Reading — 2026 Jan–Apr Recall Set 25

Australians living or traveling in rural and remote areas can face particular difficulties when they need medical care. Hundreds of kilometres from major cities and many hours by road from the closest hospital or clinic, some rural Australians do not have easy access to doctors, nurses and dentists. Organisations such as the Royal Flying Doctor Service (RFDS) have been established to bring health services to outback Australian communities. The RFDS provides free medical care to people who live, work or travel in remote and regional parts of Australia. This non-profit organisation is the oldest and largest airborne health service of its kind in the world, and since 1928 it has used small aircraft to send doctors and nurses to some of Australia's most far-away communities. In recent years, the RFDS has also started to fly dentists to regional Australia. As well as offering mobile dental clinics, the RFDS offers a range of preventative and educational services. Looking after the teeth of people in remote areas presents special challenges. These include providing care to disparate communities with no established dental facilities, and dealing with higher incidences of other diseases which are linked to, or caused by poor dental health. People in remote areas have very infrequent visits by health staff. RFDS dentists might only visit a community once every few months, or sometimes once per year. Because of infrequent dentist visits, patients in these areas often need to put up with their dental problems before they can get treatment: consequently, people in remote areas are more likely to have tooth decay (the blackening and deterioration of teeth) and develop gum and other mouth diseases. In some locations that the RFDS visits, there are no suitable dental facilities, so dentists have to bring everything with them. This includes drills, dentists' chairs, portable X-ray machines, and computers for keeping track of patients' treatments. Equipment can weigh up to 100 kilograms, and since the small planes that transport dentists have limited space, dentists cannot always bring everything that they need. While dentists in town or city centres can specialise in certain types of treatment, RFDS dentists need to be all-rounders. They need to be able to do all kinds of dental procedures, as they don't have the ability to refer patients to more specialised dentists. Even with their broad experience, there are some services that are particularly challenging for RFDS dentists. For example, dentures (or artificial teeth) can be very difficult to provide, as they need to be the right shape and size for the patient, and require many visits over a long period of time. As a result it is not practical to make dentures available. Some chronic illnesses are more common in remote communities than in the rest of Australia. These illnesses can in turn lead to a lowered resistance to infection, including gum and other oral infections. As a result, people in outback Australian communities are more likely to experience oral health problems than city folk, and this poses extra challenges for both the dentists and the doctors of the RFDS. Because there aren't a lot of dental services in remote areas, people living in these areas also receive less education about good dental hygiene than their city counterparts do. Australians in very remote communities might not be aware of things that people in cities take for granted, such as the importance of daily tooth brushing. Also, basic dental hygiene items such as toothpaste and toothbrushes can be more expensive in outback areas. Many people are on low incomes, meaning they have extra difficulty affording these products. If this is the case, the RFDS supplies these. As well as treating patients, RFDS dentists try to focus on preventative oral health and educate their patients on good oral hygiene, such as tooth brushing and flossing. The RFDS also provides mouthguards for young sports players. Playing contact sports, such as rugby league or Australian rules football, can damage young people's teeth, so mouthguards provide protection which prevents accidental injuries. Adding fluoride to water supplies has been proven to reduce the incidence of tooth decay in many parts of the world. City dwellers in Australia use water supplies that have been fluoridated, and their rates of tooth decay are lower because of this. In remote areas, it is not practical to fluoridate drinking water supplies, and so people living in these areas are more subject to tooth decay. As a result, it is particularly important that people living in areas without fluoridated water pay special attention to regular brushing of their teeth with fluoridated toothpaste. Despite many challenges, the RFDS continues to offer much-needed dental and medical support. Its presence in isolated communities greatly improves the quality of dental health, and supports important oral hygiene and health initiatives.

