‫מועד ב' ‪Final Exam‬‬ ‫מתקדמים ב‬

‫כל קבוצות מזורז‬

‫‪28.10.2024‬‬

‫מדבקה‬

‫‪English as a Foreign Language Unit‬‬

‫‪ID #‬‬ ‫‪.‬ת‪.‬ז ‪-‬‬

‫‪Booklet #‬‬ ‫‪‬‬ ‫קוד נבחן‬

‫‪‬‬ ‫‪This exam is intended to check your ability to comprehend‬‬

‫‪the text and write in English relevant to the level of the‬‬
‫‪course you have taken.‬‬
‫‪‬‬ ‫‪You have to answer all the questions.‬‬
‫‪‬‬ ‫‪Time allotted: 2,5 hours‬‬
‫‪‬‬ ‫‪Please write in pen only.‬‬
‫‪‬‬ ‫‪You may use English- Hebrew Dictionary.‬‬
‫!‪Good Luck‬‬
‫מורים המורשים להיכנס לבחינה לענות על שאלות‪ :‬ג'ודי משה‪ ,‬חגית דמרי‪ ,‬אולגה גודס‪,‬‬
‫הרצל פאר‪ ,‬אבישג שמר‪ ,‬יואל אופק‪ ,‬ויקי קוט‪ ,‬נעמי כהן‪ , ,‬זארה ארפי‪ ,‬דודי מסטיי‪ ,‬עטר‬
‫יעקב אלי אלן‪ ,‬סבטה פיכמן‪ ,‬שפילקין אולה‪ ,‬צביה שבט אגינסקי נטלי ברנרד בלום‪ ,‬צביה‬
‫שבט ‪,‬גנדלזמן אירנה‬

‫הוראות לנבחן באנגלית כשפה זרה‬

‫עליך לרשום את התשובות לשאלות במחברת המצורפת לשאלון‪.‬‬ ‫‪.1‬‬
‫מבחן זה נועד לבחון את יכולתך להבין טקסט באנגלית ברמה בה למדת ולהתבטא במילים שלך‪.‬‬ ‫‪‬‬

‫הבחינה מורכבת מטקסט ושאלות‪ .‬עליך לענות על כל השאלות‪.‬‬ ‫‪‬‬

‫זמן הבחינה‪ :‬שעתיים וחצי‪.‬‬ ‫‪‬‬

‫זמן מקסימלי לבעלי תוספת זמן הינו‪ :‬שלוש שעות‪.‬‬ ‫‪‬‬

‫נא לכתוב בעט בלבד ‪.‬אין להשתמש בטיפקס‪.‬‬ ‫‪‬‬

‫מותר שימוש במילון ‪ /‬מילונית אנגלית‪-‬עברי‬ ‫‪‬‬

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‫מועד ב' ‪Final Exam‬‬ ‫מתקדמים ב‬
‫כל קבוצות מזורז‬
‫‪28.10.2024‬‬

‫הוראות לנבחן‪:‬‬

‫עליך לרשום את התשובות לשאלות במחברת המצורפת לשאלון‪.‬‬

‫בשאלות ‪ TRUE/FALSE, YES/NO, AGREE/DISAGREE‬יש לרשום את אחת‬ ‫‪.2‬‬
‫התשובות שבחרת ואחריה ציטוט מהטקסט שתומך בבחירתך‪.‬‬
‫בשאלות רב ברירה יש לסמן את התשובה עצמה‬ ‫‪.3‬‬
‫אם ברצונך לשנות את התשובה לשאלה מסוימת‪ ,‬נא למתוח קו אלכסוני על‬ ‫‪.4‬‬
‫התשובה ולרשום את התשובה החדשה אם יש מקום לכך‪ .‬אם אין מספיק מקום‬
‫יש לרשום את התשובה אחרי התשובה לשאלה האחרונה‪.‬‬
‫חל איסור מוחלט להשתמש במרקר‪.‬‬ ‫‪.5‬‬
‫חל איסור להפריד את דפי הבחינה‪.‬‬ ‫‪.6‬‬
‫תשובה אינה יכולה להיות ארוכה יותר ממשפט אחד‪ ,‬למעט שאלות של‬ ‫‪.7‬‬
‫שבהן אין הגבלת מילים‪.‬‬ ‫‪in your own words‬‬
‫כל שאלה בה תעתיקו או תשתמשו במילים מהקטע כשנתבקשתם לענות במילים‬ ‫‪.8‬‬
‫שלכם‪ ,‬תקבל אפס נקודות‬

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28.10.2024

The Benefits of Stress

Situations we typically perceive as stressful are not necessarily the toxic type of stress that has
been linked to serious health issues

