Reading Materials for Health Professionals

preparing for the OET Test

This collection of practice materials has been

produced by Marg Tolliday & Associates
http://www.oetworkshop.com
Copyright permission has been granted to Marg Tolliday & Associates by original authors.
Some material is sourced from Open Access websites

If you would like official material, please go to the OET website

(http://www.occupationalenglishtest.org)
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Ver1.0 June 2010

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 Table of Contents

PART A reading & PART B reading....................................................................... 6

What is the difference? ............................................................................................. 6

PART A EXERCISE 1 : Stress ................................................................................... 7

PART A - EXERCISE 2 : Hearing aid for hearing loss ……………………………………………. 9

PART A – EXERCISE 3 : Prevalence of smoking in Jordan ..................................... 196

PART A - EXERCISE 4 : Panic Attacks ……………………………………………………………… .21

PART B TEXT 1 : Utopian ideal for indigenous health? ...................................... 258

PART B TEXT 2 : Case Studies from the Theatre ……………………………………………….. 33

PART B TEXT 3 : Planning for Healthy Ageing …………………………………………………... 36

PART B TEXT 4 : Generic Medicines …………………………………………………………………..42

ANSWERS .............................................................................................................. 507

PART A reading & PART B reading

What is the difference?

PART A reading is a series of 4 separate pieces of information - on all the one topic.
The information could be in the form of a dot-pointed list / a table with numbers or
percentages / perhaps a flow chart / a map / a few short paragraphs / one page of
writing - in short, different ways of presenting information.

Your task in this part is to complete the “gap fill” exercise. There will be
somewhere between 25 and 30 gaps to be completed - drawing on the information
in the separate pieces of information.

You are given 15 minutes to complete Part A. (Not enough time).

The OETWorkshop strongly recommends you adopt a ‘time management’

approach to Part A - and follow this strategy:

1. Read only the headings of each separate piece of information

2. Go to the gap-fill exercise and find out how many gaps are to be filled in
3. Estimate how much time you have to find the answer to each ‘gap’.
Example: 15 minutes LESS 2 minutes to “read” / “skim read” the 4 pieces of text –
that leaves you with 13 minutes. 13 minutes X 60 seconds = 780 seconds.
Let’s say you have 30 gaps to be filled. 780 DIVIDED BY 30 = 26 seconds per gap.
4. Don’t forget: You only need 65% correct to get a “B” score.
[65% of 30 gaps = 19.5 rounded up to 20 gaps. Get 20 out of 30 correct = “B” - a
pass! ]
5. If you have any problems finding the answer to a particular gap – move on –
don’t waste time - remember, you only need 65% correct to get a pass.

PART B reading is comprised of TWO x 600 to 650 word pieces of text – each one
with 7 or 8 multiple choice questions. You have to circle a, b, c or d - to indicate
which option you think best fits the question. [Often there are two options which
could be the right answer - but one will be more right than the other.]
You are given 45 minutes to complete Part B - about 20 minutes for each reading.

The OETWorkshop strongly recommends you try to understand the question that
is being asked: The author asserts - is different from According to the data .... .
If the author is asserting something, the author is putting forward his / her opinion
on something - whereas, ‘according to the data’ relies on factual evidence.

Again, if you have any problems trying to find a clear-cut answer to one of the
questions – leave it – move on – come back to it later. Remember, you only need
65% correct to get a pass. 65% of 16 questions (8 questions for each passage) =
10.4 rounded up to 11. You need 11 out of 16 questions to get a “B” score.

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PART A EXERCISE 1 : Stress

TIME LIMIT 15 MINUTES

x Read the following reading material about Stress.

x You only have 15 minutes to scan and fill in the summarising exercise (last
page of the reading test) – so only skim and scan read the reading material –
do not spend a lot of time reading it in depth
x In the exercise on the last page – fill in the missing word (or words) – then
check your answers – which are found at the back of this book.

Produced by Marg Tolliday & Associates ©

Reading material No.1 - Stress

Stress may be considered as any physical, chemical, or emotional factor that causes
bodily or mental unrest and that may be a factor in disease causation. Physical and
chemical factors that can cause stress include trauma, infections, toxins, illnesses,
and injuries of any sort. Emotional causes of stress and tension are numerous and
varied. While many people associate the term "stress" with psychological stress,
scientists and physicians use this term to denote any force that impairs the
stability and balance of bodily functions.

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Reading material No.2 - Stress

Who is most susceptible to stress?

x Affects people of all ages and all walks of life.

x Don’t need a traditionally stressful job to experience workplace stress

x A parent of one child may experience more stress related to parenting than a
parent of several children.

x The degree of stress in our lives is highly dependent upon individual factors
such as our physical health, the quality of our interpersonal relationships, the
number of commitments and responsibilities we carry, the degree of others'
dependence upon and expectations of us, the amount of support we receive
from others, and the number of changes or traumatic events that have
recently occurred in our lives.

x People with strong social support networks (family, friends, religious

organizations) report less stress compared to those without these support
networks..

x People who are poorly nourished, who get inadequate sleep, or who are
physically unwell also have reduced capabilities to handle the pressures and
stresses of everyday life and may report higher stress levels.

x People who are providing care for elderly or sick may also experience a
great deal of stress as caregivers.

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Reading material No.3 - Stress
What can I do to better manage stress?

A variety of methods/techniques

- Exercise
- CDs
- martial arts
- Autogenic training where one focuses on different sensations such as warmth
or heaviness
- Biofeedback (where pulse, heart rate etc are measured)
- Imagery (calming the mind and body)
- Transcendental meditation
- Progressive muscle relaxation
- Qigong (using isometrics, isotonics and aerobic conditioning)
- Tai chi (meditation in motion)
- Yoga (where body and breathing techniques are connected)
- Time management
- Develop good organizational skills

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Reading material No 4 - Stress
A MODEL OF OCCUPATIONAL STRESSORS AND MOOD DISORDER, ABSENTEEISM (SICKNESS, ABSENCE, EARLY LEAVING,
LATE ARRIVAL); PRESENTEEISM (REDUCED PERFORMANCE WHILE PRESENT AT WORK); MAJOR DEPRESSIVE DISORDER
(MDD); POST-TRAUMATIC STRESS DISORDER (PTSD); CARDIOVASCULAR DISORDER (CVD).

Occupational Environment Stress Reactions Clinical Illnesses

Chemical / Biological Mental Disorders

Environment Dysphoria (e.g. MDD PTSD)

Physical Environment Depressive syndrome Physical illnesses

(e.g. noise, light) (subclinical symptoms) (e.g. CVD, ulcers)

Work Characteristics Somatic complaints

(e.g. shift work, jet lag)
Work related fatal outcomes

Psychological Job Stress

(High demand – low
Suicide
control – effort reward
imbalance)
Death by medical causes
Vocational Symptoms (e.g. sudden cardiac death)
Interpersonal conflict
Absenteeism

Organizational policy

Presenteeism

Job insecurity /
Unemployment

Accidents

Moderating Variables Vocational Threat

Personality Age
Work related disability

Gender Family

Repeated job loss

Social support

Figure sourced from The impact of work environment on mood disorders and suicide: Evidence and
implications by Jong-Min Woo, MD, PhD and Teodor T Postolache, MD International Journal of
Disability & Human Development, 2008, 7:2, pp185-200.
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Summarising exercise - Stress 1

2
1
Stress affects people of all ages and all . . . . . . of life. How much 3
stress we have in our lives varies from one person to another. Important 4
2 3
factors are one’s . . . . . . . health, the . . . . . . . of our interpersonal 5
4 5 6
..........., the number of . . . . . . . . . and . . . . . . . . . . . . . we carry, 6
the degree of dependence others put on us and, of course, how much 7
7
. . . . .. . . . we receive from others. People can get support from social 8
8
networks like their family, friends or . . . . . . . . . . organizations. These supported 9
9
people usually report . . . . . . stress compared to those without such support. 10
10 11
Stress is a physical, chemical or . . . . . . . . factor that causes . . .. . . . . . 11
12 13
or . . . . . . . . unrest. Physical and . . . . . . . . factors that cause stress include 12
14
trauma, infections, . . . . . . . , illnesses and injuries. Emotional stressors are 13

numerous and varied. People who are caring for sick or elderly sometimes 14
15
experience a great deal of stress as . . . . . . . . . . 15

Reading 4 is a model on the impact of work environment on mood disorders and 16

suicide. The authors theorise that the occupational environment is affected by 17

many things: moderating variables such as …………….., 16 …………….…., 17 8

18 19 20.
……………... , ………………. social support and clinical …………….. 19

Reaction to stress in the workplace can manifest itself through somatic 20

complaints, depression and ……………. 21. Overstressed workers may stop 21

attending the workplace. (“absenteeism”) or simply be present, on the job, but 22

22
have low production rates (“ ……………..……”) . There are a number of ways 23

to manage stress, including …………….………. 23 , ……………..……….. , 24 24

……….………..… , 25 …………..….……. 26 and ……………….……. 27. 25

26

27

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PART A - EXERCISE 2 : Hearing aid for hearing loss

TIME LIMIT 15 MINUTES

x Read the following reading material about helping those with hearing loss.
x You only have 15 minutes to scan and fill in the summarising exercise (last
page of the reading test) – so only skim and scan read the reading material –
do not spend a lot of time reading it in depth
x In the exercise on the last page – fill in the missing word (or words) – then
check your answers – which are found at the back of this book.

