【文章內(nèi)容簡介】 rather too hard. Some say it39。s high time for the model of short, sharp onetoone appointments to give way to shared medical appointments (SMAs共享醫(yī)療預(yù)約). SMAs are doctorpatient visits in which a group of patients receive patient education and counseling (咨詢), physical examination and medical support in a group setting. Typically SMAs are designed to have one or more doctors attend to a group of patients who share a mon illness or medical condition. In contrast to onetoone visits, SMAS provide a longer appointment timeframe as well as the opportunity for patients to have improved access to their physicians and meanwhile pick up additional information and support from peers. However, doctors who have pioneered the shared appointment approach report that there are significant challenges involved. Dr. Sumego, director of shared medical appointments, Cleveland Clinic, identifies culture change as the most significant challenge. Physicians and nurses are trained in a model of personal service and privacy。 the SMA approach is a fundamental challenge to those fixed ideas. They need shared goals and a way of testing the innovation against agreed standards. Dr. Sumego says, The physicians may be worried about the possible chaos and efficiencies that are marketed. They also have to make the patients understand what their appointment is, and what the expectation is. So, if an organization was looking to start shared medical appointments, I would advise them to start the buyin from a few champion physicians, develop the workflow and develop some experience. Provide some support behind what that best practice should look like. Create some standards so that, as the concept spreads, you can employ that experience to start the next shared medical appointments and the next.（1）What is the purpose of the SMA approach? A.To improve medical service.B.To promote doctors39。 reputation.C.To conduct medical research.D.To meet patients39。 expectation.（2）According to Dr. Sumego, what prevents the SMA approach from being widely adopted? A.Personal service.B.Fixed ideas.C.Lack of equipment.D.Shared goals.（3）What can the underlined buyin in Paragraph 4 be replaced by? A.practiceB.organizationC.purchaseD.support（4）What can be learned about the SMA approach in the last paragraph? A.It is currently being questioned.B.It is impractical in some areas.C.It will enjoy wide popularity soon.D.It should be carried out step by step.【答案】 （1）A（2）B（3）A（4）D 【解析】【分析】本文是一篇說明文，介紹了SMAs (共享醫(yī)療預(yù)約) 模式，以及這種模式面臨的挑戰(zhàn)。 （1）考查推理判斷。根據(jù)第二段中的“In contrast to onetoone visits, SMA provide a longer appointment timeframe as well as the opportunity for patients to have improved access to their physicians and meanwhile pick up additional information and support from peers.”可知SMAs模式為患者提供了更長的預(yù)約時間，也為患者提供了更好地與醫(yī)生接觸的機會，同時還能從同行那里獲得額外的信息和支持。這說明SAMs的出現(xiàn)是為患者提供更好的醫(yī)療服務(wù)。故選A。 （2）考查推理判斷。根據(jù)第三段中的“Dr. Sumego, director of shared medical appointments, Cleveland Clinic, …… personal service and privacy。 the SMA approach is a fundamental challenge to those fixed ideas.”可知Dr. Sumego認為，文化轉(zhuǎn)變是最大的挑戰(zhàn)。醫(yī)生和護士接受的是針對個人服務(wù)和隱私的培訓。 SMAs方法是對這些固定想法的根本挑戰(zhàn)。也就是說，改變這些已經(jīng)固定的想法是一種挑戰(zhàn)，所以這些固定的想法會阻礙SMAs模式的推廣，故選B。 （3）考查詞義猜測。根據(jù)最后一段中的“if an organization was looking to start shared medical appointments，I would advise them to start the buyin from a few champion physicians”可知如果一個組織要尋求共享醫(yī)療模式的話，Dr. Sumego建議他們從一些優(yōu)秀的醫(yī)師開始他們的buyin，根據(jù)語境，故選A。 （4）考查推理判斷。根據(jù)最后一段中的“So, if an organization was looking to start shared medical appointments, I would advise them to start the buyin from a few champion physicians, develop the… appointments and the next.”可知如果一個組織要開始SMAs，Dr. Sumego建議他們從一些優(yōu)秀的醫(yī)師開始，開發(fā)一些流程，積累一些經(jīng)驗。制定一些標準，以便隨著概念的推廣，他們可以利用這種經(jīng)驗開始下一次共享醫(yī)療預(yù)約然后將下次的經(jīng)驗用到下下次。這說明SMAs的實施需要一步一步來，不會一步到位。故選D。 【點評】本題考點涉及詞義猜測和推理判斷兩個題型的考查，是一篇介紹類閱讀，要求考生根據(jù)上下文的邏輯關(guān)系，進行分析，推理，從而選出正確答案。5．閱讀理解 Darrell Blatchley, a marine biologist and environmentalist based in the Philippine city of Davao, received a call from the Philippines, Bureau of Fisheries and Aquatic Resources (漁業(yè)與水產(chǎn)資源局) early Friday morning reporting a death of a young whale. When the necropsy (尸檢) was performed, Blatchley told NPR, he was not prepared for the amount of plastic they found in the whale39。s stomach. It was full of plastic nothing but nonstop plastic. he said It was filled to the point that its stomach was as hard as a baseball. That means that this animal has been suffering not for days or weeks but for months or even a year or more, Blatchley added. Blatchley is the founder and owner of the D39。Bone Collector Museum, a natural history museum in Davao. In the ing days, the museum will display all the items found in the whale39。s system. Blatchley and his team work with the Bureau of Fisheries and Aquatic Resources and other organizations to assist in rescue and recovery of marine animals. Within the last 10 years, we have recovered 61 whales and dolphins just within the Davao Gulf, he said. Of them, 57 have died due to man whether they took plastic or fishing nets or other waste, or gotten caught in pollution — and four were pregnant. Blatchley said he hoped that the latest incident would launch the issue of plastic pollution in the Philippines and across the globe. If we keep going this way, it will be more unmon to see an animal die of natural causes than it is to see an animal die of plastic, he said.（1）What can he inferred from the second paragraph? A.The whale was starved to death.B.Blatchley was shocked at what he found.C.The dead whale must have swallowed a baseball.D.Blatchley didn39。t make preparations for the necropsy.（2）What will be shown in the D39。Bone Collector Museum? A.Waste collected from the ocean.B.The whole system of the whale.C.Things found in the whale39。s body.D.Many different tools of whaling.（3）What does Blatchley think of plastic pollution in the Philippines? A.Unmon.B.1