1 MIDDLE EAST TECHNICAL UNIVERSITY ENGLISH PROFICIENCY EXAM CAREFUL READING AND VOCABULARY PART PRACTICE MATERIAL MAY 2024 SET II
2 TEXT I A Ask people how they feel about getting older, and they will probably reply in the same vein as Maurice Chevalier: “Old age isn't so bad when you consider the alternative.” Stiffening joints, weakening muscles, fading eyesight and the clouding of memory, coupled with the modern world's careless contempt for the old, seem a fearful prospect—better than death, perhaps, but not much. Yet mankind is wrong to dread ageing. Life is not a long slow decline from sunlit uplands towards the valley of death. It is, rather, a U-bend. B When people start out on adult life, they are, on average, pretty cheerful. Things go downhill from youth to middle age until they reach the lowest point commonly known as the mid-life crisis. So far, it is a familiar story. The surprising part happens after that. Although as people move towards old age they lose things they treasure—vitality, mental sharpness and looks—they also gain what people spend their lives pursuing: happiness. This curious finding has emerged from a new branch of economics that seeks a more satisfactory measure of human well-being than money. Conventional economics considers money as the main value, but some economists, unconvinced that there is a direct relationship between money and well-being, have decided to go to the heart of the matter and measure happiness itself. C There are already a lot of data on the subject collected by, for instance, America's General Social Survey, Eurobarometer and Gallup. Surveys ask two main sorts of question. One concerns people's assessment of their lives, and the other how they feel at any particular time. The first goes along the lines of: thinking about your life as a whole, how do you feel? The second is something like: yesterday, did you feel happy/contented/angry/anxious? The first sort of question is said to measure global well-being, and the second hedonic well-being which is connected to the feelings of pleasure. They do not always elicit the same response: having children, for instance, tends to make people feel better about their life as a whole, but also increases the chance that they felt angry or anxious yesterday. Statisticians trawl through the vast quantities of data these surveys produce rather as miners looking for gold. They patiently separate the valuable metal from pebbles and sand. Their aim is to find the answer to the perpetual question: what makes people happy? D Four main factors seem to play a role: gender, personality, external circumstances and age. There has been a growing interest in the last factor, the effect of age on happiness. Andrew Oswald, professor of economics at Warwick Business School, says that a number of economists have been looking into it since the 1990s. The U-bend appears in research results all over the world. David Blanchflower, professor of economics at Dartmouth College, and Mr Oswald looked at the figures for 72 countries. The lowest point varies among countries, but in the great majority of countries people are at their unhappiest in their 40s and early 50s. The global average is 46. The U-bend shows up in studies not just of global well-being but also of hedonic or emotional well-being. Research breaks well-being down into positive and negative feelings and looks at how the experience of those emotions varies through life. Enjoyment and happiness dip in middle age, then pick up; stress rises during the early 20s, then falls sharply; worry peaks in middle age, and falls sharply thereafter; anger declines throughout life; sadness rises slightly in middle age, and falls thereafter.
