TEXT 1.

Especially in the last century, most Western countries have experienced significant
demographic changes with a continuing increase in the number of older people who face
medical and functional challenges, as well as diseases including obesity, cardiovascular
hearth diseases (CHD) or type 2 diabetes mellitus are caused by civilization. The World
Health Organization has identified these three diseases are the most severe
noncommunicable disease (NCD) causing problems today´s Western World.
Noncommunicable diseases are mostly diseases of slow progression and normally of long
duration.

Most NCDs primarily result from unhealthy lifestyles including the consumption of too
much or unhealthy food, too much alcohol and excessive smoking habits, combined with
physical inactivity. More specifically inactivity and unhealthy eating habits associated with
weight gain, overweight and obesity are the major underlying causes for modern diseases
such as CHD or type 2 diabetes mellitus.

Many cross-sectional and intervention studies have focused on the relationship between
an unhealthy lifestyle e.g. physical inactivity, unhealthy eating behaviors, smoking and
alcohol consumption, and diseases in different study groups, e.g. high risk groups or
different age groups. All in all, cross-sectional studies suggest that physical activity may be
an important factor for improving the general health and preventing the development of,
among others, the above mentioned NCDs. Although these diseases are very prominent in
many western countries only few longitudinal studies exist that focus on their development
during a person´s lifetime and their association with other habitual factors such as physical
activity.
4

Because NCDs develop over a long period and may have many causes, understanding
the progress of these diseases and their association with habitual factors such as physical
activity is important for elaborating long- term prevention programs and guidelines. To
investigate their development, longitudinal studies, with healthy persons, i.e. persons
without obvious diseases at baseline examination and long-term epidemiological view as
necessary.

Overall, the results of the reviewed articles provide a general view about the longitudinal
relationship between physical activity and the incidence of NCD and health problems.
Physical activity seems to be a relevant factor for preventing age-related diseases;
however more long-term research is necessary.

Retrieved and adapted from Reiner, M, Niermann C, Jekau, D. et al. Long Term- health
benefits of physical activity – a systematic review of longitudinal studies. BMC Public
Health 13, 813 (2013) 1

1. What is the genre that structures the reading passage?

● A research report

● A novel

● A magazine opinion article

● A case study report

1
https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-813
2. What is the writer´s purpose on paragraph 1?

● To report on some current diseases affecting Western´s Countries.

● To criticize the civilization as the cause of some age-specific diseases.

● To contextualize, identify and define noncommunicable diseases.

● To explain why older people face medical and functional challenges.

3. What pattern structure paragraph 2?

● List of several NCDs diseases

● Contrast between NCDs diseases

● Sequence of events related to NCDs

● Cause-effect relations concerning NCDs

4. According to what is reported in paragraph 3, it can be stated that…

● Physical activity could prevent not only the most common NCDs, but other disease

as well

● Physical inactivity undoubtedly leads to diseases such as obesity, cardiovascular

heart diseases and diabetes mellitus

● Physical activity is an important factor for curing obesity, CHD, and type 2 diabetes

mellitus.

● Physical inactivity is not associated to general health and uncommunicable

diseases prevention.
5. According to paragraph 4 what is the expect result of understanding the progress
of NCDs and their association with habitual factors?

● To carry out longitudinal studies with healthy persons.

● To achieve a long-term epidemiological view.

● Awareness about the importance of physical activity

● The creation of long-term prevention programs and guidelines.

6. According to given context in paragraph 4, the closest meaning of the word

“complains” is:

● Dissatisfaction

● Disproval

● Ailment

● Criticism

7. Which of the following ideas could support the writer´s statement: “more long-term
research is necessary”

● Few longitudinal studies exist that focus on the NCDs´ development during a

person´s lifetime.

● Researches should investigate other beneficial long-term habits such as physical

activity.

● The World Health Organization has not identified the most sever noncommunicable

diseases.
 ● Research has to be developed on specific subgroups that do not manifest any

associated symptoms.

