English Book PDF

FUNDAIA LAURENIA COALA POSTLICEAL SANITAR EUGEN NICOAR
Autori: GROSU LAURENIA MARIA

Baciu Sanda Paula
SUPORT DE CURS
COMUNICARE PROFESIONAL N LIMBA MODERN
Pentru uzul intern al colii
ANUL 2013
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TABLE OF CONTENTS
INTRODUCTION TO ENGLISH ............................................................................................. 4 CHAPTER I ............................................................................................................................... 6 LESSON 1. TWO INTERNATIONAL FRIENDS ................................................................ 6 The verb "to be" LESSON 2. GETTING A DRIVER'S LICENSE .................................................................. 8 Filling out a form; personal information LESSON 3. THE CITY AND THE COUNTRY ................................................................. 12 The degrees of the adjective LESSON 4. INTERVIEW WITH A FAMOUS ACTOR .................................................... 15 Present simple and present continuous LESSON 5. WHAT'S IN YOUR OFFICE? ......................................................................... 17 There is, there are; some/any; prepositions LESSON 6. WHAT WERE YOU DOING? ........................................................................ 19 Past simple and past continuous LESSON 7. THE OREGON WEATHER FORECAST ....................................................... 21 Will future LESSON 8. A BUSINESS PRESENTATION..................................................................... 24 Present perfect simple LESSON 9. A BUSINESS TRAVELLER ........................................................................... 26 Like and dislike LESSON 10. THE MEETING ............................................................................................. 29 Telling the time LESSON 11. A NEW OFFICE ............................................................................................ 32 This, that, some, any LESSON 12. COOKING ...................................................................................................... 34 Present simple and adverbs of frequency LESSON 13. A GREAT WORKOUT ................................................................................ 36 Modal verbs LESSON 14. TODAYS SPECIAL ..................................................................................... 38 Would like, food vocabulary
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CHAPTER II.GRAMMAR AND VOCABULARY FOCUS .................................................. 40 ANNEX 1-WHO ARE YOU? - THE VERB "TO BE" ....................................................... 40 ANNEX 2- PERSONAL INFORMATION...................................................................................................................42 ANNEX 3-DEGREES OF ADJECTIVES ........................................................................... 47 ANNEX 4 -THIS-THAT-THESE-THOSE-HERE-THERE ................................................ 50 ANNEX 5 - PREPOSITIONS .............................................................................................. 53 ANNEX 6 LIKE.............................................................................................................. 56 ANNEX 7 WHAT TIME IS IT? ....................................................................................... 59 ANNEX 8 BASIC PREPOSITIONS: TIME AND PLACE ............................................ 60 ANNEX 9 ANY/SOME .................................................................................................... 61 ANNEX 10 ADVERBS OF FREQUENCY ..................................................................... 62 ANNEX 11 MODAL VERBS OF PROBABILITY ......................................................... 65 ANNEX 12 TYPES OF FOOD ......................................................................................... 67 ANNEX 13-TABLE OF ENGLISH TENSES ..................................................................... 70 CHAPTER III ........................................................................................................................... 74 1. PET DOCTOR............................................................................................................................75 2. THE BODY SHOP ........................................................................................................... 77 3. THE TOY MUSEUM ....................................................................................................... 78 4. PHOTO PRINTING FIRM PAYS OUT COMPENSATION .......................................... 79 5. ALTERNATIVE MEDICINE .......................................................................................... 80 1. NORWICH ....................................................................................................................... 82 2. CARNIVAL SAFETY SUCCESS ................................................................................... 83 3. THE WESTERN ALPHABET ......................................................................................... 84 4. THE BATTLE OF BANNOCKBURN ............................................................................ 85 5. FACEBOOK ..................................................................................................................... 86 CHAPTER IV .......................................................................................................................... 88 BALNEOTHERAPY DEFINED ......................................................................................... 88 CLINICAL TRIALS EVALUATING BALNEOTHERAPY .............................................. 92 A SHOWER INSTEAD ....................................................................................................... 94 BALNEOTHERAPY: HEALING WITH WATER ............................................................. 97 WARM WATER THERAPY ............................................................................................. 100 CAN BALNEOTHERAPY TREAT CHRONIC BACK PAIN? ....................................... 102 BENEFITS OF BALNEOTHERAPY ................................................................................ 103
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PHYSICAL NEEDS OF THE CAREGIVER .................................................................... 104 PHYSICAL NEEDS OF THE PATIENT .......................................................................... 107 CHAPTER V .......................................................................................................................... 108 1. A PRESCRIPTION ........................................................................................................ 108 2. TROUBLING SYMPTOMS .......................................................................................... 110 3. A PHYSICAL EXAMINATION ................................................................................... 112 4. FEELING QUEASY ...................................................................................................... 115 5. JOINT PAIN ................................................................................................................... 117 6. PAIN THAT COMES AND GOES ............................................................................... 119 7. HELPING A PATIENT................................................................................................. 121 8. GETTING PATIENT DETAILS .................................................................................... 123 9. MAKING A DOCTOR'S APPOINTMENT .................................................................. 125 10. DENTAL HYGIENE ................................................................................................... 127 CHAPTER VI ........................................................................................................................ 129 READING COMPREHENSION FOR NURSING SCHOOL ........................................... 129 PRACTICE PASSAGE 1:USING THE FOUR QUESTION TYPES ............................... 131 PRACTICE PASSAGE 2: DETAIL AND MAIN IDEA QUESTIONS ........................... 134 PRACTICE PASSAGE 3: INFERENCE AND VOCABULARY QUESTIONS ............. 138 REVIEW: PUTTING IT ALL TOGETHER ...................................................................... 140 CHAPTER VII ....................................................................................................................... 141 SMALL GROUP DISCUSSION- ORAL COMUNICATION .......................................... 141 APPENDIX 1 ..................................................................................................................... 142 APPENDIX 2 ..................................................................................................................... 143 APPENDIX 3 ..................................................................................................................... 144 APPENDIX 4 ..................................................................................................................... 145 APPENDIX 5 ..................................................................................................................... 146
ANSWER KEY........................................................................................................................................147 BIBLIOGRAPHY .................................................................................................................. 153
Introduction to English
English is thought to be one of the most important languages in the world. There are many reasons why English is so important. One of the reasons is that English is spoken as the first language in many countries. There are 104 countries where English is spoken as the first language. Although English is the language of so many countries, more people in the world speak Mandarin Chinese as their first language. Mandarin Chinese is spoken in sixteen countries. Even in countries where English is not the native language, people use it for business and tourism. English is used for these purposes in most countries. English is considered the business language. English is the official language of the United Nations. English is also the official language of airlines and airports. All airline pilots that fly to other countries must be able to speak English. There are different kinds of English like British English, Canadian English and American English. These are not separate languages. They are dialects. A dialect is the way people in a particular place speak their native language. In one place, people might have a name they like to use for something that is not used in another place.
Teachers open the door, but you must enter by yourself chinese proverb.
EVERY DAY ENGLISH
CHAPTER I LESSON 1. TWO INTERNATIONAL FRIENDS

(Who Are You?)
Claudio Hello, my name's Claudio. I'm from Italy and I'm a student. I'm twenty-five years old and I'm single. I live in an apartment with my parents. I go to university five days a week. I like going to the disco on Saturdays. I don't like playing sports. I have one sister and one brother, Maria and Antonio. Chul Hi, my name's Chul and I come from Korea. I'm a businessman and I work in Seoul. I'm married and have two children, Min-Jee - a girl, and Dak-Ho a boy. I like in a small house in the suburbs. I take the subway to work from Monday to Friday. I like playing golf in my free time. I don't like singing karaoke!
MULTIPLE CHOICE- COMPREHENSION QUIZ 1. Where is Claudio from?

a. b. c.
Spain Korea Italy
2. What does Chul do?

a. b. c.
He's a student. He's a businessman. He's a Korean.
3. Where does Claudio live?

a. b. c.
In a house In a dorm In an apartment
4. How does Chul get to work?

a. b. c.
He drives to work. He walks to work. He takes the subway.
5. Who likes playing a sport?

a. b. c.
Chul Claudio Doesn't say
6. How many children does Chul have?

a. b. c.
1 2 3
7. Who doesn't live with Claudio?

a. b. c.
His parents His children His brother and sister
8. Who likes dancing?

a. b. c.
Chul Claudio Doesn't say
9. Who is married?
a. b. c.
Claudio Chul Doesn't say
10. Where are they from?

a. b. c.
Africa and Asia Europe and Asia North America and Europe
See CHAPTER II, ANNEX 1
LESSON 2. GETTING A DRIVER'S LICENSE

( Filling out a form)
A trip to the DMV to get a driver's license means you'll have to fill out a form. Sometimes, you'll have to fill out the form yourself. Other times, you'll answer questions with someone who helps you fill out the form. This dialogue will help you practice filling out forms with another person by asking and answering questions about your personal information such as date of birth, address, etc. Practice the following dialogue with a friend or classmate.
Customer Service Representative: How may I help you today? Mr. Anderson: I'd like to apply for a driver's license. Customer Service Representative: Fine. Can you fill in this form, please. Mr. Anderson: Certainly. Mr. Anderson: Peter can you help me with this form? Peter: Sure, what's your last name? Mr. Anderson: Anderson. Peter: Could you spell that please? Mr. Anderson: Certainly, A - N - D - E - R - S - O - N. Peter: What's your first name? Mr. Anderson: You know that! It's Jack. Customer Service Representative: Are you married? Mr. Anderson: No, I'm single. Peter: OK. Now, what's your address? Mr. Anderson: It's 2926 NW 2nd Ave. Customer Service Representative: and what's your zipcode? Mr. Anderson: 87665
Peter: Right. Are you an American citizen? Mr. Anderson: Good question. Yes, I am. Peter: ... and what's your date of birth? Mr. Anderson: I was born on 19th April 1961 Peter: Ha, ha! You certainly don't look your age! You look older! Mr. Anderson: Very funny, Peter. Let's continue, ok? Peter: Yes, OK, Are you disabled? Mr. Anderson: Well, my legs sometimes hurt, but I'm not disabled. How many more questions are there? Peter: Just a few. Do you wear glasses? Mr. Anderson: Yes, I need glasses to drive. Peter: OK, last question. Do you currently have a driver's license? Mr. Anderson: Yes, I do. Peter: Where's it from? Mr. Anderson: It's from California. Peter: Fine. Right. Here you go, your form is filled out. Mr. Anderson: Thanks for your help Peter. Mr. Anderson: Here's my completed form. Customer Service Representative: Thank you, please take this completed form to the cashier with your payment of $75. Mr. Anderson: Certainly. What happens next? Customer Service Representative: The cashier will help you with the next steps.
MULTIPLE CHOICE- COMPREHENSION QUIZ 1. What type of document does Mr. Anderson need?
a. b. c.
An identification card A passport A driver's license
2. Who helps Mr. Anderson fill out the form?

a. b. c.
The customer service representative He doesn't ask for help. His friend, Peter.
3. What's Mr. Anderson's marital status?

a. b. c.
Single Divorced Married
4. Which statement is true?

a. b. c.
He isn't an American. He's got a license from a different state. He needs to renew his license.
5. What does Peter joke about?

a. b. c.
His age That fact that he is single That fact that he is from California
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6. Does he need special equipment to drive a car?

a. b. c.
Yes, crutches Yes, glasses No
7. Does he currently have a driver's license?

a. b. c.
Yes No Doesn't say
8. How much does it cost to apply for a license?

a. b. c.
$50 $75 $100
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LESSON 3. THE CITY AND THE COUNTRY

(Comparative form, as ... as)
When comparing the city and country in a conversation, you'll need to use the comparative form. The comparative form changes depending on the adjective you use. It's important to learn a wide range of adjectives to describe both the physical location as well as the character of the people and places. Practice comparing the city and the country with the dialogue below and then practice your own conversations with others in your class.
David: How do you like living in the big city? Maria: There are many things that are better than living in the country! David: Can you give me some examples? Maria: Well, it certainly is more interesting than the country. There is so much more to do and see! David: Yes, but the city is more dangerous than the country. Maria: That's true. People in the city aren't as open and friendly as those in the countryside. David: I'm sure that the country is more relaxed, too! Maria: Yes, the city is busier than the country. However, the country is much slower than the city. David: I think that's a good thing! Maria: Oh, I don't. The country is so slow and boring! It's much more boring than the city. David: How about the cost of living? Is the country cheaper than the city? Maria: Oh, yes. The city is more expensive than the country. David: Life in the country is also much healthier than in the city. Maria: Yes, it's cleaner and less dangerous in the country. But, the city is so much more exciting. It's faster, crazier and more fun than the country.
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David: I think YOU are crazy for moving to the city. Maria: Well, I'm young now. Maybe when I'm married and have children I'll move back to the country.
MULTIPLE CHOICE- COMPREHENSION QUIZ 1. Maria thinks life in the city is more interesting than life in the country.
a. b.
True False
2. David says that the city is less dangerous than the country.
a. b.
True False
3. The people in the countryside aren't as open as the people in the city.
a. b.
True False
4. The country is quieter than the city.

a. b.
True False
5. The city isn't as expensive as the country.

a. b.
True False
6. The country is healthier than the city.

a. b.
True False
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7. Maria thinks the city is more fun than the country.

a. b.
True False
8. David thinks Maria is crazy for leaving the country.

a. b.
True False
9. Maria says she might move back to the country when she is married and has children.
a. b.
True False
10. Life in the country isn't as hectic as life in the city.

a. b.
True False
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LESSON 4. INTERVIEW WITH A FAMOUS ACTOR

(Daily routines, present simple)
In this dialogue you will practice speaking about daily routines, as well as current activities. Notice that the present simple is used to speak about daily routines, and the present continuous is used to speak about what is happening around the current moment in time. Practice the dialogue with your partner and then interview each other focusing on changing between a discussion of daily routines and what you are currently working on.
Interviewer: Thank you for taking some time off from your busy schedule to answer a few questions about your life! Brad: It's my pleasure.
Interviewer: Could you tell us about an average day in your life? Brad: Sure, I get up early - at 7 in the morning. Then I have breakfast. After breakfast, I go to the gym.
Interviewer: Are you studying anything now? Brad: Yes, I'm learning a new film called "The Man About Town".
Interviewer: What do you do in the afternoon? Brad: First I have lunch, then I go to the studio and shoot some scenes.
Interviewer: Which scene are you acting today? Brad: I'm acting a scene about an angry lover.
Interviewer: That's very interesting. What do you do in the evening? Brad: In the evening, I go home and have dinner and study my scripts.
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Interviewer: Do you go out at night? Brad: Not always, I like going out at weekends.
MULTIPLE CHOICE- COMPREHENSION QUIZ
1. Why does the interviewer thank Brad?

a. b. c.
for visiting him for taking time off for telephoning
2. What does Brad do after breakfast?

a. b. c.
He studies his scripts. He goes to the studio. He goes to the gym.
3. What is Brad studying now?

a. b. c.
The Man The Man About Town The Loverboy
4. What does he do in the afternoon?

a. b. c.
He goes to the studio. He goes to the gym. He studies his scripts.
5. When does he like going out?

a. b. c.
at night on Sundays at weekends
Present Simple and Present Continuous
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LESSON 5. WHAT'S IN YOUR OFFICE?

(Use of there is / there are, prepositions and office furniture vocabulary)
Speaking about objects in your office means that you'll need to understand the use of 'there is' and 'there are', as well as 'any' or 'some' for asking and answering questions about those objects. You'll also practice using prepositions of place to describe where the objects in your office are. Practice the dialogue with your partner and then continue discussing your own office or school. David: I've got a new office now Maria: That's great! Congratulations.
David: I'll need a desk and some cabinets. How many cabinets are there in your office? Maria: I think there are four cabinets in my office.
David: And do you have any furniture in your office? I mean other than the chair at your desk. Maria: Oh yes, I've got a sofa and two comfortable armchairs.
David: Are there any tables in your office? Maria: Yes, I've got a table in front of the sofa.
David: Is there a computer in your office? Maria: Oh yes, I keep a laptop on my desk next to the phone.
David: Are there any flowers or plants in your office? Maria: Yes, there are a few plants near the window.
David: Where's your sofa? Maria: The sofa is in front of the window, between the two armchairs.
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David: Thanks a lot for your help Janet. This gives me a good idea of how to arrange my office. Maria: My pleasure. Good luck with your decorating!
MULTIPLE CHOICE- COMPREHENSION QUIZ 1. David has just received a new job.
a. b. c.
True False Doesn't say
2. David is sure he will need some cabinets in his new office.

a. b. c.
3. Maria thinks it is a good idea to have comfortable furniture in an office.

a. b. c.
4. David is surprised that Maria keeps coffee on her table.

a. b. c.
5. Maria keeps a computer next to her telephone.

a. b. c.
See CHAPTER II, ANNEX 4 and 5
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LESSON 6. WHAT WERE YOU DOING?

(Use of the past continuous in combination with the past simple)
This dialogue focuses on the use of the both the past continuous and past simple. The past continuous is used to speak about actions that were interrupted in the past such as: "I was watching TV when you telephoned." Practice the dialogue with your partner and then practice the use of these two forms on your own beginning with the question "What were you doing when + past simple".
Betsy: I telephoned you yesterday afternoon but you didn't answer? Where were you? Brian: I was in another room when you called. I didn't hear the phone ringing.
Betsy: What were you working on? Brian: I was photocopying a report that I needed. What were you doing when you telephoned?
Betsy: I was looking for Tom and couldn't find him. Do you know where he was? Brian: Tom was driving to a meeting.
Betsy: Oh, I see. What did you do yesterday? Brian: I met the representatives from Driver's in the morning. In the afternoon, I worked on the report and was just finishing when you telephoned. What did you do?
Betsy: Well, at 9 I had a meeting with Ms Anderson. After that, I did some research. Brian: Sounds like a boring day!
Betsy: Yes, I don't really like doing research. But it needs to be done. Brian: I agree with you on that, no research - no business!
Betsy: Tell me about the report. What do you think of it? Brian: I think the report is a good. Tom believes it's good, too.
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Betsy: I know that every report you write is excellent. Brian: Thank you Betsy, you are always a good friend!
MULTIPLE CHOICE- COMPREHENSION QUIZ 1. What was Brian doing when Betsy telephoned?
a. b. c.
He was photocopying a report. He was having a coffee-break. He was at a meeting.
2. What was Betsy doing when she telephoned Brian?

a. b. c.
She was writing a report. She was looking for Tom. She was planning a meeting.
3. What did Brian do yesterday morning?

a. b. c.
He worked on the report. He drove to a meeting. He met representatives from Driver's.
4. When did Betsy have a meeting with Ms Anderson?

a. b. c.
this afternoon yesterday afternoon yesterday morning
5. Betsy thinks Brian does excellent work.

a. b. c.
true false doesn't say
See CHAPTER II, ANNEX 13 Past Simple and Past Continuous
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LESSON 7. THE OREGON WEATHER FORECAST

(Use of the future with will for predictions, weather vocabulary)
Forecasting the weather means that you are predicting what the weather will be. In English, we generally use the future with 'will' to make a prediction. Practice using this prediction and then make your own weather predictions. You can use a weather report on the internet, or make up your weather prediction based on what you know about your city.
The Oregon Weather Forecast
Weather Forecaster: Good afternoon and welcome to the weather forecast. Let's take a look at the weather outside now. What's it like? Well, it's currently raining and cloudy in southern Oregon while northern Oregon is cold and clear. The sun is shining, but it's rather cold up here in the North! The temperature is currently 45 degrees in the southern Oregon and only 30 degrees in the North.
Shall we see what the weather will be like tomorrow? Well, it will be rainy in the morning in southern Oregon and windy in northern Oregon. In the afternoon, The South will see cloudy weather with some rain later in the day. Northern Oregon will also see rain turning to snow and quite windy, with winds coming from the North-East.
That's the weather forecast for this afternoon. Have a good day!

