1、大学英语六级改革适用（阅读）模拟试卷 79及答案与解析 Section B 0 Patients Struck off by GPs A)Thousands of patients are being arbitrarily struck off by GPs(普通开业医生 )who say they can no longer cope with spiralling numbers. Doctors warned last night that a recruitment crisis has left surgeries with too few staff. This means th
2、ey are being forced to “deregister“ patients many of whom are elderly and have been with the same practice all their lives. B)Yesterday the Daily Mail highlighted the case of 95-year-old Lily Dove, one of 1,500 patients randomly struck off by a surgery in Watton, Norfolk, which is under pressure fro
3、m rising immigration and retirees. The widow, who has lived in the area since 1919 and remembers when the doctor would visit her family in a horse and trap, has a number of health problems. C)But senior GPs say her case is far from isolated and illustrates a national problem. They say other practice
4、s in England have been forced to deregister up to 100 patients at a time. Doctors leaders argue that they have no choice but to remove patients because the lack of GPs means they cannot provide care that is safe and of high quality. D)But relatives and patients fear vulnerable patients are being del
5、iberately removed from lists because they take up the most time and require such dedicated care. Other patients furious to have been kicked off their doctor s books yesterday included an 80 year-old widow, a blind child and a mother of 11 children. In another example, a practice deregistered a nursi
6、ng home of 59 residents, many of whom have Alzheimer s, because of a “big change in workload“. E)GPs say the profession is facing a recruitment crisis as their colleagues opt for early retirement or a move abroad. They are not being replaced by younger staff, who are often opting for hospital-based
7、careers. In the case of Watton, which is about 20 miles west of Norwich, surgeries are under pressure from a sudden rise in retirees and immigrants moving to the area. F)Last night health minister Earl Howe intervened in the case of Mrs Dove, who lives alone, and urged NHS England to “urgently“ look
8、 into the circumstances of her being struck off. He told GPs to ensure they provided “excellent care“ for all their patients, particularly the over-75s and those with longterm health conditions. G)But it has since emerged that Mrs Dove s surgery, Watton Medical Practice, has also removed other vulne
9、rable patients including a 47-year-old former soldier who has lost both legs due to severe diabetes. Dave Pendry, who is wheelchair-bound, now faces a 14-mile round trip to see his new GP in the village of East Harling. Kirsty Hutchinson, a mother to 11 children, will have to travel 16 miles every t
10、ime one of them is ill or needs an injection. And two elderly widows said they now faced difficult journeys down dangerous country roads to see their doctor. H)Other GPs warned that more surgeries would follow suit. Referring to the case in Watton, one GP partner wrote anonymously on the Pulse magaz
11、ine website: “Just wait for the domino effect.“ The practice which has deregistered a nursing home of 59 elderly residents is the Bellevue Medical Centre in Edgbaston, Birmingham the practice of Professor Steve Field, the chief inspector of GPs. I)It says it has been forced to remove a total of 75 p
12、atients who live the furthest away since a doctor retired. The decision has upset some relatives who fear the surgery has deliberately targeted the nursing home because the residents require so many visits. One said: “I think the real reason is that nursing home residents are often difficult to mana
13、ge, lots of health problems, on a lot of medication. Im sure that if they were “easier“ patients, the surgery would keep them on.“ J)The surgerys executive partner Dr Sukdev Singh insisted the reason was because there had been a “big increase in workload“ following the retirement of a doctor. He sai
14、d about 75 patients were being removed from the list as they lived outside the practices boundary. He added: “Its a national problem. We are struggling to recruit doctors and we do not have the necessary funding.“ K)There are no national figures for the numbers of patients who have been removed from
15、 surgery lists because of GPs workload. But Dr Chaand Nagpaul, chairman of the British Medical Associations GP Committee, said it was important that surgeries did not “discriminate“ against certain patients who may require more time and care. “It would not be appropriate for practices to pick and ch
16、oose, “ he said. He added: “I do not know the circumstances here but these decisions must not be taken lightly and practices must ensure they do not discriminate against certain patients. If there are boundary issues, the practice needs to make sure all patients outside the boundary are taken off th
17、e list, not just one cared home. “ L)In Watton, parish council leader Richard Leighton said: “There s immigration, because people are coming to work in the slaughterhouse and food factories around here. “ British people are also moving here because there s work about, and there are retired people wh
18、o sell up in London and buy a cheaper home here. “They keep building homes here because the Government says the area can take more people, but the infrastructure can t cope.“ M)Gillian Childerhouse, 80, who is being struck off after being on the surgery s register for almost 50 years, said: “Ive nev
19、er been much trouble to them as Im pretty fit but Ive been dumped along with the rest of them. Older people are not very important in this country. They don t want us. We re just a damned trouble. “ N)Referring to the case of Mrs Dove, Earl Howe said: “We have asked NHS England to urgently look into
