CONFIDENTIAL* MAJLISPEPERIKSAANMALAYSIAMAUJLISPEPERIKSAANMALAYSIAMAJLISPEPERIKSAANMALAYSIA MALILISPEPERIKSAANMALAYS/AMAILISPEPERIKSAANMALAYSIAMAJLISPEPERIKSAANMALAYSIA MAJLISPEPEFIKSAANMALAYSIA MAJLISPEPERIKSAANMALAYSI/ 441 DE DERICCAANMALAYSIA MAJLISPEPERIKTAANIMAl_AYSIAMAJLISPEPERIKSAANMALAYSI, MUET AANMALAYSIA MAJLISPEF 00. /3, /. YSIAMAJLISPEPERIKSAANMALAYSI, “AANMALAYSIA MAJLISPEF YSIAMAJLISPEPERIKSAANMAL? MALAYSIA Nad lseepenncaanuatarsanalisperenicanwalcd LY 2OU3 Marsa MAJLISPEPERIKSAANIMALAYS/AMAILISPEPERIKSAANMAL A oinivinat ore erincorea MA MULICEE DE ARSANNALAVSAHAL.SPE ren aanhtal ar SiAial REFERIDSaAIWALAY TA wescispeep MALAYSIAN UNIVERSITY ENGLISH TEST wviaiaysi HSER SED RRCEAOS aia ARR Rear A AA MAJLISPEPERIKSAANMALAYSANPAPER 3 READING \MAJLISPEPERIKSAANMALAYSIA MAJLISPEPERIKSAANMALAYSIAMAJLISPEPE ik SAANMALAYSIAMAILISPEPERIKSAANMALAYSIA MAJLISPEPERIKSAANIMALAYSIAMALLISPEDEDS 81 fA AYSIAMAJLISPEPERIKSAANMALAYSIA MAJLISPEPERIKSAANMALAYSIAMAJLISPH(30 minutes) 441 AYSIAIMAJLISPEPERIKSAANMALAYSIA MAJLISPEPERIKSAANIALAYSIAMALILISPEPERIK SAANMALAYSIAMAJLISPEPERIKSAANMALAYSIA MALILISPEPEFIKSAANMALAYSIAMAJLISPEPERIKSAANMALAYSIAMAJLISPEPERIKSAANMALAYSIA MAJLIS PEPERIKSAAN MALAYSIA (MALAYSIAN EXAMINATIONS COUNCIL) Instructions to candidates DO NOT OPEN THIS QUESTION PAPER UNTIL YOU ARE TOLD TO DO SO. There are forty-five questions in this test. For each question, choose the most appropriate answer. Indicate your answer on the separate answer sheet given Read the instructions on the answer sheet carefully. Attempt all questions. ‘This question paper consists of 18 printed pages and 2 blank pages. ‘© Majlis Peperiksaan Malaysia 2013 MUET 800/3/5 [Turn over *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*CONFIDENTIAL* A Questions 1 to 7 are based on the following passage. 1 When a new Chief Executive Officer (CEO) arrives, most senior executives worry about their jobs. Many worry that their history of successes and failures may not count for much. Anecdotal stories of what happens to executive teams during CEO transitions are hardly comforting. Firings, organisational reshuffles and cancelled strategies result in abrupt and unwelcome career change for a host of senior managers. On average, tumover among all executive officers was only a little when the new CEO came from within the company, but quite a lot when the CEO came from outside, In the latter situation, more than 25 per cent of the executives left within a year, and the odds of an involuntary departure more than doubled. ‘What happens to executives who leave “the best thing that ever happened to thet do they suffer massive career setbacks? ? Is losing their job, as the cliché goes, "? Do they in fact land on their feet, or ‘An executive who has been doing a good job may assume that even if he is asked to leave, he will find an equal or better job elsewhere and so may tend to be relaxed about his fate under the new leader. Unfortunately, the data of a study do not support this optimistic outlook. Of the approximately 400 senior executives who left following the arrival of a new CEO in 2002 or 2003, none moved to an equal job in any large firm. Figure 1: Executives Turnover in Companies in the United States, 2002-2003 800/3/5 *This question paper is CONFIDENTIAL until the test is over. 10 1s CONFIDENTIAL*CONFIDENTIAL* 3 5 3 The broader group of exiting executives generally fared poorly, too (see Figure 1). The researchers discovered this by comparing the executives’ previous ‘companies and job titles with theirnew ones. They separated the executives into four categories — winners, laterals, setbacks and dropouts ~ based on the combination of ‘changes in their title and their new company. For example, a person who acquired ‘a higher title at a slightly smaller firm might be classified as a Javeral, but someone ‘who accepted a lesser title at a much smaller firm would be classified as a serback. Winners are those who accepted a better position at a similarly-sized company or kept the same title but moved to a larger company; while dropouts are those who joined an extremely small venture or completely disappeared from the corporate radar screen. The results are sobering. Winners were rare - only 4 per cent of executives fell into this category. Twenty-eight percent fell into the /aterals category. Three percent were designated setbacks. The majority, a sizeable 65 per cent dropouts, ‘moved to sole proprietorship or to companies with sales of less than US$10 million, or disappeared altogether. It seems likely that this last group either retired or moved quite far down the corporate ladder. 