Practice of public health
Order Description
2016/17 – Assignment for Practice of Public Health Module

Students should complete both sections:
Marking:
Marks are allocated as follows:
Section 1: 50 marks
Section 2: 50 marks

References: In both sections 1 & 2 you should include appropriate referencing, using a standard format (Harvard or Vancouver). References to web pages should include the date the material was
viewed or downloaded. You will lose marks for inadequate or incorrect referencing.

Word counts: (References and tables should not be included in word counts)
You MUST provide a word count separately for each section of your assignment
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Assignment for Practice of Public Health Module

Section 1: Health Protection

Guideline for Part 1 of this Assignment

YOU SHOULD CHOOSE ONE OF THE FOLLOWING QUESTIONS.
You should write your answer as an essay of not more than 2000 words (not including the summary and the references). You must provide a word count both for the summary and for the main text. Do not
forget to indicate which question you are answering and which country or countries you are setting your answer in.

Your markers will be looking for how well you address the question that was set, your use of appropriate literature including your ability to synthesise and critically review the evidence and
whether your conclusions reflect the evidence and are relevant and appropriate. You will lose marks for poor presentation (e.g. failure to use the prescribed headings, frequent mistakes in spelling
and grammar) or incorrect referencing.

Use the following headings in your answer:

Summary: this should not be more that 250 words and should provide a summary of the content of the essay.
Introduction and background: this is where you set the topic into context, which may include the epidemiology of the condition (incidence, prevalence, case fatality etc.), the wider social context
and anything else you think is relevant.
Review of the Evidence: This should be where you put your most effort. You should be able to demonstrate that you have accessed a number of sources, and can use a wide range of relevant evidence.
You should demonstrate both your ability to critically review the relevance and quality of individual papers and your ability to provide a synthesis of the available evidence.
Discussion and conclusions: In this section you should draw on the evidence you have reviewed and provide the recommendations that have been requested.

QUESTION 1.1
In recent years, a number of natural disasters have been observed, including Tsunami, earthquakes and volcanoes, plus devastating flooding, often resulting in widespread mortality and adversely
affecting much larger numbers of people. You are being asked to produce a paper for a public health minister to review the disaster management system in an identified country of your choice. Please
set the subject into context; explain key elements of the disaster management system and epidemiology of disasters in the chosen country. Briefly outline the system for dealing with emergencies in
that country; discuss the strengths and weaknesses of the existing system and use evidence to make recommendations for improvement.

QUESTION 1.2
Hospital acquired infections are a major public health issue. Specifically, Norovirus outbreaks have been reported in hospitals across the UK and other countries. Provide an evidence synthesis that
will help to identify which hospital wards are most likely to be affected by Norovirus. You should use relevant evidence to make recommendations for preventative actions in these higher risk wards.
You may choose to locate this question in any country of your choice, but you must indicate which country you have chosen and use data relevant to that country in your answer.

QUESTION 1.3
You have been asked to produce a briefing paper for Health Commissioners about the implications of early identification of Hepatitis B and C cases amongst general practice population. Also discuss
the impact on health outcomes.
Hepatitis B and C are responsible for a substantial health burden. Write a briefing paper for Health Commissioners, considering the potential benefits of early identification of cases on health
outcomes. You should also consider the cost implications of implementing an early identification strategy.
You may choose to locate this question in any country of your choice, but you must indicate which country you have chosen and use data relevant to that country in your answer.

QUESTION 1.4
Choose an infectious disease of your choice, discuss the epidemiology, surveillance and control measures for that infection. Using the evidence evaluate the effectiveness of control measures. Give
recommendations for improvement of each element (surveillance, immunisation and control measures, etc.) and reduction in incidence and prevalence of the disease of your choice. You may choose to
locate this question in any country of your choice, but you must indicate which country you have chosen and use data relevant to that country in your answer.

Section 2: Disease Prevention
Guidelines for part 2 of this assignment

Briefing Papers

In this section you are asked to prepare a briefing paper. Being able to prepare a briefing paper is a key skill for working in public health and, indeed in most public service. A briefing paper is
provided for a busy chief executive or similar person so that they can quickly absorb the important facts about a topic, understand what the issues are, including anything sensitive or
controversial, and have some recommendations for action. It’s the sort of thing a junior minister might write for the Prime Minister before he goes to an important international meeting, or a
public health trainee might write for the Director of Public Health to provide the information he/she needs on a topic.

A good briefing paper should:
• Summarise the facts,
• Review the options for action, including the arguments for and against each possible course of action, and then
• Make one or more clear recommendations which are justified on the basis of the evidence.

You will find many examples of briefing papers and how to write them if you type briefing paper into a search engine.

As markers we will be looking for an ability to locate, assemble and evaluate the evidence, to weigh up the different types of evidence appropriately and to make recommendations that can be
justified. We will use the following guidelines when marking and you will lose marks if you have failed to address one of these points.

