Sample AC7026 Master of Public Health Nutrition Assignment

AC7026 - Master of Public Health (Nutrition) Assignment Sample

Assignment Brief

Module Title: Nutrition related diseases
Distributed on: 26.01.2021 / Teaching week 27
Submission Time and Date: To be submitted by 9:00 am GMT on Tuesday 4th May 2021
Word Limit: 3000 words (+/-10%)
Weighting -This coursework will be mark out of 100 and accounts for 70% of the total mark for this module

Submission of Assessment

Electronic Management of Assessment (EMA): Please note if your assignment is submitted electronically it will be submitted online via either Blackboard or Turnitin by the given deadline. You will find a Blackboard/Turnitin link on the module’s eLP site. It is your responsibility to ensure that your assignment arrives before the submission deadline stated above. See the University policy on late submission of work.

Assessment Instructions:

Funding for nutrition research comes through research councils (MRC, BBSRC, innovate UK), industrial sponsors or charitable organizations. In almost all cases funding is awarded competitively based on written grant applications. Here we will mimic that process, you are asked to create a three-year research grant project to address a pressing issue in the area of diet and disease.

Your project needs to be conducted by one person, working with limited support (i.e. technical help) and within three years. Strong projects will have the capacity to make meaningful improvements to health and will build upon topical issues covered in the module. (These improvements may be direct or indirect, i.e. your project might directly stimulate behavior change, or it might better inform those who set nutrition policy). You are encouraged to talk to the module leader about the suitability of your project ideas at an early stage.

Typically, a grant application is structured as:

Lay summary (500 words max) This is a plain language overview of your project, written for a non-expert audience.

Background and significance (850 words max) A concise literature review showing that you have something new to add, you need to be selective with your literature here, identify the most important work, show what questions are not yet answered.

Hypothesis and Aims (250 words max) be very implicit, what is your question and what do you hope to achieve?

Deliverables (400 words max) What will you determine and by when (include time points)? Structure as bullet points, GANTT charts are also useful.

Study design (650 words max). What work will you do? can it be done within 3 years? Please provide details of the study.

Impact (350 words max) This can be the hardest section to write. Why is this work important? Who will benefit and how? What steps will you take to make sure that the maximum benefit is realized?

Costings. (A page showing that you have planned how much money you will need, this includes yearly costs for staff, equipment, travel expenses, etc. Please be realistic, the project needs to deliver value for money but without costs affecting the quality of the work.

Module Learning Outcomes for assignment help

Learning outcomes assessed by the assignment:

1. Understand priorities in public health nutrition
2. Critically evaluate the scientific basis of current public health nutrition concerns
3. Independently develop plans to interrogate the nutrition evidence base.

Word Limit Guidance: For assessments where a word limit is indicated, a student’s ability to write within the word limit is part of the assessment concerned. Where a word limit is indicated students should provide a final word count by highlighting all text included in the main body of the assessment (the main body of the assessment does not include the reference list) and simply stating that word count.
The main body of the assessment includes:
-the title (if applicable)
-an abstract (if applicable) -the main body of text (including any sub-titles)
-in text citations e.g. (Smith, 2018) -direct quotations, case studies etc.
-tables, figures (including any table/ figure titles), illustrations and footnotes
Referencing Guidance.
Referencing is a key aspect of the academic assessment process, as it allows students to:
• acknowledge the contribution that other authors have made to the development of their work (and
therefore, help avoid plagiarism)
• evidence students independent research and depth and breadth of reading i.e. student ‘scholarship ‘
• demonstrate understanding of concepts proposed by other writers while developing their own ideas
• inform their readers of the sources of theories, datasets, quotes etc. that have been referred to, and enable readers to find the sources quickly and easily themselves.

