All posts by Jomon John

Insulin injection

PATIENT. Role play. SETTING: Home Visit 
You have been a diabetic for a number of years and have managed your diabetes with diet and tablets. However, your doctor wants you to start having insulin injections and has asked the district nurse to visit you at home to teach you how to give yourself these injections. You don’t really understand why you have to have insulin injections. Also, you are very nervous about the procedure of injecting yourself. 
TASK
•Ask the nurse why you have to have insulin injections, stressing that you feel you have been managing your diabetes well.
•When the nurse is explaining the procedure for giving the insulin injections, show that you are anxious about it.
NURSE. Role play. SETTING: Home Visit 
A general practitioner has asked you to visit a patient who has diabetes. Until recently, the diabetes has been moderately well-controlled by diet and oral medication. However, recently the patient’s blood sugars have been high, and the doctor has decided to commence insulin injections. The doctor wants you to show the patient how to give himself/herself the insulin injections. On arriving at the patient’s home, you find that he/she is very unsure why he/she needs insulin injections and very nervous about the procedure of administering the insulin. 
TASK
•Explain to the patient, when requested, why he/she needs insulin injections.
•Explain slowly and clearly the whole process of giving the injection (including using clean needles, administeringthe injection, sites for injection, etc.).
•Try to reassure the patient that he/she will be able to manage the injections.
•Emphasize the importance of safe needle disposal (suitable containers, proper care and handling). 

Sample role play by Lifestyle Training Centre (live transcript):

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Aching feet

PATIENT. Role play. Setting: Private Clinic 
You are a 52-year-old working long hours in customer service. You are tired and have been experiencing aching feet. Sometimes you have numbness and tingling, which is worse at night. You are worried because your uncle has Multiple Sclerosis and your aunt has Parkinson’s disease. 
TASK
•Tell the nurse that you are very tired, you suffer from symptoms in the feet, your memory is not too good, and when you are stressed, your hands shake.
•Explain that your work is stressful, moves at a frantic pace, and you have dozens of things to remember but don’t write them down. What can be done?
•Accept that perhaps stress is causing your symptoms.
•Agree to a referral to a podiatrist and seek advice from a doctor.
•Reluctantly express the ‘real’ reason you are here – you are extremely ‘paranoid’ about the chance that you may have a neurological disease because of your family history.
NURSE. Role play. Setting: Private Clinic 
You are attending to a 52-year-old who works long hours in customer service. The patient complains of being tired and has been experiencing aching feet. Sometimes he/she has numbness and tingling, which is worse at night. The patient admits to being ‘paranoid as his/her uncle has Multiple Sclerosis and his/her aunt has Parkinson’s disease. 
TASK
•Explain that working long hours and stress may produce symptoms such as tiredness and poor memory.
•Suggest initial steps to improve sore feet issues (e.g., comfortable shoes, orthopaedic shoes; compression stockings, etc.).
•Emphasise that you think the patient may be putting too much stress on him/herself.
•Recommend a visit to a podiatrist.
•Advise the patient to arrange a medical appointment.
•Highlight the importance of not self-diagnosing and thinking the worst.

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Osteomyelitis

Asked for 12 SEP 2020 OET speaking session

PATIENT. Role play. SETTING: Hospital Ward 
You are 48 years old and are in hospital because you have developed a bone infection (osteomyelitis) in your leg. 
TASK
•When asked, say that you’ve been feeling a bit feverish since you woke up today.
•Say you’re still in a lot of pain.
•Say the pain isn’t any better or worse than it was before. Say you don’t understand why the nurse is asking you about changes in pain.
•Say you’re not very clear why you can’t just take antibiotic tablets instead of the drip and then go home.
•Ask how long you’ll need to take antibiotics for.
•Agree to let the nurse do the checks.
NURSE. Role play. SETTING: Hospital Ward 
You are checking on a 48-year-old patient who has developed osteomyelitis (a bone infection) in his/her leg. 
TASK
•Explain your role (e.g., monitor wound, take vital signs, check intravenous drip, etc.). Find out how the patient is feeling.
•Describe the symptoms of osteomyelitis (fever, pain, etc.). Reassure the patient about his/her progress(reduction in fever, positive effect of antibiotics, etc.). Find out more details about the pain (change in level, change of location, any new pain, etc.).
•Give reasons for exploring changes in pain (e.g., importance of monitoring, possible sign of secondary infection, etc.). Advise the patient to communicate any changes in pain. Find out if the patient has any other concerns.
•Explain treatment stages before discharge (control infection, switch to oral antibiotics, establish self-medication routine, etc.).
•Describe antibiotic treatment plan (several more days intravenously in hospital, 4-6 weeks in tablet form at home). Establish the patient’s willingness for you to do the necessary checks 

