GAMSAT Practice - Humanities and Social Science

GAMSAT Practice - Humanities and Social Science and social science

Question 1-2 

Scratch below the surface of the environmental illness debate and you find doctors attacking each

other with barely disguised contempt, and patients muttering sinister conspiracy theories about

government plots to poison the populace. It might all seem like some nutty sideshow, except

it has the potential to become a very significant issue in both environmental politics and the

compensation courts.

On the one side of the argument is a cadre of doctors and patients who believe that

environmental illness could help explain a whole slew of mysterious modern ailments, particularly

chronic fatigue and Gulf War syndromes. These activists theorise that the symptoms of such

illnesses – overwhelming fatigue, headaches, bowel disorders, muscle aches – are so similar that

there must surely be some connection. Could the ailing Gulf War veteran who believes he was

exposed to biological weapons, the sheepshearer who has developed chemical sensitivity and the

office worker struck down by debilitating fatigue all be victims of the toxic environment?

‘It may be that as the environment becomes more and more loaded with chemicals, we will

see more and more of these people,’ says Dr Mark Donohoe, a Sydney GP who is writing a book

on environmental illness. Donohoe argues that multiple chemical sensitivity (MCS) sufferers –

many of whom have never had a major chemical exposure – must have been disabled by a steady

accumulation of low-dose chemicals from the environment. In this scenario the afflicted are merely

the earliest victims of a man-made plague that could soon affect everyone.

On the other side of the argument are psychiatrists and doctors who point out that fatigue,

nausea, headaches and muscle aches have occurred for centuries in people suffering psychological

disorders such as depression and hysteria. ‘Multiple chemical sensitivity is not a legitimate

diagnosis,’ argues Dr Stephen Barrett, a leading US campaigner against alternative medicine.

‘Instead of testing their claims with well-designed research, its advocates are promoting them

through publications, talk shows, support groups, lawsuits and political manoeuvring.’

It’s here that the debate about environmental illness gets heated. For, as Barrett points out,

if environmental illness turns out to be largely or entirely psychosomatic, the treatments being

offered would be more than just useless – they would probably contribute to the illness’s spread.

1 Those who are sceptical about multiple chemical sensitivity imply that environmental illness

A is a product of the mind.

B has been around for centuries.

C is confined to individuals with a history of mental illness.

D occurs mainly in those who use alternative rather than traditional medicine.

2 Dr Barrett gives the impression that environmental illness is likely to

A increase as the number of chemicals in the environment grows.

B decrease as governments legislate to reduce opportunities for legal compensation.

C increase as individuals are encouraged to believe in the concept of environmental illness.

D decrease as researchers become more aware of the toxicity levels of particular chemicals.

Question 3-4

Cut privet still smells of sour apples, as it did when I was sixteen; but this is a rare, lingering

exception. At that age, everything seemed more open to analogy, to metaphor, than it does now.

There were more meanings, more interpretations, a greater variety of available truths. There was

more symbolism. Things contained more.

Take my mother’s coat, for example. She had made it herself, on a dressmaker’s dummy

which lived under the stairs and told you everything and nothing about the female body (see what

I mean?). The coat was reversible, pillar-box red on one side, an expansive black and white check

on the other; the lapels, being made of the inner material, provided what the pattern called ‘a dash

of contrast at the neck’ and chimed with the large square patch pockets. It was, I now see, a highly

skilful piece of needlework; then, it proved to me that my mother was a turncoat.

This evidence of duplicity was corroborated one year when the family went to the Channel

Islands for a holiday. The size of the coat’s pockets, it transpired, was exactly that of a flat-pack

of 100 cigarettes; and my mother walked back through the customs with 400 contraband Senior

Service. I felt, by association, guilt and excitement; but also, further down, a private sense of

being right.

Yet there was even more to be extracted from this simple coat. Its colour, like its structure,

had secrets. One evening, walking home from the station with my mother, I looked at her coat,

which was turned to show its red side, and noticed that it had gone brown. I looked at my mother’s

lips and they were brown. If she had withdrawn her hands from her (now murkily) white gloves,

her fingernails, I knew, would also be brown. A trite occurrence nowadays, but in the first months

of orange sodium lighting it was wonderfully disturbing. Orange on red gives dark brown. Only in

suburbia, I thought, could it happen.

3 The first sentence of Passage I suggests that the adult narrator

A is searching for an explanation of his past.

