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2016年大學(xué)英語六級考試試題提分沖刺卷「附答案解析」
Part Ⅰ Writing (30 minutes)
Directions: For this part, you are allowed 30 minutes to write a short essay entitled Who Has the Most Important Influence on the Young. You should write at least 150 words following the outline given below.
1. 有些人認為家人對青少年的影響最大。
2.有些人認為朋友對青少年的影響最大。
3.我的看法。
Who Has the Most Important Influence on the Young
Part ⅡReading Comprehension (Skimming and Scanning) (15 minutes)
Directions: In this part, you will have 15 minutes to go over the passage quickly and answer the questions on Answer Sheet 1. For questions 1-7, choose the best answer from the four choices marked A), B), C) and D). For questions 8-10, complete the sentences with the information given in the passage.
Will Electronic Medical Records Improve Health Care?
Electronic health records (EHRs) have received a lot of attention since the Obama administration committed $19 billion in stimulus funds earlier this year to encourage hospitals and health care facilities to digitize patient data and make better use of information technology. The healthcare industry as a whole, however, has been slow to adopt information technology and integrate computer systems, raising the question of whether the push to digitize will result in information that empowers doctors to make better-informed decisions or a morass of disconnected data.
The University of Pittsburgh Medical Center (UPMC) knows firsthand how difficult it is to achieve the former, and how easily an EHR plan can fall into the latter. UPMC has spent five years and more than $1 billion on information technology systems to get ahead of the EHR issue. While that is more than five times as much as recent estimates say it should cost a hospital system, UPMC is a mammoth network consisting of 20 hospitals as well as 400 doctors’ offices, outpatient sites and long-term care facilities employing about 50,000 people.
UPMC’s early attempts to create a universal EHR system, such as its ambulatory electronic medical records rolled out between 2000 and 2005, were met with resistance as doctors, staff and other users either avoided using the new technology altogether or clung to individual, disconnected software and systems that UPMC’s IT department had implemented over the years.
On the mend
Although UPMC began digitizing some of its records in 1996, the turning point in its efforts came in 2004 with the rollout of its eRecord system across the entire health care network. eRecord now contains more than 3.6 million electronic patient records, including images and CT scans, clinical laboratory information, radiology data, and a picture archival and communication system that digitizes images and makes them available on PCs. The EHR system has 29,000 users, including more than 5,000 physicians employed by or affiliated with UPMC.
If UPMC makes EHR systems look easy, don’t be fooled, cautions UPMC chief medical information officer Dan Martich, who says the health care network’s IT systems require a "huge, ongoing effort" to ensure that those systems can communicate with one another. One of the main reasons is that UPMC, like many other health care organizations, uses a number of different vendors for its medical and IT systems, leaving the integration largely up to the IT staff.
Since doctors typically do not want to change the way they work for the sake of a computer system, the success of an EHR program is dictated not only by the presence of the technology but also by how well the doctors are trained on, and use, the technology. Physicians need to see the benefits of using EHR systems both persistently and consistently, says Louis Baverso, chief information officer at UPMC’s Magee-Women’s Hospital. But these benefits might not be obvious at first, he says, adding, "What doctors see in the beginning is that they’re losing their ability to work with paper documents, which has been so valuable to them up until now."
Opportunities and costs
Given the lack of EHR adoption throughout the health care world, there are a lot of opportunities to get this right (or wrong). Less than 10 percent of U.S. hospitals have adopted electronic medical records even in the most basic way, according to a study authored by Ashish Jha, associate professor of health policy and management at Harvard School of Public Health. Only 1.5 percent have adopted a comprehensive system of electronic records that includes physicians’ notes and orders and decision support systems that alert doctors of potential drug interactions or other problems that might result from their intended orders.
Cost is the primary factor stalling EHR systems, followed by resistance from physicians unwilling to adopt new technologies and a lack of staff with adequate IT expertise, according to Jha. He indicated that a hospital could spend from $20 million to $200 million to implement an electronic record system over several years, depending on the size of the hospital. A typical doctor’s office would cost an estimated $50,000 to outfit with an EHR system.
The upside of EHR systems is more difficult to quantify. Although some estimates say that hospitals and doctor’s offices could save as much as $100 million annually by moving to EHRs, the mere act of implementing the technology guarantees neither cost savings nor improvements in care, Jha said during a Harvard School of Public Health community forum on September 17. Another Harvard study of hospital computerization likewise determined that cutting costs and improving care through health IT as it exists today is "wishful thinking". This study was led by David Himmelstein, associate professor at Harvard Medical School.
The cost of getting it wrong
The difference between the projected cost savings and the reality of the situation stems from the fact that the EHR technologies implemented to date have not been designed to save money or improve patient care, says Leonard D’Avolio, associate center director of Biomedical Informatics at the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). Instead, EHRs are used to document individual patients’ conditions, pass this information among clinicians treating those patients, justify financial reimbursement and serve as the legal records of events.
This is because, if a health care facility has $1 million to spend, its managers are more likely to spend it on an expensive piece of lab equipment than on information technology, D’Avolio says, adding that the investment on lab equipment can be made up by charging patients access to it as a billable service. This is not the case for IT. Also, computers and networks used throughout hospitals and health care facilities are disconnected and often manufactured by different vendors without a standardized way of communicating. "Medical data is difficult to standardize because caring for patients is a complex process," he says. "We need to find some way of reaching across not just departments but entire hospitals. If you can’t measure something, you can’t improve it, and without access to this data, you can’t measure it."
To qualify for a piece of the $19 billion being offered through the American Recovery and Reinvestment Act (ARRA), healthcare facilities will have to justify the significance of their IT investments to ensure they are "meaningful users" of EHRs. The Department of Health and Human Services has yet to define what it considers meaningful use
Aggregating info to create knowledge
Ideally, in addition to providing doctors with basic information about their patients, databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be mined for new knowledge, D’Avolio says. "With just a few of these databases networked together, the power to improve health care increases exponentially," D’Avolio suggested. "All that is missing is the collective realization that better health care requires access to better information—not automation of the status quo." Down the road, the addition of genomic information, environmental factors and family history to these databases will enable clinicians to begin to realize the potential of personalized medicine, he added.