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MRSA screening

Asked for 5 December 2020 OET speaking session

PATIENT. Role play. Setting: Pre-Surgery Clinic 
You are 60 years old and are going to have an operation on your knee this week. You have been told you need to have MRSA (methicillin-resistant Staphylococcus aureus) screening. You attend an appointment for a preoperative assessment and ask for more information about the screening. 
TASK
•When asked, say you have been told that you need to get tested for MRSA, but you don’t really understand why it is necessary.
•Say the reason for the MRSA screening is clear now but you’d like to know more about what the screening involves.
•Ask what will happen if the test confirms that you have the bacteria.
•Say even if your test is negative now, you are worried you might pick up the bacteria in hospital, and then won’t be able to have the operation.
•Say everything is a lot clearer now; you are okay to have the screening.
NURSE. Role play. Setting: Pre-Surgery Clinic 
You see a 60-year-old patient who is going to have an operation on his/her knee this week. He/she attends the clinic for a preoperative assessment and wants more information about the MRSA (methicillin-resistant Staphylococcus aureus) screening. 
TASK
•Confirm reason for patient’s appointment (preoperative assessment before knee operation). Find out if patient has any questions.
•Give information about MRSA (e.g., common skin/nasal bacteria, resistant to antibiotics, harmless to healthy people, causes complications for surgery/recovery, etc.). Describe purpose of MRSA screening (e.g., infection control in hospitals, etc.).
•Outline procedure for MRSA screening (e.g., swabs from nose/groin, sent to laboratory for testing, results within a few days, etc.). Find out any other concerns.
•Explain next steps if result is positive (e.g., prescription for antiseptic body wash, extra hygiene measures, ointment for nostrils: five days, retest, etc.).
•Reassure patient about precautionary measures to prevent spread of bacteria (strict cleaning regime, e.g.,antibacterial hand-wash, sterilisation of equipment, monitoring of facilities, etc.). Establish patient’s consent to have screening.

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Bladder infection 

Asked for 26 sep 2020  OET speaking session

PARENT. Role play. SETTING: City Clinic 
You are the parent of a 4-year-old girl who has a suspected bladder infection, which she gets frequently. The doctor has requested a urine sample, and you see the nurse to get a sample bottle and to check the procedure for getting the urine sample. 
TASK
•When asked, say you need to get a urine sample for your daughter, who’s only four. Say you want to check that you just need to get her to pee into a container and then collect the sample from that.
•Say you’ll follow the nurse’s instructions. Ask how quickly you need to bring the urine sample to the clinic.
•Say your daughter keeps getting bladder infections, and you don’t think this problem will be resolved soon.
•Say the doctor gave you lots of advice, for example, about hygiene, which you have been following. Admit it’s really difficult to get your daughter to drink anything, and she doesn’t like using the toilet at nursery.
•Say that you are glad it is just a phase, and you’ll get the sample done as quickly as you can.
NURSE. Role play. SETTING: City Clinic 
You see the parent of a 4-year-old girl who has a suspected urinary tract infection (UTI), which she gets frequently. You give the parent a sample bottle and advice on the procedure for collecting a urine sample, which the doctor has requested. 
TASK 
 Find out the reason for the parent’s request to see you.
 Outline the urine collection process (e.g., get girl to drink water to fill bladder, collect mid-stream, use sterile sample bottle, etc.). Stress importance of not contaminating the sample (e.g., unreliable test results, cause of bladder infections not identified, etc.).
 Outline the next steps after sample collection (taken to the clinic within 12 hours, initial dipstick test, full lab analysis if needed, etc.)
 Give information about bladder infections in children (e.g., common, caused by reluctance to pee/lack of hydration, etc.). Establish what advice the doctor gave the parent (hygiene, cotton underwear, unscented/unperfumed products, etc.).
 Reassure the parent about child not using the toilet at nursery (e.g., common phase, will grow out of it as she gets used to the teachers, etc.). Give advice on hydration (e.g., fruit, ice blocks, etc.) 

View sample role play on YouTube

Role pay script from live speaking

Nurse: Hi, I am John, one of the registered nurses working here in this clinic. How can I help you today?

Patient: Hi John. I am Sheena. Um, I’m actually here for my daughter, and she is suspected of suffering from a urinary tract infection.

