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ENGLISH FOR HEALTH-CARE PROVIDERS Teacher’s book José A. Mompeán González Department of English. University of Murcia

Francisco Serra Alcaraz Translator and Teacher of English for Emergency Medical Technicians

This QR code will automatically redirect users to our website at www.aranformacion.es, where you can find a variety of contents related to Grado Medio (Middle Grade) and Grado Superior (Higher Grade) vocational/professional training. It also has several areas of interest and possible alternatives to the QR-code videos in this book.

© Copyright 2013. José A. Mompeán González, Francisco Serra Alcaraz © Copyright 2013. Arán Ediciones, S.L.

Castelló, 128, 1º - 28006 Madrid Tel. 917820030 e-mail: [email protected] http://www.grupoaran.com Reservados todos los derechos Esta publicación no puede ser reproducida o transmitida, total o parcialmente, por cualquier medio, electrónico o mecánico, ni por fotocopia, grabación u otro sistema de reproducción de información sin el permiso por escrito de los titulares del Copyright. El contenido de este libro es responsabilidad exclusiva de los autores. La Editorial declina toda responsabilidad sobre el mismo.

Contents Preface   1. Introduction................................................................................................. 7   2. Grammar...................................................................................................... 7   3. Reading........................................................................................................ 7   4. Vocabulary................................................................................................... 9   5. Listening...................................................................................................... 10   6. Speaking...................................................................................................... 11   7. Writing......................................................................................................... 13   8.

Keys............................................................................................................. 8.1.  Grammar.............................................................................................. 8.2.  Reading................................................................................................ 8.3.  Vocabulary............................................................................................ 8.4.  Listening.............................................................................................. 8.5.  Speaking.............................................................................................. 8.6.  Writing.................................................................................................

13 13 16 26 32 37 37

  9. Keys to further materials.............................................................................. 38 10. Transcript of videos...................................................................................... 42

Preface English for Health-care Providers is a textbook for teachers and learners of English for the health-care-providing professions, from traditional ones such as GPs to the various allied health professions. As an English language textbook, English for Health-care Providers addresses the four traditional skills language educators have long identified, i.e. listening, speaking, reading, and writing, as well as important aspects of language learning such as grammar and vocabulary. Given this, each unit follows a similar structure, with seven subsections:

❱  Introduction. ❱  Grammar. ❱  Reading. ❱  Vocabulary. ❱  Listening. ❱  Speaking. ❱  Writing. Each unit begins with a short introduction presenting the topic of the unit. The introduction is followed by a grammar section. After a reading section, a vocabulary-building section can be found. The book finishes with three sections: listening, speaking, and writing.

As can be observed, receptive skills (reading, listening) appear before productive skills (speaking, writing). Given the comprehensive treatment of grammar, vocabulary and language skills, the book should ideally be used over the course of a whole academic year, with (a variable number of) weekly lessons of 45 to 60 minutes. However, shorter sections of this book can be used and adapted to shorter teaching periods. The level of students should be intermediate or above. Maximum class size should be around 30 students. Apart from the four sections of the book, i.e. LIFESTYLE and HEALTH, DEALING with PATIENTS, SAFETY and PREVENTION, and HEALTH-CARE PROVIDERS, this book contains an APPENDICES section that contains a set of further materials for specific health-care professions. These materials are a set of reading texts that students interested in those specific professions can use in order to familiarise themselves with vocabulary relevant to their fields of interest.

Teacher’s book

1.  INTRODUCTION The introduction section of each unit introduces the topic of the unit with a brief description of its contents. This helps students see what topics will be covered in the unit.

2.  GRAMMAR Grammar is an essential part of students’ linguistic competence. Because of this, each unit begins with a grammar section featuring key verb tenses or grammatical topics such as adjectives, reported speech, conditional sentences, or phrasal verb grammar. The sections are typically sketchy, and should be completed with well-known and widely available grammar books if necessary. The grammar component in the books is supported by “grammatical tips” based on the readings of each unit addressing topics such as prepositions, derivational suffixes, or the passive voice. To check students’ grasp of basic grammar points, each units contains at least one grammar exercise that typically asks students to fill in gaps by putting the verbs or adjective in brackets into a correct form. When the verb should be in the negative, “not” accompanies the verb inside the brackets. Most items in the exercises contain vocabulary that is relevant for the topic of each unit and the book in general.

3.  READING The textbook contains two readings per unit. These deal with topics relevant to the units in which they are included. The texts draw on various sources of information and a wide range of examples to do with health-care providers. The texts are meant to exemplify some of the most common vocabulary used in the areas each unit deals with, as well as providing other useful vocabulary. The texts also exemplify, variably some of the grammar points explained at the beginning of each unit. Texts may be considered to differ in the linguistic difficulty they may pose to students, and some of them are linguistically challenging, using abundant technological jargon. Despite this, teachers should reassure students that it is not always necessary to read and understand each and every word in the text. Students should be encouraged to look at the context in which words are used and made aware that, in many cases, they may be able to figure the meaning of a word out from the context. It is up to each teacher to decide which words should be remembered by the students or groups. However, teachers should encourage them to keep at hand and use a traditional or an online dictionary during the exercise to discover what the words mean, rather than wait until teachers explain or translate the words. There are several types of exercises based on the readings, apart from the grammatical tips mentioned above. Some of the exercises focus on students’ skimming skills, or students’ ability to understand the “gist” or main idea. Some other activities focus on students’ “scanning” skills to find a particular piece of information.





ENGLISH FOR HEALTH-CARE PROVIDERS

3.1.  Matching exercises These exercises seek to check students’ understanding of some of the key words in the text as well as helping them improve their vocabulary. The target items are words relevant in the area the unit deals with, or important general vocabulary. Text lines are numbered from top to bottom, counting by 5’s (i.e. 5, 10, 15, 20...). The definitions provided in some of the exercises indicate the lines in which students can search for the key words. In a few texts, students are asked to find synonyms or antonyms in the text and match the ones provided with words from the text. These exercises make students go through texts again in preparation for reading comprehension exercises such as true/false, question answering, etc. (see below).

3.2.  True or false This type of exercises tries to assess reading comprehension. Students are supposed to consider whether each of a number of statements is true or false. Students’ answers should be provided according to the information provided in the text, and not on what common sense, knowledge or beliefs may dictate to the students. In some cases, the information from texts may be in conflict with students’ expectations.

3.3.  Multiple-choice questions The multiple-choice questions have four possible answers, labelled A, B, C, and D. The students will choose one answer per question.

3.4.  Answering questions Questions are meant to test students’ understanding of the text and ability to process the information, analyse it, and organise it for the answer. As questions may be demanding, as they require students to write answers, teachers should encourage students to provide long answers, and not very short ones.

3.5.  Information-filling exercises Some exercises ask students to provide information by filling in tables, charts, diagrams, forms, questionnaires, etc., with general and specific information.

Teacher’s book

4.  VOCABULARY Vocabulary building is a vital part of language learning. Consequently, this book contains a vocabulary section in each chapter, in which words considered to be relevant for the topics discussed in the unit are included. These sections intend to familiarise students with terms used in English for health-care providers. Some of the words in the sections will have already been found in the previous grammar and reading sections while some others may be useful for subsequent listening, speaking and writing exercises. Words within the charts are not unrelated, as they are listed under sub-headings in order to help students develop a kind of semantic map in which words are related to one another. In addition, items are often listed together taking into account collocations, i.e. sequences of words or terms that co-occur more often than would be expected by chance. Semantic connections are also sometimes provided (e.g.). The vocabulary lists in each unit may look excessively comprehensive to some teachers or incomplete to others. Whatever the teacher’s view, the idea the authors have in mind is that these lists are not in the units to be fully memorised by students, but rather, they should be considered as a repository of relevant health-care-related vocabulary that may come in handy for reading, writing, listening and speaking tasks. It is up to each teacher (or student) to decide which words should be remembered or are more important than others. Learners need to have both active and passive vocabulary knowledge, that is, English words learners will be expected to use when expressing themselves in original sentences, and those they will merely have to recognise when heard from others or read. When it comes to teaching in the vocabulary sections of units, the authors’ recommendation is that vocabulary lists not be treated for simple repetition and memorisation, as words may then be forgotten quickly by students. Instead, new words have to be introduced in such a way as to capture the students’ attention and place the words in their memories. Teachers can use different strategies to for this. For example, before presenting the vocabulary in the unit, teachers may brainstorm –and display items on a board/screen– vocabulary around an existing word in the students’ vocabulary or a word related to the issue at hand. In addition, teachers could use Wikipedia or Google to display definitions and pictures of objects, places, etc., represented by vocabulary items. Finally, they could point out similarities and differences between words in the students’ source and target languages, particularly in the case of technical terms, which may have similar structural properties in both languages due to a common etymological origin. Regarding students’ understanding of the vocabulary, this book uses basic common methods to check it. These include:

1.  Picture-word matching exercises These exercises use the visual method of linking images to a word, offering also the advantage of visual recall.



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2.  Word-definition matching exercises These exercises help students relate the meaning of a word with a full definition (or explanation) of the term.

3.  Classification exercises These ask students to classify a number of items (health-care jobs, pains, etc.) into given categories (healthcare fields, type of pain, etc.).

5.  LISTENING Each unit contains one (or two) listening activities based on videos that have been carefully chosen and transcribed. The duration of the listenings is variably, but most range between 2 and 5 minutes. The videos are available from YouTube, one of the most popular video-sharing websites on the Internet. YouTube was chosen as the repository for listening activities as it is free, available to students at all times, and it has a wide variety of resources like documentaries, commercials, tutorials, etc. that are relevant for health-care providers. In fact, the selected videos, from a variety of sources, are relevant for the unit they are found in. The appearance of videos displayed in the “Related Videos” section can also help teachers and students visualise other relevant and potentially interesting videos. One disadvantage of using YouTube is that links may cease to be available. Should this happen, teachers and authors should find replacements in their classes/further editions of this book. The linguistic difficulty of each video varies, with some of them being more challenging than others from a grammatical and vocabulary point of view. As to the pronunciation of the videos, they exemplify a variety of accents, such as different American English accents, several British English accents, Australian English, or English spoken by fluent non-native speakers. This variety aims at helping students familiarise themselves with the inherent variety of accents any language like English exhibits, and which is necessary for students. As is the case with reading text, teachers should reassure students that it is not always necessary to understand every single word in the videos. Instead, students should think instead of the context and the real-life situation that is described as they try to listen for the main ideas and necessary information to complete the exercises based on the listening. Although students should known they are not expected to understand every single word from the videos, it may reassure them to know some things about each video before doing the listening activities. In this respect, teachers could prepare students for the listening activity before it is carried out by a vocabulary presentation of key words to understanding. A vocabulary presentation of key words, for example, could be one aspect of a necessary step to a listening task, i.e. preparing the students for it. This preparation could also include an introduction to the specific topic of the listening, a discussion, or giving the students the necessary linguistic and cultural information to understand what they will hear.

Teacher’s book

Once the listening task has started, teachers should play the full video once. Then, they could play it a second time, hitting the “pause” button after short chunks (sentences, paragraphs...) containing key ideas/information, to allow the students to process what they hear. This should be repeated if necessary. Student’s should also be given enough time to complete their answers and the playing of the video should continue when all students are ready. Each listening task should be rounded up by playing the full video one final time. There are several types of exercises meant to assess students’ understanding of the videos. Many of them are similar to the ones used to check reading comprehension in the reading sections. However, the difference with those exercises is that in listening comprehension exercises it is important that students read and understand the questions before they listen/watch the videos, so that they can listen out for the answers when the listening.