Solution

Beriberi

A nutrition deficiency disease
 
Overview

The purpose of this project is to ensure better solution to a nutrition deficiency disease, beriberi, which causes fatal illness. The disease was first discovered in the year 1593 in England and is still an issue in most of the underdeveloped countries such as Bangladesh, Thailand and Kiribati. The purpose of the project is to eradicate beriberi by spreading awareness among people who are affected, providing medical aid to those people with the help of the local government and presenting schemes and policies to the government including financial aid. Many poor, underdeveloped and developing countries such as Kenya, Uganda, Kiribati, Bangladesh etc. are still facing these issues due to lack of public healthcare facilities, nutritional policies and lack of medical supplies to the people suffering from these nutrition deficiency diseases. Poverty is one of the major reason to cause beriberi as a person in unable to consume nutritional diets due to lack of capital. Proper nutrition and diet plans will help prevent this disease (Buttriss, J. L. 2015). Through this project, I would like to address such a problem with a solution to how we can eradicate this kind of disease from spreading. Arranging proper nutrients foods will also help people with thymine deficiency to gain thymine in their body. The awareness campaign should be done in different parts of the world where the problem regarding this issue is very widespread.

A sever thymine deficiency or vitamin B1 deficiency causes Beriberi. Wet and Dry beriberi are the two of its kind which causes due to low intake of Vitamin B1 or thymine rich food. Wet beriberi affects cardiovascular system resulting, in extreme case, blockage of heart and increase in heartrate affecting the circulatory system of a human body. Whereas, on the other hand, dry beriberi cases sever nervous breakdown and affects the nervous system causing paralysis, in extreme case. Consuming alcohol in a large amount and in a disorderly manner may also be the cause of thymine deficiency resulting to cardiovascular issues. Enlargement of heart, nausea, swollen legs, loss of appetite and lactic acidosis can be observed in infants affected with chronic or acute beriberi (Buttriss, 2015). Due to lack of thymine, cardiovascular and nervous system do no respond and function well as lack of thymine prevents doing so. 80 Percent of the people, due to abuse alcohol, which prevents their body to absorb thymine which in turn causes deficiency of thymine inside the body. These diseases are mostly found in third world countries rather than the developed countries. Low standard of living and ignorance towards healthcare plans lead to these kind of deficiency and causes many other nutrition deficiency diseases.

Background and significance

A forgotten disease that is still a clinical issue in many countries in southeast Asia including Bangladesh (Smith, H. A. 2017). Thymine was the first vitamin B that was discovered. In July 2009 an unknown illness caused death to a large number of African Union soldiers in Mogadishu which was later identified as wet beriberi. Laboratory investigations did not show any metabolic, infectious or toxic abnormalities which is why it was difficult to understand the nature of the disease (Emukule G, et al. 2011). After examining the blood sample of 16 soldiers it was identified that the levels of erythrocyte transketolase activation coefficient was high which caused thymine deficiency. This is considered to be an ancient disease but it is still existing in many parts of the world. The question is why is this disease still exist and how nutrition research will help control these diseases? Nutrition research will help understand the deficiencies and the food supply chain which will help people lead a healthy life and providing better outcomes for the economy. The main issue is to understand that a high number of diseases are caused due to deficiency or excess of nutrients consumptions (Buttriss, J. L. 2015). A proper nutrition and diet research will help understand the food consumption cycle which will be the stepping stone to eradicating diseases caused due to improper consumption of nutrition. Though cases of beriberi can be still seen with the introduction of advance technology and scientific methods deficiencies diseases like beriberi can be controlled.

Individual response to diet and food

Due to different metabolic rates, diet cannot be same for all people rather it should be according to the genetics, epigenetics and ethnics differences. The discovery of variability in diet will help in personalizing the diet for different people resulting in a better inform policy. The first thing is to understand the variability of metabolic responses in different people to different diet and food which can be done with the help of the following:

Omics:

Nutrigenetics and nutrigenomics are the two omics research that helps identify how nutrients reacts to different genes, proteins and metabolites that will help identify the individual health and its issues (Buttriss, J. L. 2015). It will help understand how nutrients are digested, metabolized and absorbed in different human bodies. This will help create new biomarkers which will help identify health deficiency of an individual.

Microbiome:

Different microbes such as bacteria and virus that are present inside a human body contributes to microbiomes. Microbes varies from person to person and each has a unique microbe that makes microbiomes identical and different from each other though the subpopulation may consist same microbiomes. The microbiota that changes due to change in age, diet and physiological rates should be determined accordingly to adjust the diet of an individual. Research is needed to determine different microbiota that reacts differently to different nutrients. It is also important to understand its role in disease prevention and progression.