1. What time of day is it?
a. b. c.
morning afternoon evening
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2. What's the weather like in southern Oregon at the moment?
a. b. c.
rainy and cloudy sunny and windy sunny and cold
3. What's the weather like in northern Oregon at the moment?
a. b. c.
rainy and cloudy sunny and windy sunny and cold
4. What is the temperature in southern Oregon at the moment?
a. b. c.
30 degrees 45 degrees 13 degrees
5. What is the temperature in northern Oregon at the moment?
a. b. c.
30 degrees 45 degrees 13 degrees
6. What will the weather be like in southern Oregon tomorrow morning?
a. b. c.
rainy sunny windy
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7. What will the weather be like in northern Oregon tomorrow morning?
a. b. c.
snowy sunny windy
8. What will it do later in the day in southern Oregon?
a. b. c.
rain snow be clear
9. Where will it be windy tomorrow?
a. b. c.
southern Oregon northern Oregon Seattle
10. What direction will the wind come from?
a. b. c.
North-East North-West South-East
See CHAPTER II, ANNEX 13 Will Future
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LESSON 8. A BUSINESS PRESENTATION

(Use of the present perfect)
This dialogue focuses on asking questions about a business presentation with the present perfect and past simple tenses. Make sure you understand the the differences between these two tenses, practice the dialogue and then have your own conversations about work.
On a Business Trip - A Presentation
Betsy: Hi Brian, this is Betsy. How are you doing? Brian: I've just returned from the Head Office. The weather is great! Boston is a great city!
Betsy: Have you met Frank yet? Brian: No, I haven't seen him yet. We have a meeting at 10 o'clock tomorrow morning. We are going to meet then.
Betsy: Have you made your presentation yet? Brian: Yes, I made the presentation yesterday afternoon. I was very nervous, but everything went well.
Betsy: Has management given you any feedback yet? Brian: Yes, I've already met with the sales director. We met immediately after the meeting and he was impressed with our work.
Betsy: That's great Brian. Congratulations! Have you visited any museums yet? Brian: No, I'm afraid I haven't had any time yet. I hope to take a tour around town tomorrow.
Betsy: Well, I'm happy to hear that everything is going well. I'll talk to you soon. Brian: Thanks for calling Betsy. Bye.
See CHAPTER II, ANNEX 13 Past Simple and Present Perfect Simple
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1. Where is Brian?
a. b. c.
Boston London Paris
2. Why is he there?
a. b. c.
on holiday on business for a performance
3. Has he made the presentation yet?
a. b. c.
no yes doesn't say
4. When he is going to meet Frank?
a. b. c.
at 10 o'clock tomorrow morning tomorrow afternoon at 7 o'clock tomorrow evening
5. Why hasn't he visited any museums yet?
a. b. c.
He hasn't had time. He doesn't want to visit any museums. He thinks Boston is boring.
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LESSON 9. A BUSINESS TRAVELLER

(Speaking about likes and dislikes with like, enjoy)
This dialogue focuses on speaking about various likes and dislikes using the different forms of like. The subject of the conversation is an interviewer asking a business traveller questions about his likes and dislikes when traveling for business.
A Business Traveller
Interviewer: Good morning Sir. I'd like to ask you a few questions if I may. Jack: Well, I'm waiting to catch my flight so I guess I can answer a few questions.
Interviewer: Thank you Sir. First of all, how often do you travel? Jack: I travel about twice a month.
Interviewer: Where are you flying to on this trip? Jack: I'm flying to Austin, Texas. Interviewer: and where did you fly on your last trip? Jack: I flew to Portland, Oregon. I've already been there three times!
Interviewer: Really! Do you enjoy travelling for business? Jack: Yes, although I prefer staying in the office.
Interviewer: What do you like most about travelling? Jack: I like visiting new cities and trying out new food.
Interviewer: Is there anywhere you would like to visit that you haven't visited yet? Jack: Yes, I'd like to go to Hawaii! I love going to the beach!
Interviewer: Thank you very much for your time today. Jack: You're welcome. My pleasure.
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1. Jack is waiting to catch a flight.
a. b. c.
2. Jack travels twice a month.
a. b. c.
3. Jack especially likes going to Portland.
a. b. c.
4. Jack is flying to Oregon.
a. b. c.
5. Jack flew to Portland for his last trip.
a. b. c.
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6. Jack has already been to Portland four times.
a. b. c.
7. Jack likes eating in good restaurants.
a. b. c.
8. Jack would like to visit Hawaii.
a. b. c.
9. Jack doesn't enjoy travelling for business.
a. b. c.
10. Jack likes visiting new cities and meeting new people.
a. b. c.

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LESSON 10. THE MEETING (Schedules, future plans)

At work, you'll often speak about schedules. We generally speak about schedules using a 12 hour clock to tell the time. It's not important to specify whether it's 3 am or 3 pm because work is usually done during the day. However, if necessary you can use time phrasessuch as 'in the morning', 'in the afternoon'. Practice this short dialogue about a meeting with a partner. Next, talk about your own schedule at work.
James: Hi Alice. How are you today? Alice: Hi James. I'm fine, and you?
James: Great, thank you. Remember, the meeting is at 3 o'clock. Alice: Excuse me, which meeting?
James: Which meeting?! The meeting with the boss! Alice: Are you sure there is a meeting today?
James: Alice, Alice, every month there is a meeting with the boss. This month that meeting is this afternoon. Alice: Calm down. OK, there's a meeting this afternoon. What time is it?
James: Alice, this is important. The meeting is at three o'clock sharp! Alice: Thank you James... By the way, what time is it now?
James: It's quarter past eleven. Alice: It's time for lunch!
James: Lunch, now? Lunch time is at twelve. Alice: Well, I'm hungry now.
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James: You're funny Alice. This is an office. Alice: I'm hungry ... it's just a snack ...
Key Vocabulary
to open a meeting to go over main points to add something to a discussion agenda to move on to give some background outlined summary documents figures communications marketing efforts to date to break up into groups out of time to close a meeting
MULTIPLE CHOICE- COMPREHENSION QUIZ 1. What's the first order of business a. New suggestions b. Quick review of last meeting c. Marketing ideas
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2. What would Robert like to hear? a. Some new suggestions b. Background on the suggestions c. Ideas on marketing 3. How is the summary information presented? a. By PowerPoint b. Orally c. In a summary documen 4. What seems to be the main problem? a. The Armstrong situation b. Research and development c. Customer communications 5. What hasn't worked well until now? a. The Armstrong situation b. The main points of last week's meeting c. Marketing efforts 6. Why can't they break up into groups? a. That's not the purpose of this meeting. b. They're running out of time. c. They need to go over other information.
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LESSON 11. A NEW OFFICE

(This, that, some and any with objects)
Speaking about objects in your office means that you'll need to understand the use of 'there is' and 'there are', as well as 'that', 'those', 'this' and 'these', as well as 'any' or 'some' for asking and answering questions about those objects. You'll also practice using prepositions of place to describe where the objects in your office are located. Practice the dialogue with your partner and then continue discussing your own office or school.
Jennifer: (speaking to Bob who is outside the office) Hi Bob, come in. This is my new office! Bob: Wow, it's great. There's so much furniture. A sofa, armchair ... Jennifer: How about my desk. Isn't it beautiful? Bob: Yes, look at that. Is that a new computer?
Jennifer: Yes, it is. The latest model! Bob: ... but there aren't any windows in here.
Jennifer: No, no, there are some windows. They're over there. Bob: Is that New Times magazine on your desk?
Jennifer: Yes, it is. There are some more copies in the cupboard. Bob: It's a great magazine. I love it.
Jennifer: Yes, lots of good information. Would you like a cup of coffee? Bob: Sure, is there a coffee maker here, too?
Jennifer: Yes, there is. There's everything in THIS office. Bob: You're lucky!
Jennifer: Yes, I am. You're welcome anytime, now let's make that coffee...
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MULTIPLE CHOICE- COMPREHENSION QUIZ 1. Which statement is true? a. Jennifer has some new furniture in her old office. b. Jennifer has a new office. c. Jennifer has a new job. 2. What does Bob think is only problem with the office? a. There's an old computer. b. There are no windows in the office. c. There's no coffee in the office. 3. Which magazine does Jennifer have on her desk? a. The New York Times b. New Times c. Time 4. Which statement is true? a. Bob often reads Time magazine. b. Bob has the latest computer. c. Bob likes New Times magazine. 5. What does Jennifer offer to do? a. Give Bob a magazine. b. Make Bob a cup of coffee. c. Give Bob her office.
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LESSON 12. COOKING

(Daily routines and hobbies)
In this dialogue you will practice speaking about daily routines by focusing on cooking. Notice that the present simple is used to speak about daily routines. Adverbs of frequency tell us how often we do something and include 'usually', 'sometimes', 'never', etc.. Practice the dialogue with your partner and then interview each other about how you do certain tasks you enjoy. Carol: This is a lovely house! Martha: Thank you. Carol, we call it home. Carol: It's very close to work, isn't it? Martha: Yes, it is. I always walk to work - even when it rains! Carol: I usually take the bus. It takes so long! Martha: How long does it take? Carol: Oh, it takes about 20 minutes. Martha: That is a long time. Well, have some cake. Carol: (taking a bite of some cake) this is delicious! Do you bake all of your own cakes? Martha: Yes, I usually bake something at the weekend. I like having sweets in the house. Carol: You're a wonderful cook! Martha: Thank you, it's nothing really. Carol: I never cook. I'm just hopeless. My husband, David, usually does all the cooking. Martha: Do you often go out to eat?
Carol: Yes, when he doesn't have time to cook, we go out to eat somewhere. Martha: There are some wonderful restaurants in the city.
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Carol: Too many! You can eat at a different restaurant every day. Monday - Chinese, Tuesday - Italian, Wednesday - Mexican, on and on ...
MULTIPLE CHOICE- COMPREHENSION QUIZ 1. Which statement is true?

a. b. c.
Martha works a long way from home. Martha works a short way from home. Martha works a long way at home.
2. How long does it take Carol to get to work?

a. b. c.
Only 5 minutes. About 20 minutes. She doesn't work.
3. Where does Martha get her great cakes?

a. b. c.
At a little bakery She cooks them herself. At Costco
4. Who cooks in Carol's house?

a. b. c.
She does. Her mother does. David does.
5. Where does Carol eat when David doesn't have time to cook?
a. b. c.
At Martha's At various restaurants At her mothers

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LESSON 13. A GREAT WORKOUT

(Abilities with 'can', making suggestions)
Practice speaking about what you can and can't do in this dialogue. You'll have to speak about abilities, as well as speaking about what you like and dislike. Practice speaking about your abilities by starting this dialogue and then continue to discuss your abilities with your classmates.
Janet: Wow, this gym is great! What a fantastic workout! Susan: Yes, I like coming here very much. What other sports can you do?
Janet: Well, I can play tennis, I can do a little karate and I go windsurfing in the summer. Susan: You're very fit! I can't do many sports. I like coming to the gym because the exercises are easy.
Janet: Listen, I have an idea. Why don't you come to karate class with me? Susan: No, I can't do karate...
Janet: ... but you can learn! Karate is a great sport. How about coming with me on Saturday? Susan: well, .... OK.
Janet: Great, why don't we meet at my house at 10 in the morning? Susan: Sure, that's a good idea. (changing subjects) By the way, what other hobbies do you have?
Janet: I like going to the cinema, and reading a little. Susan: Do you like cooking, or baking?
Janet: No, I can't cook. I'm a horrible cook! Susan: Oh, I love cooking. I tell you what. Why don't I cook lunch after karate class?
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Janet: Now that's a great idea! Susan: OK, karate and lunch on Saturday. It's a date! MULTIPLE CHOICE- COMPREHENSION QUIZ 1. Where are they now? a. In a gym b. On a tennis court c. At a karate center 2. Which can Janet NOT do well? a. Karate b. Windsurfing c. Cooking 3. Who is going to learn Karate? a. Janet b. Susan c. Both 4. Who enjoys cooking? a. Susan b. Janet c. Neither 5. What are they going to do on Saturday? a. Have lunch b. Go to karate c. Go to karate and then have lunch

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LESSON 14. TODAYS SPECIAL

(Ordering food in a restaurant)
Use this dialogue to practice ordering food in a restaurant. Use 'would like' to order food in a restaurant. Once you feel comfortable with this conversation, study more food vocabulary and practice ordering more elaborate meals.
Waiter: Good afternoon, how can I help you today? Jennifer: I'd like a table for one, please.
Waiter: Right this way. (walks to table) Here you are. Jennifer: Thank you. Can I have a menu?
Waiter: (hands a menu) Here you are. My name's Alan and I'm your waiter today. Would you like to hear today's specials? Jennifer: Certainly.
Waiter: Well, we have a wonderful mushroom soup to start off with. Today's main course is fish and chips. Jennifer: Fish and chips? Is the fish fresh?
Waiter: Certainly, madam. Fresh off the docks this morning. Jennifer: Alright, I'd like the fish and chips.
Waiter: Would you like to have a starter? Jennifer: hmmm, I'm not sure.
Waiter: Our salads are excellent, madam. Jennifer: I'd like a green salad.
Waiter: Very good. Would you like something to drink? Jennifer: Oh, I'd like some mineral water, please.
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Waiter: OK. So that's a green salad, fish and chips and mineral water. Jennifer: Yes, that's right.
Waiter: Thank you and enjoy your lunch. Jennifer: Thank you. MULTIPLE CHOICE- COMPREHENSION QUIZ 1. Who is Jennifer having lunch with? a. Tim b. Alan c. Nobody 2. What is today's special? a. Vegetable soup b. Fish and Chips c. Green salad 3. Jennifer is _________ a. going to have a starter and a main course. b. going to have only a starter. c. going to have a main course. 4. Is the fish fresh? a. Yes b. No c. Doesn't say 5. What is Jennifer going to have to drink? a. Nothing b. Wine c. Mineral water
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CHAPTER II GRAMMAR AND VOCABULARY FOCUS ANNEX 1 Who Are You? - the Verb "To Be"
Read the conversations below: Ken: Hello, My name's Ken. What's your name? Jack: Jack. How are you? Ken: I'm fine, and you? Jack: Great. Where are you from? Ken: I'm from Seattle. Ken: Where is that girl from? Jack: She's from Japan Ken: How old is she? Jack: She's twenty-six A.Complete the conversation. Mary: Hello. My ( 1) __________________Mary. What's (2) _________________name?
Peter: Peter. How (3) ____________________ you? Mary: I'm (4)______________and you? Peter: OK, (5)_____________ (6) __________you from? Mary: (7) ____________from Ireland. The above conversations used the verb "to be". Look at the conjugation charts of the verb "to be" Positive I He She It We You They am is from Seattle. from Toronto.
are
from Japan.
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Negative I He She It We You They Questions Where Where am is I he she it we you they from? from am not (I'm not) is not (isn't) from Seattle. from Toronto.
are not (aren't)
from Japan.
Where
are
from?
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ANNEX 2 VOCABULARY FOCUS Personal Information

What's your name? Peter. Where are you from? / Where do you come from? I'm from ... I come from ... What's your surname / family name? Smith. What's your first name? Tom. What's your address? 7865 NW Sweet Street Where do you live? I live in San Diego. What's your (tele)phone number? 209-786-9845 How old are you? Twenty-five. I'm twenty-five years old. When / Where were you born? I was born in 1961 / Seattle. Are you married? / What's your marital status? I'm single. What do you do? / What's your job? I'm a librarian.
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Where did you go? I went to a friend's house. What did you do? We played video games. Where were you? I was in New York for the weekend. Have you got a car / job / house / etc.? Yes, I've got a good job. Have you got any children / friends / books / etc.? Yes, I've got three children - two boys and a daughter. Can you play tennis / golf / football / etc.? Yes, I can play golf. Can you speak English / French / Japanese / etc.? No, I can't speak Japanese. Could you speak English / French / Japanese / etc.? when you were five / two / fifteen / etc. years old? Yes, I could speak English when I was five years old. Introducing Yourself / Saying Hello How do you do? How do you do. Pleased to meet you. How are you? Fine, thanks. And you? Shopping How can I help you? / May I help you? Yes. I'm looking for a sweater.
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Can I try it on? Sure, the changing rooms are over there. How much does it cost? / How much is it? It's $45. How would you like to pay? By credit card. Can I pay by credit card / check / debit card? Certainly. We accept all major cards. Have you got something bigger / smaller / lighter / etc.? Certainly, we've got a smaller sizes as well. Asking Something Specific What's that? It's a cat! What time is it? It's three o'clock. Can / May I open the window? Certainly. It's hot in here! Is there a bank / supermarket / pharmacy / etc. near here? Yes. There is a bank on the next corner next to the post office. Where is the nearest bank / supermarket / pharmacy / etc.? The nearest pharmacy is on 15th street. Who wrote / invented / painted / etc. the ...? Hemingway wrote "The Sun Also Rises". Is there any water / sugar / rice / etc.? Yes, there's a lot of sugar left.
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Are there any apples / sandwiches / books / etc.? No, there aren't any apples left. Is this your / his / her / etc. book / ball / house / etc.? No, I think it's his ball. Whose is this / that? It's Jack's. Questions with 'Like' What do you like? I like playing tennis, reading and listening to music. What does he look like? He's tall and slim. What would you like? I'd like a steak and chips. What is it like? It's an interesting country. What's the weather like? It's raining at the moment. Would you like some coffee / tea / food? Yes, thank you. I'd like some coffee. Would you like something to drink / eat? Thank you. Could I have a cup of tea? Asking for an Opinion What's it about? It's about a young boy who encounters adventures. What do you think about your job / that book / Tim / etc.? I thought the book was very interesting.
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How big / far / difficult / easy is it? The test was very difficult! How big / far / difficult / easy are they? The questions were very easy. How was it? It was very interesting. What are you going to do tomorrow / this evening / next week / etc.? I'm going to visit some friends next weekend. Suggestions What shall we do this evening? Let's go see a film. Why don't we go out / play tennis / visit friends / etc. this evening? Yes, that sounds like a good idea.
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ANNEX 3 GRAMMAR FOCUS Degrees of Adjectives

