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考試時間 2014年3月22日星期六 下午2:00-5:00 原創(chuàng)作者qq 347952582 Since Would War II considerable advances have been made in the area of health-care services. These include better access to health care (particularly for the poor and minorities), improvements in physical plants, and increased numbers of physicians and other health personnel. All have played a part in the recent improvement in life expectancy (life expectancy: n.平均壽命(=expectation of life)). But there is mounting criticism of the large remaining gaps in access, unbridled cost inflation, the further fragmentation of service, excessive indulgence in wasteful high-technology “gadgeteering,” and a breakdown in doctor-patient relationships. In recent years (in recent years: 最近幾年中) proposed panaceas and new programs, small and large, have proliferated at a feverish pace and disappointments multiply at almost the same rate. This has led to an increased pessimism—“everything has been tried and nothing works”—which sometimes borders on cynicism or even nihilism. It is true that the automatic “pass through” of rapidly spiraling costs (spiraling costs: 螺旋式上升的費(fèi)用) to government and insurance carriers, which was set in a publicized environment of “the richest nation in the world,” produced for a time (for a time: adv.暫時, 一度) a sense of unlimited resources and allowed to develop a mood whereby every practitioner and institution could “do his own thing” without undue concern for the “Medical Commons.” The practice of full-cost reimbursement encouraged capital investment and now the industry is overcapitalized. Many cities have hundreds of excess hospital beds; hospitals have proliferated a superabundance of high-technology equipment; and structural ostentation and luxury were the order of the day (order of the day: 議程,<口>流行的事物,風(fēng)尚). In any given day, one-fourth of all community beds are vacant; expensive equipment is underused or, worse, used unnecessarily. Capital investment brings rapidly rising operating costs (operating costs: 生產(chǎn)費(fèi)用,營業(yè)成本). Yet, in part, this pessimism derives from expecting too much of health care. It must be realized that care is, for most people, a painful experience, often accompanied by fear and unwelcome results. Although there is vast room for improvement, health care will always retain some unpleasantness and frustration. Moreover, the capacities of medical science are limited. Humpty Dumpty (一經(jīng)損壞無法修復(fù)的東西) cannot always be put back together again. Too many physicians are reluctant to admit their limitations to patients; too many patients and families are unwilling to accept such realities. Nor is it true that everything has been tried and nothing works, as shown by the prepaid group practice plans of the Kaiser Foundation and at Puget Sound. In the main (in the main: adv.大體上), however, such undertakings have been drowned by a veritable flood of public and private moneys which have supported and encouraged the continuation of conventional practices and subsidized their shortcomings on a massive, almost unrestricted scale. Except for the most idealistic and dedicated, there were no incentives to seek change or to practice self-restraint or frugality. In this atmosphere, it is not fair to condemn as failures all attempted experiments; it may be more accurate to say many never had a fair trial. 1. The author implies that the Kaiser Foundation and Puget Sound plans (lines 47-48) differed from other plans by (A) encouraging capital investment (B) requiring physicians to treat the poor (C) providing incentives for cost control (D) employing only dedicated and idealistic doctors（C） (E) relying primarily on public funding 2. The author mentions all of the following as consequences of full-cost reimbursement EXCEPT (A) rising operating costs (B) underused hospital facilities (C) overcapitalization (D) overreliance on expensive equipment（E） (E) lack of services for minorities 3. The tone of the passage can best be described as (A) light-hearted and amused (B) objective but concerned (C) detached and unconcerned (D) cautious but sincere（B） (E) enthusiastic and enlightened 4. According to the author, the “pessimism” mentioned at line 35 is partly attributable to the fact that (A) there has been little real improvement in health-care services (B) expectations about health-care services are sometimes unrealistic (C) large segments of the population find it impossible to get access to health-care services (D) advances in technology have made health care service unaffordable（B） (E) doctors are now less concerned with patient care 5. The author cites the prepaid plans in lines 46-48 as (A) counterexamples to the claim that nothing has worked (B) examples of health-care plans that were over-funded (C) evidence that health-care services are fragmented (D) proof of the theory that no plan has been successful（A） (E) experiments that yielded disappointing results 