Genome:

The role of DNA and RNA and its determination is important so as to understand the proper diet that an individual need. Genome gives a complete information about an organism as it provides all the information which is required for an individual to function (Gropper, & Smith 2013). By identifying this it will be easier to analyze what deficiencies an individual has which will help in overcoming the deficiencies diseases like beriberi.

Impact of nutrients in healthy growth and development

The research will help improve the health and well-being of an individual. Early determination of the nutrients (Buttriss, 2015) will help resist the diseases later to affect individual’s livelihood and development progression.

Early nutrients:

The role of diets is essential for the parents while preconception and during pregnancy which will help respond to early nutritional events. The introduction of an infant to solid food is a major decision as this may lead to obesity in future. The assessment of the nutrition in the early life is essential as this may cause a lot of diseases if not taken care of at an early stage.

Nutrition and reproduction:

Nutrition greatly impacts on maternal and paternal fertility. So this is an area that needs to be researched as it affects in preconception as well as post conception. Impact of nutrients are huge and it plays a key role in preventing diseases relating to reproductive organs such as prostate and ovarian cancer. The determination of the factors and mechanism is important for change in health of an individual.

Role of nutrition in health maintenance

Health maintenance requires continuous research to understand the role of nutrients and novel ingredients and its contribution in health (Chern, & Rickertsen, 2003). To rely on researches that help to dietary guidance including DRI is essential for health policy. At an early stage it is recommended to better understand the nutrient needs which will help in maintaining health in all population and subpopulations.

Optimal body functions:

It is better to determine the role of nutrition and fitness, together and individually to maintain the functions of the body that includes muscular, skeletal and nerves system.

Energy balance:

Researches require to identify system wide changes that important to reach optimum energy of a body. Experimental approach has not proven to be much effective in the past as it was unable to reach the population whereas system wise approach will help to reach wide scale of population to understand the energy balance.

Role of nutrition in medical management

Nutrition researches play an important role in connecting the diseases with their treatments. Researches that are evidence based results in more effective policy making that ensures proper patient care

Disease Progression:

To understand the medical management of the diseases, research plays and important role. It helps understand how a body response to different disease when nutritional factors influence both disease initiation and its progression. Research will also help us understand the role nutrition plays in prevention of the diseases.

Nutrition Support:

Nutritional researches are required to determine to understand the best support that is needed to for survival and growth of an individual and subpopulation (Eilender, 2016). It will help understand how nutrients helps with chronic disease among infants and the elderly people.

Understanding nutritional related behaviors
Drivers of food choices:

The drivers that influences food choices are:
• Government policies
• Cultural differences
• Environment
• Food marketing and social media

Nutrition and brain function:

The marketing of healthy food behaviors will greatly help the population to consume healthy diets. The diets will influence hormonal changes which in turn will help in metabolism (Gropper, & Smith, 2013). of an individual. Factors such as consumption of the different diets, variety, eating frequency etc. will help researchers to understand the pattern of the intake of the nutrients. It is important to understand how eating influences neural biochemistry and brain functions.

Food supply

• Collaboration between nutrition and agricultural production

• Identifying the quality factors that influences the consumption of food

• Introduction of biotechnology and nanotechnology to influence food production and providing novel nutrients to individuals

• Enhancing the knowledge of food to understand its availability.

The above factors will help identify and control nutrition deficiency diseases. In many countries there are people who still follows culture ignoring the biological harm they bring to themselves. Awareness campaigns with the help of the local leader may convince them to take precaution and understand the essentiality of consuming medicines.

Hypothesis and Aims

As beriberi is one of the many diseases that is caused by deficiency of vitamin, thymine, it is necessary to understand how food environment affects the dietary patterns and what is needed these to solve the problem.

Below is a few question that needs to addressed:

• What kind of dietary change is needed and is the current dietary change significant?
• How does assistance program helps reach and promote proper dietary patterns?
• What are consequences of negative dietary responses?
• How is marketing playing an important role in influencing dietary choice of food and how are its impacts?
• How do we monitor, assess and evaluate the dietary change changes?
• How does inclusion of quality of food influences its consumption?
• How does promoting local production of food and its supply influence dietary patterns?

