Oet Reading

Subtest

General information

Reading

Time allocation 60 minutes.

Test format and procedure In this subtest candidates must read two texts and answer approximately 20 questions. The texts are on general topics related to the medical and health professions. The texts are not specific to a profession. The questions are designed to assess understanding of the texts. The questions are in multiple choice format. For each question candidates have to choose which alternative answer is the best answer. Some questions are in the form of unfinished statements and candidates must select the best way to finish the statement. Only one alternative can be given. Answers are to be written on the computer readable answer sheet provided (see example next page) by filling in the appropriate circle with a pencil. If a mistake is made, candidates should rub out the first mark with an eraser and fill in another circle. If two answers are marked, the question will be marked wrong. Marks or smudges on the answer sheet may be mistaken for answers and may be marked wrong.

Assessment procedure This subtest is computer marked at the University of NSW.

The sample materials The sample materials consist of: •

a computer readable answer sheet (similar to example shown on the next page)

•

two texts

•

a series of questions related to the texts

•

a reading test answer key (see page 71).

Using the materials •

Allow enough time to do all the sample reading subtest in the one sitting. This will give an indication of the requirements of the actual test.

•

Set a timer or alarm clock for 60 minutes or ask someone to act as a timer.

•

Make sure a pencil and a rubber (eraser) is available.

•

Check answers against the answer key.

•

A total score of around 65% on these tests (Part A and B combined) should give you a good chance of getting a satisfactory result.

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COMPUTER ANSWER SHEET

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OET – SAMPLE

READING SUBTEST

Reading Subtest Time allowed : 60 minutes There are two reading passages in this test. After each passage you will find a number of questions or unfinished statements about the passage, each with four suggested answers or ways of finishing. You must choose the one which you think fits best, i.e. the best answer. 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 will not be deducted for incorrect answers.

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READING SUBTEST – PART A

OET – SAMPLE

PASSAGE

Latin America struggles as cholera spreads Paragraph 1

Health officials from 10 Latin American countries met in Washington DC this week to search for measures to control the growing cholera epidemic in their countries. Last week the World Health Organisation (WHO) set up a task force to combat the spread of the disease which, it predicts, could affect as many as 120 million people – a quarter of Latin America’s population. Paragraph 2

Cholera has now reached beyond the western coastal countries of Peru, Colombia, Ecuador, and Chile to the edge of Brazil. So far, the five cases reported in Brazil are thought to be Peruvians who have crossed the border at an island in the Amazon called Tabatinga. More than 163,000 cases have been reported to the WHO from Latin America. Paragraph 3

Despite the large numbers infected, the death rate has so far been relatively low. Figures from Peru show that 10 out of 158,929 cases of the disease there were 1,130 deaths – fewer than 1 per cent of those affected. The WHO says communities unprepared for cholera usually suffer a much higher death rate – up to half of those who develop the disease. Paragraph 4

This is the first widespread outbreak of cholera in the Americas for a century. “Peru has done remarkably well,” says David Bennett, coordinator for the cholera taskforce at the Pan American Health Organisation (PAHO) in Washington DC. Paragraph 5

Cholera is treatable when diagnosed promptly. Jim Tulloch, head of the diarrhoeal diseases program at the WHO, says Peru has for years been training its doctors to treat diarrhoeal disease and that this has helped to reduce the death toll. Paragraph 6

The cholera bacterium produces a toxin which paralyses the gut, stopping it from absorbing liquid. It kills only 20 because it dehydrates the body rapidly. Nine out of ten patients will recover simply by drinking oral rehydration

fluids – a balance of water, sugar and salt. Intravenous infusions of fluid are necessary for the one in ten who become severely dehydrated or are unable to keep liquids down. Antibiotics help to reduce the time that people suffer from diarrhoea for and also make the diarrhoea itself less infectious. Paragraph 7

No one is belittling the impact of the disease. The WHO says the epidemic is an “unfolding tragedy” worldwide, with growing numbers of cases in Benin and Zambia as well as those in Latin America. But Tulloch emphasises that the epidemic must be seen in the context of other deaths caused by diarrhoeal disease. He says that while 2,000 people have died of cholera worldwide since the end of January, in the same period 800,000 children under 5 years of age have died from diarrhoea. Paragraph 8

“The (Latin American) epidemic is much more of a disaster to the economy than to public health,” says Sandy 30 Cairncross at the London School of Hygiene and Tropical Medicine. Many countries have banned imports of food from Peru, despite the WHO’s advice that no large cholera outbreak has ever been traced to commercial imports. The WHO estimates that the epidemic will cost Peru $1 billion this year in losses to exports, tourism and other earnings. Paragraph 9

Officials say Peru’s poor water supply and overcrowding of the shanty towns that surround the coastal cities have helped to spread the disease. The cholera bacterium is excreted in the faeces of infected people and thrives in situations where sewage can mix with supplies of fresh water.