Adjectives can express degrees of modification: Gladys is a rich woman, but Josie is richer than Gladys, and Sadie is the richest woman in town. The degrees of comparison are: positive long, interesting comparative : of inferiority: less long, not as long as of equality: as long as of superiority: longer than, more interesting than
superlative: the longest, the most interesting We use the comparative for comparing two things and the superlative for comparing three or more things. Notice that the word than frequently accompanies the comparative and the word the precedes the superlative. The inflected suffixes -er and -est suffice to form most comparatives and superlatives, although we need -ierand -iest when a two-syllable adjective ends in y(happier and happiest); otherwise we use more and most when an adjective has more than one syllable. Positive rich lovely beautiful Comparative richer lovelier more beautiful Superlative richest loveliest most beautiful
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Certain adjectives have irregular forms in the comparative and superlative degrees:
Irregular Comparative and Superlative Forms good bad little much many some far further furthest more most better worse less best worst least
Be careful not to form comparatives or superlatives of adjectives which already express an extreme of comparison unique, for instance although it probably is possible to form comparative forms of most adjectives: something can be more perfect, and someone can have a fuller figure. People who argue that one woman cannot be more pregnant than another have never been nine-months pregnant with twins.
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Adjectives that do not admit of comparative degrees: absolute adequate chief complete devoid entire fatal final ideal impossible inevitable irrevocable main manifest minor paramount perpetual preferable principal stationary sufficient unanimous unavoidable unbroken unique universal whole
Be careful, also, not to use more along with a comparative adjective formed with er nor to use most along with a superlative adjective formed with -est (e.g., do not write that something is more heavier or most heaviest).
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ANNEX 4 This, That, These and Those

It's important to learn this and these for objects that are close at hand. This is used for singular objects, and these is used for plural objects. This and these are often used with the 'here' to indicate that the object is near. For example:
This is my bag here. These are my friends in this room.
That is used for singular objects, and those is used for plural objects that are located away from the speaker. That and those are often used with the 'there' to indicate that the object is away from the speaker. For example:
That is my car parked over there. Those are my apple trees at the back of the garden.
This That These and Those are considered demonstrative determiners and are often used with the location words 'here' and 'there'. The following conversation, short explanation and follow-up quiz can be used in class or for self-study to better understand when to use these essential words in English. For more detailed information and extensive examples, this guide to this that these and those will answer any question you or your students may have.
Read the conversations below:
David: Could you give me that book on the table over there? Frank: Do you mean this book here? David: Yes, that book.
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Frank: Here you are. Oh, could you give me those magazines on the table over there? David: These? Sure, here you are.
David: Is there an apple on that table over there? Frank: Yes, there is. Here it is. David: Great, are there any oranges? Frank: No, there aren't. David: Oh, here they are, next to me on this table.
Look at the chart below: Singular Forms
Use "here" for something which is near to us.
Example: Here is the pencil in my hand.
Use "there" for something which is far from us.
Example: There is the pen next to the lamp.
Use "this" for one object (singular) which is here (near to us).
Example: This is a book in my hand.
Use "that" for one object (singular) which is there.
Example: That is his car over there. Plural Forms
Use "these" for more than one object (plural) which are here (near to us).
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Example: These are my friends next to me.
Use "those" for more than one object (plural) which are there.
Example: Those are his toys over there.
Use "there" for one object (singular) which exists - or "is" (near to us).
Example: There is (There's) a table next to the window.
Use "there" for more than one object (plural) which exist - or "are".
Example: There are many of my friends at the party tonight.
Exercise A. Complete the sentences using this, that, these, those, here and there.
1. Could you bring me that chair over (1)_____? 2. Here are _____ pictures. 3. Can you see _____ building next to the bank? 4. Is _____ piece of pie over there for me? 5. _____ are three boys sitting on the bench. 6. I would like some of _____ cookies on that shelf. 7. _____ bicycles over there are expensive. 8. These dolls on the table _____ are very old.
B. Write some sentences about things in your room using this, that, these, those, here and there!
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ANNEX 5 PREPOSITIONS
This guide to the prepositions "in", "at" and "on" used as prepositions of place provides basic rules for beginning level English learners and classes. Each preposition has proper uses with three examples to help with understanding. Important exceptions are also included at the end of the lesson. Use this lesson to understand preposition use. In order to practice, write practice sentences using "in", "at" and "on" with various examples similar to the examples provided.
IN
Use 'in' with spaces:

in a room / in a building in a garden / in a park
Use 'in' with bodies of water:

in the water in the sea in a river
Use 'in' with lines:

in a row / in a line in a queue
AT
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Use 'at' with places:

at the bus-stop at the door at the cinema at the end of the street
Use 'at' with places on a page:

at the top of the page at the bottom of the page
Use 'at' in groups of people:

at the back of the class at the front of the class
ON
Use 'on' with surfaces:

on the ceiling / on the wall / on the floor on the table
Use 'on' with small islands:
I stayed on Maui.
Use 'on' with directions:

on the left on the right

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straight on
IMPORTANT NOTES In / at / on the corner We say 'in the corner of a room', but 'at the corner (or 'on the corner') of a street' In / at / on the front

We say 'in the front / in the back' of a car We say 'at the front / at the back' of buildings / groups of people We say 'on the front / on the back' of a piece of paper
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ANNEX 6 VOCABULARY FOCUS

'Like' can be used as a verb or as a preposition. There are a number of common questions with 'like' that are easy to confuse.
What's he like? - 'What like?' is used to ask about a person's or object's character and is general in nature.
What does he like? - This use of the verb 'like' is for general preferences. 'Like' as a verb is generally followed by the 'ing' form of the verb (I like playing tennis).
What does she look like? - 'Like' is used as a preposition to express physical appearance. In this case, 'like' can also mean 'similar to' if you are making a comparison to other people.
What would you like to drink? - Another common use of 'like' is in 'would like' to express wishes. Note that 'would like' is followed by the infinite form of the verb NOT the '-ing' form.
Like (hate, dislike, love, prefer) + -ing
When 'like' is used as a verb in a simple tense, 'like' is usually followed by the gerund (-ing).
Construction:
Subject + like + verb + ing + object
Examples:
Jack likes playing tennis. Anna likes cooking on Saturdays.
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This use of the verb 'like' is for general preferences. In other words, use 'like' + 'verb + ing' when referring to things that you like doing on specific days, hobbies you enjoy, and other things you prefer. Other important verbs that follow this pattern are 'love', 'hate', 'enjoy', 'dislike', and 'prefer'
Construction:
Subject + like / love / enjoy / prefer / dislike / + verb + ing + object
Examples:
They hate studying for exams. She loves staying out late at weekends. Jack prefers skiing to ice-skating.
Look like
With the common phrasal verb 'look like', 'like' is used as a preposition to express physical appearance. In this case, 'like' can also mean 'similar to' if you are making a comparison to other people. This question is often confused with 'What is he like?'. The key difference between these two questions is that 'What does he look like?' refers ONLY to a person's looks, stature, clothing, etc. 'What is he like?' refers to a person's personality (i.e. is he friendly, generous, mean, etc.?)
Examples:
He looks like his father. What does he look like? She looks like a model.
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Would like + infinitive
Another common use of 'like' is in 'would like' to express wishes. Note that 'would like' is followed by the infinite form of the verb NOT the '-ing' form.
Use 'would like' to express a wish that you have at the specific moment in time. This form is often used at a restaurant, when stating preferences, etc.
Construction:
Subject + would like + verb (infinitive) + object
Examples:
What would you like to do tonight? I'd like to have a steak. She'd like to visit her friends this weekend. NOTE: The contracted form of 'would like' is 'd in the positive:
He would like - He'd like to go out tonight. They would like - They'd like to have some dinner. I would like - I'd like to buy a new TV.
The contracted form of 'would not like' is 'wouldn't like' in the negative:
She would not like - She wouldn't like come for the weekend. I would not like - I wouldn't like to do that!
There is no contracted form of 'would like' in the question form.
Would you like something to drink? Would they like to play a game?
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ANNEX 7 VOCABULAR FOCUS What time is it?

10:30 am 12:15 pm 9:45 pm 4:25 pm afternoon
Its half past ten OR ten thirty in the morning Its quarter past twelve OR twelve fifteen in the afternoon Its quarter to ten OR nine forty five in the evening Its twenty-five past four OR four twenty-five in the Its ten past six OR six ten in the evening Its twenty-eight past two OR about/around half past two
6:10 2:28 pm
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ANNEX 8 GRAMMAR FOCUS Basic Prepositions: Time and Place - at, in, on and to
IN We use in with months - in May seasons - in winter country - in Greece city or town names - in New York times of the day - in the morning, afternoon or evening BUT at night! ON We use "on" with specific days - on Friday, on New Year's Day, on April the 19th American English - "on the weekend OR on weekends" AT We use "at" with specific times - at 7 o'clock, at 6.15 at night specific places in a city - at school British English - "at the weekend OR at weekends" TO We use "to" with verbs which show movement such as go and come - He goes to school. She returned to the store. They are coming to the party tonight.
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ANNEX 9 GRAMMAR FOCUS ANY/SOME
Use "some" in positive sentences. We use some for both countable and uncountable nouns. Example: I have some friends.
Use "any" in negative sentences or questions. We use any for both countable and uncountable nouns. Example: Do you have any cheese? - He doesn't have any friends in Chicago.
Use "some" in questions when offering or requesting something that is there. Example: Would you like some bread? (offer) - Could I have some water? (request)
Use "any" in negative sentences or questions. We use any for both countable and uncountable nouns. Example: Do you have any cheese? - He doesn't have any friends in Chicago.
Use "some" words - somebody, someone, somewhere and something - in positive sentences. Example: He lives somewhere near here.
Use "any" words - anybody, anyone, anywhere and anything - in negative sentences or questions. Example: Do you know anything about that boy? - She doesn't have anywhere to go.
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ANNEX 10 GRAMMAR FOCUS Adverbs of frequency

Use adverbs of frequency to say how often you do something. Adverbs of frequency are often used with the present simple because they indicate repeated or routine activities. For example, They often go out for dinner.
Adverbs of frequency include (from most often to least often):
always usually often sometimes occasionally seldom rarely never
If the sentence has one verb (e.g. no auxiliary verb) put the adverb in the middle of the sentence after the subject and before the verb.
Examples
Tom usually goes to work by car. Janet never flies. She always goes by bus.
Adverbs of frequency come after the verb 'be':
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Examples
I am never late for work. Peter is often at school.
If the sentence has more than one verb (e.g. auxiliary verb), put the adverb of frequency before the main verb. Use adverbs of frequency to say how often you do something. Adverbs of frequency are often used with the present simple because they indicate repeated or routine activities. For example, They often go out for dinner.
Adverbs of frequency include (from most often to least often):
always usually often sometimes occasionally seldom rarely never
If the sentence has one verb (e.g. no auxiliary verb) put the adverb in the middle of the sentence after the subject and before the verb.
Examples
Tom usually goes to work by car. Janet never flies. She always goes by bus.
Adverbs of frequency come after the verb 'be':
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Examples
I am never late for work. Peter is often at school.
If the sentence has more than one verb (e.g. auxiliary verb), put the adverb of frequency before the main verb.
Examples
I can never remember anything! They have often visited Rome.
When using adverbs of frequency in the question or negative form, put the adverb of frequency before the main verb.
Examples
She doesn't often visit Europe. Do you usually get up early?
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ANNEX 11 GRAMMAR FOCUS Modal Verbs of Probability

Listed below are examples and uses of modal verbs of probability. Modal verbs of probability are used to express an opinion of the speaker based on information that the speaker has. Example: He must be at work, it's 10 o'clock. In this case, the speaker is 100 % sure that the person is at work based on the speaker's knowledge that the person in question usually works at during the day.
Examples
Usage Use 'must' plus the verb when you are
They must be in 100% (or almost 100%) sure that Spain by now. something is the case. She must have done well on the test.
Use 'might' or 'may' to express an opinion She might come that you think has a good possibility of this evening. being true. David may invite Jesica to the match.
Jack might have gone to France.
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Use 'could' to express a possibilty which is Jane could be at one of many. This form is not as strong as work. 'might' or 'may'. It is just one of a number of possibilities. Peter could have arrived late.
You can't be serious!
Use 'can't' to express an opinion that you are 100% sure is NOT true.
They can't have Notice that the past form remains 'can't worked until late. have done'
Structure In the present: Subject Modal Base Form Objects at work. I You He, She We They must be might be could be can't be
In the past: Subject Modal Perfect Form Objects I early. You must have left He, She We might have left They could have left
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ANNEX 12 VOCABULAR FOCUS Types of Food

Beverages / Drinks Dairy Dessert Fruit Grains / Starches Meat / Fish Vegetables soda coffee water tea cream wine yoghurt beer juice quark half and half pie creams
milk cheese butter
cake cookies chocolate ice-cream brownies apple orange banana wheat rye beef cereal grapes toast salmon broccoli pineapple bread trout
kiwi lemon roll potato
chicken pork
lamb buffalo
beans lettuce carrots
cauliflower peas egg plan
Adjectives used to Describe Food
acidic bland creamy fatty fruity healthy nutty oily
raw salty sharp sour spicy sweet tender tough
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Cooking Food
Vocabulary for the Supermarket
Preparing Food chop peel mix slice measure Departments dairy produce dairy frozen food
Cooking Food bake fry steam boil simmer Staff stock clerk manager butcher fishmonger
Utensils blender frying pan colander kettle pot Nouns aisle counter cart display
Containers for Food
bag box carton can
sugar cereal eggs soup
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jar package piece bottle bar
jam hamburgers toast wine soap
Suggestions for Exercises
Once you have written out your vocabulary lists, start practicing using the vocabulary in conversation and writing. Here are some suggestions on how to practice food vocabulary:

Make a shopping list and compare products Write a recipe in English, be sure to include ingredients, measurements, containers and instructions
Describe a delicious meal you've had in writing Discuss your food likes and dislikes with a partner
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ANNEX 13 TABLE OF ENGLISH TENSES

Affirmative/Negative/Interrogative/ Tense Int.-neg. Present Simple A: He speaks. N: He does not speak. Q: Does he speak? I-N: Does he not speak? another Use Signal words
once, never or several times always, every , never, normally, often, seldom, sometimes, usually always, every , never, normally, often, seldom, sometimes, usually if sentences type I (If I talk, )
S+Vb.(inf.) Vb.+ s (IIIrd pers, sg)
schedule Present Continuous A: He is speaking. N: He is not speaking. Q: Is he speaking? I-N: Is he not speaking? action taking place in the moment of speaking at the moment, just, just now, Listen!, Look!, now, right now
S+ ARE/IS + Vb-ing
limited period of time
Past Simple
A: He spoke. N: He did not speak. Q: Did he speak? I-N: Did he not speak?
once, never or several times yesterday, 2 minutes ago, in 1990, the other day, last Friday, if sentence type II (If I talked,...)
S+Vb.(past) IInd form- irregular vbs.
another
another action 70
Past Continuous
A: He was speaking. N: He was not speaking. Q: Was he speaking? I-N: Was he not speaking?
going on at a certain time in the past when, while, as long as
S+WAS/WERE+Vb-ing
time
by another action Present Perfect Simple A: He has spoken. N: He has not spoken. Q: Has he spoken? I-N: Has he not spoken? result
S+HAVE/HAS+Vb (past or IIIrd form- irregular vbs)
already, ever, just, never, not yet, so far, till now, up to now
times before the moment of speaking
Present Perfect Continuous
A: He has been speaking. N: He has not been speaking. Q: Has he been speaking? I-N: Has he not been speaking?
course or duration (not the result) all day, for 4 years, since 1993, how long?, the whole week
S+ HAVE/HAS BEEN +Vb-ing
still going on
present A: He had spoken. N: He had not spoken. S+ HAD+ Vb (past or IIIrd form- Q: Had he spoken? irregular vbs) I-N: Had he not spoken? Past Perfect Simple
the past
progressive fact (not the duration)
already, just, never, not yet, once, until that day, if sentence type III (If I had talked,)
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Past Perfect Continuous S+HAD BEEN +Vb-ing
A: He had been speaking. N: He had not been speaking. Q: Had he been speaking? I-N: Had he not been speaking?
time in the past for, since, the whole day, all day duration or course of an action
past perfect simple
Future I Simple
A: He will speak. N: He will not speak. Q: Will he speak? I-N: Will he not speak?
influenced spontaneous decision
S+ SHALL/WILL+Vb.(inf)
in a year, next , tomorrow, Type I (If you ask her, she will help you.), assumption: I think, probably, perhaps
future Future I Simple (going to) A: He is going to speak. N: He is not going to speak. Q: Is he going to speak? I-N: Is he not going to speak?
decision made for the future in one year, next week, tomorrow
S+ GOING TO + Vb.(inf)
Future I Continuous S+SHALL/WILL BE+Vb-ing
A: He will be speaking. N: He will not be speaking. Q: Will he be speaking? I-N: Will he not be speaking?
going on at a certain time in the future in one year, next week, tomorrow near future action that will be finished at a certain time in the future
Future II Simple S+WILL HAVE+Vb(IIIrd form)
A: He will have spoken. N: He will not have spoken. Q: Will he have spoken?
by Monday, in a week
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I-N: Will he have not spoken? Future II Continuous S+WILL HAVE BEEN+Vb-ing A: He will have been speaking. N: He will not have been speaking. Q: Will he have been speaking? I-N: Will he have not been speaking? Conditional I Simple S+WOULD+Vb (inf) A: He would speak. N: He would not speak. Q: Would he speak? I-N: Would he not speak? Conditional I Continuous A: He would be speaking. N: He would not be speaking. Q: Would he be speaking? I-N: Would he not be speaking? duration of the action Conditional II Simple S+WOULD HAVE+Vb(IIIrd form) A: He would have spoken. N: He would not have spoken. Q: Would he have spoken? I-N: Would he have not spoken? Conditional II Continuous S+ WOULD HAVE BEEN +Vb-ing A: He would have been speaking. N: He would not have been speaking. Q: Would he have been speaking? I-N: Would he have not been sp? course /
time in the future course of an action
for , the last couple of hours, all day long
action that might take place
if sentences type II (If I were you, I would go home.)
S+WOULD BE+Vb-ing
action that might have taken place in the past
if sentences type III (If I had seen that, I would have helped.)
in the past course / duration of the action
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CHAPTER III READING COMPREHENSION PRACTICE

