Tuesday, December 31, 2019

The Damaging Effect Of Sports On Women - 924 Words

The Damaging Effect of Sports on Women When it comes to the topic of sports, many people would assert that sports are a tool that can be used to bring people together. However, in her essay, â€Å"We Don’t Like Football, Do We?† Mariah Burton Nelson argues that sports have created a platform where men can be brought together to diminish the ideas and worth of women. Nelson argues that with the idea that men are meant to play sports that require more strength and force, women are beginning to increasingly suffer the consequences of this idea. Nelson asserts that if men and women do not work to change the ideas of women that sports are creating, the damage done to women due to these ideas will not stop. Nelson claims that women are taught from a young age that they are not meant to like sports. In order to enforce this claim, Nelson uses the rhetorical strategy of narrative. In this narrative, Nelson tells the story of her young niece asking her mother, who was making din ner in the kitchen, if women are supposed to like football after seeing her father and brother watching the game together (3). Due to this narrative, Nelson is able to demonstrate that even within a family, there is the idea that men are supposed to watch sports while the women perform other tasks. Furthermore, by Nelson saying that her niece’s father did not acknowledge her when she walked past him watching the football game, Nelson demonstrates the people do not think twice about this idea (3). Nelson thenShow MoreRelatedAn Investigation Into the Media Representation of Gender in Sport1303 Words   |  6 PagesAn investigation into the media representation of gender in sport. There have been many studies and investigations into the different types and intensity of the media coverage in sport involving both sexes. This investigation will look at previous studies and reports carried out by researchers to discover why different genders receive different media attention in sport, and to see whether this has an adverse effect on other issues such as participation. It is a clear fact that menRead MoreMedia s Influence On The Media Essay1587 Words   |  7 Pagesthose who partake of the media they produce. Entertainment media can be uplifting and enjoyable, however, media normalizes damaging gender norms for men and women. Gender norms are rules believed to govern how the different sexes should look and act. People develop these behaviors by observing the world around them specifically the media. The media shapes how men and women develop standard gender norms. â€Å"In a climate of 24-hour media cycle and the proliferation of infotainment and reality televisionRead MoreEssay about Steroids545 Words   |  3 Pagesmedical purposes. Theyre used in controlling inflammation, strengthening weakened hearts, preventing conception, and alleviating symptoms of arthritis and asthma. Unfortunately research has shown that steroids have been abused in almost every kind of sport. Although steroids contribute to a muscular body, usage should remain illegal because they physically deteriorate and mentally destroy the body. Many people are fascinated about steroids because of their ability to build up the body. Whether takenRead MoreThe Media And Its Portrayal Of Athletes1573 Words   |  7 Pagesdifferences in men and women athletes body perception in the media. To get their results they used multiple questionnaires that revolved around questions dealing with body shame, self-objectification and their appearance goal. Their conclusion said grade level and ethnicity do not play a significant role in the effects of the media on body perceptions† (Riebock Bae, 2013). However, what does play a role is gender. Women are in the media more for their looks than men are. Women athletes are put toRead MoreEssay on Child Development1286 Words   |  6 PagesOur sex saturated media is also generating conflict in young girls’ development. The portrayal of women as sexual objects is discussed in the article â€Å"The sexualization of Girls is Harmful† by Olivia Ferguson and Hayley Mitchell H augen. The article cites statistics of â€Å"prime-time television shows popular among children† remarking that â€Å"12% of sexual comments involved sexual objectification toward women† and â€Å"23% of sexual behaviors involved leering, ogling or catcalling at female characters†.(par 6)Read MoreAthletes And Professional Sports Athletes914 Words   |  4 PagesMany professional sports athletes historically took steroids to enhance greatly their overall performance, to furnish them with a reasonable edge against their opposing team. Most of the trained athletes who took or are trying anabolic steroids, do not grasp the additional complications they are taking mentally and physically with on themselves. In that respect there comes consequences with taking steroids, particularly with getting caught, these matters can be a problem for the sports athletes trustworthinessRead MoreThe Eating Disorder And Anorexia Nervosa1555 Words   |  7 Pagesinterconnected facto rs of life. Characterized by strict dieting, an unrealistic perception of body image, excessive exercise, depression, and OCD, this disorder has the ability to boycott the lives of many individuals (Pinel, 2014). In order to understand the effects that this disorder has, it is essential to look at the socio-cultural, psychological, and physiological factors this disorder can entail. In addition, gender discrepancy is evident in relation to anorexia nervosa, with females presenting anorexiaRead MoreBeauty Pageants : A Little Girl s Psyche987 Words   |  4 Pages2007 study conducted by the American Psychological Association found a link between the seemingly fun and harmless beauty pageants and the development of low self-esteem, eating disorders, and depression. In addition to being mentally damaging, pageants are also damaging to the wallets of parents. Families may spend thousands of dollars on artificial tanner, teeth whitening treatments and glitzy pageant attire. Beauty pagean ts send out a wrong, toxic message to young minds. â€Å"Pageant girls are taughtRead MoreAnabolic Drug Use Among Athletes1668 Words   |  7 PagesAthletes that use this drug typically take it with testosterone to help side effects such as a loss of sex drive, depression, and moodiness. The Sixth steroid is called Oxymetholone, also known as Anadrol. This drug comes in a tablet form. Anadrol improves red blood cell production and increases the amount of hemoglobin that helps to treat anemia. Although the FDA approves Anadrol, this drug still has serious side effects. These include breast cancer in males and females and reabsorption of the boneRead MoreStress topic outline1033 Words   |  5 PagesStress and Coping written in by Dr.Yochi Cohen-Charash, a Professor at Baruch College. Distress can be caused by too much negative stress. d. Side effects of too much negative stress include. Headache, stomach ache, diarrhea, irregular periods in women, irritability, over and under eating, and depression. Transition: However the effects of stress can be different for each gender. 2. Gender is a big factor on how stress affects someone. 1. According to the book Gender Stress

