题目内容
（请给出正确答案）
Many doctors think it is helpful for night-shift workers_________.
A．to sleep with a bright light on
B．to plan sleep patterns carefully
C．to avoid being disturbed at work
D．to sleep for a long time after work
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This is【B1】______of reason, I think,
A.one
B.part
C.much
D.some
Questions are based on the following passage．
Saying they can no longer ignore the rising prices of health care， some of the most influentialmedical groups in the nation are recommending that doctors weigh the costs， not just the effectiveness of treatments， as they make decisions about patient care．The shift， little noticed outside the medical establishment but already controversial inside it，suggests that doctors are starting to redefine their roles， from being concerned exclusively about individual patients to exerting influence on how healthcare dollars are spent．In practical terms， the new guidelines being developed could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment—at the end of life， for example—is too expensive．In the extreme， some critics have said that making treatment decisionsbased on cost is a form. of rationing．Traditionally， guidelines have heavily influenced the practice of medicine， and the latest ones areexpected to make doctors more conscious of the economic consequences of their decisions， even though there"s no obligation to follow them．Medical society guidelines are also used by insurancecomoanies to help determine reimbursement （报销） policies．Some doctors see a potential conflict in trying to be both providers of patient care and fmancial
Overseers．"There should be forces in society who should be concerned about the budget， but they shouldn"t be functioning simultaneously as doctors，" said Dr．Martin Samuels at a Boston hospital．He said doctors risked losing the trust of patients if they told patients， "I"m not going to do what I think is best for you because I think it"s bad for the healthcare budget in Massachusetts．" Doctors can face some grim trade—offs．Studies have shown， for example， that two drugs are about
equally effective in treating macular degeneration， and eye disease．But one costs $ 50 a dose and the other close to $ 2，000．Medicare could save hundreds of millions of dollars a year if everyone used the cheaper drug， Avastin， instead of the costlier one， Lucentis．But the Food and Drug Administration has not approved Avastin for use in the eye．and using it rather than the alternative， Lucentis， might carry an additional， although slight， safety risk．Should doctors consider Medicare"s budget in deciding what to use？"I think ethically （在道德层面上） we are just worried about the patient in front of us and not trying to save money for the insurance industry or society as a whole，" said Dr．Donald Jensen．Still， some analysts say that there"s a role for doctors to play in cost analysis because not many others are doing so．"In some ways，" said Dr．Daniel Sulmasy， "it represents a failure of wider society
to take up the issue．"
What do some most influential medical groups recommend doctors do？ 查看材料
A.Reflect on the responsibilities they are supposed to take．
B.Pay more attention to the effectiveness of their treatments．
C.Take costs into account when making treatment decisions．
D.Readjust their practice in view of the cuts in health care．
A．could have ended the tax on fats much sooner
B．is more concerned about money than the health of its citizens
C．has enough information to see if taxes on unhealthy foods are effective
D．should ask other countries to make laws against selling fatty foods
Everybody may have seen the film "Death on the Nile (尼罗河) ," but nobody can imagine that the writer of the story, Agatha Christie, saved a baby in a most unusual way.
In June 1977, a baby girl became seriously ill in Deleville. Doctors there were unable to find out the cause of her illness, so she was sent to a famous hospital in London, where there were many excellent doctors. The baby was so seriously iii that a team of doctors hurried to examine her without any delay. The doctors, too, were puzzled by the baby's illness, and they also became discouraged. Just then a nurse asked to speak to them.
"I think the baby is suffering from thallium (铊) poisoning," said the nurse~ "A few days ago, I read a story 'A Pale Horse' written by Agatha Christie. Someone uses thallium poison, and all the symptoms (症状) are written in the book. They are exactly the same as the baby's."
"You're very good at observing things, "said a doctor, "and you may be right. We'll carry out some tests and find out whether the cause is thallium poisoning or not."
The tests proved that the baby had indeed been poisoned by thallium. Once they knew that cause, the doctors were able to give her correct treatment. The baby soon got well and was sent back to Deleville. A week later it was reported that the poison might have come from an insecticide (杀虫剂) used in Deleville.
The baby was sent to a hospital in London because ______.
A．her parents were living in London then
B．the hospitals in Deleville were full at that time
C．she was the daughter of a famous doctor in London
D．doctors in Deleville were not sure about the cause of her illness
The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how healthcare dollars are spent.
In practical terms, the new guidelines being developed could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment-at the end of life, for example-is too expensive. In the extreme, some critics have said that making treatment decisions based on cost is a form. of rationing.
Traditionally, guidelines have heavily influenced the practice of medicine, and the latest ones are expected to make doctors more conscious of the economic consequences of their decisions, even though there’s no obligation to follow them. Medical society guidelines are also used by insurance companies to help determine reimbursement(报销)policies.
Some doctors see a potential conflict in trying to be both providers of patient care and financial overseers.
