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Population Dynamics, Immigration, and Health: Critical Analysis

Contribution of immigration on world population distribution

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 

Implications of immigration on the UK's social and economic development

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). 

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