By Kristin Sainani

Introduction
There you are, stuck in traffic. Minutes tick by as you inch the car forward, gripping
the steering wheel with white-knuckled tension. What could be worse? A glance at
the clock says you are going to be late for that big meeting and there is nothing
you can do about it. You can feel your blood pressure rise and hear your rapid
pulse thrumming in your ears. Then you remember something you read in a health
magazine or heard from a daytime TV doctor about the dangers of stress—that it
can harden arteries, kill brain cells or trigger tumors. So, in an effort to be relaxed,
like a leaf on the wind, you try to recall the breathing technique from that yoga
class years ago. But it is no use. Now you are stressed about stress itself.
If this sounds familiar, you are not alone. According to a 2013 national survey by
the American Psychological Association, the average stress level among adults is
5.1 on a scale of 10. That is one and a half points above what the respondents
judged to be healthy. Two-thirds of people say managing stress is important, and
nearly that proportion had attempted to reduce their stress in the previous five
years. Yet only a little over a third say they succeeded at doing so. More
discouraging, teens and young adults are experiencing higher levels of stress (5.8
and 5.7/10, respectively). They are also struggling to manage it. “Stress has a
very bad reputation.” acknowledges Firdaus Dhabhar, an associate professor of
psychiatry and behavioral science at Stanford University. “And justifiably so,” he
adds.
Much of what we know about the physical and mental price of chronic stress stems
from seminal work by Robert Sapolsky, beginning in the late 1970s. Sapolsky, a
neuroendocrinologist, was among the first to make the connection that the
hormones released during the fight-or-flight response—the ones that helped our
ancestors avoid becoming dinner—have harmful effects when the stress is severe
and constant. Especially dangerous, chronic exposure to one of these hormones-
cortisol, causes brain changes that make it increasingly difficult to shut the stress
response down.
Acute vs Chronic Stress
However, there is good news. Recent research paints a different portrait of stress.
It is one in which it has a positive side. “There is good stress, there is tolerable
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28.10.2024
stress, and there is toxic stress,” says Bruce McEwen of Rockefeller University, an
expert on stress and the brain who trained both Sapolsky and Dhabhar.

Situations we typically perceive as stressful—a confrontation with a co-worker, the

pressure to perform, a to-do list that is too long—are not the toxic type of stress
that has been linked to serious health issues such as cardiovascular disease,
autoimmune disorders, severe depression and cognitive impairment. Short bouts
of this sort of everyday stress can actually be a good thing. Just think of the
exhilaration of the deadline met or the presentation crushed, and- the triumph of
holding it all together. And, perhaps not surprisingly, it turns out that beating
yourself up about being stressed is counterproductive, as worrying about the
negative consequences can worsen any ill effects.
When Dhabahar was starting his graduate work in McEwen’s lab in the early
1990s, “the absolutely overwhelming dogma was that stress suppresses
immunity.” But this did not make sense to him from an evolutionary perspective. If
a lion is chasing you, he reasoned, your immune system should be ramping up,
readying itself to heal torn flesh. It occurred to Dhabhar that the effects of acute
stress, which lasts minutes to hours, might differ from the effects of chronic stress,
which lasts days to years.
Dhabhar compares the body’s immune cells to soldiers. Because their levels in the
blood fall during acute stress, “people used to say: ‘See, stress is bad for you.
Your immune system is depressed,’” he commentss. “But most immune battles are
not going to be fought in the blood.” He suspected that the immune cells were
instead, traveling to the body’s “battlefields”—sites most likely to be wounded in an
attack, like the skin, gut, and lungs. In studies where rats were briefly confined (a
short-term stressor), he showed that after an initial surge of immune cells into the
bloodstream, they quickly exited the blood and took up positions precisely where
he predicted they would. “Dhabhar’s work was a pioneering demonstration of how
important the difference is between acute and chronic stress,” says Sapolsky, a
professor of biology, neurology, and neurological sciences and neurosurgery.
“Overwhelmingly, the bad health effects of stress are those of chronic stress.”
Benefits of Stress
This strategic placement of immune cells can speed wound healing, enhance
vaccine effectiveness and potentially fight cancer. In 2009, Dhabhar’s team
showed that knee surgery patients with strong immune redistribution, following the
stress of surgery, recovered significantly faster and had better knee function a year
later than those whose immune system worked slower. In other studies, volunteers
who exercised or took a math test (both acute stressors) immediately prior to being
vaccinated, had a heightened antibody response relative to volunteers who sat
quietly. And in 2010, the researchers limited the development of skin cancer in UV-
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exposed mice by stressing them before their sunlamp sessions. Dhabhar
speculates that giving cancer patients low-dose injections of stress hormones
might help prepare their immune systems to fight the cancer. “It may not work out,
but if it did, the benefits could be tremendous,” he says.
Moderate, transient stress may also have benefits beyond heightened immunity. In
a 2013 paper that Dhabhar co-authored, women who were caregivers for
husbands suffering from dementia (a chronic stressor) had more oxidative DNA
damage—a marker of biological aging—than other women their age. However,
women in the control group, who reported moderate stress levels, had less
oxidative damage than those who reported low stress levels.
Dhabhar thinks the key to maximizing the benefits of stress while minimizing any
negative effects is mixing “regular hits” of acute stress with periods of low or no
stress—what he calls “green zones.” That does not mean you have to add bungee
jumping or public speaking to your daily routine. Rather, he advises controlling the
daily frustrations that life already throws at you. In addition, Dhabhar recommends
exercising more, but maybe not for the reason you think. Exercise is widely
advertised as a stress reliever, but what many people do not realize is that it is also
a short-term stressor, he says. “Exercise activates the same biological response
as seeing a predator or making a speech.” Thus, physical exertion has a dual
benefit.
Stress and Learning
Whereas chronic stress impacts the hippocampus (one of the brain’s key memory
centers), damages cognitive function and increases risk of mental illness, short
bursts of stress can paradoxically enhance memory and learning. This makes
sense if you frame stress in a different way, says Conor Liston, a postdoctoral
research fellow in neurosciences who also did his graduate work in McEwen’s lab
at Rockefeller. “If you think of stress in terms of arousal—being awake and alert
and oriented to changes in the environment—this is a good thing for learning. If I
am dull, lethargic, disengaged and tired, I am not engaging as well with the world
around me.”
Under certain conditions, the stress hormone- cortisol- appears to boost the brain’s
receptivity to learning, what neuroscientists call “brain plasticity.” Neurons in the
brain each form thousands of synapses, structures that they use to communicate
with other neurons. As learning occurs, new synapses grow and old ones are
reduced. Using a microscope that can detect fluorescently labeled proteins through
the skull, Liston can watch this process occur in real time in the brains of living
mice. When he experimentally depleted corticosterone (the mouse equivalent of
cortisol) in a group of mice, synapse turnover—a marker of brain plasticity—
stopped. In this state, the mice were unable to learn a new skill. Conversely, when