Produced by Marg Tolliday & Associates ©

Reading material No.1 – Hearing loss

NEW COCHLEAR IMPLANT TECHNOLOGY POSSIBLE

January 16, 2008 - The Brain Activity Behind Tinnitus Uncovered
Nina Kahlbrock and Nathan Weisz, BMC Biology

Tinnitus - hearing phantom sounds - affects millions of people, but because the
physiological mechanisms behind the condition are largely unknown, treatment
options are limited. Now research published in the online open access journal BMC
Biology shows how a method that temporarily (usually for several seconds) reduces
tinnitus in some patients links the condition to brain activity.

Nina Kahlbrock of the University of Konstanz, Germany and Nathan Weisz of INSERM
in Lyon, France investigated the relationship between the tinnitus sensation and
spontaneous brain activity. Two techniques called tinnitus masking and residual
inhibition involve using a sound that temporarily reduces tinnitus (masking). The
effect sometimes continues after the masking sound has stopped (residual inhibition
or RI). The researchers used RI to reduce eight sufferers' tinnitus intensity, in an
effect lasting approximately 30 seconds, coupled with source-space projected
magnetencephalographic (MEG) data to track their brain activity.

Weisz had previously found that chronic tinnitus sufferers had different patterns of
brain activity compared with those with normal hearing. The brains of tinnitus
sufferers showed reduced alpha power (8-12 Hz) and enhancement in the delta (1.5-
4 Hz) and gamma power (>30 Hz) brainwave range. These differences were
especially pronounced in the brain's temporal cortical regions. In this research, slow
wave brain activity was decreased during RI, but the higher alpha frequencies did not
change. "The results of this study suggest that a reduction of the tinnitus
perception leads to changes in the oscillatory properties of cortical networks
connected to tinnitus," says Kahlbrock. "In particular, changes in slow-wave
frequencies appear to be RI related."

Treatment approaches would need to permanently interrupt the underlying

oscillatory pattern to succeed. Further investigation into extending the RI approach
could include combining it with top-down approaches such as neurofeedback to
extend the RI tinnitus-dimming effect. Experiments to boost alpha frequencies and
cut delta activity using neurofeedback have previously shown some success in
reducing tinnitus. "Transient reduction of tinnitus intensity is marked by
concomitant reductions of delta band power."

Nina Kahlbrock and Nathan Weisz, BMC Biology

BMC Biology - the flagship biology journal of the BMC series - publishes research and methodology articles of
special importance and broad interest in any area of biology and biomedical sciences. BMC Biology (ISSN 1741-
7007) is covered by PubMed, Scopus, CAS, BIOSIS, Zoological Record and Google Scholar. BioMed Central is an
independent online publishing house committed to providing immediate access without charge to the peer-
reviewed biological and medical research it publishes. This commitment is based on the view that open access to
research is essential to the rapid and efficient communication of science. Open Access article.
http://www.medicalnewstoday.com/ articles/93609.php Posted by 4HL on January 16, 2008 7:18 AM

Produced by Marg Tolliday & Associates © 14

Reading material No.2 – Hearing loss

NEW TECHNOLOGY MAKES HEARING

AIDS - A HOT ACCESSORY

(ARA) - When you think of a hearing aid, the image of a large piece of plastic sitting
behind an ear likely comes to mind. There has been a stigma attached to hearing
instruments because for many years they were big, bulky and looked “old.” Today’s
hearing aids are sleek, sophisticated pieces of technology, and most are nearly
invisible when worn.

At its most basic, a hearing aid amplifies sound that enters the instrument through a
microphone and then delivers that sound via a speaker into the ear. Early hearing
aids fell far short of the natural ear’s ability to tune out background noise so that the
listener can focus on particular sounds such as speech. Historically, some of the most
common complaints hearing aid users have include not being able to hear in noisy
situations; whistling (referred to as feedback) when the wearer put on a hat or
hugged a loved one; occlusion – the feeling of the ears being plugged; and poor
performance when the wearer was talking on the phone.

Today’s top-line hearing aids use the most advanced technology available to address
all of the complaints of hearing aid wearers. These hearing instruments are like small
computers that use complex algorithms to constantly identify and separate incoming
sounds.

For example, when the hearing aid picks up ambient noise, it will turn off a
microphone collecting the background sounds and turn on a microphone to focus
the hearing aid on speech. These hearing instruments are designed to provide the
closest thing to normal hearing possible, and they succeed in that task better than
ever before.

Hearing aids also incorporate a number of other interesting features now that never
would have been possible before. For example, Minnesota-based Starkey recently
introduced T2 technology in its S Series instruments, which allows wearers to use a
cell or touch-tone phone to conveniently switch modes or adjust volume without
using additional hardware. Hearing aid wearers can choose from a wide variety of
voice options for their indicators --like when the battery is low -- including a number
of languages and even golf legend Arnold Palmer's voice.

In addition, hearing aids can now be fit more precisely with a prescriptive approach,
which uses hearing and lifestyle assessments, to help ensure that the instruments
match the individual’s hearing loss, lifestyle needs and ear shape.

Finding the right solution for a hearing loss can make all of the difference in
communication with family, friends and co-workers. To find out more about the
latest in hearing aid technology, visit www.starkey.com.

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Reading material No.3 – Hearing loss

COMMUNICATION DEVICES FOR HEARING LOSS

5.3.1 COMMUNICATION DEVICES - Table 5-9 reports data from the Survey of Disability
Ageing and Carers on the use of communication devices by people who reported their
hearing loss as their main condition.

TABLE 5-9: HEARING DEVICES UTILISED

Communication Aid Used Number
Hearing aid 130,800
Cochlear implant Np
Other hearing aid(s) 20,100
Low technology reading or writing aids 3,600
Low technology speaking aids 100
High technology reading or writing aids 3,100
High technology speaking aids Np
Mobile or cordless telephone 10,700
Fax machine 3,900
Reading, writing or speaking aid not specified 4,700
Does not use a communication aid 81,500

Total 218,200

Source: ABS (2003) Survey of Disability Ageing and Carers – special data request.
Extract taken from p68, http://www.vicdeaf.com.au/files/listenhearreport.pdf
(Accessed 10 Nov 2009)

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Reading material No.4 – Hearing loss

PEOPLE WITH HEARING LOSS AND PARTIAL HEARING LOSS IN

AUSTRALIA

The Australian Bureau of Statistics conducted a study in 1993 to determine the combined total of hearing loss and
partial hearing loss in Australia. The results were as follows

