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. 有些人认为家人对青少年的影响最大。
2.有些人认为朋友对青少年的影响最大。
3.我的看法。
Who Has the Most Important Influence on the YoungPart 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 c lung to individual, disconnected software and systems that UPMC’s IT department had implemented over the years.On the mendAlthough 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 costsGiven 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 anestimated $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 wrongThe 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 p atients’ 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 useAggregating info to create knowledgeIdeally, 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 pastB) EHRs have received less attention of the public in the pastC) whether it will be useful to doctors or not is doubtfulD) UPMC knows how difficult it is to digitize the hospital2. The University of Pittsburgh Medical Center (UPMC) .A) is the first medical center to adopt information technologyB) satisfy the requirement of the government on information technologyC) spent less money on information technology than it was estimatedD) attempted to created a universal EHR system, but met some difficulties3. 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 staffB) UPMC is like many other health care organizations in the United StatesC) UPMC makes EHR systems look easyD) UMPC began digitizing some of its records in 19964. The success of the EHR program is decided by .A) the fact whether the information technology is available or notB) the fact how well the doctors are trained to use the information technologyC) not only the presence of the technology but the doctor’s training on technologyD) the fact whether physicians can see the benefits of using EHR systems5. 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 affordB) physicians are unwilling to adopt itC) there is a lack of staff with adequate IT expertiseD) doctor worry about its negative influence on patients6. According to the study led by David Himmelstein through health IT .A) it is possible to cut the costs of the hospitalB) it is possible to improve the health careC) it ensure neither cost saving nor improvement in careD) it could save as much as $100 million annually7. The hospital’s managers prefer to .A) spend money on an expensive piece of equipment than on information technologyB) charge patients access to the information technology as a billable serviceC) purchase the information technology to improve the health care of the hospitalD) invest more money on the training of the physicians to charge patients more money8. 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 Ⅲ Listening Comprehension (35 minutes)Section ADirections: In this section, you will hear 8 short conversations and 2 long conversations. At the end of each conversation, one or more questions will be asked about what was said. Both the conversation and the questions will be spoken only once. After each question there will be a pause. During the pause, you must read the four choices marked A), B), C) and D), and decide which is the best answer. Then mark the corresponding letter on Answer Sheet 2 with a single line through the centre.11. A) He doesn’t know the way to the theater.B) He doesn’t usually get up at 7:30.C) He wants to leave the theater before the drama is over.D) He wants to go early to avoid a traffic jam.12. A) She got a weekend job at the beach.B) She often goes to the beach.C) She misses the trips to the beach she used to take.D) Her home is near the beach.13. A) He will make a reservation at the restaurant.B) The woman should ask her parents for a suggestion.C) The woman should decide where to eat Saturday.D) He already has plans for Saturday night.14. A) He doubts the woman will like the novel.B) He’ll lend the woman the novel after he has read it.C) He enjoyed reading the novel.D) He hasn’t started reading the novel yet.15. A) The doctor’s office will be closed tomorrow.B) The doctor’s schedule is filled tomorrow.C) The doctor has stopped seeing new patients.D) The doctor can see the man tomorrow.16. A) She was sorry the man couldn’t finish his laundry.B) She saw the man run out.C) She thought the man’s laundry was done badly.D) She thought the man’s lawn was too dry.17. A) His coach didn’t help him enough.B) He had no chance of winning.C) His coach didn’t listen to him.D) He didn’t follow his coach’s advice.18. A) She grades papers very quickly.B) She isn’t teaching this semester.C) She didn’t require any papers last semester.D) She was more flexible last semester.Questions 19 to 21 are based on the conversation you have just heard.19. A) Father and daughter.B) Colleagues.C) Friends.D) Husband and wife.20. A) They are discussing whether they should go for a holiday.B) They are discussing where they should go for the holiday.C) They are discussing how they could save enough money for the holiday.D) They are discussing how they could pay for their house and the furniture.21. A) Sheffield.B) Hawaii.C) Wales or Scotland.D) Florida.Questions 22 to 25 are based on the conversation you have just heard.22. A) In a skating rink.B) On a bike path.C) On the campus sidewalks.D) In the street.23. A) He has trouble stopping.B) There are too many rocks.C) Going uphill is difficult.D) There are too many curves.24. A) Pull him up the hills.B) Catch him if he starts