1. In America, it is slow to adopt information technology because .
A) the funds invested by the government is not enough in the past
B) EHRs have received less attention of the public in the past
C) whether it will be useful to doctors or not is doubtful
D) UPMC knows how difficult it is to digitize the hospital
2. The University of Pittsburgh Medical Center (UPMC) .
A) is the first medical center to adopt information technology
B) satisfy the requirement of the government on information technology
C) spent less money on information technology than it was estimated
D) attempted to created a universal EHR system, but met some difficulties
3. The health care network’s IT systems require a lot of effort to ensure it can communicate with one another mainly because .
A) the integration among different system is largely up to the IT staff
B) UPMC is like many other health care organizations in the United States
C) UPMC makes EHR systems look easy
D) UMPC began digitizing some of its records in 1996
4. The success of the EHR program is decided by .
A) the fact whether the information technology is available or not
B) the fact how well the doctors are trained to use the information technology
C) not only the presence of the technology but the doctor’s training on technology
D) the fact whether physicians can see the benefits of using EHR systems
5. The most important reason of most hospitals being reluctant to adopt EHR system is that .
A) the cost is too high for the hospital to afford
B) physicians are unwilling to adopt it
C) there is a lack of staff with adequate IT expertise
D) doctor worry about its negative influence on patients
6. According to the study led by David Himmelstein through health IT .
A) it is possible to cut the costs of the hospital
B) it is possible to improve the health care
C) it ensure neither cost saving nor improvement in care
D) it could save as much as $100 million annually
7. The hospital’s managers prefer to .
A) spend money on an expensive piece of equipment than on information technology
B) charge patients access to the information technology as a billable service
C) purchase the information technology to improve the health care of the hospital
D) invest more money on the training of the physicians to charge patients more money
8. Jha said the mere act of implementing the technology guarantees ______________________.
9. D’Avolio says the investment on lab equipment can be made up by_____________________.
10. Databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be ____________________.
Part Ⅳ Reading Comprehension (Reading in Depth) (25 minutes)
Section A
Directions: In this section, there is a short passage with 5 questions or incomplete statements. Read the passage carefully. Then answer the questions or complete the statements in the fewest possible words. Please write your answers on Answer Sheet 2.
Questions 47 to 51 are based on the following passage.
Currently, there are an increasing number of new types of small advertisement becoming increasingly common in newspaper classified columns. It is sometimes placed among "situations vacant", although it does not offer anyone a job, and sometimes it appears among "situations wanted", although it is not placed by someone looking for a job, either. What it does is to offer help in applying for a job.
"Contact us before writing your application", or "Make use of our long experience in preparing your curriculum vitae or job history", is how it is usually expressed. The growth and apparent success of such a specialized service is, of course, a reflection on the current high levels of unemployment. It is also an indication of the growing importance of the curriculum vitae (or job history), with the suggestion that it may now qualify as an art form in its own right.
There was a time when job seekers simply wrote letters of application. "Just put down your name, address, age and whether you have passed any exams", was about the average level of advice offered to young people applying for their first jobs when I left school. The letter was really just for openers, it was explained, everything else could and should be saved for the interview. And in those days of full employment the technique worked. The letter proved that you could write and were available for work. Your eager face and intelligent replies did the rest.
Later, as you moved up the ladder, something slightly more sophisticated was called for. The advice then was to put something in the letter which would distinguish you from the rest. It might be the aggressive approach. "Your search is over. I am the person you are looking for", was a widely used trick that occasionally succeeded. Or it might be some special feature specially designed for the job interview.
There is no doubt, however, that it is the increasing number of applicants with university education at all points in the process of engaging staff that has led to the greater importance of the curriculum vitae.
47. There are an increasing number of new types of small advertisement in newspaper columns ______.
48. Nowadays a demand for this specialized type of service has been created because ______.
49. In the past it was expected that first job hunters would ______.
50. Later, as one went on to apply for more important jobs, one was advised to include ______ in the letter.
51. The curriculum vitae has become such an important document because ______.
Section B
Directions: There are 2 passages in this section. Each passage is followed by some questions or unfinished statements. For each of them there are four choices marked A), B), C) and D). You should decide on the best choice and mark the corresponding letter on Answer Sheet 2 with a single line through the centre.
Passage One
Questions 52 to 56 are based on the following passage.
Computers are now employed in an increasing number of fields in our daily life. Computers have been taught to play not only checkers, but also championship chess, which is a fairly accurate yardstick for measuring the computer’s progress in the ability to learn from experience.
Because the game requires logical reasoning, chess would seem to be perfectly suited to the computer. All a programmer has to do is to give the computer a program evaluating the consequences of every possible response to every possible move, and the computer will win every time. In theory this is a sensible approach; in practice it is impossible. Today, a powerful computer can analyze 40,000 moves a second. That is an impressive speed. But there are an astronomical number of possible moves in chess—literally trillions. Even if such a program were written (and in theory it could be, given enough people and enough time), there is no computer capable of holding that much data.
Therefore, if the computer is to compete at championship levels, it must be programmed to function with less than complete data. It must be able to learn from experience, to modify its own program, to deal with a relatively unstructured situation—in a word, to "think" for itself. In fact, this can be done. Chess-playing computers have yet to defeat world champion chess players, but several have beaten human players of only slightly lower ranks. The computers have had programs to carry them through the early, mechanical stages of their chess games. But they have gone on from there to reason and learn, and sometimes to win the game.
There are other proofs that computers can be programmed to learn, but this example is sufficient to demonstrate the point. Granted, winning a game of chess is not an earthshaking event even when a computer does it. But there are many serious human problems, which can be fruitfully approached as games. The Defense Department uses computers to play war games and work out strategies for dealing with international tensions. Other problems—international and interpersonal relations, ecology and economics, and the ever-increasing threat of world famine can perhaps be solved by the joint efforts of human beings and truly intelligent computers.
52. According to the passage, computers cannot be used to ______.
A) solve the threat of world famine
B) ease international tension
C) defeat world champion chess player
D) work out solutions to the industrial problems
53. In the author’s opinion, ______.
A) playing chess shows computer’s program has been developed into a new stage
B) it is practically possible now that computer can win every chess game now
C) computers even with less than complete data can be programmed to defeat the world champion chess player
D) computers can be programmed to play and reason but not learn
54. The author’s attitude toward the future use of computer is ______.
A) negative
B) positive
C) indifferent
D) critical
55. In order to "think", computer should ______.
A) be programmed to have more than enough data
B) learn from the experience and to reason
C) deal with all the unstructured situation
D) predicate every move in the chess
56. Today, the chess-playing computer can be programmed to ______.
A) have trillions of responses in a second to each possible move and win the game
B) store complete data and beat the best players
C) learn from chess-playing in the early stage and go on to win the game
D) predicate every possible move but may fail to give the right response each time
Passage Two
Questions 57 to 61 are based on the following passage.
