Pharmaceutical Science without borders: The 8th APS International PharmSci 2017

The Academy of Pharmaceutical Sciences (APSGB) is delighted to partner with the British Journal of Pharmacy to publish key abstracts of posters presented at this year’s APS PharmSci Conference held at the University of Hertfordshire 5th to 7th September 2017. The Conference is the premier pharmaceutical sciences event in the UK focussing on ‘The Science of Medicines’ and covers all aspects related to the discovery, development, production and testing of drug products

Applying health psychology principles and practice to adoption and maintenance of physical activity

Background: Many mid-life and older adults are not achieving recommended physical activity (PA) targets and effective interventions are needed to increase and maintain PA long-term for health benefits. The PACE-UP trial, a three armed primary care pedometer-based walking intervention in those aged 45-75 years, demonstrated increased PA levels at 12 months. A three-year follow-up was conducted to evaluate long-term PA maintenance, including a qualitative component. Aim: To examine facilitators and barriers to PA maintenance in mid-life and older adults previously involved in a PA trial. Method: Semi-structured telephone interviews were conducted, three years post intervention, with 60 PACE-UP participants across all three study arms. Interviews were audio-recorded, transcribed verbatim and coded independently by researchers, prior to thematic analysis. Findings: Two thirds of participants felt that since the PACE UP trial they had an increased awareness of their PA, with the pedometer reported as ‘kick-starting’ regular activity, and then helping them to maintain regular activity. PA facilitators included: maintaining good health, self-motivation, social support and good weather. Lack of time was the most frequently cited barrier. Other barriers were often the inverse of the facilitators; for example, poor health and bad weather. Participants described the type of ‘top-up’ interventions they would find beneficial to aid PA maintenance (e.g., text messages, online resources and walking groups). Conclusion: A challenge for future PA interventions is to transform barriers into facilitators; for example, educating trial participants about the value of PA for many chronic health conditions to change this from inhibiting to promoting PA. Participants provided ideas for encouraging PA maintenance which could be incorporated into future interventions

Die weisse Zelle des Faschismus. Die Große Deutsche Kunstausstellung und die Entartete Kunst

Zur Zeit des Nationalsozialismus etablierte sich ein neues Raumkonzept für Ausstellungen, das die ideologischen Grundmuster der faschistischen Kunstauffassung transportierte. Während zuvor der Raum mit dem Bereich zwischen Objekten und Subjekten gebildet wurde, konstituierte das neuere Modell die Wand als abgrenzende Hülle. Umgeben von diesem architektonischen Element konnten Dinge und Menschen kontrolliert werden. Im Kontext der Ausstellung wurden sie so zum Teil des politischen Systems, was den Dogmen des totalitären Regimes entsprach. Dieser Paradigmenwechsel soll in diesem Essay anhand der beiden Ausstellungen Große Deutsche Kunstausstellung (GDK, 1937–1944) und Entartete Kunst (1937) aufgezeigt werden. Das neue Konzept beeinflusst die meisten musealen Räume bis heute. Spätestens in den 1970er Jahren wurde dieses Modell unter dem Label „White Cube“ zu einer der populärsten Gestaltungsweisen von Ausstellungsräumen

Effectiveness of adult community-based physical activity interventions with objective physical activity measurements and long-term follow-up: a systematic review and meta-analysis.

OBJECTIVE: To identify randomised controlled trials (RCTs) of physical activity (PA) interventions with objective PA outcomes in adults and to evaluate whether intervention effects were sustained beyond 12 months. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Seven databases (Medline, Embase, PsycINFO, Web of Science, Cochrane library, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and ASSIA (Applied Social Sciences Index and Abstracts)) were searched from January 2000 until December 2019. ELIGIBILITY CRITERIA: RCTs reporting objective PA outcomes beyond 12 months with community-based participants aged ≥18 years were included; those where controls received active interventions, including advice to increase PA levels, were excluded. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers completed extraction of aggregate data and assessed risk of bias. Meta-analyses used random-effects models at different follow-up points. Primary outcomes were daily steps and weekly minutes of moderate-to-vigorous PA (MVPA). RESULTS: Of 33 282 records identified, nine studies (at generally low risk of bias) were included, five in meta-analyses with 12 months to 4 year follow-up. We observed 12 month increases for intervention vs control participants in steps/day (mean difference (MD)=554 (95% CIs: 384 to 724) p<0.0001, I2=0%; 2446 participants; four studies) and weekly MVPA minutes (MD=35 (95% CI: 27 to 43) p<0.0001, I2=0%; 2647 participants; four studies). Effects were sustained up to 4 years for steps/day (MD=494 (95% CI: 251 to 738) p<0.0001, I2=0%; 1944 participants; four studies) and weekly MVPA minutes (MD=25 (95% CI: 13 to 37) p<0.0001, I2=0%; 1458 participants; three studies). CONCLUSIONS: There are few PA interventions with objective follow-up beyond 12 months, more studies are needed. However, this review provided evidence of PA intervention effects beyond 12 months and sustained up to 4 years for both steps/day and MVPA. These findings have important implications for potential long-term health benefits. PROSPERO REGISTRATION NUMBER: CRD42017075753

How, when and why do young women use nutrition information on food labels? A qualitative analysis