to fail.C) Find some skates for him.D) Teach him how to stop on skates.25. A) Look for the man’s skates.B) Have a meal.C) Look for something to drink.D) Start skating on the path.Section BDirections: In this section, you will hear 3 short passages. At the end of each passage, you will hear some questions. Both the passage and the questions will be spoken only once. After you hear a question, you must choose the best answer from the four choices marked A), B), C) and D). Then mark the corresponding letter on Answer Sheet 2 with a single line through the centre.Passage OneQuestions 26 to 28 are based on the passage you have just heard.26. A) The beef is lost.B) Something is not as good as described.C) The beef is not as good as it is said to be.D) The food has turned bad.27. A) Because they are made from beef.B) Because they are cheaper than any other kind of food.C) Because they are served quickly and at a low price.D) Because hamburger is the only fast food in America.28. A) Because hamburgers are good to eat.B) Because they are easy to make.C) Because they could sell hamburgers throughout the country.D) Because they thought they could make large profit.Passage TwoQuestions 29 to 31 are based on the passage you have just heard.29. A) They often take place in her major industries.B) British trade unions are more powerful.C) There are more trade union members in Britain.D) Britain loses more working days through strikes every year.30. A) Such strikes are against the British law.B) Such strikes are unpredictable.C) Such strikes involve workers from different trades.D) Such strikes occur frequently these days.31. A) Trade unions in Britain are becoming more popular.B) Most strikes in Britain are against the British law.C) Unofficial strikes in Britain are easier to deal with now.D) Employer-worker relations in Britain have become tenser. Passage ThreeQuestions 32 to 35 are based on the passage you have just heard.32. A) Education.B) Wealth.C) Diligence.D) Political status.33. A) The change of the nature of occupations.B) The decrease of social wealth.C) The change of educational degree.D) The increase of job opportunities.34. A) Farmers.B) Politicians.C) Manual workers..D) Clerks.35. A) White-collar workers.B) Farm workers.C) Blue-collar workers.D) Not mentioned.Section CDirections: In this section, you will hear a passage three times. When the passage is read for the first time, you should listen carefully for its general idea. When the passage is read for the second time, you are required to fill in the blanks numbered from 36 to 43 with the exact words you have just heard. For blanks numbered from 44 to 46 you are required to fill in the missing information. For these blanks, you can either use the exact words you have just heard or write down the main points in your own words. Finally, when the passage is read for the third time, you should check what you have written.Daily newspaper has an editorial page. Here opinion is expressed on events and 36 in the news. But editorial judgment is so persuasively 37 that many people accept these opinions as facts. Good journalists 38 a code of ethics which 39 between news and editorial opinion. This code holds that in an editorial 40 the publisher is entitled to 41 any cause he chooses. It is understood that there he is speaking as a partisan and may express any view he 42 . Because a modern newspaper is so expensive to produce and so 43 to establish, newspapers have increasingly become big business organizations. Although there are exceptions, 44 _________________.In the news columns, however, the complete and unbiased facts should be reported. The better metropolitan newspapers and 45 _____________. But the less ethical publications 46 _______________.Part Ⅳ Reading Comprehension (Reading in Depth) (25 minutes)Section ADirections: 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 BDirections: 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 OneQuestions 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 carrythem 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 famineB) ease international tensionC) defeat world champion chess playerD) work out solutions to the industrial problems53. In the author’s opinion, ______.A) playing chess shows computer’s program has been developed into a new stageB) it is practically possible now that computer can win every chess game nowC) computers even with less than complete data can be programmed to defeat the world champion chess playerD) computers can be programmed to play and reason but not learn54. The author’s attitude toward the future use of computer is ______.A) negativeB) positiveC) indifferentD) critical55. In order to "think", computer should ______.A) be programmed to have more than enough dataB) learn from the experience and to reasonC) deal with all the unstructured situationD) predicate every move in the chess56. Today, the chess-playing computer can be programmed to ______.A) have trillions of responses in a second to each possible move and win the gameB) store complete data and beat the best playersC) learn from chess-playing in the early stage and go on to win the gameD) predicate every possible move but may fail to give the right response each timePassage TwoQuestions 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. Desertanimals 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.。
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