OET 2.0 READING EXERCISES & ANSWER KEY · 2020. 9. 26. · Overview of OET 2.0 Reading Sub-Test The...

OET 2.0READINGSUB-TEST

EXERCISES& ANSWER KEY

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PREFACEThis book is specifically designed for Amazon free kindle-reading app, whichis supported on any device( smartphones, laptops, computers, ebook readers,etc) on any platforms (windows, android, apple ios, etc). Therefore, you canread this book on multiple devices you own.

How this book is different from other booksavailable in the market?Unlike paper books and other e books, you don’t have to scroll or turn pagesback and forth while answering questions. One-touch navigation links (withone single touch you will execute the intended action) are available betweeneach questions and their respective texts/paragraphs, and vice versa. This willsave you a lot of time, and makes your answering quicker.Apart from this, one-touch reference links are available for every word inthis book (including any words from paragraphs, questions, instructions, oreven these words, which you are reading right now).There are mainly five types of reference links are available in this book. Theyare:1. Dictionary:– in-built dictionaries are available for referring any word youtouch and hold. This feature helps you save a lot of time by:

a. You don’t have to search through a paper bind dictionary to find themeaning of the word.

b. You don’t have to check out a word list under the heading‘vocabulary’ to improve your vocabulary. While reading this bookyou can learn the meaning of words that you don’t know, by just asingle touch and hold over the unknown word that you find.

c. There is an in-built Oxford English dictionary available for yourreference, which shows the meaning in a pop up dialogue box. If youprefer detailed meaning or the meaning of phrases related to theword, then you can easily choose full definition in the pop-up box forfurther details and pronunciation.

d. In-built English – Native languages dictionaries are also available,

if you desire to know more about the word in your mother tongue.This will increase levels of understanding the word in detail andhelpful to remember quickly later.

2. Wikipedia:– in-built Wikipedia reference is available for referring anyword you touch and hold. This feature helps you save a lot of time by:

a. You don’t have to manually browse internet to find the Wikipediareference of the word.

b. You can read Wikipedia reference without closing or minimizing thekindle app in which you are reading the book.

c. Wikipedia reference of the word you selected is available in bothpop-up dialog box and in detail as you choose.

d. This helps in the better understanding of technical and technologicalterms.

3. Translation:– in-built quick translation to selected native language isavailable for referring any word you touch and hold.4. Web-search:– helps you search about the word in your browser for anextended research.5. In book search:– helps you find the selected word appearing in the bookitself in other locations.In addition to above-mentioned features, this book is totally customizable inkindle reading app. You can adjust the text size, font style, spacing andmargins. You can also change color theme (background color) fromwhite(default) to black (for reading during night) or sepia (if you likebackground of real paper bind book) or green (for vision(eye) –friendlyreading). These options can be accessed by clicking ‘Aa’ button on the toptool bar that appear on every page.This book is fully supported in Amazon free kindle reading app; so, use onlyfree kindle reading app to enjoy all the mentioned features.

ContentsEase of AccessOverview of OET 2.0 Reading Sub-TestMethod of AnsweringPractice Test 1Practice Test 2Practice Test 3Practice Test 4Practice Test 5Practice Test 6Practice Test 7Practice Test 8Practice Test 9Practice Test 10Practice Test 11Practice Test 12Practice Test 13Practice Test 14Practice Test 15Practice Test 16Practice Test 17Practice Test 18Practice Test 19Practice Test 20Answer Key

MOREOET BOOKS

BYMAGGIE RYAN

Overview of OET 2.0 Reading Sub-Test

The topics are of generic healthcare interest and are thereforeaccessible to candidates across all professions. The Reading sub-test contains three parts and a total of 42 question items, Part Aaccounts for 20 marks, Part B accounts for 6 marks and Part Caccounts for 16 marks. All three parts take a total of 60 minutes tocomplete. You will not be given extra time at the end of the sub-test to check your answers, and it is up to you to manage your time.The test is designed so that the time available is enough for you toread, choose your answers, and check your work.

NB: Abbreviations are not accepted in the Reading sub-test unlessthey appear in the texts.

NB: You must use correct spelling in the Reading sub-test to getthe marks. Responses that are not spelled correctly will not receiveany marks. American and British English spelling variations areaccepted, e.g., color and colour are both acceptable.

Part A – 15 minutes

Reading Part A tests your ability to skim and scan quickly acrossdifferent texts on a given topic in order to locate specificinformation. For that purpose, Part A is strictly timed and you mustcomplete all 20 question items within the allocated 15 minutes. Tocomplete the task successfully, you will also need to understand theconventions of different medical text types and understand the

presentation of numerical and textual information. The 20questions consist of matching, sentence completion and shortanswer questions.

NB: In Part A you should write your answers clearly in the spacesgiven in the question booklet.

NB: Please remember that there is a strict time limit for Part A, andPart A materials will be collected from you after 15 minutes. Youwill therefore not have any time to check your Part A answers laterin the test.

NB: In Part A you must use exactly the same form of the word orshort phrase as given in the four texts.

Part B and Part C – 45 minutes

NB: In Part B and Part C, you must shade the circle next to theappropriate answer. Answers written elsewhere in your booklet willnot be marked.

Part B

Part B assesses your ability to identify the detail or main point ofsix short texts sourced from the healthcare workplace. The textsmight consist of extracts from policy documents, hospitalguidelines, manuals or internal communications, such as emails ormemos. For each text, there is one three-option multiple-choice

question. To complete the task successfully, you will need toidentify specific ideas at sentence level.

Part C

Part C assesses your ability to identify detailed meaning andopinion in two texts on topics of interest to healthcareprofessionals. For each text, you must answer eight four-optionmultiple choice questions. Reading Part C tests your ability tounderstand the explicit or implied meaning as well as the attitude oropinion presented in a longer text. To complete the tasksuccessfully, you will need to identify the relationship betweenideas at sentence and paragraph level. Part C also tests your abilityto accurately understand lexical references and complex phraseswithin the text.

METHOD OF ANSWERINGSTEP 1.

FLASH READINGFlash reading refers to high-speed reading of the whole readingpassage in few minutes, without thinking anything in your head(not even trying to guess meaning of the unfamiliar words/phrases).It helps to provide a vague idea about the matters that are discussedin the reading passage. It also forms a clear map in mind showingthe order of statements as they appear in the passage, which easeslocating the extract/paragraph referred in questions whileanswering.

STEP 2.FOCUSED READING

After finishing flash reading, start answering the questions.Eliminate all the irrelevant and impossible options from themultiple choices. Find a quick fix on location of theextract/paragraph referred in the questions and read theextract/paragraph quickly (strictly not more than twice, if it is aparagraph and not more than thrice if it is a short extract) withcomplete focus. Write the answer you had found only if you aresure enough.If the answer is confusing (if you find more than one possibleanswer for the question), write the answer you think to have morepossibility to be correct on your answer sheet, along noting thequestion and two or three other possible answer for later reference.This will avoid wastage of time due to fixating over confusingquestions.

If the question is so tough that you fail to find a proper answer to it,then leave it blank and note the question number for later reference.Focused reading helps to answer all easy question in the readingtest correctly, instead of losing marks on them in the last minuterush.

STEP 3.THOROUGH READING

After finishing all the questions in the test, you can start answeringthe tough questions by reading thoroughly the referredextract/paragraph by reading. Thorough reading refers to slowreading with maximum concentration to find all possible meaningsbetween the lines, so that you arrive at a possible answer. Don’tread more than twice.After finishing tough questions, start answering questions withconfusing answers in the same manner. If you follow these threesteps you can spend time wisely, while attending a reading test.Avoid wasting time by going after tips for reading, when you arenot getting desired results.There are only two things that can improve your OET readingscore:1. Efficient management of time2. Practicing more and more reading sample tests.

WORK HARD, SCORE MORE!

