Practice Test 9: Tuberculosis, AIDS, and Death Among Substance Abusers On Welfare in New York City

Practice Test 9
READING SUB-TEST – QUESTION PAPER: PART A
TIME: 15 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until

you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
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 and
the Text Booklet.
DO NOT remove OET material from the test room.
Tuberculosis, AIDS, and Death among Substance Abusers on Welfare in
New York City
Text A
Background
In New York City, the incidence of tuberculosis has more than doubled
during the past decade. We examined the incidence of tuberculosis and the
acquired immunodeficiency syndrome (AIDS) and the rate of death from all
causes 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 and
recipients 18 to 64 years of age who abused drugs or alcohol. The incidence
rates of tuberculosis, AIDS, and death for this group were ascertained
through vital records and New York City’s tuberculosis and AIDS registries.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text B
Results
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 were
744 for tuberculosis,
1323 for AIDS, and
2842 for death.
In this group of welfare clients,
the rate of newly diagnosed tuberculosis was 14.8 times that of the
age 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 tuberculosis
between subjects with positive skin tests and those with negative
skin tests at examination in 2009.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19”
Text C
Deaths in the cohort
There were 183 deaths in the cohort during follow-up (21.3 percent) of the
subjects, a rate of 2842 deaths per 100,000 person-years, 5.2 times that of the
age-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- narcotic 8 (4.4%) 42

substance
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
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text D
Conclusions
Of the 47 subjects with tuberculosis, 21 (44.7 percent) died before

the end 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-TB
therapy.
Of the 84 study subjects with AIDS, 68 (81.0 percent) died before
the end of 2017.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19”
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 find the
relevant information.
• Write your answers on the spaces provided in this Question
Paper.
• 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 information
comes from. You may use any letter more than once.
In which text can you find information about

1. what was the percentage of deaths caused by diabetes in the study group?
_____
Go to “Text A” “Text B” “Text C” “Text D”
2. what was the rate of incidence per 100,000 person per years for
tuberculosis? _____
3. name the city where the study was conducted? _____
4. how the incidence rates of diseases and death for the study group were
ascertained? _____
5. how many died before the end of 2017 without completing anti-TB
therapy? _____
6. what was the average age of subjects died due to other causes in the study
group? _____
7. how many years the cohort was followed? _____
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase from one of
the texts. Each answer may include words, numbers or both.
8. How many of the study subjects with only AIDS died before the end of
2017?
9. In how many of the study subjects wound was the cause of death?
10. What was the age limits of the study subjects?
11. When did the study begin?
12. What was the total number of deaths in the study group?
13. What was the percentage of deaths caused by respiratory arrest in the
study group?
Questions 14-20
Complete each of the sentences, 14-20, with a word or short phrase
from one of the texts. Each answer may include words, numbers or
both.
14. The study shows that number of the incidence of tuberculosis in
New York City has more than _____ during the past decade.
15. In conclusion, 12 of those who died had both AIDS and _____.
16. In the cohort during follow-up of the subjects, rate of deaths was 5.2
times that of the _____ general population..
17. In the group of welfare clients, the rate of ____ was 10.0 times as high.
18. The study was conducted among _____ who abuse drugs, alcohol,
or both.
19. ______ subjects died suffering from coronary artery disease.
20. There were _____ subjects in the study group.
Answer Key
“Practice Test 9”
Practice Test 10
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES

Paper.
You must answer Part B & C within the 45-minute time limit.
the Text Booklet.
Part B
In this part of the test, there are six short extracts relating to
the work of health professionals. For questions 1-6, choose the
answer (A, B or C) which you think fits best according to the
text.
Incubators for Infant
The general principle is that air is processed before it reaches baby.

An electric fan draws room air through a bacterial filter which
removes dust and bacteria. The filtered air flows over an electric
heating element. The filtered and heated air then passes over a
water tank where it is moistened. It then flows on to the incubator
canopy. The incubator canopy is slightly pressurized. This allows
expired carbon dioxide to pass back into the room via the vent
holes and most of the air to be re-circulated. It also prevents
unfiltered air entering the system.
1. The extract informs us that the incubators
A. is likely to circulate most of the air again.
B. may not work correctly in close proximity to some other
devices.
C. prevents filtered air entering the system.
Nebulizers
A nebulizer is a device used to administer medication in the form

