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Text A – Text Booklet
Text A
Whooping cough, also known as pertussis, is a very contagious respiratory illness caused by a type of bacteria called Bordetella pertussis. The disease is only found in humans. Whooping cough bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins (poisons), which damage the cilia and cause airways to swell.
Whooping cough may begin like a common cold, but unlike a cold, the coughing can last for weeks or months. Symptoms of whooping cough usually develop within 5 to 10 days after you come into contact with the bacteria that cause it. Sometimes symptoms do not develop for as long as 3 weeks.
See a doctor if you or your child are:
- Struggling to breathe.
- Turning blue or purple.
- Coughing violently.
- Coughing rapidly, over and over.
- Not drinking enough fluids
- Any time someone is struggling to breathe, it is important to get them to a doctor right away.
Early symptoms can last for 1 to 2 weeks and usually include:
- Runny or stuffed-up nose.
- Low-grade fever (less than 100.4°F).
- Mild, occasional cough (babies do not do this).
- Apnea (life-threatening pauses in breathing) and cyanosis (turning blue or purple) in babies and young children.
Text B
In its early stages, whooping cough appears to be nothing more than the common cold. Therefore, doctors often do not suspect or diagnose it until the more severe symptoms appear.
Later symptoms: Stage 2
One to 2 weeks after the first symptoms start, people with whooping cough may develop paroxysms—rapid, violent, and uncontrolled coughing fits. These coughing fits usually last 1 to 6 weeks but can last for up to 10 weeks. Coughing fits generally get worse and become more common as the illness continues.
Coughing fits can cause people to:
- Make a high-pitched “whoop” sound when they are finally able to inhale at the end of a coughing fit.
- Vomit during or after coughing fits.
- Feel very tired after the fit, but usually seem well in-between fits.
- Struggle to breathe.
- Babies may struggle to breathe, while teens and adults usually have mild symptoms.
Many babies with whooping cough don’t cough at all. Instead it may cause them to turn blue or struggle to breathe. It may seem like a common cold for the entire illness, not just the beginning.
The infection is generally milder in teens and adults than in babies and children, especially those who have gotten vaccinated against whooping cough. It may seem like a common cold. The “whoop” is often not there for people who have a milder illness.
Text C
Teens and adults, especially those who did not get whooping cough vaccines, may have lengthy coughing fits that keep them up at night. Those who get these coughing fits say it’s the worst cough of their lives. It can also cause major disruptions to daily life and serious complications.
Vaccinated people may not get as sick.
Whooping cough vaccines are effective, but not perfect. The infection is usually not as bad for people who have gotten vaccinated against whooping cough but still get sick.
In vaccinated people who get whooping cough:
- The cough usually won’t last as many days.
- Coughing fits, whooping, and vomiting after coughing fits are less common.
- Apnea and cyanosis are less common (in vaccinated babies and children).
Recovery: Stage 3
Recovery from whooping cough can be slow. The cough becomes milder and less common as you get better. Coughing fits may stop for a while but can return if you get other respiratory infections. Coughing fits can return many months after the whooping cough illness started.
Text D
Whooping cough (pertussis) can cause complications in people of all ages. Some people will get serious complications and need care in the hospital. Serious and sometimes deadly complications are more likely in babies under a year old.
Whooping cough can cause serious and sometimes deadly complications in babies and young children. Babies and children who have not had all recommended whooping cough vaccines are more likely to get serious complications.
About one third of babies younger than 1 year old who get whooping cough need care in the hospital. The younger the baby, the more likely they will need treatment in the hospital. Of those babies younger than 1 year old who are treated in the hospital with whooping cough about:
- 2 in 3 (68%) will have apnea (life-threatening pauses in breathing).
- 1 in 5 (22%) get pneumonia (lung infection).
- 1 in 50 (2%) will have convulsions (violent, uncontrolled shaking).
- 1 in 150 (0.6%) will have encephalopathy (disease of the brain).
- 1 in 100 (1%) will die
Teens and adults
Teens and adults can also get complications, like pneumonia, from whooping cough.
If they have a severe cough, teens and adults can:
- Pass out.
- Fracture (break) a rib.
- Lose bladder control.
- Lose weight
Complications are usually less serious in this older age group, especially in those who have been vaccinated against whooping cough. However, if complications are serious, some people may need care in the hospital.
Part B
Read and learn the following 6 paragraphs with all possible help and support. Questions will be provided at the time of the Test.
1. Aseptic Technique
Aseptic technique must be used when handling syringes and needles. The needle, the tip and hub, the inside of the barrel, and the plunger must be kept sterile at all times. Contamination of the plunger will contaminate the solution or medication as the plunger goes down the barrel. All syringes should be labelled with the name of the medication. If two or more syringes of the same type but containing different solutions or medications are being used, they must be clearly labelled to prevent confusion. If a needle is broken, it must be accounted for in its entirety. Bending, shearing, breaking or recapping contaminated needles is strictly prohibited.
