1. Gastric bypass surgery has been shown to be effective at helping extremely obese people lose weight. Some patients have lost as much as 300 pounds after undergoing the surgery, thereby substantially prolonging their lives. Despite the success of the treatment, most doctors have not embraced the surgery. Which of the following statements, if true, best accounts for the lukewarm reaction of the medical community to gastric bypass surgery'?






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MCQ->Gastric bypass surgery has been shown to be effective at helping extremely obese people lose weight. Some patients have lost as much as 300 pounds after undergoing the surgery, thereby substantially prolonging their lives. Despite the success of the treatment, most doctors have not embraced the surgery. Which of the following statements, if true, best accounts for the lukewarm reaction of the medical community to gastric bypass surgery'?....
MCQ-> I think that it would be wrong to ask whether 50 years of India's Independence are an achievement or a failure. It would be better to see things as evolving. It's not an either-or question. My idea of the history of India is slightly contrary to the Indian idea.India is a country that, in the north, outside Rajasthan, was ravaged and intellectually destroyed to a large extent by the invasions that began in about AD 1000 by forces and religions that India had no means of understanding.The invasions are in all the schoolbooks. But I don't think that people understand that every invasion, every war, every campaign, was accompanied by slaughter, a slaughter always of the most talented people in the country. So these wars, apart from everything else led to a tremendous intellectual depletion of the country.I think that in the British period, and in the 50 years after the British period, there has been a kind of regrouping or recovery, a very slow revival of energy and intellect. This isn't an idea that goes with the vision of the grandeur of old India and all that sort of rubbish. That idea is a great simplification and it occurs because it is intellectually, philosophically easier for Indians to manage.What they cannot manage, and what they have not yet come to terms with, is that ravaging of all the north of India by various conquerors. That was ruined not by the act of nature, but by the hand of man. It is so painful that few Indians have begun to deal with it. It is much easier to deal with British imperialism. That is a familiar topic, in India and Britain. What is much less familiar is the ravaging of India before the British.What happened from AD 1000 onwards, really, is such a wound that it is almost impossible to face. Certain wounds are so bad that they can't be written about. You deal with that kind of pain by hiding from it. You retreat from reality. I do not think, for example, that the Incas of Peru or the native people of Mexico have ever got over their defeat by the Spaniards. In both places the head was cut off. I think the pre-British ravaging of India was as bad as that.In the place of knowledge of history, you have various fantasies about the village republic and the Old Glory. There is one big fantasy that Indians have always found solace in: about India having the capacity for absorbing its conquerors. This is not so. India was laid low by its conquerors.I feel the past 150 years have been years of every kind of growth. I see the British period and what has continued after that as one period. In that time, there has been a very slow intellectual recruitment. I think every Indian should make the pilgrimage to the site of the capital of the Vijayanagar empire, just to see what the invasion of India led to. They will see a totally destroyed town. Religious wars are like that. People who see that might understand what the centuries of slaughter and plunder meant. War isn't a game. When you lost that kind of war, your town was destroyed, the people who built the towns were destroyed. You are left with a headless population.That's where modern India starts from. The Vijayanagar capital was destroyed in 1565. It is only now that the surrounding region has begun to revive. A great chance has been given to India to start up again, and I feel it has started up again. The questions about whether 50 years of India since Independence have been a failure or an achievement are not the questions to ask. In fact, I think India is developing quite marvelously, people thought — even Mr Nehru thought — that development and new institutions in a place like Bihar, for instance, would immediately lead to beauty. But it doesn't happen like that. When a country as ravaged as India, with all its layers of cruelty, begins to extend justice to people lower down, it's a very messy business. It's not beautiful, it's extremely messy. And that's what you have now, all these small politicians with small reputations and small parties. But this is part