of a mist inhaled into the lungs. Nebulizers are commonly used for
treatment of cystic fibrosis, asthma and other respiratory diseases.
The reason for using a nebulizer for medicine to be administered
directly to the lungs is that small aerosol droplets can penetrate into
the narrow branches of the lower airways. Large droplets would be
absorbed by the mouth cavity, where the clinical effect would be
low. The common technical principle for all nebulizers is to use
oxygen, compressed air or ultrasonic power as means to break up
medical solutions or suspensions into small aerosol droplets.
2. The notice is giving information about
A. ways of checking that a nebulizer has been placed correctly.
B. how the use of nebulizer is authorised.
C. why nebulizer are being used.
Oxygen Concentrators
Atmospheric air consists of approximately 80% nitrogen and 20%

oxygen. An oxygen concentrator uses air as a source of oxygen by
separating these two components. It utilizes the property of zeolite
granules to selectively absorb nitrogen from compressed air.
Atmospheric air is gathered, filtered and raised to a pressure of 20
pounds per square inch (psi) by a compressor. The compressed air
is then introduced into one of the canisters containing zeolite
granules where nitrogen is selectively absorbed leaving the residual
oxygen available for patient use. After about 20 seconds the supply
of compressed air is automatically diverted to the second canister
where the process is repeated enabling the output of oxygen to
continue uninterrupted.
3. What does this manual tell us about zeolite granules?
A. leave residual oxygen for patient use
B. selectively absorb nitrogen from air
C. absorb only nitrogen from compressed air
Arterial blood pressure
The arterial blood pressure (BP) is connected with the force, which is exerted
by the blood volume on the walls of the arteries. The level of BP is dependent
on two factors: the heart minute ejection volume and the elasticity of arterial
walls. Other factors affecting BP include: the volume and viscosity of the
blood, body position and emotional state. The BP at the top of pulse wave
(due to the constriction of heart ventricles) is called systolic BP, whereas the
respective one during the diastole is called diastolic BP. The difference
between systolic and diastolic BP is defined as amplitude or pulse pressure.
4. Which is the main factor behind BP level?
A. the heart minute rejection volume
B. volume and viscosity of the blood
C. elasticity of the arterial wall
Basic Life Support
Basic Life Support means saving lives by maintaining airway, supplying
ventilation (rescue breathing by blowing air to the victim’s mouth) and
supplying circulation (external cardiac massage – chest compressions)
performed without additional equipment. It is the first step in cardio-
pulmonary resuscitation (CPR) that should be initiated by bystanders and
continued until qualified help arrives. Next step is Advanced Life Support
(ALS), which is performed by medical services. People with cardiac arrest
(CA) need immediate CPR. First aid means BLS that is started by witnesses
before the emergency service arrival and is the key action in achieving patient
survival.
5. What does this manual tell us about cardio-pulmonary resuscitation?
A. should be initiated by bystanders
B. should be initiated immediately only for cardiac arrest
C. should be performed by medical services
Types of surgical threads
Materials, which the threads are made of, are divided into absorbable and
non- absorbable ones or natural and synthetic sutures. Non-absorbable
sutures are applied on the skin and in septic wounds. Absorbable threads,
depending on their structure are divided into monofilament, polifilament,
braided, plaits, coated and uncoated ones. Time of their absorbing is varied
and depends on material properties; it can take from 14 days to 6 months.
Absorbing progresses due to enzymatic disintegration and hydrolysis.
6. What does this extract from a handbook tell us about absorbable threads?
A. absorbing progresses due to enzymatic integration and hydrolysis
B. absorbing time is varied and depends on material properties
C. are divided into monofilament, polifilament, braided, plaits and uncoated
ones
Answer Key
Practice Test 11
TIME: 45 MINUTES