5.1.  True or false As is the case with reading comprehension exercises, this type of exercises tries to assess comprehension. Students are supposed to consider whether each of a number of statements is true or false. Students’ answers should be provided according to the information provided in the text, and not on what common sense, knowledge or beliefs may dictate to the students.

5.2.  Answering questions Questions are meant to test students’ understanding of the ideas and facts that talks and conversations in the texts contain.

5.3.  Multiple-choice questions As is the case with similar exercises in the reading sections, multiple-choice questions in listening sections have four possible answers, labelled A, B, C, and D. The students will choose one answer per question. One difference with reading comprehension questions is that in listening comprehension, students should be advised not to let their listening be guided by the options, but by the question itself. After the exercise, teachers may decide to make the transcripts, found in section 10 of this teacher’s book, available to students. Reading texts as they are listening to them may help students’ listening skills after they have been working with the text. The availability of the transcripts can also encourage some teachers to customise their reading comprehension activities and create other kind of exercises –e.g. cloze tests– to check comprehension of ideas, expressions in the text, etc.

6.  SPEAKING Speaking exercises aim to help learners use the language essential to real-life health-carerelated situations. These exercises are useful to consolidate the linguistic input students

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have been given in the units and provide students with a context in which to reinforce the use of appropriate communicative formulas, conventional approaches to making speech acts, and other language forms characteristic of spoken language. Many adult learners and late-teenager learners are self-motivated and really grateful for the time they are given to talk in the target language. However, speaking activities may be a challenge in certain teaching contexts even if the topics are relevant for health-care providers and even if they can choose from a number of options. To help students talk, it is also useful to make a friendly environment where English is not considered as a linguistic barrier, but as a means to communicate. In this respect, teachers should be understanding with students when they may occasionally slip into their mother tongue. It is also useful not to observe students talking with a view to further structural (e.g. grammatical, lexical, phonological correction), but simply actively participating in communicative exchanges. Some students it may be liberating to know mistakes are allowed. The textbook proposes two different types of exercises based on the number of students taking part in them: a) pair work; and b) group work (three or more students). All of them aim to encourage students to use critical thinking, permitting interaction, cooperation and exchange of knowledge between classmates/peers, and promoting students’ control and responsibility for their learning. Their main disadvantage is that it can be hard for the teacher to monitor and can lead to domination by a few. Because of this, it may be a good idea to set a time limit to each participation –as some students may speak more than others. Pair-work exercises increase the opportunity for student talking time and student to student interaction. They also give students a safe environment to try out ideas and thoughts before sharing with the group. Most pair-work exercises ask students to think about specific topics such as smoking, physical exercise, measures for home safety, etc., and provide binary answers (yes/no, good/bad, healthy/unhealthy, urgent/non-urgent, etc.) to a number of items. Some pair-work exercises ask to students to carry out role-play activities in which member of the pair performs a different role (patient, doctor, etc.). For these, teachers could do well to provide students with useful conversational formulas and common structures to introduce themselves and topics, as well as to maintain the listener’s attention and turn-taking. Group work, like pair-work, can visibly increase student talking time and student to student interaction, and it encourages students to cooperate and negotiate in English. Most exercises require students to work together to make a collaborative report that should be delivered at the end of the exercise to the rest of the class. Some activities even take the form of “form and against” debates or intend the groups to work towards the preparation of a collaborative report to deliver to the rest of the classroom. For this kind of task, teachers would do well to teach students efficient ways to structure speech which, in many cases, may be similar to the ones used in writing exercises.

Teacher’s book

7.  WRITING Each unit presents two writing options that are relevant for the unit they are included in. The options are also meant to elicit pieces of written work of variable formality, ranging from informal and personal descriptions of experiences and events to more formal styles such as professional letters. One important factor in writing exercises is that students need to be personally involved in order to make the learning experience of lasting value. The choice between options is meant to make students chose the topic they feel most comfortable with. In addition, the writing tasks require of students to write in pairs in role-play writing tasks. Writing can be much more motivating if each student is given a chance to play a role. In preparation for the writing activities, teachers could try to introduce, when considered appropriate, writing tips or techniques. These include writing structure (introduction, body paragraphs, and conclusion) and the wide range of discourse markers that can be used to organise a composition. Teachers should also help students with their writing by eliciting vocabulary before students start writing, as well as making connections with other sections in the unit or book. Teachers should expect each piece of writing to be between 50 and 100 words, although longer pieces can be requested if considered appropriate. Teachers should also remind students to use vocabulary and grammar structures as much as they can from the unit. Finally, it is up to each teacher to decide on which type of correction should be applied to each writing task, for which thinking of the overall target language area or areas of the exercise may help.

8.  KEYS 8.1.  Grammar Unit 1. 2.1. a) eats b) are c) doesn’t drink, drinks d) is e) do/lead f) eats g) don’t/go h) helps i) is j) recommend k) are

Unit 2. 2.1. a) hate, eat b) cleans c) am cleaning d) do/like e) don’t/study, am learning f) is crying g) is spending h) is getting i) works, is working j) go k) isn’t getting along

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Unit 3. 2.1. a) practiced b) participated c) overtrained, had d) began e) won f) was born, started g) joined, got h) skipped, used i) stretched, warmed up j) was, played k) sprained l) did/play, were m) was, had, stopped n) wasn’t, went, were

Unit 4. 2.1. a) have broken b) have/been c) have/been d) has/bought e) have/worked f) has been 2.2. a) have/visited b) was, twisted c) have argued d) have had, was e) left, didn’t feel, have felt f) have/finished, told g) didn’t feel, was h) have placed i) haven’t had j) have/finished k) has/relieved l) operated, failed m) hasn’t had n) have become 2.3. a) for b) since c) for d) since e) for f) since g) since 2.4. a) yet b) just c) still d) just e) still f) already g) yet h) already

Unit 5. 2.1. a) tall/taller/tallest b) stocky/stockier/stockiest c) curly/curlier/curliest d) small/smaller/smallest e) careful/more careful/most careful f) aggressive/more aggressive/most aggressive g) young/younger/youngest h) big/bigger/biggest i) tidy/tidier/tidiest j) wavy/wavier/waviest k) reliable/more reliable/most reliable l) clumsy/clumsier/clumsiest m) friendly/friendlier/friendliest n) skinny/skinnier/skinniest o) sensitive/more sensitive/most sensitive p) old/older/oldest (also elder/eldest) q) sensible/more sensible/most sensible

Teacher’s book

r) shabby/shabbier/shabbiest s) gentle/more gentle/most gentle t) smart/smarter/smartest 2.2. a) oldest b) more expensive c) longer d) most common e) better f) taller g) hotter h) more painful i) more urgent j) best k) most dangerous l) most difficult

Unit 6. 2.1. a) can’t b) shouldn’t c) can, could d) would e) can, may f) should g) can h) can’t i) can’t, shouldn’t, mustn’t j) should, must k) shouldn’t 2.2. Free answers

Unit 7. 2.1. a) was mopping, slipped, broke b) was speaking, saw c) burned (burnt), was frying d) broke out, were playing e) were cycling, fell f) was cooking, flooded g) was repairing, walked h) heard, were watching i) had to, was spreading

Unit 8. 2.1. a) wear, avoid b) respect c) plug d) store e) leave, unplug f) panic, call g) inform h) check i) use j) smoke k) deal with

Unit 9. 2.1. a) will check b) drove, wouldn’t crash c) won’t/use d) wear/are wearing, won’t hurt e) will/do f) will avoid g) will hear, take h) crash, will need i) did up, wouldn’t be j) drink, will/become k) don’t get up, take, will develop l) will/have to m) will see, wears off n) will go

Unit 10. 2.1. a) arrived, had had b) started, had been c) had been, was, had seen d) worked, was, hadn’t worked e) came in, didn´t find, had taken f) was, hadn’t had g) arrived, had destroyed, couldn’t h) was, had fallen i) found, had been hit j) threw up, had gone k) arrived, had finished

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Unit 11. 2.1. a) The nurse said that she had had a bad cold the previous week. b) The receptionist said that they were receiving patients in their clinic that day. c) The manager said that the new ICU would be open the following day. d) The nurse said that the traumatologist was examining a patient then/at that moment. e) The patient’s husband said that she hadn’t taken her pills the week before/the previous week. f) The EMT said that she had forgotten to take her first-aid kit. g) The nurse said that the paediatrician would come the following day/the next day. h) He added that the hospital bill had to be paid soon. i) The nurse told the assistant that she wanted him to take those samples to the laboratory then/at that moment. j) The supervisor pointed out that the delivery rooms were busy then/at that moment.

Unit 12. 2.1. a) catch up with b) picked up c) blocked up d) went down with e) come out in f) give up/cut down on g) fill in h) turned up i) had gone on j) put on k) put out, throw away l) woke up m) broke down n) give up/cut down on 2.2. a) take in b) checked up on c) warm up d) going round e) get over f) swelled up g) ruled out h) broke out i) passed down j) lie down k) scrub up l) wore off m) turned around

8.2.  Reading Unit 1. 3.1. a) beverages b) preheated c) take-away d) major e) preservatives f) intake g) grateful 3.2. a) It often contains high levels of calories from sugar or fat with little protein, vitamins or minerals. b) They serve it in a packaged form for take-out/take-away. c) It typically contains more than 1,000 Kj of calories, over half of your body needs for a day. d) They should drink a lot of water and exercise regularly. e) People who eat plenty of fruit and vegetables have a lower risk for heart disease and some cancers.

Teacher’s book

3.3. a) naturally b) carefully c) comfortably d) chronically 3.4. a) taste b) thin c) stuff yourself (with) d) crunchy e) raw f) handy g) treats h) calorie 3.5. a) false b) true c) true d) false 3.6. a) she, I b) they, us c) her, my d) she, us e) herself f) he, he g) himself h) our i) itself

Unit 2. 3.1. a) so-called b) harm c) dangerous d) illicit e) engage in f) deadly 3.2. a) Because using the adjective “soft” may convey the idea that “soft” drugs cause no or insignificant harm. b) Because tobacco cause a high percent of all hospital illnesses. c) It is gaining a similar status to cigarette smoking or excessive drinking. d) According to the text, there is no consensus as studies differ widely as to whether cannabis use is the cause of those mental problems or whether the problems have a different origin and are simply augmented by cannabis use. e) They take them at the week-end for recreational purposes. 3.3. a) intimately linked with b) profile c) killer drug d) taking up e) binge drinking f) non-spirituous g) supportive h) accurate i) prospective 3.4. a) False. It is increasing. b) False. There are far more health problems and drug-related deaths from legal drugs than there are from illegal drugs. c) False. It may be so, but the text doesn’t specify. d) True. 3.5. a) Example: The book is about a doctor who is accused of murder. b) Tim will never forget the day when/in which he became an EMT. c) We heard the speech that shocked the whole country.