Number
State/Territory
of persons
Victoria 259,300
Australian Capital Territory 14,300
New South Wales 328,300
Queensland 182,600
Northern Territory 6,700
Western Australia 93,600
South Australia 87,500
Tasmania 27,400
TOTAL IN AUSTRALIA - 999,800

http://www.vicdeaf.com.au/statistics-on-deafness-amp-hearing-loss

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 EXERCISE 2 - Hearing loss - Summarising exercise
Kahlbrock and Weisz investigated the relationship between the condition called
_______________ (1) and activity in the _______________ (2). The researchers used RI or _______________
________________ (3) and tinnitus _______________ (4) where a sound is used to temporarily
________________ (5) the tinnitus. The sound lasted for only about _______________ (6) seconds and
combined it with magnetencephalographic data to track _______________ _________________ .(7)
Kahlbrock believes the results of the investigations suggest that a diminishment of _______________
___________________ (8) leads to changes in the oscillatory properties of _____________
________________ (9) which are connected to tinnitus. Changes in slow-wave ____________ (10), he says,
appear to be related to residual inhibition. In order to be successful, treatment would be required to
_______________ _________________ (11) any existing oscillatory pattern.
The ABS 1993 study on total/partial hearing loss in Australia revealed that the State with the highest number
of hearing-affected people was _______________ (12) while the NT only had _______________ (13)
affected people. People cope with their hearing loss in a number of ways. The ABS study done ten years
later, 2003, looked at different _______________ (14) devices, and out of a total of _______________ (15)
Australians, nearly one third, of _______________ (16) used no communication aid at all. Table 5-9 focused
on disabled _____________ (17) and disabled carers whereas the other study, done ten years later, surveyed
anyone with a total or partial hearing loss. As can be seen from Table 5-9, a _______________
_______________ (18) is by far the most popular method used by people suffering partial or total hearing
loss.
The article New technology makes hearing aids a hot accessory clearly sets out some of the problems
confronted by hearing aid users in years gone by. Today, the hearing aid is _______________ (19) and
_______________ (20) and difficult to detect when worn. In older models, the user often has to put up with
a whistling sound – also known as ________________ (21) or a problem called ‘occlusion’ which is like the
feeling of one’s ears _____________ _____________ (22). However, today’s hearing aids are like small
computers that use _____________ ________________ (23) to identify and separate incoming sounds.
Inside these high tech hearing aids there is a ________________ (24) which gathers background sounds and
this will turn off – and another microphone will turn on to _______________ (25) on speech. A company in
Minnesota, USA, has introduced T2 technology allowing users to conveniently _______________
________________ (26) or adjust _______________ (27) while using a telephone. Today’s hearing aids fit
into our _______________ (28) needs and ________________ shape. (29)
Answers to the reading are at the back of this book.

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Part A – Prevalence of smoking in Jordan

TIME LIMIT 15 MINUTES

x Read the following reading material about the prevalence of smoking in

Jordan.

x You only have 15 minutes to scan the reading materials then fill in the
synthesizing exercise (last page) – so only skim and scan read the reading
material – do not spend a lot of time reading it in depth

x In the exercise on the last page – fill in the missing word (or words) – then
check the answers at the back of the book.

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Reading material No.1 - Prevalence of smoking in Jordan
Extract from A surveillance summary of smoking and review of tobacco control in Jordan

x During 2006, chronic, noncommunicable diseases (NCDs) accounted for more

than 50% of all deaths in Jordan.

x Deaths from heart disease and stroke accounted for a third of all deaths

x one-third of those who died from heart disease and stroke were aged 65 or
younger

x malignant neoplasms were responsible for about 13% of deaths

x Nearly 60% of deaths from malignant neoplasms occurred among people

younger than 65 years

x lung cancer was the leading cause of cancer death.

x The prevalence of smoking in Jordan remains unacceptably high with a current

smoking prevalence near 50% among men.

x The World Health Organization (WHO) estimates that there are more than one
billion current smokers worldwide and that

x more than 80% of the world's smokers live in low- and middle-income
countries

x An estimated 5.4 million people die from diseases directly related to cigarette
smoking worldwide each year

x Tobacco-related deaths are estimated to increase to more than eight million a

year by 2030, and 80% of those deaths will occur in the developing world

Smoking among Youth

x The prevalence of current smoking was substantially greater among boys than
girls, with approximately 1 in 5 boys reporting that they currently smoke
compared to 7 to 10% of girls.

Smoking among Adults

x Men aged 25-34 years had the highest (63%) prevalence of current smoking
and women aged 18-24 years had the lowest (<1%) prevalence.

Adel Belbeisi, Mohannad Al Nsour, Anwar Batieha, David W Brown and Henry T Walke
Globalization and Health 2009, 5:18 This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.

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Reading material No.2 - Prevalence of smoking in Jordan

What's in a cigarette

Tobacco smoke contains over 4,000 chemicals including nicotine, carbon monoxide,
hydrogen cyanide, acetone, ammonia, arsenic, phenol, naphthalene, cadmium and
vinyl chloride. At least 43 of these chemicals are cancer-causing carcinogens which
have a significant impact upon the health status of cigarette smokers.

Three specific components of cigarette smoke have the greatest effect:

Tar is composed of various organic and inorganic chemicals including nitrogen,

oxygen, hydrogen, carbon dioxide, carbon monoxide and a number of carcinogens.
Tar is the particulate matter which is inhaled in cigarette smoke. Tar causes the
yellow-brown staining on smokers' fingers and teeth, and lungs.

Nicotine is an organic compound that is highly toxic and addictive. The effects of
nicotine upon the body include: increased heart rate and blood pressure. It is both a
stimulant and relaxant. In the long term nicotine may contribute to coronary disease
and the development of cancers.

Carbon monoxide is a poisonous gas. Carbon monoxide reduces the body's red
blood cells ability to deliver oxygen to tissues with the potential to cause the
greatest damage to heart, brain and skeletal muscles.

http://www.ceitc.org.au/whats_in_a_cigarette

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Reading material No.3 - Prevalence of smoking in Jordan

Table 1
Estimated smoking prevalence by sex, number of smokers aged 15 years & older
By World Bank Region (1995)

World Region Smoking Prevalence % Total Smokers

Number
% o f all
Males Fe male s Overall –
smokers
millions
East Asia and Pacific 62 5 34 429 38
Europe and Central Asia 53 16 34 122 11
Latin America & Caribbean 39 22 31 98 9
Middle East & Nth Africa 38 7 23 37 3
South Asia (cigarettes) 20 1 11 84 7
South Asia (bidis) 20 3 12 94 8
Sub-Saharan Africa 38 8 18 56 5
Low & middle income 49 8 29 919 82
High income 37 21 29 202 18
World 47 11 29 1121 100

(American Journal of Public Health, 92 : 6, p1103)

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Reading material No.4 - Prevalence of smoking in Jordan

Current smoking prevalent amongst adults aged 18 years or older

by gender. Behavioral Risk Factor Surveillance System, Jordan (2007)

70
62.7
60 54.4 53.5
50
42.2
39.1
40
30.5
30

20
7.9 7.4 8
10 5.5
3.5
0.001
0
18-24 25-34 35-44 45-54 55-64 > /= 65

18-24 yrs 25-34 yrs 35-44 yrs 45-54 yrrs 55-64 yrs >/=65 yrs

M en 42.2 62.7 54.4 53.5 39.1 30.5

Women 0.01 3.5 7.9 7.4 8 5.5

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 Summarising exercise - Prevalence of smoking in Jordan

Tobacco related deaths, in Jordan, are expected to increase by around 8,000,000 by the year 2030
…….…...1 of these deaths will occur in the . ………….……… …………………2 Low and middle income
countries account for more than ……..……3 of the world’s smokers. According to the WHO, there
are more than 1 billion smokers in the world. Smoking has a devastating affect on the health of
the population. What’s in a cigarette? The smoke contains over 4000 ……..……4 like nitrogen,
oxygen hydrogen, carbon dioxide as well as ……………… ………..…… 5 and a number of carcinogens.
Inhaled cigarette smoke contains a substance called ……….…… 6 which leaves a yellow brown
stain on fingers and teeth and in the lungs. It is not surprising to learn that during 2006, chronic,
7
noncommunicable (NCDs) accounted for more than ……….... of all deaths in Jordan. The
8 9
survey found that …..…… of boys smoked compared to only ……..… to ………… girls. This
10
disparity widened even further amongst adults: ……….… of men aged …..……. 11 years
12 13
smoked compared to only …….……… for adult women aged ……………
While smoking may be prevalent in the Middle East (at least in Jordan), the statistics show that
this group accounts for only ……….. 14 of all smokers globally. In Table 1 the data shows that the
15
highest percentage (38%) of smokers came from …………………… countries followed by Europe
and Central Asia with …………. 16
The data clearly indicates that …………………………17 groups smoked ……….. 18
more compared to
19 20
……………… groups who only accounted for …………… of the world’s smokers.
The column chart shows the percentages of adult smokers in Jordon – both men and women –
according to age groups. Clearly the highest number of male smokers (62.7%) occurred in the
21
…………….……. range while, for woman, the highest number of female smokers (8%) were in
22
the ……………..… range.

Produced by Marg Tolliday & Associates © 24

New reading Part A TIME LIMIT 15 MINUTES

x Read the following reading material about help for those who suffer from
panic attacks.

x You only have 15 minutes to scan and fill in the synthesizing exercise (last
page) – so only skim and scan read the reading material – do not spend a lot
of time reading it in depth

x In the exercise on the last page – fill in the missing word (or words) – then
check your answers.

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 PANIC ATTACKS

Reading material No.1

WHAT IS A PANIC ATTACK?

A panic attack is a brief episode of intense anxiety, which causes the physical
sensations of fear.

