Occupational English Test

READING SUB-TEST
Part B - Text Booklet
Practice test

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READING PART B
Instructions

TIME LIMIT: 45 MINUTES

There are TWO reading texts in Part B. After each of the texts you will find a number of questions or unfinished
statements about the text, each with four suggested answers or ways of finishing.
You must choose the ONE which you think fits best. For each question, 1-20, indicate on your answer sheet
the letter A, B, C or D against the number of the question.
Answer ALL questions. Marks are NOT deducted for incorrect answers.
NOTE: You must complete your Answer Sheet for Part B within the 45 minutes allowed for this part of the
sub-test.

NOW TURN TO THE NEXT PAGE FOR TEXTS AND QUESTIONS

READING PASSAGE A

Swine Flu Found in Birds

Paragraph 1
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
Colin Butter from the UK's Institute of Animal Health agrees.
"We hope it is a rare event and we must monitor closely what happens next," he told BBC
News.
"However, it is not just about the H5N1 strain. Any further spread of the H1N1 virus
between birds, or from birds to humans would not be good.
"It might make the virus harder to control, because it would be more likely to change."

Paragraph 6
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

Swine Flu Found in Birds

1. Scientists are worried that the virus could potentially spread…

a.) …from pigs to humans

b.) …to chicken and turkey farms elsewhere
c.) …to other types of animals
d.) …to the seaport of Valparaiso

2. What does Dr. Lubroth recommend should be done with the sick birds?

a.) They should be processed immediately.

b.) They should be killed.
c.) They should be allowed to recover.
d.) They should be given Tamiflu.

3. What is the meaning of the “spill-over” effect mentioned in the passage?

a.) The virus has spread from Chile to Argentina.

b.) The virus has spread from factory workers to birds.
c.) Turkey blood has been spilled during the production process.
d.) Turkeys have become infected by eating spilled contaminated pig food.

4. Which possibility is Dr. Lubroth most concerned about?

a.) H5N1 virus spreading to Chile

b.) H591 virus spreading to Australia
c.) H191 virus spreading to Asia
d.) H191 virus spreading to Canada

5. Which statement best describes the opinion of the representative from the Institute of
Animal Health?

a.) He doesn!t 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.) He is not surprised that not enough people are studying the spread of animal diseases.
b.) He is not surprised that swine flu has been reported in birds in Chile.
c.) He is surprised that the situation is constantly changing.
d.) 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. According to the Brazilian Ministry of Health…

a.) …The United States has counted 522 fatalities.

b.) …more people have died in Brazil than in the USA.
c.) …more people have died in the USA than in Brazil.
d.) …Brazil is the 13th worst country for swine flu deaths.

8. Which of the following statements is FALSE?

a.) 52 pregnant women have died of Swine Flu in Brazil.

b.) Argentina has reported 386 H591 related deaths.
c.) Swine flu was first discovered in Mexico in April.
d.) The USA is one of the most severely affected countries annually.

9. Which of the following statements is TRUE?

a.) Young people are less likely to be affected by swine flu than old people and pregnant
women.
b.) Students in Sao Paulo have been asked to stop going to weekend classes.
c.) Students in Sao Paulo have stopped playing volleyball.
d.) Brazil has had less cases of swine flu this winter than expected.

10. When will most US citizens be protected by the vaccine, and why?

a.) Early November, because this is when the vaccine is available

b.) Mid October, because this is when the vaccine is available
c.) November, because it takes time to develop immunity following the vaccine
d.) Next June, because there is likely to be a pandemic at this time

PLEASE TURN OVER

READING PASSAGE B

Risks and Benefits of Hormone Replacement

Therapy
Paragraph 1
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
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.
10
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 Women’s
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 50–59 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
Hormone replacement therapy is associated with beneficial effects on bone mineral
density, prevention of osteoporosis and improvement in osteoarthritic symptoms. The WHI
clearly demonstrated that HRT was effective in the prevention of all fractures secondary to
osteoporosis.11 The downturn in HRT prescribing related to the concern regarding vascular
and breast cancer risks is expected to cause an increase in fracture risk, and it is predicted
that in the USA there will be a possible excess of !43,000 fractures per year in the near
future.11

Paragraph 9
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
Dr C Hardie, Dr C Bain, Dr M Walters
 Risks and Benefits of Hormone Replacement
Therapy
11. Which statement is the closest match to the description of the recent studies in Paragraph
1?

a.) They demand a prompt review of current HRT practices.

b.) They have shown that HRT can be used safely in clinical practice.
c.) They have decreased the confidence of doctors and the public in HRT.
d.) They have given menopausal women a new confidence to undergo HRT.

12. Which statement is the closest match to the description of projected menopause figures in
Paragraph 2?

a.) 47 international women will enter menopause annually for the next 20 years.
b.) All women are likely to go through menopause if they live long enough.
c.) 47 million women globally will enter menopause each year for the next 20 years.
d.) Most women will succumb to menopause if they do not undertake HRT.

13. What cause does the article cite for the symptoms of menopause?

a.) Lack of circulation

b.) Age
c.) Low progesterone levels
d.) Low !" #$%&!'()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 women!s health initiative has since been established to investigate HRT.

15. Why were many women left with menopausal symptoms and no effective treatment?

a.) They were unable to afford HRT treatments.

b.) They were concerned about coronary heart disease and breast cancer.
c.) They were concerned about breast cancer and venous thromboembulism.
d.) They were concerned about breast cancer and the cardioprotective effects.

PLEASE TURN OVER

Which of these statements is a TRUE summary of Paragraph 5?

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.) The Nurses Health Study
b.) The Million Women Study
c.) The Women!s Health Initiative Study
d.) The WISDOM Study

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.) Due to the decline in patient confidence in HRT

b.) Due to the results of studies including the WHI study
c.) Due to judicious use of HRT
d.) Due to a re-evaluation of this initial reaction

20. Which statement is NOT a recommendation of the present article?

a.) Further study should be made into oncological risks of HRT

b.) Further study should be made into cardio vascular risks of HRT
c.) Doctors should now reassure their patients that HRT can be safe
d.) Doctors should prescribe the lowest effective dose for menopause symptoms
Reading Test 1 – Answers
Part A Part B

1. life expectancy 1. B

2. 2 2. C
3. Sub Saharan Africa 3. B
4. dementia 4. A
5. Alzheimer’s Disease International
5. B
6. 2.4.2 million
6. C
7. 4.6 million
7. D
8. non-fatal stroke
8. B
9. 60
9. A
10. double
10. A
11. Latin America
11. C
12. 80%

13. 2050 12.

14. risk exposure 13. !

15. health transition 14. B

16. sedentary lifestyles 15. C

17. public health measures 16. D

18. adult daycare centres 17. "

19. supervision 18. C
20. institutional care
19. #
21. agitated
20. A
22. rule out

23. educate

24. distraction

25. Canadian

26. onset

27. 4 years