Occupational English Test

READING SUB-TEST
Part B - Text Booklet
Practice test

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multiple-choice answer sheet using 2B pencil.

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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 Part B

Part B : Multiple Choice Questions Time Limit: 20~25 Minutes

Alzheimer Disease
Author: Margaret Gatz
Source: Public Library of Open Science

Paragraph 1
Physicians now commonly advise older adults to engage in mentally stimulating
activity as a way of reducing their risk of dementia. Indeed, the recommendation
is often followed by the acknowledgment that evidence of benefit is still lacking,
but it cant hurt. What could possibly be the problem with older adults
spending their time doing crossword puzzles and anagrams, completing puzzles,
or testing their reaction time on a computer? In certain respects, there is no
problem. Patients will probably improve at the targeted skills, and may feel
goodparticularly if the activity is both challenging and successfully completed.

Paragraph 2
But can it hurt? Possibly. There are two ways that encouraging mental activity
programs might do more harm than good. First, they can falsely raise
expectations. Second, individuals who do develop dementia might be blamed for
their condition. When heavy smokers get lung cancer, they are sometimes seen
as having contributed to their own fates. People with Alzheimer disease might
similarly be viewed as having brought it on themselves through failure to
exercise their brains.

Paragraph 3
There is some evidence to support the idea that mental exercise can improve
ones chances of escaping Alzheimer disease. Having more years of education has
been shown to be related to a lower prevalence of Alzheimer disease. Typically,
the risk of Alzheimer disease is two to four times higher in those who have fewer
years of education, as compared to those who have more years of education.
Other epidemiological studies, although with less consistency, have suggested
that those who engage in more leisure activities have a lower prevalence and
incidence of Alzheimer disease. Additionally, longitudinal studies have found
that older adults without dementia who participate in more intellectually
challenging daily activities show less decline over time on various tests of
cognitive performance.

Paragraph 4
However, both education and leisure activities are imperfect measures of mental
exercise. For instance, leisure activities represent a combination of influences.
Not only is there mental activation, but there may also be broader health effects,
including stress reduction and improved vascular health both of which may
contribute to reducing dementia risk. It could also be that a third factor, such as
intelligence, leads to greater levels of education and more engagement in
cognitively stimulating activities, and independently, to lower risk of dementia.
Research in Scotland, for example, showed that IQ test scores at age 11 were
predictive of future dementia risk .

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 Reading Part B

Paragraph 5
The concept of cognitive reserve is often used to explain why education and
mental stimulation are beneficial. The term cognitive reserve is sometimes taken
to refer directly to brain size or to synaptic density in the cortex. At other times,
cognitive reserve is defined as the ability to compensate for acquired brain
pathology. Taken together, the evidence is very suggestive that having greater
cognitive reserve is related to a reduced risk of Alzheimer disease. But the
evidence that mental exercise can increase cognitive reserve and keep dementia
at bay is weaker. In addition, people with greater cognitive reserve may choose
mentally stimulating leisure activities and jobs, which makes is difficult to
precisely determine whether mentally stimulating activities alone can reduce
dementia risk.

Paragraph 6
Cognitive training has demonstrable effects on performance, on views of self, and
on brain functionbut the results are very specific to the skills that are trained,
and it is as yet entirely unknown whether there is any effect on when
or whether an individual develops Alzheimer disease. Further, the types of skills
taught by practicing mental puzzles may be less helpful in everyday life than
more straightforward techniques, such as concentrating, or taking notes, or
putting objects in the same place each time so that they wont be lost.

Paragraph 7
So far, there is little evidence that mental practice will help prevent the
development of dementia. There is better evidence that good brain health is
determined by multiple factors, that brain development early in life matters,
and that genetic influences are of great importance in accounting for individual
differences in cognitive reserve and in explaining who develops Alzheimer
disease and who does not. At least half of the explanation for individual
differences in susceptibility to Alzheimer disease is genetic, although the genes
involved have not yet been completely discovered. The balance of the
explanation lies in environmental influences and behavioral health practices,
alone or in interaction with genetic factors. However, at this stage, there is no
convincing evidence that memory practice and other cognitively stimulating
activities are sufficient to prevent Alzheimer disease; it is not just a case of use it
or lose it.