Monday, December 23, 2019

Fast Food Restaurants For The Obesity Epidemic - 1663 Words

Fast-food restaurants are very cheap and convenient way to get a quick meal and also in quick, convenient areas. Whether someone is in a hurry or just need something to eat, pulling through a drive through is very simple and a way to get food almost instantly. Obesity is a significant issue in the United States and having America plastered in fast-food chain restaurants does not help the fact, but we can not put them to blame. People need education on nutrition to learn what they need to eat and what they can enjoy in moderation. We also need many more healthy options in busy areas that also offer quick and simple meals at a reasonable price that give people the option to get a wholesome, nutritious meal. Many people want to blame fast†¦show more content†¦Another study done showed results that with a fast-food restaurant within a quarter mile of a school, resulted in a 5.2 percent increase in the incidence of obesity at that school and implied an increased caloric intake of around 30 to 100 calories per day. Another study done on pregnant women in close proximity of a fast-food restaurant showed an increase in the likelihood of gaining 20 kilograms (Currie, Dellavigna, Moretti, Pathania 2009). While the effects from these studies done in 2009 are still applicable today, I cannot help but think how the effects would not be amplified in our current society. People have only gotten busier and locations have only increased since then. Consuming the high calorie food served by fast-food restaurants on a regular basis can obviously lead to weight gain and eventually obesity. Some complications are not as obvious and can take people by surprise. Most people probably do not think of the long-term effects that can result from making regular trips to drive-thrus or stops at fast-food restaurants. Some more obvious consequences of obesity is cardiovascular complications and diabetes, but there are many consequences that people may not realize. It can lead to res piratory disorders, such as asthma. It can also lead to a numerous amount of different types ofShow MoreRelatedFast Food And The Obesity Epidemic933 Words   |  4 PagesFast –food Industries are to be Blame for Obesity Visualize the world somewhere a school-age child can step out of his school and walk into a McDonalds. Fast-food causes an array of problems in your body. The food is often high in sugar, fat, and calories while providing very few nutrients. The obesity epidemic Americans face today is a growing problem that affects more than half of the population with growing body sizes and serious medical problems associated with obesity. It is a problem thatRead MoreFast Food And The United States1279 Words   |  6 PagesDaniel Hernandez Professor Fay Lee English 1302 (TTh 10:10-11:35) 30 October 2014 Fast Food and Obesity in the United States Fast food restaurants have revolutionized the United States. It has helped people with low salaries be able to afford food for their family, but at the cost of their own health. Ever since the first fast food restaurant opened, health rates have dropped and keep continuing to drop. The visual argument I have chosen takes place in Africa in an environment that is a nice sunnyRead MoreThink Before You Eat673 Words   |  3 Pagespopulation obesity rates are not decreasing, the rates are increasing rapidly. The amount of bad food the population is consuming has affected the nation’s obesity rates, and there should be stop to this epidemic.† The percentage of obese adults has more than doubled over the last 30 years.†(Bad Food? Tax it, and Subsidize Vegetables). Obesity is a fast growing epidemic that we as a nation need to find ways to fight it and put a stop to the rapidly growing rates. â€Å"The rising epidemic of overweightRead MoreObesity Epidemic and Lack of Government Intervention Essay1085 Words   |  5 PagesIs the lack of government regulation causing an obesity epidemic? In America fast food is a staple of many people’s diets. As a result, the United States is now faced with a serious obesity epidemic that continues to grow worse every year. Along with impacting the economy, some of the impacts on people are cardiovascular disease, diabetes, and strokes which are all linked to obesity. According to the CDC, â€Å"The US Department of Health and Human Services discovered that the combination of a poor dietRead MoreObesity : A Top Problem For Public Health1706 Words   |  7 PagesA Review of the Literature Obesity, a top problem for public health, is a global epidemic that kills no less than 2.8 million people every year. Obesity is a significant factor for many diseases which include Type 2 diabetes, some cancers and cardiovascular diseases. Many at times, being overweight is mistaken for being obese. Being overweight or obese means having abnormal or excessive fat accumulations respectively that could have negative health effects. BMI, body mass index, was introduced toRead MoreThe Obesity Epidemic in America Essays1082 Words   |  5 Pages Obesity among Americans has been a growing issue in the United States predominantly over the past decade. Many may argue American’s are obese because of poor food choices, over-eating, genetic disposition, lack of exercise, or the environment which one lives, while others blame it all on fast-food chains and restaurants. Throughout my research I have come