TEXT 2

Schizophrenia is persistent and disabling psychotic illness that ruins the lives of patients
and their families. It affects emotion, behavior, perception and sleep disturbances among
others although these symptoms are not specific to schizophrenia

2.

Sleep is the state of temporary decreased awareness of environmental stimuli and

characterized by relative unconsciousness of the external world. It is a biological process
which is crucial to the maintenance of mental and physical health. Sleep quality is
satisfaction with sleep experience and integrating aspects of sleep initiation sleep
maintenance, sleep quantity and refreshment upon awakening which is relevant to optimal
health and functioning4. People with schizophrenia have been identified to experience
sleep disorders at relatively higher rates than general population and sleep problems
including difficulty falling asleep and maintaining it are common in these subjects

Short sleep duration (generally less than 7 hours) reported as an important risk factor for
different adverse outcomes and can raises rates of mortality. Decreased and non-
restorative sleep is common complaints among people with mental illness and affects up
to 30-80% of schizophrenic patients. Likewise, repeated disturbance of sleep cycle or
failure to initiate or maintain sleep can cause physical, mental, and emotional fatigue.
Moreover, Poor sleep in schizophrenia can precede psychotic onset in new patients and
associated with treatment refractory deficits, chronic medical illness, poor mental health,
accident and mortality. In addition, sleep problem can causes high economic burden; for
instance, insomnia alone affects about 25 million people in United States and leads to a
burden of 100 billion dollar annually shows that, the cost of not treating insomnia is greater
than the cost of treating it.

The literatures also showed as poor sleep quality is associated with lower quality of life,
suicidal behaviors and sometimes the disturbance even cause symptoms like paranoia
and patients with sleep disturbances of all types were about 13 folds more likely to have
suicidal ideation, suicide attempts and completed suicide than those without sleep
disturbances.

Dule A, Ahmed G, Tessema W, Soboka M. Sleep Quality in Schizophrenia. J Ment Health

Clin Psychol; (2020). 4(4): 57-64 2

8. In paragraphs 1 and 2, the author defines two concepts: schizophrenia and sleep
in order to…

● Show how the former could lead to the latter

● Contrast a mental ailment to a biological process

● Compare them as two similar biological stages

● Remark the lack of relatedness between both

2
https://www.mentalhealthjournal.org/articles/sleep-quality-in-schizophrenia.html
9. The word “illness” in paragraph 1, can be replaced by the following terms,
EXCEPT FOR..

● Pleasure

● Disease

● Healthiness

● Affection

10. According to what the writer explains in paragraph 2, why is sleeplessness

threatening for our wellbeing?

● For it decreases awareness of environmental stimuli.

● Since sleep is crucial to the maintenance of mental and physical health.

● Because it brings about recurring nightmares.

● Because it is increasing the rates of mortality

11. The main idea in paragraph 3 is…

● Short sleep duration is a crucial risk factor for adverse effects and can rise rates of

mortality.

● Repetead disturbance of sleep cycle or failure to initiate or maintain sleep can

cause physical, mental and emotional fatigue

● Decreased and non-restorative sleep is a common complaint among people with

mental illness

● Drecreased and non-restorative sleep is a common complaint that affecting up to

30-80% of schizophrenic patients.

12. The following secondary statements support the main idea in paragraph 3,
EXCEPT FOR…

● Poor sleep in schizophrenia can precede psychotic onset in new patients

● Sleep problem can cause high economic burden

● The Us government invests 100 billion dollar annually in insomnia treatment

● Failure to maintain sleep can cause physical, mental and emotional fatigue

13. The word “such” in paragraph 4 refer to..

● Types

● Patients

● Sleep

● Suicidal

14. The underline statement in paragraph 4, can be paraphrased as:

● Patients with sleep disturbances like thinking about suicide and sometimes attempt

it, while who have not such disturbances do not.

● patients without sleep disturbances like thinking about suicide and even attempt it,

while who have such disturbances do not.

● Patients with sleep disturbances think about suicide, attempt it, and end up

committing it, while who have not such disturbances do not.