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d) This is the book (that) I’ve read hundreds of times. e) This is the uniform which/that wasn’t available in the shop. f) The dentist, who had used the wrong anaesthetic, apologised. g) I met a former university colleague, whose daughter is a vet, last week. h) Tom hired a translator, who is very expensive. i) Here is a postcard of the city where/in which we spent three days. j) John is going to marry a woman whose sister works with me.

Unit 3. 3.1. a) flexibility b) short-term c) reduce d) weak

3.2. a) overall b) endurance c) life-threatening d) risk e) worldwide f) side effects

3.3. a) false b) true c) false

3.4. a) made up my mind b) hidden c) stretch d) strain, sprain e) fat f) hydrated g) sharp

3.5. a) He found it in books, on the Internet. He also went to his primary care physician. b) Because he didn’t want to have any injuries, muscle strain/sprain or discomfort at the very beginning, as many people who start a running programme become overconfident or enthusiastic and tend to over-train, which leads to the problems mentioned above. c) He ate a protein shake or protein bar. d) He had a rest.

Unit 4. 3.1. a) routine b) breathing c) hurts d) avoiding e) contractures f) sleepiness g) quality time 3.2. a) They have in common that they are as frequent and can often be traced back to inadequate daily habits. b) The reason could be that you don’t know how to use your breathing organs properly.

Teacher’s book

c) They have stomach problems because of the things they eat or drink as well as they way they do these things. d) Apart from sleepiness, they can have a negative effect on people’s energy, emotional balance, productivity, and health, as well as many physical problems and pain episodes. 3.3. a) lifting b) to do c) eating d) to help e) to do/doing 3.4. a) loosely b) inhibiting c) generic d) packaging e) over-the-counter (OTC) f) contraceptive g) mouthwash h) dosage i) absorbed j) bypasses 3.5. a) False. Analgesics are used to reduce pain. Antibiotics are used instead to reduce germ growth. b) True. c) False. A company can also name the same medicines differently in different countries. d) False. Strong painkillers can only be obtained if one has a prescription from a doctor. e) False. Intravenous means administered into the blood through a vein.

Unit 5. 3.1. a) anxious b) friendly c) shame-free d) foster e) recall f) improve g) comfortable 3.2. d) they find a friendly environment 3.3. a) False. The test says that communication can be improved by speaking slowly, and by spending just a small amount of additional time with each patient. b) True. Communication can be more useful if non-medical language is used. c) False. One strategy is to limit the amount of information provided and repeat it. Repetition enhances recall. d) True. It can be very helpful to encourage questions. 3.4. a) difficult b) large/big c) complex/complicated 3.5. a) encounters b) requests c) lie d) tips e) empathy

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3.6. a) True. b) False. Requests should be accepted if considered necessary by the health-care professional. c) False, giving patients time to speak freely and vent their feelings can help to diffuse them and avoid further unpleasant situations. d) True. If a patient starts to get aggressive, walk away politely, and call for help.

Unit 6. 3.1. a) unprovoked b) damage c) pierced d) venom e) inflammation f) risk g) swollen h) itchy 3.2. c) people or animals 3.3. a) In self-defence or apparently unprovoked. b) Spiders, insects, vertebrates like dogs and cats. c) Generalised tissue damage, serious haemorrhage, infection by bacteria/pathogens, introduction of venom (poison), introduction of irritants. d) It depends on the situation. In case of serious bites, a doctor should be consulted. e) If the stings are not very serious, red bumps on the skin, swelling, itchiness, pain.

3.4. a) PPE is used at all times (by doctors and nurses when working). b) The X-ray technician was advised (by the chief physician) not to go into the X-ray suit without the leaded apron. c) The letter was posted by the director yesterday. d) Gloves should always be used for my work. e) All the explanations that patients want should be given.

3.5. a) gashes b) environment c) home-made d) expiry date e) sterile f) scissors

3.6. a) Broken ankles, nasty gashes, first-degree burns, children falling over. b) At the local drug store or discount store. c) Yes. They may be useful whenever children are around (e.g. visiting young family members). d) No. Everyone should personalise the contents to suit their family or household.

Teacher’s book

3.7. a) False. The text doesn’t specify. b) False. They may be very useful for a first intervention, but not be sufficient for large injuries. c) True. d) True.

Unit 7. 3.1. a) sprains b) measures c) unsteady d) appointment e) improve f) well lit g) sturdy h) slippery i) edge j) uneven k) glare 3.2. d) comfortable shoes with low heels. 3.3. a) False. The text doesn’t specify. The text says that most falls are a major cause of injury for older people but it doesn’t compare older and younger people. b) True. In this way, the severity of injuries may be reduced. c) True. Exercises may improve the older person’s balance, strength and flexibility and help lessen the impact of injuries derived from falls. d) True. The text recommends keeping paths well swept, repair broken, uneven or cracked paths, patios and other walking surfaces. 3.4. a) bleach b) outlets c) healing time d) ooze e) blood vessels f) grafting g) clothing h) wiring 3.5. Type of burn First-degree

Layers of skin involved top layer

Signs and symptoms –  redness –  pain –  minor swelling – skin dry without blisters

Healing time 3-6 days

Treatment – Immersion in water – No removal of clothing stuck to the burnt area – Do not use butter, oil, lotions, creams – No adhesive dressing or bandages (Continues)

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Type of burn Second-degree

Third-degree

Layers of skin involved

Signs and symptoms

top layer of skin as well as part of the layers underneath

– blisters that may ooze, severe pain, and redness

all the layers of the skin and underlying tissue

burnt area is white, yellow, black or cherry red. The skin will be dry and leathery

– blisters sometimes break open and the area is wet looking with a bright pink to cherry red colour

Healing time – depends on the severity of the burn

depends on the severity of the burn

–  little pain –  stiff and charred

– Call for emergency medical assistance –  Go to ER

– the area may feel numb at first all the layers of the skin and down into the muscle and the bone

Same as in firstdegree burns

– can take up to 3 weeks or more

– little or no pain

Fourth-degree

Treatment

Extended time of healing

– Call for emergency medical assistance –  Go to ER

Unit 8. 3.1. a) case, receptacle b) staff c) accessories 3.2. a) needles b) case c) gloves d) prone 3.3. a) Putting used needles in their plastic case again should be avoided because workers could injure themselves, which often happens when they handle sharp objects. b) Personal Protective Equipment (PPE) is the specialized clothing or equipment worn by employees for protection against health and safety hazards and designed to protect many parts of the body, i.e. eyes, head, face, hands, feet, and ears. c) After using patient care gloves, they should never be washed and used again because it may not be possible to eliminate all microorganisms. Therefore, gloves should be discarded and thrown away in the nearest appropriate receptacle. 3.4. d) on all occasions, as they may not be safe.

Teacher’s book

3.5. a) regardless of b) secretion c) sterilizing d) droplet e) drainage f) pathogen g) airborne 3.6. Type of precautions

Standard precautions

Patients

All patients irrespective of situation

Specific precautions Personnel: Hand hygiene Use of gloves Use of gown Use of eye protection Safe injection practices Equipment: Clean, disinfect and sterilize reusable equipment For contact precautions: Wear a gown and gloves Single-patient room Spatial separation in multi-patient room

Transmission-based precautions

Patients suspected to Droplet precautions: be infected or colonized Single-patient room with infection Curtain between beds in multi-patient room Wear a mask Airborne precautions: Single-patient AIIR Mask/respirator

Unit 9. 3.1. Causes of accidents: a) drivers themselves b) bad weather c) complicated road conditions d) drinking & driving e) trying to grasp for things f) road rage Measures: a) regular car maintenance b) appropriate mirrors c) correct distance between vehicles d) wear a seatbelt e) use zebra crossings f) use better cars g) respect rules 3.2. a) developed b) countless c) mishaps d) amount e) impaired f) under the influence g) servicing h) steer clear (of) i) grasp j) temper k) go down 3.3. conscious > unconscious, fit > unfit, healthy > unhealthy, fear > fearless, help > helpless, helpful, hope > hopeless, hopeful, harm > harmful, harmless, peace > peaceful, pain > painful, painless

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3.4. a) blazing b) paramount c) timber d) handy e) licence 3.5. d) Make a bonfire in public places. 3.6. a) False. Guy Fawkes didn’t create it. In celebration of his failed plot, people throughout Britain set throughout Britain each year on the same day that Guy Fawkes’ plot was discovered. b) False. The risk may be reduced, but it will not disappear. c) True. Wearing protective clothing on Bonfire Night helps you avoid burns. d) False. It is an offence to set off fireworks in the street or public places without a licence. 3.7. a) on b) at c) at d) in e) on, in

Unit 10. 3.1. Risk Card

Meaning

Patients’ conditions High

immediate

third- and fourth-degree burns, important trauma, acute traumatic brain or even heart attacks

Yellow

urgent

not at risk, are in great pain

Green

delayed

less important injuries

White

D.O.A. (or almost)

Red

Medium

Low

Dead

x

x x x

3.2. A4, B3, C5, D1, E2 3.3. a) seen b) paediatric c) Consent to Treat d) bearable e) ordered f) squeamish g) signing out h) subsequent 3.4. c) Leave the child with professionals to make him/her less nervous.

Teacher’s book

3.5. a) False. The text says that parents should make a list of ERs available in the area, particularly those staffed best for paediatric care, but not that parents should take their children exclusively to those ERs. b) True. c) False. They don’t have to. However, younger children can be helped by the use of simplified explanations and language. d) True. They should make sure they have a copy of your discharge instructions with any prescriptions.

Unit 11. 3.1. a) resources b) acute c) failure d) deemed e) outcome f) prime g) condition

3.2. a) False. It is a specialized department. b) False. They are often admitted during the crucial hours after major surgery. c) False. It is usually only offered to those whose condition is potentially reversible and have a good chance of surviving. d) True. Since the critically ill are so close to dying, the outcome of this intervention is difficult to predict.

3.3. a) bloodstream b) procedures c) spread d) quarantine e) reservoir f) must g) refrain from h) contracting 3.4. Professionals: a) Isolation or quarantine of infectious persons or materials. b) Sterilization of surgical instruments. c) Use of protective clothing. d) Proper bandaging and injury dressing. e) Safe disposal of medical waste. f) Disinfection of reusables. g) Scrubbing up and hand-washing after using premises. Visitors: a) Hand-washing after a hospital visit. b) Limit contact with the patient. c) Refrain from touching patient’s wounds, drips or things. d) Stay at home if feeling unwell.

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Unit 12. 3.1. a) facilities b) overnight c) take in d) risky e) cases f) managed 3.2. d) patients with lower risk of deaths. 3.3. Hospitals: Large capacity (more facilities, more treatments, even specialised ones) admit inpatients for overnight stays; have specialised units. Clinics: Small capacity (fewer facilities and specialisation areas); care of outpatients; cover only primary health-care needs; general medical practice. 3.4. a) premises b) vaccination c) house-bound d) appointment e) assess f) smear test g) family planning h) handicapped 3.5. a) They may do as consultations take place on site but they can also make home visits for those who are genuinely house-bound. b) Appointments can be made in person, by telephone or online. c) GPs will refer patients to proper specialists. d) Nurses typically do it. e) Apart from their GP, they can consult midwives, who offer maternity care and discuss all matters relating family planning, pregnancy and child birth.

