The willingness of UK adults with intellectual disabilities to take COVID-19 vaccines.

BACKGROUND: Given the much greater COVID-19 mortality risk experienced by people with intellectual disabilities (ID), understanding the willingness of people with ID to take a COVID-19 vaccine is a major public health issue. METHOD: In December 2020 to February 2021, across the United Kingdom, 621 adults with ID were interviewed remotely and 348 family carers or support workers of adults with ID with greater needs completed an online survey, including a question on willingness to take a COVID-19 vaccine if offered. RESULTS: Eighty-seven per cent of interviewees with ID were willing to take a COVID-19 vaccine, with willingness associated with white ethnicity, having already had a flu vaccine, gaining information about COVID-19 from television but not from social media, and knowing COVID-19 social restrictions rules. A percentage of 81.7% of surveyed carers of adults with ID with greater needs reported that the person would be willing to take a COVID-19 vaccine, with willingness associated with white ethnicity, having a health condition of concern in the context of COVID-19, having had a flu vaccine, being close to someone who had died due to COVID-19, and having shielded at some point during the pandemic. CONCLUSIONS: Reported willingness to take the COVID-19 vaccine is high among adults with ID in the United Kingdom, with factors associated with willingness having clear implications for public health policy and practice.

The effect of food type on the portion size effect in children aged 2-12 years: A systematic review and meta-analysis.

Visual cues such as plate size, amount of food served and packaging are known to influence the effects of portion size on food intake. Unit bias is a well characterised heuristic and helps to determine consumption norms. In an obesogenic environment where large portions are common place, the unit or segmentation bias may be overridden promoting overconsumption of both amorphous or unit foods. The aim of this review was to investigate the impact of offering unit or amorphous food on the portion size effect (PSE) in children aged 2-12 years. A systematic search for literature was conducted in Medline, PsycInfo and Web of Science in February 2018. A total of 1197 papers were retrieved following the searches. Twenty-one papers were included in the systematic review, of which 15 provided requisite statistical information for inclusion in a random effects meta-analysis. Increasing children's food portion size by 51-100% led to a significant increase in intake (SMD = 0.47, 95% CI: 0.39-0.55). There was no evidence to suggest that increases in consumption were related to food type (p = 0.33), child age (p = 0.47) or initial portion size served (p=0.14). Residual heterogeneity was not significant (p=0.24). The PSE was demonstrated in children aged 2-12 years when offered both unit and amorphous food items. The effect was not restricted by food type, child age or influenced by initial portion size served. Of the studies included in the meta-analysis between study heterogeneity was low suggesting minimal variation in treatment effects between studies, however, more research is required to understand the mechanisms of the PSE in preschool children. Future research should determine feasible methods to downsize portion sizes served to children.

Evaluation of a community dental service for homeless and 'hard to reach' people.

OBJECTIVE: Since 2013, Revive Dental Care has been operating a community outreach dental service for homeless and 'hard-to-reach' patients. This research aimed to (a) explore the dental care experienced by people accessing the service, (b) examine barriers and facilitators to using a dental service, (c) examine the impact of the service and (d) identify good practice in providing dental services for homeless people. METHODS: Semi-structured interviews with 20 patients, nine members of the dental staff and four staff members from the community centres providing services for homeless people. RESULTS: Findings suggest that homeless patients have overall poor daily dental care and experience significant dental problems due to a range of lifestyle factors. Most participants had not seen a dentist for many years and previous experiences of seeing a dentist were often unpleasant. Barriers to care included fear, embarrassment, lack of money, living chaotic lifestyles, not prioritising dental care and difficulties finding an NHS dentist that would take on homeless people. Service provision for homeless and/or hard-to-reach patients needs to be proactive with dental staff going to community settings and making personal contact. CONCLUSION: Crucially, providers must acknowledge that the patients are vulnerable. A successful service needs to be informal, adapt to patient needs and accommodates chaotic lives.