Reading Comprehension Guidelines Keep in mind the exact amount of time you have to complete the exercise. Read the text through quickly without stopping to check your understanding of individual words. The first reading is to get a general understanding of the text. Read the text a second time more carefully. This time take to time to pause at sections you may find more difficult. Scan the questions without looking at the answers. See if you can answer the questions easily by yourself. Skip any questions that you cannot answer immediately. Re-read the questions and answer. Skip any question that you find too difficult. If you cannot find something close to your original answer to the question, take a look at the text again. After you have answered each question, return to the text to find a justification for each of your answers. Return to the questions that you were not able to answer immediately and see if you can answer them now. If you still have time, check that the other possible answers are not specifically referred to in the text.
The reading comprehension section consists of 1 text with 5 multiple choice questions (3 alternatives) and 1 text with 10 true or false questions. You have 20 minutes to complete this section. No dictionaries are allowed. On the following pages you will be able to practice 5 multiple choice practice tests and 5 true or false practice tests with the answer keys.
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Read through the text and choose ONE answer for each question. 1. Pet Doctor There's an old saying in the theatre world "Never work with children or animals". It's a pity that Herman Gross has never heard this piece of advice, or if he has, that he didn't pay attention to it. It's not so much that Pet Doctor is a bad film, although I can't really find many reasons for saying it's a good one. It's more that it makes me angry. Gross is a good actor. His appearance on the New York stage last winter in Shakespeare's Romeo and Juliet showed that he really can act. So what's he doing in this nonsense? It's a story about a small town doctor who finds he's making more money by looking after the local children's pets than he is by looking after humans. Then he gets into trouble with the police, because he doesn't have the right sort of licence to do this and, surprise, surprise, the children and their pets find a way to solve his problems. I won't say how, as it's the only part of the film that's even slightly original or amusing. If you have to see it, you'd be annoyed with me for telling you. But my advice is, when it comes to a cinema near you stay in and shampoo the cat. Questions 1. What is the writer trying to do in the text? a. Compare Herman Gross with another actor. b. Give his or her opinion about using animals in films. c. Give his or her opinion about Pet Doctor. 2. The text gives the reader ... a. information about a new film. b. ideas about how animals should be cared for. c. news about the lives of film stars. 3. The writer thinks that Pet Doctor is ... a. amusing. b. original. c. not worth seeing. 4. Why did the writer mention Romeo and Juliet? a. It's an example of a really good play. b. Gross proved he's a good actor in it. c. The central characters are very young. 5. Which one of these TV guides is describing Pet Doctor? a. A doctor is loved by the children whose pets he cures. But everything goes wrong and he is sent to prison.
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b. A doctor finds he can cure local animals, then discovers this isn't allowed. But it all finishes happily. c. A doctor prefers animals to humans and stops looking after his patients. People are dying, the animals are cured, then the police arrive . . .
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Read through the text and choose ONE answer for each question. 2. The Body Shop When I opened the first 'Body Shop' in 1976 my only object was to earn enough to feed my children. Today `The Body Shop' is an international company rapidly growing all around the world. In the years since we began I have learned a lot. Much of what I have learned will be found in this book, for I believe that we, as a company, have something worth saying about how to run a successful business without giving up what we really believe in. It's not a normal business book, nor is it just about my life. The message is that to succeed in business you have to be different. Business can be fun, a business can be run with love and it can do good. In business, as in life, I need to enjoy myself, to have a feeling of family and to feel excited by the unexpected. I have always wanted the people who work for 'The Body Shop' to feel the same way. Now this book sends these ideas of mine out into the world, makes them public. I'd like to think there are no limits to our 'family', no limits to what can be done. I find that an exciting thought. Questions 1. What is the writer's main purpose in writing this text? a. To tell the reader her life story. b. To introduce her ideas to the reader. c. To explain how international companies operate. 2. What would someone learn from this text? a. How to make a lot of money. b. How to write a book about business. c. What the writer's book is about. 3. How does the writer feel about the business she runs? a. She just runs it for her own entertainment. b. It is not like any other company. c. It is likely to become even more successful. 4. What kinds of workers does the writer like to employ? a. Workers who get on well with the public. b. Workers who have the same attitude as she does. c. Workers who have their own families. 5. What kind of person does the writer seem to be? a. She seems to be someone with strong opinions. b. She doesn't seem to be very confident. c. She sees running a business as just a job.
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Read through the text and choose ONE answer for each question. 3. The Toy Museum This museum is in the centre of the town, a few metres from the cathedral, and near the market. It contains dolls, dolls' houses, books, games and pastimes, mechanical and constructional toys. In this collection there are toys made by all sorts of toy manufacturers from the most important to the smallest, including the most ordinary toys and the most precious. There are also records of children's pastimes over the last hundred and fifty years. Most major manufacturing countries of Europe had toy industries in the last century; French and German factories produced millions of toys each year. Many collectors of toys think that the second half of the nineteenth century was the best period for toy production and the museum has many examples of toys from this period which are still in perfect condition. There is now a growing interest in the toys of the 1920s and 1930s and as a result of this the museum has begun to build up a collection from these years. Visitors to the museum will find that someone is always available to answer questions - we hope you will visit us. Hours of opening 10.00-17.30 every day (except December 25 and 26) Questions 1. This writing is from ... a. an advertisement. b. a school history book. c. a storybook. 2. What is the writer trying to do? a. To give advice. b. To give opinions. c. To give information. 3. The museum has so many toys from the late 19th century because ... a. it is located in the middle of town. b. many consider this period the best for manufactured toys. c. visitors are interested in toys from that time. 4. What period of toy manufacturing is receiving increased attention? a. Every day except in December. b. The 1920s and 1930s. c. The 20th century. 5. Which of the following advertisements would you find outside the Toy Museum? a. Toys of Ancient Civilizations b. BEFORE TV! - a special exhibition of indoor games from 1890 to 1940 c. How Children Dressed 1600 - 1900 "Clothes for all Ages"
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Read through the text and choose ONE answer for each question. 4. Photo printing firm pays out compensation Charlotte King made a once-in-a-lifetime visit to China last October and took lots of photographs. When she got back she decided to send away her films for printing one at a time. In this way she would more easily be able to match her photographs to the diary she had kept while she was there. The first film she sent to the company for printing was lost. Miss King was very upset that she would never see her precious pictures of Shanghai and Souzhou. The company offered her a free roll of film, but Miss King refused to accept this offer and wrote back to say that their offer wasn't enough. They then offered her 20 but she refused this too and asked for 75, which she thought was quite fair. When the firm refused to pay she said she would go to court. Before the matter went to court the firm decided to pay Miss King 75. This shows what can be done if you complain to a firm or manufacturer and insist on getting fair treatment. Questions 1. What is the writer trying to do? a. To complain about photographic printing. b. To give advice on how to complain. c. To inform us about legal problems. 2. This text is from ... a. a diary. b. a letter. c. a newspaper. 3. Before her visit, Charlotte had ... a. been to China once before. b. never been to China before. c. already been to China several times. 4. It was a good thing that Miss King sent her films away one at a time because ... a. not all the films were lost. b. she was offered a free roll of film. c. she was able to complete her diary. 5. When Miss King said she would go to court, the company ... a. offered her 20. b. said their offer wasn't enough. c. made the decision to pay 75.
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Read through the text and choose ONE answer for each question. 5. Alternative medicine Alternative medicine is, by definition, an alternative to something else: modern, Western medicine. But the term alternative can be misleading, even off-putting for some people. Few practitioners of homeopathy, acupuncture, herbalism and the like regard their therapies as complete substitutes for modern medicine. Rather, they consider their disciplines as supplementary to orthodox medicine. The problem is that many doctors refuse even to recognize natural or alternative medicine, to do so calls for a radically different view of health, illness and cure. But whatever doctors may think, the demand for alternative forms of medical therapy is stronger than ever before, as the limitations of modern medical science become more widely understood. Alternative therapies are often dismissed by orthodox medicine because they are sometimes administered by people with no formal medical training. But, in comparison with many traditional therapies, western medicine as we know it today is a very recent phenomenon. Until only 150 years ago, herbal medicine and simple inorganic compounds were the most effective treatments available. Despite the medical establishments intolerant attitude, alternative therapies are being accepted by more and more doctors, and the World Health Organization has agreed to promote the integration of proven, valuable, alternative knowledge and skills in western medicine. Questions 1. The term alternative is ... a. not entirely appropriate. b. rejected by Western medicine. c. very recent. 2. Alternative therapy is often rejected by conventional doctors because ... a. it is not beneficial. b. it is misleading. c. practitioners are often not qualified. 3. Few practitioners of alternative medicine think their therapies should ... a. substitute modern medicine. b. complement modern medicine. c. be accepted by the medical establishment. 4. Western medicine ... a. is based on many traditional therapies.
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b. has existed for a comparatively short time. c. is practised by people with no formal medical training. 5. The World Health Organization ... a. has an intolerant attitude towards alternative therapies. b. will support effective knowledge and skills. c. will support all alternative medicine.
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Read through the text and say whether the following statements are True or False. 1. Norwich Norwich, the capital of the part of Britain known as East Anglia, has existed as a place to live for more than two thousand years. It began as a small village beside the River Wensum. The first cathedral was built in 1095 and has recently celebrated its 900th anniversary, while Norwich itself had a year of celebration in 1994 to mark the 800th anniversary of the city receiving a Royal Charter. This allowed it to be called a city and to govern itself independently. Today, in comparison with places like London or Manchester, Norwich is quite small, with a population of around 150,000, but in the 16th century Norwich was the second city of England. It continued to grow for the next 300 years and got richer and richer, becoming famous for having as many churches as there are weeks in the year and as many pubs as there are days in the year. Nowadays, there are far fewer churches and pubs. With its fast growing university student population and its success as a modern commercial centre, the city now has a wide choice of entertainment: theatres, cinemas, nightclubs, busy cafes, excellent restaurants, and a number of arts and leisure centres. Now the city's attractions include another important development, a modern shopping centre called 'The Castle Mall'. The people of Norwich lived with a very large hole in the middle of their city for over two years, as builders dug up the main car park. Lorries moved nearly a million tons of earth so that the roof of the Mall could become a city centre park, with attractive water pools and hundreds of trees. But the local people are really pleased that the old open market remains, right in the heart of the city and next to the new development. Questions 1. The River Wensum flows through East Anglia. T/F 2. People have lived by the River Wensum for at least 2,000 years. T/F 3. In the 11th century Norwich was a small village. T/F 4. Norwich has been a city since its first cathedral was built. T/F 5. Norwich has always been one of the smallest English cities. T/F 7. The number of students in Norwich is increasing. T/F 8. The Castle Mall took more than two years to build. T/F 9. Norwich people still like shopping at the old market. T/F 10. The city park surrounds the Mall. T/F
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Read through the text and say whether the following statements are True or False. 2. Carnival Safety Success This years Notting Hill Carnival, Europes biggest street festival, was the best ever. Despite the cloudy skies, the carnival brought the streets to life in its own unique way with record numbers and little reported crime. After the two murders in 2009, there had been major safety worries concerning this years carnival. To deal with these fears several changes were made. Firstly, the route for the carnival was changed to avoid the narrowest streets in Notting Hill, a residential area with many small roads. Secondly, the carnival organisers provided more stewards and they received better training. Finally, the organisers ensured that the ending time, 9 p.m., was closely observed. Following these changes, Carnival 2010 saw more than a million people party in the streets of Notting Hill. More than 3,000 people dressed in spectacular colourful costumes and paraded and danced through the streets, crowds of four and five people deep lined the route to try and see the event. Residents partied on apartment balconies and even the police took part. Apart from the carnival parade, the local area was filled with sound systems pumping out music of all different kinds Samba, Reggae and Rap music being the most common. Police yesterday said that 56 arrests were made over the weekend, which included 30 arrests for pick-pocketing and three for robbery. The chairman of the Notting Hill Carnival Trust, Chris Mullard, yesterday said, "The criticism of the event has been ill-founded and I hope people will now see the carnival for what it is; a wonderful opportunity to project the multiculturalism that is metropolitan London. Questions 1. In Europe, there is a bigger festival than Notting Hill Carnival. T/F 2. The weather was very good at this years Carnival. T/F 3. The carnival parade went a different way this year. T/F 4. Many activities continued till midnight. T/F 5. Over a million people wore special costumes. T/F 6. For some people, it was difficult to see the parade. T/F 7. Some police danced and partied. T/F 8. There were many kinds of music. T/F 9. More than half the arrests were for theft. T/F 10. The carnival represents only one group or community in London. T/F
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Read through the text and say whether the following statements are True or False. 3. The Western Alphabet The Western alphabet, which is used in Europe, the Americas, Africa, Australia and New Zealand as well as in other countries, originated in the Middle East. The people who gave the world this alphabet were the Phoenicians, a people who established colonies all over the Mediterranean, including Carthage in Africa and Gades in Spain. In their alphabet, the letters were represented by little pictures which represented sounds. The Phoenician A was aleph, which means "bull". and it was made from a little picture of a bull's head. The letter B was beth which meant "house", and showed the round-roofed buildings which you can still see today in Syria. The Phoenicians had contact with another nation of sailors, the Greeks, with whom they fought and traded. The Greeks also started to use the Phoenician alphabet. They changed the names so aleph and beth became alpha and beta. The shapes of the letters are the same but they have been turned sideways. Of course, the first two letters of the alphabet give it its name. Over the years there have been changes. Latin developed an alphabet with some different letters to the Greeks, and other letters have been added since. But really westerners are using the same system of writing which has served them so well for thousands of years. Questions 1. The purpose of this text is to tell something of Phoenician history. T/F 2. The information in the text is meant to be funny. T/F 3. The Phoenicians came from Carthage. T/F 4. The Phoenicians were a nation of sailors. T/F 5. The Phoenician alphabet was composed of individual signs. T/F 6. The Greeks turned the letters in a different direction. T/F 7. The Greeks developed the alphabet from Latin. T/F 8. There were fewer letters in the original alphabet than there are now. T/F 9. Three letters compose the name of the alphabet. T/F 10. Our modern system of writing is similar to the Phoenician alphabet. T/F
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Read through the text and say whether the following statements are True or False. 4. The Battle of Bannockburn Robert the Bruce, King of Scotland, is one of the great heroes of Scottish history. At that time the English king Edward II wanted to rule the whole country, but Robert the Bruce helped the Scots to resist and to form a large army which attacked Stirling castle. King Edwards army came to help the soldiers in the castle, and the two armies met at the small town of Bannockburn on June 24, 1314. At that time the strongest part of the English army was bowmen. These bowmen, with their long bows had won many victories for the English in France. The Scots did not have many bowmen, so when the English archers attacked they could not defend themselves or fight back. However, Robert the Bruce was ready for this, and he called for his cavalry, (his soldiers on horseback). The horses were too quick for the bowmen, and the Scots knights chased them from the battlefield. As the English knights advanced, Robert the Bruce ordered the Scots to put sharp sticks in front of their soldiers, and to dig holes in the ground for the English cavalry to fall into. As a result, the English were discouraged by what happened and they did not fight very well. Many people in the area knew that a great battle was being fought, and when they heard that the Scots army was winning, they came to watch the battle. The English soldiers saw them appear on the top of a nearby hill, and they thought that they were another Scottish army arriving. The English were terrified that they would be caught between two Scots armies and they ran away. Now the Scots cavalry returned to the battle and the horsemen killed many English soldiers as they ran away. After this, the English army never really succeeded in conquering Scotland, also because they had to fight wars in other countries, such as France and Holland. Questions 1. The battle of Bannockburn was in the 14th Century. T/F 2. The battle took place in winter. T/F 3. At the time of the battle the English were in Stirling Castle. T/F 4. Many Scots at Bannockburn were killed by arrows. T/F 5. The English bowmen were the weakest part of the English army T/F 6. The English horsemen chased the Scots horsemen away. T/F 7. It was very difficult for the English to attack the Scots army. T/F 8. The English were frightened when another Scottish army appeared. T/F 9. The English soldiers won the battle. T/F 10. Scotland was also fighting with the French. T/F
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Read through the text and say whether the following statements are True or False. 5. Facebook Do you use any of the social networking websites which are so popular these days, the places where you can connect up with friends and relatives and meet people who share the same interests as you? If youre younger you may use MySpace, young adults are more likely to be found on Facebook and busy professionals may prefer something like LinkedIn. But at least two of these sites have one thing in common: apart from being social spaces where you can meet and chat to people, share photos and other things, theyve all added new verbs and nouns to the language in the past couple of years. Lets take a look at some examples. You can facebook your holiday photos (upload them to your Facebook page), facebook someone to see who they are (look him up in Facebook), facebook someone about a party (contact someone through their Facebook page) and ask permission to facebook someone (add them as a Facebook friend). As you can see, facebook is a pretty versatile word, and you could say the same about myspace, which you will find being used in much the same way all over the Net. LinkedIn (being a more adult, professional community) has not been used in the same way. While youre facebooking or myspacing you may also find yourself commenting (writing a comment on someones Facebook or MySpace page), as in this example: I commented Mary that she should come to the pub on Saturday and she commented me that she couldnt because she was going away for the weekend. Questions 1. People who use Myspace are generally not as old as people who use Facebook. T/F 2. LinkedIn is for people with good jobs. T/F 3. Sites like these have given new words such as adverbs and adjectives to the language. T/F 4. Myspace has proven to be a less versatile word than Facebook. T/F 5. All three of the sites mentioned have provided some new words. T/F 6. In this Internet context, to comment means to leave a message for someone on their site. T/F 7. You can use Facebook for different purposes. T/F 8. The new terms have been in use for ten years. T/F 9. The word facebook has various uses. T/F 10. You need someones authorisation to add their name to your facebook page. T/F
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ENGLISH FOR MEDICAL PURPOSES
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CHAPTER IV MEDICAL TEXTS AND ARTICLES Balneotherapy Defined

