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Pharmacy education for sustainable healthcare: a UK progress update and call to action
No full textThe pharmacy profession is currently facing significant challenges, including increased service demand, managing medication shortages, and financial pressures. Given these pressing issues, it is understandable that the more obscure threat of climate change may not be a top priority for many pharmacy professionals. The climate and ecological crisis represent the greatest health threat that humanity has ever faced. Human health is already impacted both in the UK and globally, but the effects are gradual and insidious, making the direct link difficult to see. To effectively tackle this challenge, it is essential that we first acknowledge climate and ecological breakdown and then seek to understand the specific problems it presents so that we can identify solutions for mitigation and adaptation going forward. This underscores the importance of integrating education on planetary health and sustainable healthcare into training for all pharmacy professionals—to raise awareness of the challenges so that we can work together toward viable solutions
Update to Trial Forge Guidance 2:Addition of the Value of Information Criterion
No full textTrial Forge Guidance 2 helps trial teams decide if another Study within A Trial (SWAT) is needed to answer an existing research question. Five criteria are listed to assist decision making. We are adding a sixth criterion, the Value of Information, to additionally consider the potential time and financial constraints of improving trial process evidence. The Value of Information criterion assesses each trial process based on its value of additional research and value of implementation. We consider evaluations of recruitment and retention strategies as exemplars of how such an approach could be applied to randomised evaluations of trial processes via SWATs. We applied the Value of Information Analysis to all recruitment strategies and categorised them according to their expected benefits in terms of improved recruitment, as well as the level of statistical uncertainty compared to other recruitment strategies. The same approach was followed for retention strategies. To support its use, we have developed an electronic tool that calculates and presents the criterion results for each available evaluation of recruitment and retention strategies. This will enable trial teams apply the Value of Information criterion, along with the five existing criteria of Trial Forge Guidance 2, when deciding if further SWATs should be prioritised for a particular trial process strategy to provide evidence for the strategy’s use, or not during a trial
Electronic patient-reported adverse event monitoring in academic early-phase clinical trials: a feasibility study
Get PDFBackground:
Adverse event monitoring is essential to monitor safety for oncology patients on early-phase clinical trials. Previous research considers that electronic patient-reported adverse events reporting is feasible and complementary to traditional clinician-led recording. An electronic patient-reported adverse event system was developed to explore the feasibility of this in early trials patients.
Methods:
A prospective single-arm feasibility study was undertaken at two recruiting hospitals. Participants were adult oncology patients who had recently (<1 month) started receiving a novel anticancer treatment on an academic early-phase trial and had access to the Internet. For a 12-week period, weekly reminders were sent to participants to complete an electronic patient-reported adverse event questionnaire remotely covering symptoms identified as relevant to the recruiting trials. The primary outcome was compliance (proportion of completed questionnaires/expected completions). Secondary outcomes included recruitment rates, attrition, electronic patient-reported outcome versus clinician-recorded adverse events, number of notifications, issues recorded, and patient acceptability.
Results:
Twenty-three participants consented (76.7% consent rate), 18 remained on study at 12 weeks (4 were withdrawn due to toxicity and 1 patient choice). Compliance with weekly electronic patient-reported adverse event was high, with a cumulative of 85.1% across the 12 weeks. Comparison with clinician-recorded adverse events showed electronic patient-reported adverse event resulted in wider coverage of adverse events: three times as many symptoms reported on electronic patient-reported adverse event (n = 174 last assessment) than recorded in the medical charts (n = 50 last record). End-of-study feedback indicated most patients reflected positively on their time on the study.
Conclusions:
Remote electronic patient-reported adverse event reporting by patients in early-phase trials is feasible and acceptable. The study highlights some logistical challenges that require consideration in future electronic patient-reported outcome work to ensure adverse events are fully captured and recorded.