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 Reading Part B

Part B : Multiple Choice Questions

1. According to paragraph 1, which of the following statements matches the

opinion of most doctors?
a. Mentally stimulating activities are of little use
b. The risk of dementia can be reduced by doing mentally stimulating
activities
c. The benefits of mentally stimulating activities are not yet proven
d. Mentally stimulating activities do more harm than good

2. In paragraph 2, the author expresses the opinion that .

a. Mentally stimulating activities may offer false hope
b. Dementia sufferers often blame themselves for their condition
c. Alzheimers disease may be caused lack of mental exercise
d. Mentally stimulating activities do more harm than good

3. In paragraph 3, which of the following does not match the information on

research into Alzheimer disease?
a. People with less education have a higher risk of Alzheimer disease
b. Cognitive performance can be enhanced by regularly doing activities
which are mentally challenging
c. Having more education reduces the risk of Alzheimer disease
d. Regular involvement in leisure activities may reduce the risk of
Alzheimer disease

4. According to paragraph 4, which of the following statements is false?

a. The impact of education and leisure is difficult to measure
b. Better vascular health and reduced stress can decrease the risk of
dementia
c. People with higher IQ scores may be less likely to suffer from
dementia
d. Cognitively stimulating activities reduce dementia risk

5. Which of the following is closest in meaning to the expression: keep

dementia at bay?
a. delay the onset of dementia
b. cure dementia
c. reduce the severity of dementia
d. treat dementia

6. Which of the following phrases best summarises the main idea presented
in paragraph 6?
a. The effect cognitive training has on Alzheimer disease is limited
b. Doing mental puzzles may not be as beneficial as concentrating in
everyday life
c. Cognitive training improves brain performance
d. The effect cognitive training has on Alzheimer disease is indefinite

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 Reading Part B

7. According to paragraph 7, which of the following is correct regarding the

development of dementia?
a. Genetic factors are the most significant
b. Environmental factors interact with behavioural factors in determining
susceptibility to Alzheimer disease
c. Good brain health can reduce the risk of developing Alzheimer disease
d. None of the above

8. Which of the following would be the best alternative title for the essay?
a. New developments in Alzheimer research
b. Benefits of education in fighting Alzheimer disease
c. Doubts regarding mental exercise as a preventive measure for
Alzheimer disease
d. The importance of cognitive training in preventing early onset of
Alzheimer disease

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 Reading Part B

Part B : Multiple Choice Questions Time Limit: 20~25 Minutes

Infectious Diseases and Climatic Influences

Authors: Bernard Cazelles, Simon Hales
Source: Public Library of Open Science

Paragraph 1
Complex dynamic relationships between humans, pathogens, and the
environment lead to the emergence of new diseases and the re-emergence of old
ones. Due to concern about the impact of increasing global climate variability
and change, many recent studies have focused on relationships between
infectious disease and climate.

Paragraph 2
Climate can be an important determinant of vector-borne disease epidemics:
geographic and seasonal patterns of infectious disease incidence are often,
though not always, driven by climate factors. Mosquito- borne diseases, such as
malaria, dengue fever, and Ross River virus, typically show strong seasonal and
geographic patterns, as do some intestine diseases. These patterns are
unsurprising, given the influence of climate on pathogen replication, vector and
disease reservoir populations, and human societies. In Sweden, a trend toward
milder winters and early spring arrival may be implicated in an increased
incidence of tick-borne encephalitis. The recent resurgence of malaria in the East
African highlands may be explained by increasing temperatures in that region.
However, as yet there are relatively few studies showing clear climatic
influences on infectious diseases at interannual or longer timescales.

