Exam practice

She is probably a nurse or a doctor: she is wearing a green hospital gown, a cap and a mask, as staff do in an operating room or a delivery room.

She is holding a newborn baby in her arms, perhaps just after it was born, and checking that it is well.

Yes. Last year I went to the district hospital with a high fever. The nurse at the emergency desk was calm and kind, and explained what the tests were for, which made me less afraid. But I waited more than three hours to see a doctor, and nobody told us why. I learned that a few kind words from staff matter almost as much as the medicine.

a – iii, b – iv, c – v, d – ii, e – i, f – ix, g – viii, h – vi, i – vii.

Her nine-week-old baby developed an extremely high fever one evening, and they had to rush her to the hospital, where she stayed three days.

Its main purpose is to make health workers think about how they behave in front of patients and their families: not to complain about each other, not to burden families with their own troubles, to read the chart, to be careful with what they say, and to make patients feel they are the priority. It is advice from a mother who is also a health worker.

Their main weakness was that they complained about each other in front of the patient’s family and seemed more concerned with their own egos, needs and skills than with the sick baby.

No, they didn’t. They kept saying “I am so busy today”, and the medicines were not given on time, so to a worried mother their words felt like “your daughter is not a priority”.

They expect to be the health workers’ priority: to be cared for and listened to, to hear good news shared warmly, to have their information read from the chart instead of being asked again, to be spoken to carefully, and to get a genuine apology when a mistake is made.

“Was she premature?” and “Was your delivery normal?”

Because the baby wore only a diaper, so nothing showed whether she was a boy or a girl, and the staff didn’t read her paperwork, which said she was female. They simply assumed the baby was a boy.

People know that health care is not a glamorous career, and they believe most health workers choose it because they want to help sick people get well.

My priority would be the patient, not my own comfort or pride. I would introduce myself, call the patient by name, and explain each test and medicine in simple words, in Nepali or the patient’s own language if I could. I would read the chart before asking questions, give medicines on time, and tell families good news as soon as I had it. If I were tired or busy, I would not say so to the family; I would talk to my colleagues instead, and never speak badly of them in front of patients. And if I made a mistake, I would say sorry honestly and correct it.

• a.What did your mother tell you? — She told me to come home early.
• b.What did the doctor tell you? — He advised me to drink plenty of water.
• c.What did the guard tell you? — He told me not to touch the paintings.
• d.What did the librarian tell you? — She told me to keep my mobile phone in flight mode.
• e.What did the teacher tell you? — She told me to arrive at school on time.
• f.What did the flight attendant tell you? — She asked me to fasten my seat belt.
• g.What did your brother tell you? — He told me to wash my clothes myself.

(He or she as the speaker is a man or a woman.)

My friend told me how to make a paper boat. First she told me to fold the paper in half along its longer side. Then she told me to fold it in half again and to open it out once. With the fold at the top, she asked me to fold the top two corners down to the middle line, and then to fold the bottom strip up on each side. Next she told me to put my thumbs inside the triangle and to open it out into a diamond shape. After that she told me to fold the bottom half up on each side, so that I had a triangle, and to put my thumbs inside and open it out again. Finally she told me to pull the outer corners of the triangle out to make the boat.
Linking words (first, then, next, after that, finally) keep a long report easy to follow; you don’t need she told me in every sentence.

• a.She requested me to help her fix that machine.
• b.The electrician requested me not to switch on the fan.
• c.My friend asked me to help him with his homework. (her for a girl)
• d.She asked me to lend her some money.
• e.The teacher told me to do my homework.
• f.The doctor advised me not to smoke. (or told me not to smoke; warned me not to smoke)
• g.My mother told me not to make a mess.

Thank her first for writing. Then apologize for each thing clearly, without excuses; explain what you will change; and close warmly.

To: appreciative.mother@example.com

Subject: Our apology, and what we are changing

Dear Madam,

Thank you for your letter, and for taking the time to tell us about your daughter’s stay in our pediatric unit. I am one of the nurses who cared for her, and I am glad to hear she is well.

I am truly sorry for the way some of us behaved. We complained to you about our colleagues and told you how busy we were, when you needed to hear only that your daughter came first. We also asked you the same questions again and again instead of reading her chart, and many of us called her “he”. These were our mistakes, and there is no excuse for them.

Your letter has been read at our staff meeting, and we have already made some changes. Every nurse and doctor now reads the chart before speaking to a family, a patient’s name and gender are written clearly on the bed, and our team leaders will meet each week so that problems between departments are settled among us, not in front of patients.

We are grateful to you for showing us how our words sound from a parent’s chair. If you ever bring your daughter back to us, I hope you will find a calmer, kinder team.