to find a lot of facts and statistics about fast food consumption causing obesity. Statistics show that without a doubt the United States isRead MoreChildhood Obesity Is The Constant Build Up Of Excessive Fats That Impair The Health Of A Child Essay1723 Words   |  7 PagesChildhood obesity is the constant build up of excessive fats that impair the health of a child. When children are obese, they have high cholesterol and high blood pressure that threatens their lives with CVD. It also causes extreme breathing problems, joint problems, and an increase in contracting type 2 diabetes. Nearly one in three kids in the Unite d States is obese and that is more than triple the amount from the 1960’s. Childhood obesity is taking control of many kid’s lives throughout theRead MoreChildhood Obesity : Obesity And Obesity Essay1671 Words   |  7 PagesFight to End Obesity Childhood obesity has increased drastically over the past years and has become a health risk to children. In fact, childhood obesity has doubled in numbers in the past thirty years (Childhood Obesity Facts). Obesity occurs when an individual becomes overweight and can be diagnosed by using the body mass index or BMI scale. Obesity causes many diseases in children which cannot be cured without a doctor, in result, childhood obesity drives high health care costs. The existenceRead MoreObesity Epidemic : A Growing Problem Within Our Population861 Words   |  4 Pages The obesity epidemic Americans face today is a growing problem within our population. With serious health issues associated with obesity, it is a problem that needs to be addressed and changed. While fast foods have been around for a long time, many people claim that fast food places are to blame. Each day people turn to fast food for a quick meal, wether it is breakfast, lunch, dinner, or even snacks. As fast foods begi n to expand and progress throughout the world, people especially in the UnitedRead MoreFast Food Essay816 Words   |  4 Pages Obesity is a major food epidemic. This food epidemic has become so global that it is a leading death cause in America. Many Americans have vouched for a sedentary lifestyle due to their unhealthy eating habits. What they do not realize is the unhealthy food choices that they make now will affect them in the future. The food industry is a major contributor to this. The food industry is affecting the health of future generations due to how easy it is for people to access and their over consumption

Sunday, December 15, 2019

Identification of Bloodstain Patterns Free Essays

The analysis of bloodstain patterns can be a decisive part of a forensic investigation. The patterns of bloodstains may concur with or challenge the sworn statements of witnesses, victims, and suspects. Such bloodstain patterns simply identify the source of the blood and the direction of the blood’s flight path, but during the process, the events of the crime can be reconstructed with reasonable accuracy. We will write a custom essay sample on Identification of Bloodstain Patterns or any similar topic only for you Order Now Unfortunately, the old method of analyzing bloodstain patterns, which uses strings, requires much time and effort. It is also subject to human error. To reduce human error, mathematical calculations are used instead, along with a computer software program known as Back Track. Yet, a three-dimensional representation of the results of bloodstain analysis will be more convincing in any court representation. Therefore, in an effort to revolutionize this aspect of forensic investigation, a concerted effort by four researchers from three agencies, Ottawa Police Service, Carleton University and Royal Canadian Mounted Police, was conducted using the AutoCAD software. The researchers were Kevin Maloney, A. L. Carter, Scott Jory, and Brian Yamashita. The results of their studies were reported in an article published by the Journal of Forensic Investigation, in 2005, volume 55, issue 6, and pages 711 to 725. The article attempts to demonstrate how the combined use of AutoCAD and Back Track programs can create three-dimensional representations of a bloodstain analysis. Summary and Critique The overall purpose of Maloney, Carter, Jory, and Yamashita is to explore the possibility of creating a three-dimensional representation of an analysis of bloodstain patterns. They utilize a simulated crime scene that is typically used at the Canadian Police College. The choice of this crime scene is to have known bloodstain patterns with which the results of the combination of Back Track and AutoCAD can be compared. Both the impact angles and the glancing angles of the bloodstain trajectories were incorporated into the program. The comparison shows that the computerized calculations of virtual strings created by the Back Track program match the known location of the blood source, with an average error of six centimeters only. These results prove the precision abilities of the said software. However, a major weakness of this study is its unquestionable reliance on the Back Track program. This program has many limitations and it was even pointed out later in 2006 by Andy Maloney (the relationship to one of the researchers is not described). For example, the Back Track is incapable of computing angled surfaces (Maloney, 2006). Yet, despite the limitations, the efficacy of using the program is grounded on established theory and supported by experimental validation (Carter, 2001). There would be expected errors but these are assumed to be insignificant in the overall investigation. At the same time, the software is known to undergo updates and modifications. The greatest strength of this research is the launching of a better interface between the laboratory science of the forensic team and the assessment abilities of the court. The AutoCAD program has a feature that locks the virtual strings and enables any user to view them from different perspectives. The three-dimensional representation of the analysis of bloodstain patterns is, as the researchers concluded, â€Å"extremely useful in court presentation† (Maloney, et. al. , 2005, p. 724). This article, as well as the research study that it describes, can be considered as a milestone towards a revolutionary aspect of bloodstain pattern analysis. Instead of numbers presented in tabular form or in picture