20 25 30 35 (Adapted from Harvard Business Review, September 2011) ‘The appointment of a new CEO may bring about career change for some executives. A True B False C Not stated More executives are fired when a new CEO is from within the organisation, A True B False C Not stated Many senior executives leave their company because they do not share the vision of the new CEO. A True B False C Not stated 4 Data from the study show that generally executives do not hold better positions in their new jobs. 800/3/5 *This question paper is CONFIDENTIAL until the testis over. A True B False © Not stated [Turn over CONFIDENTIAL*CONFIDENTIAL* 4 5 The criteria for categorising the types of executive turnover are job title, salary and size of the company. A True B False C Notstated 6 Figure 1 presents a bleak picture of executive turnover. A Tre B False © Notstated 7 Apreference to retire from work was the main reason for the high dropout percentage among executives. A True B False C Not stated 800/3/5 *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*CONFIDENTIAL* 5 Questions 8 to 14 are based on the following passage. 800/310 *This question paper is CONFIDENTIAL until the test is over. ‘A man wakes up in a New York apartment, brews coffee and goes out into the world, and everything that can appear on a smart phone or iPad appears before his ‘eyes instead ~ weather reports, calendar reminders, messages from friends, walking maps of New York, his girlfriend’s smiling face. This is the promise of Google's Project, which released the video I have just described carlier, as a preview of a still percolating project that aspires to implant the equivalent of an iPhone into a pair of science-fiction spectacles. Even if the project itself never comes to fruition, the idea deserves a life ofits ‘own, as a window into what our era promises and what it threatens to take away. If ‘modernity’s mix of achievement and alienation was once embodied by the Man in the Gray Flannel Suit, now it is embodied by the Man in the Google Glasses. On the one hand, the video is a testament to modern technology’s extraordinary facts - not only instant communication across blocks or continents, but also an almost god-like access to information about the world around us. The Man in the Google Glasses can find his way effortlessly through the mazes of Manhattan; he can photograph anything he sees; he can make an impulse purchase from any comer of the world. But the video also captures the sense of isolation that coexists with our technological mastery. The Man in the Google Glasses lives alone, in a drab, impersonal apartment. He meets a friend for coffee, but the video cuts away from this live interaction, leaping ahead to the moment when he snaps a photograph of some “cool” graffiti and shares it online, He has a significant other, but she is far away. When sunset arrives, he climbs up on a roof and shares the scenery with her via video, while she grins from a window at the bottom of his field of vision. He is, in other words, a characteristic twenty-first century American, more electronically-networked but more personally isolated than ever before. There are now more Americans living by themselves than there are Americans in intact nuclear family houscholds. Children are much more likely to grow up with only a single parent in the home; adults marry less and divorce relatively frequently; seniors are more likely to face old age alone. ‘The question hanging over the future of American social life then, is whether all the possibilities of virtual community ~ the connections forged by Facebook and ‘Twitter and the hums of virtual conversations that are available any hour of the day can make up for the weakening of flesh-and-blood ties and the declined traditional ‘communal institution, ‘The optimists say yes. The buzzing hive of the Internet is well on its way to generating a kind of “cognitive surplus” which promises to make group interactions even more effective and enriching than they were before the Web. The pessimists, on the other hand, worry that online life offers only a surreal community. As one author argues, the lure of Internet relationships, constantly available but inherently superficial, might make both genuine connection and genuine solitude impossible. 