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28.10.2024
Liston gave another group of mice a low-dose shot of corticosterone, the rate of
synapse turnover doubled.

“It’s intriguing to think we can loosen up brain plasticity,” says McEwen, who notes
that this might have applications for helping people recover after a stroke. There is
a danger in leaving the dial turned up for too long, though. When Liston exposed
mice to high-dose corticosterone for 10 days, the animals experienced a net loss
of synapses. It turned out that reducing outpaced synapse formation. This may
help explain the effects of chronic stress on mental functions.
The good news is that stress-induced cognitive impairments may be reversible. In
a 2009 study, Liston and his colleagues scanned the brains of 20 medical students
who spent a month cramming for the medical licensing boards—an exam that
could make or break their careers as doctors. Compared with the scans of a
control group of relatively unstressed medical students, the test takers’ scans
revealed deficits in the prefrontal cortex, the area that supports complex thought.
The students also scored significantly more poorly on a test of mental flexibility.
Yet, a month after the exam, their brains and performance had returned to normal.
Although it emphasizes the futility of cramming, the study suggests that even
sustained stress is not necessarily permanently damaging.
When Stress Becomes Toxic
The point at which chronic stress turns toxic is when it becomes unrelenting and
traumatic, and when sufferers lack control and social support. “What we tend to
mean when we talk about stress are the daily experiences of lack of time, job
uncertainty, social conflict and pressure,” says Kelly McGonigal, a health
psychologist and author. “I have become even more convinced that the type of
‘stress’ that is toxic has more to do with social status, social isolation and social
rejection. It is not just having a hard life that seems to be toxic, but it is some of the
social poisons that can go along with stigma or poverty.”
In a series of classic studies in Britain, called the Whitehall Studies, researchers
examined nearly 30,000 employees in the British civil service. All had secure jobs,
livable wages and access to the same health care. They also worked within a
precise hierarchy, with six levels of ranks. The researchers found that heart
disease and mortality rates increased steeply with every step down the ladder.
Those on the lower rungs tended to lead less healthy lives. They smoked more, for
example, but even factoring in lifestyle differences, the lowest-ranking employees
had twice the mortality rate of the highest-ranking individuals. The researchers
attributed this disparity to the psychological stresses of low status and lack of
control.

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Sapolsky’s studies of baboon troops in Kenya have revealed a similar effect.
Those at the bottom of a stable social hierarchy have the highest resting cortisol
levels, cholesterol levels and blood pressures. “I would say that, overall, the most
toxic type of social stress in our Western world is low socioeconomic status—i.e.,
poverty,” he says, echoing McGonigal.

