Clinical trial reporting performance of thirty UK universities on ClinicalTrials.gov-evaluation of a new tracking tool for the US clinical trial registry.

Clinical trial transparency forms the foundation of evidence-based medicine, and trial sponsors, especially publicly funded institutions such as universities, have an ethical and scientific responsibility to make the results of clinical trials publicly available in a timely fashion. We assessed whether the thirty UK universities receiving the most Medical Research Council funding in 2017-2018 complied with World Health Organization best practices for clinical trial reporting on the US Clinical Trial Registry ( ClinicalTrials.gov ). Firstly, we developed and evaluated a novel automated tracking tool ( clinical-trials-tracker.com ) for clinical trials registered on ClinicalTrials.gov . This tracker identifies the number of due trials (whose completion lies more than 395 days in the past) that have not reported results on the registry and can now be used for all sponsors. Secondly, we used the tracker to determine the number of due clinical trials sponsored by the selected UK universities in October 2020. Thirdly, using the FDAAA Trials Tracker, we identified trials sponsored by these universities that are not complying with reporting requirements under the Food and Drug Administration Amendments Act 2007. Finally, we quantified the average and median number of days between primary completion date and results posting. In October 2020, the universities included in our study were sponsoring 1634 due trials, only 1.6% (n = 26) of which had reported results within a year of completion. 89.8% (n = 1468) of trials remained unreported, and 8.6% (n = 140) of trials reported results late. We also identified 687 trials that contained inconsistent data, suggesting that UK universities often fail to update their data adequately on ClinicalTrials.gov . The mean reporting delay after primary completion for trials that posted results was 981 days, the median 728 days. Only four trials by UK universities violated the FDAAA 2007. We suggest a number of reasons for the poor reporting performance of UK universities on ClinicalTrials.gov : (i) efforts to improve clinical trial reporting in the UK have to date focused on the European clinical trial registry (EU CTR), (ii) the absence of a tracking tool for timely reporting on ClinicalTrials.gov has limited the visibility of institutions' reporting performance on the US registry and (iii) there is currently a lack of repercussions for UK sponsors who fail to report results on ClinicalTrials.gov which should be addressed in the future

Who funded the research behind the Oxford-AstraZeneca COVID-19 vaccine?

Objectives The Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19, Vaxzevira or Covishield) builds on two decades of research and development (R&D) into chimpanzee adenovirus-vectored vaccine (ChAdOx) technology at the University of Oxford. This study aimed to approximate the funding for the R&D of ChAdOx and the Oxford-AstraZeneca vaccine and to assess the transparency of funding reporting mechanisms. Methods We conducted a scoping review and publication history analysis of the principal investigators to reconstruct R&D funding the ChAdOx technology. We matched award numbers with publicly accessible grant databases. We filed freedom of information (FOI) requests to the University of Oxford for the disclosure of all grants for ChAdOx R&D. Results We identified 100 peer-reviewed articles relevant to ChAdOx technology published between January 2002 and October 2020, extracting 577 mentions of funding bodies from acknowledgements. Government funders from overseas (including the European Union) were mentioned 158 times (27.4%), the UK government 147 (25.5%) and charitable funders 138 (23.9%). Grant award numbers were identified for 215 (37.3%) mentions; amounts were publicly available for 121 (21.0%). Based on the FOIs, until December 2019, the biggest funders of ChAdOx R&D were the European Commission (34.0%), Wellcome Trust (20.4%) and Coalition for Epidemic Preparedness Innovations (17.5%). Since January 2020, the UK government contributed 95.5% of funding identified. The total identified R&D funding was £104 226 076 reported in the FOIs and £228 466 771 reconstructed from the literature search. Conclusion Our study approximates that public and charitable financing accounted for 97%-99% of identifiable funding for the ChAdOx vaccine technology research at the University of Oxford underlying the Oxford-AstraZeneca vaccine until autumn 2020. We encountered a lack of transparency in research funding reporting

LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools

OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

American Catholics and the art of the future, 1930–1975

This dissertation proposes that considering the relationship between futurist projection and ideas about church buildings and other worship spaces illuminates the spiritual lives, theological commitments, and liturgical practices of a substantial group of mid-20th-century American Catholics. These men and women, largely well-educated, professionalized, and cosmopolitan, came to embrace an evolutionary paradigm, a way of understanding the world that saw biological principles of change, development, and adaptation at the heart of every facet of creation and every human endeavor. While other Catholics built churches to assert their presence and power, to memorialize and claim their past, the subjects of this study proposed and built churches both to forecast a new tomorrow, and to mold the future in the direction of their desire. Drawing on unpublished letters, manuscripts, and brochures and personal interviews, along with period magazines, architectural journals, advertisements, floor plans, sketches, blueprints, and both archival and original photography, I argue that the professionalized (and, de facto, ecumenical) world of art and architecture was one locus where a culture of evolution took root in the decades before the Second Vatican Council, a culture which flourished during the 1960s and 1970s. Catholic artists and architects came to believe that the future would be different from the present and the past. Along with their supporters, they both imagined and tried to bring about the future they envisioned through their creative work. The built and decorated church was, for these Catholics, the art of the future, but thinking about and recreating this environment was also to artfully recreate how the Catholic Church existed in the world as it moved towards the embrace of the cosmic Omega Point anticipated by Pierre Teilhard de Chardin, S.J., a favored theologian for many of this study\u27s subjects. Their vision of the future was informed by technological, sociological, and cultural predictions alike, as well as a passionate attempt to create a church that would engage creatively with the secular world and with other Christian denominations and other faiths

Breaking free from tunnel vision for climate change and health.

