Diana Rae of Tenino, Washington, demonstrates Virtua/（虚拟的）Urgent Care with Dr. Ben Green in Seattle, who consults with her via Skype.
Telemedicine is the name for when doctors give advice to patients by telephone or the Internet, or when health care providers in rural areas connect with specialists in big cities.
Telemedicine has existed for a long time, but the rise of smartphone, tablets and webcam-equipped computers is raising telemedicine to new levels. Some health care systems in the United States now offer Virtual Urgent Care, patients see a doctor by video chat without having to leave home.
Diana Rae recently demonstrated how Virtual Urgent Care works. She used an iPad tablet and Skype—-the video chat service.
Doctor Green first has the patient describe her symptoms. Then the doctor performs a physical exam by demonstrating what he wants her to do. Doctor Green decides that the problem is an infection and gives her some penicillin for medicine. He says about 3 out of 4 patients who have health problems can be treated like this—through Virtual Urgent Care, which means a video chat could substitute a visit to the doctor’s office.
Franciscan charges $35 for this kind of virtual house call, that is much less than the cost of going to an emergency room, a doctor’s office or an urgent care clinic. After trying the video conference, Diana Rae says she would be happy to pay the 35 dollars, when she was recently home with a bad cold. "I would have paid twice that for the convenience of getting taken care of without having to sit in a waiting room, wait, and get exposed to everyone else’s germs." Rae said.
But a company official says state rules have not kept progress with development in telemedicine. The workers who provide Virtual Urgent Care must be licensed separately in each state where the company does business. For now, that means Franciscan doctors can treat patients in Washington state and California, for example, but not in neighboring Oregon or Idaho.
1. What is helping telemedicine to rise to new stages?（No more than 8 words）2. What does the underlined word "substitute" mean?（1 word）
3. Why would Diana Rae be happy to pay Virtual Urgent Care even more?（No more than 10 words）
4. Why can’t Virtual Urgent Care develop fast now?（No more than 10 words）
5. What do you think of Virtual Urgent Care’s future? Why?（No more than 20 words）
2 . A blocked airway can kill someone in three to four minutes, but it can take more than eight minutes for an ambulance to arrive. So a simple procedure such as opening someone’s airway can save their life while they’re waiting for emergency medical help. This means you’re more likely to give first aid to someone you know than a stranger.
There are many misconceptions surrounding first aid. Below are the "most popular" ones with details of what you should do.
Top four first aid misconceptions:
You should put butter or cream on a burn. The only thing you should put on a burn is cold water—keep the butter for cooking. Put the affected area under cold running water for at least ten minutes
The best way to treat bleeding is to put the wound under a tap. If you put a bleeding wound under a tap, you wash away the body`s clotting agents（凝血剂）and make it bleed more. Instead, put pressure on the wound with whatever is available to stop or slow down the flow of blood. As soon as possible call 911. Keep pressure on the wound until help arrives.
Nosebleeds are best treated by putting the head back. If you put the head back during a nosebleed, all the blood goes down the back of the airway. Instead, advise them to tilt（倾斜）their head forwards and ask them to pinch（捏）the end of their nose and breathe through their mouth.
You need lots of training to do first aid. You don’t—what you mostly need is common sense. You can learn enough first aid knowledge in a few minutes to save someone`s life—whether it`s from reading a book, attending a course or watching videos online.
Remember that anyone can save a life.
1. The most important point to save an airway blocked person’s life is to________.| A．keep his airway open |
| B．ensure the ambulance’s arriving time |
| C．keep the surroundings quiet |
| D．ask for emergency medical help immediately |
| A．put some cream on the burn area |
| B．heat up some butter for the burn |
| C．place the burn under cold running water |
| D．wash the affected area for a long time |
| A．It will help the bleeding stop at once. |
| B．The wound will help produce more clotting agents. |
| C．It will produce more pressure on the wound. |
| D．The wound will bleed more and it is hard to stop the bleeding. |
| A．When a person’s nose bleeds, please put the head back. |
| B．You can learn first aid quickly in different ways. |
| C．When a person is burnt, keep pressure on the burn until help arrives. |
| D．Not everyone can do first aid to save a life. |
| A．how to learn first aid by yourself |
| B．some misunderstandings about first aid |
| C．the importance of first aid |
| D．how to help the medical team save a life |
3 . CPR（cardiopulmonary resuscitation 心肺复苏术）and first aid are related topics. It could be said that first aid is the more general of the two, and training in first aid might include instructions and practice on how to respond to a variety of medical emergencies that could be posing threat to life or to a part of a person’s body. One such medical emergency could be cessation（停止）of breathing or heartbeat, and the appropriate response, in this case, might be to perform CPR. Thus, CPR can be seen as a type of first-aid response.