graphs, the results of the analysis can be presented in three dimensions. In three dimensions, the court presentation becomes more realistic, more convincing, and more enlightening, such that the jury can make better assessments. But this article, as far as the advances in forensic science in general and in bloodstain pattern analysis in particular go, can be considered somewhat obsolete. There are now new software or computer programs that can be utilized to produce the same three-dimensional results (Kanable, 2006). This means that in conducting an analysis of bloodstain patterns, a forensic investigator has other options, aside from the combined use of the Back Track program and the AutoCAD. But this wider range of technological tools does not detract from the greatest significance of this article. This article, in great detail and with diagrams, shows how the observed and calculated data are translated into three dimensions. Thus, this article is a recommended reading for every forensic science student. Bibliography Carter, A. L. (2001). The directional analysis of bloodstain patterns theory and experimental validation. Canadian Society of Forensic Science, 34 (4), 173-189. Kanable, R. (2006). HemoSpat: New bloodstain pattern analysis software to hit the market. Law Enforcement Technology, August issue. Retrieved September 28, 2007 from the website of Officer. com at http://www. officer. com/publication/article. jsp? pubId=1id=32890 Maloney, K. , Carter, A. L. , Jory, S. , Yamashita, B. (2005). Three-dimensional representation of bloodstain pattern analysis. Journal of Forensic Identification, 55 (6), 711-725. How to cite Identification of Bloodstain Patterns, Papers

Saturday, December 7, 2019

Factors That May Affect Vitamin D

Question: Describe about the Factors that may affect vitamin D? Anser: Factors that may affect vitamin D status Geographical Location As the majority of vitamin D is produced in the skin and requires UVB radiation to initiate the process, latitude can have a pronounced effect vitamin D status. In countries with a latitude below 35N the body can produce sufficient vitamin D all year round (Tsiaras Weinstock 2011). At latitudes above 35N, which includes much of Europe including Germany; Italy and Amsterdam, sunlight exposure is limited during the winter months and therefore there is higher risk of vitamin D3 deficiency (Webb et al., 1988). A study conducted in the USA, at high latitude 44N, by Sullivan et al.(2005), found that approximately 28% of younger girls had a serum 25(OH) D level below 75nmol/l in cold places. In contrast, hypovitaminosis D can be infected people who live in sunny countries that can produce a high amount of vitamin D because of their lifestyle (Horani et al. 2011). Season In European countries, seasonal changes has significant impact on vitamin D as compared with countries located near equator, the concentration of 25(OH)D is higher in summer and gets lower in winter season (Levis et al., 2005 ). A cross sectional study was conducted by (Mavroeidi et al., 2010) to assess vitamin D status in 3000 postmenopausal women at different seasons, over a period of one year. Additionally the study assessed the incidence of hypovitaminosis D in participants from different cities in the UK (Aberdeen 57N, Surrey 57N). The data showed that vitamin D deficiency was higher in the north of the UK than in the south. In Surrey, 17.1% of Asian women were found to be deficient in vitamin D (These datas were based on the dietary and predictors. Hypovitaminosis with the highest rates recorded among residents of regions in Aberdeen by 25-26% in postmenopausal women during winter and spring, and decreased to 4.2% in summer. Similarly, in a study carried out by (Hypponen and Po wer, 2007) showed consistent findings, confirming that the incidence of hypovitaminosis D is higher in Scotland compared to the rest of the UK. In contrast, the survey conducted by Levis et al (2005) in Florida, the prevalence of vitamin D deficiency in 212 participants was 38% and 40% in male and female respectively, in the wintertime with mean serum 25 (OH) D was 24.9 8.7 ng/cc, whereas, the mean serum 25 (OH) D concentrations of sub-optimal group (just 99 people) was (31.0 11.0 ng/ml) in the end of summer. Skin type and Race Skin type and race considered as factors could effect on vitamin D status because the effectiveness of melanin to absorb UVB radiation could increase the effectiveness of cutaneous synthesis of vitamin D3 (Kift et al., 2013). In 2007, a study carried out by Chen et al. (DATE) indicated that the skin pigmentation could have an effect on D3 production in the skin. This study was conducted by measuring serum 25(OH) D concentrations in adults with different types of skin (Universal skin classification, II or White, fair, blue eyes, III or Mediterranean, blue or brown eyes , IV or Asian, brown eyes and V or Light-skinned black, Indian. At the end of study, serum 25(OH)D concentrations were increased dramatically in all types of skin. Actual recorded mean levels for types II, III, IV and V were 210%, 187%, 125%, and 40% respectively. The authors concluded that the production of previtamin D3 in Type II skin is (5-10 fold) more potent than the type V skin (highly pigmented skin). Table 1: Skin type, skin reaction to sun exposure Skin type Skin colour Skin reaction I White, red hair, or fair Always burns, never tans II White, fair, blue eyes Burns easily III Mediterranean, blue or brown eyes Mild burn, tans average IV Asian, brown eyes Rarely burns, tans easily V Light-skinned black, Indian No burn VI Dark-skinned black No burn From Lips et al (2014) Shaw Pal (2002) reported that the prevalence of vitamin D deficiency is increasing among minority groups living in Great Britain, particularly those are from India and Pakistan and this is due to their lifestyle or habit to stay indoors. Furthermore, studies carried out by de Roos et al, (2012) and Brough et al., (2010) state that skin pigmentation in those groups is not the only reason for reduced vitamin D production but it is s also due to wearing clothes that tend to cover their entire bodies and staying indoors for longer during the day thus limiting UVB exposure. (). Kift et al. (2013) carried out a prospective cohort study in South Asian people aged 20-60 years to assess vitamin D level