Everyone agrees that balneotherapy involves water. What they don't always agree on is the source and exact chemical makeup of the water. Purists use a much narrower definition of balneotherapy that has three key elements:
Temperature: The temperature of water for balneotherapy must be at least 68 degrees Fahrenheit (20 degrees Celsius), although it is often much warmer, at 93 degrees Fahrenheit (34 degrees Celsius).
Mineral content: Balneotherapy requires water containing dissolved materials at a concentration of at least 1 gram per liter. The dissolved substances most often include salts, sulfur compounds or gases.
Natural occurrence: Natural springs are the preferred source for those seeking balneotherapy. A spring forms when an aquifer fills to the point that the water overflows onto the land surface. They range in size from small seeps to huge pools, and they vary greatly in their mineral content. Examples of natural springs include Great Pagosa Hot Springs in Colorado, Warm Mineral Springs in Florida and the Kangal Hot Springs in Turkey. Broader definitions also exist. For example, Dorland's Medical Dictionary defines balneotherapy as the use of baths in the treatment of disease. A bath, in this case, refers to immersion in any kind of water at any temperature. Sometimes, immersion isn't even required. The application of a hot or cold wrap can be considered a therapeutic use of water, too. In this broader sense, balneotherapy is also known as hydrotherapy and includes:
Full-body baths (in a tub or natural body of water) Arm and foot baths
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Sitz baths (immersion of the hips) Steam baths or saunas Motion-based therapies involving hot tubs or whirlpool baths Saline baths Wet compresses (hot or cold) Douches Mudpacks Balneotherapy has been popular for centuries, both as a way to promote relaxation and to treat certain ailments. Up next, we'll examine the history of water-based therapy, from the Roman bath to the modern spa.
History of Balneotherapy
Using water to soothe and heal is an ancient practice. Archaeologists have found remains of bathing rooms in the palace of Knossos that date from 1700 B.C., indicating that the Greeks appreciated the effects of a good, long soak. The Greek physician Hippocrates (460-377 B.C.) also wrote extensively about the healing power of water. He advocated the use of saline baths and regularly immersed his patients in seawater to cure several ailments, including aching muscles and arthritis. Ancient Egyptians embraced water-based therapies just as enthusiastically. Cleopatra (69-30 B.C.) visited the Dead Sea to soak in its mineral-rich waters and may have established pharmaceutical and cosmetic factories near its shores. But it was the Romans who took bathing to a new level of sophistication. At first, Roman baths were small, private and unobtrusive. Then came larger neighborhood baths, which were followed by massive public baths. The Baths of Caracalla represented the pinnacle of the Roman bathing experience. Constructed between A.D. 206 and
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A.D. 217, the Baths of Caracalla covered 27 acres and could accommodate 1,600 people at a time. Eventually, the Roman Empire collapsed and, with it, interest in balneotherapy. The last Roman baths were abandoned by about A.D. 537. By the time the Black Death swept through Europe in the 1340s, public bathing had all but stopped. In addition to fears associated with disease transmission, the strict moral code of the Roman Catholic Church discouraged people from visiting public watering places. Then, in the 1800s, came a renaissance. Vincent Priessnitz, an Austrian peasant, used cold-water therapy to heal wounds he obtained when a heavy cart rolled over him. Word of his recovery spread, and thousands of people came to him. He treated 1,600 patients in 1840 and, three years later, published "The Cold Water Cure," a book that spread his treatment philosophies to thousands more. Sebastian Kneipp, a German priest, picked up the baton and continued to advance balneotherapy. He improved some of Priessnitz's techniques and began to add herbs to the water. Priessnitz and Kneipp gave rise to the rebirth of spas in the Victorian era. Hot springs were found and developed, often at mountain retreats with breathtaking views. Medical practitioners often staffed these spas and dispensed various waterbased treatments. Americans treated in European spas returned home with stories of water's healing effects. Soon, similar spas emerged in the United States. As they became more popular, the spas evolved into spa resorts, featuring world-class restaurants, entertainment and recreational facilities. Not Just For Humans Other animals have discovered the healing benefits of water. In Japan, wildlife made use of the country's hot springs long before humans. For example, the Yunoyama Onsen, located in the Suzuka Kokutei Park near Gozaisho-Dake in Mie, is known as the "Deer Onsen" because eighth-century hunters discovered the
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thermal bath only after local deer jumped in to enjoy a long, hot soak. And today, Japanese macaques, which live in mountainous areas of Honshu, are often observed taking dips in the region's many volcanic hot springs. The Physiology of Balneotherapy Although the mechanisms by which spa therapies alleviate certain diseases are still being deciphered, most scientists agree that they probably have chemical, thermal, mechanical and immunological components. Let's look at each in more detail. Chemical effects. The chemical composition of water used in balneotherapy varies greatly, depending on the source. Sulfur, present in "sulfur waters" as a free or combined ion, is one of the most common chemicals in mineral spa waters. It is known to promote keratolysis, the loosening and shedding of the outer layer of the skin, which can be effective in treating certain skin conditions, such as acne. It also possesses antibacterial and antifungal properties, believed to be the result of sulfur interacting with reactive oxygen molecules in the epidermis to produce an acidic environment that prevents microbe growth. Other minerals act differently. Magnesium, for example, inhibits the synthesis of polyamines, essential molecules in eukaryotic cells. Polyamines are thought to play a role in the development of psoriasis. When patients with psoriasis soak in water with high magnesium concentrations, they often see an improvement in their conditions. Thermal effects. Hot water has several beneficial effects. Heat increases the concentration of beta-endorphin, a natural painkiller. In addition to its analgesic effects, beta-endorphin boosts the immune system, slows the growth of cancer cells and increases relaxation. Heat also prevents inflammation, probably by increasing the secretion of cortisol and catecholamines, two hormones produced by the adrenal glands. For this
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reason, doctors often prescribe hot-water baths to treat inflammatory conditions, such as arthritis or dermatitis, as well as certain autoimmune diseases. Mechanical effects. An immersed body experiences a force applied by the water on all sides. This force is known as hydrostatic pressure and can have many benefits. In the lower legs and feet, which are deeper and feel a greater force, it reduces swelling, decreases blood pooling and helps to return venous blood to the heart. Hydrostatic pressure may also contribute to lower working heart rates while in the water. Buoyancy, the upward vertical force of water on a submerged body, is another important mechanical effect. Buoyancy counteracts the effects of gravity and reduces compression of the joints. Many people who can't exercise on land bearing their full weight can exercise vigorously and comfortably in water. Immunological effects. Some research suggests that trace elements present in mineral water are absorbed through the skin and affect the immune system. Sulfur water is believed to inhibit proliferation of certain lymphocytes and their ability to produce and release cytokines. Cytokines are proteins that help regulate the immune response. For example, patients with rheumatoid arthritis produce an excess of interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha), two important cytokines. By inhibiting IL-1 and TNF-alpha, sulfur water may relieve symptoms of arthritis and other inflammatory diseases.
Clinical Trials Evaluating Balneotherapy

Much of our knowledge about how balneotherapy works physiologically has come from a variety of studies and clinical trials conducted since the 1950s. Unfortunately, conclusive data has been slow to emerge. One reason has to do with the difficulty in setting up "blinded" studies. Blinding refers to the practice of keeping both researchers and study participants in the dark about who is receiving the treatment under study and who is receiving the placebo treatment. In the case
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of balneotherapy, it's difficult to veil the treatment study when the water used in the study is hot, buoyant or smells of sulfur. Still, researchers have pushed on, doing their best to reduce observer bias, reporter bias and the placebo effect. To date, the most conclusive studies demonstrating the therapeutic effect of balneotherapy have been those focused on musculoskeletal disorders. A recent review of relevant randomized controlled studies revealed that balneotherapy resulted in statistically significant pain improvement in patients with rheumatic diseases and chronic low back pain. Rheumatic diseases affect joints and connective tissues and include more commonly known conditions such as rheumatoid arthritis and osteoarthritis. They also include fibromyalgia, a syndrome of conditions characterized by widespread pain in muscles and connective tissues, and ankylosing spondylitis, a chronic inflammatory disease of the spine and pelvis. Another promising area of research has focused on the effects of balneotherapy on dermatological conditions. There is growing evidence that water-based treatments benefit patients with psoriasis, a condition marked by uncontrollable skin cell growth, and atopic dermatitis, a type of eczema in which the skin becomes irritated and inflamed. Scientists are also studying balneotherapy as a treatment for acne, rosacea and seborrhea. Over the next few years, research may show that balneotherapy can do much more than treat ailments of the skin, bones and muscles. Studies are already under way to investigate the effectiveness of water as a therapy for cardiovascular and neurological disorders. For example, deep breathing exercises conducted in heated pools may be beneficial to people with chronic obstructive pulmonary disease (COPD). And very preliminary results from one trial indicate that repeated sauna therapy may protect against oxidative stress, which leads to the prevention of atherosclerosis. If this research bears fruit, the medical advice we are likely to hear in the future is, "Take a hot bath and call me in the morning."
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A SHOWER INSTEAD Certain individuals should avoid balneotherapy. Prolonged exposure to hot water can be dangerous for pregnant women, young children and people under the influence of alcohol or other intoxicating substances. Anyone with open cuts, sores or lesions should also stay away from public baths because the warm, wet conditions may lead to the transmission of infections, including amoebic infections that can cause death. Balneotherapy is the treatment of disease by bathing, usually practiced at spas. While it is considered distinct from hydrotherapy, there are some overlaps in practice and in underlying principles. Balneotherapy may involve hot or cold water, massage through mineral waters moving at water, relaxation or stimulation. spas are which can rich be Many in absorbed
particular minerals (silica, sulfur, selenium, radium)
through the skin. Medicinal clays are also widely used, which practice is known as 'fangotherapy' Definition and characteristics The term "balneotherapy" is generally applied to everything relating to spa treatment, including the drinking of waters and the use of hot baths and natural vapor baths, as well as of the various kinds of mud and sand used for hot applications. Balneotherapy refers to the medical use of these spas, as opposed to recreational use. Common minerals found in spa
watersare sodium, magnesium, calciumand iron,aswellas arsenic, lithium, potassiu m, manganese, bromine, and iodine. All these may be contained in the peat that is commonly used in preparation of spa waters. Resorts may also add minerals or essential oils to naturally-occurring hot springs. Though balneotherapy commonly refers to mineral baths, the term may also apply to water treatments using regular hot or cold tap water.
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Mud-baths are also included in balneotherapy, and the dirt and water used to mix mud baths may also contain minerals which are thought to have beneficial properties. Treatment of diseases Balneotherapy may be recommended for wide range of illnesses, including arthritis skin conditions and fibromyalgia. As with any medical treatment, balneotherapy should be discussed with a physician before beginning treatment, since a number of conditions, like heart disease and pregnancy, can result in a serious adverse reaction. Scientific studies into the effectiveness of balneotherapy tend to be neutral or positive, finding that balneotherapy provides no effect or a placebo effect, or that there is a positive effect. However, many of these studies suffer from methodological flaws, and so may not be entirely reliable.]A 2009 review of all published clinical evidence concluded that, while available data suggest that balneotherapy may be truly associated with improvement in several
rheumatological diseases, existing research is not sufficiently strong to draw firm conclusions. Mud baths are also included in balneotherapy, and the dirt and water used to mix mud baths may also contain minerals which are thought to have beneficial properties. There is widespread popular belief that balneotherapy is effective in the treatment of various diseases. Balneotherapy is defined as the use of baths containing thermal mineral waters from natural springs at a temperature of at least 20 C and with a mineral content of at least 1 g/l. More so, it is more common that the temperature of the thermal water is approximately 34. Balneotherapy has been used not only in the ancient years in the treatment of various illnesses but also in modern times.
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Under the broad term balneotherapy (in contrast to the strict definition given above), various treatment methods are included: Dead Sea salt or mineral baths, sulphur baths, radon-carbon dioxide baths. Balneotherapy is either provided as the solitary component of the therapeutic approach or in the context of spa therapy. Spa therapy additionally to balneotherapy employs various modalities such as physiotherapy, and even the change in environment and lifestyle per se may contribute to the changes seen in patient outcome measurements, i.e. the therapeutic result may not be attributed to the balneotherapy alone. Thus, while some researchers have regarded balneotherapy and spas as more or less interchangeable terms, others disagree. More so one has to acknowledge that the composition of the mineral water differs in its content in cations and anions, and thus assessing which is the specific therapeutic component is difficult. We thought to review the existing evidence regarding randomised controlled trials (RCTs), examining the clinical effects of balneotherapy.
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BALNEOTHERAPY: HEALING WITH WATER

One of the most important activities that takes place at a traditional spa is balneotherapy, a natural approach to health and healing that uses hot spring water, gases, mud, and climatic factors (such as heat) as therapeutic elements. In addition to bathing, modalities such as hydrotherapy, mud therapy, physical therapy, massage, steam baths, physical exercises, inhalation of water vapor, and drinking mineral water are often used as part of a complex therapy for both health and preservation and treating disease. Over the past four centuries, the science of balneology has evolved into a medical specialty in Europe and Japan, where special courses in balneotherapy are offered to both physicians and nurses by major medical schools. Doctors believe that thermal springs facilitate healing in a number of important ways. Eight Ways Balneotherapy Heals: 1. Bathing in hot springs gradually increases the temperature of the body, thus killing harmful germs and viruses. 2. Thermal bathing increases hydrostatic pressure on the body, thus increasing blood circulation and cell oxygenation. The increase in blood flow also helps dissolve and eliminate toxins from the body. 3. Hot springs bathing increases the flow of oxygen-rich blood throughout the body, bringing improved nourishment to vital organs and tissues. 4. Bathing in thermal water increases body metabolism, including stimulating the secretions of the intestinal tract and the liver, aiding digestion.
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5. Repeated hot springs bathing (especially over three- to four-week period) can help normalize the functions of the endocrine glands as well as the functioning of the bodys autonomic nervous system. 6. Trace amounts of minerals such as carbon dioxide, sulfur, calcium, magnesium, and lithium are absorbed by the body and provide healing effects to various body organs and system. These healing effects can include stimulation of the immune system, leading to enhanced immunity; physical and mental relaxation; the production of endorphins; and normalized gland function. 7. Mineral springs contain high amounts of negative ions, which can help promote feelings of physical and psychological well-being. 8. The direct application of mineralized thermal waters (especially those containing sulfur) can have a therapeutic effect on diseases of the skin, including psoriasis, dermatitis, and fungal infections. Some mineral waters are also used to help the healing of wounds and other skin injuries. Indications for Balneotherapy Over the several hundred years during which the science of medical balneology has developed, physicians have been able to identify the health conditions that can best be treated by healing springs. The following list of indications for balneotherapy is based on the research of Yuko Agishi, M.D. CHRONIC DISEASES Chronic rheumatic diseases Functional recovery of central and peripheral neuroparalysis Metabolic diseases, especially diabetes, obesity, and gout Chronic gastrointestinal diseases Chronic mild respiratory diseases Circulatory diseases, especially moderate or mild hypertension
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Peripheral circulatory diseases (affecting the hands and feet) Chronic skin diseases Psychosomatic and stress-related diseases Autonomic nervous system dysfunction Vibration disorder (a middle ear disorder affecting balance) Sequela of (conditions resulting from) trauma Chronic gynecological diseases CONTRAINDICATIONS If you have any illnesses or diseases, or are pregnant, consult with your physician before using spa therapy. CAUTIONS Avoid soaking in a hot spring alone and the elderly should use with caution. Dont use a spa if you are under the influence of alcohol or drugs, especially heart medications. Dont overheat, drink plenty of cool water and use private pools if you have a skin disease.
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WARM WATER THERAPY
Weak muscle groups together with extensive muscle pain is without a doubt a reality for Fibromyalgia sufferers. Additionally, it appears that muscle tissue strength is significantly less in people experiencing Fibromyalgia. A number of medical studies have shown that if you have Fibromyalgia the optimum isometric and dynamic muscle potency is lower in comparison to healthy people. In other words, those affected by Fibromyalgia tend to have weaker knees and the muscle groups that support the knee are typically weaker and less stable.
Additional medical studies, which focused on resistance have demostrated lower outcomes in functional assessments in relation to day to day living, including sitting yourself down and getting up from a chair, where decreased optimum muscle strength of knee extensors is seen. This type of weakness may lead to loss of mobility. It's possible you have encountered this yourself, when getting up is challenging. Your knees feel like they're going to buckle, and they may be unable to support the weight of your whole body while moving down to a sitting down position, or coming up to a standing position. A great number of people with Fibromyalgia find it next to impossible, or at the very least incredibly challenging to crouch down with knees bent and then try to stand up.
Being involved with low impact exercising such as yoga, Tai Chi, walking, water aerobics, and low impact aerobics are often recommended in treating Fibromyalgia. Balneotherapy and/or warm baths have been proven to manage muscle pain safely and effectively. The trouble is warm water exercise is harder to access than land based exercise, and so many Fibromyalgia sufferers may not have access to warm water exercise classes easily. However, it may be well worth the efforts to try to attend them if at all possible.
Studies have shown that Fibromyalgia patients achieved positive results from reduced pain and low energy using a combination of land based workout programs with warm water pool exercises. These types of exercises also helped improve cardiovascular capacity and emotional wellness. The objective of one scientific study was to evaluate the short- and long-term effectiveness of exercise therapy using a warm, waist-high pool for women with Fibromyalgia. The study observed exercisers who joined in 34 water workouts. They did not modify any of their other habits. By the end of the program, the quantity of tender points had not changed either
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in the control group or the intervention group. However, the intervention group experienced substantial improvements in levels of pain, with a 29% reduction in pain. Follow up records showed that this gain was lost after 12 weeks of stopping water exercises. Knee strengthening throughout this scientific study was significant, with knee extensors showing a 20% improvement, and knee flexors achieving a 33% improvement. Translated this means that those who suffer from Fibromyalgia may use warm water exercise to strengthen their knees and improve mobility and stability, all of which are elements of concern in Fibromyalgia patients.
This study clearly showed that warm water exercise may benefit Fibromyalgia patients. It leads to remarkable gains in strength of the knee extensors, which is a major predictor in independence as it relates directly to your day to day life. It has long been known that low impact water exercises were beneficial to individuals recovering from injuries or surgeries. Depending on results of this study it appears that if you are afflicted by Fibromyalgia warm water exercise may be very useful to you. The key is that the workouts have to be ongoing as the benefits are lost over time.
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CAN BALNEOTHERAPY TREAT CHRONIC BACK PAIN?

Balneotherapy involves taking bath in medicinal waters to treat diseases and conditions. Though the practice is prevalent more as a recreational activity in spas, its therapeutic potentials remain less explored. While outdoor activities like swimming is recommended to prevent and treat chronic back pain, little is known about the impact of doing so for treating back aches. Is Balneotherapy Effective Enough in Treating Chronic Back Pain?
o
A research study was carried out on this subject at the Kehidakustny Health Spa, Kehidakustny, Budapest, Hungary.
o o o
The benefits of bathing in mineral water as compared to tap water were studied in this trial. 60 patients suffering from lower back pain were the participants and divided into two groups. 30 patients took bath in medicated sulphurous mineral water and equal number participants had bath in ordinary tap water.
The study lasted for three months and measuring parameters like Visual Analogue Scale (VAS) score, Oswestry index and symptoms of improvement like tenderness in the muscles, movement of the spine and antalgic posture, reduction in the pain medications were assessed.
The study found that bathing in medicinal waters improved the condition during the entire course of the study and more.
On the other hand, hydrotherapy with tap water resulted in temporary relief in the group two patients along with relatively less benefits at particular sites.
The experts concluded that the chronic back pain can show signs of alleviation when the patients take bath in medicinal waters.
Additional benefits include reduction in pain and increase in the range of movements earlier restricted.
On the whole, the study clearly established the benefits of the former method over the more prevalent hydrotherapy modality and pain medications.
Conclusion: A review of the available studies on the subject was carried out in 2009. It found that balneotherapy indeed improves certain rheumatological diseases and chronic back pain conditions. However, drawing firm conclusions from the existing data is not appropriate.
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BENEFITS OF BALNEOTHERAPY
Welcome to the Health Resort which is designed to help you in various ways depending on your needs for a treatment of medical conditions, reliable rehabilitation therapies, rejuvenation and anti-ageing procedures, or just aiming to relax, reduce stress, and recover for everyday activities.
At our practice we follow the balneotherapy approaches adopted at the best European health resorts. This implies that mineral spas form a part of the complex therapy also comprising exercise programs, dietary advice, detoxification procedures, and other techniques maximising the effectiveness of the treatment.
Our spas in their mineral composition and other physicochemical properties are essentially identical to the natural ones and other popular health resorts meaning that you would reap the same health benefits. A variety of mineral spas available in our practice enables us to prescribe the most appropriate treatment for you. The mineral spas are prepared in accordance with the medically approved guidelines. They demonstrated proven results reflected in many clinical trials and observations described in peer-reviewed journals. The mineral spas are used either alone as monotherapy or in combination with Clinical Pilates, exercise programs, organic detoxifying cocktails, and other treatment methods. The progress of your treatment is reviewed in regular reassessments.
All balneotherapy treatments are prescribed only by our qualified physiotherapists what means that your health goals would be appropriately addressed. Prior to prescribing the treatment you would undergo a comprehensive diagnostic examination investigating the conditions of you musculoskeletal, respiratory, cardiovascular, and other systems. This would allow us to prepare your treatment plan addressing your specific health problems, treatment goals, and other parameters. It would also consider potential contraindications such as pregnancy, high blood pressure, acute thrombosis and thrombophlebitis, infectious diseases, and other conditions.
In our practice we strictly adhere to the principles of Good Clinical Practice where all balneotherapy procedures are thoroughly monitored and documented by specially trained professional personnel. This means you could trust that our treatments are performed in accordance with your specific health requirements and confidentiality of your records is assured.
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PHYSICAL NEEDS OF THE CAREGIVER