3 E There is always a possibility that variations are the result not of changes during the life-course, but of differences between cohorts – groups of people who share distinct characteristics. For example, an 80-year-old European may feel differently from a 30-year-old not because he is older, but because he grew up during the second world war and was thus formed by different experiences. But the accumulation of data undermines the idea of a cohort effect. Americans and Zimbabweans have not been formed by similar experiences, yet the U-bend appears in both their countries. And if a cohort effect were responsible, the U-bend would not show up consistently in 30 years' worth of data. F Another possible explanation is that unhappy people die early. It is hard to establish whether that is true or not; but, given that death in middle age is fairly rare, it would explain only a little of the phenomenon. Perhaps the U-bend is merely an expression of the effect of external circumstances. After all, common factors affect people at different stages of the life-cycle. People in their 40s, for instance, often have teenage children. Could the misery of the middleaged be the consequence of sharing space with angry adolescents? And older people tend to be richer. Could their relative contentment be the result of their piles of cash? The answer, it turns out, is no. The use of control groups for money and children in experiments shows that the Ubend is still there. So the growing happiness that follows middle-aged misery must be the result not of external circumstances but of internal changes. G There are various theories as to why this might be so. Laura Carstensen, professor of psychology at Stanford University, talks of “the uniquely human ability to recognize our own mortality and monitor our own time horizons”. Because the old know they are closer to death, they grow better at living for the present. They come to focus on things that matter now—such as feelings—and less on long-term goals. Prof Carstensen argues that “when young people look at older people, they think how terrifying it must be to be nearing the end of your life, but older people know what matters most.” There are other possible explanations. Maybe the sight of contemporaries dying suddenly fills survivors with a determination to make the most of their remaining years. Maybe people come to accept their strengths and weaknesses, give up hoping to become chief executive or have a painting shown in the Royal Art Academy, and learn to be satisfied as assistant branch manager or with their watercolor on display at the local shopping mall. Perhaps acceptance of ageing itself is a source of relief. “How pleasant is the day”, observed William James, an American philosopher, “when we give up striving to be young—or slender.” H __________. Happiness doesn't just make people happy it also makes them healthier. John Weinman, professor of psychiatry at King's College London, monitored the stress levels of a group of volunteers and then inflicted small wounds on them. The wounds of the least stressed healed twice as fast as those of the most stressed. At Carnegie Mellon University in Pittsburgh, Sheldon Cohen infected people with cold and flu viruses. He found that happier types were less likely to catch the virus, and showed fewer symptoms of illness when they did. So although old people tend to be less healthy than younger ones, their cheerfulness may help counteract their crumbliness. From: www.theeconomist.com
4 1. How does paragraph A relate to paragraph B? a) Paragraph A presents the main point and paragraph B provides a brief explanation for it. b) Paragraph A gives some examples that contrast with the idea stated in paragraph B. c) Paragraph A introduces a famous quote and paragraph B gives details about its relevance. 2. What can be inferred from paragraph C about the search through the data obtained from surveys? a) The results show that people answer different types of questions in similar ways. b) There isn’t enough information about what people feel at a particular time. c) Finding responses directly relevant to the question of happiness is a long and difficult process. 3. What is the purpose of paragraph D? a) To point out the U-bend as a general trend observed in research results in the world b) To discuss the opposing views of economists on what the U-bend represents c) To give the reasons why people experience different emotions at different ages as shown in the U-bend 4. Which idea does the writer try to prove by giving evidence in paragraph E? a) People ‘s experiences change a lot depending on which country they live in. b) People’s feelings change mainly because of the stages of life they are going through. c) People from different cultures have similar feelings when they have disastrous experiences. 5. What is the writer’s main argument in paragraph F? a) Unhappy people die young because of poor health, so only happy people reach old age. b) Having children and being poor are the main factors that increase the level of unhappiness at young age. c) Common external factors that seem to affect happiness do not in fact change the feelings throughout the life cycle. 6. Which approach do the quotes by Carstensen and James in paragraph G support? a) Increasing your efforts to be strong in the face of difficulties b) Feeling relaxed and free after giving up your ambitions c) Continuing in your career path despite feeling old and weak 7. Which statement best fits as the first sentence of paragraph H?