1. Your answer to section 2 should not exceed 2000 words (This does not include the executive summary, tables or the references).

2. Please use the following five headings for your work:
1. Executive summary,
2. Background,
3. Options for action,
4. Review of the evidence,
5. Recommendations

3. The executive summary should be no longer than 250 words and should include:
• a summary of the options,
• the evidence and
• the recommendations.

4. The Background should be brief (not more than 2-300 words). It needs to do no more than set the scene.

5. Under ‘Options for Action’ you should include two or more options that you propose to consider (one of the options could be to do nothing). The options should relate to the situation you are
writing for. The person using this document will want to know the various possibilities that he/she could decide on for action.

If you are ignoring obvious options (including the option to do nothing) then you need to justify why you have chosen to ignore them. Again, this section should be brief.

6. In the ‘Review of the Evidence’ you should consider the evidence for and against the options you have identified. This must include scientific evidence of effectiveness, but you should also
demonstrate an awareness of the resource implications and potential political implications. Remember that the person you are briefing is relying on you to ensure that she/he is not embarrassed by
failing to be aware of some important or sensitive political issue. The review should be the longest and most detailed part of the document (and will carry proportionally more of the marks). Here
you will review the evidence about whether certain options will be effective, acceptable, and feasible. You will have found the evidence from published peer reviewed papers, from reputable
websites, and possibly from local sources e.g. evidence about whether a certain course of action is feasible in the local circumstances. The evidence should be relevant to the question being
considered and must be fully referenced.

7. Your recommendations should be clearly set out and justified – you are not obliged to choose just one option for action, but if you offer several then you should indicate the strengths and
weaknesses of each one, and indicate your order of preference. Here you will have to make up your mind – do you think the evidence taken as a whole favours this or that action? State what you have
decided and justify your choice.

8. The briefing document must be properly referenced (Harvard or Vancouver style). This is important and you will lose marks if you do not do it.

YOU SHOULD CHOOSE ONE OF THE FOLLOWING QUESTIONS
QUESTION 2.1
The sales and marketing of electronic-cigarettes (e-cigarettes) have grown dramatically over the past few years, and the use of e-cigarettes is being promoted especially to young people. However, a
BMJ article has called for caution and raised several concerns about these developments (https://www.bmj.com/content/347/bmj.f7473).
Moreover, the National Institute for Health and Care Excellence has noted that e-cigarettes “could, without regulation, be marketed in a way that may ultimately promote smoking”. In addition,
researchers have highlighted the need to monitor e-cigarette marketing and flagged the potential use of these products as a way of getting around smoke-free legislation. Additional concern has been
expressed that the tobacco industry is moving into the e-cigarette market, using e-cigarettes and harm reduction to build links with public health, policy makers, and other stakeholders. All these
potential issues call for a prompt regulatory response.

Write a briefing paper for the Minister of State for Public Health about what effective actions the Government could take to address the concerns around the increasing use of e-cigarettes,
especially among young people. Critically review the likely advantages and disadvantages of possible Government interventions, which may involve legislation, changes in taxation or policy guidance
to health and/or education professionals. Identify not more than three priorities for action and justify your choice. You may choose to locate this question in a country other than UK, but you must
indicate which country you have chosen and use data relevant to that country in your answer.

QUESTION 2.2
Countries around the world are being urged to address the problems of air pollution and climate change:
https://www.ncbi.nlm.nih.gov/pubmed/27677268
https://www.ncbi.nlm.nih.gov/pubmed/27751401
Many of the policy changes which could help to reduce air pollution and mitigate climate change have health co-benefits.
The Minister of State for Public Health (MSPH) is particularly concerned about air pollution and wants to know how to advise the Prime Minister. Write a briefing paper for the MSPH starting with a
brief description of the risk to health from unchecked air pollution. Critically review the advantages and disadvantages of government interventions that could reduce air pollution. Detail at least
two policy options and identify priorities for action. You may choose to locate this question in any country of your choice, but you must indicate which country you have chosen and use data
relevant to that country in your answer.
QUESTION 2.3
Group B streptococcus (GBS) is the most common cause of severe infection in newborns when contracted by the baby from an infected mother during labour and birth. About a quarter of women have GBS
and most often they do not know this as there are no symptoms. The previous review by the UK National Screening Committee, undertaken in 2012, concluded that screening for GBS should not be offered
to all pregnant women, however many, including a national charity Group B Strep Support https://gbss.org.uk/, continue to campaign for a change in this decision.

Write a briefing paper for the Chairman of the UK (or other) National Screening Committee (https://www.gov.uk/topic/population-screening-programmes) outlining the evidence for and against different
approaches to screening for GBS in pregnant women, and making a recommendation on what national policy on such screening should be. You will need to evaluate different screening programmes in terms
of feasibility, effectiveness and cost implications. You may choose to locate this question in any country of your choice, but you must indicate which country you have chosen and use data relevant
to that country in your answer.