Practice Test 1READING SUB-TEST – QUESTION PAPER: PART A

TIME: 15 MINUTES

INSTRUCTIONS TO CANDIDATES:

DO NOT open this Question Paper or the Text Booklet untilyou are told to do so. Write your answers on the spaces provided on this QuestionPaper.You must answer the questions within the 15-minute time limit.One mark will be granted for each correct answer.Answer ALL questions. Marks are NOT deducted for incorrect answers.At the end of the 15 minutes, hand in this Question Paper andthe Text Booklet. DO NOT remove OET material from the test room.Text AAspirin Resistance

Abstract

In the last few years, the concept of aspirin resistance has beenlargely emphasised in the medical literature, although its definition,mechanism, and specific guidelines for its management remainunclear. Aspirin displays good antithrombotic activity. Variouslaboratory parameters assessing the efficacy of aspirin likebleeding time, platelet reactivity, thromboxane-A2 (TX-A2)production, and measurement of platelet aggregation, have

confirmed the lack of its uniform effect on the platelets. Fewstudies have reported aspirin resistance to the tune of 5 - 45%.Various extrinsic and intrinsic factors influence the resistance.Numerous studies reveal that aspirin resistance can be overcome bycombining it with another antithrombotic agent, i.e., clopidogrel.Further, clopidogrel resistance has also been reported. So, much isexpected in the field of diagnostic tests in order to know the truepicture of aspirin resistance.

Go toQuestions

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Text BMechanisms of aspirin resistanceThe exact mechanisms are not clear:True aspirin resistance:The proposed factors for this type of resistance include:i. Decreased bioavailability of aspirin.ii. Accelerated platelet turnover introducing newly formed, non-aspirinated platelets into the blood stream.iii. Competition of aspirin with other NSAIDs (like ibuprofen)preventing aspirin access at Serine 530 of Cox-I.iv. Transcellular formation of TxA2 by aspirinated platelets fromPGH2 released by other blood cells or vascular cells.v. TxA2 production by aspirin insensitive Cox-2 in newly formedplatelets or other cells.vi. (Theoretical) presence of variant Cox-I which is less sensitive toaspirin inhibition.vii. Poor compliance by the patient.

Go toQuestions

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Text CAspirin dosage

According to the Antithrombotic Trialists’ Collaboration, dailydoses of aspirin (75 - 150 mg) are as effective as higher doses forprevention of thrombotic events and are associated with low risk ofbleeding. Bornstein et al in their study have shown that even 100mg of aspirin completely inhibits Cox-1 enzyme, thus furthersubstantiating the fact that patients with resistance establishedduring low dose aspirin therapy may respond to higher doses. Theresults of this study showed that aspirin in doses of 500 mg/daysignificantly prolonged the time between first and second stroke (p= 0.002) compared with lower doses. Helgason et al revealed thatan increase in the dose of aspirin to 625 that suboptimal reductionof urinary 11-dehydro TxB2 level during aspirin treatment isassociated with increased risk for future MI and cardiovasculardeath, thereby suggesting that “true aspirin resistance” may be aclinically relevant phenomenon. Inadequate inhibition of TxA2biosynthesis by aspirin can be seen in patients on ibuprofentherapy, because of competition of these 14 mg/day in five patientswho were aspirin resistant with 325 mg/day showed aspirinsensitivity. Another study has revealed that these patients remainedresistant with aspirin 1,300 mg. This shows that inadequate dosecannot explain aspirin resistance in all subjects.

Go toQuestions

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Text DManagement of aspirin resistance

Currently there are no specific guidelines for the management ofaspirin resistance. The first step is to enquire about the patient’scompliance. Regarding optimal aspirin dosing, it is controversial.No convincing data are available showing that the antithromboticeffect of aspirin is dose related. The meta-analysis by Anti-Thrombotic Trialist’s Collaboration refuted the claim that highdoses of aspirin (500 - 1,500 mg/day) were effective than lowdoses (75 - 150 mg/day). Other method to manage aspirinresistance is by addition of another antiplatelet agent – clopidogrel,because CAPRIE trial has shown greater benefit of combination ofaspirin and clopidogrel compared with aspirin alone. Thecombination of aspirin with clopidogrel is an ideal one sinceclopidogrel inhibits another pathway of platelet activation.However, till date, it is not clear whether the superiority of acombination of clopidogrel and aspirin over aspirin is due toclopidogrel compensation for aspirin non-responders. Resistance toeven clopidogrel has been reported, which is associated with anincreased risk of recurrent thrombotic events in patients with acuteMI.

.Go to

Questions“1” “2” “3” “4” “5” “6” “7” “8” “9” “10”“11”“12”“13”“14”“15”“16”“17”“18”“19”“20”

Part ATIME: 15 minutes

• Look at the four texts, A-D, in the separate Text Booklet.• For each question, 1-20, look through the texts, A-D, to find therelevant information.• Write your answers on the spaces provided in this QuestionPaper.• Answer all the questions within the 15-minute time limit.• Your answers should be correctly spelt.

QUESTIONS

Questions 1-7For each question, 1-7, decide which text (A, B, C or D) the informationcomes from. You may use any letter more than once.

In which text can you find information about1. what are the factors of true aspirin resistance? _____

Goto

“TextA”

“TextB”

“TextC”

“TextD”

2. how much of aspirin completely inhibits Cox-1 enzyme? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

3. what will happen if aspirin compete with other NSAIDs? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

4. how the the true picture of aspirin resistance is revealed? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

5. what are the parameters for assessing the efficacy of aspirin?_____

Goto

“TextA”

“TextB”

“TextC”

“TextD”

6. list the methods to manage aspirin resistance? _____Go “Text “Text “Text “Text

to A” B” C” D”

7. whether true aspirin resistance is a clinically relevantphenomenon? _____

Goto

“TextA”

“TextB”

“TextC”

“TextD”

Questions 8-13

Answer each of the questions, 8-13, with a word or short phrase from one ofthe texts. Each answer may include words, numbers or both.

8. How much mg of aspirin is minimum required to completelyinhibit Cox-1 enzyme?

Goto

“TextA”

“TextB”

“TextC”

“TextD”

9. Which patients show inadequate inhibition of TxA2 biosynthesis byaspirin?

Goto

“TextA”

“TextB”

“TextC”

“TextD”

10. Name the antiplatelet agent used to manage aspirin resistance?Goto

“TextA”

“TextB”

“TextC”

“TextD”

11. What are responsible for transcellular formation of TxA2?Goto

“TextA”

“TextB”

“TextC”

“TextD”

12. What is the daily doses range of aspirin according to theAntithrombotic Trialists’Collaboration?

Goto

“TextA”

“TextB”

“TextC”

“TextD”

13. Which trial has shown greater benefit of combination of aspirinand clopidogrel?

Goto

“TextA”

“TextB”

“TextC”

“TextD”

Questions 14-20Complete each of the sentences, 14-20, with a word or short phrasefrom one of the texts. Each answer may include words, numbers orboth.14. Aspirin displays good _____ activity.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

15. Few studies have reported aspirin resistance to the tune of_____.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

16. TxA2 may be produced by aspirin insensitive _____ in newlyformed platelets or other cells.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

17. Increase in the dose of aspirin to 625 is associated withincreased risk for future MI and _____.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

18. Inadequate inhibition of TxA2 ______ by aspirin can be seen inpatients on ibuprofen therapy.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

19. The first step in management of aspirin resistance is to enquireabout the patient’s ______.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

20. The combination of _____ with clopidogrel is an ideal one.Goto

“TextA”

“TextB”

“TextC”

“TextD”

Answer Key

“Practice Test 1”

Practice Test 2READING SUB-TEST – QUESTION PAPER: PART B & C

TIME: 45 MINUTES


DO NOT open this Question Paper or the Text Booklet untilyou are told to do so. Write your answers on the spaces provided on this QuestionPaper.You must answer Part B & C within the 45-minute time limit.One mark will be granted for each correct answer.Answer ALL questions. Marks are NOT deducted for incorrect answers.At the end of the 45 minutes, hand in this Question Paper andthe Text Booklet. DO NOT remove OET material from the test room.