Climate change is widely recognised as the greatest threat to public health this century, but 'climate change and health' often refers to a narrow and limited focus on emissions, and the impacts of the climate crisis, rather than a holistic assessment of economic structures and systems of oppression. This tunnel vision misses key aspects of the climate change and health intersection, such as the enforcers of planetary destruction such as the military, police, and trade, and can also lead down dangerous alleyways such as 'net' zero, overpopulation arguments and green extractivism. Tunnel vision also limits health to the absence of the disease at the individual level, rather than sickness or health within systems themselves. Conceptualising health as political, ecological, and collective is essential for tackling the root causes of health injustice. Alternative economic paradigms can offer possibilities for fairer ecological futures that prioritise health and wellbeing. Examples such as degrowth, doughnut economics and ecosocialism, and their relationship with health, are described. The importance of reparations in various forms, to repair previous and ongoing harm, are discussed. Breaking free from tunnel vision is not simply an intellectual endeavour, but a practice. Moving towards new paradigms requires movement building and cultivating radical imagination. The review highlights lessons which can be learnt from abolitionist movements and progressive political struggles across the world. This review provides ideas and examples of how to break free from tunnel vision for climate change and health by highlighting and analysing the work of multiple organisations who are working towards social and economic transformation. Key considerations for the health community are provided, including working in solidarity with others, prioritising community-led solutions, and using our voice, skills, and capacity to address the structural diagnosis-colonial capitalism

Breaking free from tunnel vision for climate change and health.

Climate change is widely recognised as the greatest threat to public health this century, but 'climate change and health' often refers to a narrow and limited focus on emissions, and the impacts of the climate crisis, rather than a holistic assessment of economic structures and systems of oppression. This tunnel vision misses key aspects of the climate change and health intersection, such as the enforcers of planetary destruction such as the military, police, and trade, and can also lead down dangerous alleyways such as 'net' zero, overpopulation arguments and green extractivism. Tunnel vision also limits health to the absence of the disease at the individual level, rather than sickness or health within systems themselves. Conceptualising health as political, ecological, and collective is essential for tackling the root causes of health injustice. Alternative economic paradigms can offer possibilities for fairer ecological futures that prioritise health and wellbeing. Examples such as degrowth, doughnut economics and ecosocialism, and their relationship with health, are described. The importance of reparations in various forms, to repair previous and ongoing harm, are discussed. Breaking free from tunnel vision is not simply an intellectual endeavour, but a practice. Moving towards new paradigms requires movement building and cultivating radical imagination. The review highlights lessons which can be learnt from abolitionist movements and progressive political struggles across the world. This review provides ideas and examples of how to break free from tunnel vision for climate change and health by highlighting and analysing the work of multiple organisations who are working towards social and economic transformation. Key considerations for the health community are provided, including working in solidarity with others, prioritising community-led solutions, and using our voice, skills, and capacity to address the structural diagnosis-colonial capitalism

University patenting and licensing practices in the United Kingdom during the first year of the COVID-19 pandemic

Universities' decisions during technology transfer may affect affordability, accessibility, and availability of COVID-19 health technologies downstream. We investigated measures taken by the top 35 publicly funded UK universities to ensure global equitable access to COVID-19 health technologies between January and end of October 2020. We sent Freedom Of Information (FOI) requests and analysed universities’ websites, to (i) assess institutional strategies on the patenting and licensing of COVID-19-related health technologies, (ii) identify all COVID-19-related health technologies licensed or patented and (iii) record whether universities engaged with the Open COVID pledge, COVID-19 Technology Access Pool (C-TAP), or Association of University Technology Managers (AUTM) COVID-19 licensing guidelines during the time period assessed. Except for the Universities of Oxford and Edinburgh, UK universities did not update their institutional strategies during the first year of the pandemic. Nine universities licensed 22 COVID-19 health technologies. Imperial College London disclosed ten patents relevant to COVID-19. No UK universities participated in the Open COVID Pledge or C-TAP, but discussions were ongoing in autumn 2020. The University of Bristol endorsed the AUTM guidelines. Despite important COVID-19 health technologies being developed by UK universities, our findings suggest minimal engagement with measures that may promote equitable access downstream. We suggest universities review their technology transfer policies and implement global equitable access strategies for COVID-19 health technologies. We furthermore propose that public and charitable funders can play a larger role in encouraging universities to adopt such practices by making access and transparency clauses a mandatory condition for receiving public funds for research

The dangers of “health washing” the fossil fuel industry

Giulia Loffreda - ORCID: 0000-0003-4895-1051 https://orcid.org/0000-0003-4895-1051Item is not available in this repository.https://doi.org/10.1136/bmj.p843381pubpu