USING ALTHOUGH & EVEN THOUGH Some problems with this paragraph … starting with a word like ‘Although’ is problematic because nd although sets up the sentence to be a ‘ 2 conditional’ one. st nd This is the 1 condition This is the 2 condition
E.g. Although it is cold – I am going for a walk. Although I don’t like hot spicy food, I will eat some anyway – just to please you. Although the house was very untidy with small rooms, I decided to rent it anyway. So, the use of ‘although’ in your writing – is not appropriate – not the right starting word – because what follows is not a condition, but a statement: ‘they have different reasons … such as new experience, career preparation …”. You have 3 options: (1) Start this sentence with some other word, (2) fix up the second part of the sentence, or (3) delete the “but” (line 5) And!! I personally have a problem with your use of ‘every individual’ - this is just nonsense - not all of us go to college or university - some don’t even go to TAFE – some just finish their high school and get a job. What about - - - Although some individuals attend college or university to gain new experiences, some go for career preparation, increasing their knowledge, and so on. OR Individuals attend college or university for different reasons such as gaining new experiences, career preparation, increasing knowledge and so on. OR Although some individuals attend college or university, they have different reasons for doing so such as …………….. and so on. [No “but”]
Paragraphs re live animals/experiments Para 1 / Line 3 : Even though - this is like the word although - sets you up at the start of a nd 2 conditional sentence. Let’s see: Even though we cannot use all the medicines directly for humans, due to risk of side effects in newly invented medicines, [now I need the second condition to marry up with the ‘even though’ at the start.] Even though we cannot use all the medicines directly for humans, due to risk of side effects in newly invented medicines, animals still continue to die in research experiments.
USING RAISE & RISE raise: v. elevate, lift; excite, arouse; cause, bring about; grow, cultivate rise: v. stand up, get into an upright position; get out of bed; climb, ascend, move upward; rebel, revolt; , grow; appear over the horizon; come back to life, return from the dead; puff up, swell; originate in, begin in increase: v. enlarge, add to, augment; multiply, heighten, intensify another difference is that rise is an intranstive verb while raise is a transitive one. increase can be transitive and intransitive according to the context from: http://www.usingenglish.com/forum/ask-teacher/73125-raise-rise-increase.html
Lack of articles / lack of noun word / pluralisation of noun / preposition ‘with’ continuous tense / using ‘obesity’ rather than overweight th
Date: 10 June 2011 I am referring the above patient who is suffering from Cushing’s syndrome , for assessment and ongoing management. The patient is married and has a history of hay fever and colds. She has been attending this clinic for various ailments since July 2003. She was prescribed vitamin B12 injection for low Hb level due to a strict vegetarian diet. Two weeks later, her symptoms were unchanged and work-related stress was suspected. In addition, she was treated with Ventolin for mild asthma. On review five months later, Serevent and Pulmicort turbuator were commenced as had due to the side effects of Ventolin. After returning from overseas in October 2007 she experienced features of allergic rhinitis which was aggravated by close contact with domestic cats. Subsequently, she was prescribed Zyrtex and also referred to an Allergy specialist. Two weeks later, she was commenced on a course of Immunotherapy for her allergic reaction to cat fur. Four months ago, she complained of failed immunotherapy. Her symptoms have not been recovered resolved even through they she followed strict hygiene and avoidance of trigger factors for allergy. Moreover, Stilnox was trialled to help her sleep. for one month ’s duration. Today, her sleeping problem, poor wound healing, obesity and depressive mood change are suggestive of Cushing’s syndrome. I would be grateful if you take over further management of Ms Agnostolli. Yours truly, th
th
COMMENTS: The letter is dated 10 June 2009 – that is the “reference” point. If the 10 June 2009 is “today” (last paragraph) … what date would you put on “..two weeks later …” in paragraph 2 / “ … five months later …” paragraph 3 / In Paragraph 4: “October 2007” is the reference point … so what date is “ … two weeks later” … ? Final paragraph: “Four months ago …” would this be March 2009 ??? I think it is really very very very very important that you SPECIFY the PRECISE DATE if it is in the case study. Don’t be vague about it – quote the exact date.