Paragraph 3
The semi-regular El Nio climate cycle, centred on the Pacific Ocean, has an
important influence on interannual climate patterns in many parts of the world.
This makes El Nio an attractive, albeit imperfect, analogue for the effects of
global climate change. In Peru, daily admissions for diarrhoea increased by more
than 2-fold during an El Nio event, compared with expected trends based on the
previous five years. There is evidence of a relationship between El Nio and the
timing of cholera epidemics in Peru and Bangladesh; of ciguatera in the Pacific
islands; of Ross River virus epidemics in Australia; and of dengue and malaria
epidemics in several countries. The onset of meningococcal meningitis in Mali is
associated with large-scale atmospheric circulation.

Paragraph 4
These studies were performed mostly at country scale, reflecting the availability
of data sources and, perhaps, the geographically local effects of El Nio on
climate. In part because of this geographic patchiness of the epidemiological
evidence, the identification of climatic factors in infectious disease dynamics, and
the relative importance of the different factors, remains controversial. For
example, it has been suggested that climate trends are unlikely to contribute to
the timing of dengue epidemics in Thailand. However, recent work has shown a
strong but transient association between dengue incidence and El Nio in

This resource was developed by OET Online and is subject to copyright

Website: http://oetonline.com.au Email: steve@oetonline.com.au
 Reading Part B

Thailand. This association may possibly be caused by a pacemaker-like effect

in which intrinsic disease dynamics interact with climate variations driven by El
Nio to propagate travelling waves of infection.



Paragraph 5
A new study on cutaneous leishmaniasis by Chaves and Pascual also provides
fresh evidence of a relationship between climate and vector-borne disease.
Chaves and Pascual use a range of mathematical tools to illustrate a clear
relationship between climatic variables and the dynamics of cutaneous
leishmaniasis, a skin infection transmitted by sandflies. In Costa Rica, cutaneous
leishmaniasis displays three-year cycles that coincide with those of El Nio.
Chaves and Pascual use this newly demonstrated association to enhance the
forecasting ability of their models and to predict the epidemics of leishmaniasis
up to one year ahead. Interestingly, El Nio was a better predictor of disease
than temperature, possibly because this large-scale index integrates numerous
environmental processes and so is a more biologically relevant measure than
local temperature. As the authors note, the link between El Nio and epidemics
of leishmaniasis might be explained by large-scale climate effects on population
susceptibility. Susceptibility, in turn, may be related to lack of specific immunity
or poor nutritional status, both of which are plausibly influenced by climate.

Paragraph 6
Chaves and Pascual have identified a robust relationship between climate and
disease, with changes over time in average incidence and in cyclic components.
The dynamics of cutaneous leishmaniasis evolve coherently with climatic
variables including temperature and El Nio indices, demonstrating a strong
association between these variables, particularly after 1996. Long-term changes
in climate, human demography, and social features of human populations have
large effects on the dynamics of epidemics as underlined by the analyses of some
large datasets on whooping cough and measles. Another illuminating example is
the transient relationship between cholera prevalence and El Nio oscillations.
In Bangladesh, early in the 20th century, cholera and El Nio appeared
unrelated, yet a strong association emerged in 19802001. Transient
relationships between climate and infectious disease may be caused by
interactions between climate and intrinsic disease mechanisms such as
temporary immunity. If population susceptibility is low, even large increases in
transmission potential due to climate forcing will not result in a large epidemic.

Paragraph 7
A deeper understanding of infectious disease dynamics is important in order to
forecast, and perhaps forestall, the effects of dramatic global social and
environmental changes. Conventional statistical methods may fail to reveal
a relationship between climate and health when discontinuous associations are
present. Because classical methods quantify average associations over the entire
dataset, they may not be adequate to decipher long-term but discontinuous
relationships between environmental exposures and human health. On the other
hand, relationships between climate and disease could signal problems for
This resource was developed by OET Online and is subject to copyright
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 Reading Part B

disease prediction. Unless all important effects are accounted for, dynamic
forecast models may prove to have a limited shelf life. !

