In the UK since 2010, the population dynamics has dominated the political discourse. Central to this discourse is growing ageing population and immigration. The primary argument for the 2016 Brexit referendum was that the UK withdrawal from the European Union will allow the UK government to implement stricter immigration regulations. The opponents of immigration maintain that economy, schools, health care services, housing and employment are adversely affected by the increased number of foreign immigrants.
In the case study you will need to critically discuss the two mechanisms that contribute to world population growth and analysing, the contribution of immigration on world population distribution.Critically describe the five factors that influence a country’s population growth.Critically discuss the implication of immigration on the UK’s social and economic development.Briefly discuss the public health implications of rising fertility rates and declining fertility rates.
Type your answer here (1,000 words equivalent)
Case study 2 (20 marks, 1000 words equivalent)
An individual is invited for a routine screening test for HIV. She is a typical member of a population in which the prevalence of HIV is 1/1000. The test has a sensitivity of 95%. A new ELISA (antibody test) is developed to diagnose HIV infections.
Serum from 10,000 patients that were positive by Western Blot (the Gold Standard assay) was tested, and 9,990 were found to be positive by the new ELISA screening test. The manufacturers then used the ELISA to test serum from 10,000 nuns who denied risk factors for HIV infection. 9,990 were negative and the 10 positive results were negative by Western Blot.
In the case study you will need to define sensitivity and describe the ethical implications associated with a screening test that has a high sensitivity and describe three criteria used to approve a screening programme.
Case study 3 (10 marks, 500 words equivalent)
Table1 A sample of 22 persons was selected, and the table below shows the value of their age (x) and their systolic BP (y).
n Age(x) Systolic BP (y) x2 y2 xy
1 20 120 400 14400 2400
2 43 128 1849 16384 5504
3 63 141 3969 19881 8883
4 26 126 676 15876 3276
5 53 134 2809 17956 7102
6 31 128 961 16384 3968
7 58 136 3364 18496 7888
8 46 132 2116 17424 6072
9 58 140 3364 19600 8120
10 46 132 2116 17424 6072
11 58 140 3364 19600 8120
12 70 144 4900 20736 10080
13 47 128 2209 16384 6016
14 53 136 2809 18496 7208
15 60 146 3600 21316 8760
16 20 124 400 15376 2480
17 63 143 3969 20449 9009
18 43 130 1849 16900 5460
19 26 124 676 15376 3224
20 19 121 361 14641 2299
21 31 126 961 15876 3906
22 23 123 529 15129 2829
? 957 2902 41033 333439 128676
Please describe what type of data is presented in this table and critically comment about the different effect measures that can be used to measure the outcome of data presented in the table above
Please consider in your answer what type of correlation would be most appropriate to compute the relationship between age and systolic BP, and why? Finally critically discuss the differences between mean difference and standard mean difference.
A study was conducted to determine the association between per capita alcohol consumption and mortality rates from coronary heart disease (CHD) in ten countries in Europe. The investigators found a positive correlation between per capita alcohol consumption and CHD mortality.
Please describe the type of study design was used in this investigation, and critically discuss the its characteristic features. Discuss the limitations of this type of study design using the example above to illustrate your answer
You have just assumed a post as a Natal Midlands Director of Public Health when on Saturday 11 February 2009, the Edendale District hospital, KwaZulu Natal Midlands alerts you to an influx of persons presenting to their emergency department with diarrhoea and vomiting. Many are severely ill, with some patients requiring hospital admission. A presumptive source of infection is quickly identified, as the majority of the patients are taxi drivers. All patients claim to have consumed food from the same takeaway restaurant situated near a taxi rank in the Mbali Pietermaritzburg town. More than 30 individuals connected with the outbreak are also identified from other hospitals across Pietermaritzburg, Richmond and Ixopo. There is no outbreak control team in place.
Critically discuss what type of study would you use to establish the association between exposure and development of disease? You have been given the responsibility to set up an outbreak control team to investigate the cause of these episodes of diarrhoea and vomiting. What specialities will you require in your team members, and what will be their primary tasks?
The efficacy and safety of Tipapkinogen Sovacivec therapeutic HPV vaccine in cervical intraepithelial neoplasia grades 2 and 3: Randomized controlled phase II trial with 2.5 years of follow-up.
Now read the article, and answer the following questions:
Your patient had been diagnosed with cervical intraepithelial neoplasia (CIN) grade 2 or 3; she is considering tipapkinogen sovacivec (TS) vaccine; she is asking for your opinion on efficacy and safety.With reference to Harper et al. (2019) paper critically advise the patient highlighting efficacy and risk of this vaccine therapy
Critically comment about the threats to the internal and external validity of the RCT, identify the potential risks in Harper et al.’s research and discuss the measures they took to minimise the validity of their research. Outline the strategies used in RCTs to account for confounding variables and critically comment about the strategies used by Harper et al (2019).