There can be differences in the amount of first-aid training people learn, and courses can sometimes be broken down into emergency and standard training. Standard training is actually the more extensive of the two, and would include teaching and learning how to handle a variety of medical situations like bites from insects or animals, broken bones, poisoning, childbirth, and care of wounds. Emergency first aid tends to be limited to the teaching of CPR, how to handle choking emergencies, and instruction on wound care for heavy bleeding.
CPR and first aid may be taught together or are sometimes taken as separate courses. People may need a whole day of practice or longer before getting CPR certification, which should be obtained from recognized agencies like the Red Cross. The big difference between CPR and first aid, in terms of taking classes, is that CPR focuses only on learning to perform cardiopulmonary resuscitation and recognize those circumstances as soon as possible in which it should be performed; while first-aid classes may teach this too, but they will teach in the broader context of how people need to respond to lots of different injuries or illness.
The issue of CPR and first aid may get confusing when people are asked to get training in one or both of these. Some people may be asked to take a first-aid course and have CPR training. Those who need more extensive training in standard first aid certainly won’t satisfy this need by only taking a CPR course. Those confused about what training they need should get this issue clear with the person（usually an employer）requesting the training.
Being able to respond first in a medical emergency usually means needing to know CPR, but other knowledge could be just as essential. For instance, how to stop uncontrollable bleeding or how to handle an episode of anaphylactic shock（过敏性休克）could be vital too.
1. What is the purpose of performing CPR?| A．To be qualified as a first-aid trainer. |
| B．To gain practical knowledge of first aid. |
| C．To deal with all the medical emergencies. |
| D．To make a person’s heart start beating again. |
| A．CPR works faster when someone breaks his leg. |
| B．Standard training deals with more medical cases. |
| C．Emergency first aid is more useful than CPR. |
| D．CPR includes most courses of emergency training. |
| A．After finishing the CPR training. |
| B．After saving someone with CPR. |
| C．When practicing a whole day in Red Cross. |
| D．When getting instructions from recognized agencies. |
| A．They are often given in one day. |
| B．CPR training might be included. |
| C．They are intended for professionals. |
| D．They focus on less urgent medical problems. |
| A．How can you receive first-aid training? |
| B．What can you usually learn in a first aid class? |
| C．What is the difference between CPR and first aid? |
| D．Why is CPR the most important first aid response? |
4 . A mum saved her daughter's life with her newly learned first aid skills. Sonya Hall, 33, of Denny Avenue, Lancaster, had only just attended one first aid class the day before when she found herself needing to use the skills on her three-year-old daughter Tilly.
Sonya, who also has son Emmen, six, attended the first aid course at Lune Park Children's Centre in Lancaster. Then she was faced with every parent's worst nightmare when Tilly went blue in the face and stopped breathing. But thanks to her newly acquired skills, Sonya saved Tilly's life.
Sonya said, “Tilly was playing with her brother and they were fighting over a toy. Emmen won the fight. Tilly fell backwards and her head was hit. She was face down and shaking and at first I thought she was upset. But then I saw she was blue in the face and had stopped breathing. I reacted without thinking and immediately started using the first aid skills I had learned the day before which were so fresh in my mind. I began doing mouth-to-mouth and chest compression(胸外按压). It probably took about a minute before Tilly started breathing again, but to me it felt like a lifetime.”
After getting Tilly breathing again, Sonya called an ambulance and the doctors came. Since then, Tilly has been diagnosed with Reflex Anoxic Seizure(反射缺氧发作). Sonya said, “The seizure can happen when there's any unexpected pain, fear or fright. It's just so lucky that the day before it happened, I had been practicing first aid."
The Empowering Parents First Aid course is run by Lancashire Adult Learning. Sonya said, “I am just so glad I did the course and I learnt the first aid skills. I always feared I would not know what to do in a crisis situation, but luckily I had the knowledge and skills to deal with it.”
