Clinical Trials Unit Newsletter - Issue 01

What\u27s inside this issue: AKU receives JCIA reaccreditation - Clinical Trials Unit rejoice Director’s Message Informative Snippets AKU Site Surpasses Target Sample Size in the D-LIVR Global Trial Clinical Trials Unit celebrates World Pharmacists Day WHO Delegation at the Clinical Trials Unit Keynote Address at RMI\u27s Symposium Impact Report - Covid-19 Studies Impact Snapshot for the year 2024https://ecommons.aku.edu/arch_research_publications_university-wide_ctu/1000/thumbnail.jp

Realization of the farad from the dc quantum Hall effect with digitally-assisted impedance bridges

A new traceability chain for the derivation of the farad from dc quantum Hall effect has been implemented at INRIM. Main components of the chain are two new coaxial transformer bridges: a resistance ratio bridge, and a quadrature bridge, both operating at 1541 Hz. The bridges are energized and controlled with a polyphase direct-digital-synthesizer, which permits to achieve both main and auxiliary equilibria in an automated way; the bridges and do not include any variable inductive divider or variable impedance box. The relative uncertainty in the realization of the farad, at the level of 1000 pF, is estimated to be 64E-9. A first verification of the realization is given by a comparison with the maintained national capacitance standard, where an agreement between measurements within their relative combined uncertainty of 420E-9 is obtained.Comment: 15 pages, 11 figures, 3 table

Clinical Trials Unit Newsletter - Issue 02

What\u27s inside this issue: The Clinical Trials Summit of Pakistan 2025 Biosimilar trials at CTU! Completion of the Panbio Self-Test Enrolment Coming Together for Better Cancer Care Informative Snippets Clinical Trials Unit celebrates Clinical Trials Day Happenings! Achievements Trials Recruiting Now Trials Completed Publications Upcoming Eventshttps://ecommons.aku.edu/arch_research_publications_university-wide_ctu/1001/thumbnail.jp

Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials

Background Osteoarthritis (OA) is the most common long-term condition managed in UK general practice. However, care is suboptimal despite evidence that primary care and community-based interventions can reduce OA pain and disability. Objectives The overall aim was to improve primary care management of OA and the health of patients with OA. Four parallel linked workstreams aimed to (1) develop a health economic decision model for estimating the potential for cost-effective delivery of primary care OA interventions to improve population health, (2) develop and evaluate new health-care models for delivery of core treatments and support for self-management among primary care consulters with OA, and to investigate prioritisation and implementation of OA care among the public, patients, doctors, health-care professionals and NHS trusts, (3) determine the effectiveness of strategies to optimise specific components of core OA treatment using the example of exercise and (4) investigate the effect of interventions to tackle barriers to core OA treatment, using the example of comorbid anxiety and depression in persons with OA. Data sources The North Staffordshire Osteoarthritis Project database, held by Keele University, was the source of data for secondary analyses in workstream 1. Methods Workstream 1 used meta-analysis and synthesis of published evidence about effectiveness of primary care treatments, combined with secondary analysis of existing longitudinal population-based cohort data, to identify predictors of poor long-term outcome (prognostic factors) and design a health economic decision model to estimate cost-effectiveness of different hypothetical strategies for implementing optimal primary care for patients with OA. Workstream 2 used mixed methods to (1) develop and test a ‘model OA consultation’ for primary care health-care professionals (qualitative interviews, consensus, training and evaluation) and (2) evaluate the combined effect of a computerised ‘pop-up’ guideline for general practitioners (GPs) in the consultation and implementing the model OA consultation on practice and patient outcomes (parallel group intervention study). Workstream 3 developed and investigated in a randomised controlled trial (RCT) how to optimise the effect of exercise in persons with knee OA by tailoring it to the individual and improving adherence. Workstream 4 developed and investigated in a cluster RCT the extent to which screening patients for comorbid anxiety and depression can improve OA outcomes. Public and patient involvement included proposal development, project steering and analysis. An OA forum involved public, patient, health professional, social care and researcher representatives to debate the results and formulate proposals for wider implementation and dissemination. Results This programme provides evidence (1) that economic modelling can be used in OA to extrapolate findings of cost-effectiveness beyond the short-term outcomes of clinical trials, (2) about ways of implementing support for self-management and models of optimal primary care informed by National Institute for Health and Care Excellence recommendations, including the beneficial effects of training in a model OA consultation on GP behaviour and of pop-up screens in GP consultations on the quality of prescribing, (3) against adding enhanced interventions to current effective physiotherapy-led exercise for knee OA and (4) against screening for anxiety and depression in patients with musculoskeletal pain as an addition to current best practice for OA. Conclusions Implementation of evidence-based care for patients with OA is feasible in general practice and has an immediate impact on improving the quality of care delivered to patients. However, improved levels of quality of care, changes to current best practice physiotherapy and successful introduction of psychological screening, as achieved by this programme, did not substantially reduce patients’ pain and disability. This poses important challenges for clinical practice and OA research. Limitations The key limitation in this work is the lack of improvement in patient-reported pain and disability despite clear evidence of enhanced delivery of evidence-based care. Future work recommendations (1) New thinking and research is needed into the achievable and desirable long-term goals of care for people with OA, (2) continuing investigation into the resources needed to properly implement clinical guidelines for management of OA as a long-term condition, such as regular monitoring to maintain exercise and physical activity and (3) new research to identify subgroups of patients with OA as a basis for stratified primary care including (i) those with good prognosis who can self-manage with minimal investigation or specialist treatment, (ii) those who will respond to, and benefit from, specific interventions in primary care, such as physiotherapy-led exercise, and (iii) develop research into effective identification and treatment of clinically important anxiety and depression in patients with OA and into the effects of pain management on psychological outcomes in patients with OA. Trial registration Current Controlled Trials ISRCTN06984617, ISRCTN93634563 and ISRCTN40721988. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research Programme and will be published in full in Programme Grants for Applied Research Programme; Vol. 6, No. 4. See the NIHR Journals Library website for further project information. </jats:sec

Technical report to International Development Research Centre on the Internet Governance Ministerial Briefing Seminar, Anguilla, 18th – 20th April, 2007

The Caribbean Community (CARICOM) requested that the Caribbean Telecommunications Union (CTU) address issues of Internet Governance (IG). This report covers those activities with a summation regarding Internet governance, access to telecommunications, and the potential for ICT in education. Participants of the briefing seminar gained understanding of the evolution of the Internet, and technicalities that are associated with its development. There is recognition of the need for regional cooperation and collaboration about Internet Governance issues, and regional involvement at the international level with regards to global policy

Critical coastal values impacted by marine bioinvasions: What the public value about marine and coastal areas and what is at stake?

Understanding values of coastal areas that the public hold, and which values would potentially be impacted by non-indigenous marine species (NIMS) and subsequent management actions, are necessary to predict social responses to marine biosecurity interventions. With that in mind, we used survey data from a representative sample of the New Zealand population (n = 1001) to spatially identify the public’s values of coastal areas, and societal ‘hotspots’, which are either value-rich or vulnerable to the impacts of NIMS and/or management actions, and examined socio-demographic patterns in the public’s valuation of beaches and coastal areas. We used three different value categorisations to capture the large spectrum of public values in this dynamic context. Three value indices (i.e., intensity, richness, and diversity of values) were adopted for each categorisation. Our findings highlight the highly multidimensional characteristics of the values people held for marine and coastal areas; a large part of which were unrepresented using ecosystem service approaches. Moreover, the identified societal ‘hotspots’ were spatially different using different value categorisations and different value indices. These outcomes suggest a need for a comprehensive societal value typology that ensures that the public is heard, and that the identified values are accurate and meaningful. The public valuation of beach and coastal areas was different among gender, educational backgrounds, respondents’ residential city sizes, and the relative location between respondents’ hometown and their favourite beaches. The recognition of these demographic patterns can inform marine biosecurity risk and intervention communication strategies