Reading — 2026 May–Aug Recall Set 24

Australians living or traveling in rural and remote areas can face particular difficulties when they need medical care. Hundreds of kilometres from major cities and many hours by road from the closest hospital or clinic, some rural Australians do not have easy access to doctors, nurses and dentists. Organisations such as the Royal Flying Doctor Service (RFDS) have been established to bring health services to outback Australian communities. The RFDS provides free medical care to people who live, work or travel in remote and regional parts of Australia. This non-profit organisation is the oldest and largest airborne health service of its kind in the world, and since 1928 it has used small aircraft to send doctors and nurses to some of Australia's most far-away communities. In recent years, the RFDS has also started to fly dentists to regional Australia. As well as offering mobile dental clinics, the RFDS offers a range of preventative and educational services. Looking after the teeth of people in remote areas presents special challenges. These include providing care to disparate communities with no established dental facilities, and dealing with higher incidences of other diseases which are linked to, or caused by poor dental health. People in remote areas have very infrequent visits by health staff. RFDS dentists might only visit a community once every few months, or sometimes once per year. Because of infrequent dentist visits, patients in these areas often need to put up with their dental problems before they can get treatment: consequently, people in remote areas are more likely to have tooth decay (the blackening and deterioration of teeth) and develop gum and other mouth diseases. In some locations that the RFDS visits, there are no suitable dental facilities, so dentists have to bring everything with them. This includes drills, dentists' chairs, portable X-ray machines, and computers for keeping track of patients' treatments. Equipment can weigh up to 100 kilograms, and since the small planes that transport dentists have limited space, dentists cannot always bring everything that they need. While dentists in town or city centres can specialise in certain types of treatment, RFDS dentists need to be all-rounders. They need to be able to do all kinds of dental procedures, as they don't have the ability to refer patients to more specialised dentists. Even with their broad experience, there are some services that are particularly challenging for RFDS dentists. For example, dentures (or artificial teeth) can be very difficult to provide, as they need to be the right shape and size for the patient, and requires many visits over a long period of time. As a result it is not practical to make dentures available. Some chronic illnesses are more common in remote communities than in the rest of Australia. These illnesses can in turn lead to a lowered resistance to infection, including gum and other oral infections. As a result, people in outback Australian communities are more likely to experience oral health problems than city folk, and this poses extra challenges for both the dentists and the doctors of the RFDS. Because there aren't a lot of dental services in remote areas, people living in these areas also receive less education about good dental hygiene than their city counterparts do. Australians in very remote communities might not be aware of things that people in cities take for granted, such as the importance of daily tooth brushing. Also, basic dental hygiene items such as toothpaste and toothbrushes can be more expensive in outback areas. Many people are on low incomes, meaning they have extra difficulty affording these products. If this is the case, the RFDS supplies these. As well as treating patients, RFDS dentists try to focus on preventative oral health and educate their patients on good oral hygiene, such as tooth brushing and flossing. The RFDS also provides mouthguards for young sports players. Playing contact sports, such as rugby league or Australian rules football, can damage young people's teeth, so mouthguards provide protection which prevents accidental injuries. Adding fluoride to water supplies has been proven to reduce the incidence of tooth decay in many parts of the world. City dwellers in Australia use water supplies that have been fluoridated, and their rates of tooth decay are lower because of this. In remote areas, it is not practical to fluoridate drinking water supplies, and so people living in these areas are more subject to tooth decay. As a result, it is particularly important that people living in areas without fluoridated water pay special attention to regular brushing of their teeth with fluoridated toothpaste. Despite many challenges, the RFDS continues to offer much-needed dental and medical support. Its presence in isolated communities greatly improves the quality of dental health, and supports important oral hygiene and health initiatives.

A It was difficult to get about in eighteenth-century London. During the first half of that century, the physical mobility of the upper classes in the city had been considerably restricted: the poor condition of the streets did not allow walking for pleasure outside private parks or pleasure gardens. Streets were dirty, rubbish was everywhere and the British climate made matters worse. Walking could be a risky business. The terrible state of roads, always flooded and muddy, led to the employment of cleaners and street sweepers. B References to walking are not abundant in early eighteenth-century literature, except for writing about the countryside, where conditions were far better. Walking in London was regarded as inconvenient and even dangerous. For Londoners who wanted to travel, choices were limited to the use of boats and coaches. Walking in urban areas was generally associated with the poor, especially those who could not afford a coach. C This situation began to change in the mid-eighteenth century, with measures implementing the provision of public paving. The first legislation concerning paving in London was passed in 1762, and during the following decades, similar measures were enacted in many cities. By the end of the century, areas for walking were commonplace, and far more people were enjoying the pastime than before. Sophie von la Roche writes about metropolitan street life in the diary of her visit to London of 1786. She comments on how many more pedestrians there were on the broad, clean pavements, alongside the houses where, she says, "many thousands of neatly clad people, eminent men and dressy women, pursue their way safe from the carriages, horses and dirt". Although the pavements were not yet a continuous feature of London's streets, their introduction marked a profound shift in how the city was experienced. Walking was no longer solely a necessity for the poor but had become a respectable activity for the upper classes. D The transformation of London's streets had significant implications for footwear. In the early part of the century, shoes were designed primarily for protection rather than comfort or style. They were typically made of stout leather with thick soles, intended to keep the wearer's feet dry and clean when negotiating muddy, refuse-strewn thoroughfares. Pattens — overshoes with raised iron rings — were commonly worn by women to lift their delicate footwear above the filth. These contraptions were noisy and awkward, clattering against the stones and requiring a mincing gait to avoid tripping. For men, sturdy riding boots were the norm, even when walking, as they provided the best defence against the mire. E As paving spread and streets became cleaner, shoe design evolved to reflect new possibilities. Lighter materials, including softer leathers and even silk and satin for evening wear, became fashionable. Heels grew more delicate, and soles thinner. This was particularly evident in women's footwear, where shoes became objects of display rather than mere utility. The French fashion for ornate buckles, often set with paste jewels, was widely adopted by London's elite. Men's shoes also became more refined, with the heavy riding boot giving way to the buckled court shoe for those not obliged to travel on horseback. This was not merely a matter of aesthetics; it represented a fundamental change in how Londoners inhabited their city. To walk in comfort and style was to announce one's participation in the new urban order. F The rise of promenading as a social ritual further accelerated these trends. By the 1780s, certain London spaces had become established venues for the display of fashionable clothing, including footwear. Parks such as St James's and Kensington Gardens attracted crowds of strollers during the season, their circuits providing opportunities for social encounter and the mutual inspection of attire. Shoemakers responded to this demand by producing ever more varied and decorative styles. The craft of shoemaking itself was transformed, with specialist lasts— the forms around which shoes were shaped— being developed for left and right feet, a refinement not universally applied in earlier decades. This improved fit and comfort, encouraging yet more walking. G The new culture of walking also had its critics. Moralists complained that the freedom to stroll encouraged idleness and frivolous display. Young people of both sexes, it was feared, might use the promenade as an opportunity for unsuitable liaisons. The very anonymity of the crowd, so different from the close-knit community of the village, was seen by some as a threat to social order. Yet such complaints were themselves a testament to how thoroughly walking had been transformed. What had once been a dangerous necessity for the poor had become a leisure activity pursued by all ranks of society, accompanied by its own etiquette, its own spaces, and its own distinctive footwear. The pedestrian had become a familiar figure in the London scene, and the shoe had become far more than a mere protection for the foot.