Paper.
the Text Booklet.
Targeting two important risk factors for cardiovascular disease and
other major risk factors that can be lowered by modification, treatment
or control
Paragraph 1
(ARA) - It’s well known that the prevalence of diabetes is on the rise.
According to the Centers for Disease Control and Prevention (CDC), about
23.6 million, or nearly 8 percent of people in the United States, have diabetes,
and 1.6 million new cases are diagnosed each year in people aged 20 and
older. Type 2 diabetes is the most common form, accounting for about 90 to
95 percent of those diagnosed, and occurs when the body either does not
produce enough insulin or does not respond to insulin.
Questions “Q1” “Q2” “Q3” “Q4” “Q5” “Q6” “Q7” “Q8” “Q9” “Q10”
Paragraph 2
But something that many people may not know is that in addition to having
diabetes, 70 percent of adults with type 2 diabetes also have high LDL
cholesterol (LDL-C), the “bad” cholesterol that can cause build-up in the
arteries, greatly increasing their risk for cardiovascular disease. Cholesterol is
needed for the body to function normally, but when there is too much LDL-C
in the bloodstream, it is deposited in arteries, including those of the heart,
which can limit blood flow and lead to heart disease.
Paragraph 3
The American Diabetes Association (ADA) and the American College of
Cardiology (ACC) emphasize that it is critical to control both cholesterol and
blood sugar Ievels. The ADA recommends that patients with type 2 diabetes
aim for an A1C level which reflects your average blood sugar level for the
past two to three months, of less than 7 percent. The National Cholesterol
Education Program (NCEP) ATP lll recommends that patients with type 2
diabetes target an LDL-C goal of less than 100 mg/dL.
Paragraph 4
Treating these two diseases can take a combination of efforts, including a
healthy diet and increased exercise. Medications are also sometimes needed.
While there are many drugs approved by the U.S. Food and Drug
Administration (FDA) to treat type 2 diabetes and others available to lower
LDL-C, a drug called Welchol (colesevelam HCI) is the first and only
medication approved as an adjunct to diet and exercise to reduce both A1C in
adults with type 2 diabetes and LDL-C in adults with elevated cholesterol.
Welchol addresses both of these chronic health conditions with one
medication and offers the convenience of two formulations, Welchol tablets
and Welchol for Oral Suspension. Welchol can be taken alone or with other
cholesterol lowering medications known as statins and can be added to other
anti-diabetic medications (metformin, sulfonylureas, or insulin).
Paragraph 5
“For patients with type 2 diabetes and high LDL cholesterol, it is important to
manage both conditions,” said Yehuda Handelsman, MD, FACP, FACE,
Medical Director of the Metabolic Institute of America in Tarzana, Calif.
“Welchol reduces these two risk factors for cardiovascular disease in adults
with type 2 diabetes by significantly lowering A1C and LDL-C or ‘bad’
cholesterol, providing a unique therapeutic option.” It is important to note
that the affect of Welchol on cardiovascular morbidity and mortality has not
been determined.
Paragraph 6
What are the major uncontrollable risk factors for coronary heart
disease?
The American Heart Association has identified several risk factors for
coronary heart disease. Some of them can be modified, treated or controlled,
and some can’t. The more risk factors a person has, the greater the chance
that he or she will develop heart disease. Also, the greater the level of each
risk factor, the greater the risk. For example, a person with a total cholesterol
of 300 mg/dL has a greater risk than someone with a total cholesterol of 240
mg/dL, even though all people with a total cholesterol of 240 or higher are
considered high risk.
Paragraph 7
Increasing age — About 82% of people who die of coronary heart disease
are 65 or older.
Male sex (gender) — The lifetime risk of developing CHD after age 40 is
49% for men and 32% for women. The incidence of CHD in women lags
behind men I years for total CHD and by 20 years for more serious clinical
events such as sudden death.
Paragraph 8
Heredity (including Race) — Children of parents with heart disease are
more likely to develop it themselves. African Americans have more severe
high blood pressure than Caucasians and a higher risk of heart disease. Heart
disease is also higher among Mexican Americans, American Indians, native
Hawaiians and some Asian Americans. This is partly due to higher rates of
obesity and diabetes. Most people with a strong family history of heart
disease have one or more other risk factors. Just as you can’t control your
age, sex and race, you can’t control your family history. Therefore, it’s even
more important to treat and control any other risk factors you have.
Paragraph 9
Other major risk factors that can be lowered by modification, treatment
or control
Tobacco smoke — Smokers’ risk of developing CHD is two to four times
that nonsmokers‘. Smokers who have a heart attack are more likely to die and
die suddenly (within an hour) than nonsmokers. Cigarette smoking also acts
with other risk factors to greatly increase the risk for coronary heart disease.
People who smoke cigars or pipes seem to have a higher risk of death from
coronary heart disease (and possibly stroke), but their risk isn’t as great as
cigarette smokers‘. Constant exposure to other people’s smoke — called
environmental tobacco smoke, secondhand smoke or passive smoking —
increases the risk of heart disease even for nonsmokers.
Paragraph 10
High blood cholesterol levels — The risk of coronary heart disease rises as
blood cholesterol levels increase. When other risk factors (such as high blood
pressure and tobacco smoke) are present, this risk increases even more. A
person’s cholesterol level is also affected by age, sex, heredity and diet.
High blood pressure — High blood pressure increases the heart’s workload,
causing the heart to enlarge and weaken over time. It also increases the risk