The above questions are very important to address as the dietary patterns of an individual is directly related to its health care. Proper nutrition intake is far less costly then taking medicines at the stage where the disease will be chronic. The rise in number of beriberi cases in southeast Asia including Japan helps us understand that this is not only a concern in the underdeveloped countries but also in the developed countries.
As this is a disease that is caused due to deficiency of nutrition the aim and objective should be to make policies that will provide proper nutritional diets to every individual. With the help of the local government the following schemes and policies can be implemented:

National food policy plans:

Making Desirable Dietary Plans, which will formulate the requirements of energy such as needs of micronutrients and macronutrients are essential. It can influence the future of agriculture and food policies of the country. Desirable dietary plans are adaptive and improving in nature as it changes according to the growing needs of the people (Shi, 2019). A plan that will help change the idea of food nutrients and its intake not only for the urban people but also for the rural people, poor people, people living in hilly areas and people under poverty. The USP of this plan is that it is not static in nature and it will vary according to the nature of the requirement.

School feeding programs:

This is a step that can be taken very actively as it will nourish the children from a very basic level. This is a part of right to food to everyone. Introducing feeding programs in schools will not only feed them but also will encourage them to come to school every day. The countries that have a high level of poverty such as Bangladesh and Pakistan (Shi, 2019) should introduce feeding programs in the government schools so that the children are exposed to multi nutrients. In this way government can also observe the intake of the food at a large scale and plan the production and availability of the food accordingly.

Anti-poverty programs:

In this program the idea is to pay an amount to the poor section of the society directly so that they can consume adequate amount food to feed their family. This can be given according to the number of members of family members present in the family. In 2003 Mexico came up with such a plan to provide direct money to the needed class of the people. This will help the government to understand the food consumption of the country according to which policies can be made.

Deliverables

It is better to find ways to identify these diseases at a very early state so that it can be addressed accordingly. The following things should be done at an early stage to avoid these deficiencies:

• Medical checkup for every individual once in a year funded by the government

• People who are affected with these diseases should be able to access free medicine

• Involving the funded organisations to conduct medical camps in the areas with large number of cases of beriberi are high

• Making locally produced food more feasible to the people through government subsidized markets where people can afford local vegetables and food at low cost

Inadequate thymine consumption, less absorption of thymine and abnormal metabolism will result in a loss of thymine through urinary track. Transketolase is an important factor that reduces thymine in the body, when it functions improperly (Carpenter, K. J. 2000). Irritability, insomnia, loss of appetite are also the symptoms that effects the psychological stages. Factors that are influencing the thymine requirement are as follows:

• Composition of the diet: The dietary requirements of carbohydrates and fats are to be maintained in proportion. Increase in fat containing diets though does not effect at large but the consumption of carbohydrate in a large quantity happens to increase the requirements of thymine

• Climate: This influences the requirement of thymine as climate is directly proportional to energy consumption.

• Age: For the individuals those who are actively involved in work will have to increase the intake of minimum thymine.

• Body weight: The requirement of thymine will differ according to the body weight. More is the weight more is the consumption of energy and more is the requirement of thymine.

• Physical activity: More workout and activity will lead to more loss of energy resulting in more requirement of thymine.

• Pathological condition: Pathological condition influences the consumption of thymine. Patients having gastronomical disorder, alcohol issues, thyroid disorder etc. will require to consume their thymine accordingly that’s will not affect their health further.

The GANTT chart below shows the planning and duration that is needed to initiate the project. As most of the cases are observed to occur in the backward areas like Bangladesh, Pakistan, Kenya etc. choosing one of these places is important. In this project we will work in the areas of Bangladesh and try to eradicate this disease with the help of the government by making policies and schemes. Below is the time frame shown in GANTT chart to initiate the plan.

