雅思阅读考试巩固试题附答案Word文档格式.docx

雅思阅读考试巩固试题附答案Word文档格式.docx

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　　ChangesinAir

　　A

　　Afederalbanonozone-depletingchlorofluorocarbons（CFCs）,toconformwiththeCleanAirAct,is,ironically,affecting22.9millionpeopleintheU.S.whosufferfromasthma,Geneticinhaledalbuterol,whichisthemostcommonlyprescribedshort-actingasthmamedicationandrequiresCFCstopropelitintothelungs,willnolongerbelegallysoldafterDecember31,2008.Physiciansandpatientsarequestioningthewisdomoftheban,whichwillhaveaninsignificanteffectonozonebutameasurableimpactonwallets:

thereformulatedbrand-namealternativescanbethreetimesasexpensive,raisingthecosttoabout$40perinhaler.Theissueisevenmoredisconcertingconsideringthatasthmadisproportionatelyaffectsthepoorandthataccordingtorecentsurveys,anestimated20percentofasthmapatientsareuninsured.

　　B

　　Thedecisiontomakethechangewaspolitical,notmedicalorscientific,sayspharmacistLeslieHendelesoftheUniversityofFlorida,whoco-authoreda2007paperintheNewEnglandJournalofMedicineexplainingthewithdrawalandtransition.In1987CongresssignedontotheMontrealProtocolonSubstancesThatDepletetheOzoneLayer,aninternationaltreatyrequiringthephasingoutofallnonessentialusesofCFCs.Atthattime,medicalinhalerswereconsideredanessentialusebecausenoviablealternativepropellantexisted.In1989pharmaceuticalcompaniesbandedtogetherandeventually,in1996,reformulatedalbuterolwithhydrofluoroalkane.

　　C

　　Thetransitionbeganquietly,butasmorepatientsseetheirprescriptionschangeandcostsgoup,manyquestionwhythisbailmustbeginbeforegenericsbecomeavailable.AtleastonememberoftheFDAadvisorycommittee,NicholasJ.GrossoftheStritch-LoyolaSchoolofMedicine,haspubliclyregrettedthedecision,recantinghissupportandrequestingthatthebanbepushedbackuntil2010,whenthefirstpatentexpires.

　　D

　　GrossnotesthatthedecisionhadnothingtodowiththeenvironmentAlbuterolinhalerscontributedlessthan0.1percentoftheCFCsreleasedwhenthetreatywassigned.Lt&

#39;

sasymbolicissueGrossremarks.SomeskepticsinsteadpointtothebillionsofdollarstobegainedbythethreecompaniesholdingthepatentsontheavailableHFA-albuterolinhalers,namelyGlaxo-SmithKline,Schering-PloughandTeva.AlthoughtheFDAadvisorycommitteerecognizedthattheexpenseswouldgoup,Hendelessays,italsobelievedthatthecompanieswouldhelpdefraytheaddedcostsforindividuals,Firms,forinstance,hadcommittedtodonatingamillionHFAinhalerstoclinicsaroundthecountry.AccordingtoHendeles,GlaxoSmithKlinedidnotfollowthrough,althoughSchering-PloughandTevadid.GlaxoSmithKlinedidnotrespondtorequestsforcomment.

　　E

　　Theissuenow,Hendelessays,isthatpharmaceutical-gradeCFCsareinshortsupply,andthepublicfacestheriskofashortageofalbuterolinhalersiftheFDAdoesnotcontinuepromotingtheproductionofHFAinhalers.HepositsthatevencostsofgenericswouldgoupasCFCsbecomescarcer.Grossdisagrees,sayingthattheinhalershortageandtheclosureofCFCmanufacturingplantsarearesultoftheban.

