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Occupational English Test
Practice Papers
Complete the following summary using the information in the four texts provided.
You do not need to read each text from beginning to end to complete the task. You should
scan the texts to find the information you need.
Gaps may require 1, 2 or 3 words.
You should write your answers next to the appropriate number in the right-hand column.
Please use correct spelling in your responses.
TEXT 1
The Global Burden of Dementia
An expert group, working for Alzheimers Disease International, recently estimated that 24.2
million people live with dementia worldwide (based upon systematic review of prevalence data
and expert consensus), with 4.6 million new cases annually (similar to the annual global
incidence of non-fatal stroke.
Most people with dementia live in Low and Middle Income Countries - 60% in 2001 rising
to 71% by 2040.
Increases to 2040 will be much sharper in developing (300%) than developed regions
(100%).
Growth in Latin America will exceed that in any other world region.
Well designed epidemiological research can generate awareness, inform policy, and encourage
service development. However, such evidence is lacking in many world regions, and patchy in
others, with few studies and widely varying estimates. There is a particular lack of published
epidemiological studies in Latin America with two descriptive studies only, from Brazil and
Colombia.
TEXT 2
Some Little Known Facts about Dementia
A Canadian study found that a lifetime of bilingualism has a marked influence on delaying the
onset of dementia by an average of four years when compared to monolingual patients (at 75.5
years and 71.4 years old, respectively).
Adult daycare centres provide specialized care for dementia patients, including supervision,
recreation, meals, and limited health care to participants, as well as providing respite for
caregivers.
TEXT 3
The Effect of Aging World Populations on Healthcare
Demographic ageing proceeds apace in all world regions, more rapidly than at first anticipated.
The proportion of older people increases as mortality falls and life expectancy increases.
Population growth slows as fertility declines to replacement levels. Latin America, China and
India are currently experiencing unprecedentedly rapid demographic ageing.
In the health transition accompanying demographic ageing, non-communicable diseases (NCD)
assume a progressively greater significance in low and middle-income countries. NCDs are
already the leading cause of death in all world regions apart from sub-Saharan Africa. Of the 35
million deaths in 2005 from NCDs, 80% will have been in low and middle-income countries. This
is partly because most of the world's older people live in these regions - 60% now rising to 80%
by 2050. However, changing patterns of risk exposure also contribute.
Latin America exemplifies the third stage of health transition. As life expectancy improves, and
high fat diets, cigarette smoking and sedentary lifestyles become more common, so NCDs have
maximum public health salience - more so than in stage 2 regions (China and India) where risk
exposure is not yet so elevated, and in stage 4 regions (Europe) where public health measures
have reduced exposure levels. The INTERHEART cross-national case-control study suggests
that risk factors for myocardial infarction operate equivalently in all world regions, including Latin
America and China.
TEXT 4
Agitation in Dementia Patients
Agitation often accompanies dementia and often precedes the diagnosis of common age-related disorders
of cognition such as Alzheimer's disease (AD). More than 80% of people who develop AD eventually
become agitated or aggressive.
Evaluation
It is important to rule out infection and other environmental causes of agitation, such as disease or other
bodily discomfort, before initiating any intervention. If no such explanation is found, it is important to
support caregivers and educate them about simple strategies such as distraction that may delay the transfer
to institutional care (which is often triggered by the onset of agitation).
Treatment
There is no FDA-approved treatment for agitation in dementia.
Medical treatment may begin with a cholinesterase inhibitor, which appears safer than other alternatives
although evidence for its efficacy is mixed. If this does not improve the symptoms, atypical antipsychotics
may offer an alternative, although they are effective against agitation only in the short-term while posing a
well-documented risk of cerebrovascular events (e.g. stroke). Other possible interventions, such as
traditional antipsychotics or antidepressants, are less well studied for this condition.
Summary Task
Summary
Answers
1.
2.
3.
worldwide
prevalence
data
found
that
6.
7.
8.
9.
scarce
amount
of
epidemiological
10.
research.
11.
Summary
Answers
exposure.
20.
21.
23.
(21)
Doctors
should
first
(22)
24.
25.
TOTAL SCORE:
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Occupational English Test
Practice Papers
READING PASSAGE A
Last week the H1N1 virus was found in turkeys on farms in Chile. The UN now says poultry
farms elsewhere in the world could also become infected.
Scientists are worried that the virus could theoretically mix with more dangerous strains. It
has previously spread from humans to pigs.
However, swine flu remains no more severe than seasonal flu.
Paragraph 2
Chilean authorities first reported the incident last week. Two poultry farms are affected near
the seaport of Valparaiso.
Juan Lubroth, interim chief veterinary officer of the UN Food and Agriculture Organization
(FAO), said: "Once the sick birds have recovered, safe production and processing can
10 continue. They do not pose a threat to the food chain."
Paragraph 3
Chilean authorities have established a temporary quarantine and have decided to allow the
infected birds to recover rather than culling them.