and lifestyle factors and compare the result with study conducted in Caucasian people with same condition. Demographic factors, vitamin D level, UV exposure and vitamin D intakes were analysed with same methodologies in study conducted on South Asian and Caucasian people. The authors found tha t there was no difference in the percentage of body area exposed to the sun. Also, they reported that white people reach a mean vitamin D level of 65.3nmol/l in summer, whilst south Asians only reach a mean level of 22.4nmol/l. During the wintertime, it was reported that 40% of South Asians were found to be deficient (15nmol/l), due to their low vitamin D intake and increased skin pigmentation. They further stated that it should be noted that skin pigmentation could affect pre vitamin D3 production. The conclusions to this study state that future prospective studies need to find effective ways to address these apparent issues. Clothing and Sunscreen Clothing and sunscreen are known as cutaneous factors, as they are a physical barrier in absorption of solar radiation by the skin and thus effective in less production of vitamin D level (Tsiaras and Weinstock, 2011). Most of sunscreens are having a sun protection factor (SPF) 8 that helps to protect the body against UV B radiation and decreases vit. D synthesis by less than 95 %, whereas (SPF) 15 decreases by less than 99% (Webb and Engelsen, 2006). According to Holick (2004), when the skin is exposed to the sunlight, the amount of UVB photons well absorbed by Blocking out sunlight as a result of dress style is particularly associated with hypovitaminosis D amongst immigrant women in the UK and Europe (Gillie 2010). A previous study by (Glerup et al., 2000) indicated that the prevalence of vitamin D deficiency is higher in immigrant women (veiled and ethnic Muslims women) than in Danish women due to limited sunlight exposure. Another study conducted in Turkish women examined three groups of women with different dress styles (Alagl et al., 2000). Group I wore a dress, which exposed the arms and lower legs to sunlight, group II covered whole body except hands and face, last group (III) wore a traditional Islamic style that cover whole body. The result reported that the serum 25(OH) D level was significantly high in group I than in groups II and III, where all of the women were under normal levels. Obesity There are several diseases that can affect vitamin D level including kidney disease and obesity (Tsiaras Weinstock 2011). The inverse relationship between obesity and vitamin D deficiency is well-established (Wortsman et al, 2000; Esteghamati et al., 2004; Holick Chen 2008). In fact, those who are obese, living in high-risk regions such as Scotland are considered to be at twice the risk of those living in lower risk regions of Great Britain (Hyppnen Power, 2007). A study was conducted by Wortsman et al (2000) to investigate the relationship between obesity and vitamin D production. It was shown that those who were obese participants (i.e. having a BMIover 30kg/m2) had 57% lower serum vitamin D concentrations than non-obese participants after exposure to ultraviolet D3 or receiving oral D2 supplements.. The authors suggested that this was due to increased vitamin D storage in adipose tissue. They further stated that although their findings are similar to another studies, they tend t o believe that obesity did not affect vitamin D production but rather the release of vitamin D3 from the skin into the circulation . A recent crosssectional study carried out by Turner, et.al. (2013) has confirmed the latter hypothesis suggested by Wortsman et al.(2000), showing that the deposition of vitamin D3 in body fat compartments results in decreased bioavailability of vitamin D3 from cutaneous and dietary sources. Bischof et al (2006) indicated that the serum 25(OH) D concentrations associated negatively with BMI (body mass index) in a study of 483 adults. Results reported that prevalence of hypovitaminosis (25(.OH)D 22.0 nmol/l) in participants with BMI less than 30kg/m2 was increased from 8.8% to 15% in adults with BMI greater than 30kg/m2. Lee et al.(2009) found in their study that the effectiveness of supplementation of vitamin D is dependent on BMI. The obese and vitamin D deficient patients may need a higher dose of supplement than non-obese to increase vitamin D level s. 95 subjects with (25(OH) D 6 ng/mL) were given 10.000 IU (cholecalciferol) for 1 week, the authors reported that 25(OH) D concentrations correlated negatively with BMI. Socio-economic status Several studies have linked low vitamin D intake with low economic status (Dealberto, 2006). In many of these associations, the authors cite issues such as poor nutrition, poor lifestyle and inability to afford supplements to treat the deficiency. For instance, poor dietary intake is prevalent in regions with a high poverty rate, mostly affecting middle-aged women of childbearing age (Brough et al., 2010). According to Brough et al. (2010) a socially deprived population cannot afford some of the basic nutrients such as vitamin D, which are essential for normal metabolic function. Therefore, some resort to what have been described as shortcuts of life (means shortage of essential nutrients); the impact of this is exposing their immune system to chronic diseases. A report released by the Greater Manchester Poverty Commission (GMPC) in 2002, identified Manchester as one of the regions with the highest incidence of extreme poverty with approximately 25% of its population living in abject poverty (GMPC, 2012). It also revealed that those who are socio economically deprived couldnt efficiently protect themselves from low winter temperatures, causing these individuals to stay indoors longer than other UK residents, compared to those with an average annual income. According to Grimes (2011) those who have a low income and are socioeconomically deprived are also burdened with a higher risk of vitamin D deficiency. Several campaigns such as the Glasgow campaign introduced free vitamin D supplements for the ethnic groups to improve their vitamin D status (Shaw and Pal 2002). According to Dunnigan et al (1985), the campaign was started in 1979 and ran for 5 years. The intervention gave Asian schoolchildren, up to 18 years, a low daily dose of vitamin D (100 IU). After supplementation, it