6. It can be inferred that the sentence “Humpty Dumpty cannot always be put back together again” means that (A) the cost of health-care services will not decline (B) some people should not become doctors (C) medical care is not really essential to good health (D) illness is often unpleasant and even painful（E） (E) medical science cannot cure every ill 7. With which of the following descriptions of the system for the delivery of health-care services would the author most likely agree? (A) It is biased in favor of doctors and against patients. (B) It is highly fragmented and completely ineffective (C) It has not embraced new technology rapidly enough (D) It is generally effective but can be improved（D） (E) It discourages people from seeking medical care 8. Which of the following best describes the logical structure of the selection? (A) The third paragraph is intended as a refutation of the first and second paragraphs. (B) The second and third paragraphs explain and put into perspective the points made in the first paragraph. (C) The second and third paragraphs explain and put into perspective the points made in the first paragraph. (D) The first paragraph describes a problem, and the second and third paragraphs present two horns of a dilemma.（C） (E) The first paragraph describes a problem, the second its causes, and the third a possible solution. 9. The author’s primary concern is to (A) criticize physicians and health-care administrators for investing in technologically advanced equipment (B) examine some problems affecting delivery of health-care services and assess their severity (C) defend the medical community from charges that health-care has not improved since World War II (D) analyze the reasons for the health-care industry’s inability to provide quality care to all segments of the population（B） (E) describe the peculiar economic features of the health-care industry that are the causes of spiraling medical costs 1. C 2. E 3. B 4. B 5. A 6. E 7. D 8. C 9. B 10. Behavior is one of two general responses available to endothermic (endothermic: adj.吸熱(性)的,[動]溫血的) (warm-blooded) species for the regulation of body temperature, the other being innate (reflexive) mechanisms of heat production and heat loss. Human beings rely primarily on the first to provide a hospitable thermal microclimate (microclimate: n.[氣]小氣候(指森林、城市、洞穴等局部地區(qū)的氣候)) for themselves, in which the transfer of heat between the body and the environment is accomplished with minimal involvement of innate mechanisms of heat production and loss. Thermoregulatory (thermoregulatory: adj.體溫調(diào)節(jié)的,保持(一定)體溫的) behavior anticipates hyperthermia, and the organism adjusts its behavior to avoid becoming hyperthermic: it removes layers of clothing, it goes for a cool swim, etc. The organism can also respond to changes in the temperature of the body core, as is the case during exercise; but such responses result from the direct stimulation of thermoreceptors distributed widely within the central nervous system (central nervous system: n. 中樞神經(jīng)系統(tǒng)), and the ability of these mechanisms to help the organism adjust to gross changes in its environment is limited. Until recently it was assumed that organisms respond to microwave radiation in the same way that they respond to temperature changes caused by other forms of radiation. After all, the argument runs, microwaves are radiation and heat body tissues. This theory ignores the fact that the stimulus to a behavioral response is normally a temperature change that occurs at the surface of the organism. The thermoreceptors that prompt behavioral changes are located within the first millimeter of the skin’s surface, but the energy of a microwave field (microwave field: 超高頻場, 微波場) may be selectively deposited in deep tissues, effectively bypassing these thermoreceptors, particularly if the field is at near-resonant frequencies. The resulting temperature profile (temperature profile: 溫度曲線圖, 溫度輪廓) may well be a kind of reverse thermal gradient in which the deep tissues are warmed more than those of the surface. Since the heat is not conducted outward to the surface to stimulate the appropriate receptors, the organism does not “appreciate” this stimulation in the same way that it “appreciates” heating and cooling of the skin. In theory (in theory: 理論上), the internal organs of a human being or an animal could be quite literally cooked well-done (well-done: adj.做得好的, 完全煮熟的) before the animal even realizes that the balance of its thermomicroclimate has been disturbed. Until a few years ago, microwave irradiations at equivalent plane-wave power densities of about 100 mW/cm2 were considered unequivocally to produce “thermal” effects; irradiations within the range of 10 to 100 mW/cm2 might or might not produce “thermal” effects; while effects observed at power densities below 10 mW/cm2 were assumed to be “nonthermal” in nature. Experiments have shown this to be an oversimplification, and a recent report suggests that fields as weak as 1 mW/cm2 can be thermogenic. When the heat generated in the tissues by an imposed radio frequency (radio frequency: n.