Symptoms
Symptoms of a panic attack can include:

x Heightened vigilance for danger and physical symptoms

x Anxious and irrational thinking
x A strong feeling of dread, danger or foreboding
x Fear of going mad, losing control or dying
x Feeling lightheaded and dizzy
x Tingling and chills, particularly in the arms and hands
x Trembling or shaking, sweating
x Hot flushes
x Accelerated heart rate
x A feeling of constriction in the chest
x Breathing difficulties, including shortness of breath
x Nausea or abdominal distress
x Tense muscles
x Dry mouth
x Feelings of unreality and detachment from the environment.

Panic attacks are common. Up to 35 per cent of the population experience a panic
attack at some time in their lives.

A panic attack can also be called an anxiety attack.

Without treatment, frequent and prolonged panic attacks can be severely disabling.

The person may choose to avoid a wide range of situations (such as leaving their
home or being alone) for fear of experiencing an attack.

Produced by Marg Tolliday & Associates © 26

Reading material No.2
THE “FLIGHT-OR-FIGHT” RESPONSE

The ‘flight-or-fight’ response

Some of the factors that can prime the body to inappropriately activate the ‘flight-
or-fight’ response include:

x Chronic (ongoing) stress – this causes the body to produce higher than usual
levels of stress chemicals such as adrenaline.
x Acute stress (such as experiencing a traumatic event) – can suddenly flood
the body with large amounts of stress chemicals.
x Habitual hyperventilation – disturbs the balance of blood gases because
there is not enough carbon dioxide in the blood.
x Intense physical exercise – for some people, this may cause extreme
reactions.
x Excessive caffeine intake – the caffeine in coffee, tea and other beverages is
a strong stimulant.
x Illness – may cause physical changes.
x A sudden change of environment – such as walking into an overcrowded, hot
or stuffy environment.

Produced by Marg Tolliday & Associates ©

Reading material No.3
GETTING HELP

Suggestions on how to cope with a panic attack yourself, include:

x Avoid ‘self-talk’ that focuses your attention on your symptoms – don’t tell
yourself ‘Stop panicking!’ or ‘Relax!’
x Remind yourself that the symptoms of a panic attack are uncomfortable, but
not life threatening. Reassure yourself that you’ve felt these feelings before
and nothing bad happened to you.
x Focus your attention on something outside your own body and symptoms.
For example, distract yourself by counting backwards in threes from 100,
recall the words from a favourite song or concentrate on the sights and
sounds around you.
x Fleeing from the situation will only reinforce the perception that your panic
attacks are unbearable. If you sit and allow the symptoms to pass, you gain
confidence in your ability to cope.

Medical treatment options

If the physical anxiety symptoms are caused by physical illnesses, such as diabetes or
hyperthyroidism, proper treatment for these illnesses should stop the panic-like
symptoms from recurring.

Treatment options can include:

x Medications
x Psychotherapy, including cognitive behaviour therapy
x Biofeedback therapy
x Stress management techniques
x Proper breathing techniques
x Relaxation techniques
x Learning problem-solving skills
x Lifestyle adjustments, such as attention to diet, exercise and sleep.

Produced by Marg Tolliday & Associates © 28

Reading material No.4
SOME STATISTICS FROM AMERICA

Prevalence of Anxiety disorder: approximately 2.4 million Americans (NIMH)

Prevalence Rate: approx 1 in 113 or 0.88% or 2.4 million people in USA
Incidence (annual) of Panic disorder: 1.7% of US adults annually (NIMH)
Incidence Rate: approx 1 in 58 or 1.70% or 4.6 million people in USA
Incidence extrapolations for USA for Anxiety disorder: 4,624,000 per year,
385,333 per month, 88,923 per week, 12,668 per day, 527 per hour, 8 per minute, 0
per second.
Lifetime risk for Panic disorder: 3 million Americans (NIMH); 1.6% adults (USSG)
Prevalence of Anxiety disorder: Anxiety disorder strikes between 3 and 6 million
Americans, and is twice as common in women as in men.1
Incidence of Panic disorder: About 1.7% of the adult U.S. population ages
18 to 54 - approximately 2.4 million Americans - has anxiety panic disorder in a given
year. 2

Prevalence of Anxiety disorder discussion: Approximately 2.4 million American

adults ages 18 to 54, or about 1.7 percent of people in this age group in a given year,
have anxiety disorder. 3

In the United States, 1.6 percent of the adult population, or more than 3 million
people, will have anxiety panic disorder at some time in their lives.4

Prevalence statistics about Anxiety Panic disorder: The following statistics relate to
the prevalence of Anxiety Panic disorder:

x 3 million American adults (NIMH)

x 1.7% of the adult U.S. population ages 18 to 54 (NIMH)

Produced by Marg Tolliday & Associates ©

Synthesizing exercise - PANIC ATTACKS

Panic attacks can be frightening and are, nevertheless, common. Some symptoms
1
include fear of going mad, losing control or __________ A person might be
lightheaded or ____________ 2 Hot flushes and an ________________ 3heart rate
as well as ___________________ 4 of the chest and ________________ 5 difficulties
can be some of the symptoms experienced. It is estimated that in Australia up to
_____6 per cent of the population have an attack at one time or another. If
prolonged and frequent attacks are not ______________, 7 one’s health can be
severely _________ 8
The body’s autoimmune system gives rise to what is known as the “flight or fight”
response: to stay in a situation and try and cope – or run away from it. Sometimes
the body inappropriately responds such as producing higher than usual levels of
9
_______________ . Sudden environmental changes can cause panic attacks,
changes such as walking into ________________ , ___________ 10 or
11
___________ areas. Habitual _______________________ 12 disturbs the
balance of blood gases because there __________ ____________ _____________
13
CO2 in the blood.
And large amounts of stress chemicals, caused by a sudden ____________
____________ , 14 can cause ___________ ____________ .15
There are ways to help oneself: Try and concentrate on something other than your
own _______ 16 and _______________ . 17
Sufferers can remind themselves that
while panic attacks are uncomfortable, they are not ___________ ____________. 18
Doing mental exercises, such as counting backwards in ___________ 19 from one
20
hundred, or recalling the words of a ____________ song or concentrating on the
sights and __________ 21 around about - can all help. And there are some
medical treatment options: in addition to medications and psychotherapy, there is
_____________________22 therapy, stress management ____________, 23
proper
breathing techniques, and making adjustments to one’s ___________ , 24
__________ 25 and ____________. 26
In the United States, about ___________ 27 American adults, that is ________% 28
of the adult U.S. population aged 18 to 54 - suffer from anxiety panic disorder.

Produced by Marg Tolliday & Associates © 30

PART B # 1 : Utopian ideal for indigenous health?

TIME LIMIT 45 MINUTES

x The following reading material is about health amongst indigenous people

living in a community called ‘Utopia’.
x In the OET Reading test, you will have 45 minutes to two short passages and
answer the multiple choice questions at the end of each passage. (Answers
can be found in the last pages of this book).
x You do not get any pre-reading time for the reading test.
x When you are ready to start – turn the page and start reading - and also
watch your time - take 45 minutes for both passages.

Produced by Marg Tolliday & Associates ©

PART B – TEXT 1 Utopian ideal for indigenous health?

Utopian ideal for Indigenous health?

Published 1 October 2009 The Age newspaper.

Amid the grim statistics on Indigenous health, residents of the remote community of
Utopia have found that retaining a connection to country is their answer to better
health.

Utopia is about 250 kilometres north-east of Alice Springs, and its residents live off
the land in a way similar to their ancestors, hunting bush tucker and retaining
cultural traditions.

Research published in the Medical Journal of Australia has found the mortality rate
for Utopia's residents is 40 to 50 per cent lower than the Northern Territory average
for Aboriginal adults. This is, at least partly, due to the prevention of diabetes and
low rates of obesity, hypertension and smoking.

The consensus is that Utopia's Alyawarr and Anmatyerr people are healthier because
of the empowerment that comes from decentralisation and connection to country:
Utopia's 1000 residents don't live in one main township, but rather are dispersed
amongst 20 outstations, spread over almost 10,000 square kilometres.

"They live on damper made with flour and water which is cooked in the ground. They
get exercise when they hunt," says Utopia's community liaison Ricky Tilmouth.

Community elder Albert Bailey explains, "We are eating kangaroo and porcupine. We
hunt the porcupine at night."

This is supplemented with bush fruits and vegetables such as tomatoes, potatoes
and bananas. Fruit and vegetables are also purchased occasionally from the local
store.

The local doctor, Urapuntja Health Service's GP Dr Karmananda Saraswati, adds that
while their lives are "very organic" and they adhere to their cultural traditions and
look after themselves, they willingly take the necessary medicines prescribed by the
health service.