A Londoner with a sudden urge for giant African snails could do worse than head to the bustling marketplace in Brixton, a part of south London that is home to many people from Africa. Markets like Brixton Market that cater to migrants are a testament to the fact that people often retain very strong preferences for the kinds of food they grew up eating. Just ask the expatriate Britons who flock to ‘Tea and Sympathy’ in New York’s Greenwich Village for pots of Marmite, a yeast-based spread whose delights baffle other nationalities (and many of their own compatriots). Past research has shown that people are often willing to pay much more for a favoured brand than for seemingly identical alternatives. It is not always obvious why. However, there is ample evidence to support the theory that certain food preferences form in childhood. Children have a predisposition to fear new foods, which is only overcome when they are repeatedly presented with, and encouraged to consume, a particular food. Evidence shows that children’s instinctive wariness of new foods dates back to the times when humans had to forage for food, and it was important that they learnt which foods were safe to eat. In the modern world, people routinely express a strong liking for a brand even though they are unable to tell the brand apart from rival brands in blind tests, and many studies have found that advertising alone cannot explain the strength of brand loyalty. A new study by economists from the universities of Tilburg and Chicago tracks the consumption patterns of 38,000 US households over two years, and confirms the theory that such brand loyalty is widespread, deep and long-lasting. There were clear local patterns in consumption, although the same brands were available everywhere. But 16% of people studied were migrants: they had grown up in one state and moved to another. These migrants had the same options, in terms of what was on offer and at what price, as everyone else in their adopted home, but although they consumed local favourites, they bought fewer than longtime residents. This gap between purchases of migrants and those of the locally born was quite stubborn: although it faded the longer a person lived in their new state, it still took 20 years to halve in magnitude. Even 50 years on, it was still large enough to show up in the data. This could mean that the benefits of being the first brand into a market could last longer than might be assumed. David Atkin of Yale University has identified some important implications of local food favourites. He suggests in a recent paper that the effects of people being loyal to known brands may also lead economists to rethink the way they calculate the benefits resulting from trade. This is because opening up to trade is in some ways very similar to migrating, as it changes the composition and prices of the foods that are available to a person. In particular, trade can cause local foods to become relatively more expensive. Atkin’s data show something many economists do not take into account: when a traditional food has to compete with imported foods, it may no longer be the cheapest food available for people to choose to eat. Atkin decided to look at this situation in the context of developing countries. To illustrate his point, Atkin uses detailed data about people’s food choices in India. India is a good choice because it covers a large number of climatic zones where different specialised crops are grown. Despite being part of the same country, the prevalence of internal barriers to trade means that its regions are best thought of as being only partially open to trade. Atkin’s data show that the foods a region specialises in producing are instead cheaper in that region. However, there has been some opening up of internal trade in India in recent years, and this has revealed that for every rupee spent on food, people’s intake of calories declined most in regions where prices of local favourite foods had risen. In theory, when there is a greater choice of types of food, people should adjust their food habits and purchase the cheapest option so that they boost their calorie intake. However, in practice, food habits mean that consumers keep buying the things they know and like even though these foods have become relatively expensive. Atkin calculates that if all barriers to internal trade in India were abolished, the average Indian household would have to generate a rise of 3.3 percent in income to maintain their calorie intake. In developing countries where there is a high prevalence of undernutrition, such as in sub-Saharan Africa, the habit of continuing to eat favourite foods could have a serious effect on development. There is clear evidence that nutritional shortfalls in children can affect their ability to work and earn as adults, and also have detrimental effects on their long-term health. Consequently, the nutritional declines that can occur as a result of the opening up of trade are of serious concern, because an entire generation that is malnourished as children will continue to suffer irreversible consequences for the rest of their lives, which could hinder the development of their country due to a lack of a quality workforce.