(Grammar) Determiners and articles

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General and specific determiners

Determiners are words which come at the beginning of the noun phrase.

They tell us whether the noun phrase is specific or general.

Determiners are either specific or general

Specific determiners:

The specific determiners are:

• the definite article: the
• possessives: my, your, his, her, its; our, their, whose
• demonstratives: this, that, these, those
• interrogatives: which

We use a specific determiner when we believe the listener/reader knows exactly what we are referring to:

Can you pass me the salt please?
Look at those lovely flowers.
Thank you very much for your letter.
Whose coat is this?

General determiners:

The general determiners are:

• a; an; any; another; other; what

When we are talking about things in general and the listener/reader does not know exactly what we are referring to, we can use an uncount noun or a plural noun with no determiner:

Milk is very good for you. (= uncount noun)
Health and education are very important. (= 2 uncount nouns)
Girls normally do better in school than boys. (= plural nouns with no determiner)

… or you can use a singular noun with the indefinite article a or an:

A woman was lifted to safety by a helicopter.
A man climbing nearby saw the accident.

We use the general determiner any with a singular noun or an uncount noun when we are talking about all of those people or things:

It’s very easy. Any child can do it. (= All children can do it)
With a full licence you are allowed to drive any car.
I like beef, lamb, pork - any meat.

We use the general determiner another to talk about an additional person or thing:

Would you like another glass of wine?

The plural form of another is other:

I spoke to John, Helen and a few other friends.

Quantifiers

We use quantifiers when we want to give someone information about the number of something: how much or how many.


The following quantifiers will work with count nouns:
      many trees
      a few trees
      few trees
      several trees
      a couple of trees
      none of the trees

The following quantifiers will work with non-count nouns:
      not much dancing
      a little dancing
      little dancing
      a bit of dancing
      a good deal of dancing
      a great deal of dancing
      no dancing

The following quantifiers will work with both count and non-count nouns:
      all of the trees/dancing
      some trees/dancing
      most of the trees/dancing
      enough trees/dancing
      a lot of trees/dancing
      lots of trees/dancing
      plenty of trees/dancing
      a lack of trees/dancing

Articles: A Basic Quiz

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"Cold Comfort"
by Michael Castleman
from Mother Jones Magazine, March/April 1998; reprinted with permission.

Not so long ago, many of us resisted separating  glass, cans, and paper out of our garbage. What  hassle. Today, of course, every second-grader knows that  world's resources are limited and that recycling helps preserve them. We act locally, while thinking globally. It's time to bring  same consciousness to health care as we face  growing medical crisis:  loss of antibiotic effectiveness against common bacterial illnesses. By personally refusing -- or not demanding -- antibiotics for viral illnesses they won't cure, we can each take  step toward prolonging overall antibiotic effectiveness.

Media reports have likely made you aware of this problem, but they have neglected  implications. Your brother catches  cold that turns into  sinus infection. His doctor treats him with antibiotics, but  bacteria are resistant to all of them. The infection enters his bloodstream -- a condition known as septicemia -- and  few days later, your brother dies. (Septicemia is what killed Muppets creator Jim Henson a few years ago.) Or instead of cold, he has  infected cut that won't heal, or any other common bacterial disease, such as  ear or prostate infection.

Far-fetched? It's not.  antibiotics crisis is real. Consider Streptococcus pneumoniae: This common bacterium often causes post-flu pneumonia. (Pneumonia and influenza combined are  country's sixth leading cause of death, killing 82,500 Americans in 1996.) Before 1980, less than 1 percent of S. pneumoniae samples showed any resistance to penicillin. As of last May, researchers at  Naval Medical Center in San Diego discovered that 22 percent of S. pneumoniae samples were highly resistant to it, with another 15 percent moderately so. And  most recent statistics from  Sentry Antimicrobial Surveillance Program, which monitors bacterial resistance at 70 medical centers in  U.S., Canada, Europe, and South America, show that 44 percent of S. pneumoniae samples in the U.S. are highly resistant, and worldwide, resistance is at  all-time high (55 percent).

Strains of S. pneumoniae are also now resistant to tetracycline, erythromycin, clindamycin, chloramphenicol, and several other antibiotics. And there's a "plausible risk" that we'll run out of options for treating other types of pneumonia as well, according to infectious disease expert Joshua Lederberg of Rockefeller University in New York.  not-too-distant future promises  potential failure of medicine's ability to treat  broad range of bacterial infections -- from urinary tract infections to meningitis to tuberculosis.