"Their traditions are very strong here. That is all hugely empowering at a community
level. (But) sometimes I will get the nankari (witch doctor) instead of the RFDS (Royal
Flying Doctor Service) because it's more appropriate," says Saraswati.

Produced by Marg Tolliday & Associates © 32

TEXT 2 Utopian ideal for indigenous health?
Healthcare in the community

Tilmouth adds that the health service, which is community-controlled and chaired by
Bailey, has prompted residents to take greater responsibility for their health.

The clinic provides an outreach service to outstations, visiting each one at least
fortnightly, and employs drivers to ferry patients to the clinic at other times.

"This is a community decision. They can see the delivery of the service … They know
where the doctor is going to be on which days. If they need to see him they can go to
another outstation or wait for him to come to them," says Tilmouth.

As community liaison, Tilmouth, who was raised in Alice Springs but whose mother
was from Utopia, ensures the clinic provides the services needed by the community.

Saraswati explains that the service is designed to support the Aboriginal people in
their own environment.

"They set the tune of what they want. If I crossed the line and did something
culturally inappropriate [Bailey] could warn or fire me," says Saraswati.

"It is about giving them what they need and supporting them in their environment."

Saraswati's comments support the findings of the MJA article, which concluded:
"Contributors to lower than expected morbidity and mortality are likely to include
the nature of primary health care services … as well as the decentralised mode of
outstation living and social factors, including connectedness to culture, family and
land and opportunities for self-determination."

Data being compiled for this year is expected to paint a similar picture.

Common indicators complicated

Paradoxically, a follow-up study to the MJA article on the link between social
determinants and heart health for Aboriginal people (yet to published) shows that
Utopia has higher unemployment, more overcrowding, lower incomes and lower
high school completion rates than the rest of the NT Aboriginal population.

Primary author of both reports, the University of Melbourne's Kevin Rowley, explains
that for Aboriginal people some of the common indicators of health outcomes such
as employment and income are complicated.

"Employment, in itself, is good, but it has to be meaningful. Certainly in some places,

for Aboriginal people, being employed is associated with worse health," says Rowley,
Senior Research Fellow in the School of Population Health.

Dr Paul Burgess, from the Menzies School of Health Research, says while the obvious
benefits of decentralisation are better diet, exercise and empowerment, the positive
Produced by Marg Tolliday & Associates ©
effects for Indigenous communities from living on traditional homelands are more
ingrained.

"From an Indigenous perspective, it's enormously complex. They have a holistic

health promotion model, which is built on their attachment to country … built into
their identity."

Whilst Utopia's model is one that many Indigenous communities aspire to regain,
Burgess says that over the past decade the federal and state governments have
increasingly diverted funding from outstations to centralised programs.

He points out that ongoing research into other remote communities in West
Australia, the Northern Territory and Queensland consistently shows that
decentralised living leads to better health outcomes.

"The government has moved in the opposite direction to where evidence is pointing
to better health outcomes," he says.

Burgess and many Indigenous health stakeholders, therefore, continue to lobby

governments to take note of findings such as those from Utopia, and to reconsider
their policies.

Adopting broad-scale management of country programs whereby Indigenous

communities are asked to care for the land is just one solution governments could
consider to facilitate connection to country amongst Aboriginal people, believes
Burgess.

"The landscape is enormous and Indigenous [people] are best placed to manage it
and they are motivated to do it," he said.

Produced by Marg Tolliday & Associates © 34

QUESTIONS
Q1 Retaining a connection to country is –
a. good for Aboriginals’ health -
b. to live in one township -
c. the best solution being offered by the government -
d .a lifestyle which leads to better health

Q2 mortality rates amongst Aboriginals in the Northern Territory -

a. are higher than the rest of Australia
b. higher due to the prevalence of diabetes and obesity
c. half as much as the average rate for Aboriginals in the Northern Territory
d. lower due to obesity, hypertension and smoking prevention programs

Q3 the Alyawarr and Anmatyerr people -

a. number 1000 and live in one main township -
b. are living in remote communities
c. attribute their good health to government intervention
d. live as one big community which is 10,000 km 2 in size

Q4 Aboriginal residents are able to look after their own health -

a. supported by the actions of Government-controlled clinics
b. clinicians visit residents regularly
c. patient visits to the clinics are available free of charge
d. so the clinic doctors need not be depended upon to deliver a reliable service

Q5 Which of the following is not reported by the author:

a. Utopia has higher unemployment
b. fewer Utopian’s secondary students finish high school than the rest of Aborigines
in the Northern Territory
c. for Aboriginal people, some kinds of employment are associated with worsening
health
d. all employment is good.

Q6 According to the Menzies School of Health research:

a. centralisation leads to better diet, exercise and empowerment
b. Aborigines have an holistic approach to health
c. decentralisation is leading to funding abuse
d. decentralised living leads to better health outcomes.

Q7 Indigenous health stakeholders continue to lobby Governments because:

a. they want their health policies to be changed
b. they believe Indigenous people cannot care for the land
c. they believe Indigenous people are the most able to care for the land
d. they know that broad-scale management is best done by the Government

Produced by Marg Tolliday & Associates ©

READING PART B # 2 CASE STUDIES FROM THEATRE

Top Adelaide surgeon suspended in wake of death

by Pia Akerman | October 28, 2009
http://www.theaustralian.news.com.au/story/0,25197,26270149-5013404,00.html
Article from: The Australian newspaper.

LEADING Adelaide heart surgeon John Knight has been suspended from duty at one
of the city's top hospitals following new information about the death of an elderly
female heart patient almost a year ago. The death is now the subject of two
separate investigations that are heavily focused on the role of an unnamed
interstate doctor. Investigators want to know if the interstate doctor was properly
supervised during the victim's heart surgery and whether he had the credentials to
perform the operation.

In State Parliament yesterday, Health Minister John Hill said Professor Knight,
Director of the Cardiac and Thoracic Surgical Unit at Flinders Medical Centre, had
been suspended by the Southern Adelaide Health Service's chief executive, Cathy
Miller. Mr Hill said the suspension related to the case of an elderly patient who
underwent cardiac surgery on November 25 last year. "The patient died a day after
extensive surgery," Mr Hill said. "The patient's death was reported to the Coroner's
Office at that time as the patient had died within 24 hours of a general anaesthetic."

In March, Coroner Mark Johns made a finding on the woman's cause of death, but
did not hold an inquest. "Further information has come to light in regard to this
case," Mr Hill said. "The information relates to the reporting of the surgery and the
patient's death, and the appropriate supervision and credentialing of an interstate
practitioner who was involved in the surgery."

Both Mr Hill's office and the Coroner declined to name the victim or the interstate
doctor under investigation. Professor Knight's precise relationship with the
interstate doctor remains unclear. An investigations unit in the Crown Solicitor's
office is examining the case ahead of a coronial inquest expected to begin next
month.

Professor Knight, 56, has been at Flinders' Cardiac Surgical Unit at Flinders Medical
Centre since 1992. In 2007 the Federal Court fined Professor Knight and a another
surgeon $55,000 each for breach of competition laws in that they colluded to
prevent the accreditation of another surgeon. At the time, Professor Knight said he
was motivated by patient safety. The Australian understands personality clashes
over the past year have created tensions among doctors at the Flinders' cardiac unit.
Professor Knight is believed to have brought some issues to the attention of senior
management and been frustrated at the lack of action.

Professor Knight's lawyer, Nick Iles, has sought hospital records relating to the dead
woman but has so far been denied access. Mr Iles said his client was anxious to
know the details of any allegations against him. "At every point, those requests
Produced by Marg Tolliday & Associates © 36
have been refused," he said. Mr Iles said Professor Knight had not been asked to
give his version of events and had been denied the right to defend himself. "This is
an extraordinary way to treat a loyal surgeon who has been instrumental in the
establishment of FMC's cardiac unit," he said. Mr Iles said Professor Knight
welcomed a coronial inquest if it meant the hospital would have to table the
evidence it was relying on.

Patients regret sleep apnoea surgery

By Pia Akerman | The Weekend Australian, January 5-6, 2008
http://www.the-pillow.com.au/resources/patients-regret-sleep-apnea-surgery.php

Almost two-thirds of people who undergo surgery for sleep apnoea suffer persistent
side-effects and almost a quarter regret their decision to go under the knife. The
findings were made by researchers of the University of Adelaide, whose study,
published in the Jan-08 edition of the British Medical Journal, recommends surgery
for obstructive sleep apnoea be performed only after a case review by an ethics
committee. Between 2 and 4 per cent of Australians have sleep apnoea, with
middle-aged, overweight men the main sufferers, about 24% of them experiencing
the condition, which collapses the upper airways during sleep, sometimes stopping
breathing. Treatment usually begins with weight and alcohol management and use
of breathing apparatus applying continuous pressure (CPAP mask) while sleeping is
considered, before surgery is performed.