Large animals that inhabit the desert have evolved a number of adaptations for reducing the effects of extreme heat. One adaptation is to be light in color, and to reflect rather than absorb the sun’s rays. Desert mammals also depart from the normal mammalian practice of maintaining a constant body temperature. Instead of trying to keep down the body temperature deep inside the body, which would involve the expenditure of water and energy, desert mammals allow their temperatures to rise to what would normally be fever height, and temperatures as high as 46 degrees Celsius have been measured in Grant’s gazelles. The overheated body then cools down during the cold desert night, and indeed the temperature may fall unusually low by dawn, as low as 34 degrees Celsius in the camel. This is an advantage since the heat of the first few hours of daylight is absorbed in warming up the body, and an excessive buildup of heat does not begin until well into the day.
Another strategy of large desert animals is to tolerate the loss of body water to a point that would be fatal for non-adapted animals. The camel can lose up to 30 percent of its body weight as water without harm to itself, whereas human beings die after losing only 12 to 13 percent of their body weight. An equally important adaptation is the ability to replenish this water loss at one drink. Desert animals can drink huge volumes in a short time, and camels have been known to imbibe (吸收) over 100 liters in a few minutes. A very dehydrated person, on the other hand, cannot drink enough water to rehydrate at one session, because the human stomach is not sufficiently big and because a too rapid dilution of the body fluids causes death from water intoxication. The tolerance of water loss is of obvious advantage in the desert, as animals do not have to remain near a water hole but can obtain food from grazing sparse pastures. Desert-adapted mammals have the further ability to feed normally when extremely dehydrated. It is a common experience in people that appetite is lost even under conditions of moderate thirst.
57. What is the passage mainly about?
A) Animals developed different strategies to survive.
B) Large animals can take strategies to reduce the effect of extreme heat.
C) Animals can tolerate the loss of body water.
D) A very dehydrated person can drink enough water to rehydrate.
58. Why light in color is important to large animals in deserts?
A) It helped them maintain a constant normal body temperature.
B) It reflects rather than absorbs the sun-light.
C) It helps them see their peers at night.
D) It helps them keep cool during the night.
59. What will be fatal to non-adapted animals?
A) Keeping a normal body temperature.
B) Drinking polluted water.
C) Drinking huge volumes of water in a short time.
D) Feeding when dehydrated.
60. What does the author imply about desert-adapted mammals?
A) They do not need to eat much food.
B) They can eat large quantities quickly.
C) They easily lose their appetites.
D) They can travel long distances looking for food.
61. What is the following strategy not mentioned by the author?
A) The body temperature can be extremely high and cold.
B) Tolerate the loss of body water and replenish it immediately.
C) Lost appetite under the condition of moderate thirsty.
D) To be light in color.
Part V Cloze (5 minutes)
Directions: There are 20 blanks in the following passage. For each blank there are four choices marked A), B), C) and D) on the right side of the paper. You should choose the ONE that best fits into the passage. Then mark the corresponding letter on Answer Sheet 2 with a single line through the centre.
Memory is a special thing in our life. What’s your earliest childhood memory? Can you remember learning to walk? Or talk? The first time you 62 thunder or watched a television program? Adults seldom 63 events much earlier than the year or so before entering school, just as children younger than three or four 64 retain any specific, personal experiences. A variety of explanations have been 65 by psychologists for this "childhood amnesia" (兒童失憶癥). One argues that the hippocampus, the region of the brain which is responsible for forming memories, does not mature 66 about the age of two. But the most popular theory 67 that, since adults do not think like children, they can not 68 childhood memories. Adults think in words, and their life memories, are like stories or 69 —one event follows 70 as in a novel or film. But when they search through their mental 71 for early childhood memories to add to this verbal life story, they don’t find any that fits the 72 . It’s like trying to find a Chinese word in an English dictionary.
Now psychologist Annette Simms of the New York State University offers a new 73 for childhood amnesia. She argues that there simply 74 any early childhood memories to recall. According to Dr. Simms, children need to learn to use 75 spoken description of their personal experiences in order to turn their own short-term, quickly 76 impressions of them into long-term memories. In other 77 , children have to talk about their experiences and hear others talk about 78 —Mother talking about the afternoon 79 looking for seashells at the beach or Dad asking them about their day at Ocean Park. Without this 80 reinforcement, says Dr. Simms, children cannot form 81 memories of their personal experiences.
62. A) listened B) felt C) touched D) heard
63. A) involve B) interpret C) recall D) resolve
64. A) largely B) rarely C) merely D) really
65. A) canceled B) figured C) proposed D) witnessed
66. A) until B) once C) after D) since
67. A) magnifies B) intervenes C) contains D) maintains
68. A) reflect B) attain C) access D) refer
69. A) narratives B) forecasts C) regulations D) descriptions
70. A) the rest B) another C) the other D) others
71. A) outputs B) dreams C) flashes D) files
72. A) footstep B) pattern C) frame D) landscape
73. A) emphasis B) arrangement C) explanation D) factor
74. A) aren’t B) weren’t C) isn’t D) wasn’t
75. A) anyone else B) anyone else’s C) some else D) someone else’s
76. A) forgotten B) remembered C) forgetting D) remembering
77. A) senses B) cases C) words D) means
78. A) him B) theirs C) it D) them
79. A) used B) chosen C) taken D) spent
80. A) habitual B) verbal C) pretty D) mutual
81. A) permanent B) conscious C) subordinate D) spiritual
PartⅥ Translation (5 minutes)
Directions: Complete the sentences by translating into English the Chinese given in brackets. Please write your translation on Answer Sheet 2.