showed that the prevalence of rickets decreased. This effort led to significant improvement amongst these communities, particularly those targeted cities in Northern England. However, the identification of a large number of deficient people in study conducted by Roy et al., (2007) suggests that the gains made 40 years ago are no longer visible, and more people have been diagnosed with vitamin D deficiency among the minority population than ever before. Vitamin D intakes from different sources in the UK Tedstone (2014) has published the most recent survey about food consumption, which showed that many of the UKs population are still suffering from vitamin D insufficiency or deficiency with 24% of adults aged 19 years and older and 22% of children not having sufficient vitamin D levels. In wintertime, the prevalence of vitamin D deficiency was found to increase to 40% in both groups. The reason for the hypovitaminosis D was attributed to the reduction in sunlight exposure (longer nights, less external activity and weather pattern), which gives the body 90% of its vitamin D requirement (OConnor and Benelam 2011). Natural and fortified food A startling statistic is that vitamin D dietary intake is much lower in Great Britain as compared to other western nations including United States and Canada (Calvo et al., 2005). Variance in dietary intake of vitamin D between Britain, the United States and Canada has been attributed to the differing extents to which mandatory fortification food occurs in these countries. In the UK only specific foods are fortified with vitamin D, these include margarine, breakfast cereals and infant milk (OConnor and Benelam 2011). According to Sinha et al (2013) there is still a debate between whether the vitamin D intake from food is adequate and enough to maintain serum 25(OH) D concentrations at an optimal level. Some of the most common food sources, which are rich in vitamin D, are fish, liver, fortified margarine and fortified cereals (see table 2.4). Table 2: Dietary source of vitamin D in the UK Source Contribution to dietary vitamin D intakes in women % Contribution to dietary vitamin D intakes in men % Cereal and cereal products Milk and milk products Egg Fat spreads (including fortified margarine) Meat products Fish and fish products 22 3 9 15 18 30 20 2 10 19 24 21 Adopted from OConnor Benelam (2011) Clinical nutritional assessments of natural food items suggest that with the exception of fish and cod liver oil, most natural food stuffs contain minimal vitamin D, if any (Brough et al., 2010; Sinha et al., 2013). According to Schmid and Walther (2013) although there are several sources of vitamin D, it is still difficult for people to meet their recommended intake of vitamin D through consumption of natural food alone. Conversely, Hill et al. (2004) stated that in countries with low levels of sunlight, vitamin D deficiency could be treated by ensuring individuals have an abundance of food that is rich in vitamin D. Additionally, a recent study carried out by Rizzoli (2014) has shown that an improvement in bone health and a reduction in the risk of fracture in later life could be achieved through dietary intervention. It is proposed that vitamin D deficiency can be addressed by consuming 3 servings of dairy products a day, which include milk and yogurt, both of which are rich sourc es of essential nutrients and include a substantial amount of vitamin D. Significantly, it is important to note that insufficient natural sources for vitamin D is a risk factor in itself, and should be taken into consideration when plans are put into place to tackle the problem. Vitamin D supplements There are a huge number of intervention studies that have considered vitamin D supplementation, taking into account factors such as in the different forms of the vitamin used and in the dosage levels applied (Sinha et al., 2013). The expression of the amount of vitamin D in food or supplements is micrograms (g) or International Units (IU). g is most common used by Europe (1 g is equivalent to 40 IU) (OMahony et al., 2011) A summary of these studies is given in Table 2.3. Reference Study participants Vitamin D Dose Length of intervention Study design Result Close et al. (2012) Athletes male Oral D3 125 g 8 weeks (RCT) Vitamin D3 supplementation improved some measures of musculoskeletal performance including vertical jump height and sprinting performance Vieth et al. (2001) 61 male and female Oral D3 4000IU 3 months (RCT) Vitamin D3 effectively increased 25(OH)D to high-normal concentrations in practically all adult Cipriani et al. (2010) 35 female, 13 male young adults 600.000IU oral D3 Single dose (Prospective study) Single oral high dose of vitamin D rapidly increase 25(OH)D and decrease PTH Armas et al.(2004) 30 healthy men 50.000IU Oral D3, D2 Single dose (RCT) Vitamin D3 raises and maintains 25OHD levels to a substantially greater degree than does vitamin D2 Aloia et al., 2008 262 healthy white and African American male and female (Oral D3) 50 g/d and 100g/d 18 Weeks (Randomized double blind) Determination of the intake required depending on basal vitamin D concentrations Cashman et al (2008) 221 men and women 200IU, 400IU and 600IU of oral D3/d 22 weeks (RCT) Higher doses of vitamin D would be required to maintain serum 25(OH)D concentrations in the normal level Heaney et al Table 2.3: vitamin D intervention trials Calcifediol supplement 25(OH) D3 is a vitamin D metabolite used to treat vitamin D deficiency, it is hydrophilic and has a shorter half-life than vitamin D3 (Jetter et al., 2014). Supplementation of calcifediol is a simple, safe and economic treatment to increase 25(OH) D concentrations more rapidly than vitamin D3 (Bischoff-Ferrari et al., 2012). Jetter et al (2014) evidenced in their study that the (HyD3) single or bolus increases the plasma 25 (OH) D concentrations more rapidly than vitamin D3. Where the plasma 25(OH)D was between 8 to 24ng/ml at baseline, after 15 weeks 70% of those taking vitamin D3 reached a 25(OH)D concentration of 30ng/ml whilst all of the women given HyD3 reached a plasma concentration 30ng/ml. Similar findings were reported by Cashman et al (2012), 58 old age people received vitamin D3 and calcifediol in doses equivalent to 20g or 7g HyD3 for 10 weeks. At the end of the study, only 29% of the vitamin D3 group