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雅思阅读练习题:大气变化

2017-04-05 10:51:00来源:网络 柯林斯词典

  新东方在线雅思网第一时给大家带来了雅思阅读练习题:大气变化,希望以下内容能够为同学们的雅思备考提供帮助。新东方在线雅思网将第一时间为大家发布最新、最全、最专业的雅思报名官网消息和雅思考试真题及解析,供大家参考。

  Changes in Air

  A

  A federal ban on ozone-depleting chlorofluorocarbons (CFCs), to conform with the Clean Air Act, is, ironically, affecting 22.9 million people in the U.S. who suffer from asthma, Genetic inhaled albuterol, which is the most commonly prescribed short-acting asthma medication and requires CFCs to propel it into the lungs, will no longer be legally sold after December 31, 2008. Physicians and patients are questioning the wisdom of the ban, which will have an insignificant effect on ozone but a measurable impact on wallets: the reformulated brand-name alternatives can be three times as expensive, raising the cost to about $40 per inhaler. The issue is even more disconcerting considering that asthma disproportionately affects the poor and that according to recent surveys, an estimated 20 percent of asthma patients are uninsured.

  B

  "The decision to make the change was political, not medical or scientific," says pharmacist Leslie Hendeles of the University of Florida, who co-authored a 2007 paper in the New England Journal of Medicine explaining the withdrawal and transition. In 1987 Congress signed on to the Montreal Protocol on Substances That Deplete the Ozone Layer, an international treaty requiring the phasing out of all nonessential uses of CFCs. At that time, medical inhalers were considered an essential use because no viable alternative propellant existed. In 1989 pharmaceutical companies banded together and eventually, in 1996, reformulated albuterol with hydrofluoroalkane.

  C

  The transition began quietly, but as more patients see their prescriptions change and costs go up, many question why this bail must begin before generics become available. At least one member of the FDA advisory committee, Nicholas J. Gross of the Stritch-Loyola School of Medicine, has publicly regretted the decision, recanting his support and requesting that the ban be pushed back until 2010, when the first patent expires.

  D

  Gross notes that the decision had nothing to do with the environment Albuterol inhalers contributed less than 0.1 percent of the CFCs released when the treaty was signed. "Lt's a symbolic issue" Gross remarks. Some skeptics instead point to the billions of dollars to be gained by the three companies holding the patents on the available HFA-albuterol inhalers, namely Glaxo-SmithKline, Schering-Plough and Teva. Although the FDA advisory committee recognized that the expenses would go up, Hendeles says, it also believed that the companies would help defray the added costs for individuals, Firms, for instance, had committed to donating a million HFA inhalers to clinics around the country. According to Hendeles, GlaxoSmithKline did not follow through, although Schering-Plough and Teva did. GlaxoSmithKline did not respond to requests for comment.

  E

  The issue now, Hendeles says, is that pharmaceutical-grade CFCs are in short supply, and the public faces the risk of a shortage of albuterol inhalers if the FDA does not continue promoting the production of HFA inhalers. He posits that even costs of generics would go up as CFCs become scarcer. Gross disagrees, saying that the inhaler shortage and the closure of CFC manufacturing plants are a result of the ban.

  F

  The HFA inhalers also have encountered resistance because some asthmatics insist that they do not work as well as the CFC variety. But, Hendeles says, the differences are in the mechanics and maintenance—unlike CFC inhalers, the HFA versions must be primed more diligently and rinsed to accommodate the stickier HFA formulation. They also run out suddenly without the warning with a CFC inhaler, that the device is running low. "Pharmacists may not tell people of these things, and the doctors don't know," Hendeles says.

  G

  The main public health issue in this decision may be the side effects of the economics, not the drug chemistry. Multiple studies have shown that raising costs leads to poorer adherence to treatment. One study discovered that patients took 30 percent less amtiasthma medication when their co-pay doubled. In the ease of a chronic disease such as asthma, it is particularly difficult to get people to follow regular treatment plans. "Generally speaking, for any reason you don’t take medication, cost makes it more likely” that you do not, comments Michael Chernew, a health policy expert at Harvard Medical School.

  H

  Such choices to forgo medication could affect more than just the patients themselves. "For example," Hendeles points out, "in a pregnant mother with untreated asthma, less oxygen is delivered to the fetus, which can lead to congenital problems and premature birth." And considering that the disease disproportionately strikes the poor, what seemed to be a good, responsible environmental decision might in the end exact an unexpected human toll.

  Question 14-18

  Use the information in the passage to match the people (listed A-C) with opinions or deeds below. Write the appropriate letters A-C in boxes 14-18 on your answer sheet.

  NB you may use any letter more than once

  A Nicholas J. Gross

  B Michael Chernew

  C Leslie Hendeles

  14. Put forward that the increase in the price of drugs would contribute to the patients' negative decision on the treatment.

  15. Spoke out a secret that the druggists try to hold back.

  16. Pointed out that the protocol itself is not concerning the environment.

  17. Demonstrated that the stop of providing alternatives for CFCs would worsen rather than help with the situation.

  18. In public repented of his previous backing up of the prohibition proposal.

  Question 19-22

  Do the following statements agree with the information given in Reading Passage?

  In boxes 19-22 on your answer sheet, write

  TRUE if the statement is true

  FALSE if the statement is false

  NOT GIVEN if the information is not given in the passage

  19. It took almost a decade before the replacement drug for the asthma therapy was ultimately developed by the joint effort of several drug companies.