Nurse: I’m so sorry to hear that.

Patient: It’s okay. Actually, the doctor has requested us to get a urine sample, so I’m here to collect a sample bottle in order to collect her urine sample. Would you help me with that?

Nurse: Certainly. But before we proceed any further, I’d like to collect some information for documentation purposes. Is that all right?

Patient: Sure.

Nurse: How old is your daughter?

Patient: She is four.

Nurse: And do you know how to collect this urine sample?

Patient: Yeah, I guess so. Is there anything that I should do extra? I thought I just had to get my daughter to pee, collect the sample, and bring it to the lab. Am I thinking correctly?

Nurse: Yes, you are right. However, let me explain to you the proper procedure so that you can do it accurately. May I?

Patient: Sure.

Nurse: Please make sure that your daughter drinks plenty of water first.

Patient: Okay.

Nurse: When she pees, do not collect the sample immediately, but wait for a few seconds and collect the midstream urine so that you get a proper sample. Do you understand?

Patient: Oh, okay. That makes sense.

Nurse: And please make sure that the sample does not get contaminated by any means. If it gets contaminated, it would result in unreliable test results, and the doctors may not be able to identify the exact reason for the infection or pinpoint the proper cause. Do you understand?

Patient: Yeah, I’ll make sure that the sample is not contaminated. You know, I get frustrated at times; my daughter keeps getting this infection. I don’t know why, and I don’t know how long I have to keep bringing her to the hospital and so on.

Nurse: I certainly understand your concern, but don’t worry. This is just a phase in her life. It is quite common with children, particularly children of your daughter’s age.

Patient: Uh-huh, okay.

Nurse: So, has the doctor given you any advice regarding how to manage this condition?

Patient: Actually, the doctor has told me a lot of things. I recollect him talking about the importance of following hygiene and so on.

Nurse: Yes, hygiene plays a vital role here, particularly in this condition. Please also make sure that your daughter wears cotton underwear. Moreover, she should avoid scented and perfumed products. Do you understand?

Patient: Yes, I do understand. Thanks for that. One more thing, I really can’t get her to drink water. She doesn’t like drinking water, and she does not like using the toilets at nursery. I don’t know what to do.

Nurse: I totally understand your concern, but do not worry. This is just a common phase and is quite common among children of this age. Your daughter will just grow out of it. Do you understand?

Patient: Oh, okay. That’s a good thing, and I’m relieved to hear that it’s just a phase.

Nurse: Yes, definitely. I can give you a few tips to improve her hydration. If she does not like drinking water, you can introduce fruits and even ice blocks to her. In that way, somehow, she’ll get water into her system. How does that sound?

Patient: That sounds brilliant! I can definitely do that.

Nurse: Okay. Is there anything else that you would like to ask me?

Patient: No, I’ll just get the bottle, collect the sample, and bring it back to you as soon as possible. Thank you so much for listening to my concern and explaining all these things. I appreciate it.

Nurse: You’re welcome. I’ll provide you with a sample bottle, and you can bring it within 12 hours. Please remember not to collect the urine immediately but to collect the midstream urine. We will start with a dipstick test and may also go for a full lab analysis. Please remember, this is just a phase in your daughter’s life, and she will grow out of it. Make sure that she follows proper hygienic practices and wears cotton underwear, avoiding scented and perfumed products. Okay?

Patient: All right, thank you.

Nurse: So, I’ll see you next time.

Patient: Thank you.

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Transesophageal echocardiogram (TOE)

Asked for 12 Sep 2020  OET speaking session

PATIENT. Role play. SETTING Hospital outpatient Clinic
You are 52 years old and have been given information about the transoesophageal echocardiogram (an ultrasound of the heart using four small cameras going down the throat) that you are going to have next week. 
Task
•When asked, say that you have never had an echocardiogram before and are feeling quite nervous.
•Ask if there is anything you should do before you have the procedure.
•Say that you hope you feel okay afterwards as you are planning to go out with friends.
•When asked, say that you have arranged for a friend to come with you and she’ll stay with you afterwards too. Also, mention that you don’t want to have to wait for long for the results.
•Say that the information provided is clear, but you will be glad once the procedure is over.
NURSE. Role play. SETTING Hospital outpatient Clinic
You are giving a 52-year-old patient information about a transoesophageal echocardiogram (TOE) he/she is going to have next week. 
TASK
•Confirm the patient is scheduled to have a transoesophageal echocardiogram. Find out if the patient has had one before.
• Explain the function of transoesophageal echocardiogram (e g. provide detailed images, check structure of heart, analyse blood flow, enable planning of surgery/treatment, etc.)
• Outline pre- TOE requirements (e.g., avoid food/drink 6 hours before. etc. Describe preparation at the hospital (e.g.,anaesthetic spray, light sedation, mouth-guard etc)
•Advise patient about the after-effects e.g., possible discomfort/soreness drowsiness, etc)
• Outline post-procedure steps (pre-discharge: observation period; post-discharge accompanied, no driving for 24 hours, etc.). Find out if the patient has someone to support him/her post-discharge
•Give information about results [scan analysed. probably 1-2 weeks, subsequent follow-up appointment with GP).