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OET – SAMPLE

PART A – READING SUBTEST PASSAGE

Paragraph 10

Horatio Lores, senior epidemiologist at the Lima office of the PAHO, says, “We have much poverty here, no sanitation and basic conditions.” Few houses have piped water. Cairncross says that even 10 years ago people were spending a tenth of their income on water bought from street vendors. Since then real incomes have 40 declined sharply. Paragraph 11

According to the PAHO, the water and sewerage systems in Lima and Peru’s other coastal cities have not been properly repaired for years. Levels of chlorine disinfectant in the water supplies have not been checked regularly and the water pressure is not maintained for 24 hours a day, so wasted water can flow into any pipes that are cracked. Where populations have grown rapidly, water supplies have become grossly overstretched. Paragraph 12

“A traditional practice in the dry coastal plains is to use sewage to fertilise fields when water is scarce,” says Cairncross. “People even smash open sewers or pump water contaminated with raw sewage direct from rivers,” he says. “Farmers need to grow the kind of crops that have high cash yields and short growing seasons, and these are often vegetables that are eaten raw.” Paragraph 13

But while epidemiologists blame poverty and the deteriorating infrastructure for the cholera outbreak, no one 50 can explain why it should have happened suddenly. The conditions that have fuelled the disease have been worsening for years. “One assumes that cholera must have been introduced periodically during the last 20 or 30 years,” admits Bennett. However, Tulloch in Geneva, says, “The precise origin of the epidemic is irrelevant because the level of contamination in the environment now is very high.” Paragraph 14

The bacterium that causes cholera, Vibrio Cholerae, has two main forms or “biotypes”: the El Tor biotype is the cause of the current epidemic and the classical biotype was responsible for outbreaks earlier this century. The WHO says Latin America’s current epidemic is part of the seventh pandemic, or world epidemic, which began as long ago as 1961. Paragraph 15

El Tor was endemic in Indonesia before it began to spread. Probably carried by travellers, it reached Bangladesh in 1963, India a year later and the Soviet Union in the mid-1960’s. In 1970, El Tor reached West Africa, a region 60 that had been virtually free of cholera until then. The disease remains endemic in this area, where it is difficult to distinguish from other causes of diarrhoea. Children are most affected. Paragraph 16

Bennett says that El Tor spreads rapidly before it is detected, because for every one person to suffer severe diarrhoea there are eight who have no symptoms or only mild disturbance, and so do not seek medical help. In contrast, the classical biotype causes severe symptoms in half of those infected. Paragraph 17

“Malnourished people and those who are carrying many intestinal parasites may be more susceptible than healthy people,” says Cairncross. “It takes 100 billion vibrios in the gut of a healthy person to cause the disease, because large numbers are immobilised by acid in the stomach. But in someone whose gut is less acidic because of a heavy parasite burden, it takes only 1 million organisms.” Paragraph 18

The PAHO believes good surveillance and speedy reporting by countries is more cost effective than border 70 controls for halting the spread of the disease. The organisation has sent diagnostic equipment to laboratories in countries at risk and has sent some staff on training courses at the Centers for Disease Control in Atlanta. Paragraph 19

The existing vaccine against cholera, which is based on killed vibrios, protects only half of those who receive it, and then only for a few months. The WHO hopes to start a trial in Brazil of an oral vaccine that contains fragments of cholera toxin as well as killed vibrios. This vaccine was tested in Bangladesh in the mid-1980’s, with partial success. OET – CANDIDATE INFORMATION & SAMPLE MATERIALS

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READING SUBTEST – PART A

OET – SAMPLE

QUESTIONS

Latin America struggles as cholera spreads 1

2

3

4

5

16

So far, the number of people affected by the current cholera epidemic in Latin America is: a)

about 120 million

b)

between 160,000 and 120 million

c)

between 60,000 and 160,000

d)

less than 60,000

The number of people who have died from the current epidemic in Peru is: a)

surprisingly high

b)

about 1 percent of the population

c)

surprisingly low

d)

about 50 percent of those affected

According to the article, which of the following statements about cholera is FALSE? a)

it usually kills about 50 percent of the people affected by it

b)

it has not been seen on such a large scale in that region for more than 100 years

c)

the gut of a person affected by it is unable to process liquids

d)

