain embodied the thrusting, can-do spirit of Fifties America with staff mottoes such as “If you've got time to lean, you've go time to clean.”
1. McDonald's was founded _____.
A. by a kitchen equipment salesman
B. in California.
C. by a marketing genius called Dick McDonald.
D. after the first World War.
2.What do we know about McDonald's brothers?
A. They were not McDonald's founders although they named the restaurant.
B. Their business was still in depression after several years.
C. They had clear job separation on business.
D. They sold their restaurant to a salesman in 1954.
3. Which is not Kroc's contribution to McDonald's ?
A. He launched the restaurant image Ronald McDonald on to television.
B. Under his lead, international cuisine as the Big Mac and the Egg McMuffin earned worldwide fame
C. He spotted the gap in postwar market for cheap, family-orientated restaurants.
D. He built McDonald's empire with a philosophy which led to its world domination.
4.Which statement is true according to the passage?
A. The single biggest food provider was however, not named after its founder
B. The international cuisine as the Big Mac, a beef hamburger, is provided every chain restaurant in the world.
C. Employees in McDonald's have no time to lean.
D. The symbol Ronald McDonald, means fun in any language, is said to the word most recognized person after Santa Claus.
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科目：高中英语 来源：2012-2013学年江苏省高三12月质量检测英语试卷（解析版） 题型：阅读理解
Homeownership has let us down. For generations, Americans believed that owning a home was undoubtedly good. Our political leaders hammered home the point. Franklin Roosevelt held that a country of homeowners was “unconquerable.” Homeownership could even save babies, save children, save families and save America. A house with a lawn and a fence wasn’t just a nice place to live in or a risk-free investment; it was a way to shape a nation. No wonder leaders of all political types wanted to spend more than $100 billion a year on subsidies（补助）and tax breaks to encourage people to buy.
But the dark side of homeownership is now all too apparent: Indeed, easy lending stimulated（刺激）by the cult of homeownership may have triggered（引起）the financial crisis. Housing remains a drag on the economy. Existing-home sales in April dropped 27% from the previous month, worsening fears of a double-dip. And all that is just the obvious tale of a housing bubble and what happened when it popped. The real story is deeper and darker still.
For the better part of a century, politics, industry and culture lined up to create a fetish of the idea of buying a house. Homeownership has done plenty of good over the decades; it has provided stability to tens of millions of families. Yet by idealizing the act of buying a home, we have ignored the downsides. In the bubble years, lending standards slipped dramatically, allowing many Americans to put far too much of their income into paying for their housing. And we ignored longer-term phenomena too. Homeownership contributed to the hollowing out of cities and kept renters out of the best neighborhoods. It fed America’s overuse of energy and oil. It made it more difficult for those who had lost a job to find another. Perhaps worst of all, it helped us become casually self-deceiving: By telling ourselves that homeownership was a pathway to wealth and stable communities and better test scores, we avoided dealing with these frightening issues head-on.
Now, as the U.S. recovers from the biggest housing bust（破产）since the Great Depression, it is time to rethink how realistic our expectations of homeownership are—and how much money we want to spend chasing them. Many argue that homeownership should not be a goal pursued at all costs.
1.Political leaders wanted to spend money encouraging people to buy houses because______.
A．owning a home was undoubtedly good
B．homeownership could shape a country
C．houses could save families and America
D．homeownership was unconquerable
2.The underlined sentence in Para. 2 means ______.
A．homeownership has quite a lot of bad effects
B．there might be another housing breakdown in the U.S.
C．the existing-home sales will keep decreasing in the U.S.
D．the result of homeownership is much worse than it appears
3.It can be inferred from Para. 3 that ______.
A．Americans choose to live out of urban areas
B．it is the way to wealth to have one’s own house
C．it is hard for Americans to get a home loan
D．homeownership has made many people out of work
4.What is the author’s attitude towards homeownership?
A．Cautious. B．Ambiguous. C．Favorable. D．Optimistic.
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科目：高中英语 来源： 题型：阅读理解
McDonald's is the world single biggest food provider with annual sales of around $12.4bn. And the company's symbol Ronald McDonald is now （or so the company claims） the word's most recognized person after Santa Claus.
The first McDonald's restaurant was opened in San Bernardino, California, in 1948 by brothers Mac and Richard “Dick” McDonald. Mac ran the restaurant side; Dick was the marketing genius. He had already invented the drive-in laundry and had been the first person to use neon lights in advertising. Now he spotted the gap in the post-war, baby-boom market for cheap, family-orientated restaurants with simple menus, standardized food and efficient service.
After a slow start, business began to boom. By 1954, the brothers were joined by another entrepreneur, a kitchen equipment salesman called Ray A Kroc who owned the franchise to the Multimixer, milk shake maker used throughout the McDonald's chain. A year later, Kroc had bought the McDonald brothers' chain of 25 franchises for the equivalent of around $70m（￡44m）. Dick remained with the company until the Seventies, when he and Kroc fell out over Kroc's claim that the chain was his creation.
Today, an almost Stalinist cult of personality surrounds Kroc （who died in 1984） at McDonald's, while the brothers who gave the company its name have all but been written out of its history. But though Kroc did not found McDonald's, he was certainly responsible for the empire-building philosophy which led to its world domination. He ushered in such essential contributions to international cuisine as the Big Mac （1968） and the Egg McMuffin （1973）; and helped launch Ronald McDonald —— “in any language he means fun” —— on to television in 1963.
Every three hours, a new McDonald's franchise opens somewhere in the world; it can be found in more than 100 countries including India （vegetarian-only to avoid offending the non-beef-eating populace） and Israel （non kosher, despite fierce local objection）. McDonald's chain embodied the thrusting, can-do spirit of Fifties America with staff mottoes such as “If you've got time to lean, you've go time to clean.”
51. McDonald's was founded _____.
A. by a kitchen equipment salesman .
B. in California.
C. by a marketing genius called Dick McDonald.
D. after the first World War.
52. What do we know about McDonald's brothers?
A. They were not McDonald's founders although they named the restaurant.
B. Their business was still in depression after several years.
C. They had clear job separation on business.
D. They sold their restaurant to a salesman in 1954.
53. Which is not Kroc's contribution to McDonald's ?
A. He launched the restaurant image Ronald McDonald on to television.
B. Under his lead, international cuisine as the Big Mac and the Egg McMuffin earned worldwide fame
C. He spotted the gap in postwar market for cheap, family-orientated restaurants.
D. He built McDonald's empire with a philosophy which led to its world domination.
54. Which statement is true according to the passage?
A. The single biggest food provider was however, not named after its founder
B. The international cuisine as the Big Mac, a beef hamburger, is provided every chain restaurant in the world.
C. Employees in McDonald's have no time to lean.
D. The symbol Ronald McDonald, means fun in any language, is said to the word most recognized person after Santa Claus.
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