Part B

In this part of the test, there are six short extracts relating to thework of health professionals. For questions 1-6, choose the answer(A, B or C) which you think fits best according to the text.

Anaesthetic MachinesThe anaesthetic machine (or anaesthesia machine in America) is used byanaesthesiologists and nurse anaesthetists to support the administration ofanaesthesia. The most common type of anaesthetic machine is thecontinuous-flow anaesthetic machine, which is designed to provide anaccurate and continuous supply of medical gases (such as oxygen and nitrousoxide), mixed with an accurate concentration of anaesthetic vapour (such as

halothane or isoflurane), and deliver this to the patient at a safe pressure andflow. Modern machines incorporate a ventilator, suction unit, and patientmonitoring devices.1. The manual is giving information aboutA. how to use anaesthetic machinesB. types of anaesthetic machinesC. an overview of anaesthetic machines

Autoclaves and Sterilizers

Sterilization is the killing of microorganisms that could harm patients. It canbe done by heat (steam, air, flame or boiling) or by chemical means.Autoclaves use high pressure steam and sterilizers use boiling water mixedwith chemicals to achieve this. Materials are placed inside the unit for acarefully specified length of time. Autoclaves achieve better sterilization thanboiling water sterilizers. Heat is delivered to water either by electricity orflame. This generates high temperature within the chamber. The autoclavealso contains high pressure when in use, hence the need for pressure controlvalves and safety valves. Users must be careful to check how long items needto be kept at the temperature reached.2. Why autoclaves are better than boiling water sterilizers?A. Heat is transferred to water by electricity or flameB. Autoclaves use high pressure steamC. Autoclaves generates high temperature within the chamber

ECG: How it works

The electrical activity is picked up by means of electrodes placed on the skin.The signal is amplified, processed if necessary and then ECG tracingsdisplayed and printed. Some ECG machines also provide preliminaryinterpretation of ECG recordings. There are 12 different types of recordingdisplayed depending upon the points from where the recordings are taken.Care must be taken to make the electrode sites clean of dirt before applyingelectrode jelly. Most problems occur with the patient cables or electrodes.3. The guidelines establish that the healthcare professional should

A. aim to make patients fully aware of how ECG works .B. carefully clean the electrode sites.C. respect the wishes of the patient above all else.

Benefits of electronic health records

EHR systems are complex applications which have demonstrated benefits.Their complexity makes it imperative to have good application design,training, and implementation. Studies have evaluated EHR systems andreported on various benefits and limitations of these systems. Benefitsincluded increase in immunization rates, improved data collection, increasedstaff productivity, increased visitor satisfaction with services, improvedcommunication, quality of care, access to data, reduced medical errors, andmore efficient use of staff time. Some of the disadvantages noted were: time-consuming data entry, slow access of data and decreased quality of patient-doctor interaction.4. The notice is giving information aboutA. pros and cons of electronic health recordsB. necessity of electronic health recordsC. demonstrated benefits of electronic health records

mHealth

The use of mobile technologies for data collection about individuals andinteractive information services are a part of a growing area of eHealth calledmHealth. The GOe published a volume on this subject in 2011 whichdocuments the uptake of mHealth worldwide by types of initiatives and mainbarriers to scale. Mobile technologies are emerging as a powerful tool forhealth information transfer including making patient information portable.Such technologies can be more fully utilized through electronic patientinformation such as EMRs and EHRs. Electronic records will work best,however, if there are standards in place for their use and interoperability.

5. The note tells us that the mHealthA. is a published volume on the GOe

B. is a powerful tool for information transferC. makes patient information portable

Systematized Nomenclature of Medicine (SNOMED)

SNOMED was designed to provide a comprehensive nomenclature of clinicalmedicine for the purpose of describing records of clinical care in humanmedicine. It is a multi-axial and hierarchical classification system. It is multi-axial in that any given clinical condition can be described through multipleaxes such as topography (anatomy), morphology, organisms such as bacteriaand viruses, chemicals such as drugs, function (signs and symptoms),occupation, diagnosis, procedure, physical agents or activities, social context,and syntactic linkages and qualifiers. SNOMED is hierarchical in that each ofthe axes has a hierarchical tree that proceeds from general terms to morespecific ones. For example topography (anatomic) terms are first divided intomajor organs such as lung, heart, and then into the smaller components ofeach.

6. What does this extract from a handbook tell us about SystematizedNomenclature of Medicine?A. is a multi-axial and hierarchical classification systemB. is a comprehensive nomenclature of trial medicinesC. is used to described any clinical condition through axis

Answer Key“Practice Test 2”


TIME: 45 MINUTES



Part CIn this part of the test, there are two texts about different aspects ofhealthcare. Choose the answer (A, B, C or D) which you think fitsbest according to the text.

All life is connected Cancer in Humans and WildlifeWILDLIFE—HUMAN LINKS

Paragraph 1It may be that biologists, rather than physicians, will be the majorcontributors to the health of our wildlife caused by the combined action ofpesticides planet and its people. It was Rachel Carson, a biologist, whoresearched and wrote of the harm to wildlife caused by the combined action

of pesticides and radiation. In the tradition of the observant biologist is TheoColborn, who, with her colleagues, provided a significant breakthrough inunderstanding the hormonal effects of environmental contaminants. In July1991, a gathering of some of the world’s most astute, - scientists were held atthe Wingspread Conference Center in Wisconsin, where they defined thepattern of diverse endocrine malfunction seen throughout the animalkingdom. They revealed a gm“: picture of the Brave New World we shouldm rigorously seek not to leave as a legacy to our children.

Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”

Paragraph 2The conferees, studying wildlife over the globe, described ominous findingsof disease an linked to environmental pollution. Exposure to toxic chemicalsthat possess unintended h actions has resulted in anatomic, physiologic,reproductive, carcinogenic, and behavioral abnormalities across all forms ofanimal life: in mollusks, fish, birds, seals, and rodents. These creatures are towe humans as canaries were to the miners. We must understand that thedestruction of eons of evolutionary function and development in wildlifeforeshadows destruction of the entire biosphere, humans included.


Paragraph 3These widespread adverse effects were attributed to xenoestrogens. Xeno -comes from a Greek origin, meaning “foreign.” Foreign itself is not bad: howelse do we share and spread culture and ideas? But xenoestrogens are lessforeigners than invaders, gaining entrance by the Trojan horse of seeminglyharmless routes: milk, meat, cheese, fish, the products we use to nourishourselves and families. Like the invaders of Troy, after the xenoestrogensgain entrance to the bodies of animals and humans alike, they weakendefenses and wreak their harm of cancer, hormonal disruption,immunological abnormalities, and birth defects.


Paragraph 4Xenoestrogens are an insidious enemy, but they have had help from powerfulallies: the purveyors of products and chemicals, and legislators, regulators,and scientists reluctant to bite the money- laden hands that feed them.Wingspread researchers found that birds exposed to xenoestrogens showreproductive failure, growth retardation, life-threatening deformities, and

alterations in their brains and liver functions.” There is direct experimentalevidence for permanent [organizational] effects of gonadal steroids on thebrain as well as reproductive organs throughout life. This means thatoffspring whose brains have been altered are unable to function as had theirparents. They become different in ability or function.


Paragraph 5This means that the sea of hormonally active chemicals in which the fetusdevelops may change forever the health and function of the adult, and insome cases, may alter the course of an entire species. Worldwide there arereports of declining sperm counts and reduced ratio in births of male babies.Without the capacity to reproduce, a species ceases to exist. Extinction isforever; a species loss has never been reversed.