of stroke, heart attack, kidney failure and heart failure. When high blood
pressure exists with obesity, smoking, high blood cholesterol levels or
diabetes, the risk of heart attack or stroke increases several times.
Paragraph 11
Physical inactivity — An inactive lifestyle is a risk factor for coronary heart
disease. Regular, moderate-to-vigorous physical activity is important in
preventing heart and blood vessel disease.
Obesity and overweight — People who have excess body fat — especially
if a lot of it is in the waist area — are more likely to develop heart disease
and stroke even if they have no other risk factors. Excess weight increases the
strain on the heart, raises blood pressure and blood cholesterol and
triglyceride levels, and lowers HDL (good) cholesterol levels. It can also
make diabetes more likely to develop. Many obese and overweight people
have difficulty losing weight. If you can lose as little as 10 to 20 pounds, you
can help lower your heart disease risk.
Paragraph 12
Diabetes mellitus — Diabetes seriously increases the risk of developing
cardiovascular disease. Even when glucose levels are under control, diabetes
greatly increases the risk of heart disease and stroke. From two-thirds to three
—quarters people with diabetes die of some form of heart or blood vessel
disease.
Paragraph 13
What other factors contribute to heart disease risk?
Stress — Individual response to stress may be a contributing factor. Some
scientists have noted a relationship between coronary heart disease risk and
stress in a person’s life, their health behaviors and socioeconomic status.
These factors may affect established risk factors. For example, people under
stress may overeat, start smoking or smoke more than they otherwise would.
Paragraph 14
Excessive alcohol intake — Drinking too much alcohol can raise blood
pressure, cause heart failure and lead to stroke. It can contribute to high
triglycerides, cancer and other diseases, and produce irregular heartbeats. It
also contributes to obesity, alcoholism, suicide and accidents. The risk of
heart disease in people who drink moderate amounts of alcohol (an average
of one drink for women or two drinks for men per day) is lower than in
nondrinkers. One drink is defined as 1-1/2 fluid ounces (fl oz) of 80-proof
spirits (such as bourbon, Scotch, vodka, gin, etc.), 1 fl oz of 100- proof
spirits, 4 fl oz of wine, or 12 fl oz of beer. It’s not recommended that
nondrinkers start using alcohol or that drinkers increase their intake.
QUESTIONS
Q1. According to paragraph 1 of the article states that__________
a. Diabetes has stabilised
b. 1.6 million people aged 20 and older have diabetes
c. Type 2 diabetes is the most common
d. Type 2 diabetes occurs when there is an over-production of insulin
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q2. In addition to having diabetes__________
a. 30% of adult with Type 2 diabetes do not have high counts of low density
lipids
b. 70% of adults with Type 2 diabetes do have high counts of low density
lipids
c. Too many LDLs in the bloodstream go straight to the heart
d. LDLs in the bloodstream cannot hinder blood flow
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q3. According to the ADA and the ACC__________
a. Both blood sugar levels and cholesterol levels need to be controlled if
diabetes is avoided
b. Blood sugar levels need to be controlled if diabetes is to be avoided
c. ACA believes less than 7% average blood sugar level over a one month
period indicates diabetes risk
d. The NCEP does not recommend Type 2 diabetics aim for less than 100
mg/dL of low density lipids
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q4. Welchol, a drug to lower the level of LDLs in the blood__________
a. has not been approved by the U.S. FDA
b. Welchol must be taken with other statins
c. Welchol should not be added to medications such as metformin,
sulfonylureas or insulin.
d. Welchol needs to be taken together with a healthy diet and an exercise
program to reduce A1C in Type 2 diabetics and LDL-C in adults with
elevated cholesterol levels.
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q5. Welchol’s affect on cv mobidlty and mortality..
a. is supported by the evidence
b. has not been positively established
c. has been positively established
d. none of the above
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q6. Some risk factors can be controlled, or lowered; some cannot be
controlled: such as advancing age, one’s gender, and one’s genetic
inheritance. However, there are some major risk factors that can be lowered
— by modifying one’s lifestyle - or by medical intervention.
Risk factors such as__________
a. high blood pressure
b. high cholesterol levels
c. obesity
d. all of the above
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q7. The article states that stress __________
a. causes overeating and/or habitual smoking
b. does not interact with lifestyle and socioeconomic status
c. depends on how one reacts to it
d. may depend on how one reacts to it
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q8. Alcohol contributes to heart failure and strokes;
a. if you drink very less amount
b. moderate alcohol intake leads to less risk of heart disease
c. but not contribute to high triglycerides
d. is not a factor in developing cancer
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q9. To have just “one drink” of alcohol, means __________
a. to consume no more than 1½ fluid ounces
b. to consume 4 fluid ounces
c. to consume 12 fluid ounces
d. depends on the type of alcohol
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Q10. High blood pressure and physical inactivity__________
a. are contributing factors for coronary heart disease
b. people with high blood pressure should not do physical activities
c. people with high blood pressure have no risk of renal failure
d. to prevent heart disease, one should have regular mild physical activity
Para- “1” “2” “3” “4” “5” “6” “7”
graphs “8” “9” “10” “11” “12” “13” “14”
Answer Key
Practice Test 12
TIME: 45 MINUTES