Trial registration:
ClinicalTrials.gov ID: NCT03461939 (first registered: 05/03/2018
Examining the influence of target–distractor similarity on difficulty in a working memory game
Get PDFVideo games often feature complex game environments, with many elements irrelevant to the current task, which may distract from goal-relevant information. From a game design perspective, this increased difficulty factor may either be desired or lead to unwanted consequences and accessibility concerns. Evidence from cognitive science suggests that information processing is more susceptible to distracting items similar to the target. The current study therefore investigated the effects of target–distractor similarity on difficulty in a Working Memory (WM) game that requires participants to memorise a target path on a grid. Distractors with varying similarity to the path were presented either simultaneously with the path (encoding period), or after the path has disappeared (delay period). Results revealed that distractors generally led to poorer performance, and further that performance gradually declined with increasing target–distractor similarity during memory encoding. Exploratory analyses between performance and player experience suggest that higher success rates may be related to higher ratings of enjoyment. The present findings highlight the importance of considering the visual design of goal-relevant and task-irrelevant surrounding elements to provide an optimal challenge level and ensure positive player experiences in video games that place demand on WM capabilities
Discrimination in the Local Welfare State
Get PDFR (LL and AU) v Trafford Metropolitan Council [2025] EWHC 2380 (Admin) represents the most comprehensive judicial scrutiny of a local welfare scheme to date. The claimants succeeded on all grounds: Trafford's Council Tax Reduction Scheme was unlawfully adopted, breached the Public Sector Equality Duty, was irrational, and contravened ss.15 and 19 of the Equality Act 2010. Trafford illustrates the broader public law challenges posed by the localisation of council tax support since 2013. Instead of one national benefit, there are now 296 separate means-tested schemes operating across England. With each having its own eligibility criteria and administration, the risks of unlawful, discriminatory, and irrational decision-making are considerable. This case comment argues that Trafford illustrates how the localisation of council tax support generates risks that outweigh its purported benefits and adds further weight to the argument that council tax support should be restored as a national benefit
Integrating dynamic features into machine learning models for predicting sewer network failures: a Random Forest approach
Get PDFSewer blockages and flooding remain persistent challenges. Water utilities often deploy labour-intensive, iteratrive approaches, such as repeated CCTV inspections and jetting, to detect and address these problems. Recently, machine learning (ML) based asset failure prediction has emerged as a cost-effective alternative, enabling proactive identification of vulnerable pipe sections that can then be the focus for inspection and intervention. Early ML-based predictive models primarily focused on non-dynamic factors, such as physical pipe attributes, while newer approaches have incorporated dynamic variables like rainfall and pipe flow, resulting in significant accuracy improvements. This study examines the integration of sediment transport mechanics, using network hydraulic model derived parameters, into a predictive Random Forest (RF) model. Results demonstrate that incorporating dynamic features representing sediment transport capacity and its spatial variation considerably enhances the RF model’s predictive power, offering a more reliable tool for identifying and managing blockages, and flooding in combined sewer networks
Held out wings RNA binding activity in the cytoplasm during early spermatogenesis
No full textHeld out wings (HOW) is an RNA-binding protein essential for spermatogenesis in Drosophila melanogaster. HOW is a signal transduction and activation of RNA (STAR) protein, regulating post-transcriptional gene expression. The characteristics of RNA-binding by the conserved short cytoplasmic isoform, HOW(S), are unknown. In vivo RIP-seq identified 121 novel transcripts bound by HOW(S) in germ stem cells and spermatogonia, many with signal transduction functions. (A/G/U)CUAAC motifs were enriched in 3’-UTRs and GCG(A/U)G in 5’-UTRs. HOW binds with high affinity to sites containing CUAAC motifs from lola and hipk mRNAs. The binding of cytoplasmic HOW(S) specifically to CUAAC motifs in 3’-UTRs can result in stabilization or destabilization of mRNAs and translational regulation potentially depending on position of binding, number of sites and interacting partners. This study provides new insight into STAR protein-RNA interactions and functions in spermatogenesis
Eyring–Polanyi Rate Theory for the Homogeneous Nucleation of Organic Crystals from Solution
Get PDFUsing elementary concepts of chemical reaction kinetics, the rates of primary homogeneous organic crystal nucleation from supersaturated solutions are modeled as nucleation with first order kinetics from large solute density fluctuations (LSDFs). Solute density fluctuations are modeled as diffusively driven many-body collisions of weakly interacting solvated solute molecules. The first order rate constant is a system-specific supersaturation-independent rate constant for nucleation in LSDFs. It is shown for several solute–solvent systems that the temperature-dependence of this nucleation rate constant exhibits Arrhenius behavior. The activation enthalpy (ΔH⧧) and activation entropy (ΔS⧧) for homogeneous nucleation is determined from an Eyring–Polanyi analysis of temperature-dependent nucleation rates. The steps of the Eyring–Polanyi analysis are described in detail for the homogeneous nucleation of l-histidine from aqueous solutions. The analysis is also applied to temperature-dependent homogeneous nucleation rates of salicylic acid in four different solvents. For all systems, the supersaturation- and the temperature-dependence of the primary homogeneous nucleation rates are completely reproduced by reference to temperature-dependent solubility data through the activation parameters ΔH⧧ and ΔS⧧. ΔH⧧ is for all examined systems approximately 12 times the enthalpy of solution determined from solubility data, suggesting that nucleation from LSDFs resembles, at the molecular level, a reverse dissolution process. Within the temperature ranges used for measuring nucleation rates, the Gibbs energy of activation ΔG⧧ does not vary strongly, resulting in an inverse correlation between enthalpies and entropies of activation. The Eyring–Polanyi framework thus provides, for the first time, a method for semiquantitative predictions of homogeneous nucleation rates from temperature-dependent solubilities
Surface Tension Isotherms:Reconceptualizing Adsorption, Self-Assembly, and Micelle Formation via the Fluctuation Theory
No full textRethinking consumer convenience as a barrier to reusable packaging systems
Get PDFReusable packaging systems have been recognised as a part of sustainability and circular economy transitions but they are widely considered to be inconvenient for the consumer. This article challenges the notion that reuse systems are necessarily inconvenient by drawing attention to reuse practices, differences between reusable packaging systems, and associated complexes of consumption practices. Theoretical insights from studies of convenience food and meal planning are used to inform our approach to convenience and convenient practices. In the UK, recent reusable packaging trials in mainstream retail have offered consumers the opportunity to participate in reusable packaging systems as part of their otherwise ordinary consumption. Based on qualitative research conducted with reusable packaging system users participating in these trial systems and others during this time, three practice complexes are identified and examined. These are bulk buying, organisational practices and weekly shopping. The analysis of these complexes provides insight into difficult aspects of reusable packaging systems, while separating discussion of these aspects from areas which would change with system transition. This locates the niche position of reusable packaging systems within a potential transition process and reiterates the importance of considering convenience in context
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