● Patients with sleep disturbances more probably think about suicide, attempt it, and

commit it that those who have not such disturbances.

TEXT 3

HIV/AIDS is a leading cause of mortality and morbidity worldwide. In spite of successful

interventions and treatment protocols, an HIV vaccine would be the ultimate prevention
and control strategy. Ever since identification of HIV/AIDS, there have been meticulous
efforts for vaccine development.

Once HIV was formally identified as the cause of AIDS, there have been ongoing efforts
on vaccines against the desease. On April 24, 1984, the US Secretary of Health and
Human Services, Margaret Heckler, announced that vaccines will be researched and
made ready for preliminary testing by the year 1986. However, this initial optimism was
criticized by many eminent researchers because it failed to be coherent with existing
knowledge about the pathophysiology and the mechanism of the virus itself. Traditional
approaches of using live attenuated or whole inactivated viruses were considered unsafe
because of the risk of permanently integrating proviral DNA within host chromosomes.
Advancements in vaccine development had to wait until mid-1980s when recombinant
DNA technologies were becoming available for research applications. Following the
success of recombinant Hepatitis B vaccine, recombinant DNA technologies were also
being researched for HIV vaccines. Rapid advances in the pathophysiology and molecular
mechanisms of HIV enabled many structural components and proteins to be discovered
and artificially synthesized through recombinant DNA technology. The culmination was the
cloning and sequencing of HIV genome which led scientists to believe that an effective
vaccine could be developed in the future.

However, all these efforts came to a standstill with growing knowledge about extreme
mutability and immune evasion mechanisms of existing HIV strains. This was further
complicated by the fact that neutralizing antibodies had no protective effects and their
titers were similar among asymptomatic carriers and patients with active disease. The
exact mechanism of immunity against HIV is a puzzle and remains unsolved.
Muni Rubens, Venkataraghavan Ramamoorthy, Anshul Saxena, Nancy Shehadeh,
Sandeep Appunni, “HIV Vaccine: Recent advances, Current Roadblocks, and Future
Directions”, Journal of Immunology Research, vol 2015, Article ID 560347, 9 pages, 2015.
3

15. One of the following assertions is opposite to the statement in paragraph 1:

“HIV/AIDS is leading cause of mortality and morbidity worldwide”:

● HIV/AIDS does not lead to mortality and morbidity worldwide

● HIV/AIDS brings about mortality and morbidity worldwide

● Mortality and morbidity worldwide is induced by HIV/AIDS

● HIV/AIDS results in mortality and morbidity worldwide

16. According to paragraph 1 it could be inferred that…

● Research for HIV/AIDS vaccine development is relatively new

● There have not been research on a vaccine for curing HIV/AIDS

● Research on vaccine for curing HIV/AIDS started after 1990

● Once HIV/AIDS was identified, research on vaccine development started.

17. In paragraph 2, Margaret Heckler, announced that…

● Vaccines will be ready for preliminary testing in 1986 by the latest

● Vaccines will not be ready for preliminary testing in 1986

3
https://www.hindawi.com/journals/jir/2015/560347/
● Vaccines would be tested and researched quite before 1986

● Preliminary vaccines testing will be ready after 1986

18. Based on paragraph 2, why Margaret´s announcement criticized by many eminent

researchers?

● Because it was not grounded on rational knowledge about the virus functions

● Since she was not an expert on the topic as the eminent researchers

● Because her announcement was considered very optimistic

● She did not consider the risk, of integrating proviral DNA within host chromosomes

19. What is the author´s main purpose in paragraph 2?

● To explain the causes and effects associated to the disease

● To report the sequential advancement of vaccines against the disease

● To compare and contrast vaccine research advances

● To list some difficulties hindering the vaccine development

20. The statement in paragraph 3: “However, all these efforts came to a standstill”,
suggest that…

● Research efforts came to cessation

● Efforts focused on a new vaccine

● Efforts were finally rewarding

● Efforts remained despite difficulties