"There should be forces in society who should be concerned about the budget, but they shouldn’t be functioning simultaneously as doctors," said Dr. Martin Samuels at a Boston hospital. He said doctors risked losing the trust of patients if they told patients, "I’m not going to do what I think is best for you because I think it’s bad for the healthcare budget in Massachusetts."
Doctors can face some grim trade-offs. Studies have shown, for example, that two drugs are about equally effective in treating macular degeneration, an eye disease. But one costs $50 a dose and the other close to $2,000. Medicare could save hundreds of millions of dollars a year if everyone used the cheaper drug. Avastin, instead of the costlier one, Lucentis.
But the Food and Drug Administration has not approved Avastin for use in the eye, and using it rather than the alternative, Lucentis, might carry an additional, although slight, safety risk. Should doctors consider Medicare’s budget in deciding what to use？
"I think ethically(在道德层面上)we are just worried about the patient in front of us and not trying to save money for the insurance industry or society as a whole," said Dr. Donald Jensen.
Still, some analysts say that there’s a role for doctors to play in cost analysis because not many others are doing so. "In some ways," said Dr. Daniel Sulmasy, "it represents a failure of wider society to take up the issue."
57.What do some most influential medical groups recommend doctors do？
A.Reflect on the responsibilities they are supposed to take.
B.Pay more attention to the effectiveness of their treatments.
C.Take costs into account when making treatment decisions.
D.Readjust their practice in view of the cuts in health care.
58.What were doctors mainly concerned about in the past？
A.Specific medicines to be used.
B.Professional advancement.
C.Effects of medical treatment.
D.Patients’ trust.
59.What may the new guidelines being developed lead to？
A.The redefining of doctors’ roles.
B.Conflicts between doctors and patients.
C.Overuse of less effective medicines.
D.The prolonging of patients’ suffering.
60.What risk do doctors see in their dual role as patient care providers and financial overseers？
A.They may be involved in a conflict of interest.
B.They may be forced to divide their attention.
C.They may have to use less effective drugs.
D.They may lose the respect of patients.
61.What do some experts say about doctors’ involvement in medical cost analysis？
A.It may add to doctors’ already heavy workloads.
B.It will help to save money for society as a whole.
C.It results from society’s failure to tackle the problem.
D.It raises doctors’ awareness of their social responsibilities.
A visit to a doctor’s office costs from fifteen to fifty dollars. It is impossible to pay for the medical care they need. Many people in the United States think that doctors are overpaid. Most doctors, however, disagree. They say that they were required to study medicine for a long time. Tuition(学费)for many years of medical education costs a lot of money. Doctors say that it is necessary for most medical students to borrow money from a bank to pay their tuition. Because this money must be repaid to the bank, young doctors need a lot of money for their work. So, they charge people high prices for medical care. Therefore it is possible that the high cost of medical care in America is unnecessary. Because high tuition is one cause of high costs, one way to lower costs would be to have medical schools that are free or have low tuition.
Some people do not have their medical care they need because ______.
A．they are not willing to pay high tuition for the doctors
B．they don't think it necessary to have medical care
C．they don't want to spend much money on it
D．they haven't got enough money to pay for it
Doctors have their own special sleep problems. Residents are famously short of sleep. It is not unusual for them to work 40 hours in a row without rest. They are not in the least worried about it, confident they can still deliver the highest quality of medical care. But an article in the Journal of the American Medical Association points out that in the morning after 24 hours of sleeplessness, a person‟s motor performance is comparable to that of someone who is drunk. Curiously, surgeons who believe that operating under the influence of alcohol is grounds for sacking often don‟t think twice about operating without enough sleep.
“ I could tell you horror stories, ” says Jaya Agrawal, president of the American Medical Student Association, which runs a website for residents. Some are terrifying. “I was operating after being up for over 36 hours, “ one writes. “ I literally fell asleep standing up and nearly planted my face into the wound.”
“ Practically every surgical resident I know has fallen asleep at the wheel driving home from work,” writes another. “I know of three who have hit parked cars. Another hit a „ Jersey gate‟ on the New Jersey Expressway, going 105km/h.”
“Your own patients have become the enemy,” writes a third, because they are “the one thing that stands between you and a few hours of sleep.”
The U.S. controls the hours of pilots and truck drivers. But until such a system is in place for doctors, patients are on their own. If you‟re worried about the people treating you or a loved one, you should feel free to ask how many hours of sleep they have had and if more rested staffers are available.
1.Sleep is a funny thing because ____________.
A. the longer one sleeps, the less sound sleep he gets
B. the more sleep one gets, the more likely a stroke occurs
C. many people stick to about eight hours of sleep to stay fine
D. many people who sleep six hours a night still feel energetic in the day
2.A surgeon who has worked 40 hours in a row without sleep ___________.
A. can still provide quality medical care
B. will remain alert because he is used to it
C. may ignore the potential risk of insufficient sleep
D. should be fired if he continues the medical operation
3.According to one resident, they are short of sleep because ____________.