It is thought the incident represents a "spill-over" from infected farm workers to turkeys.
Canada, Argentina and Australia have previously reported spread of the H1N1 swine flu
virus from farm workers to pigs.
Paragraph 4
The emergence of a more dangerous strain of flu remains a theoretical risk. Different strains
of virus can mix together in a process called genetic reassortment or recombination.
So far there have been no cases of H5N1 bird flu in flocks in Chile.
However, Dr Lubroth said: "In Southeast Asia there is a lot of the (H5N1) virus circulating in
20 poultry.
"The introduction of H1N1 in these populations would be of greater concern."
Paragraph 5
William Karesh, vice president of the Wildlife Conservation Society, who studies the spread
of animal diseases, says he is not surprised by what has happened.
30 "The location is surprising, but it could be that Chile has a better surveillance system.
"However, the only constant is that the situation keeps changing."
Paragraph 7
The United States has counted 522 fatalities through Thursday, and nearly 1,800 people
had died worldwide through August 13, U.S. and global health officials said.
In terms of mortality rate, which considers flu deaths in terms of a nation's population,
Brazil ranks seventh, and the United States is 13th, the Brazilian Ministry of Health said in a
news release Wednesday.
Paragraph 8
Argentina, which has reported 386 deaths attributed to H1N1 as of August 13, ranks first
per capita, the Brazilian health officials said, and Mexico, where the flu outbreak was
discovered in April, ranks 14th per capita.
40 Brazil, Argentina, Chile, Mexico and the United States have the most total cases globally,
according to the World Health Organization.
Paragraph 9
The Brazilian Ministry of Health said there have been 6,100 cases of flu in the nation, with
5,206 cases (85.3 percent) confirmed as H1N1, also known as swine flu.
The state of Sao Paulo had 223 deaths through Wednesday, the largest number in the
country. In addition, 480 pregnant women have been confirmed with H1N1, of whom 58
died. Swine flu has been shown to hit young people and pregnant women particularly hard.
Paragraph 10
Many schools in Sao Paulo have delayed the start of the second semester for a couple of
weeks, and students will have to attend classes on weekends to catch up. Schools also
have suspended extracurricular activities such as soccer, volleyball and chess to try to
50 curtail spread of the disease.
Paragraph 11
Flu traditionally has its peak during the winter months, and South America, where it is
winter, has had a large number of cases recently. The World Health Organization said this
week that the United States and other heavily populated Northern Hemisphere countries
need to brace for a second wave of H1N1 as their winter approaches.
Paragraph 12
Officials at the Centres for Disease Control and Prevention and other U.S. health agencies
have been preparing and said this week that up to half of the nation's population may
contract the disease and 90,000 could die from it.
Seasonal flu typically kills about 64,000 Americans each year.
Paragraph 13
A vaccine against H1N1 is being tested but is not expected to be available until at least
60 mid-October and will probably require two shots at least one week apart, health officials
have said. Since it typically takes a couple of weeks for a person's immunity to build up
after the vaccine, most Americans would not be protected until sometime in November.
The World Health Organization in June declared a Level 6 worldwide pandemic, the
organization's highest classification.
CNN News
QUESTIONS
2.
What does Dr. Lubroth recommend should be done with the sick birds?
a.)
b.)
c.)
d.)
3.
4.
5.
Which statement best describes the opinion of the representative from the Institute of
Animal Health?
a.) He doesnt want the virus to spread further because it could lead to genetic
reassortment.
b.) He thinks H5N1 is no longer important but he is worried about H1N1.
c.) He hopes that BBC News will pay more attention to closely monitoring the virus.
d.) Birds and humans should be under more control otherwise the virus may change.
6.
Which statement best describes the opinion of the Vice President of the Wildlife
Conservation Society?
a.)
b.)
c.)
d.)
He is not surprised that not enough people are studying the spread of animal diseases.
He is not surprised that swine flu has been reported in birds in Chile.
He is surprised that the situation is constantly changing.
He is surprised that swine flu has been reported in birds in Chile, but suspects other
countries may be unaware of the spread to birds.
7.
8.
9.
10. When will most US citizens be protected by the vaccine, and why?
a.)
b.)
c.)
d.)
READING PASSAGE B
Several recent large studies have provoked concern amongst both health professionals and
the general public regarding the safety of hormone replacement therapy (HRT). This article
provides a review of the current literature surrounding the risks and benefits of HRT in
postmenopausal women, and how the data can be applied safely in everyday clinical
practice.
Paragraph 2
10
Worldwide, approximately 47 million women will undergo the menopause every year for the
next 20 years.1 The lack of circulating oestrogens which occurs during the transition to
menopause presents a variety of symptoms including hot flushes, night sweats, mood
disturbance and vaginal atrophy, and these can be distressing in almost 50% of women.