of growth, this is part of development. You must remember that these people, and the people they represent, have never had rights before.When the oppressed have the power to assert themselves, they will behave badly. It will need a couple of generations of security, and knowledge of institutions, and the knowledge that you can trust institutions — it will take at least a couple of generations before people in that situation begin to behave well. People in India have known only tyranny. The very idea of liberty is a new idea. The rulers were tyrants. The tyrants were foreigners. And they were proud of being foreign. There's a story that anybody could run and pull a bell and the emperor would appear at his window and give justice. This is a child's idea of history — the slave's idea of the ruler's mercy. When the people at the bottom discover that they hold justice in their own hands, the earth moves a little. You have to expect these earth movements in India. It will be like this for a hundred years. But it is the only way. It's painful and messy and primitive and petty, but it’s better that it should begin. It has to begin. If we were to rule people according to what we think fit, that takes us back to the past when people had no voices. With self-awareness all else follows. People begin to make new demands on their leaders, their fellows, on themselves.They ask for more in everything. They have a higher idea of human possibilities. They are not content with what they did before or what their fathers did before. They want to move. That is marvellous. That is as it should be. I think that within every kind of disorder now in India there is a larger positive movement. But the future will be fairly chaotic. Politics will have to be at the level of the people now. People like Nehru were colonial — style politicians. They were to a large extent created and protected by the colonial order. They did not begin with the people. Politicians now have to begin with the people. They cannot be too far above the level of the people. They are very much part of the people. It is important that self-criticism does not stop. The mind has to work, the mind has to be active, there has to be an exercise of the mind. I think it's almost a definition of a living country that it looks at itself, analyses itself at all times. Only countries that have ceased to live can say it's all wonderful.The central thrust of the passage is that
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MCQ-> The story begins as the European pioneers crossed the Alleghenies and started to settle in the Midwest. The land they found was covered with forests. With incredible efforts they felled the trees, pulled the stumps and planted their crops in the rich, loamy soil. When they finally reached the western edge of the place we now call Indiana, the forest stopped and ahead lay a thousand miles of the great grass prairie. The Europeans were puzzled by this new environment. Some even called it the “Great Desert”. It seemed untillable. The earth was often very wet and it was covered with centuries of tangled and matted grasses. With their cast iron plows, the settlers found that the prairie sod could not be cut and the wet earth stuck to their plowshares. Even a team of the best oxen bogged down after a few years of tugging. The iron plow was a useless tool to farm the prairie soil. The pioneers were stymied for nearly two decades. Their western march was hefted and they filled in the eastern regions of the Midwest.In 1837, a blacksmith in the town of Grand Detour, Illinois, invented a new tool. His name was John Deere and the tool was a plow made of steel. It was sharp enough to cut through matted grasses and smooth enough to cast off the mud. It was a simple too, the “sod buster” that opened the great prairies to agricultural development.Sauk Country, Wisconsin is the part of that prairie where I have a home. It is named after the Sauk Indians. In i673 Father Marquette was the first European to lay his eyes upon their land. He found a village laid out in regular patterns on a plain beside the Wisconsin River. He called the place Prairie du Sac) The village was surrounded by fields that had provided maize, beans and squash for the Sauk people for generations reaching back into the unrecorded time.When the European settlers arrived at the Sauk prairie in 1837, the government forced the native Sank people west of the Mississippi River. The settlers came with John Deere’s new invention and used the tool to open the area to a new kind of agriculture. They ignored the traditional ways of the Sank Indians and used their sod-busting tool for planting wheat. Initially, the soil was generous and the nurturing thrived. However each year the soil lost more of its nurturing power. It was only thirty years after the Europeans arrived with their new technology that the land was depleted, Wheat farming became uneconomic and tens of