8.3.  Vocabulary Unit 1. 4.1. From left to right: hot dog, fizzy drink/popcorn, eggs, fruit, coffee, vegetables, cheese, sweets, milk, (portion of) pizza 4.2. a) beef b) oil c) seasonal d) unsalted e) chamomile f) ale g) non-caloric 4.3. Australia - Anzac biscuit Singapore - bak chang Jamaica - Ackee & saltfish

Teacher’s book

USA - hamburgers UK - Yorkshire pudding Ireland - colcannon India - chicken tikka masala Canada - bacon with maple glaze Cameroon - fufu/foofoo in sauce

Unit 2. 4.1. a) personality disorder b) sleep disturbance c) cold turkey d) drowsiness e) depression f) mental retardation g) delusion 4.2. a) nervousness/wakefulness b) depression c) delusions d) mental retardation e) addiction

Unit 3. 4.1. a) cycling b) swimming c) basketball d) gymnastics e) running f) football/soccer g) hockey h) water polo i) tennis j) horse riding 4.2. Free answers. 4.3. a) contusion b) strained c) dislocated/luxated d) sprained e) (muscle) cramp f) contracture g) stitch

Unit 4. 4.1. a) chest pain b) backache c) swollen ankle d) toothache e) headache f) earache g) stomachache h) fever 4.2. A3 B7 C6 D1 E4 F5 G2 4.3. Gnawing pain: backache, labour pains, abdominal pain (appendicitis), wasp sting, dislocated shoulder, twisted ankle (unbroken but inflamed), bone pain (once broken, when weather changes).

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Throbbing pain: headache, in-growing nail. Stabbing pain: backache, toothache (wisdom tooth), labour pains, duodenal ulcer, abdominal cramps. Burning pain: stomach-ache, sore throat, duodenal ulcer. Pressing pain: chest pain (heart attack), headache, toothache (wisdom tooth).

Unit 5. 4.1. Normal data (medium-level protection): fines, criminal records, creditworthiness, tax information, basic personality features to evaluate behaviour. Sensitive, personal data (high-level protection): religion, sexual health, sexual orientation, racial and ethnic origin, disabilities, health history.

4.2. Physical appearance (“looks”): fat, medium-height, plump, short, skinny, slim, stocky, strong, tall, thin, weak, well-built. Psychological description: aggressive, cheerful, clumsy, curious, energetic, frail, friendly, generous, intelligent, naive, open-minded, peaceful, reliable, secretive, shy, stubborn, tough. Clothes: casual, close-fitting, colourful, comfortable, designer, formal, ill-fitting, old-fashioned, smart, tidy, trendy. Age: elderly, middle-aged, old, teenage, young. Hair: bald, curly, spiky, straight, wavy, white.

4.3. a) passive b) careless c) treacherous d) intolerant e) lazy f) dull g) unreasonable h) selfish i) immodest j) carefree k) unsure l) insensitive/unreactive

4.4. Open answers.

Unit 6. 4.1. a) √ b) x c) x d) √ e) √ f) x g) x h) x

Teacher’s book

4.2. Face: a) left side (from top to bottom): eyebrow, eye, cheek, lip, chin. b) right side (from top to bottom): forehead, nose, mouth, tooth. Body: a) left side (from top to bottom): face, shoulder, chest, arm/forearm, wrist, finger, leg, foot. b) right side (from top to bottom): head, ear, neck, abdomen/stomach, elbow, hand, knee, toe. 4.3. Hand: a) left side (from top to bottom): ring finger, little finger (“pinky”), knuckle, wrist. b) right side (from top to bottom): nail, index/fore finger, thumb. c) top: middle finger or knuckle. Foot: a) left side (from top to bottom): toe nail, (big) toe, (small) toe. b) right side (from top to bottom): ankle, heel. 4.4. a) blackheads, sebum/skin oil b) wart c) spider veins, varicose veins d) snot/(nasal) mucus e) ribs f) hip bone g) spine/backbone h) spot/mole 4.5. Left side (from top to bottom): oesophagus, gallbladder, large intestine, small intestine, appendix. Right side (from top to bottom): stomach, pancreas, bladder, rectum. 4.6. (from left to right): brain, heart, lungs, liver, intestines, stomach.

Unit 7. 4.1. a) fire extinguisher b) cabinet with safety lock c) poisoning d) toddler e) ladder f) drawn g) plug 4.2. a) tweezers b) choking/suffocation c) outlet adapter d) sticking plaster e) gauze 4.3. (upper row): thermal/burning, boiling water, climatic/snow, chemical/toxic material, climatic/sun (lower row): thermal/barbecue, chemical/toxic gas, thermal/fire, chemical/toxic fumes

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4.4. a) utility room b) cupboard c) vacuum cleaner d) dishcloth e) sheet 4.5. a) living room b) bath mat c) deodorant d) floor e) wardrobes

Unit 8. 4.1. Clothing: coat, gonadal shield, coverall, disposable gloves, high visibility waistcoat, leaden apron Hand protection: wrist support, hand wipes, gauntlet Face, eyes, neck and head protection: mask, goggles, helmet, thyroid collar, lens, respirator, specs Foot protection: anti-fatigue insoles, safety boots 4.2. a) wrist support b) anti-fatigue insoles c) helmet d) lead apron e) coat 4.3. Craftsmanship: painter, bricklayer, plumber, carpenter, builder Offices: secretary, call handler, tax advisor, journalist, solicitor Selling & food services: cook, waiter, sales-manager, shop-assistant Transport: flight assistant, bus driver, taxi driver, pilot Education: head teacher, student, teacher, janitor Security, defence and law: policeman/policewoman, fire-fighter, soldier, judge Health-care: dietician, General Practitioner (GP), emergency medical technician (EMT), radiation therapist, dental hygienist, paramedic, vet, druggist/chemist, surgeon, nurse 4.4. a) General Practitioner (GP) b) emergency medical technician c) dental hygienist d) surgeon e) paramedic f) radiation therapist 4.5. A6 B2 C5 D4 E3 F1

Unit 9. 4.1. a) ditch b) traffic warden c) sleeping policeman/speed bump d) seatbelt e) diversion f) fence

Teacher’s book

4.2. Car (clockwise, starting at the left top): boot, steering wheel, headlight, bumper, bonnet, door, wheel, tyre Bike (clockwise, starting at the left top): saddle, handlebars, brakes, spokes, pedal, chain, reflector 4.3. a) stop sign, crashed into/bumped into b) zebra crossing, run over c) helmet d) fasten, seatbelt 4.4. From left to right, top to bottom: no left turn • no right turn • no u-turns • no overtaking • no entry for vehicular traffic • maximum speed • priority over oncoming vehicles • right hand curve • school crossing • crossroads • road narrows (right) • two way traffic • roundabout • slippery road • stop • priority over traffic in opposite direction • ahead only • turn left ahead • minimum speed • no through road for vehicles 4.5. a) beach b) hill c) department store d) tram e) countryside

Unit 10. 4.1. A3 B8 C4 D1 E2 F5 G6 H7 4.2. A4 B7 C6 D5 E8 F3 G2 H1 4.3. Arrival at hospital Triage and initial treatment Category I

Category II

Category III

Priority surgery

No surgery

Wait for surgery

Direct to surgery or close supervision near operating theatre

Discharge home Surgery Ward

Admit to a quiet place

Admit to ward to wait for surgery

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4.4. a) intubation b) IV therapy c) stable vital signs d) improvement

Unit 11. 4.1. A3 B6 C5 D14 E1 F2 G4 H10 I8 J9 K7 L13 M12 N15 O11 4.2. a) lancets b) scalpel c) crutches d) otoscope e) stethoscope f) gown g) rollator h) shoe cover 4.3. A3 B4 C1 D6 E2 F5

Unit 12. 4.1. A4 B10 C3 D5 E1 F8 G7 H9 I6 J11 K2 4.2. a) weight, height b) ear syringing c) health check/check-up d) prescription, referred e) make/ book, appointment

8.4.  Listening Unit 1. 5.1. a) People with a busy schedule, like busy mums and fathers, people at school, etc. b) Go to the grocery store and buy all fruit that you need for that week. In that way, you can challenge yourself to try to get those pieces of fruit in every day. c) He says they are kept in a pantry. d) Keep a cup by your bathroom and sink, and in the morning drink one glass when you wake up, and before you go to bed at night drink another glass and enjoy/during the day.

Unit 2. 5.1. a) False. Speaker 2 says that the phenomenon is nothing new and statistics prove it. b) False. The average American boy would take as first sip of alcohol when he is eleven, while American girls try a little later by the age of thirteen.

Teacher’s book

c) False. These ages are the ones in which girls and boys take their first sip of alcohol. It is the age of sixteen when the average teen starts drinking regularly. d) True. e) False. Taking drugs at any age can lead to addiction but teenagers are even at greater risk. The younger you are when you start using drugs, the greater your chances of developing a dependency. f) True. g) False. Peer-group pressure can also play a big role in substance abuse. h) False. Parents should talk to their children immediately.

Unit 3. 5.1. a) Brent says men need to know when o stop, or when to slow down, or when to change their exercise pattern. Listen to their bodies. b) They can use a lightweight racket, look at how their racket is strung (it shouldn’t be very tightly strung; looser strings are better), and play on softer surfaces –clay or grass–. c) People need to do it for about 30 seconds. d) You can use ice, probably the best pain relief. You can also resort to massages and rest. e) No he doesn’t. That would mean you are sedentary, which he doesn’t recommend for anybody.

5.2. a) No. He believes in physical activity more than exercise, but he doesn’t think that one is more important than the other. b) Dancing is a great physically active form of recreation. c) No. He doesn’t think people can life without stress, and that stress is a part of human life. d) No. According to him, there is an array of options out there, though his favourite ones are breathing techniques. e) Because they are so simple, they don’t require equipment, they’re extremely time-effective and they are free.

Unit 4. 5.1. a) It is produced by the brain. b) It is called acute pain. c) It is called persistent or chronic pain. d) 1 in 5 people have it. e) Yes, it can; but to a limited extent. It is the more active approaches that are necessary to retrain the brain. f) When it comes to a complex problem like chronic pain, surgery may not be helpful.

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g) Yes. Thoughts, beliefs, emotions are brain impulses. If patients learn ways to reduce stress and wind down the nervous system, this may help them with their emotional well-being and can reduce pain as well. h) Yes. It may help gradually restore patient’s body’s tissues.

Unit 5. 5.1. a) They specialize in implant, cosmetic and general dentistry. b) It describes itself as attentive, supportive, compassionate and knowledgeable. c) He uses the patient’s X-ray to demonstrate visually by drawing or highlighting directly on the image. d) Because he wants patients to understand his diagnosis and treatment recommendations. Understanding allows patients to have peace of mind and trust on the services provided. e) They can access the clinic’s website and complete the questionnaire forms. They should also be planned and prepared for their procedure, dressing comfortably, and taking any prescribed medication. f) Yes. The clinic says it will treat them as their invited guests. g) To ensure comfort and tranquility for the patient, so that he or she can relax and let the staff do what we do the best. h) The staff will call them to check on them and answer any questions or concerns the patients might have.

Unit 6. 5.1. a) With the proper use of CPR or “Cardio Pulmonary Resuscitation”. b) They should check for signs of breathing and pulse. c) They should: a) position the victim on their back; b) turning the victim’s head to the side and remove any foreign objects from the airway; c) tilt the victim’s head back; d) pinch the victim’s nostrils closed; and e) place the rescuer’s mouth over the victim’s to form a tight seal. d) They should press fifteen times. e) They should continue rescue breathing.