20、 the case. We expect practices to work with their patients and NHS England to make sure that residents get the excellent care they need from local GPs, particularly those over 75 or with long-term conditions. “ O)Cancer specialist Dr Clive Peedell, coleader of National Health Action Party, said: “I
21、ve certainly heard that up and down the country patients are being removed from practice lists because they can t deal with the workload. The pressures are enormous at the moment. There are real staffing issues and we are extremely worried about the lack of funding. The Royal College of GPs says the
22、y are short of 8,000 GPs.“ 1 Removing patients from the register is a national problem because there is not enough GPs. 2 The profession is now lacking GPs seriously because many GPs are leaving and there are not enough new GPs to replace the them. 3 Because of the recruitment crisis, many GPs have
23、no choice but to deregister many patients. 4 Since a doctor has retired, 75 patients has been removed from the register but many people guess that the surgery has remove patients in the nursing home on purpose. 5 There is very likely to be more patients to be deregistered by GPs in the future as mor
24、e GPs will follow suit. 6 Dr Sukdev Singh said they removed those 75 patients because the workload increased hugely when a doctor retired. 7 Some relatives and patients worry that the surgeries may remove vulnerable patients who need more time and careful care, such as residents in a nursing home. 8
25、 Because of the immigration, the workload has increased in this area and the GPs can not cope with so many people. 9 There is no national figure for those removed patients by far but Dr Chaand Nagpaul worn that the surgeries should not remove some patients because they take more time and care. 10 Gi
26、llian Childerhouse said that he has been struck off because old people have no use and they don t want them. 10 Social Media and Marketing A)In May 2013, Ritz-Carlton Hotel Co. bought ads to promote its brand page on Facebook. After a few days, unhappy executives halted the campaign but not because
27、they werent gaining enough fans. Rather, they were gaining too many, too fast. “We were fearful that our engagement and connection with our community was dropping“ as the fan base grew, says Allison Sitch, Ritz-Carlton s vice president of global public relations. B)Today, the hotel operator has abou
28、t 498,000 Facebook fans; some rivals have several times as many. Rather than try to keep pace, Ritz-Carlton spends time analyzing its social-media conversations, to see what guests like and dont like. It also reaches out to people who have never stayed at its hotels and express concern about the cos
29、t. C)Ritz-Carlton illustrates a shift in corporate social- media strategies. After years of chasing Facebook fans and Twitter followers, many companies now stress quality over quantity. They are tracking mentions of their brand, and then using the information to help the business. “Fans and follower
30、 counts are over. Now it s about what is social doing for you and real business objectives,“ says Jan Rezab, chief executive of Socialbakers AS, a social-media metrics company based in Prague. D)When many companies joined Facebook in the late 2000s, they used it as another brand website where they p
31、rovided links, contact information and monitored consumer gripes. Then, they got caught up in the numbers game, trying to rack up raw masses of fans and followers, believing they were building a solid marketing channel. But that often wasnt the case. “Social media are not the powerful and persuasive
32、 marketing force many companies hoped they would be,“ concludes Gallup Inc., which on Monday released a report that examines the subject. E)Gallup says 62% of the more than 18,000 U.S. consumers it polled said social media had no influence on their buying decisions. Another 30% said it had some infl
33、uence. U.S. companies spent $5.1 billion on social-media advertising in 2013, but Gallup says “consumers are highly adept at tuning out brand-related Facebook and Twitter content.“(Gallup s survey was conducted via the Web and mail from December 2012 to January 2013. The survey has a margin of error
34、 of plus or minus 1 percentage point.) F)In a study last year, Nielsen Holdings NV found that global consumers trusted ads on television, print, radio, billboards and movie trailers more than social-media ads. Gallup says brands assumed incorrectly that consumers would welcome them into their social
35、 lives. Then they delivered a hard sell that turned off many people. G)More recently, changes in how Facebook manages users news feeds have hindered brands ability to reach their fans. Rather than a largely chronological stream, Facebook now manages the news feed to feature items it thinks users wil
36、l want to see. The result: brands reached 6.5% of their fans with Facebook posts in March, down from 16% in February 2012, according to EdgeRank Checker, a social-media analytics firm recently acquired by Socialbakers. H)Indian Road Cafe in New York City estimates it spent about $5,000 on Facebook a
37、ds, and its page now has about 13,000 fans. “But the return is really disappointing“, says co-owner Jason Minter. “Unless you spend to boost a post, you only reach 300 to 400 people. Ive certainly noticed the loss of organic reach. You spend all this time, and unfortunately, the return is not there.