Paper.
the Text Booklet.
Fluoride
Paragraph 1
Globalization has provoked changes in many facets of human life,
particularly in diet. Trends in the development of dental caries in population
have traditionally followed developmental patterns where, as economies
grow and populations have access to a wider variety of food products as a
result of more income and trade, the rate of tooth decay begins to increase.
As countries become wealthier, there is a trend to greater preference for a
more “western” diet, high in carbohydrates and refined sugars. Rapid
globalization of many economies has accelerated this process. These dietary
have a substantial impact on diseases such as diabetes and dental caries.
Questions “Q1” “Q2” “Q3” “Q4” “Q5” “Q6” “Q7” “Q8” “Q9”
Paragraph 2
The cariogenic potential of diet emerges in areas where fluoride
supplementation is inadequate. Dental caries is a global health problem and
has a significant negative impact on quality of life, economic productivity,
adult and children’s general health and development. Untreated dental caries
in pre-school children is associated with poorer quality of life, pain and
discomfort, and difficulties in ingesting food that can result in failure to gain
weight and impaired cognitive development. Since low-income countries
cannot afford dental restorative treatment and in general the poor are most
vulnerable to the impacts of illness, they should be afforded a greater degree
of protection.
Paragraph 3
By WHO estimates, one third of the world‘s population have inadequate
access to needed medicines primarily because they cannot afford them.
Despite the inclusion of sodium fluoride in the World Health Organization‘s
Essential Medicines Model List, the global availability and accessibility of
fluoride for the prevention of dental caries remains a global problem. The
optimal use of fluoride is an essential and basic public health strategy in the
prevention and control of dental caries, the most common non-
communicable disease on the planet. Although a whole range of effective
fluoride vehicles are available for fluoride use (drinking water, salt, milk,
varnish, etc.), the most widely used method for maintaining a constant low
level of fluoride in the oral environment is fluoride toothpaste.
Paragraph 4
More recently, the decline in dental caries amongst school children in Nepal
has been attributed to improved access to affordable fluoride toothpaste. For
many low-income nations, fluoride toothpaste is probably the only realistic
population strategy for the control and prevention of dental caries since
cheaper alternatives such as water or salt fluoridation are not feasible due to
poor infrastructure and limited financial and technological resources. The use
of topical fluoride e.g. in the form of varnish or gels for dental caries
prevention is similarly impractical since it relies on repeated applications of
fluoride by trained personnel on an individual basis and therefore in terms of
cost cannot be considered as part of a population based preventive strategy.
Paragraph 5
The use of fluoride toothpaste is largely dependent upon its socio-cultural
integration in personal oral hygiene habits, availability and the ability of
individuals to purchase and use it on a regular basis. The price of fluoride
toothpaste is believed to be too high in some developing countries and this
might impede equitable access. In a survey conducted at a hospital dental
clinic in Lagos, Nigeria 32.5% of the respondents reported that the cost of
toothpaste influenced their choice of brands and 54% also reported that the
taste of toothpastes influenced their choice.
Paragraph 6
Taxes and tariffs on fluoride toothpaste can also significantly contribute to
high prices, lower demand and inequity since they target the poor.
Toothpastes are u; classified as a cosmetic product and as such often highly
taxed by governments. For example, various taxes such as excise tax, VAT,
local taxes as well as taxation on the ingredients and packaging contribute to
25% of the retail cost of toothpaste in Ne and India, and 50% of the retail
price in Burkina Faso. WHO continues to recommend the removal taxes and
tariffs on fluoride toothpastes. Any lost revenue can be rest by higher taxes
on sugar and high sugar containing foods, which are common risk factors for
dental caries, coronary heart disease, diabetes and obesity.
Paragraph 7
The production of toothpaste within a country has the potential to make
fluoride toothpaste more affordable than imported products. In Nepal,
fluoride toothpaste was limited to expensive imported products. However,
due to successful advocacy locally manufactured fluoride toothpaste, the least
expensive locally manufactured fluoride toothpaste is now 170 times less
costly than the most expensive imported Philippines, local manufacturers are
able to satisfy consumer preferences and compete against multinationals by