thousands of farmers left Wisconsin seeking new land with sod to bust.It took the Europeans and their new technology just one generation to make their homeland into a desert. The Sank Indians who knew how to sustain themselves on the Sauk prairie land were banished to another kind of desert called a reservation. And they even forgot about the techniques and tools that had sustained them on the prairie for generations unrecorded. And that is how it was that three deserts were created — Wisconsin, the reservation and the memories of a people. A century later, the land of the Sauks is now populated by the children of a second wave of European tanners who learned to replenish the soil through the regenerative powers of dairying, ground cover crops and animal manures. These third and fourth generation farmers and townspeople do not realise, however, that a new settler is coming soon with an invention as powerful as John Deere’s plow.The new technology is called ‘bereavement counselling’. It is a tool forged at the great state university, an innovative technique to meet the needs of those experiencing the death of a loved one, tool that an “process” the grief of the people who now live on the Prairie of the Sauk. As one can imagine the final days of the village of the Sauk Indians before the arrival of the settlers with John Deere’s plow, one can also imagine these final days before the arrival of the first bereavement counsellor at Prairie du Sac) In these final days, the farmers arid the townspeople mourn at the death of a mother, brother, son or friend. The bereaved is joined by neighbours and kin. They meet grief together in lamentation, prayer and song. They call upon the words of the clergy and surround themselves in community.It is in these ways that they grieve and then go on with life. Through their mourning they are assured of the bonds between them and renewed in the knowledge that this death is a part of the Prairie of the Sauk. Their grief is common property, an anguish from which the community draws strength and gives the bereaved the courage to move ahead.It is into this prairie community that the bereavement counsellor arrives with the new grief technology. The counsellor calls the invention a service and assures the prairie folk of its effectiveness and superiority by invoking the name of the great university while displaying a diploma and certificate. At first, we can imagine that the local people will be puzzled by the bereavement counsellor’s claim, However, the counsellor will tell a few of them that the new technique is merely o assist the bereaved’s community at the time of death. To some other prairie folk who are isolated or forgotten, the counsellor will approach the Country Board and advocate the right to treatment for these unfortunate souls. This right will be guaranteed by the Board’s decision to reimburse those too poor tc pay for counselling services. There will be others, schooled to believe in the innovative new tools certified by universities and medical centres, who will seek out the bereavement counsellor by force of habit. And one of these people will tell a bereaved neighbour who is unschooled that unless his grief is processed by a counsellor, he will probably have major psychological problems in later life. Several people will begin to use the bereavement counsellor because, since the Country Board now taxes them to insure access to the technology, they will feel that to fail to be counselled is to waste their money, and to be denied a benefit, or even a right.Finally, one day, the aged father of a Sauk woman will die. And the next door neighbour will not drop by because he doesn’t want to interrupt the bereavement counsellor. The woman’s kin will stay home because they will have learned that only the bereavement counsellor knows how to process grief the proper way. The local clergy will seek technical assistance from the bereavement counsellor to learn the connect form of service to deal with guilt and grief. And the grieving daughter will know that it is the bereavement counsellor who really cares for her because only the bereavement counsellor comes when death visits this family on the Prairie of the Sauk.It will be only one generation between the bereavement counsellor arrives and the community of mourners disappears. The counsellor’s new tool will cut through the social fabric, throwing aside kinship, care, neighbourly obligations and communality ways cc coming together and going on. Like John Deere’s plow, the tools of bereavement counselling will create a desert we a community once flourished, And finally, even the bereavement counsellor will see the impossibility of restoring hope in clients once they are genuinely alone with nothing but a service for consolation. In the inevitable failure of the service, the bereavement counsellor will find the deserts even in herself.Which one of the following best describes the approach of the author?