Unit 7. 5.1. a) 20,000 deaths on average each year. 5.2. a) true b) false c) true d) true

Teacher’s book

Unit 8. 5.1. c) Routine tasks alternate with emergencies.

5.2. a) You are the most important person (i.e. the person that safety program is aimed at). b) These are safety rules, policies and procedures. c) The major type of injuries in the health-care industry is back injuries. d) Frequent washing of your hands, appropriate protected clothing where required, or avoiding needle sticks.

Unit 9. 5.1. a) True b) False. According to him, it is applicable all over the world, not something for developed countries.

5.2. According to Etienne Krug (speaker 1), the Plan for the decade on Road Safety will take into account: creating a lead agency, improve trauma care, changing people’s behaviour, improving infrastructures, creating a data collection system.

5.3. a) better roads b) seatbelts c) crash-helmets d) actions against speeding and drinking

Unit 10. 5.1. a) False. It is between 9 and 13 per cent. b) True. c) False. In the last seven days, not weeks. d) True. e) False. The best thing to do, according to her, is always try to get out of the situation if you can.

5.2. c) The US military and its allies in the Pacific.

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5.3. a) The critical care medical personnel work in the Pacific. b) Teams are made up of three personnel typically a critical care physician, critical care nurse, and a respiratory therapist or a paramedic. c) LtCol. Linda Vue says they use the ventilator, suction, monitor, defibrillator, blood analyzer and then triple-channel ID pump. d) Courses help her know what to prepare for and how to prepare for patient transfers.

Unit 11. 5.1. a) The Australian health system has 2 parts. These are the public system and the private system. b) The public system is paid for by people’s taxes. c) You can’t choose which hospital, which doctors treat you, and when you are treated (you may have to go on a waiting list). d) No. Patients may have to pay some money towards them. e) They pay for it themselves or get private health insurance to help cover the cost. f) You can choose which hospital or which doctors treat you. You can also skip public hospital waiting lists.

Unit 12. 5.1. a) While they are pregnant, during the birthing experience, and when the new family returns home. At every step of the way. b) The classes are: basic childbirth education, breastfeeding, tobacco cessation and infant/ child CPR and choking prevention. c) The Stork Club is a program at Kettering Medical Center for those who are planning to deliver there. d) It includes monthly newsletters, ‘Moms in Motion’ exercise class, a child care class, the mommy network series, a gift bag during the stay at the center, and a gift certificate for a postpartum massage. e) Mothers can have an epidural 24 hours a day. f) “Doula” is a Greek word that refers to a woman experienced in childbirth who provides continuous physical, emotional and informational support before, during and just after childbirth. g) The special care nursery provides 24-hour neonatology coverage to care for those babies needing extra care and attention. h) Mothers can talk to a lactation consultant. i) Parents can use the new parents’ 24-hour Answer Line, which can assist them with questions or concerns that arise after they return home.

Teacher’s book

5.2. a) The main advantage of the WPCC is that it is local. b) What does it mean for the WPCC to be a walk-in center? It means that patients can just walk in, so they don’t need to phone up and arrange an appointment (which is difficult for some patients). c) Yes, it does. In fact, patients find it very useful being able to pull in until eight o’clock in the evening. d) Yes. They integrate their services with others such as renal dialysis and chemotherapy services. e) An average sessions for Patient 2 last for four hours. f) Patient 2 fills in his time reading a book and watching the telly.

8.5.  Speaking Speaking activities, by their very nature, contain exercises with multiple outcomes. However, teachers could prepare these activities by making bullet-point lists of things students could mention. For example, exercise 6.2. in Unit 10, asks students to discuss why people and patients often wait for so long in emergency departments. In this respect, teachers could make a list of possible reasons (e.g. the triage process itself, lack of capacity, boarding of patients, on-call physician shortages, local crises and disasters, etc.) to help students arrive at if they get stuck at some point during the exercise.

8.6.  Writing As is the case with listening exercises, writing exercises cannot have model “answers”, as their very nature implies that there will be endless possible outputs in students’ work. Despite this, teachers could make a list of possible points students should make or examples they could give in an attempt to help students with feedback. By way of example, in Unit 5, writing option “a” asks students to write about the qualities students think good health professionals should have to approach and treat patients –as well as comparing those qualities with those of bad health professionals–. In preparation for these exercises, teachers could make a list of qualities (e.g. excellent communication and interpersonal skills, emotional stability, empathy for the pain and suffering of patients, flexibility with regards to working hours and responsibilities, strong physical endurance, etc.). Another example is option “b” in Unit 11, which asks students to write a letter to a hospital’s authorities. Two of the options students can choose from are A job application letter and CV and a commercial letter offering products to a hospital. Teachers would do well to explain the structure of commercial letters to students, with their parts (heading, date, inside address, greeting, subject line, body paragraphs, complimentary close, signature and writer’s identification). In addition, the parts of a CV should also be outlined by teachers to help students practice writing a CV in English. These parts include the student’s name, address, profile/personal statement, employment, education, skills, and personal details as well as references.

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9.  KEYS TO FURTHER MATERIALS Anatomical pathology a) gross examination b) histopathology c) cytopathology d) fine needle aspiration e) cysts a) Anatomical pathology is the diagnosis of disease based on the gross, microscopic, chemical, immunologic and molecular examination of organs, tissues, and whole bodies. Clinical pathology is the diagnosis of disease through the laboratory analysis of bodily fluids and/or tissues. However, the distinction between anatomic and clinical pathology is increasingly blurred by the introduction of technologies b) It involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by non-surgeons. c) Autopsies are not carried out very frequently. In fact, they represent less than 10% of the workload of typical pathologists.

Audiologists a) hearing loss b) hearing aid c) hearing test d) late-deafened e) ear plug a) They treat hearing loss and they proactively prevent related damage. b) They provide recommendations as to what options (e.g. hearing aid, cochlear implants, surgery, appropriate medical referrals) may be of assistance. c) They work with a wide range of clientele, including newborn babies, children (paediatric) and adult populations.

Clinical laboratory a) specimen b) haematology c) vacutainer tube d) sticker e) centrifuged a) No, they aren’t. Their distribution in health institutions varies greatly from one place to another. b) They are performed at research laboratories. c) Competent professionals verify results. In some countries lower-rank staff do the majority of this work, with results only referred to the relevant pathologist when they are abnormal.

Dental technicians a) dentures b) dental braces c) dental stone d) prosthesis e) inlay f) occlusion a) Dental technicians use a wide range of materials, including gold, porcelain and plastic.

Teacher’s book

b) Fixed dental restorations, once placed, cannot be removed. Removable restorations can be removed by the patient for cleaning and at night. c) Orthodontic appliances are used to either move teeth to form a more harmonious occlusion and aesthetic appearance of teeth or to maintain the position of previously moved teeth.

Diagnostic imaging a) clues b) scope c) exposed d) screen e) doses of radiation a) It is decided depending on the patient’s symptoms and part of the body being examined. b) No, they are not. Some tests are uncomfortable as they require patients to stay still for a long time inside a machine, or a long, thin tube to be inserted in the body, which often requires anaesthesia. c) A Radiology Department is a very risk-free environment in which to work, as they are exposed to low doses of radiation as they protect themselves, for example, by going in another room when the X-ray beam is switched on and the x-ray is being taken.

Dietetics a) nutrition b) food pyramid c) food wheel d) supplement e) eating disorder a) Women of childbearing age may require folic acid supplements and people over the age of 50 may require vitamin B12 supplementation. b) Dieticians can work in a variety of areas within hospitals, in the community, in the food industry, in education, or in the media. c) No, they don’t. These terms should not be considered interchangeable as the training, regulation and scope of practice of the two professional titles can be very different.

Emergency medical services a) cardiac arrest b) pump blood c) asystolic d) heart beat e) misconceptions a) The main aim of CPR is at keeping heart and brain oxygenated. Without oxygen those organs will die. b) It finishes when the patient regains a heart beat spontaneously or is declared dead. Some other times, the EMT is too exhausted to go ahead with the compressions, and he has to stop. c) What is their role on an emergency scenario according to the text? Emergency Medical Services. When EMS arrives they will likely give medication in an IV line, atropine and adrenaline, intubate the patient (tube down patients throat), place them on a cardiac

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monitor, and possibly defibrillate the patient. CPR can help induce a shockable rhythm in an asystolic patient. d) Chest compressions work by pressing with your hands on the patient’s chest to manually pump blood through the heart. Artificial respiration works exhaling into the patient to ventilate the lungs and pass oxygen in to the blood. e) CPR uses chest compressions and artificial respiration, CCR only chest compressions (Chest Compression Resuscitation).

Environmental health a) liquid waste disposal b) noise pollution c) risk assessment d) recommended levels e) mixtures a) Observational studies are common, because humans cannot ethically be exposed to agents that are known or suspected to cause diseases. b) They can include randomized controlled trials and other experimental studies because they can use animal subjects. c) The main advantage is that it can very accurately quantify exposures to specific chemicals. However, it does not generate any information about health outcomes like environmental epidemiology or toxicology.

Medical records personnel a) report b) storage c) reviewing d) release e) clerical a) They are important because they are used to evaluate patient care, diagnose and treat illnesses, and plan health-care activities. b) They can according to regulations, but they have to make sure that confidentiality is safeguarded. c) They could, as medical records are needed on a 24-hour basis, so specific jobs could include weekend or evening hours, or shift work.

Nursing assistant a) aide b) bathing c) ambulatory d) nursing homes e) long-term a) They do, as they have a great deal of contact with patients and provide personal care. b) It is necessary to be a team player who is able to take orders well. A good nursing assistant should also be emotionally stable and have a great deal of patience. Physical fitness is a plus. c) Because the population is rapidly growing older, which will demand in future more emphasis on rehabilitation and long-term care.

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Oral hygienist a) tooth scaling b) tartar c) bristles d) receding gums e) coating f) plaque a) It includes tooth scaling, tooth polishing, and, if too much tartar has built up, debridement, followed by a fluoride treatment. b) They can be massaged with the bristles on a toothbrush can also be used to massage gums to prevent bleeding as well as encouraging the health of the gums to continue their support of and binding to the teeth. c) Because they consider that alcohol-containing mouthwashes should be prescribed by dentists, like any other medication, as there could be a possible connection between mouthwashes that contain alcohol and an increased risk of oral cancer. d) Having good lifestyle habits is necessary such as avoiding smoking, drinking water, and eating a balance diet.

Orthotics a) immobilize b) cast c) sizes d) made-to-measurement e) replica a) They are named after the joints that they cross.  b) They are not enough because either patients do not fit within the pre-fabricated model parameters or orthoses do not address all issues that patients need.  c) They obtain it by either casting the patient’s affected area and immediately removing the cast or by a scanning device to collect all the data, later downloaded to a computer.

Pharmacy and parapharmacy a) pharmaceutical drugs b) dispensing c) advice d) all-night/duty pharmacy e) toiletries. a) They offer advice on coughs, colds, aches and pains, as well as healthy eating and stopping smoking. b) They work at community pharmacies, also known as chemist’s in the UK or drug store in North America. c) We can find prescription drugs or medicines as well as a diverse arrangement of additional items such as cosmetics, shampoo, toiletries, baby products, pregnancy testing kits, etc.