90 percent of those affected do not need to be treated intravenously

According to the article, Peru’s water supply… a)

is linked directly to the large number of houses

b)

has a constant pressure

c)

is chlorinated

d)

system is being overhauled

The practice of using sewage to fertilise fields… a)

is traditionally carried out throughout the country

b)

has been recently introduced

c)

has caused the current outbreak of cholera

d)

is an old solution to an old problem

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OET – SAMPLE

PART A – READING SUBTEST QUESTIONS

6

7

8

9

10

The current cholera epidemic in Latin America… a)

began in Colombia

b)

began in Brazil

c)

is part of a world-wide epidemic

d)

is of unknown origin

El Tor… a)

is NOT the classical biotype of the cholera bacterium

b)

was most likely spread by travellers

c)

was identified in India after Bangladesh

d)

is/was all of the above

Which of the following statements about El Tor is TRUE? a)

it was the first cholera bacterium to be detected in West Africa

b)

it is not detected as easily as the old biotype

c)

it causes severe diarrhoea in all sufferers

d)

it has also appeared in isolated cases in Geneva

Which of the following is given as THE LEAST USEFUL MEASURE for keeping the disease in check? a)

increased patrols along common borders

b)

monitoring areas in which cholera has been detected

c)

efficient sharing of information

d)

an improved diet

From the article, it can be inferred that… a)

WHO is now close to finding an effective preventative vaccine for cholera

b)

people are more likely to die from diarrhoeal disease than from cholera

c)

up to a quarter of Latin America’s population could die unless trials with a new oral vaccine succeed

d)

the outbreak of cholera in any country will affect its economy as much as its public health

THAT IS THE END OF PART A TURN OVER AND COMPLETE PART B

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READING SUBTEST – PART B

OET – SAMPLE

PASSAGE

Trans Fat – Does margarine really lower cholesterol? Paragraph 1

Butter, as anyone who has not been living in a cave for the past 10 years has probably heard, contains a lot of saturated fat, which increases the levels of cholesterol in the blood. Margarine, on the other hand, is made from vegetable oils, which contain cholesterol-lowering polyunsaturated fat. So switching to a diet with only vegetable fats should lower cholesterol levels, right? Paragraph 2

“Wrong,” says Margaret A. Flynn, a nutritionist at the University of Missouri. When she performed the experiment with a group of 71 faculty members – switching in both directions – she found that “basically it made no difference whether they ate margarine or butter.” The reason, according to a growing group of nutritionists, could be partially hydrogenated fats. Recent studies suggest that such fats might actually alter cholesterol levels in the blood in all the wrong ways, lowering the “good” high-density lipoprotein and 10 increasing the “bad” low-density lipoprotein. Paragraph 3

Partially hydrogenated fats are made by reacting polyunsaturated oils with hydrogen. The addition of hydrogen turns the oils solid, and some of their polyunsaturated fat is turned into trans monounsaturated fats. Monounsaturated fat is generally perceived as good, but things are not so simple. “Trans monounsaturates act in the body like saturated fats,” says Fred A. Kummerow, a food chemist at the University of Illinois at Urbana-Champaign. “Almost all naturally occurring monounsaturated fat is of the cis variety, which is more like polyunsaturated fat.” Paragraph 4

Flynn’s study is not the first to raise questions about trans fatty acids. Ten years ago a Canadian government task force noted the apparent cholesterol-raising effects of trans fats and requested margarine manufacturers to reduce the amounts – which can easily be done by altering the conditions of the hydrogenation reaction. Paragraph 5 20 Last August two Dutch researchers, Ronald P. Mensink and Martijn B. Katan, published a study in the New

England Journal of Medicine that showed eating a diet rich in trans fats increased low-density lipoprotein and decreased levels of high-density lipoprotein. In an editorial accompanying the study, Scott M. Grundy, a lipid researcher at the University of Texas Southwestern Medical Centre at Dallas, wrote that the ability of trans fatty acids to increase low-density lipoprotein “in itself justifies their reduction in the diet.” Grundy called for changes in labelling regulations so that cholesterol-raising fatty acids, including trans monounsaturates, are grouped together. Paragraph 6

James I. Cleeman, coordinator of the National Cholesterol Education Program, disagrees. “To raise a red flag is premature,” he says. “Mensink’s audience is the research community – the public needs useable simplifications.” Cleeman points out that the subjects in Mensink and Katan’s study ate relatively large 30 amounts of trans fats. He believes more typical consumption levels should be investigated before any change in recommendations is warranted. Paragraph 7

Furthermore, Cleeman notes that studies like Flynn’s are hard to interpret because subjects were allowed to eat as they pleased. Flynns’s study, published this month in the Journal of the American College of Nutrition, found considerable variability among subjects in their blood lipid profiles. “The only way to study the question properly is in a metabolic ward,” Cleeman says. “Trans fats are a wonderful example of an issue that’s not ready for prime time.”