15 20 25 30 35 {Turn over CONFIDENTIAL*CONFIDENTIAL* 6 9 Today, social media are hailed for empowering dissidents and bringing the downfall of tyrannies around the world. Yet it is hard not to watch the Google video and agree with critics that such a technology could ultimately accelerate the arrival of the persistent and pervasive citizen surveillance state in which everything 45 ‘you see and do can be recorded, reported and subpoenaed. In this kind of world, the Man in the Google Glasses might feel like a king of infinite space. But he could actually be inhabiting a comfortable, full-serviced cage. (Adapted from The New York Times, April 16, 2012) 8 Information found on a smartphone can also appear on the Google Glasses. A Te B False € Notstated 9 The Google Glasses project is nearing completion. A True B False C Not stated 10 While Google Glasses provide instant access to information to its user, it also alienates him from his community. A Tne B False C Notstated 11 The following statements are true about the Man in the Google Glasses video except A. he often travels across continents B_ he can access information instantly he can buy things from anywhere in the world 12. The focus in paragraph 7 is “A. the decline of traditional communities B virtual conversations that can take place anytime C_ virtual communities forged through Facebook and Twitter 13. surreal (line 39) means A strange B imagined C temporary 14 The writer develops the concluding paragraph through A\ cause and effect B_ problem and solution C comparison and contrast 800/3/5 *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*CONFIDENTIAL* 7 Questions 15 t0 21 are based on the following passage. 800/3/5 * This question paper is CONFIDENTIAL until the test is over. ‘Across a patch of pineapples shrouded in smoke, Idris Hadrianyani battled a menace that has left his family sleepless and sick. Against the advancing flames, he waved ‘a hose with a handmade nozzle crafted from a plastic soda bottle. This lopsided struggle is part of a battle against one of the biggest, and most over-looked causes of global climate change: a vast and often smouldering layer of coal-black peat that has made Indonesia the world’s third biggest emitter of greenhouse gases after ‘China and the United States. Unlike the noxious gases pumped into the atmosphere by petrol-guzzling vehicles in the United States and smoke-belching factories in China, the danger here in the heart of Borneo rises from the ground itself. Peat, formed over thousands of years from decomposed trees, grass and scrub, contains gigantic quantities of carbon dioxide (CO;), which used to stay locked in the ground. It is now dying and disintegrating and when it bums, carbon dioxide gushes into the atmosphere. For Agus Purnomo, head of Indonesia’s National Council of Climate Change, dealing with peat requires that the world answers a difficult question: How to make protection of the environment as economically rewarding as its often lucrative destruction? Carbon trading was meant to do just that, by allowing developing countries that cut their emissions to sell carbon credits. Carbon credits are tradable equities in global market exchanges just as securities and commodities in the stock markets. But this and other incentives for conservation developed since a United Nations conference in Kyoto, Japan, in 1977 has done nothing to protect Indonesia's abused peatlands. Less than a quarter of a century ago, 75 per cent of Kalimantan was covered in thick forests. Cleared away since by loggers, oil palm plantations and grandiose projects, the forests have shrunk by about half. Fires, meanwhile, have grown ‘more frequent and serious. For centuries, Kalimantan locals have burned forest land to create plots for farming. But what used to be small, controlled fires have become fearsome conflagration as dry and degraded peat goes up in smoke. In 2006, according to Wetlands International, Indonesia’s peatlands released roughly 1.9 billion tonnes of CO,, This is equal to the combined emissions in that year of Germany, Britain and Canada, and more than emissions from road and air travel of the United States. How dirt became so dangerous ~ and why reversing the damage is so difficult is on grim display here in Central Kalimantan, inhabited by about two million People and a rapidly dwindling population of orang-utans. Economic logic here is firmly on the side of those wrecking the environment. For example, Hadrianyani, the fire-fighter in Taruna Jaya, also has another job: he clears peatland of trees and scrub for cultivation — a task done most easily by buming. That work ears him about US$8 (RM28) a day twice what he gets for putting out fires. ‘The uneven match of reality and good