Paragraph 6The data derived from animal observations are unequivocal: breast andgenital cancers, _ ital abnormalities, interference with sexual development,and changes in reproductive behavior all expressions of a root cause. Apossible connection between women with breast cancer and those havingchildren with reversed sexual orientation is a question that bears study. Thisis n n. from science fiction, considering what we have learned from observingwildlife and the effects inappropriate hormonal influence upon the breast,brain, and reproductive organs. If an unequivocal answer were to emergefrom human observation, it could have a significant impact upon theprevailing political and economic landscape, and may finally settle the natureor nu issue of sexual orientation.


Paragraph 7SILENT SPRING-SILENT WOMEN Considering the accumulated knowledge linking chemical and radioactivecontamination environment with increasing breast cancer rates means wemust focus our energies and prevention. Early were the eloquent words andpleas for prevention from Rachel Carson. Her book, Silent Spring, originallypublished in 1962, while she herself was suffering from breast cancer, is stilla best seller. Ms. Carson documented wholesale killing of species; animals,birds, fish, insects; the destruction of food and shelter for wild creatures;

failure of reproduction; damage to the nervous system; tumors in wildanimals; increasing rates of leukemia in children; and chronicled thepesticides and chemicals known at that time to cause cancer. This was over30 years ago!


Paragraph 8Carson’s is a book for every citizen, for without understanding of ourcollective actions and permissions, we cannot govern democratically. InAustralia, a citizen is required to vote. In the United States, proclaimed bysome politicians as the “greatest democracy on earth,” often fewer than 50%bother to vote in a major election. Of those who do take the time to registerand vote, few are sufficiently alert and/or educated to vote with intelligence,thought, and compassion. Requiring participation in the governance of one’sown country is not a bad idea. Requiring thoughtful voting may be moredifficult, especially when it comes to such issues as cancer, pesticide use,consumer products, nuclear radiation, toxic chemicals, and environmentaldestruction. Taking this thought one step further; this democracy could do farworse than to require reading of Silent Spring as a requirement to vote!Radical? Perhaps. But is the ongoing cancer epidemic any less radical?


Paragraph 9One successor to Ms. Carson has emerged in the person of SandraSteingraber, an ecologist, poet, and scientist. In her book, LivingDownstream, she writes eloquently of the connections betweenenvironmental contamination and cancer. Dr. Steingraber was diagnosed withbladder cancer at age 20, a highly unusual diagnosis in a woman, a youngwoman, a nonsmoker and nondrinker. She pursued the question, why? Sherealized a connection with our wild relations and she asks: Tell me, does theSt. Lawrence beluga drink too much alcohol and does the St. Lawrencebeluga smoke too much and does the St. Lawrence beluga have a bad diet. . .is that why the beluga whales are ill? ...Do you think you are somehowimmune and that it is only the beluga whale that is being affected?


Paragraph 10The portion of Dr. Steingraber’s book that struck me most personally waswhen she says: First, even if cancer never comes back, one’s life is utterly

changed. Second, in all the years I have been under medical scrutiny, no onehas ever asked me about the environmental conditions where I grew up, eventhough bladder cancer in young women is highly unusual. I was once asked ifI had ever worked with dyes or had been employed in the rubber industry.(No and no.) Other than these questions, no doctor, nurse, or technician hasever shown interest in probing the possible causes of my disease-even when Ihave introduced the topic. From my conversations with other cancers,patients, I gather that such lack of curiosity in the medical community isusual.


Paragraph 11I take her words as an indictment of the medical and scientific establishment,whose point of view must be changed. Certainly the lack of curiosity amongphysicians, scientists, policymakers, and politicians has contributed to theepidemic of illness among humans and wildlife alike. An equally talentedwoman is Terry Tempest Williams, an ecologist and wildlife researcherwhose book, Refuge: An Unnatural History of Family and Place, tells thestory of her Utah family, whom she “labels “a clan of one—breastedwomen.” Ms. Williams contrasts the life-affirming awareness Great Salt Lakewildlife refuge against the erosion-of-being, as cancer takes away the womenin her family: her mother, her grandmothers, and six aunts. She writes: “Icannot prove that my mother Diane Dixon Tempest, or my grandmothers,Lettie Romney Dixon and Kathryn Blackett Tempest along with my aunts,developed cancer from nuclear fallout in Utah. But I can’t prove that didn’t.”


Paragraph 12Times are changing. It is becoming impossible to ignore the carnage ofendocrine-disruption chemicals, nuclear radiation, and chemical carcinogens,alone and in combination, invading nearly every family with cancer. Facingthis reality may be too much for some people, afraid to look, or afraid ofbeing the next victim. The story of cancer is not an easy one, and neither iscancer. But if we do not exert our efforts to prevent this disease, we doom ourchildren and grandchildren to repeat our collective errors. What does it taketo change from environmental destruction and random killing to affirmationof life? Can the protection of life for ourselves and our environment beaccomplished by women with breast cancer; the women at risk for breast

cancer; the families of breast cancer victims? Who should lead? If we citizenscan’t and don’t try, what are our alternatives?


QUESTIONSQ1. The author’s main contention is thata. wildlife all around the world is being linked to environmental pollutionb. fish, birds, seals and canaries are being exposed to toxic chemicalsc. humans need to understand the link between destroying the planet’swildlife, through exposure to toxic chemicals, and the destruction of theentire biosphere — which includes human life itself.d. humans need to understand the link between destroying the planet’swildlife, through exposure to toxic chemicals, and behavioural abnormalitiesacross all forms of life.

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Q2. The author states that in an environment of “hormonally activechemicals”a. males with higher sperm counts may result ‘b. more male babies are bornc. lower sperm count in males may result in a particular species being wipedout ‘d. males with more sperm count may result

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Q3. Dr Sandra Steingraber, ecologist, poet and scientist:a. realised that contracting bladder cancer was not due to her alcohol drinkingb. realised her bladder cancer was not due to her smokingc. believed her bladder cancer was due to environmental contaminationd. doctors, nurses and technicians were very interested in her unusual cancer

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Q4. The wildlife researcher, Terry Tempest Williams, sees the dichotomywhich exists in the Salt Lake wildlife refuge area:a. many women in her family have died from breast cancer after a nuclearfallout in Utahb. many men in her family have died from breast cancerc. her family have many one-breasted women — unusual for Utahd. such wide-spread cancer is probably due to environmental, not geneticcauses

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Q5. Animal observations show:a. changes in sexual maturity are not only due to a root causeb. genital abnormalities may be due to a root causec. inappropriate hormones adversely affect the development of breast, brainand reproductive organsd. humans are not similarly affected.

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Q6. The author puts forward several ideas about governance except for one ofthe following:a. People who participate in elections are not alert and educated enoughb. Unless the wants and needs of the population are known, it is difficult forpoliticians to govern democraticallyc. People being required to vote, to participate in the decision makingprocess, is a good idead. Reading Carson’s book, Silent Spring, should be made compulsory for allvoters.

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Q7. Rachel Carson’s book Silent Spring, written in 1962, revealed:a. more had to be done to prevent chemical contamination of the environmentb. there was a link between pesticides, chemicals and cancerc. chemicals were leading to an inability to reproduce leading to theeradication of entire species of insects, birds, fish and animalsd. all of the above

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Q8. Research about xenoestrogens revealsa. they are everywhereb. they are harmlessc. they are in our everyday foodsd. they are in our everyday foods and disrupt hormonal function

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TIME: 45 MINUTES




Does Tamiflu really work?Paragraph 1 The British Medical Journal (BMJ) was dominated in 2009 by a cluster ofarticles on oseltamivir (Tamiflu). Between them the articles conclude that theevidence that oseltamivir reduces complications in otherwise healthy peoplewith pandemic influenza is now uncertain and that we need a radical changein the rules on access to trial data.