Estilos sanos de vida en adultos con discapacidad intelectual: qué conocen, factores que los benefician y dificultan / No disponible

Las personas con discapacidad intelectual son más propensas a tener problemas de salud que las que no la tienen. Hasta ahora se ha investigado poco la salud desde la perspectiva de las propias personas con discapacidad intelectual. Intentamos centrarnos sobre qué es lo que estas personas entienden por estar sanos, y cuáles son sus experiencias sobre los estilos sanos de vida. Se llevaron a cabo entrevistas semiestructuradas a 13 adultos con discapacidad intelectual para preguntarles sobre su salud y estilos sanos de vida. Los datos fueron analizados por los temas recogidos. Los participantes demostraron comprender el significado de estar sanos, llevar una dieta sana, los peligros del uso de sustancias y los beneficios del ejercicio. Mostraron cierto conocimiento sobre las razones para embarcarse en conductas sanas. Surgió la idea de la moderación, así como la existencia de factores que benefician y dificultan la implicación en un estilo sano de vida. Estos resultados sugieren que las personas con discapacidad intelectual demuestran tener cierta comprensión de lo que constituye estar sano y ser conscientes de los estilos sanos de vida, las consecuencias de conductas poco sanas y la necesidad de tener moderación (AU)

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A highly sensitive immunofluorometric assay for the measurement of aldosterone in small sample volumes: validation in mouse serum.

Data on the involvement of aldosterone in the regulation of the renin-angiotensin-aldosterone system (RAAS) in rodents are still scarce, partly due to the high sample volumes needed by commercially available assays and to the very low aldosterone concentrations present. We have developed a highly sensitive and non-isotopic immunoassay, requiring a volume of only 50 microl serum for a duplicate measurement, employing a highly specific monoclonal antibody against aldosterone. The assay was validated in human and mouse samples and exhibited a linear working range from 10 to 1000 pg/ml. Values obtained after a chromatographic purification step correlated significantly to the dichloromethane extraction ordinarily used. Basal aldosterone values were measured in 75 mouse hybrids and found within the linear range (173+/-21 pg/ml), with no significant difference between males and females. Additionally, we show an increase in serum aldosterone in mice from 3 to 11 weeks of age. Mice of the same genetic background were treated with dexamethasone intraperitoneally (n=7), resulting in significantly decreased concentrations (35+/-3 vs 114+/-33 pg/ml in controls; P<0.001). In contrast, adrenocorticotropic hormone resulted in significantly increased serum aldosterone (603+/-119 pg/ml; n=7; P<0.001), as did the physiological stimulation of the RAAS by a high K(+)/low Na(+) diet (1369+/-703 vs 172+/-36 pg/ml). In conclusion, we have developed and validated an extremely sensitive assay for determination of aldosterone concentrations from very small serum samples, which could be especially useful in pharmacological intervention studies in rodent models.

Acute effects of an alcoholic drink on food intake: aperitif versus co-ingestion.

To compare the effects on appetite and energy intake (EI) within a meal and across 4 days of drinking wine either before (aperitif) or with (co-ingestion) a meal, 11 men attended the laboratory on three occasions. On each occasion participants were given breakfast in the laboratory then 3 h later returned for a two course (garlic bread, pizza) lunch, then recorded food intake for the remainder of the day and the next 3 days. In the control condition, participants ate lunch ad libitum; in the aperitif condition 375 ml of red wine was consumed 20 min before lunch; and in the co-ingestion condition 125 ml of red wine was consumed with the starter and 250 ml of red wine was consumed with the main course. Subjective ratings of appetite and mood were administered before and after the meal. EI at lunch was greater when wine was consumed (p<0.01) (aperitif: 6436+/-435 kJ; co-ingestion: 6254+/-417 kJ) compared to control (5125+/-262 kJ). In particular, intake of the starter was enhanced by wine consumption. Having wine as an aperitif significantly influenced subjective ratings of light headedness and fatigue. These results suggest that the effects of wine on appetite are immediate, and stimulate food intake early in the meal. Total EI during the test days was significantly higher than during subsequent days revealing a tendency to overeat in the laboratory, exacerbated by drinking wine before or with lunch. However, lean healthy men adjusted total EI on the days following the laboratory in all conditions.