Part B : Multiple Choice Questions
1. According to paragraph 2, which of the following is true?
a. The incidence of infectious diseases is rarely caused by climatic
factors.
b. Seasonal variations and geography always lead to increases in
mosquito borne diseases.
c. An increase in the rate of tick-borne encephalitis has been caused by
milder winters and early arrival spring in Sweden.
d. Malaria may have reappeared in East African highlands due to higher
temperatures.

2. Which of the following would be the most appropriate heading for the
paragraph 2?
a. The link between global warming and disease epidemics .
b. The strong relationship between climate and outbreaks of disease.
c. The unexpected influence of climate on infectious diseases.
d. The need for further research into climate change and infectious
diseases.

3. Which of the following is closest in meaning to the expression relatively

few?
a. comparatively few
b. several
c. quite a few
d. three

4. In paragraph 3, which of the following is not true?

a. In Peru, the El Nino event led to increased rates of diarrhoea .
b. El-Nino has a significant yearly effect on global climate patterns.
c. Outbreaks of cholera in Bangladesh and Peru can be linked to El Nino.
d. Meningococcal meningitis in Mali is influenced by weather patterns.

5. The main point the author wishes to raise in paragraph 4 is.

a. Despite differing opinions, there is strong current evidence linking
climate factors and infectious disease.
b. There is insufficient data to determine how significant climatic factors
are on infectious disease.
c. The link between climate trends and disease epidemics is still
inconclusive.
d. There is no connection between climatic trends and dengue fever in
Thailand.

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 Reading Part B

6. According to paragraph 5 which of the following statements is correct?

a. Outbreaks of cutaneous leishmaniasis in Costa Rica correspond with El
Nino events.
b. The mathematical tools used by Chaves and Pascual demonstrate the
link between sandflies and cutaneous leishmaniasis.
c. Research by Chaves and Pascual will allow for annual prediction of
leishmaniasis outbreaks.
d. El Nino is an accurate predictor disease due its complexity and
biological relevance.

7. Which of the following is closest in meaning to the word plausibly?

a. definitely
b. possibly
c. regularly
d. occasionally

8. According to paragraph 6, which of the following statements is correct?

a. The relationship between climate and disease is constant.
b. Outbreaks of cholera appear to be unrelated to El Nino patterns.
c. The dynamics of epidemics are affected by changes in population,
society and weather.
d. Large epidemics rarely occur due to climate changes.

9. Which of the following is closest in meaning to transient relationship?

a. Strong relationship
b. Long term relationship
c. Close relationship
d. Non-permanent relationship

10. In paragraph 7, which of the following statements is most correct?

a. There may be weaknesses in orthodox statistical methods.
b. The dynamics of infectious diseases in well understood.
c. The data measuring long term relationships between human health and
environmental exposure is inadequate.
d. Relationships between climate and disease will make disease
prediction difficult.

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 Reading Part B

Answer Key
1. c 2. a 3. b 4. d 5. a 6. d 7.a 8. c
Question 1
a) Incorrect: No, they believe it may help
b) Incorrect: This is their advice, but they acknowledge there is no evidence
c) Correct: See highlight
d) Incorrect: No, (this is the authors opinion in paragraph 2)
Question 2
a) Correct: synonym: (may offer false hope= can falsely raise expectations)
b) Incorrect: Not mentioned
c) Incorrect: No, some people may believe this, but not the author
d) Incorrect: No, they might i.e it is possible
Question 3
a) Incorrect: Matches
b) Correct: Does not match: will not enhance, just stop the decline
c) Incorrect: Matches
d) Correct: Matches
Question 4
a) Incorrect: True
b) Incorrect: True
c) Incorrect : True
d) Correct: False: could reduce, not reduce(degrees of certainty)
Question 5
a) Correct
b) Incorrect
c) Incorrect
d) Incorrect
Question 6
a) Incorrect: Not mentioned
b) Incorrect: True: but a detail
c) Incorrect: True, but not the main idea
d) Correct: synonym: unclear=unknown
Question 7
a) Correct: see highlight
b) incorrect:
c) Incorrect: could be true but not mentioned
d) Incorrect:
Question 8
a) Incorrect: no new developments mentioned
b) Incorrect: not the main focus
c) Correct: Best summary
d) Incorrect: opposite is true