1. What happened to Tilly?| A．She was knocked down by her brother. |
| B．She fell on the floor and hit her head. |
| C．She was hit by a toy on the head and felt upset |
| D．She was hit by her brother and stopped breathing. |
| A．be crying | B．recognize her failure |
| C．pretend to be hurt | D．be very angry |
| A．Tilly's illness would last all her life. |
| B．Sonya was very nervous and frightened. |
| C．It was very difficult to give first aid. |
| D．It was a long time before Tilly got breathing again. |
| A．enjoyable | B．excited | C．grateful | D．awkward |
| A．Mum saves girl with first aid | B．How to practice first aid |
| C．The importance of first aid | D．Mums should attend first courses |
Therapy dogs are dogs that are trained to give comfort (安慰) and love to people in unfortunate situations. They are often used to help people in hospitals, retirement homes, schools and disaster areas. Whether or not a dog is suitable for this line of work is based on its personality. Because therapy dogs must work with many kinds of people, such as young children or the elderly, they must have patience.
During World War II, a soldier named William Wynne found a dog abandoned (遗弃) on the battlefield. He became friends with the dog and named it Smoky. When Wynne became ill and entered a hospital, his friends brought Smoky for a visit. Smoky became so popular with the other sick soldiers in the hospital that he was allowed to stay. The doctors in the hospital used Smoky to help cheer up the patients. After the war ended, he continued to work as a therapy dog in the United States.
In the 1970s, an American nurse named Elaine Smith started a program to train therapy dogs. Smith noticed that patients in hospitals seemed to get better faster when they were around dogs. Many other doctors and nurses noticed that having animals regularly visit hospitals helped lower stress and blood pressure among patients. In the 1980s and 1990s, other animals also started to help the sick. Cats, birds and rabbits have become “therapy pets” and they are now used in many hospitals around the world.
Today, therapy pets not only help injured soldiers, but also help children with reading disabilities by providing an audience that won't look down upon them. Some therapy pets are used to work along with the doctor to help the patient learn to walk again after a serious injury.
1. What dogs are most suitable to be therapy dogs? (No more than 5 words)2. Why was Smoky allowed to stay in the hospital? (No more than 10 words)
3. What encouraged Elaine Smith to train and use therapy dogs? (No more than 8 words)
4. What does the underlined word ''therapy'' mean? (No more than 1 words)
5. What can we learn from the last paragraph? (No more than 15 words)
6 . Although vaccines(疫苗) are required for entry into school in most places in the United States, the government does allow for exceptions, like religious reasons.
In the last few years, the rates of vaccine-preventable illness have been on the rise. In most cases, these outbreaks began with children who were unvaccinated. To deal with this treat, some schools in New York have been refusing to allow unvaccinated children to attend school. Several parents thought this was unfair and field lawsuits(起诉). Just recently, though, a court ruled in favor of the city schools.
The court made the right decision. Vaccine policy depends not only on the added protection that vaccines provide for those who get shots, but also on the decreased likelihood that anyone will come into contact with the disease. This is known as community immunity. It refers to the fact that when enough people are immunized, then there really can’t be an outbreak. And if there can’t be an outbreak, then everyone is protected.
This is important, because there are people who cannot be given immunizations for various reasons. For example, small babies can’t be given all vaccines. In 1995, the chicken pox(水痘) vaccine was introduced in the United States. Over time, more and more children received it. In 2011, a study looked at how the program affected the number of children who died from the disease.
The first thing noted in the paper was the death from chicken pox went down considerably after the vaccine was introduced. From 2001 through 2007, the rates of death remained much lower, with just a few children dying from chicken pox nationally each year.
What’s more from 2004 through 2007, not one child less than 1 year of age died in the United States from chicken pox. This is important, because we cannot give the chicken pox vaccine to babies. In other words, all those babies were saved not because we vaccinated them against this illness, but because older children were.
Therefore, people who refuse to vaccinate their children aren’t just putting themselves at risk — they’re putting everyone else in danger, too.
1. What does the underlined word “outbreaks” mean in Paragraph 2?| A．Long peace. | B．Sudden starts. |
| C．Intense competition. | D．Planned escapes. |
| A．Students’. | B．School leaders’. |
| C．Several parents’. | D．Unvaccinated kids’. |
| A．Requiring everyone to be immune. |
| B．Vaccinating babies as early as possible. |
| C．Making sure enough people get vaccinated. |
| D．Separating unvaccinated people from vaccinated. |
| A．The vaccine is safe for every kid. |
| B．No deaths have been seen since 2004. |
| C．The vaccine has lowered the death rate. |
| D．The vaccine is more effective among babies. |
| A．No vaccine, no risk. |
| B．No vaccine, no school. |
| C．Vaccination is a personal choice. |
| D．Vaccine-preventable illness is dropping. |
7 . Jenny was driving her six-year-old son, Tony, to his piano lesson. They were late, and Jenny was beginning to think she should have given it up. There was always so much to do, and Jenny recently helped with an operation. She was tired. The storm and ice roads added to her tension. Maybe she should turn the car around.