5 a) The implication of the U-bend is that the old can be more productive despite their poor health. b) Whatever the causes of the U-bend, it has consequences beyond the emotional. c) The old are better at controlling their emotions and feel less stressed. 8. What does the word “contempt” in the text mean? a) The neglect of the required action b) A gradual loss of strength c) A strong feeling of lack of respect 9. What does the word “conventional” in the text mean? a) traditional b) advanced c) statistical TEXT II A Simply put, a lucid dream is one in which the person is aware that they’re dreaming and can either exert some control over the dream, or passively observe its unfolding while maintaining awareness that it’s a dream. This gives the dreamer an opportunity to potentially influence their dream life—perhaps by consciously interrupting a nighttime narrative to rescript a new outcome—which can be especially helpful for reducing the frequency of nightmares in those who have them, according to research in a 2023 issue of Encephale. Research has also found that engaging in lucid dreaming can help people reduce the severity of their insomnia, along with symptoms of anxiety. “Some people who have lucid dreams don’t want to alter the dream; they want to explore the dream and see what it offers them,” notes Antonio Zadra, a professor of psychology at the University of Montreal and co-author of When Brains Dream. “It’s a way of exploring your own mind and opening opportunities to engage with different parts of your psyche.” There’s also entertainment value in lucid dreaming, says Benjamin Baird, a cognitive neuroscientist and a research professor at the University of Texas at Austin. “It’s like having your own form of virtual reality.” B Although the history of the awareness of dream states dates back centuries, it wasn’t until 1913 that the Dutch psychiatrist Frederik Van Eeden coined the term “lucid dream,” based on his own experiences. In the 1980s, researchers, including Stanford psychophysiologist Stephen LaBerge, proved that lucid dreaming was a phenomenon during REM (Rapid Eye Movement) sleep. Dreamers were asked to move their eyes in distinct patterns when they became lucid during their dreams and their pre-arranged eye signal was measured with electrooculogram recording. C Practitioners of Tibetan Buddhism have long believed that people can train to be lucid while dreaming through a practice called dream yoga. “All dream yoga is lucid dreaming,” explains Michael Sheehy, a Tibetan Buddhism scholar. “The difference is, in dream yoga, you’re
6 intentionally performing meditative techniques while you’re in the dream. You’re aware of what you’re doing while you’re dreaming and you’re doing things you can’t normally do when you’re awake.” These intentional actions include making unusual objects appear in your dream, transforming the dream’s environment or location, or transforming one item into another, he explains. After the dream, “you may experience cognitive flexibility, realizing how easily you can change your thoughts and mindset or how you perceive your circumstances. And you can imagine new possibilities, perspectives, and situational outcomes,” Sheehy says. D As far as the potential benefits of lucid dreaming go, they range from the scientific to the personal and the therapeutic. “Traditionally, it’s been very difficult to study dreams—you’re trying to correlate reports of dreaming with what was going on physiologically in the brain,” says Baird. With techniques developed to induce eye movements and lucid dreams during REM sleep, researchers can essentially mark the start and end of a lucid dream, “which allows for clear association of subjective reports with brain physiology reports, which used to be impossible,” he explains. On a personal level, lucid dreams can enhance creativity and contribute to people’s well-being by helping them learn things about themselves that they wouldn’t otherwise know. “They can learn skills, come up with answers to problems, and experience spiritual transformation,” says Ken Paller, a neuroscientist at Northwestern University in Illinois. E Christopher Mazurek heard about lucid dreaming when he was in high school and tried for a year and a half to do it based on a book he read. (I)It wasn’t until he volunteered in Paller’s lab in 2019, as a college student at Northwestern, that Mazurek had his first lucid dream. The lab uses the targeted memory reactivation technique, in which specific sounds are used to provoke a lucid dream while the person is asleep. (II) Preliminary research suggests there is greater activity in the brain’s prefrontal cortex which regulates executive functions, such as thinking and problem-solving, and emotions. Once he was able to do it, Mazurek’s lucid dreaming was particularly healing; his grandparents had recently passed away and he was able to talk to them in his lucid dreams.(III) “It was powerful and it helped me process my grief,” says Mazurek, who is now a research assistant at Northwestern University. “It was an exhilarating, rewarding experience.” F Lucid dreaming also offers people opportunities to practice their skills. Research has found that practicing motor skills in lucid dreams is a form of mental rehearsal that improves subsequent performance in sports or games in real life. Meanwhile, on a therapeutic level, lucid dreaming has been found to help with insomnia and nightmares. If someone has recurrent nightmares and learns how to engage in lucid dreaming, they can recognize that they are dreaming, that what they’re experiencing isn’t real, and possibly change the dream’s outcome. “This can be a powerful transformative experience, helping them reach some level of resolution or healing,” Baird explains. In a study published in the journal Sleep Advances, researchers examined and analyzed 400 posts on a lucid-dreaming discussion forum and discovered both positive effects and negative experiences. On the upside, many people reported dream enhancement, waking up in a positive mood, and fewer nightmares. On the negative side, people reported feeling paralyzed—unable to yell or move—or having trouble distinguishing whether they were asleep or really awake, and less restorative sleep. “Some people don’t want to have lucid dreams—they just want to sleep,” says Remington Mallett, a