A. they are too tired to fall asleep
B. they are forbidden to sleep at work
C. they are kept by treating their patients
D. they are too worried about oversleeping
4.They resident who hit a “Jersey gate” on the New Jersey Expressway must have________.
A. fallen asleep
B. drunk too much
C. been driving too long
D. avoided hitting parked cars
5.Patients are now advised to __________.
A. monitor the hours of doctors by themselves
B. make sure that the doctors who treat them have had enough sleep
C. ask for legal control of the hours of doctors
D. allow their doctors to sleep several hours before the operation
【C8】______too soon.
The police did not have much to do【C9】______the citizens took the exercise seriously. They stayed underground for twenty minutes and waited for the siren to sound again【C10】______leaving the air-mid shelters. They saw that doctors and nurses were【C11】______. A great many .people had【C12】______to act as casualties. Theatrical make-up and【C13】______blood had been used to make the injuries look realistic. A lot of people were lying【C14】______in the streets. The living helped to carry the dead and the wounded to special stations. A child of six was【C15】______in by two adults. The child was【C16】______to be dead. With theatrical make-up on his face, he looked【C17】______he had died【C18】______shock. Some people were【C19】______moved by the sight that they began to cry. However, the child suddenly sat up and a doctor asked him to comment on his death. The child looked around for a moment and said, "I think they arc all【C20】______."
【C1】
A．less
B．far
C．many
D．so
Doctors have their own special sleep problems. Residents are famously short of sleep. It is not unusual for them to work 40 hours in a row without rest. They are not in the least worried about it, confident they can still deliver the highest quality of medical care. But an article in the Journal of the American Medical Association points out that in the morning after 24 hours of sleeplessness, a person‟s motor performance is comparable to that of someone who is drunk. Curiously, surgeons who believe that operating under the influence of alcohol is grounds for sacking often don‟t think twice about operating without enough sleep.
“ I could tell you horror stories, ” says Jaya Agrawal, president of the American Medical Student Association, which runs a website for residents. Some are terrifying. “I was operating after being up for over 36 hours, “ one writes. “ I literally fell asleep standing up and nearly planted my face into the wound.”
“ Practically every surgical resident I know has fallen asleep at the wheel driving home from work,” writes another. “I know of three who have hit parked cars. Another hit a „ Jersey gate‟ on the New Jersey Expressway, going 105km/h.”
“Your own patients have become the enemy,” writes a third, because they are “the one thing that stands between you and a few hours of sleep.”
The U.S. controls the hours of pilots and truck drivers. But until such a system is in place for doctors, patients are on their own. If you‟re worried about the people treating you or a loved one, you should feel free to ask how many hours of sleep they have had and if more rested staffers are available.
1.Sleep is a funny thing because ____________.
A. the longer one sleeps, the less sound sleep he gets
B. the more sleep one gets, the more likely a stroke occurs
C. many people stick to about eight hours of sleep to stay fine
D. many people who sleep six hours a night still feel energetic in the day
2.A surgeon who has worked 40 hours in a row without sleep ___________.
A. can still provide quality medical care
B. will remain alert because he is used to it
C. may ignore the potential risk of insufficient sleep
D. should be fired if he continues the medical operation
3.According to one resident, they are short of sleep because ____________.
A. they are too tired to fall asleep
B. they are forbidden to sleep at work
C. they are kept by treating their patients
D. they are too worried about oversleeping
4.They resident who hit a “Jersey gate” on the New Jersey Expressway must have________.
A. fallen asleep
B. drunk too much
C. been driving too long
D. avoided hitting parked cars
5.Patients are now advised to __________.
A. monitor the hours of doctors by themselves
B. make sure that the doctors who treat them have had enough sleep
C. ask for legal control of the hours of doctors
D. allow their doctors to sleep several hours before the operation
听力原文：M: Hi, Sue.
W: Hello, Jill, how are you？
M: I'm fine. Did you watch the TV special about barnacles last night？
W: No, I missed it. What did you learn about them？
M: They glue themselves to rocks in the ocean, shortly after birth. They also stay in the same place forever.
W: Right, have you ever tried removing one of these things？ It would be easier to chip the rock away than to get the barnacles off.
M: Exactly, and that's why scientists are trying to figure out what the barnacles glue is made of. It's considered one of the strongest adhesives in nature.
W: And it would have the advantage of being able to work on wet surfaces too.
M: Precisely, and because it's natural protein, it probably wouldn't be harmful to people like so many synthetic glues in use today.
W: Think of all the ways in which doctors and dentists could use such a glue to mend broken bones and fasten false teeth.
M: There could be countless uses. Scientists hope to learn soon exactly how the glue is made, so that people can make use of it.
W: That's good news for the general public. I hope it won't take long for the new glue to be put into use.
(23)
A．The reproductive cycle of barnacles.
B．A new source of protein.
C．Types of sea animals.
D．The adhesive quality of barnacles.
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