USING PARTICIPLE ‘HAD’ OR ‘HAS’ / THE ARTICLE ‘THE’ I am pleased to refer the above patient, with multiple myloma, for monitoring of her diet plan and medication. � The patient is a 65 year old retired teacher , divorced with no children. � She first attended my clinic on 12.2.2009 complaining� of generalised muscle aches and pain for six weeks. � She was given Ibuprofen t.i.d� and advised to stop taking Simvastatin. � On review one week later , her pain was persistent all the time, especially at night, however, it resolves by warm bath. In addition , she had reported loss of 6 kg over two months and was depressed about life. � [reported is already past tense – so do not need to double-up by using the past-participle ‘had’ ] On review today, Mrs. ____________ is suffering from severe pain and reports that she is drinking more alcohol. On examination, her BP was 155/90 and her pulse was 88. � Skeletal survey and urinanalysis test were ordered and these confirmed the diagnosis of multiple myloma.
As a divorced elderly lady , who lives alone with no one to take care after her, I believe that she needs to be visited two times a week to monitor her compliance with the diet plan and medication ( Amitriptyline 25 mg t.i.d). ��� Therefore , I would be grateful if you could visit her at home to monitor her compliance with the diet plan and medication. Please do not hesitate to contact me for any further information. Yours truly, COMMENTS Overall – an excellent letter. 1. Make sure you put in a date 2. Take care not to put past-participles together with a past-tense verb – no need for this “over kill” ! 3. Events that are happening here and now “On review today …” and “ … she is drinking more alcohol.” need to be all in the continuous tense. “Mrs V____ is suffering from … “ 4. “Skeletal” is the adjective describing the noun “survey” - however - “urinanalysis” is a kind of what? - a test - so you need to put in that noun word. Your letter is 18-19 lines long. It is “tightly” written – just the facts – which is what the OET Center want. Well done. Is certainly not too long. If anything – it’s a bit short! …Marg
THIS LETTER HAD MANY PROBLEMS: No date / no specific recipient – just the Nursing Centre / Continuous form of “to be” / preposition “with” / singular verb form missing (para 3) / Adverb and pronoun missing “near her …” / noun form “treatment” / last sentence was not a sentence as it lacked subject “me” 11 March 2011
[Always put in a date]
Palliative Care Nurse District Nursing Centre COBURG Victoria 3058 Dear Nurse, Re: M_______ S ________, 58 year old I am referring Mrs S______ who will be discharged home after being diagnosed with terminal cancer. Her cancer is already at the end stage. Mrs S________ was diagnosed with left breast cancer in 1997. She had a mastectomy in 2004 after radiotherapy. The patient was in remission from 2004 to 2008 until a carcinoma in her right breast was detected. This latest cancer has pulmonary secondaries. Mrs S ________ wishes to die at home with her husband, children and near her eight grandchildren who also live in Coburg. Upon discharge Mrs S_______ and her family need your help in four-hourly pressure-area care, daily sponging, assistance with care and application of Duoderm dressings to a small pressure sore on the right buttock. Morphine 10mg is required as pain relief. The family needs your help in explaining preparation of food that Mrs S______ can tolerate (mashed, with fluids). As you know, in her case the most important treatment is psychological support for her and her family, and pastoral care from her local parish priest, as she has strong links with her local Catholic Church. Please do not hesitate to contact me if you require any further information.
AN ALMOST NEAR-PERFECT LETTER FROM SOMEONE WHO THOUGHT THEIR WRITING WAS VERY SUBSTANDARD. THIS CANDIDATE PASSED THE FEBRUARY 2010 OET TEST ! 230 instead of 220 words is not a problem. Anyway – this is only 21 lines long. You have written an excellent letter - clearly worth a “B” - however, you do occasionally leave out the article “a” “an” or “the”. Subjects / nouns usually have an article before them …. unless they are the generic form ….. otherwise you would be getting an “A” for a letter like this. I am confident you are going to pass. rd 23 January 2010 � Dear Dr. Smith � th
Re: Mrs L_____ C________ D.O.B 18 April 1955.
Bank Manager �
I am writing to refer Mrs C________ ,who is suffering from a Barette’s oesphagus and needs a gastrointestinal assessment for further management (fundoplication). � She initially presented� to me on 18.08.2009, complaining� of difficulty in swallowing of solid foods. She also reported discomfort and a burning sensation in the upper abdomen since her early 20’s. �The clinical examination was unremarkable except for an increased blood pressure (135/85 mmHg).She seemed to have dysphagia,due to either hiatus hernia or other organic lesions. � She has been smoking 20 cigarettes daily for the past 30 years. She was advised to quit smoking and some life style 1 modifications. Her past medical history includes mild hypertension. � She re-presented �on 20.11.2009 with complaints �of persistent worsening of her symptoms along with� regurgitation of undigested solid foodstuffs. She was concerned about her weight loss (5 kgs in 2 three months). � At� her review on 25.11.20009 she reported cough production of clear sputum at night. At that time, certain investigations were done which were unremarkable except for a biopsy and 3 an endoscopy indicating an oesphagitis and a stricture at 56 cm from incisor teeth showing a small hiatus hernia. She was diagnosed to have a � Barette’s oesophagus and was commenced on Gavison and Omperazole. She was also advised regarding the possibility of an�� operation if the repeat endoscopy suggested malignancy. She is an occasional alcohol drinker. Today, she is asymptomatic and wishes to stop her medications. In my opinion, she needs a further assessment for an operation.