  20. One of the FDA committee members had a decisive impact on the implement of the ban on chlorofluorocarbons.

  21. As a matter of fact, the emitted chlorofluorocarbons in asthma treatment took up quite an insignificant amount at the time when the pact was reached.

  22. The HFA and CFC inhalers have something different regarding the therapeutic effect.

  Question 23-27

  Complete the following summary of the paragraphs of Reading Passage, using No More than Three words from the Reading Passage for each answer. Write your answers in boxes 23-27 on your answer sheet.

  American people with asthma would be impacted by...23...about chlorofluorocarbons which would consume the ozone layer. The usually used...24...would be considered illegal because it needs the propelment of...25.... The...26...would cost the patients considerably more money. Impoverished people are far more likely to Suffer from asthma and what makes it even worse is that some of them are in...27...condition.

  参考译文:

  大气变化

  A

  与《空气清洁法》相适应,联邦政府提出法令禁止使用消耗臭氧层的氯氟烃(CFCs)。讽刺的是,这一禁令影响了美国2290万哮喘病患者。一般吸入性沙丁胺醇(albuterol)是最常用的速效气喘处方用药,它需要用氯氟烃(CFCs)作为推进剂将其推送至肺部。自2008年12月31日起,这类吸入器将不能再合法销售。医生和患者都在质疑这一禁令是否真的明智,因为对于臭氧层保护,它并不能起到太大作用,反而是人们的钱包受到了很大影响:著名药商重新生产的替代药物价格提高到了40美元每管,是原来的哮喘药价格的三倍。这一现象更令人头疼的地方在于,哮喘病较为严重地影响到穷人,而且据调查,这些哮喘病患者中约有20%没有购买保险。

  B

  “做出这个改变只是出于政治原因,而不是出于医疗或科学考虑”,佛罗里达大学的药学家Leslie Hendeles说道。2007年,Leslie Hendeles和其他学者共同在《新英格兰医药杂志》发表了论文,就哮喘药物的撤离和转变作了解释。1987年,美国国会签署了国际性的《关于消耗臭氧层物质的蒙特利尔议定书》,要求逐步取消所有不必要的氯氟烃使用。当时,医疗吸入器是属于必须使用的范围,因为还没有可替代的推进剂可供使用。1989年,几家药商联合研发并最终于1996年成功使用氢氟烷生产出替代药物。

  C

  哮喘药物的这一转变悄悄地进行着,直到越来越多的患者看到他们处方中药名的改变以及费用的增加,开始质疑为什么要在药物普及化之前就颁布这一禁令。至少,FDA咨询委员会成员之一、来自Stritch-Loyola医学院的Nicholas J. Gross曾公开表示后悔这一决定,撤回了他此前支持这一决议的态度,并要求该禁令延迟到第一个专利到期的2010年。

  D

  Gross意识到禁止使用氯氟烃(CFCs)与环境毫无关系。签署《蒙特利尔议定书》的时候,使用沙丁胺醇吸入器所释放的氯氟烃(CFCs)不到总释放量的0.1%。“这项决议就是做做样子罢了”, Gross评论道。另外,一些对此持怀疑态度的人指出这几十亿美元是由持有新药物HFA沙丁胺醇专利的药商,即Glaxo-SmithKline, Schering-Plough和Teva这三家公司赚取的。Hendeles说,FDA委员会虽然意识到药物的费用会上涨,但是他们也认为这些公司会帮助个人支付药费中增加的部分。例如,这些公司已经承诺给全国各诊所捐赠100万支沙丁胺醇吸入器。据Hendeles说,Schering-Plough和Teva兑现了这一承诺,而Glaxo-SmithKline没有。Glaxo-SmithKline对于评述并没有做出任何回应。

  E

  Hendeles说,现在的问题是医用氯氟烃(CFCs)供不应求。如果FDA不加大HFA吸入剂的生产,公众还面临沙丁胺醇吸入器短缺的风险。他断定,随着氯氟烃(CFCs)越来越稀缺,即使是通用药物的价格也会上涨。Gross不同意这一论断,认为吸入器供不应求和氯氟烃(CFCs)生产商的倒闭都是禁令的实施导致的。

  F

  HFA吸入器也遇到了阻力:一些哮喘病患者认为它不如氯氟烃(CFCs)系列吸入器有效。但Hendeles说两者的不同之处只在于操作方法和保存方法。与氯氟烃(CFCs)系列不同,更具粘性的HFA系列需要更频繁地填充和清洗。另外,CFC系列会在药剂快用完时进行提示,而HFA系列则没有这一提示,患者会突然就用光了。“药商不会告诉人们这一点,而医生也不知道”, Hendeles说。

  G

  这项决议主要影响到了公众健康问题,但这是经济的副作用,而不是药物化学本身造成的。多项研究表明,药物费用增加导致人们不能坚持治疗。其中一项研究发现,综合治疗费用翻倍时,患者治疗使用的药物会减少30%。治疗如哮喘这样的慢性病,人们尤其无法按治疗计划坚持治疗。“一般来说,不管出于什么原因不使用药物,费用原因使得人们更不愿治疗”,哈佛医学院卫生政策专家Michael Chernew如是评论道。

  H

  选择放弃治疗影响的不仅仅是患者自身。Hendeles举例说,“如果一个孕妇没有治疗哮喘,输送给胎儿的氧气相对就比较少,这会导致胎儿的一些先天性疾病甚至是早产”。而考虑到这一问题尤其严重地影响到穷人,这一看起来很好很负责任的环境决策最终可能导致无法估计的人员死亡。


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