Caregiving can take a serious toll on your health, even if you did not have any previous medical problems. Poor eating habits, lack of sleep, and continuous stress can run you down and put you at risk for fatigue, injury, and illness. However, there are some important strategies that can help you to maintain your health: Diet Fighting Fatigue Exercise Relaxation Diet As a caregiver, it is not uncommon to get so busy that you forget to eat. Other times, you may find that it is easiest to grab a snack or fast food on the run. While these things are okay once in a while, you should try not to make a habit out of them. Your body needs nutritious meals to use as fuel to keep you going. Tips for proper eating Eat 3 well-balanced meals per day, including breads and cereals, milk and cheese, fruits and vegetables, and lean meat, poultry, fish, and eggs. Cut down on fatty foods, sugar, and alcoholic beverages. Eat healthy snacks in between meals (e.g. fruit, vegetables, low-fat cheese, yogurt, cereals, and crackers). Drink enough water (6-8 glasses per day). Avoid drinking too much caffeine, such as soda, coffee, and tea. Fighting Fatigue Waking up numerous times in the middle of the night to help the patient... Getting up early and going to bed late in order to get everything done. Staying up all night with a patient who can't sleep... All of these situations can cause serious disruptions to your sleep and can lead to exhaustion. Sleep restores your body and mind. So, it is important for you to
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get enough rest in order to be able to maintain proper physical and emotional functioning. Ideally, you should be getting at least 6-8 hours of uninterrupted sleep per night. Tips to fight fatigue: Try to schedule your sleep around the patient's sleeping pattern (e.g. if the patient sleeps during the day, take a nap at the same time). Rest when you get tired. Avoid caffeine before bedtime so that you don't have trouble falling asleep. Get outside help for the evenings if you are unable to sleep because the patient is up a lot during the night. Every so often, recruit a friend or family member to stay over and care for the patient while you get some uninterrupted sleep.
The Benefits of Exercise Exercise has many benefits, including lowering blood pressure, easing depression and anxiety, and decreasing physical and mental tension. Exercise can help you ease your mind, take a break from the patient, and stay in shape to foster good health. As a caregiver, you confront a great deal of physical and emotional stress that can build up if not properly addressed. Exercise is one of the best ways to prevent yourself from becoming overwhelmed. Tips for exercising: Consult with your doctor to determine an exercise regimen that will be right for you. Walking and swimming are two great forms of low-impact exercise. No amount of exercise is too little, but it is suggested that you work out at least 3 times per week for at least 20 minutes each time. Be sure to stretch your muscles before and after you work out. If possible, try to work out with a partner (especially the patient) who can help keep you motivated. Pick a form of exercise that you enjoy. Listen to your favorite music to keep you going while you are working out.
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Choose a workout that is convenient so that you are more likely to stick with it. Finding Time to Relax Taking a little time to relax can help reduce the physical and emotional stress that come with caregiving. As little as 10 minutes of relaxation per day can help you feel more calm, rested, and able to cope with the stresses in your life. Tips for relaxation: Practice! Learning how to relax is a skill that takes time and practice. Do it as often as you can until you feel comfortable with the technique. Take time out at least once per day to relax, do something you enjoy, and get your mind off the illness. Do relaxation exercises in a quiet place where you will not be disturbed. Practice relaxation at times when the patient is asleep or does not need you. Take the phone off the hook and put a "Do Not Disturb" sign on the door. Read a book, watch TV, or listen to music. These can serve as relaxing breaks from the demands of caregiving. Schedule some time to pamper yourself by getting a massage, facial, or something else you enjoy.
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PHYSICAL NEEDS OF THE PATIENT

We all have the same physical needs. Most adults fulfill these needs for themselves , however, illness, age, and handicaps can interfere with the persons ability to take care of these needs without assistance. The basic physical needs of everyone, patients included, are: 1. Sleep 2. Exercise 3. Food 4. Elimination 5. Cleanliness 1. Sleep is necessary for our bodies and minds to rest and to be able to continue the activities of the next day. Rest is particularly important for people who are weak or ill. Much of their energy is directed toward healing and overcoming the weakness. Rest and sleep renew energy, therefore, the person who is weak and/or ill need more rest. 2. Exercise is what all of us need. Patients need exercise much more than the rest of us. They should be encouraged to move within their physical limits. Walking is one of the best form of exercise. Patients who are able to walk should be encouraged to do it. If they cannot walk by themselves, the nurse will provide a chain of exercise meant to help them regain mobility. 3. Food provides the energy for our bodies. Eating is also enjoyable and most often a time to be with other people. The nurse should encourage the patient to eat and can help them make meal times relaxing and pleasurable. If assistance is needed in cutting food, this should be provided in a pleasant and cheerful manner. 4. Elimination is absolutely normal for everybody. All body processes produce waste materials that must be eliminated. Many patients may need assistance when eliminating the waste products through urine and feces. Helping the patient remember to use the toilet or assisting him when help is needed eases his/her embarrassment.
5. Cleanliness is essential in killing bacteria and germs. It means assisting the patient in bathing, nail and teeth care and hair care as well. This helps patients feel good about their appearance.
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CHAPTER V MEDICAL QUIZES 1. A PRESCRIPTION

Patient: what about the problems I've been having sleeping? Doctor: I'm going to give you a prescription for some medicine to help you get a better night's sleep. Patient: Thank you doctor. Doctor: Here, you can get this prescription at any pharmacy. Patient: How often should I take the medicine? Doctor: Just take one pill about 30 minutes before you go to bed. Patient: How long should I take them? Doctor: The prescription is for thirty days. If you're not sleeping well after thirty days, I'd like you to come back in. Patient: Is there anything else I can do to help me sleep at night? Doctor: Don't worry so much about things at work. I know, I know... easier said than done. Patient: Should I stay home from work? Doctor: No, I don't think that's necessary. Just remember to stay calm. Key Vocabulary prescription to get a good night's sleep pharmacy to take medicine to take a pill easier said than done to stay calm
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1.
Which problem has the doctor prescribed some medicine for?
a. b. c.
Headaches Sleep Hypertension
2.
Where can the patient get the medicine?
a. At any store b. At any pharmacy c. At a specialist pharmacy
3.
How often should the patient take the medicine?
a. Twice a day b. Once a day c. Before meals 4. What other recommendation does the doctor make? a. Take a holiday from work b. Work harder c. Worry less about work 5. Should the patient stay home from work for a while? a. Yes b. Not necessarily
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2. TROUBLING SYMPTOMS
Patient: Good afternoon. Doctor: Good afternoon. Have a seat. So, what have you come in for today? Patient: Thank you. I'm feeling ill, I've got quite a bad cough, but I don't seem to have a fever. Doctor: I see. How long have you had these symptoms? Patient: Oh, I've had the cough for two weeks, but feeling ill just these past few days. Doctor: Are you having any other problems? Patient: Well, I've got a headache. I've also had a little bit of diarrhea. Doctor: Do you produce any phlegm when coughing? Patient: Sometimes, but it's usually pretty dry. Doctor: Do you smoke? Patient: Yes, a few cigarettes a day. Certainly no more than a half a pack a day. Doctor: How about allergies? Do you have any allergies? Patient: Not that I'm aware of. Doctor: Does your head feel stuffy? Patient: Yes, for the past few days. Doctor: OK. Now let's have a look. Could you please open your mouth and say 'ah'? Key Vocabulary symptoms to feel ill cough fever to have a cough headache diarrhea phlegm to cough allergy stuffy to feel stuffy
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1. Which symptom is not mentioned? a. Bad cough b. Stomachache c. Diarrhea 2. How long has the patient had the symptoms? a. He's had all of the symptoms for two months. b. He's had the cough for two weeks, and feeling ill for a few days. c. The symptoms just began yesterday. 3. What other problems does the patient mention? a. Headache and vomiting b. Joint pain c. Headache and diarrhea 4. Does the patient produce phlegm when coughing? a. Yes, always b. No c. Sometimes 5. Does the patient have any allergies? a. Yes, he's allergic to food. b. No, none that he knows of. c. He's not sure.
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3. A PHYSICAL EXAMINATION
Doctor: When did you last come in for a physical exam? Patient: I had my last physical two years ago. Doctor: Have you had any other exams recently? Blood work, an EKG or an ultra-sound? Patient: Well, I had a few X-rays at the dentist's. Doctor: How have you been feeling in general? Patient: Pretty well. No complaints, really. Doctor: Could you roll up your left sleeve? I'd like to take your blood pressure. Patient: Certainly. Doctor: 120 over 80. That's fine. You don't seem to be overweight, that's good. Do you exercise regularly? Patient: No, not really. If I run up a flight of stairs, it takes me a while to get my breath back. I need to get out more. Doctor: That would be a good idea. How about your diet? Patient: I think I eat a pretty balanced diet. You know, I'll have a hamburger from time to time, but generally I have well-balanced meals. Doctor: That's good. Now, I'm going to listen to your heart. Patient: Ooh, that's cold! Doctor: Don't worry it's just my stethoscope. Now, breathe in and hold your breath. Please pull up your shirt, and breathe deeply... Everything sounds good. Let's take a look at your throat. Please open wide and say 'ah'. Patient: 'ah' Doctor: OK. Everything looks ship shape. I'm going to order some blood work and that's about it. Take this slip to the front desk and they'll arrange an appointment for the tests. Patient: Thank you doctor. Have a nice day.
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Key Vocabulary physical examination (exam) blood work EKG ultra-sound x-rays to roll up sleeves overweight - underweight to exercise regularly balanced diet well-balanced meals stethoscope to breath in to hold one's breath to pull on one's shirt to breathe deeply to open wide to look ship shape slip front desk to arrange an appointment
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1. When did the patient have his last physical exam? a. He doesn't remember. b. Two years ago c. Last year 2. Has the patient had any other exams recently? a. No b. Yes, for dental work c. Yes, for a broken bone 3. How has the patient's health been in general? a. Poor b. Fine 4. Which might be a problem for the patient according to the physical exam? a. Weight b. Lack of exercise c. High blood pressure 5. Which action bothers the patient a little? a. The use of the stethoscope b. Taking his blood pressure c. Taking a look at his throat 6. What does the doctor ask him to do? a. Lose weight b. Take a ship c. Have some blood work done
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4. FEELING QUEASY
Nurse: Good morning, Mr Adams. How are you doing today? Patient: Horrible! I can't eat anything! I just feel sick to my stomach. Take the tray away. Nurse: That's too bad. I'll just put this over here for now. Have you felt queasy for very long? Patient: I woke up during the middle of the night. I couldn't get back to sleep, and now I feel terrible. Nurse: Have you been to the toilet? Any diarrhea or vomiting? Patient: I've been to the toilet twice, but no diarrhea or vomiting. Perhaps, I should drink something. Can I have a cup of tea? Nurse: Certainly, I'll get you a cup immediately. Would you like black tea or peppermint tea? Patient: Peppermint, please. Do you think I could have another blanket? I'm so cold. I think I'm getting the chills. Nurse: Here's an extra blanket. Let me tuck you in. Patient: You're so sweet. What is your name? Nurse: My name is Alice. I'll be on shift during the day for the next few days. Patient: Hello Alice. My name is Jack. Nice to meet you. Nurse: Let's get you feeling better Jack! Is there anything else I can get for you? Patient: That's alright. I think a cup of tea and a warm blanket should help. Nurse: OK. I'll be back as soon as the tea is ready. Patient: Thank you. Key Vocabulary to feel queasy to feel sick to one's stomach tray to wake up
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to feel terrible, awful, horrible to get (go) back to sleep to be to the toilet diarrhea
vomit black tea, peppermint tea blanket
to get the chills to tuck someone in
1. How much has the patient eaten today? a. Just a little b. A big breakfast c. Nothing 2. Why is the patient not eating? a. He has no appetite. b. He feels sick to his stomach. c. He's been vomiting. 3. Has the patient had any other symptoms besides feeling sick to his stomach? a. Yes, vomiting and diarrhea b. No, only feeling nauseous c. Yes, he's getting some chills 4. Which request does the patient not make? a. A cup of tea b. An extra blanket c. An extra pillow 5. What shift will Alice be working for the next few days? a. The night shift b. The day shift c. No shift, she'll be on vacation.
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5. JOINT PAIN
Patient: Good morning. Doctor Smith? Doctor: Yes, please come in. Patient: Thank you. My name is Doug Smith. Doctor: What have you come in for today Ms Anders? Patient: I've been having some pain in my joints, especially the knees. Doctor: How long have you been having the pain? Patient: I'd say it started three or four months ago. It's been getting worse recently. Doctor: Are you having any other problems like weakness, fatigue or headaches? Patient: Well I've certainly felt under the weather. Doctor: Right. How much physical activity do you get? Do you play any sports? Patient: Some. I like to play tennis about once a week. I take my dog on a walk every morning. Doctor: OK. Let's have a look. Can you point to the area where you are having pain? Key Vocabulary joint pain knees weakness fatigue headache to feel under the weather physical activity to play sports to have pain
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1. What seems to be Mr. Smith's problem? a. Broken knees b. Fatigue c. Joint pain 2. Which joints are bothering him the most? a. Elbow b. Wrist c. Knees 3. How long has he been having this problem? a. three or four years b. three or four months c. three or four weeks 4. Which other problem does the patient mention? a. He's felt under the weather. b. He's been vomiting. c. He doesn't mention another problem. 5. Which phrase best describes the amount of exercise the patient gets? a. He works out a lot. b. He gets some exercise, not a lot. c. He doesn't get any exercise.
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6. PAIN THAT COMES AND GOES

Doctor: How long have you been having this pain? Patient: It started in June. So for more than five months now. My stomach hurts after some meals, but not always. Doctor: You should have come in earlier. Let's get to the bottom of this. Have you changed your eating habits during this period? Patient: No, not really. Well, that's not true. I'm eating the same foods, but less. You know, the pain seems to come and go. Doctor: How strong is the pain exactly? On a scale of one to ten, how would you describe the intensity of the pain? Patient: Well, I'd say the pain is about a two on a scale of one to ten. Like I say, it's not really bad. It just keeps coming back... Doctor: How long does the pain last when you get it? Patient: It comes and goes. Sometimes, I hardly feel anything. Other times, it can last up to half an hour or more. Doctor: Is there a type of food that seems to cause stronger pain than other types? Patient: Hmmm ... heavy foods like steak or lasagna usually brings it on. I've been trying to avoid those. Doctor: Does the pain travel to any other parts of your body - chest, shoulder or back? Or does it remain around the stomach area. Patient: No, it just hurts here. Key Vocabulary pain stomach to hurt to get to the bottom of something eating habits to come and go on a scale of one to ten
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to keep coming back to last (an amount of time) heavy foods to avoid chest shoulder back
1. How often does the patient have this pain? a. After every meal b. After some meals c. Between meals 2. How long has the patient been having stomach pains? a. For less than five weeks b. For more than five months c. For less than five days 3. Has the patient changed his eating habits during this period? a. No, not at all. b. Yes, he's eating different types of food. c. Yes, he's eating the same foods, but less. 4. How severe is the pain? a. Not very severe b. Extremely severe c. Not at all severe 5. What types of food causes stronger pain? a. Vegetables and fruits b. Sweets c. Heavy foods like pasta and beef
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7. HELPING A PATIENT
Patient: Nurse, I think I might have a fever. It's so cold in here! Nurse: Here, let me check your forehead. Patient: What do you think? Nurse: Your temperature seems raised. Let me get a thermometer to check. Patient: How do I raise my bed? I can't find the controls. Nurse: Here you are. Is that better? Patient: Could I have another pillow? Nurse: Certainly, Here you are. Is there anything else I can do for you? Patient: No, thank you. Nurse: OK, I'll be right back with the thermometer. Patient: Oh, just a moment. Can you bring me another bottle of water, too? Nurse: Certainly, I'll be back in a moment. Key Vocabulary fever to check someone's forehead raised temperature thermometer to raise / lower the bed controls pillow
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1. What problem does the patient think she has? a. A fever b. Vomiting c. A broken bone 2. What does the nurse think? a. That the patient has a raised fever. b. That the patient needs to see the doctor immediately. c. That the patient should eat something. 3. What other problem is the patient having? a. She's very hungry. b. She can't find the bed controls. c. She can't sleep. 4. What request does the patient make? a. She asks for an extra blanket. b. She asks for an extra pillow. c. She asks for a magazine. 5. What other problem might the patient have? a. She's overweight because she asks for food. b. She's thirsty because she asks for a bottle of water. c. She's very old because she mentions her 80th birthday.
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8. GETTING PATIENT DETAILS

Administrative Staff: Hello, how can I help you? Patient: I've got an appointment with Dr. Adams. Administrative Staff: Are you Ms Moyers? Patient: Yes, I am. I have an appointment at ten. Administrative Staff: We just need to fill in some information for our files. Could you fill out these forms? Patient: Certainly ... (comes back after filling out the forms) What's this form for? Administrative Staff: It's just a privacy form informing you of our policies. Patient: Is that really necessary? Administrative Staff: I'm afraid it is. Could you also sign that form? Patient: OK, there you go. Here's my insurance provider's card. Administrative Staff: Thank you. OK, that'll be $20. Patient: Why do I have to pay $20? Administrative Staff: It's the deductible for office visits required by your health care provider. Patient: ... but I'm insured aren't I? Administrative Staff: Yes, of course. Your health care provider asks for deductibles on office visits. Patient: Every time I turn around I've got some additional fee to pay. I don't know why I pay for insurance! Administrative Staff: I know it's frustrating. We also have a lot of paperwork. Every provider has different forms and requirements! Patient: This can't continue on like this! Administrative Staff: I agree with that! Key Vocabulary appointment to fill in forms files form privacy policies to sign a form insurance provider insurance provider's card deductible office visit health care provider to be insured additional fee frustrating paperwork
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1. Who does the patient have an appointment with? a. With the nurse for blood work b. With the physical therapist c. With Dr. Adams 2. What does the staff member ask for? a. Her passport b. To fill out some forms c. Her driver's license 3. Which form does the patient ask about? a. The health history form b. The privacy form c. The insurance form 4. What type of identification does the patient provide? a. Credit card b. Driver's license c. Insurance provider's card 5. What does the patient not understand? a. Why she has to visit the doctor. b. Why she has to pay a deductible. c. Why she has to have blood work done. 6. What does the staff member complain about? a. The patient's questions b. The amount of paperwork from various health care providers c. The weather
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9. MAKING A DOCTOR'S APPOINTMENT