　　F

　　TheHFAinhalersalsohaveencounteredresistancebecausesomeasthmaticsinsistthattheydonotworkaswellastheCFCvariety.But,Hendelessays,thedifferencesareinthemechanicsandmaintenance&

mdash;

unlikeCFCinhalers,theHFAversionsmustbeprimedmorediligentlyandrinsedtoaccommodatethestickierHFAformulation.TheyalsorunoutsuddenlywithoutthewarningwithaCFCinhaler,thatthedeviceisrunninglow.Pharmacistsmaynottellpeopleofthesethings,andthedoctorsdon&

tknow,Hendelessays.

　　G

　　Themainpublichealthissueinthisdecisionmaybethesideeffectsoftheeconomics,notthedrugchemistry.Multiplestudieshaveshownthatraisingcostsleadstopooreradherencetotreatment.Onestudydiscoveredthatpatientstook30percentlessamtiasthmamedicationwhentheirco-paydoubled.Intheeaseofachronicdiseasesuchasasthma,itisparticularlydifficulttogetpeopletofollowregulartreatmentplans.Generallyspeaking,foranyreasonyoudon&

rsquo;

ttakemedication,costmakesitmorelikely&

rdquo;

thatyoudonot,commentsMichaelChernew,ahealthpolicyexpertatHarvardMedicalSchool.

　　H

　　Suchchoicestoforgomedicationcouldaffectmorethanjustthepatientsthemselves.Forexample,Hendelespointsout,inapregnantmotherwithuntreatedasthma,lessoxygenisdeliveredtothefetus,whichcanleadtocongenitalproblemsandprematurebirth.Andconsideringthatthediseasedisproportionatelystrikesthepoor,whatseemedtobeagood,responsibleenvironmentaldecisionmightintheendexactanunexpectedhumantoll.

　　Question14-18

　　Usetheinformationinthepassagetomatchthepeople（listedA-C）withopinionsordeedsbelow.WritetheappropriatelettersA-Cinboxes14-18onyouranswersheet.

　　NByoumayuseanylettermorethanonce

　　ANicholasJ.Gross

　　BMichaelChernew

　　CLeslieHendeles

　　14.Putforwardthattheincreaseinthepriceofdrugswouldcontributetothepatients&

negativedecisiononthetreatment.

　　15.Spokeoutasecretthatthedruggiststrytoholdback.

　　16.Pointedoutthattheprotocolitselfisnotconcerningtheenvironment.

　　17.DemonstratedthatthestopofprovidingalternativesforCFCswouldworsenratherthanhelpwiththesituation.

　　18.Inpublicrepentedofhispreviousbackingupoftheprohibitionproposal.

　　Question19-22

　　DothefollowingstatementsagreewiththeinformationgiveninReadingPassage?

　　Inboxes19-22onyouranswersheet,write

　　TRUEifthestatementistrue

　　FALSEifthestatementisfalse

　　NOTGIVENiftheinformationisnotgiveninthepassage

　　19.Ittookalmostadecadebeforethereplacementdrugfortheasthmatherapywasultimatelydevelopedbythejointeffortofseveraldrugcompanies.

　　20.OneoftheFDAcommitteemembershadadecisiveimpactontheimplementofthebanonchlorofluorocarbons.

　　21.Asamatteroffact,theemittedchlorofluorocarbonsinasthmatreatmenttookupquiteaninsignificantamountatthetimewhenthepactwasreached.

　　22.TheHFAandCFCinhalershavesomethingdifferentregardingthetherapeuticeffect.

　　Question23-27

　　CompletethefollowingsummaryoftheparagraphsofReadingPassage,usingNoMorethanThreewordsfromtheReadingPassageforeachanswer.Writeyouranswersinboxes23-27onyouranswersheet.

　　Americanpeoplewithasthmawouldbeimpactedby...23...aboutchlorofluorocarbonswhichwouldconsumetheozonelayer.Theusuallyused...24...wouldbeconsideredillegalbecauseitneedsthepropelmentof...25....The...26...wouldcostthepatientsconsiderablymoremoney.ImpoverishedpeoplearefarmorelikelytoSufferfromasthmaandwhatmakesitevenworseisthatsomeofthemarein...27...condition.