Bacterial resistance to antibiotics is a direct outgrowth of the overuse of these drugs. In classic Darwinian fashion,  more doctors prescribe antibiotics,  more likely it is for some lucky bacterium blessed with  minor genetic variation to survive antibiotic assault-and pass its resistance along to its offspring. The solution is obvious: Doctors should prescribe antibiotics only as  last resort.

This strategy works. In  early 1990s, Finnish public health authorities responded to rising bacterial resistance to erythromycin by discouraging its use as a first-line treatment for certain infections. From 1991 to 1992, erythromycin consumption per capita dropped 43 percent. By 1996, bacterial resistance to  antibiotic had been cut almost in half. But American doctors are doing  spectacularly lousy job of keeping their pens off their prescription pads, most notably by prescribing antibiotics for  common cold and other upper respiratory tract infections (URIs). Data from  National Ambulatory Medical Care Survey show that bronchitis and URIs account for  third of  nation's antibiotic prescriptions. Antibiotics treat only bacterial infections and are completely powerless against viral illnesses. Every doctor knows this.

Yet, according to  recent study by Dr. Ralph Gonzalez,  assistant professor of medicine at the University of Colorado Health Sciences Center in Denver, when adults consult physicians for URIs and  bronchitis that often follows them, more than half walk out with  prescription for  antibiotic. If doctors simply stopped prescribing antibiotics for conditions they know don't respond to them, we'd instantly be well on our way to minimizing antibiotic resistance.

Why are doctors so ready to prescribe antibiotics? Physicians are quick to blame  public. Patients, they say, demand antibiotics, and doctors are so terrified of malpractice suits they prescribe them to keep their customers happy and their lawyers at bay.

There's another side to  story: Doctors are trained that there's  pill for every ill (or there should be). All of their medical education conspires to make  antibiotic prescription their knee-jerk reaction to any infection, which may or may not have  bacterial cause.

In addition, prescribing antibiotics is the doctors' path of least resistance. It's easier than taking  time to explain that antibiotics are worthless against viral infections, and to recommend rest, fluids, and vitamin C-or, God forbid,  herbal, homeopathic, Chinese, or other complementary treatment. Most medical practices schedule patients at 15-minute intervals. Rather than doing what they know is right for public health, it's much quicker for doctors to whip out the prescription pad and send people on their merry, albeit misinformed way.

In  better world, medical education would be less drug-oriented and  health care system would encourage doctors to take  time to be effective health educators. But even in our imperfect world, some basic health education can help prevent frivolous antibiotic use from boomeranging.

Like our doctors, we Americans have been socialized into believing that antibiotics are miracle drugs that can cure just about everything. They aren't, and they don't. We've also been trained to think that colds and their lingering coughs should clear up in  few days. They usually don't -- even if you load up on cold formulas that promise to make all symptoms magically vanish. A study by University of Virginia professor of medicine Jack Gwaltney, one of nation's top cold researchers, shows that nearly one-third of adults with colds are still coughing after 10 days. Meanwhile, according to a recent survey by researchers at Louisiana State University Medical Center in New Orleans, after just five days of cold symptoms, 61 percent of adults are ready to head for their doctors -- and ask for unnecessary antibiotic prescriptions.

My fellow Americans, the next time you feel  cold coming on, mark your calendar. Unless you start coughing up lots of green sputum or develop unusual symptoms -- for example, a fever that does not respond to aspirin, acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) -- think twice about calling your doctor before two weeks have passed.

What I do instead is, from  moment I feel the infection coming on, I drink lots of hot fluids, take 500 to 1,000 milligrams of vitamin C four times a day, suck on  zinc lozenge every two waking hours, and mix half a teaspoon of tincture of echinacea,  immune-boosting herb, into juice or tea three times a day.

Reliable studies show that these approaches reduce  severity and duration of colds. If you develop  persistent cough at  tail end of your cold, keep taking vitamin C and try an over-the-counter cough suppressant containing dextromethorphan.

If we hope to preserve antibiotic effectiveness, it's up to us,  public, to convince doctors to prescribe these drugs only when they're necessary. This from-the- bottom-up approach is nothing new. Health consumers have taken the lead in showing doctors  value of fitness, nutrition, and alternative therapies. It's time we get serious about antibiotics.

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