Paragraph 2 The use of meta-analysis is governed by the Cochrane review protocol.Cochrane Reviews investigate the effects of interventions for prevention,treatment and rehabilitation in a healthcare setting. They are designed tofacilitate the choices that doctors, patients, policy makers and others face inhealth care. Most Cochrane Reviews are based on randomized controlledtrials, but other types of evidence may also be taken into account, ifappropriate.


Paragraph 3 If the data collected in a review are of sufficient quality and similar enough,they are summarised statistically in a meta-analysis, which generally providesa better overall estimate of a clinical effect than the results from individualstudies. Reviews aim to be relatively easy to understand for non-experts(although a certain amount of technical detail is always necessary). Toachieve this, Cochrane Review Groups like to work with “consumers”, forexample patients, who also contribute by pointing out issues that areimportant for people receiving certain interventions. Additionally, theCochrane Library contains glossaries to explain technical terms.


Paragraph 4 Briefly, in updating their Cochrane review, published in late 2009. TomJefferson and colleagues failed to verify claims, based on an analysis of 10drug company trials, that oseltamivir reduced the risk of complications inhealthy adults with influenza. These claims have formed a key part ofdecisions to stockpile the drug and make it widely available.


Paragraph 5 Only after questions were put by the BMJ and Channel 4 News has themanufacturer Roche committed to making “full study reports” available on apassword protected site. Some questions remain about who did what in theRoche trials, how patients were recruited, and why some neuropsychiatricadverse events were not reported. A response from Roche was published inthe BMJ letters pages and their full point by point response is publishedonline.


Paragraph 6 Should the BMJ be publishing the Cochrane review given that a morecomplete analysis of the evidence may be possible in the next few months?Yes, because Cochrane reviews are by their nature interim rather thandefinitive. They exist in the present tense, always to be superseded by thenext update. They are based on the best information available to thereviewers at the time they complete their review. The Cochrane reviewershave told the BMJ that they will update their review to incorporate eightunpublished Roche trials when they are provided with individual patient data.


Paragraph 7 Where does this leave oseltamivir, on which governments around the worldhave spent billions of pounds? The papers in last years journal relate only toits use in healthy adults with influenza. But they say nothing about its use inpatients judged to be at high risk of complications- pregnant women, childrenunder 5, and those with underlying medical conditions; and uncertainty overits role in reducing complications in healthy adults still leaves it as a usefuldrug for reducing the duration of symptoms. However, as Peter Doshi pointsout on this outcome it has yet to be compared in head to head trials with non-steroidal inflammatory drugs or paracetamol. And given the drug’s knownside effects, the risk-benefit profile shifts considerably if we are talking onlyin terms of symptom relief.


Paragraph 8 We don’t know yet whether this episode will turn out to be a decisive battleor merely a skirmish in the fight for greater transparency in drug evaluation.But it is a legitimate scientific concern that data used to support importanthealth policy strategies are held only by a commercial organisation and havenot been subject to full external scrutiny and review. It can’t be right that thepublic should have to rely on detective work by academics and journalists topatch together the evidence for such a widely prescribed drug. Individualpatient data from all trials of drugs should be readily available for scientificscrutiny.


QUESTIONSQ1. A cluster of articles on oseltamivir in the British Medical Journal

conclude__________a. complication are reduced in healthy people by oseltamivirb. the efficacy of Tamiflu in now in doubtc. complications from pandemic influenza are currently uncertaind. a series of articles supporting Tamiflu

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Q2. Cochrane Reviews are designed to __________a. set randomized controlled trials to specific valuesb. compile literature meta-analysisc. peer review articlesd. influence doctors choice of prescription

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Q3. According to the article, which one of the following statements aboutTamiflu is FALSE?a. The use of randomized controls is suspectb. The efficacy of Tamiflu is certainc. Oseltamivir induces complications in healthy peopled. Cochrane reviews are useful when examining the efficacy of Tamiflu

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Q4. According to the article, Cochrane Review Groups __________a. like to work for “consumers”.b. are being overhauled.c. use language suitable for expert to expert communication.d. evaluate a clinical effect better than individual studies.

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Q5. Which would make the best heading for paragraph 4?a. Analysis of 10 drug company trialsb. The stockpiling of Oseltamivirc. Risk of complications in healthy adults

d. Tamiflu claims fail verificationParagraphs“1”“2”“3”“4”“5”“6”“7”“8”

Q6. According to the article, which one of the following statements aboutRoche is TRUE?a. Full study reports were made freely available on the internetb. Patients were recruited through a double blind trialc. The identities and roles of researcher in the Roche trials are not fullyaccounted ford. Not all neuropsychiatric adverse events were reported

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Q7. Cochrane reviews should __________a. use a more complete analysisb. not be published until final data is availablec. be considered interim rather than definitive adviced. be superseded by a more reliable method of reporting results

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Q8. Which would make the best heading for paragraph 7?a. Risk-benefit profile of Tamiflub. Studies limited to healthy adultsc. High risk of complicationsd. Oseltamivir only for high risk patients

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TIME: 15 MINUTES


DO NOT open this Question Paper or the Text Booklet untilyou are told to do so. Write your answers on the spaces provided on this QuestionPaper.You must answer the questions within the 15-minute time limit.One mark will be granted for each correct answer.Answer ALL questions. Marks are NOT deducted for incorrect answers.At the end of the 15 minutes, hand in this Question Paper andthe Text Booklet. DO NOT remove OET material from the test room.Text AMorgellons diseaself you have fatigue, skin lesions, aches and pains and a sensation that insectsare crawling around under your skin, you most probably have Morgellonsdisease. But this disease may actually not exist. Whether or not Morgellons isa real disease, no one knows. Something like the symptoms described above,supplemented by the appearance of strange fibres or filaments growing on orjust beneath the skin, was reported by the 17th-century physician ThomasBrowne. There were no other reported cases, and the disease seemed todisappear. Then, in 2002, the mother of a child with a skin ailmentchampioned its comeback. Her child, she insisted, had Morgellons.Delve into the medical literature, though, and Morgellons disease isfrequently described as “unexplained dermopathy” or “delusional parasitosis”- a psychiatric illness that results in people mistakenly believing their skin to

be infested with parasites. We may soon find out more. The US Centers forDisease Control and Prevention (CDC) is in the middle of a large, systematicstudy into Morgellons. The study aims to determine whether there is actuallya physiological basis to the disease. The CDC is keeping an open mind onMorgellons, says Michele Pearson, who is leading the study. “CDC hasapproached this as an unexplained condition,” she says.

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Text BCDC, Kaiser to study puzzling illnessThe Centers for Disease Control and Prevention and Kaiser Permanente‘sNorthern California Division of Research announced they are launching astudy to learn more about an unexplained skin condition called Morgellonsdisease. The CDC will identify patients with the condition in Kaiser‘sNorthern California health plan. The study is expected to take at least 12months. Reports of cases have been made in every state and 15 countries.Many reported cases have been clustered in California, Texas and Florida,according to the Mayo Clinic.

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Text CDelusional ParasitosisDelusional Parasitosis is an uncommon psychiatric disorder presented bypersons with an unremitting false belief that they are infested withectoparasites or infected with endoparasites. The delusion is usually long-standing and well integrated into the patient’s persona. Patients with thedisorder are predominantly older women, although younger people and mencan be affected. Most cases involve patient beliefs that the skin has beeninvaded by insects, but some involve delusions that internal parasites are thecause of their condition.

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Text DThe causes for the disorder are not clear, but sufferers are generally ofaverage or higher intelligence and are otherwise functional. Patients withdelusional parasitosis generally have a long history of visiting physiciansseeking information of their diagnosis and help with their condition. Thepatients have certain characteristics or exhibit behaviors that strongly suggestthe presence of the disorder. Moreover, these patients can be antagonistic andrelentless in their need to find someone who will agree with their self-diagnosis and help them. Because these delusional patients may seek helpfrom non-physician medical professionals, such as parasitologists, clinicalmicrobiologists, entomologists, or biologists, such individuals should beaware of this disorder. Delusional parasitosis can be treated withantipsychotic medication and psychiatric consultations but generally does notrespond well to such treatment.