“Mom!” Tony cried. “Look!” Just ahead a car had lost control on the patch of ice. As Jenny tapped the brakes, the other car wildly rolled over; then crashed sideways into a telephone pole.
Jenny pulled over, stopped and threw open her door. Thank goodness she knew her job well—she might be able to help these unfortunate passengers. Then she paused. What about Tony? She couldn’t take him with her. Little boys shouldn’t see scenes like that. But was it safe to leave him alone? What if their car were hit from behind? For a brief moment Jenny considered going on her way.
She asked Tony to stay in the car and ran, slipping and sliding, toward the crash site. It was worse than she’s feared. Two girls of high school age in the car. One was killed. The driver, however, was still breathing. Jenny quickly applied pressure to the wound in the teenager’s head while her practiced eye checked the other injuries. A broken leg, maybe two, along with probable internal bleeding. But if help came soon, the girl would live.
A trucker had pulled up and was calling for help on his cellphone. Soon ambulance and rescue workers came. “Good job,” one said while examining the wounds. “You probably saved her life!” Later the families of the victims came to meet Jenny, expressing their gratitude for the help she had offered.
1. What was Jenny doing when the accident happened?| A．She was helping with an operation. |
| B．She was driving for her son’s lesson. |
| C．She was driving home with her son. |
| D．She was making a telephone for help. |
| A．A taxi-driver. | B．A firefighter. |
| C．A nurse. | D．A teacher. |
| A．the tiredness of the driver |
| B．the truck who was telephoning while driving |
| C．the students’ careless driving |
| D．the bad weather and terrible road conditions |
| A．her poor skills of saving people |
| B．her little son’s safety in the car |
| C．her little son’s piano lesson |
| D．the students killed in the accident |
| A．the driver was saved thanks to Jenny’s timely help |
| B．there were at least two deaths in the car accident |
| C．Jenny was to blame for the terrible car accident |
| D．Jenny was late for his piano lessons for this accident |
8 . It can be truly terrifying to fall through ice on a frozen lake, but if you remain calm, it can save your life. Most people don’t realize that you have more time than you think. This is due to the concept of body temperature and how your body deals with the shocking cold that immediately surrounds the body.
As you first hit the freezing water, you will almost immediately breathe quickly. It is important that you remember to get control of your breathing and not to move around. It can help to remember the “1-10-1 principle”. This means that it takes about one minute to gain control of your breathing, and then you have 10 minutes to move before you get too cold. The final one is to remind you that it will take one hour before you become unconscious.
Take that first minute and fully focus on your breathing. Slow it down, and then look around to see if you can locate the thickest area of ice. When you locate the ice, stretch your arms over the surface, and then begin to do flutter-kick(上下打水) until your body becomes horizontal with the surface. Kick hard and use your arms and hands to climb out of the water.
It is possible that you can live for several hours after passing out if you can get out of the frigid water. This, however, does require some planning. You only have about 10 minutes after falling in before your muscles and nerves become too cold to work. If you feel too weak to get out, place your arms over the surface of the ice and just remain still. The point is to encourage your coat to freeze to the ice, so that if you lose consciousness(意识) you will keep your head out of ice. Additionally, you will remain visible for rescue, even if you pass out.
1. What does the underlined word “it” in Paragraph 1 refer to?| A．Keeping clam. |
| B．Having enough time. |
| C．Pushing through ice. |
| D．Dealing with the cold. |
| A．Moving around. |
| B．Calling for help. |
| C．Breathing rapidly. |
| D．Holding their breath. |
| A．How to use the first minute. |
| B．How to locate the thickest ice. |
| C．How to control the floating ice. |
| D．How to pull yourself onto the ice. |
| A．Take off your coat. |
| B．Do some workouts. |
| C．Keep your head above water. |
| D．Relax your muscles and nerves. |
| A．1-10-1 principle. |
| B．Hitting the freezing water. |
| C．Floating over the icy water. |
| D．Surviving falling through ice. |
9 . The health of millions could be at risk because supplies of medicinal plants are being used up. These plants are used to make traditional medicine, including drugs to fight cancer. “The loss of medicinal plants is a quiet disaster,” says Sara Oldfield, secretary general of the NGO Botanic Gardens Conservation International.