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Catarrh

Asked for 11 OCT 2020  OET speaking session

PATIENT. Role play. SETTING Community Health Centre 
You are 22 years old and have had a cold which has left you with a build-up of mucus (catarrh) and & constant need to clear your throat. You have come for advice on treatment.

TASK
§ When asked, say you have had a cold for a couple of weeks and it’s left you with a build-up of mucus, which means you need to clear your throat a lot. This is quite unpleasant for you and people around you. Say you want some advice on treatment.
§ Say you don’t have a runny nose, but you are coughing up lots of white mucus and your face and neck hurt as a result. Your senses of smell and taste are fine.
§ Say you were hoping the nurse would give you a prescription for something which would be more effective than over- the-counter medication.
§ Say you will try over-the-counter medication, but you are worried the problem might carry on for a long time.
Say you It follow the nurse’s advice and will make an appointment with your GP if there is no improvement
NURSE. Role play. SETTING Community Health Centre 
You see a 22-year-old patent who has had a cold and as a result has a build-up of mucus (catarrh) and a constant need to clear his/her throat. He/she wants some advice on treatment.

TASK
§ Find out the reason for the patient’s visit
§ Find out more details of symptoms (runny nose, colour of mucus, facial pain, reduced sense of smell/taste, etc.)
• Ouitline ways to relieve catarrh (e.g., drink cold water before clearing, saline nasal rinse. avoid warm dry atmosphere, stay well-hydrated, etc.), Suggest over-the-counter medication (e.g., decongestants, antihistamines, etc.).
• Resist request for prescription (e.g., not necessary. not your role, etc.).
• Reassure patient about catarrh (e.g., usually temporary, not harmful, self-limiting, etc.). Advise need to see GP if problem persists for more than six weeks {e.g., rule out any underlying condition/unidentified food sensitivity etc)

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Pneumococcal Polysaccharide Vaccination (PPV)

Asked for 26 Sep 2020 OET speaking session

PATIENT. Role play. Setting: Suburban Clinic 
You are 62 years old and have rheumatoid arthritis. You are attending an appointment to get information about the Pneumococcal Polysaccharide Vaccination (PPV) which you have been advised to have.

Task
§ When asked, say that the clinic sent a letter to say you had to have the vaccination. Say that you don’t think you need to have it.
§ Say that you always get an annual flu jab; you thought that would be enough protection.
§ Ask if you are likely to feel unwell after you have the vaccination.
§ Say you had an annual flu vaccination two weeks ago so maybe it is better to wait before you have another vaccination.
§ Say you felt fine after the flu vaccination; it didn’t cause any problems at all.
§ Agree to have the vaccination.
NURSE. Role play. Setting: Suburban Clinic 
You see a 62-year-old patient who has rheumatoid arthritis. He/she is attending an appointment to get
information about the Pneumococcal Polysaccharide Vaccination (PPV) which he/she has been advised to have.

Task:
• Confirm the reason for the patient’s visit (PPV).
• Explain the need for the vaccination (e.g., rheumatoid arthritis patients at higher risk of pneumococcal infections/compromised immune systems, etc.). Stress the importance of immunisation against pneumococcal infections (e.g., pneumonia, septicaemia, etc.).
• Give details about the vaccines: PPV (bacterial, remains the same, given every three years, etc.) and flu (viral, strain constantly changes, given yearly, etc.).
• Outline possible temporary mild side effects (e.g., slight temperature, redness/swelling at injection site, etc.). Recommend making an appointment with a GP if not well.
• Ask the patient about any reaction to the flu vaccination (e.g., high temperature, muscle aches, fatigue, etc.).
• Reassure the patient about having the PPV today (e.g., no adverse reaction to flu vaccine, suitable interval since earlier vaccine, etc.). Establish the patient’s consent to have the PPV.