Radiotherapy a) malignant b) cell growth c) adjuvant d) palliative e) chemotherapy a) It works by damaging the DNA of exposed tissue leading to cellular death. b) They include lymph nodes if they are clinically or radiologically involved with tumour, or if there is thought to be a risk of subclinical malignant spread. c) Most common cancer types can be treated with radiation therapy in some way.

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10.  Transcript of videos Unit 1. How to have a healthy diet with a busy schedule So the next step is to go ahead and come up with a plan on how you’re going to eat healthy. You are a busy person, in your school, you have to plan how to get your homework done, you’re a busy mum, and you’re busy father, you have to plan how to take care your children, it’s the same with your diet. You have to put a plan into place. So how do you do that is you make these foods variably available for you. So let’s say you have consultation with your dietician and your dietician tells you that you need to eat two fruits a day along with other, a variety of foods. But what we are going to go ahead and talk about the fruit curve right now. So what you want to when you go to the grocery store is to go ahead and buy all the fruit that you need for that week, and that way, you can challenge yourself to try to get those two pieces of fruit in every day. These kinds of foods, the deserts and the salty they are great to have in your pantry, but if you don’t have a plan you might go ahead and resort to these quick convenient foods when you’re really hungry. But if you come up with the plan and have something like this meal already in the refrigerator, maybe you prepare it the night before and go ahead with the batch cooking and decided that you would eat it again, then you would have a nice healthy meal for the next day. Water is another important thing that people just don’t think about. So if you need eight glasses of water a day, keep a cup by your bathroom and sink, and in the morning drink one glass before you, when you wake up, and before you go to bed at night drink another glass and enjoy/during the day, find a bottle like this which contains six, eight glasses of water. And if you drink this throughout the day then you’ve got your eight glasses throughout the day. And that’s the way you want to plan to be healthy.

Unit 2. Teen addiction: prevent alcohol and drug abuse Lady: The teen years are the time of newfound independence, as kids begin to become adults, venturing out into the world, making their own decisions. It’s also the time many will experiment with drugs and alcohol. Dr. Jeff Gardere: Experimenting with drugs and alcohol is nothing new for teens. Consider the statistics: by the age of fourteen, forty-one per cent of kids would have at least one drink. The average American boy would take as first sip of alcohol when he is eleven, while American girls try a little later, by the age of thirteen.

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The average teen begins drinking regularly just before turning sixteen, around the time they get their learner’s permit and driver’s license. Drinking or using drugs before the age of fifteen triples their risk of becoming addicts. Consider this sobering stat: right now, three millions teenagers in the U.S. are alcoholics; and that’s just one substance. Teens today have greater access to a lot more drugs than ever before; and many of them can be found right inside your house. High school and college students have been known to abuse ADHD drugs like Ritalin to help them study or control their appetite. They might try steroids to help them bulk up. Or they snag their parents’ prescription painkillers from the medicine cabinet because they’ve heard you can get high off of them. Teens’ brains are not yet fully developed. “Pot”, alcohol, and other drugs can impair brain development and lead to permanent changes in the teenage brain. Taking drugs at any age can lead to addiction. But teenagers are at even greater risk. The younger you are when you start using drugs, the greater your chances of developing a dependency. Parents need to stay involved in their kids’ life, and let them know early on about the dangers of drug use. Providing your teen with a stable home environment and a close, loving relationship is the best thing you can do to prevent alcohol and drug abuse. Establishing rules and boundaries as a key part of that. Even if they don’t like it, kids need to know what is expected of them and what is acceptable behaviour. Peer pressure can also play a big role in substance abuse. Whether a teenager is a misfit or runs with a popular crowd having a low self-esteem and feeling like they don’t fit in can make them try things in order to look cool. If all of their friends are doing it, there’s a good chance that they will do it, too. That’s why it’s imperative for parents to keep the lines of communication open. Common signs of alcohol or drug abuse in teens include: withdrawing from family and friends, doing poorly in school, discipline problems, anger, and hostility. If you suspect that your teen is using any illegal substances, even if he or she is just experimenting, talk to them immediately. If their behaviour continues or worsens, seek professional help. Remember: the sooner you can get them help, the better their chances of kicking an addiction. Note: ADHD: Attention deficit hyperactivity disorder Pot: (Slang) Cannabis used as a drug in any form, such as leaves (marijuana or hemp) or resin (hashish).

Unit 3. Sports injuries: How to avoid a sport injury Lisa: I’m Lisa Birnbach for howdini.com. You love to play sports but your always worried that you’re going to get in some kind of injury, and often you do. With me to talk about men and sports-related accidents is Dr. Brent Ridge, Mount Sinai Hospital. Hi!

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Brent: Hi! Lisa: A lot of men want to play sports, feel like they’re athletes, and they’re terrified that they’re going to mess up their backs, their leg, their knee, their rotator cuff. What’s a guy to do? Brent: Well, obviously, I always promote exercise. I’m glad to see people who are out there doing physical activity. What men need to know is to know when to stop, or when to slow down, or when to change their exercise pattern. You really have to listen to your body, and that’s what most men don’t do. Lisa: Sometimes you need to work through a pain though, and a lot of men seem to want to tough it out. Brent: Yeah, working through pain is a misnomer. That’s almost never the case. Sometimes if you have a little muscular pain, then working through it doing some stretching, and that type of thing is good. But if you have a problem like a sore knee, you’ve hurt your knee; you’ve run too far on your knee, working through that is not going to help; it’s only going to make the problem worse. Lisa: How can tennis players avoid tennis elbow? Brent: Oh, tennis elbow is really a modern problem. And, it’s because we’re hitting the tennis ball much harder. And we’re all about speed when we’re playing tennis. And the problem with tennis elbow is that the force that’s transmitted when the ball hits the racket is transmitted into your elbow and causes an inflammation of the tendons around your elbow. And so what you need to do to prevent that, if it’s a reoccurring problem for you is look at your racket, use a lightweight racket as much as possible. Look and see how your racket is strung. If it is very tightly strung it’s transmitting a lot of force from that ball hit. That’s going to make tennis elbow much worse; so having looser strings on your tennis racket will help. And then really look at the surface on which your playing tennis. Using a softer surface, clay or grass, is going to reduce the amount of tennis elbow that you have. Lisa: And be better on your knees as well. Brent: Absolutely. Lisa: Now in terms of pre-workout protocols to make your survival of your own workout better, what should we all do? And especially if we warm up men. Brent: A warm-up is really important; making sure that your muscles are warm and are ready to begin exercise, that’s important. And that’ why stretching could have some benefit, ‘cause it can help to get your muscles warmed up. And when you’re doing a stretch to warm up your muscles, you need to stretch that muscle and hold that stretch for about thirty seconds so then that muscle is getting warmed up and prepared for the exercise to come. Lisa: If you’re sore after a workout, it could mean that you, you know, you broke through, you connect to the next level, or does it always mean that you’ve done something wrong?

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Brent: It doesn’t always mean that you’ve done something wrong, you could have just been, exerted a little more than what you should have. But if you look even at some of the biggest body builders they’ll tell you they often work out and are not sore after their workouts. So just working out to the point where you’re sore the next day is not necessarily helping you build more muscle or helping you build more strength. If you do have sore muscles, ice, you know, something as simple as ice is probably the best pain relief out there. Massage is also very good very indulgent but very good. And then the most important thing is rest. Your muscles are growing and getting stronger as you rest. And that’s why it’s so important if you’re a really... if you are really big into weight lifting that you take that day off in-between periods of exertion or you´re working different muscle groups on different days so those muscles have time to rest. Lisa: What if you rest and don’t exercise. Is that good for your muscles, too? Brent: Well then you’re sedentary, and I don’t recommend that for anyone. Lisa: Thank you Dr. Ridge. For howdini.com, I’m Lisa Birnbach.

Unit 3. Physical activity and breathing Interviewer: Let’s talk a minute about exercise. We eat too much of the wrong kind of food, and we don’t exercise enough. What do you recommend to people who are underexercised; what should they do to begin? Dr. Weil: Well, I think, I’m a believer in physical activity more than exercise so, you know, more than wanting to see people go to gyms and do workouts, I think it’s good to build physical activity into your daily routine whether that’s, you know, walking, gardening, going up and downstairs. I think it’s good to be physical active and also to find physically active forms of recreation: dancing, for example, which is great and not seating in front of the television. Interviewer: You have a number of unique stress management techniques and stress management is a large and unique part of your protocols. How do you characterize stress management and how do we bring it into our lives? Dr. Weil: I don’t think we can life without stress, I think is part of human life, but we can learn and practice methods that neutralize its harmful effects on our bodies and minds. There’s an array of options out there. My favorite are breathing techniques because they are so simple, they don’t require equipment, they’re extremely time-effective and they are free. So I teach a lot of those to my patients and I practice them myself. Interviewer: And people say they can’t really do anything but there’s a habituation: the more you it do the better it works. Dr. Weil: Yeah, the power of these techniques is in the repetition of them, it’s not the intensity with which you do them or the amount of time per day, it’s doing it every day that this pattern becomes part of your nervous system.

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Unit 4. Understanding pain: What to do about it in less than five minutes? Everyone agrees that pain is a universal human experience. We now know the pain is 100% of the time produced by the brain. This includes all pain –no matter how it feels– sharp, dull, strong or mild, and no matter how long you’ve had it. You might have had it for a few weeks or months. This is called “acute pain” and it’s common with tissue damage –say from a back injury or ankle sprain– and generally, you’ll be encouraged to stay active, and gradually get back to doing all your normal things, including work. Or you might have had it for three months or more, and this pain is generally called persistent or chronic, because in this type of pain, tissue damage is not the main issue. What’s less clear though is when you are told you have chronic pain is knowing what’s best to do about it. Well, in Australia chronic pain is a really big problem. In fact, 1 in 5 people have it. Having a brain that keeps on producing pain even after the body tissues are restored and out of danger is no fun. Some people say it still feels like they must have something wrong. But that’s just it. Once anything dangerous is ruled out, health professionals can explain that most things in the body are healed -as well as they can be- by 3 or 6 months. So, on-going pain being produced by the brain is less about structural changes in the body, and more about the sensitivity of the nervous system. In other words: it’s more complex. So to try and figure out what’s going on, you need to retrain the brain and nervous system. To do this, it’s helpful to look at all the things that affect the nervous system; and may be contributing to your individual pain experience. What can help is to look at persistent pain from a broad perspective and by using a structured approach and a plan, it’s less likely that anything important will be missed. Let’s start with a medical side. Firstly, taking medication can help, but only to a limited extent. It is the more active approaches that are necessary to retrain the brain. So using medications to get going is OK, and then mostly they can be tapered and ceased. Some people also think surgery might be the answer. But when it comes to a complex problem like chronic pain, surgery may not be helpful. So, if you’re thinking of surgery, it’s best to get a second opinion, and remember to consider all the things. Next, it is helpful to consider how your thoughts and emotions are affecting your nervous system. Pain really impacts on people’s lives and this could have a big effect on your mood and stress levels. All those thoughts and beliefs are brain impulses, too, but you can learn ways to reduce stress and wind down the nervous system. This helps with emotional wellbeing and can reduce pain as well.