82. Children are very eager___________________________ in the film (成為像電影中英雄那樣強壯勇敢的人).
83. The essence of the scientific attitude is ______________________________. (人類一定能將宇宙探究清楚).
84. It is _____________________________ that keeps freedom alive (是沖突而不是絕對的一致).
85. With full determination, we are ___________________________________ (有能力最終解決這個棘手的問題).
86. There was something _______________________________ about the plan that pleased all of them (富于創(chuàng)造性，獨出心裁，很有氣勢).
Part I Writing
【寫作思路】
青少年的成長一直是一個有爭議的話題，有人認為家庭的影響至關(guān)重要，會作用于青少年的一生;也有人認為“人以群分”，朋友在青少年的成長發(fā)育過程中具有不可替代的影響作用。
大學(xué)生也屬于青少年，經(jīng)歷著成長過程中父母和朋友的影響。本篇作文以考生自身為題材，難度不大。
文章開篇提出在青少年成長過程中，很多人都起到了非常重要的作用。一部分人認為父母重要，其原因在于孩子從小和父母在一起，他們受到很大影響而不自知。
第二段討論不同的觀點，即認為同齡人對青少年的影響更大。因為青少年喜歡和朋友一起玩，喜歡互相學(xué)習(xí)，喜歡追逐流行。
第三段談?wù)撟髡弑救说挠^點。首先肯定兩方觀點都有合理的部分，青少年孩提時代和父母在一起，父母的所作所為為孩子以后的發(fā)展奠定了基礎(chǔ)，也影響了孩子的價值觀和世界觀。當孩子長大時，他們需要獨立和認同，需要得到同齡人的認可，受到朋友的影響更多一些。所以得出結(jié)論：父母和朋友對青少年的影響都很大，只是在不同的階段。
【參考范文】
Many parties are occupying important positions in the growth of the young. Some people think that the parents are the most essential in this process, arguing that the young have been together with their parents since birth and that they are influenced without their notice.
Other people hold the opinion that the peers of the young play a major role in their growing up. The young prefer to hang out with their friends, like to learn from one another, and are more likely to follow the so-called "fashion".
Of course, both views have an element of reason. In the first few years of life, the young see whatever their parents are doing and learn from them, which lays a basic foundation for their later development as well as their value on life, their outlook. When they grow older, they have a sense of independence and identity. They want to be recognized as members of certain groups. Thus, both parents and friends greatly affect the young, but in different stages.
Part II Reading Comprehension (Skimming and Scanning)
原文精譯
電子病案能提高衛(wèi)生保健嗎?
今年年初，奧巴馬政府建立190億美元的刺激基金，鼓勵醫(yī)院和衛(wèi)生保健機構(gòu)將病人信息數(shù)字化，更好的利用信息技術(shù)。自此之后，使用電子健康記錄(EHR)的舉措引起了很大關(guān)注。但是，整體而言，【1】衛(wèi)生保健行業(yè)在采用信息技術(shù)、整合計算機體系方面一直滯后，于是問題就出現(xiàn)了：這項推行數(shù)字化的舉措所帶來的信息，究竟是使醫(yī)生的決策更明智，還是只是一堆零散的數(shù)據(jù)?
【2】Pittsburgh大學(xué)的醫(yī)療中心(UPMC)擁有第一手資料，只是知道實現(xiàn)前者很難，而陷入后者的困境卻很容易。UPMC歷經(jīng)五年，在信息技術(shù)體系方面花費10多億美元，在HER計劃中處于領(lǐng)先地位。盡管它的花費是最近預(yù)估的一個醫(yī)院系統(tǒng)所需花費的五倍，但UPMC現(xiàn)在擁有一個龐大的網(wǎng)絡(luò)機構(gòu)，包括20家醫(yī)院，400個醫(yī)生辦公室，門診處，長期護理機構(gòu)，這些機構(gòu)有5萬多名員工。
UMPC早期試圖建立一個普遍的EHR體系，比如2000年—2005年之間推出的流動電子醫(yī)療記錄，就受到了醫(yī)生、員工以及其他使用者的抵制，他們或者不用新技術(shù)，或者只用個人記錄，不和UPMC的IT部門近年來推行的軟件和系統(tǒng)聯(lián)網(wǎng)。
情勢好轉(zhuǎn)中
UPMC早在1996年就開始將自己的記錄數(shù)字化，而轉(zhuǎn)折點卻出現(xiàn)在2004年，它的電子記錄體系(EHR)已在整個醫(yī)療保健網(wǎng)絡(luò)鋪展開來�，F(xiàn)在電子記錄包括360多萬病人的信息，其中有圖像和CT掃描結(jié)果，臨床試驗信息，放射治療數(shù)據(jù)，還有圖片庫和交流系統(tǒng)，使圖像數(shù)字化，在個人電腦上得以顯示。EHR系統(tǒng)有29000名用戶，包括5000多名內(nèi)科醫(yī)生，其中有些是UPMC的醫(yī)生，有些則附屬于UPMC。