Pleasure and alcohol: manipulating pleasantness and the acute effects of alcohol on food intake.

To examine the effects of manipulating pleasantness on subsequent energy intake following a moderate dose of alcohol, 12 males attended the laboratory on four occasions. On each occasion participants consumed breakfast then 4 h later were offered lunch. Twenty minutes before lunch participants received an alcohol (24 g ethyl alcohol, 1508 kJ, 405 ml) or a no-alcohol (867 kJ, 405 ml) containing beverage followed by a lunch of either "bland" (rated pleasantness=66+/-13 mm) or "flavoured" (73+/-10 mm) foods. Subjective ratings of appetite, mood and pleasantness of several bland and tasty foods were taken before and after preloads and lunch. Ad libitum energy intake at lunch was greater following alcohol in both taste conditions (p<0.01) (Alcohol/Bland, 2053+/-663 kJ; Alcohol/Flavoured, 1989+/-580 kJ) in comparison to the no-alcohol conditions (No-alcohol/Bland, 1548+/-357 kJ; No-alcohol/Flavoured 1670+/-401 kJ). No additive effect of palatability and alcohol was found; alcohol did not differentially affect intake of lunch items. Nor did alcohol increase the pleasantness of foods. Sensory specific satiety (SSS) was observed both following the preload and following lunch, with no discernible effects of alcohol on SSS. In conclusion, alcohol promoted food intake but this did not occur via the additive effects of alcohol and palatability nor through increasing the pleasantness of the taste of foods. Further research on the mechanism underlying the stimulating effects of alcohol on appetite is warranted.

Dose-dependent effects of alcohol on appetite and food intake.

To examine the potential dose-response effect of alcohol on appetite and food intake, 12 males attended the laboratory on three occasions. On each occasion, they were given a standard breakfast, then lunch 3 h later, and dinner, 4 h after that. Thirty minutes before lunch, Ss received 330 ml of no-alcohol lager (263 kJ: no-alcohol condition), the same amount of lager spiked with 1 unit (1 UA: 8 g ethyl alcohol, 498.2 kJ) or 4 units of alcohol (4 UA: 32 g ethyl alcohol, 1203.8 kJ). Visual analogue scale (VAS) ratings of appetite and mood were recorded before and after preloads and lunch, then hourly across the day. Intake at lunch (excluding energy from the preload) was significantly higher following 4 UA (5786+/-991 kJ) compared to 1 UA (4928+/-1245 kJ). Participants consumed more high-fat salty food items at lunch following 4 UA compared to the other preloads. Hunger was rated higher following 4 UA across the day in comparison to the other preloads, but fullness ratings failed to reflect any difference by condition. Energy intake at dinner was similar in all conditions and total energy intake across the day was significantly higher after 4 UA (14,615+/-1540 kJ) than after 1 UA (13,204+/-2156 kJ). In conclusion, above a certain threshold, alcohol appears to stimulate appetite in part, due to elevated levels of subjective hunger. When this occurs, energy intake is not reduced at subsequent meals. Thus, alcohol may contribute to positive energy balance via its additive effects to total energy intake and by short-term appetite stimulation.

[Aspects of integral anti-tuberculosis chemotherapy in 15 rural medical stations of the Constanta district]. / Aspecte ale integrarii chimioterapiei antituberculoase la nivelul a 15 circumscriptii rurale din judetul Constanta

The study of aspects of integration of chemotherapy during the initial stages of the anti-tuberculous treatment, carried out in 15 rural medical circumscriptions in the Constantza and mpedgidia anti-tuberculous dispensaries, has demonstrated the applicability of standardized chemotherapy schemes at the level of general practice network. The personnel working in the frame of this network showed considerable interest and preoccupation with the optimal achievement of the strictly supervised treatment. The results of bacteriological controls (direct BK examination and cultures), indicated that in 97,4% of the cases these results are maintained negative in patients that could be evaluated. An assessment of this action revealed that the indices showing the incorporation of patients in the strictly supervised treatment as well as the regularity of the administration have been very good.