7 cognitive neuroscientist at the Center for Advanced Research in Sleep Medicine at the University of Montreal. If you decide to try lucid dreaming, a prerequisite is to have fairly good dream recall, experts say. “If you keep a dream journal, you will start to have better dream recall,” Mallett says. From: www.natgeo.com 10. According to paragraph A, which one of the following is true about the research carried out on lucid dreaming? a) Research shows that lucid dreaming has beneficial effects from different aspects. b) There is disagreement among researchers about the need to interrupt a lucid dream. c) There are contradictory results in research about the benefits and harms of lucid dreaming 11. From the historical information given in paragraph B we learn that _________. a) the term “lucid dream” was used for the first time in the second half of the 20th century. b) the link between REM and lucid dreams has been known for centuries. c) it was in the 1980s that researchers observed lucid dreamers in experimental conditions. 12. According to paragraph C, what does the practice of dream yoga consist of? a) It is a meditative technique that helps you remember different places you have been to and unusual objects you have seen. b) It is an exercise that allows you to shape the environment and the place of your dream and the objects that appear in it. c) It is a way to take a break from your real circumstances by dreaming about beautiful locations and environments. 13. According to paragraph D, how do the new techniques contribute to the work on lucid dreaming? a) They give to the subjects the flexibility to end their dreams whenever they want during the experiment. b) They facilitate the recording of physiological changes in the brain during lucid dreams. c) They make people feel better after they have had lucid dreams in researchers’ labs. 14. Which sentence does NOT belong in paragraph D? a) (I) b) (II) c) (III)
8 15. As we understand from paragraph F, lucid dreamers can reduce the frequency of their nightmares by ___________. a) noting them regularly on a dream diary b) doing mental rehearsals of their nightmares during the day c) acting on the story of their nightmare and changing it 16. What does the word enhancement in the text mean? a) Improvement of the quality or strength of something b) The process of coming into existence c) The action of making a judgment about something 17. What does the word restorative in the text mean? a) demanding b) thrilling c) healing
9 TEXT III A Until recently, the story of our origins was thought to be settled: Homo sapiens evolved in eastern Africa about 150,000 years ago, became capable of modern behavior some 60,000 years ago and then swept out of Africa to colonize the world, completely replacing any archaic (prehistoric) humans they encountered. But new fossils, tools and analyses of ancient and modern genomes are tearing apart that neat story. “Should we be thinking of a completely different model?” asks Robert Foley, a paleoanthropologist at the University of Cambridge. “Shall we abandon the out-of-Africa theory?” B The out-of-Africa model briefly described above and to which Foley refers has become so entrenched that it is easy to forget how new it is. For decades before its emergence, human origins research was dominated by the early characters in the story: Homo erectus, for example, including “Peking Man”, unearthed in 1929; or Australopithecus afarensis, the famous “Lucy” discovered in Ethiopia in 1974. There was some debate about where modern humans appeared, and ideas were floating around a recent African origin, but the fossil record seemed to support a model called multi-regionalism. This argued that archaic humans were distributed across Africa and Eurasia at least a million years ago and evolved in parallel into modern humans. C Then, in1987, a bombshell fell. A team of geneticists at the University of California, Berkeley, sequenced 147 mitochondrial genomes from living people around the world. The mitochondria in cells are inherited from mothers only, and the study indicated that everyone was descended from a single woman– dubbed “mitochondrial Eve” –who probably lived in Africa about 200,000 years ago. The result was very influential, says Foley. It was quickly formulated as a model called the “recent out-of-Africa” theory, the idea that modern humans appeared quite abruptly in eastern or southern Africa sometime between 150,000 and 200,000 years ago and later went on to conquer the world. The theory also introduced the distinction between anatomical and behavioral modernity. Based on archaeological evidence, it looked as though early homo sapiens had bodies like us but weren’t as advanced mentally. Only later, about 60,000 years ago, did they fully evolve, which made their dispersal out of Africa possible. This neat, compelling narrative became known as “the human revolution”. D For a while, the fossil evidence supported this story. Although remains from the crucial time of about 150,000 years ago were absent, there were several older human skulls that seemed to fit the idea. One of the most distinct features of modern humans is the shape of our heads. Compared with our extinct ancestors, we have small, flat, delicate faces, prominent chins and spherical braincases. A skull with all or most of these features will generally be classified as belonging to our species. Two of the oldest-known complete skulls with hints of this anatomy were discovered by Richard Leakey and his team at Omo-Kibish in southern Ethiopia in 1967. Known as Omo I and Omo II, they are now dated to about 200,000 years old and have a mixture of archaic and modern features – exactly what you would expect of an archaic African human shortly before the evolution of anatomical modernity. Several other specimens from around eastern and southern Africa told a similar story until the end of 1990s.