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Website: http://oetonline.com.au Email: steve@oetonline.com.au
 Reading Part B

Alzheimer Disease

Author: Margaret Gatz
Source: Public Library of Open Science

Paragraph 1
Physicians now commonly advise older adults to engage in mentally stimulating
activity as a way of reducing their risk of dementia. Indeed, (1)the
recommendation is often followed by the acknowledgment that evidence of
benefit is still lacking, but it cant hurt. What could possibly be the problem
with older adults spending their time doing crossword puzzles and anagrams,
completing puzzles, or testing their reaction time on a computer? In certain
respects, there is no problem. Patients will probably improve at the targeted
skills, and may feel goodparticularly if the activity is both challenging and
successfully completed.

Paragraph 2
But can it hurt? Possibly. There are two ways that encouraging mental activity
programs might do more harm than good. First, (2) they can falsely raise
expectations. Second, individuals who do develop dementia might be blamed for
their condition. When heavy smokers get lung cancer, they are sometimes seen
as having contributed to their own fates. People with Alzheimer disease might
similarly be viewed as having brought it on themselves through failure to
exercise their brains.

Paragraph 3
There is some evidence to support the idea that mental exercise can improve
ones chances of escaping Alzheimer disease. Having more years of education has
been shown to be related to a lower prevalence of Alzheimer disease. Typically,
the risk of Alzheimer disease is two to four times higher in those who have fewer
years of education, as compared to those who have more years of education.
Other epidemiological studies, although with less consistency, have suggested
that those who engage in more leisure activities have a lower prevalence and
incidence of Alzheimer disease. Additionally, (3)longitudinal studies have found
that older adults without dementia who participate in more intellectually
challenging daily activities show less decline over time on various tests of
cognitive performance.

Paragraph 4
However, both education and leisure activities are imperfect measures of mental
exercise. For instance, leisure activities represent a combination of influences.
Not only is there mental activation, but there may also be broader health effects,
including stress reduction and improved vascular health both of which may
contribute to reducing dementia risk. (4)It could also be that a third factor, such
as intelligence, leads to greater levels of education and more engagement in
cognitively stimulating activities, and independently, to lower risk of dementia.
Research in Scotland, for example, showed that IQ test scores at age 11 were
predictive of future dementia risk .

This resource was developed by OET Online and is subject to copyright

Website: http://oetonline.com.au Email: steve@oetonline.com.au
 Reading Part B

Paragraph 5
The concept of cognitive reserve is often used to explain why education and
mental stimulation are beneficial. The term cognitive reserve is sometimes taken
to refer directly to brain size or to synaptic density in the cortex. At other times,
cognitive reserve is defined as the ability to compensate for acquired brain
pathology. Taken together, the evidence is very suggestive that having greater
cognitive reserve is related to a reduced risk of Alzheimer disease. But the
evidence that mental exercise can increase cognitive reserve and (5)keep
dementia at bay is weaker. In addition, people with greater cognitive reserve
may choose mentally stimulating leisure activities and jobs, which makes is
difficult to precisely determine whether mentally stimulating activities alone can
reduce dementia risk.

Paragraph 6
Cognitive training has demonstrable effects on performance, on views of self, and
on brain functionbut the results are very specific to the skills that are trained,
and (6) it is as yet entirely unknown whether there is any effect on when
or whether an individual develops Alzheimer disease. Further, the types of skills
taught by practicing mental puzzles may be less helpful in everyday life than
more straightforward techniques, such as concentrating, or taking notes, or
putting objects in the same place each time so that they wont be lost.