UPMC醫(yī)療信息的主要負責(zé)人Dan Martich警告說：如果UPMC讓EHR系統(tǒng)看似簡單，千萬不要上當。他說，衛(wèi)生保健網(wǎng)絡(luò)的IT系統(tǒng)需要“巨大的、不間斷的努力”，以確保這些系統(tǒng)交流順暢。【3】主要原因之一是，UPMC，以及很多其他衛(wèi)生保健組織，都從很多不同的賣主那里購買醫(yī)療和IT系統(tǒng)，而最后的整合工作則由IT成員來做。
由于醫(yī)生一般不愿意為了某個計算機系統(tǒng)而改變工作方式，【4】因而EHR項目的成功，不僅僅在于技術(shù)，更在于醫(yī)生如何能接受好的培訓(xùn)，學(xué)會使用新科技。UPMC的 Magee女子醫(yī)院的信息部門主管Louis Baverso說，內(nèi)科醫(yī)生需要看到EHR系統(tǒng)帶來了持久的好處。同時他又說，這些好處剛開始也許并不明顯，“剛開始醫(yī)生看到的是，他們沒有辦法再和紙質(zhì)文件打交道，而這些文件對他們來講是迄今為止最重要的”。
機會和代價
鑒于在整個衛(wèi)生保健體系中，并沒有完全使用EHR系統(tǒng)，因此還有很多機會可以做好，也可能做糟。哈佛公共衛(wèi)生學(xué)院、健康政策與管理專業(yè)的副教授Ashish Jha組織了一項調(diào)查，結(jié)果表明，美國只有不到10%的醫(yī)院采用了電子醫(yī)療記錄系統(tǒng)，而且是以最基本的形式;只有1.5%的醫(yī)院使用了綜合的電子記錄系統(tǒng)，包括醫(yī)生的記錄、醫(yī)囑以及決策支持體系，這些都可以警示醫(yī)生，他們的醫(yī)囑可能會導(dǎo)致潛在的藥物反應(yīng)或其他問題。
【5】Jha認為，阻礙EHR系統(tǒng)推廣的主要因素是需要付出的代價，其次還有醫(yī)生的抵制，他們不愿意使用新科技，還有IT部門人員不足等方面原因。他暗示，根據(jù)醫(yī)院規(guī)模，醫(yī)院需要歷時幾年時間花費2000萬到20億美元不等，來安裝電子記錄系統(tǒng)。一個醫(yī)生辦公室配備一個EHR系統(tǒng)，大概需要5萬美元。
9月17日，哈佛公共衛(wèi)生學(xué)院研討會上，Jha認為EHR系統(tǒng)的優(yōu)勢很難量化。有些人估計說，使用EHR，醫(yī)院、醫(yī)生辦公室每年至少可以節(jié)省10億美元;【8】而單單安裝這個系統(tǒng)并不能保證節(jié)省開支，也不能保證醫(yī)療的改進。【6】同樣哈佛關(guān)于醫(yī)院電子化的另一個調(diào)查表明，通過現(xiàn)有的衛(wèi)生保健IT來縮減開支，改進醫(yī)療水平是“癡心妄想”。這項調(diào)查由David Himmelstein主導(dǎo)，他是哈佛醫(yī)學(xué)院的副教授。
情況變糟的代價
Leonard D’Avolio是麻省退伍軍人傳染病研究和信息中心(MAVERIC)的生物醫(yī)學(xué)信息學(xué)中心副主任，他認為，節(jié)省開支的預(yù)想和目前的現(xiàn)實之間的區(qū)別，源于迄今為止實施EHR技術(shù)并不是為了省錢或提高病人護理，相反，它是為了記錄單個病人的情況，將這些信息在臨床中傳遞用以治療其他病人，合理解釋醫(yī)療費用，也可成為法律證據(jù)。
D’Avolio說，這是因為保健機構(gòu)若有一百萬美元可花，【7】管理階層更愿意把它花在實驗室設(shè)備上，并非信息科技上。他接著說，【9】用在設(shè)備上的投資可以通過向使用設(shè)備的病人收費得以彌補，而IT系統(tǒng)卻并非如此。還有，醫(yī)院和保健機構(gòu)使用的電腦和網(wǎng)絡(luò)系統(tǒng)并沒有聯(lián)網(wǎng)，由不同的廠商制造銷售，沒有統(tǒng)一的交流方式。他說，“很難對醫(yī)療數(shù)據(jù)統(tǒng)一標準，因為護理病人是個復(fù)雜的過程。我們需要找到某種方法，不僅在各個部門，而是在所有醫(yī)院中互相搜索。不能衡量，就無法改進提高。得不到這些數(shù)據(jù)，就不能衡量。”
美國復(fù)興和再投資法(ARRA)提供了190億美元，想要有資格拿到這筆錢，保健機構(gòu)必須說明他們的IT投資有意義，保證他們有效使用了EHR。而健康和社會服務(wù)部還沒有確定什么是“有意義的用途”。
收集信息 創(chuàng)造知識
D’Avolio說，從理想的角度出發(fā)，【10】除了EHR可以給醫(yī)生提供病人的基本信息外，包括重要標記、圖像、實驗室數(shù)據(jù)、用藥、病史、治療中斷、病人人口信息的數(shù)據(jù)庫，可以用來發(fā)掘新知識。D’Avolio建議，“僅僅幾個此類的數(shù)據(jù)庫聯(lián)網(wǎng)，就可大大提高改進醫(yī)療保健的能力。缺失的是這樣的集體意識：健全的醫(yī)療保健需要更全面的信息，而并非現(xiàn)狀能自動改變。”他接著說，沿著這條路走，這些數(shù)據(jù)庫中還會增加染色體信息，環(huán)境因素，家族史，使臨床醫(yī)生開始意識到用藥個性化的潛在可能性。
1. 答案C
解析：根據(jù)題干，考生可將答案定位在文章的第一段。第一段段末講到，在采用EHR系統(tǒng)方面，衛(wèi)生保健行業(yè)很滯后，原因在于，這對醫(yī)生來講，到底能幫助用藥決定，還是會帶來一團糟?從中考生可以判斷，這個舉措對醫(yī)生來講有沒有用，值得懷疑。
2. 答案D
解析：根據(jù)題干中的UPMC，考生可鎖定文章的第二段。接著文章的第一段，UPMC根據(jù)自身經(jīng)歷，認為能使醫(yī)生的決定更明智很難，而收集一堆毫無關(guān)系的數(shù)據(jù)卻很容易，從中可以判斷他們在使用EHR的過程中遇到了難題。
3. 答案A
解析：根據(jù)題干，考生可鎖定第一個小標題下面的第二段。從不同賣主那里購買系統(tǒng)，想要保證交流暢通，IT成員必須做最后的整合工作。
4. 答案C
解析：根據(jù)題干中“EHR項目的成功”，考生可鎖定第一個小標題下面的第三段，其中講到，成功不僅僅在于有科技，還在于如何培訓(xùn)醫(yī)生使用這些新科技。
5. 答案A