Watch on YouTube

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Malaria prophylaxis

Asked for 23 JAN 2021 OET speaking session

PATIENT. Role play. Setting: Community Heath Centre.
You are 35 years old and are going on a rip soon. You know that you need to take Malaria medication but are concerned as you have suffered from depression in the past, and you’ve read that there is some malaria mediation you shouldn’t take.

Task:
§ When asked, say you’re going on a trip around southeast Asia soon. Say you know you need to take malaria medication but you’ve had depression in the past and you’ve read that there is some malaria medication you shouldn’t take.
§ Say you’re going to be traveling for a month and will be mainly in rural areas, but plan to visit some cities too.
§ Say you’d rather not take medication for so long when you return, so maybe you can just try to avoid getting bitten.
§ Say you don’t want to take medication for a long time because you’re worried about the side effects.
§ Say you don’t want to have those problems. Agree to take the medication.
Nurse. Role play. Setting: Community Heath Centre.
You see a 35-year-old patient who is going on a trip soon and needs to take malaria medication. He/she is concerned about taking this medication as he/she has suffered from depression in the past, and has read that there is some malaria medication he/she shouldn’t take.

Task:
• Find out reason for patient’s visit.
• Find out relevant details about trip (length of visit, rural/urban, etc.),
• Recommend doxycycline for malaria prophylaxis (no contraindications for patients with history of depression, etc). Give details of dosage (100mg daily with food, Iwo days before trip, during trip and four weeks after return, etc).
• Stress the need for both medication and bite prevention measures (e.g., high-risk area visited, length of visit etc). Give reasons for long dose of doxycycline (e.g.: reluctance to take medication over long period of time).
• Give details of possible side effects (e.g., Heartburn, upset stomach, increased risk of sunburn etc.) Warn patient of risks of not taking medication if malaria is contracted (e.g.: heart/kidney problems, etc).

Watch on YouTube

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MAKING TIME FOR SCIENCE IELTS READING

Reading paragraph 1

Chronobiology might sound a little futuristic – like something from a science fiction novel, perhaps – but it’s actually a field of study that concerns one of the oldest processes life on this planet has ever known: short-term rhythms of time and their effect on flora and fauna.

This can take many forms. Marine life, for example, is influenced by tidal patterns. Animals tend to be active or inactive depending on the position of the sun or moon. Numerous creatures, humans included, are largely diurnal – that is, they like to come out during the hours of sunlight. Nocturnal animals, such as bats and possums, prefer to forage by night. A third group are known as crepuscular: they thrive in the low- light of dawn and dusk and remain inactive at other hours.

When it comes to humans, chronobiologists are interested in what is known as the circadian rhythm. This is the complete cycle our bodies are naturally geared to undergo within the passage of a twenty-four hour day. Aside from sleeping at night and waking during the day, each cycle involves many other factors such as changes in blood pressure and body temperature. Not everyone has an identical circadian rhythm. ‘Night people’, for example, often describe how they find it very hard to operate during the morning, but become alert and focused by evening. This is a benign variation within circadian rhythms known as a chronotype.

Scientists have limited abilities to create durable modifications of chronobiological demands. Recent therapeutic developments for humans such as artificial light machines and melatonin administration can reset our circadian rhythms, for example, but our bodies can tell the difference and health suffers when we breach these natural rhythms for extended periods of time. Plants appear no more malleable in this respect; studies demonstrate that vegetables grown in season and ripened on the tree are far higher in essential nutrients than those grown in greenhouses and ripened by laser.

Knowledge of chronobiological patterns can have many pragmatic implications for our day-to-day lives. While contemporary living can sometimes appear to subjugate biology – after all, who needs circadian rhythms when we have caffeine pills, energy drinks, shift work and cities that never sleep? – keeping in synch with our body clock is important.

The average urban resident, for example, rouses at the eye-blearing time of 6.04 a.m., which researchers believe to be far too early. One study found that even rising at 7.00 a.m. has deleterious effects on health unless exercise is performed for 30 minutes afterward. The optimum moment has been whittled down to 7.22 a.m.; muscle aches, headaches and moodiness were reported to be lowest by participants in the study who awoke then.

Once you’re up and ready to go, what then? If you’re trying to shed some extra pounds, dieticians are adamant: never skip breakfast. This disorients your circadian rhythm and puts your body in starvation mode. The recommended course of action is to follow an intense workout with a carbohydrate-rich breakfast; the other way round and weight loss results are not as pronounced.