intentions have put Central Kalimantan’s government in a bind, “The carbon here is huge. It should be safeguarded,” said Humda Pontas, head of the economies department at the regional planning board. “But palm plantations, though a serious threat to carbon-rich peatland, are the only real investment opportunity. These plantations employ people and pay taxes. The rest is just theory,” he said. 10 15 20 25 30 35 45 (Adapted from The Star, February 23, 2010) {Turn over CONFIDENTIAL*CONFIDENTIAL* 8 15 In paragraph 1, the writer mentions Idris Hadrianyani to A. emphasise the harmful effects of peat fire on health B_ contrast between the global problem of peat fire against the feeble attempt at fire fighting C highlight the skills of the locals at firefighting in spite of the lack of sophisticated equipment 16 The word lopsided (line 3) can best be replaced by A unwieldy B_ unbalanced C unimaginable 17 [How to make protection of the environment as economically rewarding as its often lucrative destruction? (lines 15 to 17) ‘This means that ‘A. the money gained from destroying the environment should be spent on conserving it B protecting the environment should be more profitable than destroying it saving the environment and destroying it should be equally profitable 18 Which of the following are true of carhon trading (line 18)? I Itserves as an incentive for conservation of the environment. II Ithas helped to reduce deforestation and burning in Indonesia. IIT Carbon credits are based on the quantity of CO, reduced from emissions. A land I Blandi © Mand Ir 19 [For centuries, Kalimantan locals have burned forest land to create plots for farming. (ines 27 and 28) This implies that this practice A. was not harmful B_ could cause peat fires C released more carbon emission 20 The intention of the writer in mentioning emissions from road and air travel of the United States (lines 32 and 33) is to A show that the United States ranks highest in CO, emissions B_ highlight the huge quantity of CO, emissions from Indonesia C compare it with CO, emissions from Germany, Britain and Canada 800/3/5 *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*CONFIDENTIAL* 9 21 [The restis just theory (lines 45 and 46) ‘This implies that A. the problem needs to be further investigated B clearing the land for plantations will continue Central Kalimantan’s government cannot decide on a plan of action 800/3/) [Turn over *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*CONFIDENTIAL* 10 Questions 22 10 29 are based on the following passage. 1 The ideal — as we are often reminded — is to go organic, to trade processed foods for fresh food, and the supermarkets for the farmers’ market. Organic foods currently represent only about 3 per cent of the total United States (U.S.) market, and anywhere from around | per cent to 7 per cent in European countries. Japan has traditionally been the largest organic market in Asia, but those in China, Thailand, Singapore, Malaysia and India are growing as consumers are becoming more affluent. In India, the certified-organic market has grown 200 per cent in the past two years. True, the importance of going organic is less relevant in the developing world but those who can afford it, so we are told, should support the movement. That sounds like a great idea, but there is a price to be paid for it. Organic fruits, vegetables, meat and milk usually cost more than ordinary produce — and in some cascs much more. What is more, while grass-fed beef is lower in fat, and milk without chemicals is clearly a good idea, itis less obvious that organic fruits and vegetables have a nutritional edge to speak of. A 2009 study in the American Journal of Clinical Nutrition found no difference between organic and conventional produce with regard to all but three of the vitamins and other food components studied, and conventional produce actually managed to be better than organic produce. “We draw these bright lines between organic and conventional food,” says MeWilliams. “But science does not draw those lines. They criss-cross, and you have people on both sides of the argument. What is needed are not arguments but answers.” Keeping the food flowing ~ and prices low ~ requires a lot of industrial- engineering tricks, and those have secondary effects of their own. In the U.S., up to 10 million tonnes of chemical fertilizer per year are poured onto fields to cultivate ‘com alone, which has increased yields by 23 per cent from 1990 to 2009 but this has led to toxic run offs that are poisoning the Gulf of