With sincere apologies,
Sabina Karki
Staff Nurse, Pediatric Unit

• a.wonderfood: a food claimed to have amazing health benefits, such as preventing cancer or making people live longer; often more of a newspaper idea than a proven fact.
• b.cardiovascular diseases: diseases of the heart and blood vessels, such as heart attacks, strokes and high blood pressure.
• c.bioeconomy: the part of the economy that uses renewable living resources from land and sea (crops, forests, fish, animals, microorganisms) to produce food, materials and energy.
• d.demographic change: a change in the size or make-up of a population, such as people living longer, fewer children being born, or people moving from villages to cities.
• e.multidisciplinary approach: a way of tackling a problem that brings together people and knowledge from several different fields, such as medicine, nutrition and the social sciences.
• f.economic inequalities: unequal sharing of income, wealth and opportunities between people or groups, so that some are much richer than others. (This phrase is not in the speech, but it matters to diet: poorer families often can’t afford healthy food.)
• g.neurological disorders: diseases of the brain, spinal cord and nerves, such as epilepsy, stroke, Parkinson’s disease and Alzheimer’s disease.
• h.biomarkers: measurable signs in the body, such as a substance in the blood, that show whether a disease is present or how it is progressing (blood sugar for diabetes, for example).

a. delighted b. conference c. innovation d. dramatically e. chronic (neurological or cardiovascular also fit) f. diagnosis g. unprecedented h. diagnostics i. avenues
In c, cooperation (in the speech, but not one of the red words) would fit too. In h, diagnostics are the tests themselves; biomarkers are what some tests look for.

She is talking about diet and health: the endless media stories about whether carbohydrates, fat, sugar or protein are good or bad, and about “wonderfoods” said to stop cancer or help us live longer.

A poor diet and low physical activity, a trend that the Council of the EU said was getting even worse.

They should live healthier lifestyles and eat healthier diets: for example, more vegetables, fruit and whole grains, less sugar and fat, and regular exercise. Such diseases can be prevented or changed in this way.

Horizon 2020 is the European Union’s research and innovation program, worth about 80 billion euros, which ran for seven years (2014–2020) to tackle society’s biggest challenges, including health, food safety and ageing.

Research shows how diseases such as diabetes and obesity can be prevented, how they develop, how early diagnosis can improve life and which treatments work best. It also produces new biomarkers, tests and medicines, and, with the social sciences, helps us understand why people eat as they do, so that we can help them choose better.

It can turn the best research on nutrition, health, diet-related disease and ageing into innovative and effective products, treatments, services and strategies that benefit all patients and prevent many people from getting ill in the first place.

She expects an excellent conference full of innovative ideas and interesting discussions, and above all that its plans will be turned into concrete action: member states unlocking national funding and aligning their research programs.

Yes, I think so. If the countries share their research instead of repeating it, they will find answers faster and at less cost. People could benefit from earlier diagnosis of diseases like diabetes, better treatments, clearer advice about healthy eating, and safer food. Children in particular could be protected from obesity before it starts. But the benefits will come only if the plans are put into action, as the speaker herself warns.

Respected principal, teachers, and my dear friends,

Good morning. Today I would like to speak about something that costs nothing and can add years to our lives: exercise.

Our grandparents walked for hours every day to fetch water, carry grass and reach the market. Today many of us sit for most of the day: in class, on a bus, and in front of a phone. Our bodies were made to move, and when they don’t, they grow weak.

Exercise makes the heart and lungs strong and keeps our weight healthy. It lowers the risk of diabetes, high blood pressure and heart disease later in life. It builds strong bones and muscles. It also helps the mind: after a run or a game of football we feel calmer and happier, we sleep better, and we can concentrate better in class.

We don’t need a gym. We can walk or cycle to school, play volleyball or dandi biyo, dance, climb the stairs instead of waiting for the lift, or skip with a rope at home. Doctors advise young people to be active for at least an hour a day.

So let us make a promise today: one hour of movement every day. Our bodies will thank us for it.

Thank you.

a. digestive problems (lactose intolerance) b. lactase c. northern Europe d. dairy products (animal milk) e. lactose-free

• a.Lactose intolerance: being unable to digest dairy products such as milk and ice cream.
• b.Any two of bloating, stomach aches and diarrhea.
• c.About 68 percent.
• d.To fight famine: when people began farming and raising cows, sheep and goats, animal milk kept them alive in hungry times.
• e.Dairy-free milk, such as soya, almond or rice milk (or lactose-free ice cream, or a tablet that helps break down lactose).

