I choose a topic and did a summary on it. The professor left the following comments.

The summary covers the background and significance of vitamin D deficiency very well (I assume you’ll be adding details, such as prevalence, risk factors for deficiency, and sources of vitamin D) as you write your final paper). The second half (approximately) of your paper should introduce current interventions (clinical trials are okay to include, but what else is in place?) and your own recommendations for public health interventions/future steps. Also, please be sure to define your population. Is this U.S. women?

Please write a paper including the following components and make sure to cover the points mentioned abouve about the summary!!!!!

The paper structure should be :

Background (suggested length: 1-2 pages)

Nutritional information on the dietary factor (e.g., calories, a particular vitamin, breastfeeding). You might include:
Physiological role
Sources
Related nutrients
Description of the problem (approximately 1-2 pages), e.g,

populations at risk for deficiency/too much
physiological consequences of too little/too much (as relevant to your problem)
public health implications
morbidity and mortality
economic costs
how to address it (are specific groups at higher risk?)
Current public health interventions in place (about 1 page)

Discuss at least 1-2 programs that are addressing the issue
Program components and justification – why are they doing what they are doing?
Program evaluation: methods of evaluating effectiveness and findings
Your own thoughts (about 1 page). May include:

Critiques of current programs and suggestions for improvement
Ideas for a novel intervention
How to get more attention for the problem (if you feel it should get more attention)
Which groups to involve
Partnerships with other interest groups
Include references as appropriate in APA style. Include at least five references from peer-reviewed journal articles, including at least three original research articles.

Grading will be based on:

completeness and adherence to requirements
use of information and resources
demonstration of understanding of key concepts
clear writing
demonstration of student’s analytic skills

Include reference and I would like to see a draft 3 days before time is up!!

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Attachment

Vitamin D deficiency in pregnant women

Role of Vitamin D

   Vitamin D is an important soluble of fat vitamin that plays an essential regulatory function in various metabolic conditions. Deficiency of this vitamin leads to several chronic health conditions and is relatively common. In particular, this deficiency frequently appears in pregnant women and as such, could potentially harm both them as well as the development of their children. Therefore, it is crucial that women who are pregnant or women who are planning to become pregnant supplement themselves appropriately to avoid the consequences. Furthermore, women who are pregnant are more prone to vitamin D deficiency as compared to other individuals, due to both maternal and fetal demands for the vitamin. Should a mother lack sufficient supply of the vitamin, newborns of such deficient mothers have a high risk of developing rickets as a result of their inadequate maternal-fetal transfer of vitamin D. The studies indicate that individuals born 1-2 years after mandatory fortification and were therefore, exposed to extra vitamin D during their fetal development as well as the next 25 years had a lower lifetime risk of developing certain diseases (Jacobson et al, 2013).

   The newborns of Vitamin D deficient mothers have a high risk of developing rickets as a result of their inadequate maternal-fetal transfer of vitamin D. Secondary outcomes of rickets include infant heart failure and respiratory tract infections. Newborn infants also display lower bone mineral concentrations, abnormal glucose homeostasis, and soft skull bone formation. In addition, long-term effects of maternal and fetal vitamin D deficiency present as asthma, schizophrenia, and type 1 diabetes. Thus, all individuals, particularly women in their reproductive years, should take vitamin D supplements to ensure that their future offspring will not present with the many disorders and diseases associated with this deficiency. With all that vitamin D deficiency in pregnant women entails, it is apparent that this is the main and chronic health issue that should be sought out and understood

   A Metabolic Outlook analyzes the role of vitamin D in pregnant women, newborns, and infants. Researchers argue that vitamin D deficiency during pregnancy is correlated with preeclampsia, resistance to insulin, diabetes mellitus associated with gestation, virginities, and an increased risk for cesarean section delivery (Kaushal et al, 2013). They go on to indicate that supplementation with vitamin D reduces preeclampsia risk as compared to un-supplemented controls (Kaushal et al., 2013). The researchers go on to state that vitamin D may affect the course of infectious diseases during pregnancy, suggesting that they play a strong role in the immune system. It was found that vitamin D has effects on the cytokines and antibacterial peptides that are likely to regulate the bacterial flora (Kaushal et al., 2013). The sources of vitamin D   include the synthesis of the vitamin from sunlight as well as fortified food and supplements

   In conclusion, the scientific evidence clearly points to the numerous benefits of adequate levels of the vitamin as well as its contributions to the prevention of certain diseases. In regards to gestation, vitamin D is of great importance to prevent fetal defects during development, as well as childhood defects, later on. I truly believe that more research into this field will further support the consensus that its role in development and gestation will be of vital importance. Consumption of vitamin D thus is not an option, but something that one ought to do. Get Vitamin D, get a smooth life even from as from basic basking in the sun.