Mexico. China, which uses more chemicals on its crops than any other country, goes through over 47 million tonnes of fertilizer annually. ‘The battle over meat generates the most ferocious disagreement in the food wars, ‘The vast majority of people in developed nations are carnivores. The U.S. produces 36 billion kilogrammes of meat per year. The European Union (E.U.) produces roughly the same amount, and all Asia produces a total of 103 billion kilogrammes. It is now common knowledge that animals are raised in poor conditions, jammed together on factory farms and filled with high-calorie feed that fattens them up and moves them to slaughter as fast as possible. The idea of animals living such short, brutish lives introduces an element of altruism into the organic versus commercial debate. ‘There are material advantages to humane treatment. Cattle that eat more grass have higher ratios of omega-3 fatty acids to omega-6, a balance that is widely- believed to reduce the risk of cancer, heart disease and arthritis and to improve cognitive function, Take the cows out of the pasture and stuff them with corn- based feed, and omega-3 plummets. What is more, animals not raised on feedlots have less chances of spreading E.coli bacteria through contact with the manure of other animals. 800/3/3 *This question paper is CONFIDENTIAL until the test is over. 10 15 20 25 30 35 45 CONFIDENTIAL*=o CONFIDENTIAL* ul 7 Short of swearing off meat, there are no easy solutions. For one thing, if we all decided to switch to healthier meat, there would not be enough to go around, ‘What is more, the scarcity helps drive the prices higher still. Another alternative is to eat more fish which is healthier because it is leaner, lower in calories and higher in omega-3. But with fish stocks collapsing worldwide because of over 50 consumption, there is only so far that solution can take us. A half-measure — but a very powerful one — is simply to cut back on whatever meat we do eat, even if we cannot quit it altogether. (Adapted from TIME, September 6, 2010) 2 In paragraph 1, the writer mentions that the Indian organic market has grown 200 per cent in the past two years. This is to A. illustrate the rapid growth of the organic market in Asia B_ compare the growth of the organic markets in Europe and Asia C_ highlight the fact that India’s organic market is larger than that in the U.S. 23 [but those who can afford it, so we are told, should support the movement. (lines 8 and 9) This implies that the writer is of the opinion that ‘A. only the rich can afford organic food B__ we should be cautious about going organic C since organic food is now more available, we should buy it 24 Paragraph 4 is mainly about the A. attempts at lowering food prices B_ effects of the heavy use of fertilizers adverse effects of industrial-engineering on farming 25. ‘The main reason for supporting organic beef is that A. the cows are better treated B this increases the supply of chemical-free milk the chemicals in commercially-reared beef are harmful 26 The following are advantages of grass-fed cattle except ‘A. its meat has more fatty acids B_ it may reduce the risk of various cancers there is less possibility of £.coli transmission 8003/5 [Turn over *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*CONFIDENTIAL* i) 27 The word plummets (line 43) means A. to fall sharply B_ to remain constant C to increase gradually 28 According to the writer, which of the following is the preferred solution? A. Eat more fish B_ Eat less meat of any kind C Eat only chemical-free meat 29 The purpose of this passage is to ‘A. evaluate the reasons for advocating organic products B_ help consumers choose between organic and conventional products compare the advantages and disadvantages of organic and non-organic products 8003/5 *This question paper is CONFIDENTIAL until the testis over. CONFIDENTIAL*CONFIDENTIAL* 13 Questions 30 10 37 are based on the following passage, 800/3/5 *This question paper is CONFIDENTIAL until the test is over. ‘Nnaemeka, for his own part, was very deeply-affected by his father’s grief. But he kept hoping that it would pass away. IF it had occurred to him that never in the history of his people had a man married a woman with a different tongue, he might have been less optimistic. “It has never been heard,” was the verdiet of an old man speaking a few weeks later, In that short sentence he spoke for all of his people. This man had come with others to commiserate with Okeke when news went round about his son’s behaviour. By that time