A Ever had a song stuck in your head, playing on an endless loop? Scientists call them 'involuntary musical images', or 'earworms', and a wave of new research is shining light on why they occur and what can be learned from them. Some neuroscientists and cognitive psychologists are studying earworms to explore the mysteries of memory and the part of the brain that is beyond our conscious control. 'The idea that we have full control over our thought processes is an illusion,' says psychologist Lauren Stewart, who founded the master's program in music, mind and brain at Goldsmiths, University of London, UK, where recent research has taken place. Researchers haven't been able to watch what happens in the brain when earworms occur, because they happen unpredictably. Much of what is known about them comes from surveys, questionnaires, diaries and lab experiments. B A Goldsmiths study published in the journal Memory and Cognition this year showed that the singing we hear in our heads tends to be true to actual recordings. Researchers had 17 volunteers tap to the beat of any earworm they heard during a four-day period while a device attached to their wrist recorded their movements. The tapping tempos were within 10% of the tempos of the original recordings. Another Goldsmiths study, published this year in Consciousness and Cognition, found that people who report hearing earworms often, and find them most intrusive, have slightly different brain structures, with more gray matter in areas associated with processing emotions. C Studies also show that the music in our heads often starts playing during times of 'low cognitive load', such as while showering, getting dressed, walking, or doing chores. Dr Stewart likens earworms to 'sonic screen savers' that keep the mind entertained while it is otherwise unoccupied. She and her colleagues tested that theory by having volunteers listen to songs and giving them various tasks afterwards. The volunteers who sat idly for the next five minutes were the most likely to report hearing the music in their heads. Dr Stewart observed that the more challenging the activity, the less likely the volunteers were to hear the music. Diary studies also show songs tend to match people's moods and therefore they are not random. If you are energized and upbeat, an earworm that occurs is likely to be uptempo too. D Songs the brain fixates on are usually those it has been exposed to recently, surveys show, which is why tunes getting heavy radio play frequently top the earworm charts. Even tunes you may have heard but didn't pay attention to can worm their way into your subconscious, says Ira Hyman, a psychologist at Western Washington University in Bellingham, USA. In an unpublished study there, participants who listened to music while doing other tasks were more likely to report that the songs returned as earworms later on, compared with participants who simply listened. E Some earworms are just fragments of a song that repeat like a broken record. So, when the mind hits a part of a song it can't remember, it loops back rather than moving on. That could make an earworm even more entrenched, Dr Hyman says. According to a theory known as the Zeigarnik effect, named for a Soviet psychologist, Bluma Zeigarnik, unfinished thoughts and activities weigh on the mind more heavily than those that are completed, although experiments exposing students to interrupted songs have yielded mixed results. F Researchers say they can't pinpoint a spot in the brain where earworms live. Imaging studies by Andrea Halpern at Bucknell University, in Lewisburg, USA, have shown that deliberately imagining music and actually listening to music activate many of the same neurological networks. Dr Halpern's earlier studies showed that when subjects listened to the first few notes of familiar music, areas in the right frontal and superior temporal portions of the brain became activated, along with the supplementary motor area at the top, which is typically involved in remembering sequences. When the same subjects listened to unfamiliar music and were asked to recall it, there was activity in the left frontal portions of the brain instead. G One factor that makes some songs stick might be repetition. 'Repetition leads to familiarity which leads to anticipation, which is satisfied by hearing the song,' says John Seabrook, author of The Song Machine: Inside the Hit Factory, about how producers pump pop songs full of aural "hooks', the punchy melodic phrases designed to target the brain and leave it wanting more. The researchers are comparing the melodic structure of 100 often-mentioned songs with 100 similarly popular songs that weren't cited as earworms, to assess the difference. Songs with earworm potential appear to share certain features: a repeating pattern of ups and downs in pitch, and an irregular musical interval. H The researchers plan next to test their results in reverse, and play ringtones from songs of both the earworm and non-earworm variety for volunteers several times a day to see which ones get stuck. Drs Stewart and Halper are now working together to recruit survey participants for a study looking at whether people at different stages of life experience earworms differently. 'You can argue that older people might get them more often because they know more songs,' Dr Halpern says. 'But the few responses we have so far indicate that they have earworms less often. It could be that they don't play music as often as younger people do.'