References:

Jacobsen R, Abrahamsen B & Bauerek M. 2013.Vitamin D in Pregnancy: 3 A Metabolic Outlook.” US National Library of Medicine National Institutes of Health. NCBI. U.S. 4 National Library of Medicine.pp. 1-10

El Rahman RN, Abd & Aly YF El Koumi.2013.The Influence of Early Exposure to Vitamin D for Development of Diseases Later in Life. National Library of Medicine National Institutes of Health (2013).  NCBI. U.S.4 National Library of Medicine. Pp. 1-11

Web. 12 Nov. 2013.Impact of Maternal Vitamin D Status during Pregnancy on the Prevalence of Neonatal Vitamin D Deficiency. US National Library of Medicine National Institutes of Health (2013) NCBI. U.S. 3 National Library of Medicine. Pp.1-6

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PUBLIC HEALTH NUTRITION

Task: This assignment is not exactly either an essay or a case study.  The best way to address it is to answer each question separately.  The first part is a small essay on breastfeeding inequities, but using the HEAT questions to guide it. The next parts are sort of case studies in that you refer to actual settings/ initiatives in NZ, but answer them as the question asks and use the HEAT templates (I will upload a file about it).  You can use the actual template or you can just refer to the sections in it- either ways is OK.
Assignment: (the underlining words have more detailed in a separate file)
The National Strategic Plan of Action for Breastfeeding 2008-2012 sets out a framework to support the establishment of a breastfeeding culture in New Zealand. The Plan is underpinned by the Ottawa Charter and sets out desired objectives and outcomes for support at family/whanau, community, regional and national levels.
1.    Using the Health Equity Assessment Tool (HEAT) identify and discuss what inequalities exist in relation to targets for full and exclusive breastfeeding. Use the HEAT tool (steps 1-3) to guide your answer. ( I will upload a file about HEAT tool)
2.    In a setting of your choice, describe and critique policies and practices that may create, maintain, increase or decrease inequalities associated with breastfeeding.
(focus on one setting) Read about settings in the first section of the study notes ( I will upload it in another word file). You may want to choose a setting that was mentioned in section 1, but not necessary
3.    In this same setting propose additional interventions that will:
a.    Reduce inequalities.  Distribute the cause of inequalities across the four levels of the intervention framework. Use the Heat tool, template for step 4, to discuss possible ways to intervene to reduce these inequalities.
b.    Address needs of Maori by considering the Treaty of Waitangi and Maori models of health (I will upload it).
4.    Choose one breastfeeding promotion intervention currently active in this setting (an actual activity that is taking place in NZ, in the setting you chose for the previous questions.  It could be a national activity or it could be something in one location, e.g. you could find out what is happening in your local community).
a.    Briefly describe the intervention
b.    Use Heat tool steps 6-8 to evaluate the activity.  Refer to any data available.
c.    Based on the evaluation suggest ways it could better help reduce inequalities (step 9).
d.    Describe how the intervention could actually be evaluated (step 10).
This assignment is both practical application and an academic exercise.  The main focus is in the application of the HEAT tool and exploring inequality.  As an academic exercise you will need to refer to the literature to support your statements, for example, if you suggest a specific type of workforce policy promotes breastfeeding cite evidence to support this. Length 7- 10 (max) pages.

Requirements:
•    Identification and discussion of inequalities related to breastfeeding target.
•    Critique policies and policies impact on inequalities; show understanding of a settings-based approach to health promotion (focus on one setting).
•    Propose interventions to address inequalities (Possible intervention in that setting. Multiple foci/ strategies.
•    Existing breastfeeding promotion activity in NZ
–    Describe breastfeeding intervention (use Logic Model)
–    Review and evaluate using HEAT (Evaluation of intervention using HEAT (steps 6-10))
?    Use exiting data, literature on effective ways to promote breastfeeding, brain storm (based on your knowledge), identify who /how you would consult and /or other data you would collect.
?    References & presentation
Explanations:
?    when the assignment refers to the ‘steps’ of HEAT this means the ‘questions’
?    ‘Setting’ is a public health term, although you understand the word in English you should read about it in the first section of the study notes (I will upload it). For the assignment please clearly state the setting you are referring to
?    ‘policies and practices’ in the setting refers to national policies related to breastfeeding as well as other policies or practices that might be relevant
?    An ‘intervention currently active in your setting’ could cover a wide range of possibilities. If it’s a very large intervention with a lot of activities/aspects you may want to focus in depth on some part(s) of it– that is OK, just clearly define what activity (ies) you are referring to.
?    HEAT template- you can use the actual template or just use the headings. Note, if you use the template you still need to reference/support with evidence your statements.  So for example if you state that increased parental leave will support breastfeeding you need a reference to support that.