Adam Elshaug, a lecturer at the University of Adelaide, reviewed reports from

around the world, including his own audit of 94 patients in Adelaide. He found that
up to 62% of 21,346 patients who had surgery reported persistent side-effects such
as a dry throat, difficulty in swallowing, voice changes and disturbances of smell and
taste. Up to 22% regretted having surgery. “The success rates were relatively low,
ranging from 13% for certain procedures, up to 47% for the more advanced
procedures,” Dr Elshaug said.

The number of patients undergoing surgery for obstructive sleep apnoea is growing,
with 3585 private patients recorded nationally in 2005, up from 3242 in 2004. Sleep
specialists and surgeons agree surgery should not be the first port of call for apnoea
sufferers, but say it is a viable option for patients who do not benefit from other
treatments. Sam Robinson, and ear, nose and throat surgeon who works with the
Adelaide Institute for Sleep Health, said it was “nonsense” to restrict surgery to
clinical trials overseen by an ethics committee. “Modern reconstructive surgery
will give a satisfactory response in 70 to 80% of patients, maybe up to 90%,” Dr
Robinson said.

Produced by Marg Tolliday & Associates ©

QUESTIONS:
Q1 The article infers that the main reason/s for Professor Knight’s suspension is/are:
a. he was responsible for the death of a cardiac patient?
b. he did not adequately supervise the other doctor?
c. he did not properly report the circumstances of the death to the Coroner’s Office?
d. all of the above

Q2 Professor Knight’s relationship with the interstate doctor and the Medical
Centre:
a. is one where he gets on well with others at the Flinders Medical Centre
b. is not clear
c. was one involving collusion
d. was a protective one in respect of the interstate doctor

Q3 In the first case study, the interstate doctor:

a. performed the surgery
b. was not properly registered
c. has a close working relationship with Professor Knight
d. none of the above

Q4 Professor Knight’s lawyer claims:

a. his client has not been allowed to see the Coroner’s findings
b. his client was prepared to be involved in an investigation
c. his client would get involved in an investigation but only if the hospital provided its
official records
d. his client has been asked to give his version of what happened but he is not
prepared to do this

Q5 In the sleep apnoea article, it is reported that sleep apnoea occurs:

a. in 24% of Australians
b. in 62% of Australians
c. in 2% to 4% of Australians
d. in 94 patients in Adelaide

Q6 Surgery for sleep apnoea patients:

a. has grown by nearly 350 cases in Australia in just 12 months
b. is always the best option
c. should first be subjected to clinical trials
d. always has excellent results

Q7 According to the author:

a. Nearly 66% of sleep apnoea sufferers who have surgery have ongoing side effects
b. 25% are pleased with their surgical outcomes
c. 52% are pleased with their surgical outcomes
d. Nearly 33% of sleep apnoea sufferers who have surgery have no side effects

Produced by Marg Tolliday & Associates © 38

PART B – #3 PLANNING FOR HEALTHY AGEING

Practice reading – take 45 minutes for this passage on its own.

Answers are in the back of the book
Planning for healthy ageing – new solutions for staying young and
healthy – and dodging winter aches and pains

Planning for healthy ageing

(ARA) - In just two short years, the first wave of baby boomers will turn 65. For some,
this milestone birthday may signal retirement; for others it may not. For all boomers,
it should mean an increased focus on health care. Baby boomers can take steps now
to help ensure many more healthy years.

A focus on early prevention – including regular tests for certain cancers and heart
disease, a healthy diet and exercise – is an important start to staying healthy well
into the golden years.

Most baby boomers will count on Medicare to support them in their efforts to stay
healthy. In fact, Medicare has long been a source of comfort for those 65 and older
who otherwise wouldn't have health coverage. But as more people older than 65
seek care, they may find it increasingly difficult to get in to see a doctor, or they may
find that their choice of doctors is limited because of planned Medicare payment
cuts to physicians.

Prevention
"As we age, we have an increasing role to play in our health care to ensure our
golden years are healthy ones," says Dr. J. James Rohack, president of the American
Medical Association. "Have regular discussions with your physician about any health
problems or concerns you may have and make sure you are up-to-date on
preventive exams."

At age 50, it's important to start annual exams for colorectal cancer, and men should
have a prostate exam. For those boomers who weigh less than 154 pounds,
screenings for osteoporosis should start at age 60. It's also important to start annual
exams with a physician before you reach age 65 to:

* Monitor and discuss blood pressure, cholesterol, needed vaccines and tests to
monitor or prevent disease.
* Identify activities and goals to address healthy eating, physical activity, tobacco use
cessation, moderating alcohol use and attention to stress and mood.
* Discuss screenings needed to prevent and/or monitor degenerative or chronic
disorders in vision, hearing, bone density, cancer and obesity.

Produced by Marg Tolliday & Associates ©

Access to care, choice of physician
Weighing in with legislators is another way boomers can take charge of their health
care, because what happens in Washington in the next couple months, with regards
to the health-reform debate, could have a significant impact on their ability to see
their doctor of choice.

A recent AMA/AARP poll shows that nearly 90 percent of people 50 and older are
concerned that the current Medicare physician payment formula threatens their
access to care. Without permanent repeal of the broken Medicare payment system
as part of health reform, physicians face steep payment cuts which might force them
to limit the number of new Medicare patients they can treat.

"Without health-reform action by Congress, the 21 percent payment cut planned for
this January puts many physicians in the difficult position of not being able to treat
new Medicare patients and still keep their practice doors open," says Rohack. "For
years, Congress has taken short-term action to stop the cuts and preserve seniors'
access to care, but they can no longer put a Band-Aid on the problem. It's time for
permanent action to preserve the stability and security of Medicare and ensure
seniors can keep their choice of physician."

As the health system reform debate continues, and final legislation approaches, a
permanent fix for the broken Medicare physician payment formula must be included
to preserve access to care for the millions of baby boomers headed toward Medicare
enrolment age. Replacing the physician payment formula with a system that better
reflects the costs and practice of 21st century medical care will help improve quality
and reduce costs by allowing physicians to increase care coordination, reduce costly
hospital admissions and adopt health information technology.

"I encourage all baby boomers to take preventive action now to prepare for a long,
healthy life, and to ensure that their physician will still be there for them when they
begin relying on Medicare," says Rohack.

New solutions for staying young and healthy

(ARA) - As we grow older, we look forward to the changes that life brings –
retirement, grandchildren, financial security and travel. Other changes that we might
not accept so readily are the aches, pains and mental slowdowns that leave us
longing for the good old days of our youth.

We think we have to put up with degeneration when aging, but that is not true.
Staying active is key for a healthy lifestyle, but what else can we do to benefit our
bodies as we age?

The human growth hormone (HGH) might be a key element in feeling your best as
you age. When HGH was first discovered, its only purpose was thought to be to
stimulate body growth to adult size. Recent studies have found that one of the main
reasons the body ages is because of the decrease in HGH, which helps the body
regenerate.

Produced by Marg Tolliday & Associates © 40

It is possible that aging symptoms – rise in blood glucose, high blood pressure and
even skin wrinkles – can be treated by maintaining HGH levels in the body. Receptor
sites for HGH exist in almost every cell in the human body, so regeneration and
healing effects can be quite comprehensive.

Until now, HGH therapy was injectable, costly and messy, available only to
celebrities and the very wealthy. In 1997, a group of doctors and scientists
developed an all-natural source-product which causes your own natural HGH to be
released again. GHR, manufactured by GlobalHealth Products, is a capsule that
works as a natural releaser for HGH. It has no known side effects, unlike the
synthetic version, and has no known drug interactions. Aging baby boomers and
seniors can feel young again by realizing HGH potential.

Some think that HGH is so comprehensive in its healing and regenerative powers
that it has the capability to displace many prescription and non-prescription drugs.
HGH is known to help treat hemorrhoids, autoimmune diseases, macular
degeneration, cataracts, fibromyalgia, angina, chronic fatigue, diabetic-neuropathy,
hepatitis C, chronic constipation, high blood pressure, sciatica, kidney dialysis, and
heart and stroke recovery.

As seniors and others deal with health care coverage problems, it is important to
look at what you can do for yourself to ensure your healthiness. HGH can be
particularly helpful to the elderly who, given a choice, would rather stay happy,
healthy and independent in their own home. HGH gives the possibility of real health,
not just treating sickness.