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Part ATIME: 15 minutes• Look at the four texts, A-D, in the separate Text Booklet.• For each question, 1-20, look through the texts, A-D, to find therelevant information.• Write your answers on the spaces provided in this QuestionPaper.• Answer all the questions within the 15-minute time limit.• Your answers should be correctly spelt.

QUESTIONS

Questions 1-7

For each question, 1-7, decide which text (A, B, C or D) the informationcomes from. You may use any letter more than once.

In which text can you find information about1. what is the minimum expected time period for CDC’s study to learn moreabout Morgellons disease? _____

Goto

“TextA”

“TextB”

“TextC”

“TextD”

2. what are the treatments for Morgellons disease? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

3. name the places where Morgellons disease reported so far? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

4. what is the aim for CDC’s study to learn more about Morgellons disease?_____

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“TextA”

“TextB”

“TextC”

“TextD”

5. which are the age groups predominantly affected by Morgellonsdisease? _____

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“TextB”

“TextC”

“TextD”

6. what is the current approach of CDC’s towards Morgellons disease?_____

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“TextB”

“TextC”

“TextD”

7. what are the other names of Morgellons disease? _____Goto

“TextA”

“TextB”

“TextC”

“TextD”

Questions 8-13

Answer each of the questions, 8-13, with a word or short phrase from one ofthe texts. Each answer may include words, numbers or both.

8. Who reported a medical condition similar to Morgellons diseasefor the first time?

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“TextA”

“TextB”

“TextC”

“TextD”

9. Name the person who leads CDC’s study to learn more about Morgellonsdisease?

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“TextA”

“TextB”

“TextC”

“TextD”

10. Name the type of medications used to treat Morgellons disease?Goto

“TextA”

“TextB”

“TextC”

“TextD”

11. How many countries reported Morgellons disease?Goto

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“TextB”

“TextC”

“TextD”

12. Name the type of illness under which the Morgellons disease isclassified?

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“TextD”

13. what is the popular delusion of the people affected by Morgellonsdisease?

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“TextA”

“TextB”

“TextC”

“TextD”

Questions 14-20Complete each of the sentences, 14-20, with a word or short phrasefrom one of the texts. Each answer may include words, numbers orboth.14. Morgellons disease is frequently described as _____ or “delusionalparasitosis”.

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“TextA”

“TextB”

“TextC”

“TextD”

15. Morgellons disease is a psychiatric illness that results in peoplemistakenly believing their skin to be infested with _____.

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“TextA”

“TextB”

“TextC”

“TextD”

16. Many reported cases have been clustered in California, Texas andFlorida, according to the _____.

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“TextA”

“TextB”

“TextC”

“TextD”

17. The _____ will identify patients with the condition in Kaiser‘s NorthernCalifornia health plan.

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“TextA”

“TextB”

“TextC”

“TextD”

18. The delusion is usually long- standing and well integrated into thepatient’s _____.

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“TextA”

“TextB”

“TextC”

“TextD”

19. Patients with delusional parasitosis generally have a long history ofvisiting ______.

Goto

“TextA”

“TextB”

“TextC”

“TextD”

20. Patients with delusional parasitosis can be antagonistic and ______.Goto

“TextA”

“TextB”

“TextC”

“TextD”



TIME: 45 MINUTES



Part B

In this part of the test, there are six short extracts relating to thework of health professionals. For questions 1-6, choose the answer(A, B or C) which you think fits best according to the text.

Electronic Diagnostic EquipmentThere are many items of equipment in a hospital that use electronics foroperation. The maintenance of such equipment is a task for specialised andtrained staff. However, regular inspection and cleaning will help suchequipment last for a long time and deliver safe function. These are tasks thatthe equipment user can carry out and should be done regularly, as laid out onthe checklists on the next pages. The types of equipment that might be

included in this category are for instance audiometers, blood gas analyzers,cardiac monitors, cryoprobes, infusion pumps and stimulators. The steps inthis section can also be applied to most laboratory equipment, although itshould be noted that the WHO publication Maintenance Manual forLaboratory Equipment deals with these in much better detail.1. The type of equipment that might not be included in the category ofElectronic Diagnostic Equipment isA. cardiac analyzersB. stimulatorsC. audiometersElectrosurgical Units (ESU) and Cautery Machines

Electrosurgery is the application of a high-frequency electric current tobiological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue.Its benefits include the ability to make precise cuts with limited blood loss inhospital operating rooms or in outpatient procedures. Cautery, orelectrocautery, is the application of heat to tissue to achieve coagulation.Although both methods are sometimes referred to as surgical diathermy , thischapter avoids the term as it may be confused with therapeutic diathermy,which generates lower levels of heat within the body.2. What does this manual tell us about electrocautery?A. make precise cut with limited blood lossB. uses high-frequency electric currentC. application of heat to tissue to achieve coagulationEndoscopy

Endoscopy means looking inside the body using an endoscope, an instrumentused to examine the interior of a hollow organ or cavity of the body.Endoscopes are inserted directly into the organ. An endoscope can consist ofa rigid or flexible tube, a light delivery system (light source), an optical fibresystem, a lens system transmitting the image to the viewer, an eyepiece andoften an additional channel to allow entry of medical instruments, fluids ormanipulators. There are many different types of endoscopy, includingarthroscopy, bronchoscopy, colonoscopy, colposcopy, cystoscopy,laparoscopy and laryngoscopy.

3. What does this extract from a handbook tell us about endoscopes?A. are inserted directly into the organB. used to examine the exterior of a hollow organ or cavity of the bodyC. there are mainly 7 typesMessaging standards

Messaging is the electronic communication of health information from thepoint of collection or storage to a point of use. This can be a short distancesuch as within a clinic or larger distances across facilities or districts.Messages can be used to retrieve historical data as well as current data. Ahealth message includes health data that is expressed in a standardvocabulary. It may also include metadata about the definitions orenvironment of the data. The message itself is in a precisely defined formatso that it can be received by a computer program which will understand itsmeaning.4. The email is reminding staff that theA. health message should include health data expressed in a standardvocabularyB. health message should include metadata about the definitions orenvironment of the dataC. health message should be precise in any format to be received by acomputer programCommunication skills during medical examination

An appropriate contact with the patient requires applying professionalknowledge about psychological aspects of interpersonal relations. Whileexamining the patient, most doctors apply just the experience or abilities toestablish interpersonal contacts that have been acquired on a social level. Thisknowledge would definitely be insufficient in unusual and problematicsituations. For many years, clinical and social aspects of doctors’psychological education have been neglected. The ability of conversationshould be based on appropriate education, not only on personal intuition orown experience.5. The notice is giving information aboutA. necessity of communication based on appropriate psychological education

B. necessity of establishing interpersonal contacts with patientC. necessity of appropriate contact based on personal experienceLiver PalpationLiver palpation is performed with the right hand placed flat under right costalchest border, parallel to the long body axis, then applying pressure at thedepth of inspiration in an attempt to move under the costal border in the rightmiddle clavicular line and towards its right side. In normal conditions, thelower liver border is not touched. During the respiration, the lower liverborder is slightly moving down and upwards.If the liver edge can be detected on palpation, some additional features haveto be determined as there are various abnormalities related with specificdiseases.6. What must all staff involved in liver palpation do?A. should place right hand flat under right chestB. should apply pressure at the depth of aspirationC. should place left hand flat under right chest



TIME: 45 MINUTES




Tufts University faculty debunks common dental mythsParagraph 1Brushing, flossing, and twice-yearly dental check-ups are standard for oralhealth care, but there are more health benefits to taking care of your pearlywhites than most of us know. In a review article, a faculty member at TuftsUniversity School of Dental Medicine (TUSDM) debunks common dentalmyths and outlines how diet and nutrition affects oral health in children,teenagers, expectant mothers, adults and elders.