the son had gone back to Lagos. “Ithas never been heard,” said the old man again with a sad shake of his head. “What did our Lord say?” asked another gentlemen. “Sons shall rise against their Fathers; it is there in the Holy Book.” “It is the beginning of the end.” said another. The discussion thus tending to become theological, Madubogwu, a highly practical man, brought it down once to the ordinary level. “Have you thought of consulting a native doctor about your son?” he asked Naemeka’s father. “He isn’t sick,” was the reply. “What is he then? The boy’s mind is diseased and only a good herbalist can bring him back to his right senses. The medicine he requires is Amalile, the same that women apply with success to recapture their husbands’ straying affections.” “Modubogwu is right,” said another gentleman. “This thing calls for medicine.” “I shall not call in a native doctor.” Nnaemeka’s father was known to be obstinately ahead of his more superstitious neighbours in these matters. “If my son were to kill himself, let him do it with his own hands. It is not for me to help him.” Six months later, Nnaemeka was showing his young wife a short letter from his father: Itamazes me that you could be so unfeeling as to send me your wedding picture. T would have sent it back. But on further thought I decided to cut off your wife and send it back to you because I have nothing to do with her. How I wish I have nothing to do with you either. ‘When Nene read through the letter and looked at the mutilated picture, her eyes filled with tears, and she began to sob. “Don’t ery my darling,” said her husband. “He is essentially good-natured and will one day look more kindly on our marriage.” But years passed and that one day did not come. 1 For eight years, Okeke would have nothing to do with his son, Nnaemeka. Only three times when Nnaemeka asked to come home and spend his leave did his father write to him. “L can’t have you in my house,” he replied in one occasion. “It can be of no interest to me where and how you spend your leave or your life, for that matter.” The story eventually got to the little village in the heart of the Ibo country that ‘Nnaemeka and his young wife were the most happy couple. But his father was one of the few people in the village who knew nothing about this. He always displayed so much temper whenever his son’s name was mentioned that everyone avoided it inhis presence. By tremendous effort of will, he had succeeded in pushing his son to the back of his mind. The strain had nearly killed him but he had persevered, and ‘won. 10 15 20 25 35 45 (Turn over CONFIDENTIAL*CONFIDENTIAL* 4 5 30 31 32 33 ‘The prejudice against Nnaemeka’s marriage was not confined to his litle village. In Lagos especially among his people who worked there, it showed itself ina different way. Their women when they meet at their village meeting were not hostile to Nene, Rather, they paid her such excessive deference as to make her feel she was not one of them. But as time went on, Nene gradually broke through some of this prejudice and began to make friends among them. Slowly and grudgingly, they began to admit that she kept her home much better than most of them. “Then, one day he received a letter from Nene, and in spite of himself he began to glance through it perfunctorily until out of a sudden the expression of his face changed and he began to read more carefully. "Our two sons from the day they learnt that they had a grandfather, have insisted on being taken to him. find it impossible to tell them that you will not see them, implore you to allow Nnaemeka to bring them home for a short time during his leave next month, I shall remain here in Lagos... 55 60 (Adapted from Smalzer, W. and Lim, P.L (1994). Across Cultures: Universal Themes in Literature. United States. Heinle & Heinle Publishers) ‘The first paragraph tells us that the people from Nnaemeka’s village were A. close knit B_ hospitable interfering D_ conservative Why did Okeke not want to call in a native doctor? ‘A. He was stubborn, B_ He disliked the use of herbal medicine. He was less religious than the other villagers. D_ He was less superstitious than the other villagers. ‘The first letter written to his son shows that Okeke felt A. betrayed by his son B_ rejected by Nnaemeka’s wife unable to stand up to his peers D insulted for not being invited to the wedding mutilated (line 30) means A. rejected B_ damaged C discarded D disfigured 800/33 *This question paper is CONFIDENTIAL until the test is over. (CONFIDENTIAL*CONFIDENTIAL* 15 34 The