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PART B – READING SUBTEST PASSAGE

Paragraph 8

Edward A. Emken, a specialist on trans fats at the Agricultural Research Service in Peoria, Illinois, also downplays the concern but for different reasons. Although Mary G. Enig, a nutritional researcher at the University of Maryland, has estimated American adults consume 19 grams of trans fat per day, Emken thinks 40 that figure is too high. According to his calculations, eliminating trans fatty acids from the diet will for most people make only a tiny change in lipoprotein levels. “If you’re hypercholesterolemic, it could be important, but if you’re not, then it is not going to affect risk at all,” he concludes. Paragraph 9

Emken, together with Lisa C. Hudgins and Jules Hirsch, has performed a study to be published in the American Journal of Clinical Nutrition, that finds no association between levels of trans fats in fat tissue in humans and their cholesterol profiles. To Emken, that suggests trans fats are not a major threat for most people. Paragraph 10

Nevertheless, trans fats seem destined for more limelight. “How can one defend having cholesterol and saturated and unsaturated fats listed on food labels but not allow public access to trans information when such fats behave like saturates?” asks Bruce J. Holub, a biochemist at the University of Guelph in Ontario. “At 50 the very least, one has to ask whether cholesterol-free claims should be allowed on high-trans products.” – Tim Beardsley

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READING SUBTEST – PART B

OET – SAMPLE

QUESTIONS

Trans Fat – Does margarine really lower cholesterol? 11

12

13

14

15

20

M. A. Flynn’s finding is supported by the proposition that… a)

butter lowers high-density lipoprotein while margarine increases low-density lipoprotein

b)

butter contains just as much partially hydrogenated fat as margarine

c)

trans monounsaturates behave similarly to most naturally-occurring monounsaturates

d)

trans monounsaturated fat increases cholesterol level

Recent studies suggest that… a)

partially hydrogenated fats decrease high-density lipoprotein

b)

partially hydrogenated fats do not increase low-density lipoprotein

c)

both a) and b)

d)

neither a) nor b)

According to the article, a)

eating butter is not as dangerous for cholesterol levels as was previously thought

b)

cholesterol levels in humans can be noticeably reduced by cutting out animal fats

c)

eating margarine is healthier than eating butter

d)

the benefits of using only vegetable fats in the human diet are arguable

Research into trans fats… a)

has been going on for at least ten years

b)

has been going on for less than ten years

c)

has reached an advanced stage

d)

has led to popular support for relabelling of butter and margarine

As a result of Flynn’s study, a)

a Canadian government task force recommended the reduction of trans fats in margarine

b)

a Canadian government task force recommended that the conditions for the hydrogenation reaction should be changed

c)

margarine manufacturers in Canada changed their practices

d)

none of the above

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OET – SAMPLE

PART B – READING SUBTEST QUESTIONS

16

17

18

19

20

Which of the following statements is FALSE? a)

we do not know what conclusions Flynn drew about lipoproteins

b)

Mensink and Katan came to the same conclusion about lipoprotein as Flynn

c)

Grundy’s recommendation was supported by Mensink and Katan’s findings

d)

None of the above

James I. Cleeman DOES NOT… a)

agree with Grundy’s recommendation for relabelling

b)

dispute Mensink and Katan’s research into the effects of eating trans fats

c)

want Mensink and Katan’s work discussed outside the research community

d)

want to wait any longer before warning the public

Which statement would Cleeman agree with? a)

Flynn’s study is not very valuable because she is hard to understand

b)

Trans fats should now be discussed and debated by interested members of the public

c)

Flynn’s study was not sufficiently rigorous

d)

Flynn’s subjects should have had more food of a more varied nature

It has been estimated that American adults consume 19 grams of trans fats per day. Edward Emken… a)

believes that a reduction in this figure could be achieved quite easily

b)

is not very concerned about trans fat intake levels for most people

c)

does not think that they should consume so much in trans fats

d)

thinks that people should eliminate trans fats from their diets

According to Tim Beardsley, the writer of the article, a)

Emken, in a study published in the American Journal of Clinical Nutrition, has challenged other researcher’s claims

b)

the levels of trans fats tissue in humans and their cholesterol profiles are not connected

c)

the issue of trans fat is likely to receive more, rather than less, attention in the future

d)

food products should be labelled with their trans information in addition to the current information

THAT IS THE END OF THE READING TEST

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ANSWERS – READING SUBTEST

OET – SAMPLE

Answer Key Part A – Latin America struggles as cholera spreads 1

b

paragraphs 1-3

2

c

paragraph 3

3

a

paragraphs 3-6

4

c

paragraphs 9-11

5

d

paragraph 12

6

c

paragraphs 1-14

7

d

paragraphs 14-15

8

b

paragraphs 13-16

9

a

paragraph 18

10

b

paragraph 7-19

Part B – Trans Fat

72

11

d

paragraphs 1-3

12

a

paragraph 2

13

d

paragraphs 1-4

14

a

paragraphs 1-5

15

d

paragraphs 4-5

16

b

paragraphs 2-5

17

a

paragraph 6

18

c

paragraphs 6-7

19

b

paragraph 8

20

c

paragraphs 9-10

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