Background. Nutrition information on food packaging offers a public health tool which could be used to promote informed consumer choice and aid consumption of a healthy diet. Research indicates that use of nutrition information can lead to reduced energy intake and lower BMI, but little evidence is available regarding how, when or why people use nutrition information when making everyday food choices. Methods. This qualitative study explored motivations and contexts surrounding the use of nutrition information among 25 UK-based female nutrition information users aged 23-35 years, using semi-structured individual interviews. Verbatim transcripts were analysed using thematic analysis. Results. Six themes were identified: (1) understanding and (2) functions of nutrition information, (3) health versus appearance motives, nutrition information use in (4) affective and (5) symbolic food episodes, and (6) competing point-of-purchase influences. Notable observations included a difficulty in understanding and converting nutrition information into personally meaningful terms, and eschewal of nutrition information in settings where food plays an affective or symbolic role (e.g. food consumption after a stressful day, buying food for a dinner party). Conclusions. We suggest evidence-based directions for future research and offer policy and practice recommendations, including the adoption of clear and consistent nutrition information formats

The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults.

BACKGROUND: Step-count monitors (pedometers, body-worn trackers and smartphone applications) can increase walking, helping to tackle physical inactivity. We aimed to assess the effect of step-count monitors on physical activity (PA) in randomised controlled trials (RCTs) amongst community-dwelling adults; including longer-term effects, differences between step-count monitors, and between intervention components. METHODS: Systematic literature searches in seven databases identified RCTs in healthy adults, or those at risk of disease, published between January 2000-April 2020. Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcome was mean differences (MD) with 95% confidence intervals (CI) in steps at follow-up between treatment and control groups. Our preferred outcome measure was from studies with follow-up steps adjusted for baseline steps (change studies); but we also included studies reporting follow-up differences only (end-point studies). Multivariate-meta-analysis used random-effect estimates at different time-points for change studies only. Meta-regression compared effects of different step-count monitors and intervention components amongst all studies at ≤4 months. RESULTS: Of 12,491 records identified, 70 RCTs (at generally low risk of bias) were included, with 57 trials (16,355 participants) included in meta-analyses: 32 provided change from baseline data; 25 provided end-point only. Multivariate meta-analysis of the 32 change studies demonstrated step-counts favoured intervention groups: MD of 1126 steps/day 95%CI [787, 1466] at ≤4 months, 1050 steps/day [602, 1498] at 6 months, 464 steps/day [301, 626] at 1 year, 121 steps/day [- 64, 306] at 2 years and 434 steps/day [191, 676] at 3-4 years. Meta-regression of the 57 trials at ≤4 months demonstrated in mutually-adjusted analyses that: end-point were similar to change studies (+ 257 steps/day [- 417, 931]); body-worn trackers/smartphone applications were less effective than pedometers (- 834 steps/day [- 1542, - 126]); and interventions providing additional counselling/incentives were not better than those without (- 812 steps/day [- 1503, - 122]). CONCLUSIONS: Step-count monitoring leads to short and long-term step-count increases, with no evidence that either body-worn trackers/smartphone applications, or additional counselling/incentives offer further benefit over simpler pedometer-based interventions. Simple step-count monitoring interventions should be prioritised to address the public health physical inactivity challenge. SYSTEMATIC REVIEW REGISTRATION: PROSPERO number CRD42017075810

Meeting commentary-"Medicines for older adults: Learning from practice to develop patient centric drug products"

A meeting jointly organised by the Academy of Pharmaceutical Sciences (APSGB), the Geriatric Medicine Society and the UCL School of Pharmacy took place on the 13th of March 2013, in Stevenage, UK [*]. The meeting was attended by a number of experts involved with the treatment and development of drugs for the older adult, including clinicians, pharmacists, academics, regulators and representatives from industry. The event created the platform to discuss the provision of medicines for older adults from a pharmaceutical sciences perspective

Age-Related Medicine

A meeting organised by the Academy of Pharmaceutical Sciences focussed on the challenges of developing medicines for older adults. International experts discussed the complexity introduced by polypharmacy and multiple morbidities and how the risk–benefit ratio of a medicine changes as an individual ages. The way in which regulatory authorities are encouraging the development of age-appropriate medicines was highlighted. Examples were provided of the difficulties faced by the older population with some medicinal products and suggestions given as to how the pharmaceutical scientist can build the requirements of the older population into their development of new medicines, as well as improvements to existing ones

Nanomedicines for the delivery of biologics

A special symposium of the Academy of Pharmaceutical Sciences Nanomedicines Focus Group reviewed the current status of the use of nanomedicines for the delivery of biologics drugs. This meeting was particularly timely with the recent approval of the first siRNA-containing product Onpattro™ (patisiran), which is formulated as a lipid nanoparticle for intravenous infusion, and the increasing interest in the use of nanomedicines for the oral delivery of biologics. The challenges in delivering such molecules were discussed with specific emphasis on the delivery both across and into cells. The latest developments in Molecular Envelope Technology® (Nanomerics Ltd, London, UK), liposomal drug delivery (both from an academic and industrial perspective), opportunities offered by the endocytic pathway, delivery using genetically engineered viral vectors (PsiOxus Technologies Ltd, Abingdon, UK), Transint™ technology (Applied Molecular Transport Inc., South San Francisco, CA, USA), which has the potential to deliver a wide range of macromolecules, and AstraZeneca’s initiatives in mRNA delivery were covered with a focus on their uses in difficult to treat diseases, including cancers. Preclinical data were presented for each of the technologies and where sufficiently advanced, plans for clinical studies as well as early clinical data. The meeting covered the work in progress in this exciting area and highlighted some key technologies to look out for in the future