Paragraph 7
So far, there is little evidence that mental practice will help prevent the
development of dementia. There is better evidence that good brain health is
determined by multiple factors, that brain development early in life matters,
and that genetic influences are of great importance in accounting for individual
differences in cognitive reserve and in explaining who develops Alzheimer
disease and who does not. (7)At least half of the explanation for individual
differences in susceptibility to Alzheimer disease is genetic, although the genes
involved have not yet been completely discovered. The balance of the
explanation lies in environmental influences and behavioral health practices,
alone or in interaction with genetic factors. However, at this stage, there is no
convincing evidence that memory practice and other cognitively stimulating
activities are sufficient to prevent Alzheimer disease; it is not just a case of use it
or lose it.

This resource was developed by OET Online and is subject to copyright

Website: http://oetonline.com.au Email: steve@oetonline.com.au
 Reading Part B

Answer Key
1. d 2. b 3. a 4. b 5. a 6. a 7.b 8. c 9. d 10. a
Question 1
a) Incorrect: Not rarely, often
b) Incorrect: Not mentioned
c) Incorrect: may be implicated, not has lead
d) Correct: (synonym resurgence=reappearance) key word may
Question 2
a) Incorrect: global warming not mentioned
b) Correct: (synonym disease epidemics=outbreaks of disease) important determinant=strong
relationship
c) Incorrect: Opposite is true
d) Incorrect: True fact but a detail not the main idea
Question 3
a) Correct
b) Incorrect
c) Incorrect
d) Incorrect
Question 4
a) Incorrect: True: diarrhoea increased by more than 2-fold during an El Nio event
b) Correct: Not true as the effects are semi-regular/interannual i.e between years not yearly
c) Incorrect: True: There is evidence of a relationship between El Nio and the timing of cholera
epidemics in Peru and Bangladesh
d) Incorrect: True: The onset of meningococcal meningitis in Mali is associated with large-scale
atmospheric circulation
Question 5
a) Correct: The author is trying demonstrate that there is a clear link between climate factors
and infectious disease. Key words However & synonym: current=recent
b) Incorrect: While this may be true, it s not the authors main point
c) Incorrect : as in B
d) Incorrect
Question 6
a) Correct: (synonym coincide=correspond)
b) Incorrect: incorrect meaning
c) Incorrect: not annually, one year ahead
d) Incorrect: not given, it is a better predictor than temperature
Question 7
a) Incorrect
b) Correct
c) Incorrect
d) Incorrect
Question 8
a) Incorrect: not constant, changes over time
b) Incorrect: This was a past opinion, not now
c) Correct: similar meaning
d) Incorrect: Incomplete information
Question 9
a) Incorrect
b) Incorrect
c) Incorrect
d) Correct
Question 10
a) Correct: (synonyms conventional=orthodox & may be short comings=may fail)
b) Incorrect: no, deeper understanding is important
c) Incorrect: Not the data, the methods
d) Incorrect: Degrees of certainty: Could not will

This resource was developed by OET Online and is subject to copyright

Website: http://oetonline.com.au Email: steve@oetonline.com.au
 Reading Part B

Infectious Diseases and Climatic Influences

Bernard Cazelles, Simon Hales

Paragraph 1
Complex dynamic relationships between humans, pathogens, and the environment
lead to the emergence of new diseases and the re-emergence of old ones. Due to
concern about the impact of increasing global climate variability and change, many
recent studies have focused on relationships between infectious disease and climate.

Paragraph 2
(2)Climate can be an important determinant of vector-borne disease epidemics:
geographic and seasonal patterns of infectious disease incidence are often, though not
always, driven by climate factors. Mosquito- borne diseases, such as malaria, dengue
fever, and Ross River virus, typically show strong seasonal and geographic patterns,
as do some intestine diseases. These patterns are unsurprising, given the influence of
climate on pathogen replication, vector and disease reservoir populations, and human
societies. In Sweden, a trend toward milder winters and early spring arrival may be
implicated in an increased incidence of tick-borne encephalitis. (1)The recent
resurgence of malaria in the East African highlands may be partly explained by
increasing temperatures in that region. However, as yet there are (3) relatively few
studies showing clear climatic influences on infectious diseases at interannual or
longer timescales.