• Acidity (gastritis), very common in Nepal: a burning pain in the upper stomach, often from long gaps between meals, spicy or oily food, tea on an empty stomach, or a germ called H. pylori. Eating regular meals helps.
• Diarrhea from dirty water or food: the body loses water and salt, so drink oral rehydration solution (jeevan jal) and see a health worker if it lasts.
• Constipation: hard, difficult stools, from too little water and fiber; vegetables, fruit, whole grains and water help.
• Food poisoning: vomiting and diarrhea a few hours after eating food that has gone bad.

Both are correct and mean the same: to tell no one and not to tell anyone are two ways of making the promise negative.

• a.She asked Punita to bring some sugar.
• b.The teacher told me to submit my assignment soon.
• c.He reminded Anu to come early.
• d.He advised Mrs. Tamang to see a doctor.
• e.My father warned Nona to keep all the windows open.
• f.Furba told Prashun to go home.

The name after the comma (Punita, Anu, Mrs. Tamang, Nona, Prashun) becomes the person after the reporting verb.

• a.The hermit advised us not to idle away our time.
• b.Madan requested his friend to help him with money.
• c.The Guru told the noble prince not to be afraid. (Be not afraid is an old way of saying Don’t be afraid. To keep the respect in noble prince, you can also write: The Guru addressed the prince as noble and told him not to be afraid.)
• d.He asked me to let him do his work. (Let me here asks for permission, so it is not a suggestion.)
• e.The General ordered his troops to guard the fort.
• f.Aaswin requested the teacher to excuse him. (or Aaswin politely asked the teacher to excuse him)
• g.The guide told the visitors to follow him carefully.
• h.My teacher told me not to look behind.
• i.Mother told her daughter to get ready to receive the guests.
• j.The boy begged the rescuers to help him to get out of that well.
• k.The teacher told the boys to read silently.
• l.The coach suggested that they should play a friendly football match. (or suggested playing a friendly football match)
• m.The monk advised us to give up bad habits.
• n.Father told me not to tell a lie. (or advised me never to tell a lie)

Use the frame of Reading II: greeting, why the topic matters, causes, consequences, what to do, a closing line, thanks.

Respected chairperson, honorable chief guest, teachers, and my dear friends,

Good morning. I am honored to speak to you today about a problem that is growing quietly around us: obesity.

Obesity means having so much body fat that it harms our health. A generation ago we thought of it as a problem of rich countries. Today, the World Health Organization counts about one person in eight in the world living with obesity, and the number is rising fastest in countries like ours.

What causes it? The main cause is simple: we take in more energy from food than our bodies use. Packets of noodles, chips, fried snacks, sweets and sugary drinks are cheap and everywhere, and they are full of calories. At the same time, we move less: we ride instead of walking, and we spend hours sitting in front of screens. Too little sleep, stress, and sometimes our genes add to it.

What are its consequences? Obesity raises the risk of type 2 diabetes, high blood pressure, heart disease, stroke, joint pain and some cancers. It can also hurt the mind: children who are teased about their weight may lose confidence and become lonely.

What can each of us do? Eat home-cooked meals with plenty of vegetables, fruit, pulses and whole grains, like a balanced plate of dal bhat tarkari. Drink water instead of soft drinks, and keep junk food for rare treats. Be active for at least an hour a day: walk, cycle, dance or play. Sleep well, and keep screen time in check. And let us never mock anyone for their weight; let us help each other instead.

Friends, good health is built one meal and one step at a time. Let us start today.

Thank you.

• a.The nurse told the patient to take that medicine after meals.
• b.Ramesh requested me not to tell his parents.
• c.The coach told us not to drink cold water during the match.
• d.The health worker advised the mothers to wash their hands before feeding their babies.
• e.Grandfather suggested that we should go for a walk after dinner. (or suggested going for a walk)
• f.The doctor advised Sita to sleep at least eight hours.

a. how long b. to drink c. not to eat d. to rest e. to come f. make
(f: after suggested that, the plain verb, make (or should make), never to make.)

• a.Every year on 7 April.
• b.The birthday (founding) of the World Health Organization, in 1948.
• c.To draw attention to one health problem that affects people all over the world.
• d.Any two of: depression, diabetes, the safety of food.
• e.Health posts and schools hold rallies, free health camps and talks.

Subject line; polite greeting; who you are and why you write; the problem, with an example; your exact request (fruit, boiled corn, sprouted beans, milk, clean water); a polite close. Use I request you to… or We would be grateful if….

Address and greeting; what mental health is (how we feel, think and cope); signs that someone is struggling (sleeping badly, withdrawing from friends, losing interest); what helps (talking to someone you trust, sleep, exercise, time with friends, less screen time, asking a counselor or doctor for help, which is not a weakness); a closing call to be kind to each other; thanks.