GANTT Chart

Study design

Availability of the food ingredients should not be the reason for inadequate food intake or dietary composition. Cultural diversity and changes in food habits according (Eilender, E. 2016). to that must also be the key points while making dietary plans and policies. Integration of human rights education in school level is an important policy (Battle-Fisher, M. 2014) that should not be ignored as it will help people would realize of the right to food. To identify food insecurity in the vulnerable groups and the reason for their inadequate supply of food (National Center for Health Statistics (U.S.). 2013). Measures should be taken according to the results found about why is their insecurity of food among these groups.

With the help of the local government of Bangladesh the following work is to be done to address the issue:

• Collaborating with the human rights groups and nutrition community which can be a stepping stone towards success in overcoming nutrition deficiency diseases

• Conduct education and awareness programs that are essential as this will help people to understand their right to food and why is it important to all

• Educating the people about nutrition sensitive food with the help of local volunteers which will not only help them understand the importance of food nutrients but also will help them choose from the diverse food options which they can afford and will be available to them easily

• Collaborate with the NGO’s to organise camps and programs for free medical checkup to the people holding below poverty level cards.

• It has been estimated that about 40% of the population is have inadequate thymine intake which needs to addressed by appointing free volunteers in different areas where the poverty level is spiking (Shi, L. (2019).

The project will take more or less two and a half years to conclude where we can set up people andorganisation who will carry on with the work. Research is one of the most important part which will take first two quarters after the grant approval. The reason why it should be done is because this is a kind of disease that can be eradicated with the help of a little awareness. The only reason this disease is existing is because of poor food and nutritional policy of the government in the country and that is the target of this project which is to make policies and programs, collaborate with the human rights groups, ask for help from the funded organisations and collaborate with the pharmaceutical companies providing vitamin B1 medicines at a subsidized rate.

Impact

One of the overriding challenges is to identify the group of people that requires right to food which will help in further studying about how and what to plan. Next comes the identification of the food insecurity and finding the root cause of this inadequacy of food (Chern, W. S., &Rickertsen, K. 2003) should be the ultimate priority. The fundamental approach should be taken to identify these problems and when the plans are in action to monitor its implementation to venerable groups. Socio-economics factors will highly influence these plans and it may happen that sometime the plan may not works as expected but the basic idea and the plan should not be altered. Human rights principal make human right framework more effective (Ho, L.-sang. 2013) as it will involve multiple stakeholders to get involved that will help in proper implementation of the plan and its smooth running. Right to food involves nutrition benefits as well and if these two are constantly been involved together the outcome will be sustainable development (Ho, L.-sang. 2013). Education and information on human rights and right to food will also play a vital part. This will help people of different vulnerable groups and ethnic groups to follow their culture without suffering from nutrition deficiency diseases.

 Costing

Grand total: £168,582 per annum

References

Battle-Fisher, M. (2014). Application of systems thinking to health policy & public health ethics public health and private illness

Buttriss, J. L. (2015). Public health nutrition (2nd ed., Ser. The nutrition society textbook ser) John Wiley & Sons, Incorporated.

Carpenter, K. J. (2000). Beriberi, white rice, and vitamin b: a disease, a cause, and a cure

Chern, W. S., &Rickertsen, K. (2003). Health, nutrition and food demand.

Eilender, E. (2016). Public health and community nutrition (First, Ser. Nutrition and
dietetics practice collection). Momentum Press.

Gropper, S. A. S., & Smith, J. L. (2013). Advanced nutrition and human metabolism (6th ed.)
Wadsworth/Cengage Learning

Ho, L.-sang. (2013). Health policy and the public interest. Routledge

National Center for Health Statistics (U.S.). (2013). National health and nutrition
examination survey (Vol., estimation procedures, 2007-2010, Ser.

Shi, L. (2019). Introduction to health policy (Second, Ser. Gateway to healthcare management)
Health Administration Press

Smith, H. A. (2017). Forgotten disease: illnesses transformed in chinese medicine

Watson JT, El Bushra H, Lebo EJ, Bwire G, Kiyengo J, Emukule G, et al. (2011) Outbreak of Beriberi among African Union Troops in Mogadishu, Somalia. PLoS ONE 6(12): e28345. https://doi.org/10.1371/journal.pone.0028345