10 E It has been finished and decided, you might think, with nothing more to be said and done. But the discoveries since the end of 1990s have been almost impossible to slot into this neat little box. In addition, the reevaluation of some early fossil discoveries has urged researchers to question the “recent out-of-Africa” theory. One of the most important of these is known as the Jebel Irhoud fossils. In 1961, in Jebel Irhoud, Morocco, a miner discovered a near-complete human skull in the foothills of the Atlas Mountains. Archaeologists who investigated it found that the skull was old, but not that old. It was filed away and largely forgotten. Back then, researchers noted that the skull had modern facial features – a flat and delicate face, and a prominent chin– together with an archaic, lengthened braincase. The skull went through the dating procedures of the time and researchers put it at around 40,000 years old. It was classified as maybe belonging to an African Neanderthal or a remaining population of an archaic human species. But doubts about the dating persisted and, in 2004, a team led by Jean-Jacques Hublin of the Max Planck Institute for Evolutionary Anthropology in Germany reopened the site. The researchers hoped to get a more accurate date. When the date came back, it was shocking: 315,000 years old, plus or minus 34,000 years. F This was a serious challenge to the out-of-Africa idea. “Anatomically, Jebel Irhoud fossil belonged to a creature which is an early homo sapiens, thus a modern human,” says Foley. “And yet it lived at least 130,000 years before homo sapiens was meant to have evolved, at a time when our distant ancestors were thought to still bang rocks together in eastern or southern Africa. The Jebel Irhoud site is also marked by the discovery of a finer and more varied toolkit than the one produced by earlier human species. These tools indicate behavioral and cultural development and present evidence of earlier-than-expected technological progress. New dating from Irhoud and old sites such as Olorgesailie in Kenya suggests that the transition to modern minds happened as far back as 320,000 years ago. When the new Jebel Irhoud dates were published in 2017, they inspired a major rethink of other fossil skulls from around the same time. It turned out that these told a similar story. (I) Originally excavated in the mid-1980s, Olorgesailie is a site known for stones rather than bones, specifically an abundance of prehistoric tools. (II)The Florisbad specimen from South Africa, for example, is about 260,000 years old, yet has a surprisingly modern face. (III)The same thing is true for some skulls from Laetoli in Tanzania and two locations in Kenya, Guomde and Eliye Springs. All possess a variety of modern and archaic features – but, oddly, are also very different from one another. G It looks as though the transition to modern human behavior and mental capabilities happened right at the start of the Homo sapiens journey, or maybe even before it. There is no longer any support for the out-of-Africa theory, which claims that humanity became physically modern first, but behavioral modernity didn’t evolve until much later. “I think the two-step model is dead,” says Foley. From the stones and bones of Jebel Irhoud and elsewhere, a new and increasingly mainstream view of human origins is emerging. It is called “African multi-regionalism”. This new view doesn’t completely overturn the current model. The continent is still the cradle of humanity – although, as Foley points out, “saying humans evolved in Africa doesn’t mean very much, it’s a vast area” – and humanity did disperse out of Africa to eventually inhabit the entire world. But the idea of a recent, localized origin within a separate population has been buried. In
11 its place is a much deeper origin story beginning at least 300,000 years ago, and perhaps as many as half a million years. From www.newscientist.com 18. As we understand from paragraph A, the new evidence from archaeological sites ________. a) allows researchers to give a specific date for the appearance of Homo sapiens b) challenges a well-established view about humans’ origins and development c) confirms that there was a larger variety of human species than previously thought 19. According to paragraph B, which view of human origins did the fossils “Peking man” and “Lucy” support? a) The out-of-Africa model b) The model called multi-regionalism c) The appearance of modern humans limited to Africa 20. According to paragraph C, which one of the following is part of the “recent out-ofAfrica” theory? a) The mentally developed modern human appeared only about 60 000 years ago. b) Our ancestors who lived about 150 000 years ago were anatomically different from us. c) Modern humans’ ancestors spread out of Africa before they evolved into Homo sapiens. 21. How does paragraph D relate to paragraph E? a) Paragraph D describes the fossil evidence that supported a mainstream theory whereas paragraph E introduces evidence against the same theory. b) Paragraph D gives examples of fossil record that helped formulate a theory and paragraph E confirms this theory by presenting further fossil evidence. c) Paragraph D introduces a new theory of anatomical evolution of humans and paragraph E supports that theory by citing recent research.