discounting the price of toothpaste by as much as 55% against global brands;
and typically receive a 40% profit margin compared to 70% for multinational
producers.
Paragraph 8
In view of the current extremely inequitable use of fluoride throughout
countries and regions, all efforts to make fluoride and fluoride toothpaste
affordable and accessible must be intensified. As a first step to addressing the
issue of affordability of fluoride toothpaste in the poorer countries in-depth
country studies should be undertaken to analyze the price of toothpaste in the
context of the country economies.
QUESTIONS
Q1. Which of the following would be the most appropriate heading for the
paragraph 1?
a. High sugar intake and increasing tooth decay
b. Globalisation, dietary changes and declining dental health
c. Dietary changes in developing nations
d. Negative health effects of a western diet
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q2. Which of the following is not mentioned as a negative effect of untreated
dental caries in pre-school children?
a. Decreased mental alertness
b. Troubling chewing and swallowing food
c. Lower life quality
d. Reduced physical development
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q3. According to paragraph 3, which of the following statement is correct?
a. Dental caries is the most contagious disease on earth.
b. Fluoride in drinking water is effective but rarely used
c. Fluoride is too expensive for a large proportion of the global population.
d. Fluoride toothpaste is widely used by 2/3 of the world’s population.
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q4. Fluoride toothpaste is considered the most effective strategy to reduce
dental caries in low income countries because.....
a. it is the most affordable.
b. topical fluoride is unavailable.
c. it does not require expensive infrastructure or training.
d. it was effective in Nepal.
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q5. Which of the following is closest in meaning to the word impede?
a. stop
b. prevent
c. hinder
d. postpone
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q6. Regarding the issue of taxation in paragraph 6 which of the following
statements is most correct?
a. Income tax rates are higher in Burkina Faso than India or Nepal.
b. WHO recommends that tax on toothpaste be reduced.
c. Governments would like to reduce tax on toothpastes but can’t as it is
classified as a cosmetic.
d. WHO suggests taxing products with a high sugar content instead of
toothpastes.
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q7. Which of the following is closest in meaning to the word advocacy?
a. marketing
b. demand
c. development
d. support
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q8. Statistics in paragraph 7 indicate that....
a. local products can’t compete with global products and make a profit at the
same time.
b. Philippine produced toothpaste is profitable while being less than half the
price of global brands.
c. in Nepal, fluoride toothpaste is limited to imported products which are very
expensive
d. toothpaste produced in the Philippines has a higher profit margin than
internationally produced toothpaste.
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Q9. What would make the most suitable alternative title for the article
a. Globalisation and declining dental health
b. Best practice in global fluoride supplementation
c. Increased dental problems in developing countries
d. Global affordability of fluoride toothpaste
Para- “1” “2” “3” “4”
graphs “5” “6” “7” “8”
Answer Key

Practice Test 9: Tuberculosis, AIDS, and Death Among Substance Abusers On Welfare in New York City

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Practice Test 9: Tuberculosis, AIDS, and Death Among Substance Abusers On Welfare in New York City

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Practice Test 9

READING SUB-TEST – QUESTION PAPER: PART A

DO NOT open this Question Paper or the Text Booklet until

tuberculosis developed in 47 (5.5 percent),

Causes of death No. of subjects Average Age at Death

Infectious diseases 18 (9.8%) 43

Cirrhosis of the liver 16 (8.7%) 43

Coronary artery disease 10 (5.5%) 47

Overdose of non- narcotic 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

Upper gastrointestinal bleeding 3 (1.6%) 44

Chronic renal failure 2(1.1%) 59

Respiratory arrest 2(1.1%) 46

Of the 47 subjects with tuberculosis, 21 (44.7 percent) died before

In which text can you find information about

DO NOT open this Question Paper or the Text Booklet until

Incubators for Infant

The general principle is that air is processed before it reaches baby.

A nebulizer is a device used to administer medication in the form

Atmospheric air consists of approximately 80% nitrogen and 20%

DO NOT open this Question Paper or the Text Booklet until

DO NOT open this Question Paper or the Text Booklet until

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