Doctor's Assistant: Good morning, Doctor Jensen's office. How may I help you? Patient: Hello, I'd like to make an appointment to see Doctor Jensen, please. Doctor's Assistant: Have you been in to see Doctor Jensen before? Patient: Yes, I have. I had a physical last year. Doctor's Assistant: Fine, what is your name? Patient: This is Maria Sanchez. Doctor's Assistant: Thank you Ms Sanchez, let me pull up your file. Patient: I haven't been feeling very well lately. Doctor's Assistant: Do you need urgent care? Patient: No, not necessarily, but I'd like to see the doctor soon. Doctor's Assistant: Of course, how about next Monday? There's a slot available at 10 in the morning. Patient: I'm afraid I'm working at 10. Is there anything available after three? Doctor's Assistant: Let me see. Not on Monday, but we have a three o'clock opening next Wednesday. Would you like to come in then? Patient: Yes, next Wednesday at three would be great. Doctor's Assistant: Alright, I'll pencil you in for three o'clock next Wednesday. Patient: Thank you for your help. Doctor's Assistant: Your welcome. We'll see you next week. Goodbye. Patient: Goodbye. Key Making an Appointment Phrases How may I help you? I'd like to make an appointment Have you been in before? I had a physical (examination) This is ... to pull up a file
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I haven't been feeling very well. urgent care a slot available Is there anything open (available) ... to pencil someone in
1. Ms Sanchez has never seen Doctor Jensen. a. True b. False 2. Ms Sanchez had a physical examination with Doctor Jensen last year. a. True b. False 3. Ms Sanchez is feeling fine these days. a. True b. False 4. Ms Sanchez needs urgent care. a. True b. False 5. Ms Sanchez schedules an appointment for next week. a. True b. False
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10. DENTAL HYGIENE

Sam: Hello. Gina the Dental Hygienist: Hello Mr. Waters. I'm Gina. I'll be cleaning your teeth today. Sam: Dr. Peterson has just filled two cavities. Why do I need a cleaning? Gina the Dental Hygienist: Well, we have to make get your teeth and gums clean and disease free. Sam: I guess that makes sense. Gina the Dental Hygienist: Oral health leads to trouble-free teeth. I'll start off by removing plaque. Please lean back and open wide. Sam: OK, I hope it's not too bad. Gina the Dental Hygienist: Everybody gets plaque, even if they floss regularly. That's why it's important to come in twice a year for check-ups. Sam: (getting his teeth cleaned, can't say much...) Gina the Dental Hygienist: OK, please take a drink and rinse. Sam: Ah, that's better. Gina the Dental Hygienist: OK, now I'll apply some fluoride. Which flavor would you like? Sam: I have a choice? Gina the Dental Hygienist: Sure, we have mint, spearmint, orange or bubble-gum - that's for the kids. Sam: I'd like to have the bubble-gum! Gina the Dental Hygienist: OK. (applies fluoride) Now, let me give your teeth a final flossing. Sam: What type of floss tape do you recommend? Gina the Dental Hygienist: Personally, I like the flat tape. It's easier to get between the teeth. Sam: OK, I'll remember that the next time I buy floss. How often should I floss? Gina the Dental Hygienist: Everyday! Twice a day if possible! Some people like to floss after every meal, but that's not absolutely necessary.
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Sam: (after finishing the cleaning) I feel much better. Thank you. Gina the Dental Hygienist: My pleasure. Have a pleasant day, and remember to floss every day - at least once a day! Key Vocabulary to clean someone's teeth dental hygienist to fill cavities gums disease free oral health to lead to plaque to remove plaque to floss check-up to rinse fluoride to apply fluoride flavor flossing floss tape floss after meals
1. The dental hygienist is responsible for drilling cavities. a. True b. False 2. Teeth need to be cleaned regularly. a. True b. False 3. The dental hygienist begins by removing plaque. a. True b. False 4. There are different flavors of fluoride. a. True b. False 5. Flossing every day is not so important. a. True b. False
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CHAPTER VI READING COMPREHENSION FOR NURSING SCHOOL

Reading Comprehension for Nursing School Entrance Exam Study Guide Because reading is such a vital skill, many nursing school entrance exams include a reading comprehension section that tests your ability to understand what you read. The tips and exercises in this chapter will help you improve your comprehension of written passages so that you can increase your score in this area. As a nursing professional, you will do a lot of readingmemos, policies, and manuals, as well as medical and technical reports, charts, and procedures. Understanding written material is a key part of the job. Reading comprehension is also an essential skill for students of nursing programsmost likely, you will need to read and understand scientific and medical textbooks as part of the training for your career. As a result, nursing school entrance exams attempt to measure how well applicants understand what they read. The reading comprehension section of your test will look much like reading comprehension segments you have encountered before on other standardized tests. You read a passage one to five paragraphs long, usually scientific in nature, and then answer one or more questions based on what you have read. You do not need to have any prior or specific knowledge to answer the questionsyou need onlythe information presented in the passage. You will be asked to interpret passages, identify the author's purpose, look at how ideas are organized and presented, and draw conclusions based on the information in the passage. Types of Reading Comprehension Questions As a test taker, you have two advantages when answering multiple-choice questions about reading passages: 1. Before you start reading, you don't have to know anything about the topic of the passage. 2. You're being tested only on the information the passage provides. The disadvantage is that you have to know where and how to find that information quickly in an unfamiliar text. This makes it easy to fall for one of the wrong answer choices, especially since they are designed to mislead you. The best way to do well on this passage/question format is to be very familiar with the kinds of questions that are typically asked on the test. Questions most frequently ask you to:
Identify a specific fact or detail in the passage.

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Note the main idea of the passage. Make an inference based on the passage. Define a vocabulary word from the passage.
Facts and details are the specific pieces of information that support the passage's main idea. The main idea is the thought, opinion, or attitude that governs the whole passage. Generally speaking, facts and details are indisputablethings that don't need to be proven, like statistics (18 million people) or descriptions (a green overcoat). Let's say, for example, you read a sentence that says, "After the department's reorganization, workers were 50% more productive." A sentence like this, which gives you the fact that 50% of workers were more productive, might support a main idea that says, "Every department should be reorganized." Notice that this main idea is not something indisputable; it is an opinion. The writer thinks all departments should be reorganized, and because this is his opinion (and not everyone shares it), he needs to support his opinion with facts and details. An inference is a conclusion that can be drawn based on facts or evidence. For example, you can inferbased on the fact that workers became 50% more productive after the reorganization, which is a dramatic changethat prior to the reorganization, the department had not been efficiently organized. The fact sentence, "After the department's reorganization, workers were 50% more productive," also implies that the reorganization of the department was the reason workers became more productive. There may, of course, have been other reasons, but we can infer only one from this sentence. As you might expect, vocabulary questions ask you to determine the meanings of particular words. If you have read carefully, you can determine the meaning of a word from its context that is, how the word is used in the sentence or paragraph. Because most of the texts you will read as a nursing student and professional are scientific in nature, you are most likely to find fact or detail and vocabulary questions on your entrance exam. However, because all four types of questions are important to reading comprehension (because not all scientific texts are objective fact, and because analysis and interpretation are important parts of the scientific process), you will find main idea and inference questions on the tests as well. The following is a sample test passage, followed by four questions. Read the passage carefully, and then answer the questions, based on your reading of the text, by circling your choice. Note under your answer which type of question has been asked (fact or detail, main idea, inference, or vocabulary). Correct answers appear immediately after the questions.
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Practice Passage 1:Using the Four Question Types

The immune system, which protects the body from infections, diseases, and other injuries, is composed of the lymphatic system and the skin. Lymph nodes, which measure about 1 to 25 centimeters across, and small vessels called lymphatics compose the lymphatic system. The nodes are located in the groin, armpits, throat, and trunk, and are connected by the lymphatics. The nodes work with the body's immune system to fight off infectious agents like bacteria and fungus. When infected, the lymph nodes are often swollen and sensitive. The skin, the largest organ of the human body, is also considered part of the immune system. Hundreds of small nerves in the skin send messages to the brain to communicate pressure, pain, and other sensations. The skin encloses the organs to prevent injuries and forms a protective barrier that repels dirt and water and stops the entry of most harmful chemicals. Sweat glands in the skin help regulate the body's temperature, and other glands release oils that can kill or impede the growth of certain bacteria. Hair follicles in the skin also provide protection, especially of the skull and groin. 1. Lymph nodes are connected by a. blood vessels. b. smaller nodes. c. nerves. d. small vessels. Question type: _______ 2. According to the passage, pain in the lymph nodes most likely indicates that the a. skin is dirty or saturated with water. b. nodes are battling an infection. c. brain is not responding properly to infection. d. lymphatics are not properly connected to the nodes. Question type: _______ 3. Which of the following best expresses the main idea of the passage? a. The immune system is very sensitive and registers minute sensations. b. The skin and its glands are responsible for preventing most infections.
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c. The lymphatic system and the skin work together to protect the body from infection. d. Communication between the lymphatic system and the brain is essential in preventing and fighting infection. Question type: _______ 4. As it is used in this passage, the word compose most nearly means a. create, construct. b. arrange, put in order. c. control, pull together. d. form, constitute. Question type: _______
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Detail and Main Idea Questions Detail or fact questions and main idea questions both ask you for information that is right there in the passage. All you have to do is find it. Detail or Fact Questions In detail or fact questions, you have to identify a specific item of information from the text. This is usually the simplest kind of question. You just have to be able to separate important information from less important information. However, the choices may often be very similar, so you must be careful not to get confused. Be sure you read the passage and questions carefully. In fact, it is usually a good idea to read the questions first, before you even read the passage, so you will know what details to look out for. Main Idea Questions The main idea of a passage, like that of a paragraph or a book, is what it is mostly about. The main idea is like an umbrella that covers all of the ideas and details in the passage, so it is usually something general, not specific. For example, in Practice Passage 1, question 3 asked about the main idea, and the correct answer was the choice that said the skin and the lymphatic system work together to prevent infection. This is the best answer because it is the only one that includes both the skin and the lymphatic system, both of which are discussed in the passage. Sometimes, the main idea is stated clearly, often in the first or last sentence of the passage. The main idea is expressed in the first sentence of Practice Passage 1, for example. The sentence that expresses the main idea is often referred to as the topic sentence. At other times, the main idea is not stated in a topic sentence but isimplied in the overall passage, and you will need to determine the main idea by inference. Because there may be a lot of information given in the passage, the trick is to understand what all that information adds up to the gist of what the author wants you to know. Often, some of the wrong answers on main idea questions are specific facts or details from the passage. A good way to test yourself is to ask, "Can this answer serve as a net to hold the whole passage together?" If not, chances are you have chosen a fact or detail, not a main idea. Practice answering main idea and detail questions by working on the questions that follow this passage. Check your answers against the key that appears immediately after the questions.
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Practice Passage 2: Detail and Main Idea Questions

Because the body responds differently to different allergens, allergic reactions have been divided into four categories. Type I allergies, the most common, are characterized by the production of immunoglobulin E (IgE), a type of antibody the immune system releases when it thinks a substance is a threat to the body. IgE releases chemicals called mediators, like histamine, which cause blood vessels to dilate and release fluid into the surrounding tissues, usually resulting in a runny nose and sneezing. Type I allergies include allergic asthma and hay fever as well as reactions to insect stings and dust. Type II allergies, far more rare, are usually reactions to medications and can cause liver and kidney damage or anemia. The body sends immunoglobulin M (IgM) and immunoglobulin G (IgG) to the site to fight the infection. Type III allergies are usually caused by reactions to drugs like penicillin. The body releases IgM and IgG, but these allergens cause IgM and IgG to bind away from cell surfaces. This creates clumps of allergens and antibodies that get caught in the tissues and cause swelling, which can affect the kidneys, joints, and skin. Type IV allergies cause the release of mediators that create swelling as well as itchy rashes. These are usually skin reactions to irritants like poison ivy, soaps, cosmetics, and other contact allergens. 1. Which type(s) of allergic reactions result in swelling? a. Types I and III b. Types III and IV c. Type III only d. Types II and IV 2. IgE, IgG, and IgM can be classified as a. allergens. b. mediators. c. antibodies. d. medications. 3. Which of the following would be the best title for this passage? a. Preventing Allergic Reactions b. Determining the Causes of Allergies c. Allergens and the Human Body d. Four Types of Allergic Reactions
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4. Which of the following best expresses the main idea of the passage? a. Allergies cause different responses in the body. b. People should avoid things that may cause allergic reactions. c. Type I allergies affect the most people. d. Mediators play an important role in allergic reactions.
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Inference and Vocabulary Questions Questions that ask you about the meaning of vocabulary words in the passage and those that ask what the passage suggests or implies(inference questions) are different from detail or main idea questions. In vocabulary and inference questions, you usually have to pull ideas that are not expressly stated in the passage, sometimes from more than one place in the passage. Inference Questions Inference questions can be the most difficult to answer because they require you to draw meaning from the text when that meaning is implied rather than directly stated. Inferences are conclusions that we draw based on the clues the writer has given us. When you draw inferences, you have to be something of a detective, looking for clues such as word choice, tone, and specific details that suggest a certain conclusion, attitude, or point of view. You have to read between the lines in order to make a judgment about what an author is implying in the passage. A good way to test whether you have drawn an acceptable inference is to ask, "What evidence do I have for this inference?" If you can't find any, you probably have the wrong answer. You need to be sure that your inference is logical and that it is based on something that is suggested or implied in the passage itselfnot by what you or others might think. Like a good detective, you need to base your conclusions on evidencefacts, details, and other informationnot on random hunches or guesses. Vocabulary Questions There are generally two types of vocabulary questions. The first tests to see how carefully you have read a passage that may contain a number of new or technical terms and definitions. If you see that a passage has a number of unfamiliar terms, mark each term as it is defined. This will make it easier for you to go back and find the right answer. The second type of vocabulary question is designed to measure how well you can figure out the meaning of a word from its context.Context refers to how the word is used in the sentencehow it works with the words and ideas that surround it. If the context is clear enough, you should be able to substitute a nonsense word for the one being sought, and you would still make the right choice because you could determine meaning strictly from the sense of the sentence. For example, you should be able to determine the meaning of the following italicized nonsense word based on its context:
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The speaker noted that it gave him great terivinix to announce the winner of the Outstanding Leadership Award. In this sentence, terivinix most likely means 1. pain. 2. sympathy. 3. pleasure. 4. anxiety. Clearly, the context of an award makes choice c, pleasure, the best answer. Awards don't usually bring pain, sympathy, or anxiety. When confronted with an unfamiliar word, try substituting a nonsense word and see if the context gives you the clue. If you are familiar with prefixes, suffixes, and word roots, you can also use this knowledge to help you determine the meaning of an unfamiliar word. More often, however, you will be asked about how familiar words or phrases are used in context. These questions can be very tricky because words often have more than one acceptable meaning. Your job is to figure out which meaning makes the most sense in the context of the sentence. For example, the word manipulate can mean either (a) to handle or manage skillfully or (b) to arrange or influence cleverly or craftily. The meaning of this word depends entirely upon the context in which it is used, as you can see from the following sentences. 1. The patient manipulated the wheelchair around the obstacles. 2. The media's manipulation of the facts has a powerful effect on politics. Sentence a uses the first definition of the word, while sentence b uses the second. When you are confronted with this type of question, your best bet is to take each possible answer and substitute it for the word in question in the sentence. Whichever answer makes the most sense in the context of the sentence should be the correct answer. The questions that follow this passage are strictly vocabulary and inference questions. Circle the answers to the questions, and then check your answers against the key that appears immediately after the questions.
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Practice Passage 3: Inference and Vocabulary Questions

The rise of science in the seventeenth century ushered in the modern world. Four men are primarily responsible for the discoveries that form the foundation of scientific and philosophical thought today: Copernicus, Kepler, Galileo, and Newton. Copernicus overthrew the geocentric notion of the universe which held that the earthand therefore humanitywas at the center of the universe and showed that the planets revolve around the sun. Kepler, the first major astronomer to adopt Copernicus's heliocentric theory, discovered three laws of planetary motion that helped validate Copernicus's theory. Galileo revealed the role of acceleration in dynamics and established the law of falling bodies. Finally, Newton's studies of motionmade possible only by the work of the three scientists before himled to his laws of motion and the universal law of gravitation: "Everybody attracts every other body with a force directly proportional to the product of their masses and inversely proportional to the square of the distance between them." It is these theories upon which much of modern science is based. 1. As it is used in the passage, the word "adopt" most nearly means to a. take and use as one's own. b. approve or accept. c. make suitable for a new situation. d. take guardianship for. 2. From the passage, which of the following can be inferred about Copernicus's heliocentric theory? a. It supported the religious doctrine of the time. b. It was accepted only because of Kepler. c. It went against established ideas. d. It revealed the laws of planetary motion. 3. Information contained in the passage supports which of the following statements about the four scientists? a. Their scientific discoveries contributed to the philosophical and social turmoil of the seventeenth century. b. Of the four, Newton's theories have been most instrumental in modern science. c. Their primary goal was to refute the theory that Earth was the center of the universe.
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d. They recognized that their achievements were based on the achievements of those before them. 4. As it is used in the passage, the word established most nearly means a. instituted or ordained by law or agreement. b. set up permanently, brought into existence. c. settled in a place or position. d. introduced and secured acceptance of.
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Review: Putting It All Together

A good way to solidify what you have learned about reading comprehension questions is for you to write the questions. Here is a passage, followed by space for you to write your own questions. Write one question of each of the four types: fact or detail, main idea, inference, and vocabulary. In the years since it was first proposed, the free radical theory of aging has gained wide acceptance. But hypotheses that attempt to explain exactly how free radicals are involved in the aging process are muddled by the lack of a clear definition of aging. Is aging a programmed stage of cellular differentiation, or is it the result of physiological processes impaired by free radical or other damage to cells? Despite the want of a clear definition, few question that free radical damage to cell nucleic acids and lipids are an important factor in aging. A recent study shows that oxygen free radicals cause approximately 10,000 DNA base modifications per cell per day. Perhaps the accumulation of unrepaired damage of this type accounts for the deterioration of physiological function. A new theory, however, indicates that free radicals also damage cell proteins and that the accumulation of oxidized protein is an important factor in aging. 1. Detail question: __________ a. b. c. d. 2. Main idea question: __________ a. b. c. d. 3. Inference question: __________ a. b. c. d. 4. Vocabulary question: __________ a. b. c. d.
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CHAPTER VII SMALL GROUP DISCUSSION- ORAL COMUNICATION