無線電頻率) (plus the heat generated by metabolism) exceeds the heat-loss capabilities of the organism, the thermoregulatory system has been compromised. Yet surprisingly, not long ago (not long ago: adv.不久前), an increase in the internal body temperature was regarded merely as “evidence” of a thermal effect. 1. The author is primarily concerned with (A) showing that behavior is a more effective way of controlling bodily temperature than innate mechanisms (B) criticizing researchers who will not discard their theories about the effects of microwave radiation on organisms (C) demonstrating that effects of microwave radiation are different from those of other forms of radiation (D) analyzing the mechanism by which an organism maintains its bodily temperature in a changing thermal environment（C） (E) discussing the importance of thermoreceptors in the control of the internal temperature of an organism 2. The author makes which of the following points about innate mechanisms for heat production? I. They are governed by thermoreceptors inside the body of the organism rather than at the surface. II. They are a less effective means of compensating for gross changes in temperature than behavioral strategies. III. They are not affected by microwave radiation. (A) I only (B) I and II only (C) I and III only (D) II and III only（B） (E) I, II, and III 3. Which of the following would be the most logical topic for the author to take up (take up: 繼續(xù)) in the paragraph following the final paragraph of the selection? (A) A suggestion for new research to be done on the effects of microwaves on animals and human beings (B) An analysis of the differences between microwave radiation (C) A proposal that the use of microwave radiation be prohibited because it is dangerous (D) A survey of the literature on the effects of microwave radiation on human beings（A） (E) A discussion of the strategies used by various species to control hyperthermia 4. The author’s strategy in lines 39-42 is to (A) introduce a hypothetical example to dramatize a point (B) propose an experiment to test a scientific hypothesis (C) cite a case study to illustrate a general contention (D) produce a counterexample to disprove an opponent’s theory（A） (E) speculate about the probable consequences of a scientific phenomenon 5. The author implies that the proponents of the theory that microwave radiation acts on organisms in the same way as other forms of radiation based their conclusions primarily on (A) laboratory research (B) unfounded assumption (C) control group surveys (D) deductive reasoning（B） (E) causal investigation 6. The tone of the passage can best be described as (A) genial and conversational (B) alarmed and disparaging (C) facetious and cynical (D) scholarly and noncommittal (noncommittal: adj.不明朗的, 不承擔(dān)義務(wù)的)（E） (E) scholarly and concerned 7. The author is primarily concerned with (A) pointing out weaknesses in a popular scientific theory (B) developing a hypothesis to explain a scientific phenomenon (C) reporting on new research on the effects of microwave radiation (D) criticizing the research methods of earlier investigators（A） (E) clarifying ambiguities in the terminology used to describe a phenomenon 1. C 2. B 3. A 4. A 5. B 6. E 7. A 8. 9. 10. Agricultural progress provided the stimulus necessary to set off (set off: v.引起, 使爆發(fā)) economic expansion in medieval France. As long as those who worked the land were barely able to ensure their own subsistence (the minimum (as of food and shelter) necessary to support life) and that of their landlords, all other activities had to be minimal, but when food surpluses increased, it became possible to release more people for governmental, commercial, religious and cultural pursuits. However, not all the funds from the agricultural surplus were actually available for commercial investment. Much of the surplus, in the form of food increases, probably went to raise the subsistence level; an additional amount, in the form of currency gained from the sale of food, went into the royal treasury to be used in waging war. Although Louis VII of France levied a less crushing tax burden on his subjects than did England’s Henry II, Louis VII did spend great sums on an unsuccessful crusade, and his vassals—both lay and ecclesiastic—took over spending where their sovereign stopped. Surplus funds were claimed both by the Church and by feudal landholders, whereupon (1: on which; 2: closely following and in consequence of which) cathedrals and castles mushroomed throughout France. The simultaneous progress of cathedral building and, for instance, vineyard expansion in Bordeaux (Bordeaux: n.