Paragraph 2Myth 1: The consequences of poor oral health are restricted to themouth Expectant mothers may not know that what they eat affects the toothdevelopment of the fetus. Poor nutrition during pregnancy may make theunborn child more likely to have tooth decay later in life. “Between the agesof 14 weeks to four months, deficiencies in calcium, vitamin D, vitamin A,protein and calories could result oral defects,” says Carole Palmer, EdD, RD,professor at TUSDM and head of the division of nutrition and oral healthpromotion in the department of public health and community service. Somedata also suggest that lack of adequate vitamin B6 or B12 could be a riskfactor for cleft lip and cleft palate formation


Paragraph 3In children, tooth decay is the most prevalent disease, about five times morecommon than childhood asthma. “If a child’s mouth hurts due to tooth decay,he/she is less likely to be able to concentrate at school and is more likely tobe foods that are easier to chew but that are less nutritious. Foods such asdonuts and pastries are often lower in nutritional quality and higher in sugarcontent than nutritious foods that require chewing, like fruits and vegetables,”says Palmer. Oral complications combined with poor diet can also contributeto cognitive and gr problems and can contribute to obesity


Paragraph 4Myth 2: More sugar means more tooth decay It isn’t the amount of sugar you eat; it is the amount of time that the sugar hascontact with the teeth. “Foods such as slowly-dissolving candies and soda arein the mouth for longer periods of time. This increases the amount of timeteeth are exposed to the acids formed by oral bacteria from the sugars,” saysPalmer.


Paragraph 5Some research shows that teens obtain about 40 percent of their carbohydrateintake from soft drinks. This constant beverage use increases the risk of toothdecay. Sugar-free carbonated drinks and acidic beverages, such as lemonade,are often considered safer for teeth than sugared beverages but can also

contribute to demineralization of tooth enamel if consumed regularly.Questions“Q1”“Q2”“Q3”“Q4”“Q5”“Q6”“Q7”“Q8”

Paragraph 6Myth 3: Losing baby teeth to tooth decay is okay

It is a common myth that losing baby teeth due to tooth decay is insignificantbecause baby teeth fall out anyway. Palmer notes that tooth decay in babyteeth can result in damage to the developing crowns of the permanent teethdeveloping below them. If baby teeth are lost prematurely, the permanentteeth may erupt mal-positioned and require orthodontics later on.


Paragraph 7Myth 4: Osteoporosis only affects the spine and hips

Osteoporosis may also lead to tooth loss. Teeth are held in the jaw by the facebone, which can also be affected by osteoporosis. “So, the jaw can also sufferthe consequences of a diet lacking essential nutrients such as calcium andvitamins D and K,” says Palmer. “The jawbone, gums, lips, and soft and hardpalates are constantly replenishing themselves throughout life. A good diet isrequired to keep the mouth and supporting structures in optimal shape.”


Paragraph 8Myth 5: Dentures improve a person’s diet If dentures don’t fit well, older adults are apt to eat foods that are easy tochew and low in nutritional quality, such as cakes or pastries. First, denturewearers should make sure that dentures are fitted properly. In the meantime,if they are having difficulty chewing or have mouth discomfort, they can stilleat nutritious foods by having cooked vegetables instead of raw, canned fruitsinstead of raw, and ground beef instead of steak. Also, they should drinkplenty of fluids or chew sugar-free gum to prevent dry mouth,” says Palmer.


Paragraph 9Myth 6: Dental decay is only a young person’s problemIn adults and elders, receding gums can result in root decay (decay along theroots of teeth). Commonly used drugs such as antidepressants, diuretics,antihistamines and sedatives increase the risk of tooth decay by reducing

saliva production. “Lack of saliva means that the mouth is cleansed moreslowly. This increases the risk of problems,” says Palmer. “In this case,drinking water frequently can help cleanse the mouth.”


Paragraph 10Adults and elders are more likely to have chronic health conditions, likediabetes, which are risk factors for periodontal disease (which begins with aninflammation of the gums and can lead to tooth loss). “Type 2 diabetespatients have twice the risk of developing periodontal disease of peoplewithout diabetes. Furthermore, periodontal disease exacerbates diabetesmellitus, so meticulous oral hygiene can help improve diabetes control,” saysPalmer.


QUESTIONSQ1. This article is abouta. how the nutritional needs of children, teenagers and expectant mothers hasan effect on oral healthb. how the oral health is affected by nutritional needs of children, teenagers,expectant mothers and other groups.c. how diet and nutritional needs of children, teenagers, mothers-to-be, andadults affects one’s oral healthd. disproving some long held beliefs

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Q2. Carole Palmer observes thata. pies and pastries have low food value and require more chewingb. lower nutritional quality food needs more chewingc. nutritious foods like fruits and vegetables have less sugar and require morechewingd. too much vitamin B6 or B12 could lead to problems with cleft palateformation

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Q3. According to Palmer

a. asthma is five times less common in childhood than tooth decayb. school kids with tooth decay pain may have concentration problems atschoolc. mouth and dental problems plus a poor diet can affect thinking abilities andbe a factor later on in obesityd. all of the above

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Q4. According to the article :a. it’s important to make sure you retain baby teethb. It’s important that teeth are not exposed for a long time to acids formed byoral bacteria as a result of eating sugary foodsc. it’s important to look after your baby teethd. it’s important that teeth are not exposed to acids formed by oral bacteriafrom sugary foods

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Q5. According to the article, baby teetha. are dispensableb. develop to help eat foodc. if lost prematurely, may result in poor development of permanent teethd. help with correct development of permanent teeth

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Q6. Dental health in older people requiresa. properly fitting denturesb. a calcium rich dietc. nutritious food containing vitamins D and Kd. all of the above

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Q7. The article says that Osteoporosisa. may prevent loss of teethb. may affect jaw bones

c. jaw bone health may be affected by chewing sugar-free gumd. none of the above

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Q8. Lack of salivaa. all of the followingb. results in mouth being cleansed more slowlyc. can be addressed by chewing sugar-free gumd. may increase the risk of tooth decay

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TIME: 45 MINUTES




Global Health Care WorkforceParagraph 1 Health care systems worldwide continue to be plagued by difficulties inrecruiting and retaining health workers, resulting in a shortage of health careprofessionals that is now considered a global crisis. However, although thegap between the need for health care workers and the supply is experiencedglobally, it widens disproportionately, so that the regions with the greatestneed have the fewest workers. For example sub-Saharan Africa and south-east Asia together have 53% of the global disease burden but only 15% of theworld’s health care workforce. Moreover, the shortage experienced by

countries that can least afford it is exacerbated by health worker migration tohigh-income countries. South Africa, for example, has fewer than 7 doctorsper 10,000 people, but reported in 2002 that 14% of the physicians who hadtrained there had emigrated to the US or to Canada.


Paragraph 2 And the problem is not going away as in the UK, US, Canada and Australia,23% C: to 28% of all physicians are international graduates. Efforts to reducemigration usually focus on reducing recruitment by high-income countries,and these efforts are gaining a higher profile. Improving the workingconditions in source countries has not received the same attention, however,even though this would help counter the factors that push health professionalsto seek better conditions elsewhere. It would also make work healthier forthose who remain in lo income countries, and thereby reduce occupationalconcerns such as injuries violence and stress, and exposure to biological,chemical and physical hazards.


Paragraph 3Although concerns about healthy work conditions exist to varying degreesaround the world, they are greatest in nations with few resources, andparticularly in Africa, where work conditions are the most challenging. It iswe] documented that health workers in low and middle-income countriesexperience fear and frustration when caring for patients with tuberculosis andblood—borne diseases, and that they do so often in difficult workenvironments. Health workers may also be ostracised by their owncommunities due to the ever present stigma associated with exposure. It isnow also well established that health workers are indeed at higher risk ofacquiring numerous infectious diseases.