How does someone become expert in music? And is it really possible to have a talent for music? Does that class of people acknowledged to be musical experts just have more of the same basic skills we are all endowed with, or do they have a set of abilities — or neural structures — that are totally different from those of the rest of us? Are high levels of musical achievement simply the result of training and practice, or are they based on innate brain structure — what we refer to as talent? Talent can be defined as something that originates in genetic structures and that is identifiable by trained people who can recognize its existence before a person has achieved exceptional levels of performance. The emphasis on early identification means that to investigate it, we study the development of skills in children. It is evident that some children acquire skills more rapidly than others: the age of onset for walking and talking varies widely, even between children in the same household. There may be genetic factors at work, but these are closely linked with other factors — with a presumably environmental component — such as motivation and family dynamics. Similar factors can influence musical development and can mask the contribution of genetics to musical ability. Brain studies, so far, haven’t been of much use in sorting out the issues. Gottfried Schlaug at Harvard collected brain scans of individuals with absolute pitch* (AP) and showed that a region in the brain called the planum temporale is larger in these people than in others. This suggests that the planum is involved in AP, but it’s not clear if it starts out larger in people who eventually acquire AP, or if the acquisition of AP makes the planum increase in size. Results of research into the areas of the brain involved in skilled motor movement are more conclusive. Studies of violin players have shown that the region of the brain responsible for controlling the movement of the left hand (the hand that requires greater precision in violin playing) increases in size as a result of practice. We do not know yet if the propensity for increase pre-exists in some people and not others. *individuals with absolute pitch: people who can identify or sing any musical note correctly without help The evidence against talent comes from research on how much training the experts do. Like experts in mathematics, chess, or sports, experts in music require lengthy periods of instruction and practice. In several studies, the very best music students were found to have practised more than twice as much as the others. In another study, students were secretly divided into two groups based on teachers’ perceptions of their talent. Several years later, it was found that the students who achieved the highest performance ratings had practised the most, irrespective of which talent group they had been assigned to, suggesting that practice does not merely correlate with achievement, but causes it. Anders Ericsson, at Florida State University, approaches the topic of musical expertise as a general problem in cognitive psychology. He takes as a starting point the assumption that there are certain issues involved in becoming an expert at anything; that we can learn about musical expertise by studying expert chess players, athletes, artists, mathematicians, as well as the musicians themselves. The emerging picture from such studies is that ten thousand hours of practice is required to achieve the level of mastery associated with being a world-class expert — in anything. In study after study, of composers, ice-skaters, concert pianists, chess players and master criminals, this number comes up again and again. Someone would do this amount of practice if they practised, for example, roughly 20 hours a week for ten years. Of course, this does not address why some people do not seem to get anywhere when they practise, and why some people get more out of their practice sessions than others. But no-one has yet found a case in which true world-class expertise was accomplished in less time. It seems that it takes the brain this long to assimilate all that it needs to know to achieve true mastery. The ten-thousand-hour theory is consistent with what we know about how the brain learns. Learning requires the assimilation and consolidation of information in neural tissue. The more experiences we have with something, the stronger the memory/learning trace for that experience becomes. Although people differ in how long it takes them to consolidate information neurally, it remains true that increased practice leads to a greater number of neural traces, which create stronger memory representation. The classic rebuttal to this theory goes something like this: What about Mozart? I hear that he composed his first symphony at the age of four! First, there is a factual error here: Mozart did not write it until he was eight. Still, this is unusual, to say the least. However, this early work received little acclaim and was not performed very often. In fact, the only reason we know about it is because the child who wrote it grew up to become Mozart. And Mozart had an expert teacher in his father, who was renowned as a teacher of musicians all over Europe. We do not know how much Mozart practised, but if he started at age two and worked thirty-two hours a week (quite possible, given that his father was a stern task-master) he would have made his ten thousand hours by the time he composed his first symphony. This does not mean that there are no genetic factors involved in Mozart’s greatness, but that inborn traits may not be the only cause.