波爾多葡萄酒) illustrates the very real competition for available capital between the Church and commercial interests; the former produced inestimable moral and artistic riches, but the latter had a stronger immediate impact upon gross national product. Moreover, though all wars by definition are defensive, the frequent crossings of armies that lived off (live off: v.住在...外, 靠...生活) the land and impartially burned all the huts and barns on their path consumed considerable resources. Since demands on the agricultural surplus would have varied from year to year (from year to year: adv.年年), we cannot precisely calculate their impact on the commercial growth of medieval France. But we must bear that impact in mind when estimating the assets that were likely to have been available for investment. No doubt castle and cathedral building was not totally barren of profit (for the builders, that is), and it produced intangible dividends of material and moral satisfaction for the community. Even wars handed back (hand back: 退還) a fragment of what they took, at least to a few. Still, we cannot place on the same plane a primarily destructive activity and a constructive one, nor expect the same results from a new bell tower as from a new water mill (water mill: n.水磨, 水力磨粉機(jī)). Above all, medieval France had little room for investment over and above the preservation of life. Granted that war cost much less than it does today, that the Church rendered all sorts of educational and recreational services that were unobtainable elsewhere, and that government was far less demanding than is the modern state—nevertheless, for medieval men and women, supporting commercial development required considerable economic sacrifice. 1. According to the passage, agricultural revenues in excess of the amount needed for subsistence were used by medieval kings to (A) patronize the arts (B) sponsor public recreation (C) wage war (D) build cathedrals（C） (E) fund public education 2. According to the passage, which of the following was an important source of revenue in medieval France? (A) Cheese (B) Wine (C) Wool (D) Olive oil（B） (E) Veal 3. The passage suggests that which of the following would have reduced the assets immediately available for commercial investment in medieval France? I. Renovation of a large cathedral II. A sharp increase in the birth rate III. An invasion of France by Henry II (A) III only (B) I and II only (C) I and III only (D) II and III only（E） (E) I, II, and III 4. It can be inferred from the passage that more people could enter government and the Church in medieval France because (A) the number of individual landholdings in heavily agricultural areas was beginning to increase (B) an increase in the volume of international trade had brought an increase in the population of cities (C) a decrease in warfare had allowed the king to decrease the size of the army (D) food producers could grow more food than they and their families needed to survive（D） (E) landlords were prospering and thus were demanding a smaller percentage of tenants’ annual yields 5. The author implies that the reason we cannot expect the same results from a new bell tower as from a new water mill is that (A) bell towers yield an intangible dividend (B) bell towers provide material satisfaction (C) water mills cost more to build than bell towers (D) water mills divert funds from commerce（A） (E) water mills might well be destroyed by war 6. The author of the passage most probably bases his central argument on which of the following theoretical assumptions often made by economists? (A) Different people should be taxed in proportion to the benefit they can expect to receive from public activity. (B) Perfect competition exists only in the case where no farmer, merchant, or laborer controls a large enough share of the total market to influence market price. (C) A population wealthy enough to cut back its rate of consumption can funnel the resulting savings into the creation of capital. (D) A full-employment economy must always, to produce one good, give up producing another good.（C） (E) There is a universal tendency for population, unless checked by food supply, to increase in a geometric progression. 7. The author suggests that commercial expansion in medieval France “required considerable economic sacrifice” (lines 59-60) primarily for which of the following reasons? (A) Cathedrals cost more to build and rebuild than did castles. (B) The numerous wars fought during the period left the royal treasury bankrupt. (C) Louis VII levied a more crushing tax burden on his subjects than did Henry II. (D) Although much of the available surplus had been diverted into vineyard expansion, the vineyards had not yet begun to produce.（E） (E) Although more food was being produced, the subsistence level was not very far above the minimum required to sustain life. 8. The passage implies that which of the following yielded the lowest dividend to medieval men and women relative to its cost? (A) Warfare (B) Vineyard expansion (C) Water mill construction (D) Castle building（A） (E) Cathedral building 9. Which of the following stateme