38、“ Mr. Minter says the restaurant still uses Facebook, but in a more targeted way, and is looking to a new website and other digital marketing approaches rather than building up the Facebook audience. I)A spokesman for Facebook Inc. says companies need to adjust their priorities. “The way brands shou
39、ld think about this is changing,“ he says. “Fans should be a means to positive business outcomes not the end themselves.“ The spokesman says Facebook has been honest with companies about the diminishing reach of their posts. J)Companies reach more nonfans than fans on Facebook, as friends share cont
40、ent, which pushes posts higher in Facebooks ranking system, according to Socialbakers. That puts value on conversation, rather than just posting content. K)Another reason companies are looking beyond fan numbers is that the numbers are easily gamed. Researchers say many fans are fake, or automated,
41、accounts designed to inflate numbers. Italian security researcher Andrea Stroppa says he found a new breed of sites offering Facebook fans or Twitter followers for pennies. In experiments, Mr. Stroppa paid 42 cents for 700 fans and seven cents for 100 likes on a Facebook post. L)While companies are
42、adjusting their social media strategies, they continue to advertise on Facebook. First-quarter net income nearly tripled at the social-network on a 72% increase in revenue. Twitter Inc. says companies can have big followings as well as meaningful conversations with users. “Engagement is key and is s
43、omething that can in turn further grow your audience,“ says Ross Hoffman, Twitters director of brand strategy. “The onus of good content is on the marketer, and we are working with brands and agencies to sharpen this skill.“ M)Indeed, some brands value a large social-media community. “We want to rea
44、ch a very large audience,“ says Ben Blatt, executive director of digital strategy at Walt Disney Co. s ABC Television. The Facebook page for “Dancing with the Stars“ has 5.2 million likes. Mr. Blatt says such a large fan base can be useful in tracking how popular one theme or episode is compared wit
45、h others. N)Cable and media company Comcast Corp. monitors social media extensively and analyzes data from 11 different sources, including which consumers click its links, engage with its social content or discuss its products and services. Those tools help Comcast see trends about the quality of se
46、rvice nationally or regionally, or ideas for new features, says Robin Dagostino, who runs social media for Comcast. O)The NBA has 23 million Facebook fans. But executives are less concerned by the numbers than capitalizing on the social chatter. The NBAs social team monitors conversation across a va
47、riety of social networks during games and posts video highlights of games in real time, hoping to prompt people to tune in to television. Employees monitor comments on social media to see what fans thought of a commercial, or when might be the best time to sell a T-shirt. “We want to give them more
48、of what theyre talking about,“ says Melissa Rosenthal Brenner, the league s senior vice president of digital media. 11 Some brands want a large amount of fans on the Facebook such as Walt Disney which can use its fan base to test the popularity of one particular episode. 12 In a study last year, the
49、y found that people do not have much trust in ads on social-media so many brands sells on the social media are useless. 13 The NBA use social network to prompt people to watch their games and to gather information about how and when to sell products. 14 Though some companies are changing their social-media strategies, they still use it to advertise its products and the Twitter Inc. says the key to make it useful is engagement. 15 Spokesman of Facebook Inc. says companies should not take fans as the end but rather they should use