2. Infection Prevention and Control
Each year, an excess of £1 billion is spent by NHS on healthcare-associated infection. This is an infection that was neither present nor incubating at the time of contact with the healthcare facility. All staff have a duty to protect patients from harm and ensure colleagues, patients and visitors take infection prevention seriously. It is necessary to apply standard precautions of infection at all times. Additional precautions may be required in certain circumstance, and these will be advised by a nurse in charge or a member of the infection control team. For instance, certain conditions may require a face mask to be worn.
3. Subject: Faxing Confidential Information
Please note the following: Take safety measures before faxing confidential information. A fax cover sheet should contain instruction that the faxed material is to be given only to the named recipient. Consent is needed from the client to fax information. Check that the fax number is correct, check the number on the display of the machine after dialling, and check a third time before pressing the “send” button. Follow up with the agency receiving the fax to assure that the private records are received and placed in a secure location as soon as the fax has been sent.
4. Clear Communication
Medical personnel are so immersed in jargon that it becomes part of their daily speech The patient may not understand the words or may have a different idea of their meaning. Technical words such as myocardial infarction are in obvious need of avoidance or explanation. Consider also terms such as exacerbate, chronic, numb, and sputum – these may seem obvious in meaning to you but not to the patient. You may think that some terms such as angina and migraine are so well-known that they don’t need explanation, but these are very often misinterpreted.
5. Physical Examination
Many individuals perceive a comprehensive physical examination to be an intrusive event that is best avoided if possible. However, for older people, in whom the ‘typical’ presentations of illness may be subtle or unusual, a thorough physical examination is a cornerstone of assessment. The value of a thorough physical examination can be underestimated by healthcare professionals, but
may be highly regarded as a therapeutic benefit by patients. Talking to the patient during the examination is also a method of reassurance, while potentially gaining additional history and most of all, engendering trust. The key message is the value of a comprehensive, holistic and unrushed examination.
6. Role of the Pharmacist
The pharmacist is legally responsible for the supply and distribution of drugs in accordance with the law. However, in some cases, nurses who have had additional training may dispense medicines, if this is in line with the hospital policy and with the written instructions of a medical practitioner. The role of a pharmacist also includes that of being a resource person for medicine information, and they are responsible for checking that any newly prescribed medicine will not interact dangerously with, or nullify, any existing medication.
Part C1
Read and learn the following 6 paragraphs with all possible help and support. Questions will be provided at the time of the Test.
More and more children today need eye tests and glasses. The world has been gripped by an unprecedented rise in myopia, also known as short-sightedness. Sixty years ago, 10-20% of the population was short-sighted. Today, up to 60% of teenagers and young adults are. By some estimates, one-third of the world’s population – 2.5 billion people – could be affected by short-sightedness by the end of this decade. We seem to be having a myopia epidemic. The condition is more than an inconvenience. Glasses, contact lenses and surgery can help correct it, but they do not address the underlying defect: a slightly elongated eyeball which means that the lens focuses light from far objects slightly in front of the retina, rather than directly on it. In severe cases, this condition increases the risk of retinal detachment cataracts, glaucoma and even blindness.
Because the eye grows throughout childhood myopia generally develops in school-age children and adolescents. About one-fifth of university-aged people in East Asia now have this extreme form of myopia, and half of them are expected to develop irreversible vision loss. This threat has prompted a rise in research to try to understand the causes of the disorder. As a result old ideas that myopia is the domain of e bookish child are being thrown out and a new notion has come up: that spending too long indoors is placing children at risk. For many years, the consensus was that myopia was largely down to genes. But it was obvious that genes could not be the whole story.
One of the clearest signs came from a study of people in the northern tip of Alaska whose lifestyle was changing. Of adults who had grown up in isolated communities, only 2 of 131 had myopic eyes. But more than half of their children and grandchildren had the condition. Genetic changes happen too slowly to explain this rapid change – or the soaring rates in myopia that have since been documented all over the world. The only explanation was that an environmental effect has caused the difference.
There was one obvious culprit: book work. The modern rise in myopia mirrored a trend for children in many countries to spend more time engaged in reading, studying or – more recently – glued to computer and smartphone screens. This is particularly the case in East Asian countries, where the high value placed on educational performance is driving children to spend longer in school and on their studies.
Researchers have consistently documented a strong association between measures of education and the prevalence of myopia In the 1990s, for example, they found that teenage boys in Israel who attended schools where they spent their days studying had much higher rates of myopia than did students who spent less time at their books. On a biological level, it seemed plausible that sustained close work could alter growth of the eyeball as it tries to accommodate the incoming light and focus close-up images squarely on the retina.
Attractive though the idea was, it did not hold up. In the early 2000s, when researchers started to look at specific behaviours, such as books read per week or hours spent reading or using a computer, none seemed to be a major contributor to myopia risk. But another factor did. A 2007 survey tracked more than 500 eight and nine-year-olds in California who started out with healthy vision. The team examined how the children spent their days. After five years, one in five of the children had developed myopia, and the only environmental factor that was strongly associated with risk was time spent outdoors. A year later another study tracking more than 4.000 children at Sydney primary and secondary schools for three years found that children who spent less time outside were at greater risk of developing myopia.