Paragraph 4 International organizations are recognizing the importance of promoting andprotecting the health of the global health care workforce, which isconservatively estimated to be 59 million, and are undertaking constructiveinitiatives to do so. The World Health Organization (WHO) has explicitlyrecognized the need to improve the environment of health care workers inorder to increase retention and is promoting the use of workplace audit

checklists to help guide the reduction of infectious disease transmission inhealth care. WHO is also promoting the immunization of all health careworkers against hepatitis B, and, is working to move forward specificHealthy Hospital Initiatives, which include projects that involve bothinfection control and occupational health practitioners, and that trainpractitioners along with health and safety representatives in conductingworkplace inspections.


Paragraph 5 Canada and other countries that receive health care workers from lowresource settings compromise the workforce in the source country as theysupplement their own. The situation is inequitable and, over time, willundermine those low resources further, worsening the already challengingworking conditions and creating even more pressure for health care workersto emigrate. To offset this effect, high-income countries can reciprocate byimproving working conditions in source countries. British Columbia, whichattracts the highest number of South African physicians of all Canadianprovinces, has taken a step in this positive direction by sharing expertise inoccupational health and infectious p disease transmission control through thePelonomi Hospital project.


Paragraph 6 At the university level, researchers and practitioners can contribute to thisknowledge exchange by partnering with their colleagues in low-incomecountries. Such collaborations are essential. Also needed are intensifiedefforts to promote further integration of worker safety and patient safety. Toensure information systems being developed support this goal, we need topromote evidence based decision making and share our information withthose who can; benefit from it. That way, each region will not need to findmillions of dollars annually to design, implement and maintain separatesystems that could b easily shared and reproduced.


Paragraph 7 To achieve this aim, we need international collaboration in order to reachconsensus on a data dictionary and complete the programming of non-proprietary information systems such as OHASIS, which can be tailored to

different technological environments and made widely available usingCreative Commons licensing. Much of what needs to be done can beaccomplished with simple and effective solutions that benefit both patientsand workers. What it will take is commitment from high-income countries toassist in the development, refinement and implementation of these tools incollaboration with low-income countries. Such endeavours can be madepossible by making them a priority at the national funding level.


QUESTIONSQ1. The main idea presented in paragraph 1 is__________a. Recruiting health care workers is a problem in most countriesb. There is a shortage of health care workers in Sub-Saharan Africa andSoutheast Asiac. There are not enough health care Workers in places which have the highestneed for medical treatmentd. A significant number of South African doctors are migrating to the US andCanada

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Q2. The main point raised by the authors in paragraph 2 is that__________a. there are too many international graduates in UK, US, Canada andAustraliab. high income countries must reduce recruitment of overseas healprofessionalsc. more effort is required to improve work conditions in sourced. work conditions in poorer countries are dangerous

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Q3. According to paragraph 3 which of the following is false regardingconditions in low & middle income countries?a. Work conditions are most difficult in Africab. Health Workers fear exposure to contagious diseasesc. Health Workers feel frustration towards patients

d. Being exposed to infectious diseases may lead to shame within localcommunities.

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Q4. Regarding the size of the global health care workforce, we can inferparagraph 4 that__________a. there may be more than 59 million Workersb. there may be less than 59 million workersc. there are exactly 59 million Workersd. the number of health care workers in unknown

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Q5. According to paragraph 4, which of the following statements is trueregarding WHO?a. WHO realises that improvements in the working environment of healthcareworkers is necessaryb. WHO wants to increase immunisation rates of health care workers againsthepatitis Bc. WHO is advancing Healthy Hospital Initiatives including training andinfection controld. All of the above

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Q6. In paragraph 5 the authors infer that__________a. High-income countries have a responsibility to help build better workingconditions in low-income countriesb. High income countries should not recruit health professionals from low-income countriesc. The working conditions in low-income countries is improvingd. British Columbia has stopped recruiting South African doctors

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Q7. Which of the following is closest in meaning to the word reciprocate?a. helpb. give back

c. supportd. take back

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Q8. According to paragraph 6, which of the following statements is true?a. Researchers and medical practitioners in low & high income countries haveexpressed a desire to work togetherb. Improved safety of health workers and patients is a priorityc. Millions of dollars are needed to develop information systems that can beshared between countriesd. None of the above

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TIME: 15 MINUTES


DO NOT open this Question Paper or the Text Booklet untilyou are told to do so. Write your answers on the spaces provided on this QuestionPaper.You must answer the questions within the 15-minute time limit.One mark will be granted for each correct answer.Answer ALL questions. Marks are NOT deducted for incorrect answers.At the end of the 15 minutes, hand in this Question Paper andthe Text Booklet. DO NOT remove OET material from the test room.Tuberculosis, AIDS, and Death among Substance Abusers on Welfare inNew York City

Text ABackground In New York City, the incidence of tuberculosis has more than doubledduring the past decade. We examined the incidence of tuberculosis and theacquired immunodeficiency syndrome (AIDS) and the rate of death from allcauses in a very-high-risk group —indigent subjects who abuse drugs,alcohol, or both. Methods In 2009 we began to study prospectively a cohort of welfare applicants andrecipients 18 to 64 years of age who abused drugs or alcohol. The incidencerates of tuberculosis, AIDS, and death for this group were ascertainedthrough vital records and New York City’s tuberculosis and AIDS registries.

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Text BResults The cohort was followed for eight years. Of the 858 subjects;

tuberculosis developed in 47 (5.5 percent),84 (9.8 percent) were given a diagnosis of AIDS, and

183 (21.3 percent) died. The rates of incidence per 100,000 person- years were744 for tuberculosis,1323 for AIDS, and2842 for death. In this group of welfare clients,the rate of newly diagnosed tuberculosis was 14.8 times that of theage matched general population of New York City;the rate of AIDS was 10.0 times as high;

the death rate was 5.2 times as high.no significant difference in the rate of new cases of tuberculosisbetween subjects with positive skin tests and those with negative skintests at examination in 2009.

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Text CDeaths in the cohort There were 183 deaths in the cohort during follow-up (21.3 percent) of thesubjects, a rate of 2842 deaths per 100,000 person-years, 5.2 times that of theage-matched general population.

Causes of death - Table 3

CAUSES OF DEATH IN THE STUDY GROUP

Causes of death No. of subjects(%)

Average Age at Death(years)

AIDS 66 (36.1%) 40

Infectious diseases 18 (9.8%) 43

Cirrhosis of the liver 16 (8.7%) 43

TB 11 (6%) 42

Coronary artery disease 10 (5.5%) 47

Pneumonia 9 (4.9%) 42

Cancer 8 (4.4%) 54

Overdose of non- narcoticsubstance

8 (4.4%) 42

Other heart disease 7 (3.8%) 43

Drug dependence 4 (2.2%) 37

Alcohol abuse 3 (1.6%) 43

Cerebrovascular disease 3 (1.6%) 47

Diabetes 3 (1.6%) 53

Upper gastrointestinal bleeding 3 (1.6%) 44

Wound 3 (1.6%) 47

Chronic renal failure 2(1.1%) 59

Respiratory arrest 2(1.1%) 46

Other 7 (3.8%) 48

Total 183 43

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Text DConclusions

Of the 47 subjects with tuberculosis, 21 (44.7 percent) died before theend of 2017;12 (57.1 percent) of those who died also had AIDS.Of 15 persons with both tuberculosis and AIDS, 12 (80.0 percent)died before the end of 2017 and 8 died before completing anti-TBtherapy.Of the 84 study subjects with AIDS, 68 (81.0 percent) died before theend of 2017.

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Part A

TIME: 15 minutes• Look at the four texts, A-D, in the separate Text Booklet.• For each question, 1-20, look through the texts, A-D, to fi

OET 2.0 READING EXERCISES & ANSWER KEY · 2020. 9. 26. · Overview of OET 2.0 Reading Sub-Test The...

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