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MCQ-> When people react to their experiences with particular authorities, those authorities and the organizations or institutions that they represent often benefit if the people involved begin with high levels of commitment to the organization or institution represented by the authorities. First, in his studies of people's attitudes toward political and legal institutions, Tyler found that attitudes after an experience with the institution were strongly affected by prior attitudes. Single experiences influence post- experience loyalty but certainly do not overwhelm the relationship between pre-experience and post- experience loyalty. Thus, the best predictor of loyalty after an experience is usually loyalty before that experience. Second, people with prior loyalty to the organization or institution judge their dealings with the organization’s or institution's authorities to be fairer than do those with less prior loyalty, either because they are more fairly treated or because they interpret equivalent treatment as fairer.Although high levels of prior organizational or institutional commitment are generally beneficial to the organization or institution, under certain conditions high levels of prior commitment may actually sow the seeds of reduced commitment. When previously committed individuals feel that they were treated unfavourably or unfairly during some experience with the organization or institution, they may show an especially sharp decline in commitment. Two studies were designed to test this hypothesis, which, if confirmed, would suggest that organizational or institutional commitment has risks, as well as benefits. At least three psychological models offer predictions of how individuals’ reactions may vary as a function of a: their prior level of commitment and b: the favorability of the encounter with the organization or institution. Favorability of the encounter is determined by the outcome of the encounter and the fairness or appropriateness of the procedures used to allocate outcomes during the encounter. First, the instrumental prediction is that because people are mainly concerned with receiving desired outcomes from their encounters with organizations, changes in their level of commitment will depend primarily on the favorability of the encounter. Second, the assimilation prediction is that individuals' prior attitudes predispose them to react in a way that is consistent with their prior attitudes.The third prediction, derived from the group-value model of justice, pertains to how people with high prior commitment will react when they feel that they have been treated unfavorably or unfairly during some encounter with the organization or institution. Fair treatment by the other party symbolizes to people that they are being dealt with in a dignified and respectful way, thereby bolstering their sense of self-identity and self-worth. However, people will become quite distressed and react quite negatively if they feel that they have been treated unfairly by the other party to the relationship. The group-value model suggests that people value the information they receive that helps them to define themselves and to view themselves favorably. According to the instrumental viewpoint, people are primarily concerned with the more material or tangible resources received from the relationship. Empirical support for the group-value model has implications for a variety of important issues, including the determinants of commitment, satisfaction, organizational citizenship, and rule following. Determinants of procedural fairness include structural or interpersonal factors. For example, structural determinants refer to such things as whether decisions were made by neutral, fact-finding authorities who used legitimate decision-making criteria. The primary purpose of the study was to examine the interactive effect of individuals a: commitment to an organization or institution prior to some encounter and b: perceptions of how fairly they were treated during the encounter, on the change in their level of commitment. A basic assumption of the group-value model is that people generally value their relationships with people, groups, organizations, and institutions and therefore value fair treatment from the other party to the relationship. Specifically, highly committed members should have especially negative reactions to feeling that they were treated unfairly, more so than a: less- committed group members or b: highly committed members who felt that they were fairly treated.The prediction that people will react especially negatively when they previously felt highly committed but felt that they were treated unfairly also is consistent with the literature on psychological contracts. Rousseau suggested that, over time, the members of work organizations develop feelings of entitlement, i.e., perceived obligations that their employers have toward them. Those who are highly committed to the organization believe that they are fulfilling their contract obligations. However, if the organization acted unfairly, then highly committed individuals are likely to believe that the organization did not live up to its end of the bargain.The hypothesis mentioned in the passage tests at least one of the following ideas.