解析： 考生可將答案定位在文章第二個小標題“Opportunities and Costs”下面的第二段。一開始作者提及了不愿意采用EHR的原因�？忌貏e注意題干中使用了the most important，和原文中的primary同義。
6. 答案C
解析：根據(jù)題干中的人名 David Himmelstein，考生可鎖定文章第二個小標題下面的第三段。David Himmelstein做了一項調(diào)查，發(fā)現(xiàn)衛(wèi)生IT不能縮減開支，也無法改進護理。
7. 答案A
解析：根據(jù)題干中的manager，考生可將答案定位在文章第三個小標題下面的第二段。段首講到管理人員更愿意把錢投資在設(shè)備上，而并非是信息科技上。
8. 答案 neither cost savings nor improvements in care
解析：根據(jù)題干中的Jha，考生可鎖定文章的第二個小標題，尤其是下面的第三段。Jha認為，單單安裝這個系統(tǒng)并不能保證節(jié)省開支，不能保證醫(yī)療的改進。
9. 答案 charging patients access to it as a billable service
解析：根據(jù)題干中的人名Leonard D’Avolio，考生可鎖定文章中的第三個小標題。D’Avolio認為，用在設(shè)備上的投資可以通過向使用設(shè)備的病人收費得以彌補。
10. 答案 mined for new knowledge
解析：根據(jù)題干中的主語，考生可鎖定文章的最后一段。這些數(shù)據(jù)庫可以用來發(fā)掘新知識。
Part IV Reading Comprehension(Reading in Depth)
Section A
原文精譯
目前，報紙的分類廣告中有一類新型小廣告，數(shù)量越來越多，越來越常見。有時候它出現(xiàn)在“招聘”廣告這一欄，卻不提供任何工作;有時候出現(xiàn)在“求職”這一欄，卻沒有說明是誰在找工作。【47】它的任務(wù)是，為申請工作提供幫助。
它經(jīng)常這么描述，“申請之前請先與我們聯(lián)系”，或“在準備簡歷或工作經(jīng)歷方面，我們可以提供寶貴經(jīng)驗”。【48】這種特別服務(wù)的出現(xiàn)并獲得顯著成功，反映了當前極高的失業(yè)率，也暗示簡歷(或工作經(jīng)歷)越來越重要，同時也表明它本身就是一門藝術(shù)。
曾經(jīng)，【49】求職者只需要寫簡單的求職信。我畢業(yè)的時候，對正在尋找人生第一份工作的年輕人，大家給出的一般建議是，“只用寫下姓名，地址，年齡，有沒有通過何種考試”。人們解釋說，【49】求職信僅僅是開門磚而已，其他一切信息可能、也應(yīng)該留給面試時提供。在那個人人有工作的年代，這樣做確實有效。信件證明你能夠書寫，可以工作。你渴望的神情與睿智的回答則解決了剩余的問題。
隨后，當你往上爬的時候，需要稍微復(fù)雜的東西。這時候的建議是，【50】信中需要添加信息把你和其他人區(qū)分開來。有可能采取強硬的態(tài)度：“招聘現(xiàn)在即可停止，我就是你要找的那個人。”這招常用，偶爾也會成功;有時候則需要為面試專門設(shè)計一些特色。
【51】但是，毋庸置疑，不管什么時候招聘，持有大學(xué)畢業(yè)證的求職者越來越多，致使簡歷變得越來越重要。
47. 答案offering useful advice to those looking for employment
解析：根據(jù)題干，考生可鎖定文章第一段。第一段段末，講到報紙上有一個專欄專門為就業(yè)提供有用的建議。考生要注意，offer在原文中用在to后面做不定式，而此處用現(xiàn)在分詞形式作后置定語，修飾前面的名詞advertisement。
48. 答案there are so many people out of work
解析：根據(jù)題干中的關(guān)鍵詞specialized type of service，考生可定位到原文中The growth and apparent success of such a specialized service is，of course，a reflection on the current high levels of unemployment。所以需要這種服務(wù)的原因在于很多人失業(yè)了。
49. 答案keep any detailed information until they obtained an interview
解析：根據(jù)題干，考生可將答案定位在文章的第三段。其中講到，你只需要寫最簡單的求職信，而其他一切信息要留在面試的時候�？忌枰獙⒈径蔚男畔⒖偨Y(jié)一下：一直把詳細信息保留到面試的時候。
50. 答案something that would distinguish one from other applicants
解析：根據(jù)題干中的later，可將答案定位在文章的第四段。其中講到，你想往上爬，必須有與眾不同的東西�？忌⒁猓琲nclude的賓語為something，隨后使用定語從句來確定“某事”的具體內(nèi)容。
51. 答案there has been an increase in the number of applicants with degrees
解析：文章的最后一段講到簡歷越來越重要的原因，持有大學(xué)畢業(yè)證的人數(shù)越來越多。篇章中的原句是個強調(diào)句型，考生要注意修改以符合英語語法，比如the applicants with university education are increasing。
Section B
Passage One
原文精譯
現(xiàn)在日常生活中越來越多的領(lǐng)域內(nèi)都使用了電腦。不僅教會電腦下西洋棋，它還會下國際象棋，這些相對來說比較準確的衡量了電腦的進步，它擁有了從經(jīng)驗中學(xué)習(xí)的能力。
象棋要求邏輯推理，這似乎很適合電腦。程序設(shè)計員只須給電腦一個程序，評估針對可能走的每一步會采用的招數(shù)，這樣電腦每一次都會贏。這種方法理論上講是合理的;實踐上卻不可能。目前，性能極好的電腦每秒鐘可分析4萬步棋，這個速度很驚人。但象棋中可能的走法卻是個天文數(shù)字——確切的說有幾萬億。即使能寫出這種程序(只要有足夠多的人花足夠多的時間，理論上是可能的)，也沒有電腦能儲存如此多的數(shù)據(jù)。