Morning is also great for breaking out the vitamins. Supplement absorption by the body is not temporal- dependent, but naturopath Pam Stone notes that the extra boost at breakfast helps us get energised for the day ahead. For improved absorption, Stone suggests pairing supplements with a food in which they are soluble and steering clear of caffeinated beverages. Finally, Stone warns to take care with storage; high potency is best for absorption, and warmth and humidity are known to deplete the potency of a supplement.

After-dinner espressos are becoming more of a tradition – we have the Italians to thank for that – but to prepare for a good night’s sleep we are better off putting the brakes on caffeine consumption as early as 3 p.m. With a seven hour half-life, a cup of coffee containing 90 mg of caffeine taken at this hour could still leave 45 mg of caffeine in your nervous system at ten o’clock that evening. It is essential that, by the time you are ready to sleep, your body is rid of all traces.

Evenings are important for winding down before sleep; however, dietician Geraldine Georgeou warns that an after-five carbohydrate-fast is more cultural myth than chronobiological demand. This will deprive your body of vital energy needs. Overloading your gut could lead to indigestion, though. Our digestive tracts do not shut down for the night entirely, but their work slows to a crawl as our bodies prepare for sleep. Consuming a modest snack should be entirely sufficient.



Questions 1-7
Do the following statements agree with the information given in Reading Passage 1? In boxes 1-7 on your answer sheet, write

TRUE if the statement agrees with the information FALSE if the statement contradicts the information NOT GIVEN if there is no information on this

1. Chronobiology is the study of how living things have evolved over time.

2. The rise and fall of sea levels affects how sea creatures behave.

3. Most animals are active during the daytime.

4. Circadian rhythms identify how we do different things on different days.

5. A ‘night person’ can still have a healthy circadian rhythm.

6. New therapies can permanently change circadian rhythms without causing harm.

7. Naturally-produced vegetables have more nutritional value.

Questions 8-13
Choose the correct letter, A, B, C or D.
Write the correct letter in boxes 8-13 on your answer sheet.

8. What did researchers identify as the ideal time to wake up in the morning?
A 6.04
B 7.00
C 7.22
D 7.30

9. In order to lose weight, we should
A avoid eating breakfast
B eat a low carbohydrate breakfast
C exercise before breakfast
D exercise after breakfast

10. Which is NOT mentioned as a way to improve supplement absorption?
A avoiding drinks containing caffeine while taking supplements
B taking supplements at breakfast
C taking supplements with foods that can dissolve them
D storing supplements in a cool, dry environment

11. The best time to stop drinking coffee is
A mid-afternoon
B 10 p.m.
C only when feeling anxious
D after dinner

12. In the evening, we should
A stay away from carbohydrates
B stop exercising
C eat as much as possible
D eat a light meal

13. Which of the following phrases best describes the main aim of Reading Passage 1?
A to suggest healthier ways of eating, sleeping and exercising
B to describe how modern life has made chronobiology largely irrelevant
C to introduce chronobiology and describe some practical applications
D to plan a daily schedule that can alter our natural chronobiological rhythms



Reading passage 2

The Triune Brain


The first of our three brains to evolve is what scientists call the reptilian cortex. This brain sustains the elementary activities of animal survival such as respiration, adequate rest and a beating heart. We are not required to consciously “think” about these activities. The reptilian cortex also houses the “startle centre”, a mechanism that facilitates swift reactions to unexpected occurrences in our surroundings. That panicked lurch you experience when a door slams shut somewhere in the house, or the heightened awareness you feel when a twig cracks in a nearby bush while out on an evening stroll are both examples of the reptilian cortex at work. When it comes to our interaction with others, the reptilian brain offers up only the most basic impulses: aggression, mating, and territorial defence. There is no great difference, in this sense, between a crocodile defending its spot along the river and a turf war between two urban gangs.

Although the lizard may stake a claim to its habitat, it exerts total indifference toward the well-being of its young. Listen to the anguished squeal of a dolphin separated from its pod or witness the sight of elephants mourning their dead, however, and it is clear that a new development is at play. Scientists have identified this as the limbic cortex. Unique to mammals, the limbic cortex impels creatures to nurture their offspring by delivering feelings of tenderness and warmth to the parent when children are nearby. These same sensations also cause mammals to develop various types of social relations and kinship networks. When we are with others of “our kind” – be it at soccer practice, church, school or a nightclub – we experience positive sensations of togetherness, solidarity and comfort. If we spend too long away from these networks, then loneliness sets in and encourages us to seek companionship.