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MCQ-> The second plan to have to examine is that of giving to each person what she deserves. Many people, especially those who are comfortably off, think this is what happens at present: that the industrious and sober and thrifty are never in want, and that poverty is due to idleness, improvidence, drinking, betting, dishonesty, and bad character generally. They can point to the fact that a labour whose character is bad finds it more difficult to get employment than one whose character is good; that a farmer or country gentleman who gambles and bets heavily, and mortgages his land to live wastefully and extravagantly, is soon reduced to poverty; and that a man of business who is lazy and does not attend to it becomes bankrupt. But this proves nothing that you cannot eat your cake and have it too; it does not prove that your share of the cake was a fair one. It shows that certain vices make us rich. People who are hard, grasping, selfish, cruel, and always ready to take advantage of their neighbours, become very rich if they are clever enough not to overreach themselves. On the other hand, people who are generous, public spirited, friendly, and not always thinking of the main chance, stay poor when they are born poor unless they have extraordinary talents. Also as things are today, some are born poor and others are born with silver spoons in their mouths: that is to say, they are divided into rich and poor before they are old enough to have any character at all. The notion that our present system distributes wealth according to merit, even roughly, may be dismissed at once as ridiculous. Everyone can see that it generally has the contrary effect; it makes a few idle people very rich, and a great many hardworking people very poor.On this, intelligent Lady, your first thought may be that if wealth is not distributed according to merit, it ought to be; and that we should at once set to work to alter our laws so that in future the good people shall be rich in proportion to their goodness and the bad people poor in proportion to their badness. There are several objections to this; but the very first one settles the question for good and all. It is, that the proposal is impossible and impractical. How are you going to measure anyone's merit in money? Choose any pair of human beings you like, male or female, and see whether you can decide how much each of them should have on her or his merits. If you live in the country, take the village blacksmith and the village clergyman, or the village washerwoman and the village schoolmistress, to begin with. At present, the clergyman often gets less pay than the blacksmith; it is only in some villages he gets more. But never mind what they get at present: you are trying whether you can set up a new order of things in which each will get what he deserves. You need not fix a sum of money for them: all you have to do is to settle the proportion between them. Is the blacksmith to have as much as the clergyman? Or twice as much as the clergyman? Or half as much as the clergyman? Or how much more or less? It is no use saying that one ought to have more the other less; you must be prepared to say exactly how much more or less in calculable proportion.Well, think it out. The clergyman has had a college education; but that is not any merit on his part: he owns it to his father; so you cannot allow him anything for that. But through it he is able to read the New Testament in Greek; so that he can do something the blacksmith cannot do. On the other hand, the blacksmith can make a horse-shoe, which the parson cannot. How many verses of the Greek Testament are worth one horse-shoe? You have only to ask the silly question to see that nobody can answer it.Since measuring their merits is no use, why not try to measure their faults? Suppose the blacksmith swears a good deal, and gets drunk occasionally! Everybody in the village knows this; but the parson has to keep his faults to himself. His wife knows them; but she will not tell you what they are if she knows that you intend to cut off some of his pay for them. You know that as he is only a mortal human being, he must have some faults; but you cannot find them out. However, suppose he has some faults he is a snob; that he cares more for sport and fashionable society than for religion! Does that make him as bad as the blacksmith, or twice as bad, or twice and quarter as bad, or only half as bad? In other words, if the blacksmith is to have a shilling, is the parson to have six pence, or five pence and one-third, or two shillings? Clearly these are fools' questions: the moment they bring us down from moral generalities to business particulars it becomes plain to every sensible person that no relation can be established between human qualities, good or bad, and sums of money, large or small.It may seem scandalous that a prize-fighter, for hitting another prize-fighter so hard at Wembley that he fell down and could not rise within ten seconds, received the same sum that was paid to the Archbishop of Canterbury for acting as Primate of the Church of England for nine months; but none of those who cry out against the scandal can express any better in money the difference between the two. Not one of the persons who think that the prize-fighter should get less than the Archbishop can say how much less. What the prize- fighter got for his six or seven months' boxing would pay a judge's salary for two years; and we all agree that nothing could be more ridiculous, and that any system of distributing wealth which leads to such absurdities must be wrong. But to suppose that it could be changed by any possible calculation that an ounce of archbishop of three ounces of judge is worth a pound of prize-fighter would be sillier still. You can find out how many candles are worth a pound of butter in the market on any particular day; but when you try to estimate the worth of human souls the utmost you can say is that they are all of equal value before the throne of God:And that will not help you in the least to settle how much money they should have. You must simply give it up, and admit that distributing money according to merit is beyond mortal measurement and judgement.Which of the following is not a vice attributed to the poor by the rich?
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