因此，如果電腦想打冠軍賽，必須用稍微少一點的數(shù)據(jù)來運行程序�！�55】它必須能夠從經(jīng)驗中學(xué)習(xí)，可以調(diào)整自己的程序，處理相對來說沒有條理的情況，簡而言之，要能自己思考。事實上，這是可以做到的。下象棋的電腦還沒有打敗所有的世界冠軍，但有幾臺已經(jīng)打敗了級別只比冠軍低一點點的玩家�！�53】【56】電腦程序已經(jīng)使象棋游戲度過了最開始的機械階段，進入了推理和學(xué)習(xí)階段，有時候會贏得比賽。
【54】有其他證據(jù)證明，可以給電腦設(shè)置程序讓他們學(xué)習(xí)，但這一個例子足以說明問題�！�52】的確，電腦贏得象棋比賽，也不是件震撼全球的事情。但是，人類有很多嚴重的問題，可以通過游戲的解決方式獲得成效。國防部門使用電腦來玩戰(zhàn)爭游戲，找出解決國際爭端的策略�！�52】其他問題，比如國際關(guān)系，人際關(guān)系，生態(tài)和經(jīng)濟，日益嚴重的世界饑荒，都可以通過人類和智能計算機的共同努力來解決。
52. 答案D
解析：本題是個細節(jié)推斷題。文章最后一段，講到電腦可能會幫人類解決的問題，比如打敗世界冠軍，解決國際關(guān)系，處理世界饑荒等，唯一沒有提到的是選項D中的工業(yè)問題。
53. 答案A
解析：本題是個建立在細節(jié)上的推斷題。文章第三段特別分析了電腦和人類下象棋的問題。很明顯，象棋還沒有打敗所有的世界冠軍，但贏得了其他一些象棋玩家。這個例子說明電腦已經(jīng)發(fā)展到一個新的階段，會推理和學(xué)習(xí)。
54. 答案B
解析：本題是個總結(jié)概括題。文章的最后一段開始講到，可以給電腦設(shè)置程序，讓他們學(xué)習(xí);接著講到，國防部門可以從中找到解決國際紛爭的策略;最后提及，人類很多問題可通過和智能電腦的共同努力來解決。從中可以看出，作者非常看好電腦的未來用途。
55. 答案B
解析：本題是個細節(jié)題。根據(jù)題干中的think，考生可將答案定位在文章的第三段。簡而言之，電腦要會思考，要具有學(xué)習(xí)能力、調(diào)整能力，可以處理相對來說沒有條理的情況等。選項C是個干擾項，原文用的是a relatively unstructured situation，而并不是all the unstructured situation。
56. 答案C
解析：本題是個細節(jié)題。根據(jù)題干，考生可鎖定文章的第四段。段末講，現(xiàn)在電腦在下棋方面，進入了學(xué)習(xí)推理階段，最后可贏得比賽。由此細節(jié)，判斷C為正確答案。
Passage Two
原文精譯
【57】為了降低酷熱的影響，生活在沙漠中的大型動物已經(jīng)進化來適應(yīng)這種環(huán)境。【58】【61】其中一種進化適應(yīng)是，顏色變淺，用以反射而不是吸收太陽光線。沙漠哺乳動物維持體溫恒定的方式與普通哺乳動物不同。它們并不試圖通過消耗體內(nèi)水分和能量來降低體內(nèi)溫度。相反，它們可以允許體溫上升到一般認為是發(fā)燒的溫度。人們在大羚羊身上就測到過高達46度的體溫。超熱的體溫在沙漠寒冷的夜里降下來，甚至在拂曉前會降得異常低，駱駝可以低至34攝氏度。這是個優(yōu)勢，吸收日照開始幾小時的熱量來溫暖身體，過度的熱量直到日中才開始聚集。
【59】大型沙漠動物的另一個策略是，【61】可以忍受體內(nèi)水分流失到一定的程度，而這種程度對不適應(yīng)的動物來講是致命的。駱駝失水達到體重的30%對其本身并無傷害，但人類在失水僅達到12%—13%時就會死亡。同樣重要的另一個進化是，【61】喝一次水就能夠補充喪失的水分�！�59】沙漠動物短時間內(nèi)可以喝大量的水，已知駱駝短短幾分鐘內(nèi)可以喝水100多升。而一個嚴重脫水的人，不能一次性的喝大量的水來補充所缺水分。這是因為人的胃不夠大，同時體液的過快稀釋會導(dǎo)致水中毒而引起死亡。能夠忍受水分流失，是在沙漠中生存的一個顯著優(yōu)勢，【60】這樣動物可以不用必須住在水源旁，而能在廣闊的草原上四處覓食。即使特別干旱的情況下，適應(yīng)沙漠的哺乳動物也可以正常飲食生活。而對人類來講，人們的普遍感受是，即便在中等干渴的時候，也會失去胃口。
57. 答案A
解析：本題是個總結(jié)概括題。本篇文章主要講述為了適應(yīng)沙漠環(huán)境，大型哺乳動物在體溫方面、忍受水分流失等方面的進化，從而說明動物可采取不同的策略來生存。選項A符合題意。
58. 答案B
解析：本題是個細節(jié)題。根據(jù)題干，可將答案定位在文章的第一段。顏色變淺，是為了反射太陽光，所以B為正確選項。
59. 答案C
解析：本題是個建立在細節(jié)上的推斷題。根據(jù)題干，考生可鎖定文章的第二段。一開始講，對于不適應(yīng)沙漠環(huán)境的動物來講，水分流失是致命的。接下來講到原因，因為他們沒有辦法在短時間內(nèi)補充足夠的水分，所以C為正確答案。
60. 答案D
解析：本題是個細節(jié)判斷題。題干中用到imply，表示“暗示”，說明文章并沒有直接說明。選項A、B、C文章中并沒有提及，也無從判斷。文章第二段段末講到，能夠忍受水分流失，在沙漠中至關(guān)重要。原因在于，動物可以不必一定生活在水邊，可以在廣闊的草原上四處走動尋找食物。從中可以推理，它們有能力長途跋涉，喂飽自己。
61. 答案C
解析：本題是個細節(jié)題。選項A和D出現(xiàn)在文章的第一段，選項B出現(xiàn)在文章的第二段。只有選項C沒有提及。 Part V Cloze
原文精譯
記憶在我們的生命中很特殊。孩提時代最早的記憶是什么?你能記得學(xué)習(xí)走路或說話時的樣子嗎?記得第一次聽到雷聲或第一次看電視節(jié)目的情形嗎?成年人很難回想起上學(xué)以前的事情，就像三四歲以前的小孩很難記得確切的個人經(jīng)歷。心理學(xué)家有各種不同的解釋來解讀這種“兒童失憶癥”。其中一個認為，腦內(nèi)的海馬狀突起，即大腦負責(zé)記憶的區(qū)域，到兩歲才成熟。但是比較流行的理論卻認為，由于成年人的思維方式和孩子不一樣，他們并不能反應(yīng)孩子的記憶方式。成年人以“詞”的形式來思考，他們的人生記憶，就像是故事或記敘文，如同小說或電影中的事件，一個接一個。但是當他們搜索自己的記憶庫，尋找兒提時代的記憶來豐富這個人生故事，他們找不到任何符合這個模板的材料，好像是在英語字典里找漢字一樣。