How to dodge or deal with winter aches and pains

(ARA) - Happy holidays, time with friends and family, the

freshness of a new year - there are many things to look forward
to with the arrival of winter. If you're among the millions of
Americans, however, who suffer from chronic pain, winter can
bring on a whole new set of problems and pains.

Whether you suffer from chronic ailments like arthritis or fibromyalgia, or simply
experience the aches, pains and stiffness associated with past injuries or with aging,
winter's cold and dampness can exacerbate these problems. Plus, there's the
potential to suffer painful injuries from winter activities like shoveling snow or
hazards like slipping on icy ground.

Here is some simple advice to minimize winter's impact on chronic pain and avoid
new pains from injuries:

Arthritis and fibromyalgia : While both conditions can cause excruciating pain, both
also respond well to positive influences like exercise, diet and hot/cold therapy. To
help minimize winter's impact on these two chronic ailments, be sure to stay active
and maintain prescribed medications and therapies. Dress warmly when going
outdoors, wearing layers that help trap heat near your body.

Produced by Marg Tolliday & Associates ©

Turn to hot and cold therapy to soothe sore muscles and aching joints. You don't
need to resort to a hot water bottle or an ice pack to get hot/cold therapy relief. The
IMAK Therapy Wrap is a 38-inch wrap that fits virtually any part of the body.
Insertable gel packs can be heated or chilled, depending on what works for your
pain. Breathable cotton Lycra fabric keeps the wrap comfortable against the skin.

Hot and cold therapy had also proven useful in treating normal aches and pains
associated with aging, and with pain resulting from injury. To avoid common winter
injuries from shoveling snow or slips and falls, follow this advice:

* Stretch before you start, just as you would if engaging in a workout.

* Shovel while it's still snowing and shovel repeatedly throughout the snowfall. That
way, you're not trying to move a large amount of heavy, wet snow when the
snowfall is over and the accumulation greater.
* Use a small shovel - a large one may tempt you to overdo it - and let the stronger
muscles of your legs do most of the lifting and pushing work. Bend at the knees to
avoid excess strain on your back.

If you do overdo it and wind up with some aches and pains, turn to hot and cold
therapy to soothe sore muscles.

Other outdoor dangers : Raking leaves, shoveling snow, even sitting for long hours
in the cold on stadium bleachers watching a football game - all can put undue strain
on your neck and shoulders. When performing outdoor physical activity that could
strain your neck, be sure to take regular breaks, and let your strong leg muscles do
as much of the work as possible. If you're sitting for long periods in the cold, dress
warmly in layers and be sure to protect your neck with a warm scarf. Shift position
often, standing up when possible, bending forward and gently stretching your neck,
arm and shoulder muscles to avoid stiffness.

Finally, be aware of the risk and dangers of inclement winter weather. Slips on ice
and frostbite from snow send thousands to emergency rooms every winter. If you
must walk on ice, take measures to ensure your footing is good, such as using special
cleats that attach to your shoes or wearing thick-soled snow boots. Never shovel
snow, play in snow or spend time outdoors in snow unless you are appropriately
dressed in warm layers, including hat, gloves and warm boots.

With a few precautions and the right therapy, you can enjoy winter months free of
the aches and pains associated with colder weather.

Courtesy of ARAcontent
Founded in 1996, ARAcontent's mission is to provide copyright-free, high-quality content for editors,
ad directors and publishers http://www.aracontent.com

Produced by Marg Tolliday & Associates © 42

Planning for healthy ageing : Questions

Q1 The text about planning for healthy ageing claims:

a. people over 65 will find it difficult to see a doctor of their choice
b. regular medical testing is going to be essential for staying healthy
c. regular medical testing for heart related problems is important
d. healthy diet and exercise helps prevent cancer

Q2 To prevent disease and maintain one’s health as we get older:

a. older folk should talk with their physician regularly about their general health
b. older folk should make sure they undergo all preventative health checks
c. people aged 50 or older and weigh less than 154 pounds (70 Kg) should get
checked for the onset of prostate cancer as soon as possible
d. all of the above

Q3 Things to talk about with the doctor:

a. problems that come and go
b. lifestyle
c. bad habits or attitudes
d. all of the above

Q4 Legislation changes planned for the American Medicare system :

a. may jeopardise compensation payments to physicians due to a planned 21%
payment cut
b. will ensure that nearly all people aged 50 or order will be looked after
c. is going to preserve access to care for all
d. none of the above

Q5 Some of the solutions for staying young and healthy are:

a. staying employed
b. staying active
c. develop a healthy attitude towards aches and pains
d. practice yoga

Q6 HGH therapy:
a. is expensive and only used by celebrities and the wealthy
b. is now cheaper because of an all-natural product which replaces HGH in our own
bodies
c. does away with the need for prescription drugs
d. helps many different common ailments that come with aging

Q7 The cold and wet associated with Winter:

a. can help relieve stiffness in joints
b. can make arthritis and other aches and pain worse particularly after exercising
c. makes it essential to wear warm clothing when outdoors to minimize its impact
d. can make you want to exercise

Produced by Marg Tolliday & Associates ©

Q8 Some ways to treat or avoid aching body joints is to:
a. use cotton Lycra fabric
b. put heated (or chilled) IMAK gel backs on the affected area
c. stretch well after exercise
d. exercise before going to bed

Q9 Outdoor dangers and ways to combat them:

a. simple activities like raking up leaves or clearing snow can make us very hungry
b. sitting still for long hours in the cold outdoors can strain necks and shoulders
c. avoid stiffness by lying flat in a layered position
d. frostbite is best if avoided

Produced by Marg Tolliday & Associates © 44

PART B # 4 Generic Medicines
By: Andy Casasanta

Generic Online Pharmacies started making a big impact on the net since the mid to
late 90's. This has allowed the prescription drug buyer to save hundreds with the
click of a mouse. Generics really slash the prices on prescription drugs and
medications because they do not carry brand names but they are essentially the
same drug. As the cost of prescription drugs and medications continue to soar, more
and more Americans are choosing Generic Pharmacies to maintain their quality of
life. Buying prescription drugs and medications through Generic Pharmacies is a true
alternative to paying the high medication prices that a bricks and mortar pharmacy
would charge.

What are Generic Drugs? A generic pharmaceutical drug is identical to a brand

name drug in safety, strength and quality. Even though generics are identical to
brand name drugs, they are typically sold at substantial discounts from the branded
price.Typically, savings of at 50 to 70 per cent can be saved for the average
consumer It has been estimated that generic drugs save consumers an estimated $8
to $10 billion a year at retail pharmacies. Even more when hospitals use generics.

Are Generic Drugs Safe? One of the most common concerns about purchasing
Generic Drugs from online pharmacies is the safety of the drugs, and the safety of
the patients ordering them.In most cases, generic drugs are considered safe due to
the testing process used by the Food and Drug Administration and must meet or
exceed all strict quality control standards, in compliance with WHO international
guidelines.

If brand-name drugs and generic drugs have the same active ingredients, why do
they look different? Trademark laws do not allow a generic drug to look like the
brand-name drug. However, a generic drug must duplicate the active ingredient.
Colors, flavors, and certain other inactive ingredients may be different.

Does every brand-name drug have a generic counterpart? No. Brand-name drugs
are generally given patent protection for 20 years from the date of submission of the
patent.

Are generic drugs as strong as brand-name drugs? Yes. FDA requires generic drugs to
have the same quality as brand-name drugs.

Do generic drugs take longer to work in the body? No. Generic drugs are basically
the same in quality, strength, purity as brand-name drugs. More and more people
every day are taking advantage of the savings that Generic Pharmacies offer.
Purchasing your prescription drugs and medications from Generic Pharmacies or
internet pharmacies has never been easier.

Author Bio Submitted by Mr Andy Casasanta. www.medheadquarters.net

Article Source: http://www.ArticleGeek.com - Free Website Content

Produced by Marg Tolliday & Associates ©

Generic Medications - The Truth Behind The Myths
By: Richard Clement

These days the subject of generic medications troubles many "anxious about our
health government minds ".Generic drugs are unsafe, not as helpful as brand names
for your diseases , they are made in unauthorised facilities – and so on. Is this the
truth or is it just an attempt to favour some American drug manufacturers and
pharmacies?

Drug products sold in the United States are approved by the FDA whether they are
brand name or generic. "Most people believe that if something costs more, it has to
be better quality. In the case of generic drugs, this is not true," says Gary Buehler,
Director of FDA's Office of Generic Drugs. "The standards for quality are the same for
brand name and generic products."