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The third area to consider is the role of diet and lifestyle. Now it turns out that our modern lifestyle might not be so good for us. In fact, what we eat and how we live may really be contributing to a sensitized nervous system. Looking at all the things like smoking, nutrition, alcohol and activity levels, and seeing if there are any issues is a good beginning. And these things can go on your plan. Then, there’s often enormous value in exploring the deeper meaning of pain and the surrounding personal story. By stepping back and looking at all the things that were happening around the time the pain developed, many people with pain can make useful links between the worrying period of life and a worsening pain picture. For many, recognizing deeper emotions can be part of the healing process. Last, but by no means least, is physical activity and function. From the brain’s perspective getting moving at comfortable labels, without fear, and where the brain does not ‘protect by pain’, is best. And you’ll gradually restore your body’s tissues. So, to sum up pain, it comes from the brain and it can be retrained, and when looked at from a whole personal broad perspective gives you a lot of opportunities to begin. So get a helping hand if you need it, set the goal and begin!

Unit 5. San Francisco Dentist -Welcome video to new patient Doctor Mohamed Ali and his team specialize in implant, cosmetic and general dentistry. They are here to assist you on your journey to a healthy smile. You may be in need of dental implants, cosmetic-dental procedures, or other dental procedures. Perhaps you are on track for full-mouth rehabilitation. This attentive team is supportive, compassionate and knowledgeable, and will help you every step of the way. One of our advanced technology features in Doctor Ali’s office is the treatment planning and communication software. This software is an effective and efficient tool that allows Doctor Ali’s patients to see and understand his treatment recommendations on their own X-rays, CT scans or digital photographs. No more waiting for X-rays to be developed and evaluated. During your new patient consultation, digital format radiographs are taken and immediately imported into the software program. During your consultation, Doctor Ali will truly remain with you, with discuss its evaluation, diagnosis and treatment recommendations and you’ll see exactly what he sees. You’re not looking a prototype, you see your mouth on the computer monitor. A picture is worth a thousand words. Using your X-ray, Doctor Ali can demonstrate visually by drawing or highlighting directly on the image. This eliminates the confusion and frustration of not understanding dental terms. So you can understand what Doctor Ali is explaining.

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Communication is the key to the treatment success. It’s important to Doctor Ali that you understand his diagnosis and treatment recommendations. Understanding allows you to have peace of mind and trust in the services provided. Using innovative technology like the treatment planning communication and consult proeducational softwares, this will help you visualize your treatment plan and it’s just one more way of saying we care. We want to make your transition to an office as soon as possible. Our scheduling coordinator will arrange a convenient ninety-minute appointment, and collect information. So we can begin preparing for your consultation immediately. Before you arrive, within a couple of days of your initial call, you can access our website and complete the questionnaire forms or we will send you a welcome package in the mail. We want you to have the time to complete the questionnaire in the comfort of your home and at your convenience. Upon arrival, a warm and comfortable atmosphere welcomes you. We’ve been waiting for you. While you’re here we will start with four mouth digital radiographs and oral pictures to evaluate your conditions and dental therapy. Our treatment coordinator will conduct preliminary evaluation and discussion. Doctor Ali will review the findings and explain your treatments alternatives and together you will decide what appropriate course of action will be. Before you arrive, be planned and prepared for your procedure day. We’re ready to take excellent care of you. Your only task is to dress comfortably, and take any prescribed medications. If you’ve chosen oral or IV sedation, please have someone to accompany you to your appointment. We promise to treat them as our invited guests. Upon arrival registration is simple and quick. You will briefly review your procedure and answer any lingering questions. While you’re here, Doctor Ali has taken extra-care in the design of the office to ensure comfort, and soothing tranquility awaits you. You’ll wrap you in a cosy blanket and play soft music. We want you to relax and let us do what we do best: excellent implants, cosmetic and general dentistry, and exceptional patient care. You can be assured, we’re also vigilant about your safety and meticulous about infection control. We’ll place dark eye-glasses for your protection, moisten your lips with antibiotic cream, and ask you to rinse with an antiseptic mouthwash. In no time, your procedure is complete, and we escort you to our awaiting chauffeur with care package filled with an assortment of goodies. From an ice pack to post-care instructions and a nutritional supplement. We’ve thought of everything.

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After you leave, we won’t sleep well until we know you are well on your way to recovery. That evening, we’ll call you to check on you and answer any questions or concerns you might have. And of course, Doctor Ali is available 24/7 if the need arises.

Unit 6. First Aid Manual Physicians believe that many deaths can be prevented with the proper use of CPR or “Cardio Pulmonary Resuscitation”. The rescuers should first check for signs of breathing and pulse. If neither is present have someone fun for help. Meanwhile, the rescuers should position the victim on their back. Turning the victim’s head to the side and remove any foreign objects from the airway. Then, tilt the victim’s head back. Pinch the victim’s nostrils closed. Inhale deeply, and place the rescuer’s mouth over the victim’s to form a tight seal. The rescuers should exhale twice slowly into the victim’s mouth until the chest rises. The rescuers should bend with arms held straight up and down. Press fifteen times on the middle of the victim’s chest alternating this compression with mouth to mouth resuscitation for nine to eleven seconds or until breathing resumes. After completing four cycles of CPR, the rescuers should check for any signs of breathing or pulse. If there is a pulse but no breathing, continue rescue breathing. If the victim has neither pulse but no breathing, continue CPR as necessary.

Unit 7. Home safety Crystal Park: This is the Army Today. Is your home ready for an emergency? Tips on how to make your home a safer place. Home safety should be an everyday concern for everyone, no matter where you live. But deaths and injuries resulting from home safety issues are all too common. Mari-K Apee: It’s a really big problem, resulting in almost twenty thousand deaths and more than twenty one million medical visits on average each year. Crystal Park: A survey conducted by the Home Safety Council found that people are aware of the issue, but are doing little to address it. Mari-K Apee: The majority told us that they think a lot about home safety, but very few reported actually taking steps to make their home a safer place. Crystal Park: The top five causes of home injury deaths are: falls, poisonings, fires, choking and suffocation, and drowning. The Home Safety Council lists some simple ways you

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can make your home safer. To prevent accidental falls, install a second handrail. Also placing night lights around the home will help when you navigate around the house at night. Be sure to write down the phone number for poison control in case of an emergency. Post emergency phone numbers clearly where they can be easily read. Securely lock any poisonous materials away where children cannot access them. To prevent injuries from fires make sure the batteries in your smoke detector are working. Replace all batteries and regularly test the smoke detectors to make sure they are functioning properly. Check out the Home Safety Council’s webpage at www.homesafetycouncil.org for more practical and simple advice on how to be hands on home safety. That’s the Army Today from the soldier media center in Washington. I’m Crystal Park.

Unit 8. Safety orientation nursing Speaker: Welcome to our great team of professionals. We are proud of our organization and all of our employees. Today we are going to provide some basic safety information, so you may better understand your safety responsibilities, and to help you became safer and healthier employees. You may not realise it, but you are the most important part of any safety program. Each individual must make hundreds of independent decisions on a daily basis, that must always reflect somehow on the well-being of all employees. By using good judgement each individual can make your work environment clean, efficient and, of course, safe and healthful. Regardless of your job, safety is an integral part of your responsibility, which means: no matter the task you perform, safety must be a vital concern. Let´s begin with some basics. The health-care environment can be hazardous to your health if you neglect safety rules, policies and procedures. The first step is to learn these policies and procedures, then apply them on a daily basis for each assigned task. We understand that your work is fast-paced. You are busy, there are many things to do; but if you maintain a safety attitude, you’ll make the right decision when the time comes to perform all your jobs safely. In the health-care industry, back injuries are the major type of injuries. You can prevent them by learning how your back works, and by using your body correctly to maintain your back’s three natural curves. Infection is a risk all health-care providers share, but infection is also a risk to your co-workers and patients. Prevent the spread of infection by following infection control procedures and techniques, such as frequent washing of your hands, appropriate protected clothing where required, and avoiding needle sticks.

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Modern health-care procedures help you to take your patients better and more safely, but these procedures often involve hazardous substances that are potential risk to you unless you know how to prevent exposure. The health-care environment is a 24-hour-a-day business, where routine tasks alternate with emergencies. The potential for accidents is everywhere, but if you have a good attitude and think safety first, you can prevent accidents from occurring. Certainly this program cannot cover all possible potential hazards...

Unit 9. Global Plan - 5 pillars for the Decade of Action for Road Safety Etienne Krug: We have a clear a plan for the decade. And it is really a plan that emphasizes working in countries, with countries to strengthen road safety. We’ll work on five different pillars. We’ll work on the management of road safety making sure there is a lead agency, there is a data collection system, we will work on improving infrastructures, the roads, improving vehicle safety, changing people’s behaviour to make sure they don’t drink and drive, they put their seatbelts, they don’t speed and finally improve the trauma care, the post-crash response. It is a problem that can be tackled. We have cost-effective solutions. Ban Ki-moon: This U.N. decade of action for road safety provides good policies. We have good tools. We have also good knowledge. We have to build safer roads, and safer vehicles. Therefore, we need to have a concerted effort. If we live by example, we can save millions and millions of lives. Michael Bloomberg: You know the “make roads safe” campaign was really the impetus to get going the U.N. decade of action for road safety, and if in this decade we can focus on a few simple things… because there are solutions and they are measurable and implementable. Fred Wegman: I’m very much in favour of a system approach, and design the system in such a way that the risk of serious injuries or of fatalities is very very low indeed. How to diminish kinetic energy in crashes and to reduce speed when you have a potential crash between a car and a, and a pedestrian so the system approach is applicable all over the world, not something for developed countries. You can apply everywhere… Lord Robertson: It’s very important that we translate the awareness that we have now created in this issue into some real and genuine action that involves every section of the community. So we are hoping that this will bring in the private sector, it will bring in the corporate sector, it will bring in philanthropic organizations who now know that there is an epidemy that it’s the biggest single killer of young people in the world today; and that there are ways on which it can be prevented, and that there are remedies: better roads, seatbelts, crash-helmets and action against speeding and against drinking. These are all areas in which we can reduce this massive toll of misery and death that road crashes produce.

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Unit 10. ER Safety Narrator: Every week in the United States between eight and thirty percent of emergency department nurses are victims of physical violence, according to a new study released by the Emergency Nurses Association. Elizabeth McCoy: It’s been kind scary. We have had nurses that were severely injured, from violent acts towards them. It makes you feel frightened. It makes you scared to come into your job sometimes because you just don’t know if you’re going to get hurt like, you know, it’s not like a police officer. We wear a vest and you’re expecting something to happen. We don’t do that, we just want to get care, we’re not thinking about always protecting ourselves. Narrator: Elizabeth McCoy is a nurse at the emergency room at Morristown Memorial for close to fourteen years. Elizabeth McCoy: There have been broken necks, there have been stabbings, there have been some very acute injuries were our staff members weren’t able to come back to work. Narrator: More than half the nurses surveyed by ENA reported experiencing physical or verbal abuse at work in the last seven days. Emergency department violence survey study also found that fifty percent of the nurses who reported experiencing physical violence said they sustained a physical injury as a result of the incident in enormous half the cases no action was taken against the perpetrator. Dr. Mary Kamienski: People suddenly come into the emergency department I’m an emergency nurse… Narrator: Dr. Mary Kamienski is currently serving as a member of the ENA Board of Directors. Dr. Mary Kamienski: Emergency nurse violence is… it is such an issue that is a part of our strategic plan of the National Emergency Nurses Association to make the workplace safe for emergency nurses and all the other personnel there. And it isn’t just an issue for emergency nurses or health-care personnel that are working in the department, because every patient in that department, if there is violence going on in there, they are also a risk. There’s a lot of strategies that we teach nurses and we teach health-care personnel things such as if the person is drinking or under the influence, you don’t get cornered in the room with them. Those are just safety precautions. Narrator: Having an enclosed nurses’ station, security sites and well-laid areas are associated with significantly lower verbal abuse rates. Elizabeth McCoy: On all our nursing and emergency department, you can only have access if you work here and have appropriate privileges to be in the emergency department, and this helps prevent on patients and people who should not be in here.