Most people worldwide rely on herbal (药草制的) medicines which are got mostly from wild plants. But some 15,000 of the 50,000 medicinal species are under threat of dying out, according to report from the international conservation group Plantlife. Shortages have been reported in China, India, Kenya, Nepal, Tanzania and Uganda.
Over-harvesting does the most harm, though pollution and competition from invasive species (入侵物种) and habitat destruction all contribute. “Businessmen generally harvest medicinal plants, not caring about sustainability (可持续性),” the Plantlife report says, “damage is serious partly because they have no idea about it, but it is mainly because such collection is unorganized.” Medicinal trees at risk include the Himalayan yew (紫衫) and the African cherry, which are used to treat some cancers.
The solution, says the report’s author, Alan Hamilton, is to encourage local people to protect these plants. Ten projects studied by Plantlife in India, Pakistan, China, Nepal, Uganda and Kenya showed this method can succeed. In Uganda, the project has kept a sustainable supply of low-cost cancer treatments, and in China a public-run medicinal plant project has been created for the first time.”
“Improving health, earning an income and keeping cultural traditions are important in encouraging people to protect medicinal plants,” says Hamilton, “You have to pay attention to what people are interested in.”
Ghillean Prance, the former director of the Royal Botanic Gardens at Kew in London, agrees that medicinal plants are in need of protection. “Not nearly enough is being done,” he told New Scientist. “We are destroying the very plants that are of most use to us.”
1. From the first two paragraphs, we can learn that ________.| A．millions of people are threatened with-cancer |
| B．most countries see a shortage of herbal medicines |
| C．about two thirds of medicinal species will disappear |
| D．a number of medicinal species are in danger of extinction |
| A．pollution | B．habitat destruction |
| C．over-harvesting | D．invasive species |
| A．over-harvesting | B．sustainability |
| C．other species’ invasion | D．pollution |
| A．Protecting medicinal plants has a long way to go. |
| B．Ghillean Prance is optimistic about medicinal plants’ future. |
| C．Local people don’t know how to protect medicinal plants. |
| D．China has made great progress in protecting medicinal plants. |
| A．Low-cost Cancer Treatment |
| B．The Importance of Sustainability |
| C．Medicinal Plants on Verge of Extinction |
| D．Sustainable Development of the Environment |
10 . Most people will experience at least one wrong medical diagnosis in their lifetime, resulting in health problems, psychological suffering and financial cost, according to a new report. Because diagnostic errors are generally discovered in retrospect(回顾), researchers said more work needs to be done to improve medical teams and find ways to avoid errors that can change people’s life in the distant future.
“Diagnosis is a collective effort that often involves a team of health care professionals---from primary care physicians to nurses.” said John Ball, chair of the committee which wrote the report. “The type of a single physician observing a patient case and deciding a diagnosis is not always accurate, and a diagnostic errors, we have to look more broadly at the entire process of how a diagnosis is made.”
The researcher, said there are not enough data on diagnostic errors, and efforts to improve diagnosis and reduce errors have not been frequent. The medical culture discourages transparency and makes it more difficult to correct them. The blame lies in cooperation and communication between members of medical teams treating patients, patients themselves, and their families. Besides this, researchers found the healthcare system is not designed for the collaboration needed in the diagnostic process and that diagnosis will continue to worsen if new ideas are not put forward.
The committee recommended more information, from electronic health records to test results, be made more easily available to families and caregivers, to help them better learn and understand what is going on with their health. Creating an environment for patients to question a diagnosis or add information about their condition could also help better influence diagnosis.
Most significantly, the researchers said methods need to be established to make communication between doctors and patients easier. Doctors are not encouraged or paid to communicate with patients as much as they should be.
1. It can be inferred from the new report that .| A．diagnostic errors have a great influence on people |
| B．new ways are found to avoid diagnostic errors |
| C．nobody can avoid those diagnostic errors |
| D．diagnostic errors are difficult to be found |
| A．For lack of advanced technological equipment |
| B．For lack of strict rules of managing the medial environment |
| C．For lack of enough professional knowledge about medicinal treatment |
| D．For lack of cooperation and communication between physicians, patients and their families |
| A．Researches on the diagnostic process |
| B．New ways to better protect patients |
| C．Advice on reducing diagnostic errors |
| D．Communication between patients and doctors |
| A．Because of the different belief |
| B．Because of the medical situation |
| C．Because of being short of money |
| D．Because of the current rules |
| A．a hospital advertisement | B．a science book |
| C．a medical magazine | D．a research report |