increased their 25(OH) D3 concentrations after 5 weeks and no further increases by week 10. In contrast, the groups given HyD3 showed increased serum 25(OH)D3 concentrations within the 5 week period with further increases by week 10. The above studies have a limitation in that they examine the effect of calcifediol on increasing plasma 25(OH) D concentrations in old aged (50 to 70 years) and the refore the previous findings may not be generalizable to all adults. Further studies are therefore required in order to confirm these results in younger adults. References Alagl, F., Shihadeh, Y., Boztepe, H., Tanakol, R., Yarman, S., Azizlerli, H., Sandalci, . (2000) Sunlight exposure and vitamin D deficiency in Turkish women. Journal of Endocrinological Investigation, 23(3) pp. 173-177.Aloia, J. F., Patel, M., DiMaano, R., Li-Ng, M., Talwar, S. A., Mikhail, M., ... Yeh, J. K. (2008) Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration. The American journal of clinical nutrition, 87(6) pp. 1952-1958Ann M. Coulston, Carol J. Boushey, Mario Ferruzzi (2012) Nutrition in the Prevention and Treatment of Disease. Academic Press.Bischof, M. G., Heinze, G., Vierhapper, H. (2006) Vitamin D status and its relation to age and body mass index. Hormone Research in Paediatrics, 66(5) pp. 211-215.Bischoffà ¢Ã¢â€š ¬Ã‚ Ferrari, H. A., Dawsonà ¢Ã¢â€š ¬Ã‚ Hughes, B., Stcklin, E., Sidelnikov, E., Willett, W. C., Edel, J. O., ... Egli, A. (2012) Oral supplementation with 25 (OH) D3 versus vitamin D3: effects on 25 (OH) D levels, lower extre mity function, blood pressure, and markers of innate immunityl. Journal of Bone and Mineral Research, 27(1) pp. 160-169.Bischoff-Ferrari, H. A., Giovannucci, E., Willett, W. C., Dietrich, T., Dawson-Hughes, B. (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. The American Journal of Clinical Nutrition, 84(1) pp.18-28Blair. M. (2012) 'Action needed on vitamin D levels'. [Online] [Accessed on 16th May 2014] https://www.bbc.co.uk/news/health-20710026.Brough, L., Rees, G. A., Crawford, M. A., Morton, R. H. and Dorman, E. K. (2010) 'Effect of multiple-micronutrient supplementation on maternal nutrient status, infant birth weight and gestational age at birth in a low-income, multi-ethnic population.' British Journal of Nutrition, 104(3) pp. 437-445.Calvo, M. S., Whiting, S. J. and Barton, C. N. (2005) 'Vitamin D intake: A global perspective of current status.' Journal of Nutrition, 135(2) pp. 310-316.Cashman, K. D., Seamans, K. M., Luc ey, A. J., Stcklin, E., Weber, P., Kiely, M. and Hill, T. R. (2012) 'Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults.' American Journal of Clinical Nutrition, 95(6) pp. 1350-1356.Cashman, K. D., Hill, T. R., Lucey, A. J., Taylor, N., Seamans, K. M., Muldowney, S., Kiely, M. (2008) Estimation of the dietary requirement for vitamin D in healthy adults. The American journal of clinical nutrition, 88(6) pp. 1535-1542.Dawson, C., (2009) Introduction to Research Methods: A Practical Guide for Anyone Undertaking a Research Project. How to Books, Oxford.de Roos, B. Sneddon, A. and Macdonald, H. (2012) ' Fish as a dietary source of healthy long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) and vitamin D'. Food Health Innovation Service, available at https://www.abdn.ac.uk/rowett/documents/fish_final_june_2012.pdf.Dealberto, M.J. (2006) 'Why immigrants at increased risk for psychosis? Vitamin D insuffie ncy,epigenetic mechanisms, or both?' Medical Hypothesis, Vol. 68, pp. 259- 267.Dehghan, M., Del Cerro, S., Zhang, X., Cuneo, J. M., Linetzky, B., Diaz, R., Merchant, A. T. (2012) Validation of a semi-quantitative food frequency questionnaire for Argentinean adults.' PloS one, 7(5) pp. e37958.DeLuca, H. F., Prahl, J. M., Plum, L. A. (2011) 1, 25-Dihydroxyvitamin D is not responsible for toxicity caused by vitamin D or 25-hydroxyvitamin D. Archives of biochemistry and biophysics, 505(2) pp. 226-230.Dunnigan, M. G., Glekin, B. M., Henderson, J. B., McIntosh, W. B., Sumner, D., Sutherland, G. R. (1985) 'Prevention of rickets in Asian children: assessment of the Glasgow campaign.' British Medical Journal (Clinical research ed), 291(6490) pp. 239.Esteghamati, A., Aryan, Z. and Nakhjavani, M. (2004) 'Differences in vitamin D concentration between metabolically healthy and unhealthy obese adults: Association with inflammatory and cardiometabolic markers in 4391 subjects. Diabetes Metabo lism, [Online] [Accessed on 5 May 2014] https://www.sciencedirect.com/science/article/pii/S1262363614000469Gillie, O. (2010) 'Sunlight robbery: A critique of public health policy on vitamin D in the UK.' Molecular Nutrition and Food Research, 54(8) pp. 1148-1163.Glerup, H., Mikkelsen, K., Poulsen, L., Hass, E., Overbeck, S., Thomsen, J., ... Eriksen, E. F. (2000) 'Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited.' Journal of Internal Medicine, 247(2) pp. 260-268.Greater Manchester Poverty Commission (GMPC) (2012) 'Research Report. The Centre for Local Economic Strategies. [Online] [Accessed on 16th May 2014] https://www.cles.org.uk/publications/greater-manchester-poverty-commission-evidence-and-recommendations-report/.Grimes, D. S. (2011) 'Vitamin D and the social aspects of disease.' QJM Oxford University Press, 104(12) pp. 1065-1074.Hill, T. R., O'Brien, M. M., Cashman, K. D., Flynn, A. and Kiely, M. (2004) 'Vitamin D intakes in 18- 64-y-old Irish adults.' European Journal of Clinical Nutrition, 58(11) pp. 1509-1517.Hoffmann, M. R., Senior, P. A., Mager, D. R. (2015). Vitamin D Supplementation and Health-Related Quality of Life: A Systematic Review of the Literature. Journal of the Academy of Nutrition and Dietetics.Holick, M. F. (2004a) 'Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease.' The American Journal of Clinical Nutrition, 80(6 Suppl) pp. 1678S-1688S.Holick, M. F. (2004b) 'Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis.' The American Journal of Clinical Nutrition, 79(3) pp. 362-371.Holick, M. F. and Chen, T. C. (2008) 'Vitamin D deficiency: A worldwide problem with health consequences.' American Journal of Clinical Nutrition, 87(4) pp. 1080S-1086S.Horani, M., Dror, A., Holland, D., Caporaso, F., Sumida, K. D. and Frisch, F. (2011) 'Prevalence of vitamin D3 deficiency in Orange County residents.' Journal of Community Health, 36(5) pp. 760-764.Hyppnen, E. and Power, C. (2007) 'Hypovitaminosis D in British adults at age 45 y: Nationwide cohort study of dietary and lifestyle predictors.' American Journal of Clinical Nutrition, 85(3) pp. 860-868.Janet Houser (2011) Nursing Research: Reading, Using, and Creating Evidence. 