High-ranking individuals may have demanding jobs, but they also enjoy a greater
sense of autonomy. In a study that appeared in the Proceedings of the National
Academy of Sciences, just before the 2012 presidential election, researchers
found that a group of leaders—military officers and government officials—had
lower resting cortisol and self-reported anxiety than a comparable group of non-
leaders. This is despite the fact that leaders appeared more stressed. They slept
fewer hours per night than non-leaders. Among the leaders, those who managed
more people and had more authority also had lower cortisol levels and lower
anxiety than those with less power. This association was directly related to their
greater sense of control.
In the early1990s, researchers surveyed 7,268 participants from one of the
Whitehall cohorts about their current stress levels and their perceptions of the
impact of stress on their health. Independent of job rank, initial health status or the
level of stress reported that those who believed that stress had a large effect on
their health had double the risk of suffering a heart attack within the 18-year follow-
up period compared with those who viewed stress as being unrelated to their
health. Similarly, in a large U.S. study, people with high stress levels had an
elevated mortality rate only if they also believed that stress greatly affects health.
Stress as an Opportunity
We try to avoid stress or letting others know we are stressed. McGonigal is worried
that may lead people to stay away from exactly the kinds of experiences that are
critical for health and longevity. “We know that having a meaningful job is
protective-protecting our health. We also know that social connection is protective
and mastery of challenges is protective.”
Additionally, how people view stress—as a threat versus an opportunity—can alter
their physiologic responses to it. In a 2011 study at Harvard, volunteers were
exposed to positive messages about stress—that it is adaptive and aids
performance—prior to a public speaking task. They had healthier heart profiles
(their hearts pumped more efficiently and their blood vessels constricted less)
during the stressor than controls who were given no information or were told to
suppress stressful emotions. “This shows that you can change your moment-to-
moment cardiovascular physiology, depending on how you think about stress,”
McGonigal says.

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In her lectures and classes, McGonigal used to teach people how to reduce or
cope with stress, as if it were something to be avoided and dreaded. But
considering this research, she has changed her tune. She no longer focuses on
training people to relax, breathe and calm down in the face of stress. Instead, she
encourages them to harness the stress: “Rather than trying to slow your pounding
heart, why couldn’t you view it as your body giving you energy?” she says.

After all, even if you could live in a stress-free bubble, you would probably have to
erase all the things that fill your life with happiness and meaning—like
relationships, challenging work, learning and growth. “In a way,” McGonigal
concludes, “stress is a kind of meeting with life.”

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Final Exam '‫מועד ב‬ ‫מתקדמים ב‬
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28.10.2024
Questions: The Benefits of Stress

.‫עליך לרשום את התשובות לשאלות במחברת המצורפת לשאלון‬

Answer the following questions according to section Introduction.

1. In YOUR OWN WORDS, how would you summarize all the statistics in the
second paragraph. What is the common issue?
(8 pts)

2. According to Sapolsky’s discovery, the hormone cortisol can be harmful

under what circumstances? (8 pts)

Answer the following questions according to section Acute vs Chronic

Stress
3. Complete the following chart according to the text.
(12 pts)

Type of Stress Description/What is it? Example

Acute a. b.

Chronic/Toxic c. d.

4. Complete the following sentence. (8 pts)

The most significant difference between acute stress and chronic stress is_

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Final Exam '‫מועד ב‬ ‫מתקדמים ב‬
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28.10.2024
Answer the following questions according to section Benefits of Stress
5a. The following sentence is TRUE/FALSE (choose one) (8 pts)
Temporary stress may benefit healing and help bring about a stronger immune
system.
5b. support your answer with a quote from the text.

6. Explain IN YOUR OWN WORDS (8 pts)

Explain the concept of “green zones”

Answer the following questions according to section Stress and Learning

7a. The following statement is TRUE/FALSE (choose one) (8 pts)

Chronic stress can aid in recalling information by causing us to be more alert.
7b. Support your answer with a quote from the text.

8.The example of the medical students is given to illustrate what point? (8 pts)

Answer the following questions according to section When Stress Becomes

Toxic
9. Explain IN YOUR OWN WORDS.
Write a short composition of no less than 5 sentences. (Less than 5
sentences is zero points)

What is toxic stress and who is the most vulnerable to suffer from it?
(8 pts)

10. There were similar findings in both the Whitehall Studies and Sapolsky’s
studies of baboons in Kenya. What were the findings? (8 pts)

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Final Exam '‫מועד ב‬ ‫מתקדמים ב‬
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28.10.2024
Answer the following question according to section Stress as an
Opportunity
11. What is meant by the expression that McGonigal “has changed her tune”?
(8 pts)
Answer the following question according to the entire text.
12. Answer the following question IN YOUR OWN WORDS.
What is the main idea of the text?
(8 pts)

11