Stroke and TIA Survivors' Perceptions of the COVID-19 Vaccine and Influences on Its Uptake: Cross Sectional Survey.

BACKGROUND: People who have experienced a stroke or transient ischaemic attack (TIA) have greater risks of complications from COVID-19. Therefore, vaccine uptake in this vulnerable population is important. To prevent vaccine hesitancy and maximise compliance, we need to better understand individuals' views on the vaccine. OBJECTIVES: We aimed to explore perspectives of the COVID-19 vaccine and influences on its uptake from people who have experienced a stroke or TIA. METHOD: A cross-sectional, electronic survey comprising multiple choice and free text questions. Convenience sampling was used to recruit people who have experienced a stroke/TIA in the UK/Ireland. RESULTS: The survey was completed by 377 stroke/TIA survivors. 87% (328/377) had either received the first vaccine dose or were booked to have it. The vaccine was declined by 2% (7/377) and 3% (11/377) had been offered the vaccine but not yet taken it up. 8% (30/377) had not been offered the vaccine despite being eligible. Some people expressed concerns around the safety of the vaccine (particularly risk of blood clots and stroke) and some were hesitant to have the second vaccine. Societal and personal benefits were motivations for vaccine uptake. There was uncertainty and lack of information about risk of COVID-19 related complications specifically for people who have experienced a stroke or TIA. CONCLUSION: Despite high uptake of the first vaccine, some people with stroke and TIA have legitimate concerns and information needs that should be addressed. Our findings can be used to identify targets for behaviour change to improve vaccine uptake specific to stroke/TIA patients.

Assessment of Regular and NPH Insulin Concentration via Two Methods of Quantification: The Washington State Insulin Concentration Study (WICS).

BACKGROUND: Recent reports have suggested that insulin vials purchased in community pharmacies do not meet the minimum required intact insulin concentration (≥95 U/mL) as defined by the United States Pharmacopeia. We sought to independently obtain multidose human insulin vials from a variety of community pharmacies across the state of Washington and quantitatively measure intact insulin. METHODS: Sixty 10-mL vials of insulin (n = 30 regular human insulin and n = 30 neutral protamine Hagedorn insulin) were purchased and assayed. To ensure random selection of lots and supply chain sources, insulin samples were purchased on a variety of calendar dates from various pharmacy locations across Washington State, inclusive of both chain and independent pharmacies. All samples were assessed for intact insulin concentration via both Ultra Performance Liquid Chromatography coupled with UV detection (UPLC-UV) and Ultra Performance Liquid Chromatography-Mass Spectrometry (UPLC-MS). RESULTS: When considering all samples (N = 60), the mean concentration was 101.8 ± 4.4and 91.5 ± 1.9 U/mL as determined by UPLC-UV and UPLC-MS, respectively. Measured concentrations ranged from 90.0 to 108.4 U/mL when assayed by UV UPLC and 86.1 to 95.4 U/mL for UPLC-MS. CONCLUSION: To our knowledge, this is the first study following the report by Carter et al that assessed human insulin concentrations by both UPLC-UV and UPLC-MS. These findings are important because they demonstrate that the results obtained from these two methods differ and that the method used must be considered when interpreting findings.

Food Advertising to Children in New Zealand: A Critical Review of the Performance of a Self-Regulatory Complaints System Using a Public Health Law Framework.

New Zealand has the second highest overweight and obese child population in the Organisation for Economic Co-operation and Development (OECD). This paper evaluates whether New Zealand's self-regulatory controls on the advertising of unhealthy food and beverages to children and young people adequately protects children from the exposure to, and power of, such marketing in order to limit its impact on children's food and beverage preferences. First, an analysis of the relevant New Zealand Advertising Standards Authority (ASA) Codes was conducted, including the ASA Complaints Board and Appeals Board decisions from 2017-2019 to determine the application of the Codes in practice. Second, a public health law framework was applied to the self-regulatory system. Of the 16 complaints assessed, 12 were not upheld, and only one was upheld under the Children and Young People's Advertising Code (CYPA Code). Three complaints were upheld under the Advertising Standards Code (ASC) but not the CYPA Code. An analysis of the Codes and their interpretation by the Complaints Board found that many facets of the public health law framework were not met. The self-regulatory system does not adequately protect children from the exposure to, and power of, unhealthy food and beverage marketing, and government-led, comprehensive, and enforceable marketing restrictions are required.

Role of familiarity on effects of caffeine- and glucose-containing soft drinks.

Familiarity, through conditioned responses and expectations, may play a significant role in the expression of liking for, and mood and performance effects of, food and drink constituents. The role of familiarity and the effects of caffeine and glucose in Lucozade Energy were investigated by testing this familiar soft drink, and its non-caffeine/non-CHO placebo match, against novel coloured/flavoured full and placebo drinks. Both the familiar drink and its placebo improved alertness, mental energy and mental performance compared to baseline and compared to the novel placebo drink. After repeated exposure, that is, after having gained familiarity with the novel drinks in addition to the already existing familiarity with Lucozade Energy, only the full (caffeine and CHO containing) drinks showed sustained beneficial effects compared to placebo drinks and baseline measures, as well as an increase in liking compared to placebo drinks. Therefore, participants appeared to have learned that beneficial effects were mainly linked to the full products. The results illustrate the restorative combination of caffeine and CHO in the drink, and emphasises the need to implement the appropriate placebo(s) in any study design employing familiar foods or drinks.

Targets and actions for noncommunicable disease prevention and control in New Zealand.

AIM: To propose non-communicable diseases (NCD) prevention and control targets for New Zealand, where NCDs are the leading causes of death and health inequalities in men and women. METHOD: We adapted NCD global targets for New Zealand in the light of local progress, priorities and feasibility. RESULTS: National NCD targets relevant to New Zealand, yet congruent with global targets, together with inclusive, collaborative and feasible actions to achieve them are outlined. CONCLUSION: A national commitment to collaborative and pragmatic action is needed to capitalise on opportunities for further progress in the prevention and control of NCDs in New Zealand.