B values this access to a former perception.

C yearns for a return to the innocence of youth.

D wishes that he could erase memories of the past.

4 In the adult narrator’s view the sixteen-year-old character’s tendency to find ‘more meanings, more

interpretations’ (line 3) was

A bizarre and silly.

B insightful and mature.

C ingenious but often trivial.

D self-destructive and malicious.

Question 5-7

An effect model for the assessment of drug benefit:

Example of antiarrhythmic drugs in postmyocardial infarction patients

An effect model is a function that defines the relationship between the clinical efficacy of a

treatment and specific covariates. The simplest effect model defines the probability of failure

in treated patients as a linear function of the probability for these patients if they received no

treatment. We used this approach to explore the effects of Class I antiarrhythmic agents in patients

after myocardial infarction. Evidence from one large trial, the Cardiac Arrhythmic Suppression

Trial (CAST), and the pooling of data from several smaller trials, suggests that these agents have

harmful effects in postmyocardial infarction patients. The relevance of results from pooled data is

dependent on the homogeneity of the trials and is assessed by a heterogeneity test that is dependent

on the analytical method used, i.e., odds ratio or rate difference methods, which correspond to two

different effect models. We have developed an effect model that considers both iatrogenic1 effects

of these drugs, i.e., depression of ventricular function and arrhythmogenic effects. When applied

to the data from 13 published trials (including CAST), we found that these drugs may be beneficial

in high-risk patients (with a 1-year mortality rate of > or = 15%) and that the background lethal

iatrogenic effect is likely to affect low- and very low-risk patients (1-year mortality rate of < or =

5%). The accuracy of the proposed model was confirmed with use of the results from the recent

CAST II study.

1 iatrogenic: an illness caused or produced by the treatment of a physician

5 The CAST suggests that anti-arrhythmogenic treatment should

A not be used for postmyocardial infarction patients.

B only be used for postmyocardial infarction patients.

C only be used for those with low risk of mortality from postmyocardial infarction.

D only be used for those with high risk of mortality from postmyocardial infarction.

6 According to the abstract, pooling data should involve

A testing for homogeneity.

B eliminating homogeneity.

C various analytical methods.

D heterogeneous analytical methods.

7 CAST suggests that the iatrogenic effects of Class I antiarrhythmic agents

A outweigh the benefits.

B may outweigh the benefits.

C have collateral benefits.

D do not outweigh the benefits.

Question 8-10

We know the principle on which it was based: at the periphery, an annular building; at the centre,

a tower; this tower is pierced with wide windows that open onto the inner side of the ring; the

peripheric building is divided into cells, each of which extends the whole width of the building;

they have two windows, one on the inside, corresponding to the windows of the tower; the other, on

the outside, allows the light to cross the cell from one end to the other. All that is needed, then, is to

place a supervisor in a central tower and to shut up in each cell a madman, a patient, a condemned

man, a worker or a schoolboy. By the effect of backlighting, one can observe from the tower,

standing out precisely against the light, the small captive shadows in the cells of the periphery.

They are like so many cages, so many small theatres, in which each actor is alone, perfectly

individualised and constantly visible. The panoptic mechanism arranges spatial unities that make

it possible to see constantly and to recognise immediately. In short, it reverses the principle of the

dungeon; or rather of its three functions – to enclose, to deprive of light and to hide – it preserves

only the first and eliminates the other two.

8 The observation ‘to shut up in each cell a madman, a patient, a condemned man, a worker or a schoolboy’

(lines 6–7) suggests that

A the Panopticon had a range of inmates with different needs.

B all prisoners are treated compassionately in the Panopticon.

C the panoptic principle can be adapted to a range of institutions.

D whatever the individual circumstances, solitary confinement is a useful disciplinary measure.

9 Prior to the development of the Panopticon, prisoners were housed together in large cells – sometimes chained

to the walls.

Compared to this method the main advantage of the Panopticon for prison authorities is that

A prisoners do not intrude on one another’s privacy. C the public is protected from prisoners.

B additional physical coercion is unnecessary. D supervisors are accessible to prisoners.

10 The passage suggests that unlike the dungeon, the Panopticon

A focuses on the moral rehabilitation rather than the punishment of prisoners.

B uses darkness to intimidate prisoners.

C necessarily isolates prisoners.

D deprives prisoners of light.

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