ARTICLES “A” AND “THE” WERE LACKING I'm writing to refer the above patient, a 35 year old male, who presented today to my surgery with a large and hard swelling on the right cheek.� The patient has visited me four times, and all were emergency situations. On his first visit, he complained of pain associated with tooth 46: my radiograph showed periapical infection. I arranged an appointment with the patient to start root canal therapy but he didn't attend. � On 15.05.08, the above patient presented with pain on the same tooth (46). I wrote a course of antibiotics for the patient, and arranged another appointment with the patient, but he didn't attend.� Today the patient presented with a large hard swelling on the right cheek. My clinical examination showed a fistula in the lower right vestibule with pus discharge. The radiograph shows a well-defined radiolucent area that includes apices of the teeth 45,46 and 47. The pus has been drained using a 1
‘She was advised to - quit smoking and - some lifestyle modifications Does this sound right to you? The connecting word “and” separates 2 clauses: quit smoking and some lifestyle modifications. If you took out the first clause – and this sentence was “She was advised to some lifestyle modificiations” what would you have to ADD in this second clause to make it grammatically correct ??? [I will put MY answer on the next page … see if you can work this out yourself……don’t look just yet …….] 2 You need production because you are talking about something – a noun cough-production 3 The incisor teeth – because you have two of them - ‘teeth’ is already the plural form of one tooth.
needle aspirating syringe. I'm referring the above patient for curettage of the cyst wall and bone augmentation. Please note that, the remaining mandible bone needs support and it's currently high risk of mandibular fracture. and it currently has a high risk of I have to mention, the patient was recently diagnosed with diabetes. If you need more information, please do not hesitate to contact me. Your truly
30 July 2010 � Dr Nathan Helliwell Mental Health Unit Alice Springs Hospital NT 0870
� � �
Dear Dr. Helliwell, � Re Barbara Marika, 22 years old. � I am writing to refer Mrs. Marika, a patient of mine, association with domestic violence.
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to you. She is having a conversion disorder in
Mrs. Marika is 22 years old, recently married, a smoker (4-5 cigarettes per day), and drinks alcohol (45 beers per day). Her previous medical history is significant for chronic otitis media (4 years old) and pneumonia (6 years old). She also has a mild degree of deafness. 2 months ago she underwent wound debridement and skin grafting for an infected wound on her right foot. Both her parents have diabetes and hypertension. She has no allergies. Please note that Mrs. Marika is not fluent in English. th
I have seen her on the 12 of July. She was brought in by a community health worker chiefly complaining of numbness and tingling in her feet of 1 month’s duration, severe headaches and nausea. Nothing remarkable was found on examination. The community health worker reported that she Mrs Marika has a poor home situation and an aggressive husband who bullies her. She was diagnosed to have tension headache and prescribed mild painkillers. An Advice about healthy life style was also given. th
On the 19 of July she came back for a follow up. She was still complaining of the same symptoms plus a colicky abdominal pain. She also had an attack of chest pain that was associated with shortness of breath. She admitted inability to do household chores due to lack of concentration. Nothing remarkable was found on examination. Anxiety disorder was suspected and the plan was family counseling, life style education and social support. Today she was brought in by her sister who reports that the patient had a 5 minutes fit (jerky movement in all limbs, no incontinence, no tongue biting) after a quarrel with her husband. On examination I found that she had bruises and scratch marks on her face and forearms. However, her neurological exam was normal. She was given painkillers and advised to use ice compressions. I also contacted the social worker to arrange for a safe sheltered accommodation. I think she is having a conversion disorder associated with domestic violence, and I believe she needs further psychological assessment and psychotherapy. Please do not hesitate to contact me if you require any further information. Yours truly, DOCTOR *
Not necessary to say ‘a patient of mine’ as this is self-evident
