AIMTo increase public awareness and understanding of clinical research in Scotland.METHODSA generic media campaign to raise public awareness of clinical research was launched in 2008. The ‘Get Randomised’ campaign was a Scotland-wide initiative led by the University of Dundee in collaboration with other Scottish universities. Television, radio and newspaper advertising showed leading clinical researchers, general practitioners and patients informing the public about the importance of randomised clinical trials (RCTs). ‘Get Randomised’ was the central message and interested individuals were directed to the http://www.getrandomised.org website for more information. To assess the impact of the campaign, cross-sectional surveys were conducted in representative samples of 1040 adults in Scotland prior to campaign launch and again 6 months later.RESULTSThere was an improvement in public awareness of clinical trials following the campaign; 56.7% [95% confidence interval (CI) 51.8, 61.6] of the sample recalled seeing or hearing advertising about RCTs following the campaign compared with 14.8% (10.8, 18.9) prior to the campaign launch (difference = 41.4%; 95% CI for difference 35.6, 48.3; P < 0.01). Of those who recalled the advertising, 49% felt that the main message was that people should take part more in medical research. However, on whether they would personally take part in a clinical trial if asked, there was little difference in response following the campaign [‘yes’ 31.3% (28.4, 34.1) prior; 30.4% (27.6, 33.2) following; difference =−0.9%; 95% CI for difference −4.8, 3.1%; P= 0.92].CONCLUSIONSIt is possible to raise public awareness of clinical research using the media, but further efforts may be required to influence individuals' decisions to take part in clinical research.

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The proportion of all deaths due to euthanasia varies greatly between different diseases. If death does not come unexpectedly, the decision to perform euthanasia apparently depends greatly on the extent to which intolerable and hopeless suffering are experienced. This study provides some evidence that this differs not only between patients but also between diseases.

Nitric oxide (NO) is an important mediator in both health and disease. In addition to its effects on vascular tone and platelet function, it plays roles in inflammation and pain perception that may be of relevance in osteoarthritis. Many patients with osteoarthritis take nonsteroidal anti-inflammatory drugs (NSAIDs) long term for pain control. Over recent years concern has been raised about the possible cardiovascular side effects of NSAIDs. The reasons for this possible increased cardiovascular risk with NSAIDs are not yet entirely clear, although changes in blood pressure, renal salt handling and platelet function may contribute. Recently, drugs that chemically link a NSAID with a NO donating moiety (cyclo-oxygenase-inhibiting NO-donating drugs [CINODs]) were developed. NO is an important mediator of endothelial function, acting as a vasodilator and an inhibitor of platelet aggregation, and having anti-inflammatory properties. The potential benefits of CINODs include the combination of effective analgesic and anti-inflammatory actions with NO release, which might counterbalance any adverse cardiovascular effects of NSAIDs. Effects of CINODs in animal studies include inhibition of vasopressor responses, blood pressure reduction in hypertensive rats and inhibition of platelet aggregation. CINODs may also reduce ischemic damage to compromised myocardial tissue. In addition, endothelial dysfunction is a recognized feature of inflammatory arthritides, and therefore a drug that might provide slow release of NO to the vasculature while treating pain is an attractive prospect in these conditions. Further studies of the effects of CINODs in humans are required, but these agents represent a potential exciting advance in the management of osteoarthritis. IntroductionRecently issued guidelines for the management of osteoarthritis [1] have emphasized the use of lifestyle advice, weight loss, and exercise as first-line interventions in the management of osteoarthritis, followed by the addition of paracetamol or topical nonsteroidal anti-inflammatory drugs (NSAIDs). However, many patients with osteoarthritis will require the use of systemic NSAIDs for control of their pain.Recently, NSAIDs (both traditional and cyclo-oxygenase [COX]-2 selective) were linked to an increased incidence of cardiovascular events, at least in patients at increased baseline cardiovascular risk [2][3][4][5]. The degree of the risk associated with the various NSAIDs and the mechanisms underlying the link with cardiovascular events are still being investigated in large clinical trials. Findings to date have had a major influence on the use of these drugs in the management of chronic arthritic conditions, with regulatory authorities advising against the use of these drugs in patients with known cardiovascular disease or who are at high cardiovascular risk. However, many patients rely on NSAIDs to achieve adequate pain relief, and the risk/benefit ratio must be carefully considered when deciding whether to prescribe these agents. Options to amel...