subsequent letters written by Okeke revealed that he was A. distant B distrustful C indifferent D_ unforgiving 35 [By tremendous effort ... and won. (lines 44 to 46) This description of Okeke shows his j A. lack of judgement B_ need to be independent anguish over his decision D_ inability to stand up to his beliefs 36 | they paid her such excessive deference as to make her feel she was not one of them. (lines 50 and 51) ‘The quote above can best be paraphrased as ‘Nene felt overwhelmed by their politeness the womenfolk made Nene feel very unhappy the womenfolk were so polite that Nene felt like a misfit pour Nene was unable to integrate because she was different from them 37 Nene’s letter can most aptly be described as ‘A. anappeal B an inquiry acomplaint D ‘a negotiation - 800/3/5 [Turn over This question paper is CONFIDENTIAL until the testis over. CONFIDENTIAL*CONFIDEN’ 16 Questions 38 to 45 are based on the following passage. ‘The World Health Organization (WHO) says the world is in the grip of a “crisis” of non-infectious diseases. Salt is one of the main culprits because of its effect on blood pressure. Only one substance gives the WHO greater cause for concer, and that is tobacco. For the past 40 years, doctors around the world have been waging a war on salt. In some places they have been very successful. And yet in recent ‘months something has shifted. Headlines have appeared questioning the benefits of eating less salt. Some have claimed salt reduction is positively harmful; even Scientific American declared: “It is time to end the war on salt.” ‘The food available to our hunter-gatherer ancestors would have been low in salt so we have evolved an exquisite system detecting it in our diet. Unlike energy, our bodies cannot readily store salt and so we ate experts at hanging on to it, largely through a recycling unit in the kidneys. It is possible to survive perfectly well ‘on very little salt. But most people eat much more salt than they need. While US dietary guidelines set an adequate intake of 3.75 grammes a day, the average Westerner eats about eight grammes; in some parts of Asia, 12 grammes is the norm. This effortless consumption of salt horrifies doctors. Our kidneys can excrete some excess salt but to keep fluid concentrations stable, our bodies retain extra water, An inevitable consequence of this excess fluid is a rise in blood pressure. Exactly how is not clear. Nor is the reason why some people are more sensitive than others. But the fact that it does is uncontroversial, It is the effect on blood pressure that causes problems. High blood pressure is one of the main risk factors for cardiovascular disease; even small increases raise your risk of having a stroke. For this reason, salt reduction has become one of thé most important public health targets in the West. Dietary guidelines vary, but generally recommend no more than five to six grammes of salt a day. In the United Kingdom, this kind of salt reduction was mooted in 1994 but hastily shelved after protests from food manufacturers. In the intervening years, lobbying by scientists, public health groups gradually turned the tide — not least by raising public awareness — and now the industry is broadly reconciled to modest salt reductions. The most vigorous defender of the status quo is the Salt Institute, a trade body representing 48 producers and sellers of sodium chloride. This institute has a long history of trumpeting any research that goes against the orthodoxy and picking holes in the evidence against salt. So what is the evidence? Over the years dozens of studies have been done and the findings are far from uniform. One approach is to look for link between how much salt people cat when left to their own devices and their rates of heart attacks and strokes. In 2009, cardiologist, Francesco Cappuccio pooled all the data and found a strong relationship between a salty diet and cardiovascular disease (British Medical Journal (BMJ, vol. 339, p. 4567). Another way is to intervene directly in people's diets — take two groups of people, get one of them to eat less salt for a while and see what the outcome is. ‘These trials take more work than observational studies but several have been done. The biggest managed to get thousands of people to cut down on salt by about two grammes a day for up to four years and saw a 25 per cent fall in cardiovascular disease (BMJ, vol. 334, p. 885). Or you can look at whole countries, taking the before-and-after approach. Fifteen years ago, northern Japan had one of the world’s 800/3/5 *This question paper is CONFIDENTIAL until the test is over. 10 15 20 2s 30 35 45 CONFIDENTIAL*CONFIDENTIAL* 17 biggest appetites for salt — an average of 18 grammes a day, a person — and shockingly high numbers of strokes. The government implemented a salt reduction programme and by the late 1960s, average salt consumption had fallen by four grammes a day and stroke deaths were down by 80 per cent, Finland, another salt- guzzling nation, achieved similar gains in the 1970s. However, the evidence is not always so clear. In July, Cochrane Collaboration, an international body dedicated to assessing medical evidence, published a study on salt and cardiovascular disease. The study was a “meta-analysis”, pooling the results of all the best-designed randomised controlled trials that have been done. Seven trials met the quality criteria, with over 6000 subjects in total. The analysis did show that people who cut back on salt have slightly lower blood pressure and are less likely to die from heart attacks. But, crucially, the effect on deaths was not big ‘enough to be statistically significant. The research was published simultaneously by Cochrane and the American Journal of Hypertension (vol. 24, p. 834), whose editor Michael Alderson is a long-time critic of salt reduction. Alderson claims that the Cochrane study is flawed. When he re-analysed the same data ina slightly different way, he found a reduction that was statistically significant. Far from casting doubt ‘on salt reduction, some argued that the findings supported it. The Cochrane report was not the end of it. Last month, Alderson’s journal published further meta-analysis purporting to show salt reduction could actually be harmful. It concluded that while cutting salt lowered blood pressure, blood levels of certain hormones were increased, which could raise cardiovascular risk. But many of the studies included in the analysis lasted just a few days and involved big salt reductions. Sudden and steep salt reduction can lead to counter-productive hormonal changes but modest reductions do not, 50 55 65 70 (Adapted from New Scientist, December 2011) 38 Which of the following questions best addresses the issue in paragraph 1? A B a D Is salt a health hazard? Is salt as bad as tobacco? Is the war on salt ever going to end? Is salt to be blamed for high blood pressure? 39 Which of the following is true of paragraph 2? A- Our ancestors avoided salt in their food. Asians’ consumption of salt is the highest. C Salt in our bodies is recycled in the kidneys. D_ Eating eight grammes of salt a day is about the right amount. 800/3/0 [Turn over *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*CONFIDENTIAL* 18 40 41 a2 43 45 Based on paragraph 3, which of the following statements are accurate? I We know that there is a consensus on a safe limit of salt intake. II We know how excess liquid in the kidney increases blood pressure. IIL We know that excess fluid in the body causes a rise in blood pressure. IV. We know why some people are more sensitive to excess fluid in the body. and I land IV. Mand I land IV amp c What is the writer’s main intention in paragraph 5? To create awareness of the importance of salt reduction To evaluate the findings of some studies on salt reduction ‘To highlight studies that clearly show a relationship between salt intake and heart disease To explain the approaches adopted in studies on the relationship between salt intake and heart disease camp Which of the following is an observational study? ‘A. The study published in BMJ, vol. 339, p. 4567. (lines 39.and 40) B_ The study reported in BMJ, vol. 334, p. 885. (line 45) C. The study conducted in Japan. (line 46) D_ The study carried out in Finland. (line 50) ‘The most significant finding of the Cochrane Collaboration study is ‘A. the higher the salt intake, the more likely death will strike there is a direct link between salt intake and level of blood pressure when blood pressure is lowered, death through heart attacks is reduced the relationship between salt reduction and death rate is not statistically significant vor Alderson claims that the Cochrane study is flawed. What is his reason? ‘A. The sample size was small, B_ The data was wrongly analysed. C_ The meta-analysis approach was not suitable, D_ Only seven trials were included in the analysis. The main purpose of this article is to ‘A. encourage research B_ resolve controversies C promote healthy living D_ present a balanced view 800/3/3 *This question paper is CONFIDENTIAL until the test is over. CONFIDENTIAL*