Animal experiments support the idea that light is protective. Researchers first demonstrated this in chicks, a common lab model for studying vision. By fitting chicks with goggles that alter the resolution and contrast of incoming images, it is possible to induce the development of myopia while raising the birds under controlled conditions in which only light intensity is changed. High illumination levels – comparable to those encountered outside – slowed the development of experimentally induced myopia in chicks by about 60% compared with normal indoor lighting conditions. Researchers elsewhere have found similar protective effects in tree shrews and rhesus monkeys.
But what explains how bright light could prevent myopia? The leading hypothesis is that light stimulates the release of dopamine in the retina, and this neurotransmitter in turn blocks the elongation of the eye during development Retinal dopamine which is produced during the day tells the eye to switch from night-time vision to daytime vision. Under indoor lighting, the cycle is disrupted and the system starts to get a bit noisy and the development of the eye becomes irregular.
Text C2
Read and learn the following 6 paragraphs with all possible help and support. Questions will be provided at the time of the Test.
Getting too little sleep for several nights in a row disrupts hundreds of genes that are essential for good health, including those linked to stress and lighting disease. Tests on people who slept less than six hours a night for a week revealed substantial changes in the activity of genes that govern the immune system, metabolism, sleep and wake cycles, and the body response to stress, suggesting that poor sleep could have a broad impact on long-term wellbeing.
The changes, which affected more than 700 genes, may shed light on the biological mechanisms that raise the risk of a host of ailments, including heart disease, diabetes obesity, stress and depression, in people who get too little sleep. “The surprise for us was that a relatively modest difference in sleep duration leads to these kinds of changes”, said Professor Derk-Jan Dijk, director of the Surrey Sleep Research Centre at Surrey University who led the study. “It’s an indication that sleep disruption or sleep restriction is doing more than just making you tired.”
Previous studies have suggested that people who sleep less than five hours a night have a 15% greater risk of death from all causes than people of the same age who get a goodnight’s sleep, In one survey of workers in Britain more than 5% claimed to sleep no more than five hours a night. Another survey published in the US In 2010 found that nearly 30% of people claimed to sleep no more than six hours a night.
Professor Dijk’s team asked 14 men and 12 women, all healthy and aged between 23 and 31 years, to live under laboratory conditions at the sleep centre for 12 days. Each volunteer visited the centre on two separate occasions. During one visit, they spent 10 hours a night for a week. In the other, they were allowed only six hours in bed a night. At the end of each week, they were kept awake for a day and night, or around 39 to 41 hours. Using EEG (electroencephalography) sensors, the scientists found that those on the 10-hours-per-night / week slept around 8.5 hours a night, while those limited to six hours in bed each night got on average 5 hours and 42 minutes of sleep.
The time spent asleep had a huge effect on the activity of genes, picked up from blood tests on the volunteers, according to a report in the US Journal Proceedings of the National Academy of Sciences. Among the sleep-deprived, the activity of 444 genes was suppressed while 267 genes were more active than in those who slept for longer Changes to genes that control metabolism might trigger or exacerbate conditions such as diabetes or obesity, while disruption to other genes, such as those that govern the body’s inflammatory response, might have an impact on heart disease. Further genes that were affected have been linked to stress and ageing.
Sleep loss also had a dramatic effect on genes that govern the body’s biological clock suggesting that poor sleep might trigger a vicious cycle of worsening sleep disruption. The tests showed that people who slept for 8.5 hours a night had around 1,855 genes whose activity rose and fell over a 24-hour cycle. But in the sleep-deprived, nearly 400 of these stopped cycling completely. The remainder rose and fell in keeping with the biological CIOC but over a much smaller range. “There is a feedback between what you do to your sleep and how that affects your circadian Clock, and that is going to be very important in future an investigation,” said Dijk.
The researchers did not check how long it took for one to return to the normal levels of duty in the sleep deprived volunteers, but they hope to in further studies. Though scores of genes were disrupted in the sleep-deprived, the scientists cannot say whether those changes are a hamiess short-term response to poor sleep, a sign of the body adapting to sleep- deprivation, or are potentially harmful to health.
Jim Horne, professor of psychophysiology at Loughborough University’s Sleep Research Contre, said: “The potential effects of ‘sleep debt’ in today’s society and the need for ‘eight hours of sleep a night’ are often overplayed and can cause undue worry. Although this important study seems to support this concern, the participants had their sleep suddenly restricted to an unusually low level, which must have been somewhat stressful. “We must be careful not to generalize such findings, to say, people who have their habitual six-hour sleep and happy with their sleep. Besides, sleep can adapt to some change, and should also be judged on its quality, not simply on its total amount.”