Only human capabilities extend far beyond the scope of these two cortexes. Humans eat, sleep and play, but we also speak, plot, rationalise and debate finer points of morality. Our unique abilities are the result of an expansive third brain – the neocortex – which engages with logic, reason and ideas. The power of the neocortex comes from its ability to think beyond the present, concrete moment. While other mammals are mainly restricted to impulsive actions (although some, such as apes, can learn and remember simple lessons), humans can think about the “big picture”. We can string together simple lessons (for example, an apple drops downwards from a tree; hurting others causes unhappiness) to develop complex theories of physical or social phenomena (such as the laws of gravity and a concern for human rights).

The neocortex is also responsible for the process by which we decide on and commit to particular courses of action. Strung together over time, these choices can accumulate into feats of progress unknown to other animals. Anticipating a better grade on the following morning’s exam, a student can ignore the limbic urge to socialise and go to sleep early instead. Over three years, this ongoing sacrifice translates into a first class degree and a scholarship to graduate school; over a lifetime, it can mean ground¬breaking contributions to human knowledge and development. The ability to sacrifice our drive for immediate satisfaction in order to benefit later is a product of the neocortex.

Understanding the triune brain can help us appreciate the different natures of brain damage and psychological disorders. The most devastating form of brain damage, for example, is a condition in which someone is understood to be brain dead. In this state a person appears merely unconscious – sleeping, perhaps – but this is illusory. Here, the reptilian brain is functioning on autopilot despite the permanent loss of other cortexes.

Disturbances to the limbic cortex are registered in a different manner. Pups with limbic damage can move around and feed themselves well enough but do not register the presence of their littermates. Scientists have observed how, after a limbic lobotomy ,“one impaired monkey stepped on his outraged peers as if treading on a log or a rock”. In our own species, limbic damage is closely related to sociopathic behaviour. Sociopaths in possession of fully-functioning neocortexes are often shrewd and emotionally intelligent people but lack any ability to relate to, empathise with or express concern for others.

One of the neurological wonders of history occurred when a railway worker named Phineas Gage survived an incident during which a metal rod skewered his skull, taking a considerable amount of his neocortex with it. Though Gage continued to live and work as before, his fellow employees observed a shift in the equilibrium of his personality. Gage’s animal propensities were now sharply pronounced while his intellectual abilities suffered; garrulous or obscene jokes replaced his once quick wit. New findings suggest, however, that Gage managed to soften these abrupt changes over time and rediscover an appropriate social manner. This would indicate that reparative therapy has the potential to help patients with advanced brain trauma to gain an improved quality of life.

Questions 14-22
Classify the following as typical of
A the reptilian cortex
B the limbic cortex
C the neocortex



Write the correct letter, A, B or C, in boxes 14-22 on your answer sheet.

14 giving up short-term happiness for future gains
15 maintaining the bodily functions necessary for life
16 experiencing the pain of losing another
17 forming communities and social groups
18 making a decision and carrying it out
19 guarding areas of land
20 developing explanations for things
21 looking after one’s young
22 responding quickly to sudden movement and noise

Questions 23-26
Complete the sentences below. Write NO MORE THAN TWO WORDS from the passage for each answer. Write your answers in boxes 23-26 on your answer sheet.

23 A person with only a functioning reptilian cortex is known as…………………
24 …………………in humans is associated with limbic disruption.
25 An industrial accident caused Phineas Gage to lose part of his……………………….
26 After his accident, co-workers noticed an imbalance between Gage’s………………and higher-order thinking.

HELIUM’S FUTURE UP IN THE AIR

A In recent years we have all been exposed to dire media reports concerning the impending demise of global coal and oil reserves, but the depletion of another key non-renewable resource continues without receiving much press at all. Helium – an inert, odourless, monatomic element known to lay people as the substance that makes balloons float and voices squeak when inhaled – could be gone from this planet within a generation.

B Helium itself is not rare; there is actually a plentiful supply of it in the cosmos. In fact, 24 per cent of our galaxy’s elemental mass consists of helium, which makes it the second most abundant element in our universe. Because of its lightness, however, most helium vanished from our own planet many years ago. Consequently, only a miniscule proportion – 0.00052%, to be exact – remains in earth’s atmosphere. Helium is the by¬product of millennia of radioactive decay from the elements thorium and uranium. The helium is mostly trapped in subterranean natural gas bunkers and commercially extracted through a method known as fractional distillation.

