We examined the use of in vitro (including in silico) techniques in preclinical safety testing by the pharmaceutical industry between 1980 and 2013 to determine patterns, drivers and challenges in uptake. Data were collected via a survey sent to the Association of the British Pharmaceutical Industry (ABPI) member companies from the Nonclinical and Biological Discovery Expert Network (NaBDEN) requesting the number of compounds screened using in vitro and in silico tests at 5-year intervals between 1980 and 2005 then yearly from 2008 onwards. A utility score from 1 ( poor) to 5 (excellent) for each assay was also requested. Four pharmaceutical companies and 3 contract research organisations (CROs) responded to the survey, providing >895 000 data points across all years and all assays. Overall, there was a steady increase in the use of in vitro tests by the pharmaceutical industry between 1980 and 2013; indeed >20% of all in vitro tests reported were conducted in the last year of the survey window (2013) and >70% of all in vitro tests reported were conducted since 2010. Use of in vitro tests peaked at >190 000 tests per annum in 2012; >99% of this usage was in the three main areas reported of ADME, safety pharmacology and genotoxicity. Trends and step changes in uptake were most notable in the three main areas of ADME, safety pharmacology and genotoxicity and may be explained by the timing of adoption of the relevant International Committee on Harmonisation (ICH) guidelines. Trends in uptake may also be explained by perceptions of utility where scores varied from poor (Eye Irritation -flourescein leakage) to excellent (Genotoxicity -Ames and Skin irritation -EpiSkin/Epiderm). In summary, the data show a large increase and a continuing upwards trend in development and adoption of in vitro alternatives to animal testing in pharmaceutical drug development providing new opportunities to improve success rates coupled with a strong commitment to the 3Rs. † Now at ApconiX,
Government reports have stressed the importance of community-based interventions in addressing health inequalities. This article discusses the pivotal role played by a health visitor and school nurse team in identifying the health needs of a local community and working in partnership with local people, key community groups, health and youth workers to address these specific needs. A health needs assessment highlighted the need for a parenting programme to support parents in managing young children's behaviour, a forum for teenagers to socialize and access pertinent health information and health days to raise public awareness of key community health issues. To date the parenting programme and the youth club have been implemented. Evaluation has considered how accessible, appropriate, efficient and effective they have been and the knowledge and skills gained by participants. This community development demonstrates how health promotion works through effective community action.
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