Paragraph 3
The (4) semi-regular El Nio climate cycle, centred on the Pacific Ocean, has an
important influence on interannual climate patterns in many parts of the world. This
makes El Nio an attractive, albeit imperfect, analogue for the effects of global
climate change. In Peru, daily admissions for diarrhoea increased by more than 2-fold
during an El Nio event, compared with expected trends based on the previous five
years. There is evidence of a relationship between El Nio and the timing of cholera
epidemics in Peru and Bangladesh; of ciguatera in the Pacific islands; of Ross River
virus epidemics in Australia; and of dengue and malaria epidemics in several
countries. The onset of meningococcal meningitis in Mali is associated with large-
scale atmospheric circulation.

Paragraph 4
These studies were performed mostly at country scale, reflecting the availability of
data sources and, perhaps, the geographically local effects of El Nio on climate. In
part because of this geographic patchiness of the epidemiological evidence, the
identification of climatic factors in infectious disease dynamics, and the relative
importance of the different factors, remains controversial. For example, it has been
suggested that climate trends are unlikely to contribute to the timing of dengue
epidemics in Thailand. (5)However, recent work has shown a strong but transient
association between dengue incidence and El Nio in Thailand. This association may
possibly be caused by a pacemaker-like effect in which intrinsic disease dynamics
interact with climate variations driven by El Nio to propagate travelling waves of
infection.

This resource was developed by OET Online and is subject to copyright

Website: http://oetonline.com.au Email: steve@oetonline.com.au
 Reading Part B

Paragraph 5
A new study on cutaneous leishmaniasis by Chaves and Pascual also provides fresh
evidence of a relationship between climate and vector-borne disease. Chaves and
Pascual use a range of mathematical tools to illustrate a clear relationship between
climatic variables and the dynamics of cutaneous leishmaniasis, a skin infection
transmitted by sandflies. (6)In Costa Rica, cutaneous leishmaniasis displays three-
year cycles that coincide with those of El Nio. Chaves and Pascual use this newly
demonstrated association to enhance the forecasting ability of their models and to
predict the epidemics of leishmaniasis up to one year ahead. Interestingly, El Nio
was a better predictor of disease than temperature, possibly because this large-scale
index integrates numerous environmental processes and so is a more biologically
relevant measure than local temperature. As the authors note, the link between El
Nio and epidemics of leishmaniasis might be explained by large-scale climate effects
on population susceptibility. Susceptibility, in turn, may be related to lack of specific
immunity or poor nutritional status, both of which are plausibly influenced by
climate.

Paragraph 6
Chaves and Pascual have identified a robust relationship between climate and disease,
with changes over time in average incidence and in cyclic components. The dynamics
of cutaneous leishmaniasis evolve coherently with climatic variables including
temperature and El Nio indices, demonstrating a strong association between these
variables, particularly after 1996. (8)Long-term changes in climate, human
demography, and social features of human populations have large effects on the
dynamics of epidemics as underlined by the analyses of some large datasets on
whooping cough and measles. Another illuminating example is the transient
relationship between cholera prevalence and El Nio oscillations. In Bangladesh,
early in the 20th century, cholera and El Nio appeared unrelated, yet a strong
association emerged in 19802001. Transient relationships between climate and
infectious disease may be caused by interactions between climate and intrinsic disease
mechanisms such as temporary immunity. If population susceptibility is low, even
large increases in transmission potential due to climate forcing will not result in a
large epidemic.

Paragraph 7
A deeper understanding of infectious disease dynamics is important in order to
forecast, and perhaps forestall, the effects of dramatic global social and environmental
changes. (10) Conventional statistical methods may fail to reveal
a relationship between climate and health when discontinuous associations are
present. Because classical methods quantify average associations over the entire
dataset, they may not be adequate to decipher long-term but discontinuous
relationships between environmental exposures and human health. On the other hand,
relationships between climate and disease could signal problems for disease
prediction. Unless all important effects are accounted for, dynamic forecast models
may prove to have a limited shelf life. !

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