C The loss of helium on Earth would affect society greatly. Defying the perception of it as a novelty substance for parties and gimmicks, the element actually has many vital applications in society. Probably the most well known commercial usage is in airships and blimps (non-flammable helium replaced hydrogen as the lifting gas du jour after the Hindenburg catastrophe in 1932, during which an airship burst into flames and crashed to the ground killing some passengers and crew). But helium is also instrumental in deep-sea diving, where it is blended with nitrogen to mitigate the dangers of inhaling ordinary air under high pressure; as a cleaning agent for rocket engines; and, in its most prevalent use, as a coolant for superconducting magnets in hospital MRI (magnetic resonance imaging) scanners.

D The possibility of losing helium forever poses the threat of a real crisis because its unique qualities are extraordinarily difficult, if not impossible to duplicate (certainly, no biosynthetic ersatz product is close to approaching the point of feasibility for helium, even as similar developments continue apace for oil and coal). Helium is even cheerfully derided as a “loner” element since it does not adhere to other molecules like its cousin, hydrogen. According to Dr. Lee Sobotka, helium is the most noble of gases, meaning it’s very stable and non-reactive for the most part … it has a closed electronic configuration, a very tightly bound atom. It is this coveting of its own electrons that prevents combination with other elements’. Another important attribute is helium’s unique boiling point, which is lower than that for any other element. The worsening global shortage could render millions of dollars of high-value, life-saving equipment totally useless. The dwindling supplies have already resulted in the postponement of research and development projects in physics laboratories and manufacturing plants around the world. There is an enormous supply and demand imbalance partly brought about by the expansion of high-tech manufacturing in Asia.

E The source of the problem is the Helium Privatisation Act (HPA), an American law passed in 1996 that requires the U.S. National Helium Reserve to liquidate its helium assets by 2015 regardless of the market price. Although intended to settle the original cost of the reserve by a U.S. Congress ignorant of its ramifications, the result of this fire sale is that global helium prices are so artificially deflated that few can be bothered recycling the substance or using it judiciously. Deflated values also mean that natural gas extractors see no reason to capture helium. Much is lost in the process of extraction. As Sobotka notes: “*t+he government had the good vision to store helium, and the question now is: Will the corporations have the vision to capture it when extracting natural gas, and consumers the wisdom to recycle? This takes long-term vision because present market forces are not sufficient to compel prudent practice”. For Nobel-prize laureate Robert Richardson, the U.S. government must be prevailed upon to repeal its privatisation policy as the country supplies over 80 per cent of global helium, mostly from the National Helium Reserve. For Richardson, a twenty- to fifty-fold increase in prices would provide incentives to recycle.

F A number of steps need to be taken in order to avert a costly predicament in the coming decades. Firstly, all existing supplies of helium ought to be conserved and released only by permit, with medical uses receiving precedence over other commercial or recreational demands. Secondly, conservation should be obligatory and enforced by a regulatory agency. At the moment some users, such as hospitals, tend to recycle diligently while others, such as NASA, squander massive amounts of helium. Lastly, research into alternatives to helium must begin in earnest.



Questions 27-31
Reading Passage 3 has six paragraphs, A-F.

27 a use for helium which makes an activity safer
28 the possibility of creating an alternative to helium
29 a term which describes the process of how helium is taken out of the ground
30 a reason why users of helium do not make efforts to conserve it
31 a contrast between helium’s chemical properties and how non-scientists think about it

Questions 32-35
Do the following statements agree with the claims of the writer in Reading Passage 3? In boxes 32-35 on your answer sheet, write

YES if the statement agrees with the claims of the writer
NO if the statement contradicts the claims of the writer
NOT GIVEN if it is impossible to say what the writer thinks about this

32 Helium chooses to be on its own.
33 Helium is a very cold substance.
34 High-tech industries in Asia use more helium than laboratories and manufacturers in other parts of the world.
35 The US Congress understood the possible consequences of the HPA.

Questions 36-40
Complete the summary below. Choose NO MORE THAN TWO WORDS from the passage for each answer.

Sobotka argues that big business and users of helium need to help look after helium stocks because (36)………………… will not be encouraged through buying and selling alone. Richardson believes that the (37) …………………needs to be withdrawn, as the U.S. provides most of the world’s helium. He argues that higher costs would mean people have (38)………………… to use the resource many times over. People should need a (39)………………… to access helium that we still have. Furthermore, a (40)………………… should ensure that helium is used carefully.

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