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Narrator: Nurses working in emergency departments at hospitals with policies regarding violence reported experiencing fewer incidents of physical or verbal violence. Elizabeth McCoy: We’ve had our secretaries, our tax, our nurses trained, in several different venues where the main one is the nurse safe training on that we have and it has been very very successful. Everyone’s been very happy with that, because it teaches us how to get out the whole how to get out restraints and you really don’t have to think about it. This patient, who has an altered mental status, and increased aggression, and I was going to medicate her in order to calm her down and she grabbed my arm and in the nursing training they teach us how to grab out their hand and pull out so that I can pull out away, so I don’t hurt the patient but I’m able to get away. The patient was trying to choke me. So one of the things we are taught to get away from the choke is to take our heel and slide it down vision of the leg. We are going the opposite direction of the nerve endings, so this elicits a lot of pain and should back away and let go. I approach the patient in the room, her mental status and her aggravation level has increased. She had clenched fists. She had her arms ready to hit me. The best thing to do is to get out of the situation. The patient feels cornered, and the patient doesn’t feel like she is in control anymore, so the best thing to do is always try to get out of the situation if you can. Narrator: The emergency department violence surveillance study also found that patients and their relatives were the perpetrators of the abuse in nearly all incidents of physical violence. Additional information is available at ENA’s website, which is www.ena.org. Dr. Mary Kamienski: A big goal is that it will be a felony offense in every emergency department in the United States. It is in New Jersey it’s a felony offense if you physically abuse or assault an emergency nurse or health-care worker. Note: ENA: Emergency Nurses Association.

Unit 10. Transporting sick and injured patients Nick Tovo: Critical care medical personnel in the Pacific, learning how to get patients ready for air medical evacuation. LtCol (Dr.) Linda Vu: The teams are made up of three personnel typically a critical care physician, critical care nurse, and a respiratory therapist or a paramedic. Nick Tovo: Medics practice operating intensive care equipment. LtCol (Dr.) Linda Vu: The ventilator, suction, monitor, defibrillator, bloody analyzer and then triple-channel ID pump.

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Nick Tovo: Once in flight the plane is the hospital and these medics have only one chance to get patients ready on the ground. LtCol (Dr.) Linda Vu: Safety first, and that’s a lot of what we’re teaching them here is how to package up their patients. Nick Tovo: Captain Natalie Baldauf has never worked with the patient in the air or this type of equipment. Cap. (Dr.) Natalie Baldauf: I think the most challenging thing. For me as I’m a general pediatrician, so that is more critical care medicine. Nick Tovo: Working in the Pacific she has to learn new ways to operate. Cap. (Dr.) Natalie Baldauf: For us on Guam… and we often have patients that need a higher level of care, so these courses really help me know what to prepare for and how to prepare for those transfers. Nick Tovo: These are jointly life-saving missions carried out by the US military and its allies in the Pacific. LtCol (Dr.) Linda Vu: It’s very important throughout our theatre just because we don’t have an ability to transport all critical care patients in this theatre safely without the assistance of our maybe an army, an air force military medical personnel. Nick Tovo: Preparing patients on the ground, to keep them alive in the air. Nick Tovo, Hickam Air Force Base, Hawaii.

Unit 11. Australian Public and Private Health-care System Ever wondered how it works when we get sick or need medical help? In Australia, we are looked after by a health system that has two parts. The public part, run by the government through Medicare, is paid for by our taxes. When someone like Alison, for instance, gets sick and needs to see a doctor or specialist, get medical tests like X-rays or blood tests, take prescription medicines, or be treated in a public hospital, our tax money helps pay for it. There’s a few things to remember about public health and Medicare. Alison won’t pay anything to go to a public hospital, but she won’t get to choose which hospital or which doctors treat her. She might have to go on the public hospital waiting list, and wait a while for a treatment, although if it’s an emergency she’ll be treated straight away. Medicare doesn’t usually cover the full cost of doctors’ visits, tests and prescription medicines, so Alison might have to pay some money towards them. The private, or non-government part of the health system, is made up of private hospitals, health insurance companies, and other health providers like dentists. If someone like Ray

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here gets sick and wants or needs things like treatment in a private hospital, ambulance trips, dentistry or eyeglasses and treatment like physio and acupuncture, he can get them through the private health system, and pay for them himself or get private health insurance to help cover the cost. There are some things to remember about the private health system too. Ray won’t have to wait on a public hospital waiting list. He can choose which hospital and which doctors treat him, and he may get his own room. Well, Medicare will pay part of Ray’s doctors’ bills. He’ll have to pay for everything else. If he joins a health insurance fund to help pay for his treatment, he might have to wait a while before he is covered; that’s called a waiting period. So, that’s how it goes. The public health system provides a basic level of health-care, our taxes pay for some, or all of it, and they can be waiting lists for public hospitals. The private health system provides things the public system doesn’t. There is no public hospital waiting list, but you pay for things yourself, or through private health insurance. That’s it for now. Look after yourself, we’ll see you around.

Unit 12. Women’s and children’s services at Kettering Medical Center Narrator: The birth of a baby is nothing sort of a miracle. Welcome to Precious Beginnings at Kettering Medical Center. We believe families deserve special attention during this precious time. Having a baby is an extraordinary experience, and it all starts with Precious Beginnings at Kettering Medical Center. Miriam Cartmell: Hello, I’m Miriam Cartmell, Administrative Director for Women’s and Children’s Services at Kettering Medical Center. Our entire staff is committed to providing you quality care while you are pregnant, during your birthing experience, and when your new family returns home. We are here for you, every step of the way. Narrator: Our birthing classes and programs for the expecting couple and the entire family are unsurpassed. We will help prepare you for the birth of your baby, through a wide selection of classes, including basic childbirth education, breastfeeding, tobacco cessation and infant/child CPR and choking prevention. For an extra especial touch during this exciting time in your life, we offer our unique Stork Club for those who are planning to deliver here at Kettering Medical Center. This includes monthly newsletters, ‘Moms in Motion’ exercise class, a child care class and the mommy network series. You will also receive a gift bag during your stay, and a gift certificate for a postpartum massage. Precious Beginnings, Kettering Medical Center maternity unit clearly delivers the area’s most compassionate and competent birthing care. When the big day arrives, we are committed to meeting you and your baby’s unique needs.

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From our private, home-like labour and delivery suits to our skilled and compassionate staff, everything we do is focused on providing excellent care for you and your baby. Our labour and delivery suits are spacious and have a family-centered home-like environment. We provide 24-hour anesthesiology for mothers who wish to have an epidural. Our Precious Beginnings “Doula” program seeks to nurture the mother and family at the time of the baby’s birth. “Doula” is a Greek word that refers to a woman experienced in childbirth who provides continuous physical, emotional and informational support before, during and just after childbirth. We have experienced doulas on staff to facilitate the birthing experience. And when your baby is born our entire hospital rejoices. Every birth is announced with the playing of the Brahms’ lullaby across the public address system as we celebrate a new life. Parents can be assured that our level 2 special care nursery has 24-hour neonatology coverage to care for those babies needing extra care and attention. Our especial care nursery is equipped with a special webcam that allows you to view your baby in real time via the Internet, day or night. Seeing your baby on the web camera can provide extra confidence reassurance at those times when you cannot be at your baby’s side. Only Kettering Medical Center offers a web camera to our special-care families. After your delivery, you will be taken to a mother-baby unit when the same nurse that cares for you will also care for your baby. For breast-feeding mothers, a lactation consultant is available each day. Following your return home, outpatient visits may be scheduled in the lactation consultant office. Our excellent care continues even when you and your baby are ready to go home. Kettering Medical Center is proud to offer our Precious Beginnings home program where newly discharged mothers and babies are visited at home by a mother-baby nurse. The visit gives new parents peace of mind of the baby can be checked soon after discharge in the comfort of their home. Families tell us this eases the transition from hospital to home, for both infant and mother. After the birth of your baby, the online baby gallery gives new moms and dads an opportunity to share their new addition with family and friends, who can turn post personalized greetings to your new-born page through our secure website. Miriam Cartmell: Many new parents have questions about caring for a new baby. Kettering Medical Center offers the new parents’ Answer Line to assist the new mom or dad with questions or concerns that arise after you return home. The answer line is staffed 24 hours each day with registered nurses who specialize in maternal and new-born care. You can have peace of mind knowing that we are only a phone call away. Narrator: We are committed to providing the best childbirth experience possible. Kettering Medical Center Precious Beginnings. We are here for you every step of the way.

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Unit 12. Washington Primary Care Center Staff member: The big advantage here is that it’s just local, and the patients previously in Washington have to travel into Sunderland to track this sort of service so, we are really finding that the local community are really appreciating having something along these lines on they’re doorstep. The advantage of the walk-in center here is that patients can just walk in. They don’t need to phone up and arrange an appointment, and for many patients that’s a big advantage. For some, just the barriers and anxieties of phoning up and arranging an appointment are quite difficult. The times of opening, particularly in the evenings… patients find it very useful being able to pull in up to eight o’clock in the evening. We work as a team of GPs and nurses working closely together, and between us we provide a very comprehensive service. Really anything is seen. We find particularly children’s service is appreciated by the patients and often we do find that, although they may come with an acute problem, it’s very much linked with their chronic and long-term conditions. Patient 1: When I was actually, I was shopping in the galleries with the wife and then I started getting heavy pains down my left arm. So I just said to the wife I’ll have to go somewhere and get this seen. I am going to go to that shopping center over the road they put us on ASG. My blood pressure was sky high, but within ten minutes the ambulance was out the front and that was it. I was whisked off. Staff member 1: Working in the walk-in center here we are very aware of the other services that are provided, and it’s good to integrate with the, for instance, the renal dialysis and chemotherapy services. We work with them, and if they are patients there with a minor illness that needs to be seen the same day it’s good to be here to provide that. Patient 2: For me, I leave five minutes away, I can walk here. That’s such a big advantage plus the fact that for me the staff’s even more efficient here. An average session for me is four hours to fill my time in I bring a book, have the telly. It’s a real big advantage for me to be here. Patient 1: It’s easy to get to and it’s right in the heart of the community. Patient 2: It’s a convenient relaxed environment with no waiting around and it’s very friendly. Patient 3: There’s a plant and nurse-led service for chemotherapy patients. Staff member: We are a local GP-led, minor injuries and illness walk-in center, providing high-caliber comprehensive services connected with the community.

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