現(xiàn)在紐約州立大學(xué)心理學(xué)家Annette Simms為“兒童失憶癥”提供了新的解釋。她認為，根本就沒有可以回憶的兒時記憶。Simms博士認為，孩子需要通過和別人交流描述自己的經(jīng)歷，來把他們的個人經(jīng)歷從短期、易忘的印象轉(zhuǎn)化為長期記憶。換句話說，孩子必須講述他們的經(jīng)歷，聽他人談?wù)摻?jīng)歷，比如媽媽談?wù)撓挛缭诤＿厯熵悮さ氖虑椋职衷儐査麄冊诤Ｑ蠊珗@如何度過了一天。Simms博士說，沒有這種語言強化，孩子沒有辦法形成對個人經(jīng)歷的記憶。
62. 答案D
解析：考生要注意前后文的對應(yīng)。此空和or后面的成分并列，看電視，聽到雷聲，所以D為正確答案。
63. 答案C
解析：文章一開始就講到人們能不能記起以前的事情，接下來舉了一系列的例子。此空用recall表示“回憶，回想”，和前文呼應(yīng)。
64. 答案B
解析：as連接這個句子，表示類比。前面講到成年人很難記起以前的記憶，孩子也很難回憶起具體的個人經(jīng)歷。選項B中的rarely和前面句子中的seldom是同義詞。
65. 答案C
解析：本空是個比較固定的動賓搭配。心理學(xué)家提出了很多解釋，propose意為“提出，建議”。
66. 答案A
解析：not...until是個常見的句子結(jié)構(gòu)，“直到……才”。孩子的記憶區(qū)域直到2歲左右才發(fā)育完全。
67.答案D
解析：but的使用告訴考生，后面這個理論和前面的解釋應(yīng)該是相反的。選項A中的magnify意為“放大，夸大”;選項B中的intervene原意為“干涉，干預(yù)”;選項C中contain意為“包括，包含”，均不符合題意;選項D中的maintain意為“堅持認為”。but后面的這句話討論現(xiàn)在比較流行的觀點看法。
68.答案A
解析：這個理論是，成人和孩子思考的方式不一樣，所以他們并不能反映兒時的記憶。選項B中attain意為“達到，得到”;選項C中access意為“進入，獲取”;選項D中refer意為“指的是”。
69.答案A
解析：本句是個比喻，把成人的記憶比作故事，空白處之后有一個解釋說明，就像小說或電影中一個接一個的事件，從中可以推斷這是記敘文的形式。
70.答案B
解析：one經(jīng)常和another連用，表示一個接一個。
71.答案D
解析：上文把成人的記憶比作故事;本句意為“他們從記憶庫中搜索兒時的記憶”，在這里用file是個暗喻，file本意為“檔案”，這里指的是“腦海中存放記憶的地方”。
72.答案B
解析：上文把成人的記憶也比作記敘文。成人搜索記憶庫，沒有任何記憶符合這個模板，“模板”在這里是個暗喻，是針對“成人的記憶是記述文”這個比喻的。選項C中的frame意為“框架，股價”。
73.答案C
解析：此空比較簡單。對于“兒童失憶癥”有不同的解釋，而心理學(xué)家Annette Simms提出了另外一種解釋。
74.答案A
解析：本句主句用了一般現(xiàn)在時，所以賓語從句也選擇一般現(xiàn)在時。There be結(jié)構(gòu)中的主謂一致，要求be動詞和后面的名詞一致。名詞使用了復(fù)數(shù)形式memories，所以謂語使用了aren’t。
75.答案D
解析：本文講的是孩子要記住自己的經(jīng)歷，既需要自己的描述，也需要聽別人的談?wù)�。因為文章下文列舉了媽媽和爸爸的例子，都是別人的，可見這里強調(diào)的應(yīng)該是別人的描述，所以選擇D中的someone else’s。
76.答案A
解析：此空之前用short-term來修飾后面的印象impression，前文Dr. Simms也說了，孩子沒有記憶。所以這種印象很快就會忘記。選項A中forgotten表示“已經(jīng)忘記的”;而選項C中forgetting意為“正在忘記的”。
77.答案C
解析：這是個固定短語，in other words，“也就是說，換句話說”。
78.答案B
解析：此空選擇了名詞性物主代詞，theirs這里指的是their experiences。孩子不僅要談?wù)撟约旱慕?jīng)歷，也要聽別人討論經(jīng)歷。
79.答案D
解析：這里用動詞的過去分詞做后置定語。花費時間做某事，一般使用動詞短語spend time doing sth.，此空中，用spent作后置定語修飾前面表示時間的the afternoon。
80.答案B
解析：Dr. Simms一直在強調(diào)孩子要說，也要聽他人說。選項B中的verbal意為“口頭的，語言方面的”。
81.答案A
解析：第二段開頭部分，Dr. Simms認為，通過口頭表達可以把短暫記憶轉(zhuǎn)化為長期記憶。而第二段段末，重復(fù)了她的觀點。這里，選項A中permanent和long-term是同義詞，“長期的，永久的”。
Part VI Translation
82.答案to become as strong and brave as heroes
解析：本題是對比較級的考查。“和……一樣”在英語中用as...as結(jié)構(gòu)。電影中的主角用名詞hero。考生要注意主語用的是名詞復(fù)數(shù)，此處hero也需要名詞復(fù)數(shù)形式heroes。
83.答案that the human mind can succeed in understanding the universe
解析：本句是對表語從句的考查。is后面是個句子作表語，所以使用that引導(dǎo)的表語從句，that不能省略。“一定能”可以用succeed in doing的結(jié)構(gòu)來表達。
84.答案not unquestioning agreement but conflict
解析：本句使用了強調(diào)句型，對主語進行強調(diào)。本題主要考查短語“not...but”，意為“不是……而是”。英文中用conflict和agreement表示“沖突”和“一致”。
85.答案capable of finding a final solution to this thorny matter
解析：主句中be動詞的使用要求考生運用形容詞表示能力，可以用be able to do的結(jié)構(gòu)，也可以用be capable of doing的結(jié)構(gòu)。考生要特別注意，solution后面要用介詞to，表示“某個問題的解決方案”。
86.答案original, independent, and heroic
解析：本題是對考生詞匯量以及詞義的考查。這里用到original表示“有創(chuàng)意的，新穎的”，independent表示“與眾不同的，獨樹一幟的”，heroic表示“英勇的，巨大的，有氣勢的”。
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