The use of dietary supplements in USA with respect to chronic disease prevention.
Use of dietary supplements in UNITED STATES OF AMERICA (USA) has increased markedly in recent years, because of the perception that antioxidant vitamins and minerals may reduce the risk of chronic conditions such as cancer and cardiovascular disease. However, there have been disappointing findings from several costly clinical trials of antioxidant supplements showing not only no health benefits but potential harms. Specifically, concern has been raised about possible adverse health effects for some of these supplements, especially when they are used at high doses in well-nourished populations.
An editorial in the Annals of Internal Medicine has further exacerbated the current controversy on the use of dietary supplements for chronic disease prevention in the general public, attracting the headlines of many national and international newspapers (http:/annals.org/article.aspx?articleid=1789253).
WRITE A BRIEFING PAPER for the Minister of State for Public Health (USA). Critically appraise potential benefits or harms around the use of dietary supplements with respect to chronic disease prevention. Review the possible interventions for nutritional policy options, which may involve legislation, changes in policy guidance to health and/or education professionals. Identify not more than three priorities for action and justify your choice (Use data relevant to the USA).
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.
Please use the following five headings for your work:
1. Executive summary,
3. Options for action,
4. Review of the evidence,
1. THE EXECUTIVE SUMMARY should be no longer than 250 words and should include:
• a summary of the options,
• the evidence and
• the recommendations .
2. THE BACKGROUND should be brief (not more than 2-300 words). It needs to do no more than set the scene.
3. Under “OPTIONS FOR ACTION” you should include one 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.
4. In the “REVIEW OF 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.
5. 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.
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.
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