Health professionals and consumers can be assured that FDA approved generic drugs
have met the same rigid standards as the innovator drug. To gain FDA approval, a
generic drug must:
- contain the same active ingredients as the innovator drug (inactive ingredients
may vary)
- be identical in strength, dosage form, and route of administration
- have the same use indications
- be bioequivalent
- meet the same batch requirements for identity, strength, purity, and quality
- be manufactured under the same strict standards of FDA's good manufacturing
practice regulations required for innovator products

So we can make the conclusion that: The Generic Drug is a drug which is
bioequivalent to a brand name drug with respect to pharmacokinetic and
pharmacodynamic properties. Generic medicines must contain the same active
ingredient at the same strength as the "innovator" brand, be bioequivalent, and are
required to meet the same pharmacopoeial requirements for the preparation. By
extension, therefore, generics are identical in dose, strength, route of
administration, safety, efficacy, and intended use.

Thus, in some cases, the "generic" product is actually the brand product but inside a
different box. The principal reason for the reduced cost of generic medicines is that
these are manufacturered by smaller pharmaceutical companies which do not invest
in research and development into new drugs. The significant research and
development costs incurred by the large pharmaceutical companies in bringing a
new drug to the market is often cited as the reason for the high cost of new agents -
they wish to recover these costs before the patent expires. Other reasons for high
prices is that every year pharmaceutical companies spend billions to market their
products.

Produced by Marg Tolliday & Associates © 46

When a pharmaceutical company first markets a drug, it is usually under a patent
that only allows the pharmaceutical company that developed the drug to sell it. This
allows the company to recoup the cost of developing that particular drug. It will
frequently cost millions of dollars to develop and test a new drug before it is
approved for use. After the patent on a drug expires, any pharmaceutical company
can manufacture and sell that drug. Since the drug has already been tested and
approved, the cost of simply manufacturing the drug will be a fraction of the original
cost of testing and developing that particular drug. So despite the strict standards
imposed by the FDA for approval of generic drugs, and their enforcement of these
standards, a number of misconceptions about generic drugs persist that we must
disprove:

MYTH: Generics take longer to act in the body.

FACT: The firm seeking to sell a generic drug must show that its drug delivers the
same amount of active ingredient in the same timeframe as the original product.

MYTH: Generics are not as potent as brand-name drugs.

FACT: FDA requires generics to have the same quality, strength, purity, and stability
as brand-name drugs.

MYTH: Generics are not as safe as brand-name drugs.

FACT: FDA requires that all drugs be safe and effective and that their benefits
outweigh their risks. Since generics use the same active ingredients and are shown
to work the same way in the body, they have the same risk-benefit profile as their
brand-name counterparts.

MYTH: Brand-name drugs are made in modern manufacturing facilities, and generics
are often made in substandard facilities.
FACT: FDA won't permit drugs to be made in substandard facilities. FDA conducts
about 3,500 inspections a year in all firms to ensure standards are met. Generic firms
have facilities comparable to those of brand-name firms. In fact, brand-name firms
account for an estimated 50 percent of generic drug production. They frequently
make copies of their own or other brand-name drugs but sell them without the
brand name.

MYTH: Generic drugs are likely to cause more side effects.

FACT: There is no evidence of this. FDA monitors reports of adverse drug reactions
and has found no difference in the rates between generic and brand-name drugs.
And finally what we can conclude is that the only "unsafe and unhealthy" thing
about generics is the financial loss for the big pharmaceutical companies that want
to protect their monopol on our health,despite the necessity of some low income
households for effective medical care.

We believe that it takes knowledge & understanding to make wise decisions about
the prescription meds that we take. In today's society we are bombarded with huge
amounts of confusing information about our health and the prescription drugs that
are available. In an effort to clear some of this confusion we strive to provide you
with as much information as possible concerning your health and prescription drugs.

Produced by Marg Tolliday & Associates ©

So if you can afford to buy brand name medications, you can help yourself visiting
our site, where we hope that you will find all the drug information that you seek to
get rid of your diseases.

Generic Medicines - Questions

Q1 Generic pharmaceuticals:
a. have continued to soar in price
b. are another way to get one’s required medications
c. are the same price as regular medications
d. save the consumer money

Q2 The author reports that:

a. generic drugs are safe
b. buying from online pharmacies is safe
c. generic drugs are safe because they must meet strict quality control standards
d. generic drugs are safe creating a huge demand for them

Q3 The author asserts the following about generic drugs, except for:
a. the law requires them to look different to their brand name counterparts
b. can have the same vital element
c. colours used in generic drugs must be the same as in their brand name
counterparts
d. must be of the same strength as their brand name counterparts

Q4 Richard Clement puts forward some common beliefs:

a. generic drugs are safer than brand name drugs
b. if the product is cheaper, it has to be better value
c. the quality of brand name and generic pharamaceuticals are the same
d. generic drugs are made in unauthorised facilities

Q5 The article sets out why we should not be afraid to use generic drugs, except for:
a. generic drugs are manufactured according to strict standards
b. brand name drugs are manufactured according to strict standards
c. both must have the same potency
d. share the same inactive ingredient properties

Produced by Marg Tolliday & Associates © 48

 THE ANSWERS

Produced by Marg Tolliday & Associates ©

ANSWERS
Answers to Part A - Stress

Q1 walks Q2 physical Q3 quality Q4 relationships Q5 commitments

Q6 responsibilities Q7 support Q8 religious Q9 less Q10 emotional

Q11 bodily Q12 mental Q3 chemical Q14 toxins Q15 caregivers

Q16 personality Q17 age Q18 gender Q19 family Q20 illnesses
Q22
Q21 dysphoria
presenteeism
Q23 - 27 Choose five from : Exercise CDs Martial arts
Transcendental Progressive
Autogenic training Biofeedback Imagery
meditation muscle relax’n
Develop good
Qigong Tai chi Yoga Time management
organiz. skills

Answers to Part A - Hearing Loss

Q3 Residual
Q1 Tinnitus Q2 Brain Q4 Masking Q5 Reduces
inhibition

Q6 30 Seconds/ Q8 Tinitus Q9 Cortical

Q7 Brain activity Q10 Frequencies
thirty seconds perception networks

Q11 Permanently Q12 New South Q13 Q14 Q15

interrupt Wales / NSW 6,700 Hearing 218,200
Q17 Aged (must
Q16 Q18 Q20
be in the past Q19 Sleek
81,500 Hearing aid Sophisticated
tense)
Q22 Being Q23 Complex Q24
Q21 Feedback Q25 Focus
plugged algorithms Microphone

Q26 Switch Q29 Ear

Q27 Volume Q28 Lifestyle
modes

Answers to Part A - Summary on smoking & review of tobacco control

in Jordan
Q1 80% Q2 Developing Q3 80% Q4 chemicals Q5 carbon
world monoxide
Q6 tar Q7 50% Q8 20% Q9 7% to 10% Q10 63%
Q11 25 to 34 Q12 less than 1% Q13 18 to 24 Q14 3 Q15 East Asia
and Pacific
Q16 11% Q17 Low and Q18 82% Q19 high income Q20 18%
middle income
Q21 25 to 34 Q22 55 to 64
years old years old

Produced by Marg Tolliday & Associates © 50

Answers to Part A - Summary on Panic Attacks
1. dying 2. dizzy 3. accelerated
4. constriction 5. breathing 6. 35%
7. treated 8. disabled 9. adrenaline
10. overcrowded, hot 11. stuffy
12. hyperventilation 13. is not enough
14. traumatic event 15. acute stress
16. body 17. symptoms 18. life threatening
19. threes 20. favourite 21. sounds
22. biofeedback 23. techniques
24. diet 25. exercise 26. sleep
27. 3 million (or) 3,000,000 28. 1.7%

Answers to Part B reading exercise (Text 1) – Indigenous health

Q1 – d Q2 – d Q3 – d Q4 – a Q5 – d
Q6 – d Q7 – c

Answers to Part B reading exercise (Text 2) – Case studies from Theatre

Q1 – d Q2 – b Q3 – d Q4 – c Q5 – c Q6 – a
Q7 - a

Answers to Part B reading exercise # 3 - Healthy ageing

Q1 – c Q2 – a Q3 – a Q4 – a Q5 – b
Q6 – d Q7 - c Q8 - b Q9 - b

Answers to Part B reading exercise # 4 - Generic medicines

Q1 – b Q2 – c Q3 – c Q4 – d Q5 – d

Good luck in your OET test.

Comments / Feedback are always welcome.
Please email: info@oetworkshop.com

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