12 22. According to paragraphs E and F, the significance of the discovery in Jebel Irhoud is that although the skull had modern human features, __________. a) it has been recently shown to belong to a Neanderthal population b) recent research has determined that it didn’t belong to a modern human c) it belonged to an era earlier than the first appearance of Homo sapiens 23. Which one of the following statements does NOT belong in paragraph F? a) (I) b) (II) c) (III) 24. What does Foley refer to by the “two-step-model” in paragraph G ? a) Modern humans first appeared in Africa and then evolved after they had spread to the world. b) First anatomical features evolved and later humans gained the behavioral features that define modern humanity. c) Humans lived in different places of the large African continent and evolved into modern humans in these locations. 25. What does the word “entrenched” in the text mean? a) particularly noticeable b) combined to form a whole c) firmly established 26. What does the word “compelling” in the text mean? a) comprehensive b) common c) convincing
13 TEXT IV A As a pharmacist in a big hospital in Adelaide, Australia, Emily Reeve would often see patients overwhelmed by the number of drugs they took each day and she worried that some of the medications these patients were on seemed useless, or even harmful. Dr Reeve’s patients are not unusual, at least in the rich world. About 15% of people in England take five or more prescription drugs every day. So do 20% of Americans and Canadians aged 40-79. Since the old tend to be sicker, the number of pills a person pops tends to rise over time. Of Americans who are 65 or older, two-thirds take at least five medications each day. In Canada, a quarter of over65s take ten or more. B Not all those prescriptions are beneficial. Half of older Canadians take at least one that is, in some way, inappropriate. A review of overprescribing in England last year concluded that at least 10% of prescriptions handed out by family doctors, pharmacists and the like should probably not have been issued. And even properly prescribed drugs have side effects. The more medicines someone takes, the more side effects they will experience. “Polypharmacy”, as doctors call it, results in a lot of harm. A recent study at a hospital in Liverpool found that nearly one in five hospital admissions was caused by adverse reactions to drugs. The Lown Institute, an American think-tank, estimates that, between 2020 and 2030, medication overload in America could cause more than 150,000 premature deaths and 4.5m hospital admissions. C Taking excessive amounts of pills burdens patients in several ways. One is just the logistics of it all. “People feel like their entire lives revolve around their medications,” says Michael Steinman, a professor of medicine at the University of California, San Francisco. The more drugs someone takes, the greater the chances are that some of them will be taken wrongly. Other problems are more directly medical. Some patients end up taking several drugs that affect the same biological pathways. One example is anticholinergics, which suppress the activity of acetylcholine, a neurotransmitter. Several drugs, including some anti-allergy pills and tricyclic antidepressants, work this way. But doctors are not always aware of that, says Dr Reeve. That can cause overdosing. Loading up on anticholinergics can suppress acetylcholine so strongly that it can leave patients stupefied or confused. Often such effects are wrongly ascribed to old age, or to disease. By cutting away problematic drugs, “we’ve had incidents where we have been able to reverse the incorrect diagnosis of dementia,” says Barbara Farrell, an academic and pharmacist at the Bruyere Research Institute in Canada. D The problems are intensified in other ways, too. The more pills someone takes, the more likely it becomes that some of them will interact in harmful ways. Pharmacists have reference databases which they check for nasty drug interactions, but knowledge is limited because clinical trials tend to test only one drug at a time. Pharmacists cannot catch problematic combinations when different prescriptions are dispensed at different pharmacies. And anything bought over the counter is “completely invisible”, says Dr Steinman. All these effects are worsened yet again in the elderly, whose bodies are less efficient at absorbing drugs. Sleeping pills, for example, might make a youngster a bit drowsy the next morning. In an elderly individual they can cause “brain fog” that makes everyday tasks impossible. Getting the dose right is difficult, says Dr Farrell, “because old people are usually excluded from clinical trials for new drugs”.