2nd ed., Jones Bartlett.Jetter, A., Egli, A., Dawson-Hughes, B., Staehelin, H. B., Stoecklin, E., Goessl, R., Henschkowski, J. and Bischoff-Ferrari, H. A. (2014) 'Pharmacokinetics of oral vitamin D3 and calcifediol.' Bone, 59 pp. 14-19.Kift, R., Berry, J. L., Vail, A., Durkin, M. T., Rhodes, L. E. and Webb, A. R. (2013) 'Lifestyle factors including less cutaneous sun exposure contribute to starkly lower vitamin D levels in U.K. South Asians compared with the white population.' British Journal of Dermatology, 169(6) pp. 1272-1278.Lee, P., Greenfield, J. R., Seibel, M. J., Eisman, J. A., Center, J. R. (2009) 'Adequacy of vitamin D replacement in seve re deficiency is dependent on body mass index.' The American Journal of Medicine, 122(11) pp. 1056-1060.Levis, S., Gomez, A., Jimenez, C., Veras, L., Ma, F., Lai, S., Roos, B. A. (2005) 'Vitamin D deficiency and seasonal variation in an adult South Florida population.' The Journal of Clinical Endocrinology Metabolism, 90(3) pp. 1557-1562.Lips, P., van Schoor, N. M. and de Jongh, R. T. (2014) 'Diet, sun, and lifestyle as determinants of vitamin D status.' 92-98-page Handout, distributed in lecture 1317 for moduleMavroeidi, A., Oneill, F., Lee, P. A., Darling, A. L., Fraser, W. D., Berry, J. L., ... Macdonald, H. M. (2010)' Seasonal 25-hydroxyvitamin D changes in British postmenopausal women at 57 N and 51 N: A longitudinal study'. The Journal of Steroid Biochemistry and Molecular Biology, 121(1) pp. 459-461.Maxwell, S. M., Salah, S. M., Bunn, J. E. G. (2006) 'Dietary habits of the Somali population in Liverpool, with respect to foods containing calcium and vitamin D: a cause for concern?.' Journal of Human Nutrition And Dietetics, 19(2) pp. 125-127.OMahony, L., Stepien, M., Gibney, M. J., Nugent, A. P., Brennan, L. (2011) ' The potential role of vitamin D enhanced foods in improving vitamin D status.' Nutrients, 3(12) pp. 1023-1041.O'Connor, A. and Benelam, B. (2011) 'An update on UK Vitamin D intakes and status, and issues for food fortification and supplementation.' Nutrition Bulletin, 36(3) pp. 390-396.Pal, B. R., Marshall, T., James, C. and Shaw, N. J. (2003) 'Distribution analysis of vitamin D highlights differences in population subgroups: Preliminary observations from a pilot study in UK adults.' Journal of Endocrinology, 179(1) pp. 119-129.Pearce, S.H. and Cheetham, T.D. January, (2010)' Diagnosis and management of Vitamin D deficiency'. BMJ, 11: 340.Peat, J., Mellis, C., Williams, K. and Xuan W (2002) Health Science Research: AHandbook of Quantitative Methods. London: Sage.Preece, M. A., McIntosh, W. B., Tomlinson, S., Ford, J. A., Dunnigan, M. G. and O'Riordan, J. L. (1973) 'Vitamin-D deficiency among Asian immigrants to Britain.' Lancet, 1(7809) pp. 907-910.Rizzoli, R. (2014) 'Dairy products, yogurts, and bone health.' The American Journal of Clinical Nutrition, 99(5), 1256S-1262S.Roy, D. K., Berry, J. L., Pye, S. R., Adams, J. E., Swarbrick, C. M., King, Y., Silman, A. J. and O'Neill, T. W. (2007) 'Vitamin D status and bone mass in UK South Asian women.' Bone, 40(1) pp. 200-204.Ruston D, Hoare J, Henderson L et al. (2002) 'The National Diet and Nutrition Survey: adults aged 19 to 64 years.' Volume 4:Nutritional status (anthropometry and blood analytes), blood pressure and physical activity. London: TSO.Schmid, A. and Walther, B. (2013) 'Natural vitamin D content in animal products.' Advances in Nutrition (Bethesda, Md.), 4(4) pp. 453-462.Shaw, N. J. and Pal, B. R. (2002) 'Vitamin D deficiency in UK Asian families: Activating a new concern.' Archives of Disease in Childhood, 86(3) pp. 147-149.Sinha, A., Cheetham, T. D. and Pearce, S. H. S. (2013) 'Prevention and treatment of vitamin D deficiency.' Calcified Tissue International, 92(2) pp. 207-215.Sullivan, S. S., Rosen, C. J., Halteman, W. A., Chen, T. C., Holick, M. F. (2005) 'Adolescent girls in Maine are at risk for vitamin D insufficiency'. Journal of the American Dietetic Association, 105(6) pp. 971-974.Tedstone, A. (2014) New National Diet and Nutrition Survey shows UK population is eating too much sugar, saturated fat and salt. https://www.gov.uk/government/news/new-national-diet-and-nutrition-survey-shows-uk-population-is-eating-too-much-sugar-saturated-fat-and-salt.Thuesen, B., Husemoen, L., Fenger, M., Jakobsen, J., Schwarz, P., Toft, U., Ovesen,T. and Linneberg, A. (2012) 'Determinants of vitamin D status in a general population of Danish adults.' Bone, 50(3) pp. 605-610.Tsiaras, W. G. and Weinstock, M. A. (2011) 'Factors influencing vitamin D status.' Acta Dermato-Venereologica, 91(2) pp. 115-124.Turner, C. B., Lin, H., Flores, G. (2013 ) 'Prevalence of vitamin D deficiency among overweight and obese US children.' Pediatrics, 131(1) pp. e152-e161.Utiger, R. D. (1998) 'The need for more vitamin D.' New England Journal of Medicine, 338(12) pp. 828-829.Van Teijlingen, E., Hundley, V. (2002) The importance of pilot studies. Nursing Standard, 16(40) pp. 33-36.Vieth, R. (2009) How to optimize vitamin D supplementation to prevent cancer, based on cellular adaptation and hydroxylase enzymology. Anticancer research, 29(9) pp. 3675-3684.Webb, A. R. and Engelsen, O. (2008) 'Ultraviolet exposure scenarios: Risks of erythema from recommendations on cutaneous vitamin D synthesis'.72-85-page handout, distributed in lecture 624 for module.Webb, A. R., Kline, L., Holick, M. F. (1988) 'Influence of Season and Latitude on the Cutaneous Synthesis of Vitamin D3: Exposure to Winter Sunlight in Boston and Edmonton Will Not Promote Vitamin D3 Synthesis in Human Skin'. The Journal of Clinical Endocrinology Metabolism, 67(2) pp.373-378.W elman, C., Kruger, F. Mitchell, B. (2005) Research Methodology. 3rd ed., Oxford: University PressWHO. (2009) Global Database on Body Mass Index. World Health Organization, An interactive surveillance tool for monitoring nutrition transition. https://www.who.int/bmi/index.jsp?introPage=intro_3.html , Geneva (accessed 17, May 2010).Wortsman, J., Matsuoka, L. Y., Chen, T. C., Lu, Z., Holick, M. F. (2000) Decreased bioavailability of vitamin D in obesity.' The American journal of clinical nutrition, 72(3) pp. 690-693.