A role play: doctors and patients Objectives of the activity (role play) - To consolidate students knowledge of the topic nervous co-ordination. - To check students understanding of the topic. - To arouse students interest in the topic. - To give students a chance to practise oral English. Introduction After teaching the topic nervous co-ordination, I devised the following activity to help students gain a better and deeper understanding of the topic. I have tried out the activity four times with four classes. The following is a brief description. Procedure 1. Students are divided into groups of five. 2. Task sheet 1 is given to students (refer to appendix 1). 3. One of the group members plays the role of a patient (student A) whose nervous system is damaged during a traffic accident. The other group members (students B to E) act as doctors. 4. Student A describes his/her condition to the doctors (refer to appendix 2). He/She should rephrase and explain the symptoms in detail. However, the patient should not discuss the symptoms with the doctors. 5. Students B to E should discuss each symptom and make a diagnosis. One student should record the diagnoses on Task Sheet 3 (refer to appendix 3). Another student should report back to the class. 6. Ten marks will be given to each correct answer. An extra ten marks will be given to the group speaking only English during their discussion. 7. Prizes will be given to the winners. Post-lesson Evaluation To improve the activity, I will give students a list of useful vocabulary and a sample dialogue. (See Appendix 4) The role of patient and doctors should be rotated as well. The ten symptoms should be printed on ten cue cards instead of one task sheet.
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APPENDIX 1
TASK SHEET 1 (for all students to read)
WHICH PART(S) OF THE NERVOUS SYSTEM IS/ARE DAMAGED? After a traffic accident, the driver (student A) has difficulties in coordinating his/her body. Decide which part(s) of his/her nervous system is/are damaged (Assumption: the patient does not suffer from brain damage) Roles: Student A (the driver, i.e. the patient): - Describe the symptoms one by one Student B (doctor): - Discuss the symptoms, write down the answers on the answer sheet Student C (doctor): - Discuss the symptoms, report to your classmates at the end of the discussion Student D (doctor): - Discuss the symptoms in detail and thoroughly Students E (doctor): -Discuss the symptoms in detail and thoroughly (HINT: sketch the neural pathway of the action first) (You SHOULD use English only)
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APPENDIX 2
TASK SHEET 2 (Only student A is allowed to read these symptoms) 1. When my finger is pricked by a needle, a. I show neither a reflex action nor a voluntary action but I have a sensation of pain. (Description given to Dr. B) _______________________________________________________________ b. I have the withdrawal reflex but I am not aware of the pricking action. (Description given to Dr. C) _______________________________________________________________ c. I show neither a reflex action nor a voluntary action and I do not have the sensation of pain. (Description given to Dr. D) _______________________________________________________________ 2. When my stretch receptor (receptor below the knee cap of the leg) is tapped, a. I feel the tapping stimulus but cannot give the knee jerk response. (Description given to Dr. B) _______________________________________________________________ b. I do not feel the tapping stimulus but can still move voluntarily. (Description given to Dr. C) _______________________________________________________________ c. I have the knee jerk reflex action but I am not aware of it. (Description given to Dr. D) _______________________________________________________________ 3. The parts of my body below the abdomen have lost voluntary action and sensation but the parts of the body above my abdomen do have voluntary action and sensation. _____________________________________________________________________ 4. I have the sensation of sight, have the ability to move the tongue, can give a knee jerk reflex but cannot move my hands and feet (limbs) at will and have no sensation of pain in my limbs. ____________________________________________________
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APPENDIX 3
TASK SHEET 3 (for students B, C, D and E) Answer sheet 1 a. _________________________________________________________________ b. _________________________________________________________________ c. _________________________________________________________________ 2 a. _________________________________________________________________ b. _________________________________________________________________ c. _________________________________________________________________ 3. _________________________________________________________________ 4. _________________________________________________________________
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APPENDIX 4
Useful dialogue in consulting a doctor Dr. Jones: Good morning. Come and sit down. What can I do for you? Mr. Jack: Good morning. I dont feel so well. I would like something to make me better. Dr. Jones: How do you feel? Mr. Jack: I feel hot and tired. I dont sleep well at night. My head aches. Dr. Jones: When did all this start? Mr. Jack: Three days ago. I thought I had a cold but it has got worse. Dr. Jones: Do you have backache? Mr. Jack: No. But my eyes are sore. Dr. Jones: Are your eyes itchy? Mr. Jack: Yes, they itch a lot. I also have a running nose and a cough. Dr. Jones: Oh, dear, it sounds like the flu. Mr. Jack: Is there anything you can give me? Dr. Jones: No, Im afraid not. Just drink plenty of fluids. Take aspirin when needed but no more than 8 in a day. Rest as much as you can. Mr. Jack: Ill do that. What can I do to sleep at night? Dr. Jones: Take aspirin, your fever is high, so cool yourself with a lukewarm bath. If it doesnt get any better, come back. Mr. Jack: Thank you, doctor. Vocabulary and Useful phrases backache my eyes are sore my eyes are itchy lukewarm bath to take medication e.g. aspirin
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APPENDIX 5
ANSWER 1 a. a cut in the motor neurone of the reflex arc b. intermediate neurone to the cerebrum /spinal cord around the neck has been damaged c. receptor/sensory neurone of the withdrawal reflex arc has been damaged 2. a. motor neurone or the extensor muscle of the leg has been damaged b. receptor/sensory neurone is damaged BUT motor neurone is not damaged c. intermediate neurone to the brain is damaged/spinal cord is broken in the lumbar region 3. a section of the spinal cord in the abdomen is seriously injured 4. spinal cord below the neck has been damaged
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ANSWER KEY
CHAPTER I: EVERY DAY ENGLISH LESSON 1. TWO INTERNATIONAL FRIENDS 1.c 2.b 3.c 4.c 5.a 6.b 7.a 8.c 9.b 10.b LESSON 2. GETTING A DRIVER'S LICENSE 1.c 2.c 3.a 4.b 5.a 6.b 7.a 8.b LESSON 3. THE CITY AND THE COUNTRY 1.a 2.b 3.b 4.a 5.b 6.a 7.a 8.a 9.a 10.a LESSON 4. INTERVIEW WITH A FAMOUS ACTOR 1.b 2.c 3.b 4.a 5.c LESSON 5. WHAT'S IN YOUR OFFICE 1.c 2.a 3.c 4.c 5.a LESSON 6. WHAT WERE YOU DOING? 1.a 2.b 3.c 4.c 5.a LESSON 7. THE OREGON WEATHER FORECAST 1.b 2.a 3.c 4.b 5.a 6.a 7.c 8.a 9.b 10.a LESSON 8. A BUSINESS PRESENTATION 1.a 2.b 3.b 4.a 5.a LESSON 9. A BUSINESS TRAVELLER 1.a 2.a 3.c 4.b 5.a 6.b 7.a 8.a 9.b 10.a LESSON 10. THE MEETING 1.b 2.b 3.c 4.c 5.c 6.b LESSON 11. A NEW OFFICE 1.b 2.b 3.b 4.c 5b LESSON 12. COOKING 1.b 2.b 3.b 4.c 5b LESSON 13. A GREAT WORKOUT 1.a 2.c 3.c 4.a 5.c LESSON 14. TODAYS SPECIAL 1.c 2.b 3.a 4.a 5. C
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CHAPTER II: GRAMMAR AND VOCABULARY FOCUS ANNEX1: Exercise A. (1) name is (2)your (3)are (4)fine (5)where (6)are (7) Im ANNEX 4: Exercise A 1. Could you bring me that chair over there? 2. Here are these pictures. 3. Can you see that building next to the bank? 4. Is there a piece of pie for me? 5. There are three boys sitting on the bench. 6. I would like some of those cookies on that shelf. 7. Those bicycles over there are expensive. 8. These dolls on the table here are very old. CHAPTER III: READING COMPREHENSION PRACTICE READING COMPREHENSION - MULTIPLE CHOICE 1. Pet Doctor: 1.c 2.a 3.c 4.b 5.b. 2. The Body Shop: 1.b 2.c 3.c 4.b 5.a. 3. The Toy Museum: 1.a 2.c 3.b 4.b 5.b. 4. Photo printing firm pays out compensation: 1.c 2.c 3.b 4.a 5.c. 5. Alternative medicine: 1.a 2.c 3.a 4.b 5.b. READING COMPREHENSION TRUE OR FALSE 1. Norwich: 1.T 2.T 3.F 4.F 5.F 6.F 7.T 8.T 9.T 10.F 2. Carnival Safety Success: 1.F 2.F 3.T 4.F 5.F 6.T 7.T 8.T 9.F 10.F. 3. The Western Alphabet: 1.F 2.F 3.F 4.T 5.F 6.T 7.F 8.T 9.F 10.T. 4. The Battle of Bannockburn: 1.T 2.F 3.T 4.T 5.F 6.F 7.T 8.F 9.F 10.F. 5. Facebook: 1.T 2.T 3.F 4.F 5.F 6.T 7.T 8.F 9.T 10.T. CHAPTER V: MEDICAL QUIZES 1. A Prescription 1.b 2.b 3.b 4.c 5.b 2. Troubling Symptoms 1.b 2.b 3.c 4.c 5.b. 3. A Physical Examination 1.b 2.b 3.b 4.a 5.c 4. Feeling Queasy 1.c 2.b 3.c 4.c 5.b 5. Joint Pain 1.c 2.c 3.b 4.a 5.b 6. Pain That Comes And Goes 1.b 2.b 3.c 4.a 5.c 7. Helping A Patient 1.a 2.a 3.b 4.b 5.b 8. Getting Patient Details 1.c 2.b 3.b 4.c 5.b 6.b 9. Making A Doctor's Appointment 1.b 2.a 3.a 4.a 5.b 10. Dental Hygiene
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CHAPTER VI: READING COMPREHENSION FOR NURSING SCHOOL Answers and Explanations for Practice Passage 1 Don't just look at the right answers and move on. The explanations are the most important part, so read them carefully. Use these explanations to help you understand how to tackle each kind of question the next time you come across it. 1. d. Question type: fact or detail. The third sentence of the passage says that the nodes are connected by the lymphatics, which are defined in the second sentence as small vessels. You may know that nerves and blood vessels make a web of connections in our bodies, but the passage specifically states that lymphaticssmall vessels, not blood vessels
(choice a)connect the nodes. 2. b. Question type: inference. The passage says that when lymph nodes are infected, they are often swollen and sensitive. Thus, if nodes are painful, they are probably swollen and sensitive, and they are swollen and sensitive because they are fighting an infection. This is also the best answer because none of the other answers are clearly connected to pain in the lymph nodes. Dirty or saturated skin (choice a) may indeed result in infection, but that is not what the question is asking. Choices c and d describe malfunctions of the immune system, a subject that is not discussed in the passage. 3. c. Question type: main idea. The idea that the lymphatic system and the skin work together to protect the body from infection is the only answer that can serve as a "net" for the whole passage. The other three answers are limited to specific aspects of the immune system and therefore are too restrictive to be the main idea. For example, choice b refers only to the skin, so it does not encompass all of the ideas in the passage. d. Question type: vocabulary. Although all of the answers can mean compose in certain
circumstances, choice d is the only meaning that really works in the context of the passage, which says that the lymph nodes and the lymphatics "compose the lymphatic system." The passage makes it clear that the lymph nodes and the lymphatics are the two parts of the lymphatic system. Thus, they form or constitute the lymphatic system. They don't create it, arrange it, or control it; they are it.
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Answers and Explanations for Practice Passage 2 1. b. The passage says that both Type III and Type IV allergic reactions cause swelling. In Type III allergies, IgM and IgG bind away from cell surfaces. This creates clumps of allergens and antibodies that cause swelling. Type IV allergies also cause the release of mediators that create swelling as well as itchy rashes. 2. c. The passage says that immunoglobulin E (IgE) is a type of antibody the immune system releases. The Ig in IgE, IgG, and IgM stands for immunoglobulin; all three are different types of immunoglobulin and therefore different types of antibodies. The immunoglobulins then release the mediators, like histamine, so choice b is incorrect. Further, immunoglobulins are produced in response to allergens, so choice a cannot be correct. And the passage clearly indicates that immunoglobulins are produced by the body, so choice d is also incorrect. 3. d. Titles generally reflect the main idea of a passage and must therefore be general enough to cover everything in that passage. The passage does not discuss how to prevent allergic reactions, so choice a is not a good answer. The passage does discuss what causes allergic reactions, but that is only part of what the passage covers, and it does not discuss how to determine the specific causes of a reaction, so choice b is incorrect. Choice c is not right because the passage does not focus on allergens; in fact, specific allergens aren't even mentioned for Type II allergies. Finally, it is clear that choice d is the best answer because the first sentence in the passage is a topic sentence:Because the body responds differently to different allergens, allergic reactions have been divided into four categories. This indicates that the passage is primarily about the four types of allergic reactions and not about allergens. 4. a. This choice best expresses the main idea of the passage because it restates the topic sentence, which tells us the bodyresponds differently to different allergens. Choice b is not a good answer because the passage does not discuss ways to avoid allergic reactions, and although choices c and d are mentioned in the passage, they are too specific to encompass the whole passage. Remember, the main idea should be general enough to include all of the ideas in the passage. Answers and Explanations for Practice Passage 3 1. b. Look at how adopt is used in the sentence: Kepler, the first major astronomer
to adopt Copernicus's heliocentric theory, discovered three laws of planetary motion that
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helped validate Copernicus's theory. Because Kepler helped validate this theory, choice a can't be correct, and neither can choice d; the passage clearly indicates that it's Copernicus's theory, not Kepler's. Furthermore, there's no indication from the context that Kepler changed the theory to make it suitable for another situation, so choice c cannot be correct either. 2. c. We can infer that Copernicus's theory went against established ideas because the passage says that Copernicusoverthrew the notion that humanity was at the center of the universe, suggesting that the geocentric theory was the accepted theory of the time and that Copernicus's idea was revolutionary. There is no suggestion in the passage that Copernicus's theory supported the religious doctrine of the time, so choice a cannot be correct. Furthermore, the passage says that Kepler's discovery helped validate Copernicus's theory, but this does not imply that it was accepted only because of Kepler (choice b). Finally, the laws of planetary motion were discovered by Kepler, not Copernicus, so choice d cannot be correct. 3. a. The passage discusses scientific discoveries that challenged and changed the way human beings saw themselves in the universe and how the motion of bodies on Earth and in the universe was understood. We can thus infer that these discoveries greatly altered ideas in both philosophy and, of course, in science. Again, the word overthrew suggests upheaval, so choice a is the best answer. Choice b cannot be correct because the passage does not favor one scientist over the others; in fact, the passage tells us that Newton could not have done his work without those who came before him. Furthermore, although these men did refute the theory that Earth was the center of the universe, there's no indication in this passage that that was what the men were out to prove, as in choice c. Finally, while the writer of the passage recognizes that the achievements of these men were based only on the achievements of the others before them, there is no indication here of what the men themselves thought, so choice d cannot be correct. 4. d. If you insert the possible answers into the sentence, it should be clear that
choice d makes the most sense in context. Galileo "established the law of falling bodies" a law of gravity and motion that naturally exists in the universeso he could not have personally instituted these laws by law or agreement (choice a), set them up or brought them into existence (choice b), or settled them in a place or position (choice c). Instead, he introduced them to the public and secured acceptance of them by revealing the role of acceleration in dynamics (choice d). Review: Putting it all together
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Possible Questions Here is one question of each type based on the previous passage. Your questions may be very different, but these will give you an idea of the kinds of questions that could be asked. 1. Detail: DNA modification can occur a. 10,000 times in the life of a cell. b. 1,000 times every second. c. thousands of times a day. d. once a day. 2. Main idea: Which sentence best sums up this passage? a. There are many theories, but no one knows how free radicals really affect aging. b. Free radicals are deadly. c. Scientists need a clearer definition of aging. d. Free radicals will lead scientists to the fountain of youth. 3. Inference: The passage suggests which of the following about the aging process? a. A clear definition of aging must be found in order to determine the cause of aging. b. DNA controls the aging process. c. Free radical damage to proteins increases with age. d. Aging is somehow related to free radical damage to cells. 4. Vocabulary: The phrase want of as used in the fourth sentence most nearly means a. desire for. b. lack of. c. requirement of. d. request for. Answers 1. c. 2. a. 3. d. 4. b.
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Bibliography
Carola Koenig, Specialized Hydro-, Balneo-and Medicinal Bath Therapy. Publisher:
iUniverse, 2005.
Anne Williams, Spa bodywork: a guide for massage therapists. Lippincott Williams &
Wilkins, 2006.
Chisholm, Hugh, ed. (1911). "Balneotherapeutics". Encyclopdia Britannica (11th ed.).
Cambridge University Press.
"Balneotherapeutics". The Encyclopaedia Britannica (1911). III. New York. pp. 284285
(300301 in electronic page field). Retrieved 2011-07-16.
"Balneotherapy." Beth Israel Deaconess Medical Center, Conditions A-Z. (Sept. 3,
2009)http://www.bidmc.org/YourHealth/ConditionsAZ.aspx?ChunkID=168773
"Balneotherapy."
Healthline.
(Sept.
3,
2009)http://www.healthline.com/natstandardcontent/alt-water-therapy?print=true
Contey, Genevieve. "50 Top Wellness Destinations: Glossary." National Geographic
Traveler. (Sept. 3, 2009) http://traveler.nationalgeographic.com/wellness-directory/glossary-text
Falagas, M.E., E. Zarkadoulia and P.I. Rafailidis. "The Therapeutic Effect of
Balneotherapy: Evaluation of the Evidence from Randomised Controlled Trials." International Journal of Clinical Practice, published on Medscape. July 21, 2009. (Sept. 3, 2009) http://www.medscape.com/viewarticle/705221
Matz, Hagit, Edith Orion and Ronni Wolf. "Balneotherapy in dermatology."
Dermatologic Therapy. Vol. 16, 2003.
Sinclair, Marybetts. Modern Hydrotherapy for the Massage Therapist. Lippincott
Williams & Wilkins. 2007.
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FUNDAIA LAURENIA COALA POSTLICEAL SANITAR EUGEN NICOAR

Autori: GROSU LAURENIA MARIA

Pentru uzul intern al colii

ANSWER KEY........................................................................................................................................147 BIBLIOGRAPHY .................................................................................................................. 153

EVERY DAY ENGLISH

CHAPTER I LESSON 1. TWO INTERNATIONAL FRIENDS

MULTIPLE CHOICE- COMPREHENSION QUIZ 1. Where is Claudio from?

Spain Korea Italy

2. What does Chul do?

He's a student. He's a businessman. He's a Korean.

3. Where does Claudio live?

In a house In a dorm In an apartment

4. How does Chul get to work?

He drives to work. He walks to work. He takes the subway.

5. Who likes playing a sport?

Chul Claudio Doesn't say

6. How many children does Chul have?

7. Who doesn't live with Claudio?

His parents His children His brother and sister

8. Who likes dancing?

Chul Claudio Doesn't say

Claudio Chul Doesn't say

10. Where are they from?

See CHAPTER II, ANNEX 1

LESSON 2. GETTING A DRIVER'S LICENSE

An identification card A passport A driver's license

2. Who helps Mr. Anderson fill out the form?

3. What's Mr. Anderson's marital status?

Single Divorced Married

4. Which statement is true?

5. What does Peter joke about?

6. Does he need special equipment to drive a car?

Yes, crutches Yes, glasses No

7. Does he currently have a driver's license?

Yes No Doesn't say

8. How much does it cost to apply for a license?

$50 $75 $100

See CHAPTER II, ANNEX 2

LESSON 3. THE CITY AND THE COUNTRY

4. The country is quieter than the city.

5. The city isn't as expensive as the country.

6. The country is healthier than the city.

7. Maria thinks the city is more fun than the country.

8. David thinks Maria is crazy for leaving the country.

10. Life in the country isn't as hectic as life in the city.

See CHAPTER II, ANNEX 2

LESSON 4. INTERVIEW WITH A FAMOUS ACTOR

MULTIPLE CHOICE- COMPREHENSION QUIZ

1. Why does the interviewer thank Brad?

for visiting him for taking time off for telephoning

2. What does Brad do after breakfast?

He studies his scripts. He goes to the studio. He goes to the gym.

3. What is Brad studying now?

The Man The Man About Town The Loverboy

4. What does he do in the afternoon?

He goes to the studio. He goes to the gym. He studies his scripts.

5. When does he like going out?

at night on Sundays at weekends

See CHAPTER II, ANNEX 13

Present Simple and Present Continuous

LESSON 5. WHAT'S IN YOUR OFFICE?

True False Doesn't say

2. David is sure he will need some cabinets in his new office.