14 E Medication overload persists for several reasons. One, particularly in America, is advertising, which oversells the benefits of medicines, says Dr Farrell. Lack of unified personal health records is another. A cardiologist may prescribe drugs for a patient without knowing what the doctor treating his lungs may have put him on. __________. In America one in five patients who are given gabapentin, a powerful painkiller, after surgery are still taking it 90 days later (the recommended maximum is four weeks). Often prescriptions are renewed automatically by other doctors, who see them on a patient’s notes and assume they have to be continued. F Many doctors presume that, in any case, patients are not particularly interested in stopping their medicines. That is probably wrong: studies from a number of countries show that eight out of ten patients are willing to give up a drug if their doctor advises them to do so. But those doctors face problems of their own. Money for de-prescribing studies is scant. Drug firms, the main sponsors of clinical trials, are not interested, for obvious reasons. Evidence about how to proceed is nevertheless starting to build up. Brochures have been developed in Canada to help patients wean themselves off a number of common drugs. They explain, among other things, what alternatives are available—such as cognitive behavioral therapy rather than sleeping pills for insomnia. Trials suggest they work. Automated de-prescribing tools and guidelines for some medicines have also been developed in recent years. Medsafer, one such electronic tool, increased the share of hospital patients for whom drugs were de-prescribed from 30% to 55%, according to a study published earlier this year in jama Internal Medicine. The Drug Burden Index, another tool, tallies the cumulative doses of drugs with anticholinergic or sedative effects. Briefly, we can say that a medical movement is beginning. Its potential impact could be considerable. www.theeconomist.com 27. What is the function of paragraph A? a) To present an expert who has a solution to the problem b) To show the extent of the problem with examples and statistics c) To contrast different attitudes towards the problem in different countries 28. Which one of the following is mentioned as a negative effect of “polypharmacy” in paragraph B? a) Common use of non-prescription drugs b) Difficulty in accessing some useful drugs c) An increase in the side-effects of drugs 29. As we understand from paragraph C, drugs that include the substance anticholinergics _________. a) are prescribed to the same patient to treat different conditions b) are often wrongly prescribed as a cure for allergy and depression c) have been found to cause dementia in old patients
15 30. According to paragraph D, there isn’t enough information about the effects of the interaction between different drugs because _________. a) in clinical trials drugs are tested separately b) the tests for new drugs are insufficient c) it is difficult to test the right dose for each drug 31. Which of the following best fits in the blank in paragraph E? a) One of the most common reasons is that patients are not told when to stop taking a drug. b) England’s National Health Service has recently published a plan to reduce overprescribing. c) As a result, doctors and pharmacists are setting up “de-prescribing networks” to try to spread the word. 32. As we understand from paragraph F, the new trend in medical treatment consists of ________. a) encouraging patients to use drugs that have been fully tested in clinical trials b) increasing efforts to get patients to reduce the amount of drugs they have been taking c) using electronic tools that remind patients the time and dosage of their prescribed drugs 33. What does the word “premature” in the text mean? a) happening suddenly b) in a way that cannot be explained c) occurring before the proper time 34. What does the word “suppress” in the text mean? a) repeat b) repair c) repress
16 CAREFUL READING AND VOCABULARY SET II ANSWER KEY TEXT I 1 A 2 C 3 A 4 B 5 C 6 B 7 B 8 C 9 A TEXT II 10 A 11 C 12 B 13 B 14 B 15 C 16 A 17 C TEXT III 18 B 19 B 20 A 21 A 22 C 23 A 24 B 25 C 26 C TEXT IV 27 B 28 C 29 A 30 A 31 A 32 B 33 C 34 C