Paragraph 3
For many years, oestrogen alone or in combination with progestogens, otherwise known as
hormone replacement therapy (HRT), has been the treatment of choice for control of
problematic menopausal symptoms and for the prevention of osteoporosis. However, the
use of HRT declined worldwide following the publication of the first data from the Womens
Health Initiative (WHI) trial in 2002.2
Paragraph 4
The results led to a surge in media interest surrounding HRT usage, with the revelation that
20 there was an increased risk of breast cancer and, contrary to expectation, coronary heart
disease (CHD) in those postmenopausal women taking oestrogen plus progestogen HRT.
Following this, both the Heart and Estrogen/Progestin Replacement Study Follow-up
(HERS II)3,4 and the Million Women Study5 published results which further reduced
enthusiasm for HRT use, showing increased risks of breast cancer5 and venous
thromboembolism (VTE),4 and the absence of previously suggested cardioprotective
effects3 in HRT users. The resulting fear of CHD and breast cancer in HRT users left many
women with menopausal symptoms and few effective treatment options.
Paragraph 5
Continued analysis of data relating to these studies has been aimed at understanding
whether or not the risks associated with HRT are, in fact, limited to a subset of women. A
30
recent publication from the International Menopause Society6 has stated that HRT remains
the first-line and most effective treatment for menopausal symptoms. In this article we
examine the evidence that has contributed to common perceptions amongst health
professionals and women alike, and clarify the balance of risk and benefit to be considered
by women using HRT.
Paragraph 6
One of the key messages from the WHI in 2002 was that HRT should not be prescribed to
prevent age-related chronic disease, in particular CHD. This was contradictory to previous
advice based on observational studies. However, recent subgroup analysis has shown that
in healthy individuals using HRT in the early postmenopausal years (age 5059 years), there
was no increased CHD risk and HRT may potentially have a cardioprotective effect.8
Paragraph 7
Recent WHI data has suggested that oestrogen-alone HRT in compliant women under 60
years of age delays the progression of atheromatous disease (as assessed by coronary
arterial calcification).9 The Nurses Health Study, a large observational study within the USA,
40 demonstrated that the increase in stroke risk appeared to be modest in younger women,
with no significant increase if used for less than five years.
Paragraph 8
The WHI results published in 2002 led to a significant decline in patient and clinician
50 confidence in the use of HRT. Further analysis of the data has prompted a re-evaluation of
this initial reaction, and recognition that many women may have been denied treatment.
Now is the time to responsibly restore confidence regarding the benefit of HRT in the
treatment of menopausal symptoms when used judiciously. Hormone replacement therapy
is undoubtedly effective in the treatment of vasomotor symptoms, and confers protection
against osteoporotic fractures.
Paragraph 10
The oncologic risks are relatively well characterised and patients considering HRT should
be made aware of these. The cardiovascular risk of HRT in younger women without overt
vascular disease is less well defined and further work is required to address this important
question. In the interim, decisions regarding HRT use should be made on a case-by-case
basis following informed discussion of the balance of risk and benefit. The lowest dose of
hormone necessary to alleviate menopausal symptoms should be used, and the
prescription reviewed on a regular basis.
60
Lack of circulation
Age
Low progesterone levels
Low circulating estrogen levels
14. What has been the effect of the 2002 WHI study?
a.) HRT has become less popular.
b.) HRT has increased in popularity as the treatment of choice for problematic menopause
symptoms.
c.) There has been an increase in combined estrogen and progesterone therapy.
d.) The womens health initiative has since been established to investigate HRT.
15. Why were many women left with menopausal symptoms and no effective treatment?
a.)
b.)
c.)
d.)
16.
a.) Surveys since WHI have attempted to find out if the WHI results are representative.
b.) Results of past surveys are only valid for a subset of women, whether or not the public is
aware of this.
c.) The present study aims to show that HRT is safer than previously believed.
d.) Women should ask their doctors to clarify the balance of risks and benefits of HRT.
Which study showed an increased risk of VTE?
17.
a.)
b.)
c.)
d.)
18. Which of the following does the article recommend HRT should NOT be used to treat?
a.) Vasomotor symptoms
b.) Atheromatous disease
c.) Age-related chronic disease
d.) Osteoarthritic symptoms
19. Why were women denied treatment? (Paragraph 9)
a.)
b.)
c.)
d.)
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Occupational English Test
Practice Papers
Part B
1.
life expectancy
1. B
2.
2. C
3.
3. B
4.
dementia
4. A
5.
6.
2.4.2 million
7.
4.6 million
8.
non-fatal stroke
9.
60
10.
double
11.
Latin America
12.
80%
13.
2050
12. C
14.
risk exposure
13. D
15.
health transition
14. B
16.
sedentary lifestyles
15. C
17.
16. D
18.
17. B
19.
supervision
18. C
20.
institutional care
19. A
21.
agitated
22.
rule out
23.
educate
24.
distraction
25.
Canadian
26.
onset
27.
4 years
5. B
6. C
7. D
8. B
9. A
10. A
11. C
20. A