The path is made by walking: knowledge, policy design and impact in Indigenous policymaking
In: Policy design and practice: PDP, Band 4, Heft 3, S. 413-425
ISSN: 2574-1292
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In: Policy design and practice: PDP, Band 4, Heft 3, S. 413-425
ISSN: 2574-1292
In: http://alzres.com/content/7/1/31
Abstract Dementia is a substantial and increasing public health concern. Despite decades of research, a cure or effective preventative treatment for dementia remains elusive. We offer critical review of contemporary dementia research and discuss potential reasons why progress in the field has not been as rapid as in other disciplines. We adopt a broad approach in keeping with the broad nature of the topic. We cover the difficulties inherent in studying dementia from 'bench' to 'bedside' to 'population'. We make particular reference to issues of operationalisation of the dementia syndrome and our evolving understanding of dementia as a research 'outcome'. We discuss contemporary 'hot topics' in dementia research methodology focussing on dementia models, pre-dementia states and biomarkers. Recognising the importance of prospective epidemiological cohorts and large-scale clinical trials we pay particular attention to these approaches and the challenges of generating results that have 'real world' external validity. Based on our thoughts we end with suggestions for future dementia research. Our review is designed to be critical but not unnecessarily negative. There is reason for cautious optimism in dementia research. The recent G8 summit on dementia and subsequent establishment of the World Dementia Council are examples of initiatives that reflect societal and political will to increase research efforts in dementia.
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Dementia is a substantial and increasing public health concern. Despite decades of research, a cure or effective preventative treatment for dementia remains elusive. We offer critical review of contemporary dementia research and discuss potential reasons why progress in the field has not been as rapid as in other disciplines. We adopt a broad approach in keeping with the broad nature of the topic. We cover the difficulties inherent in studying dementia from 'bench' to 'bedside' to 'population'. We make particular reference to issues of operationalisation of the dementia syndrome and our evolving understanding of dementia as a research 'outcome'. We discuss contemporary 'hot topics' in dementia research methodology focussing on dementia models, pre-dementia states and biomarkers. Recognising the importance of prospective epidemiological cohorts and large-scale clinical trials we pay particular attention to these approaches and the challenges of generating results that have 'real world' external validity. Based on our thoughts we end with suggestions for future dementia research. Our review is designed to be critical but not unnecessarily negative. There is reason for cautious optimism in dementia research. The recent G8 summit on dementia and subsequent establishment of the World Dementia Council are examples of initiatives that reflect societal and political will to increase research efforts in dementia.
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In: Alcohol and alcoholism: the international journal of the Medical Council on Alcoholism (MCA) and the journal of the European Society for Biomedical Research on Alcoholism (ESBRA)
ISSN: 1464-3502
In: Alcohol and alcoholism: the international journal of the Medical Council on Alcoholism (MCA) and the journal of the European Society for Biomedical Research on Alcoholism (ESBRA)
ISSN: 1464-3502
Alzheimer's disease (AD) is among the most significant health care burdens. Disappointing results from clinical trials in late-stage AD persons combined with hopeful results from trials in persons with early-stage suggest that research in the preclinical stage of AD is necessary to define an optimal therapeutic success window. We review the justification for conducting trials in the preclinical stage and highlight novel ethical challenges that arise and are related to determining appropriate risk-benefit ratios and disclosing individuals' biomarker status. We propose that to conduct clinical trials with these participants, we need to improve public understanding of AD using unified vocabulary, resolve the acceptable risk-benefit ratio in asymptomatic participants, and disclose or not biomarker status with attention to study type (observational studies vs clinical trials). Overcoming these challenges will justify clinical trials in preclinical AD at the societal level and aid to the development of societal and legal support for trial participants. ; The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement no 115736, resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007–2013) and EFPIA companies' in kind contribution.
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In order to address the oft-cited societal, economic, and health and social care impacts of neurodegenerative diseases, such as Alzheimer's disease, we must move decisively from reactive to proactive clinical practice and to embed evidence-based brain health education throughout society. Most disease processes can be at least partially prevented, slowed, or reversed. We have long neglected to intervene in neurodegenerative disease processes, largely due to a misconception that their predominant symptom — cognitive decline — is a normal, age-related process, but also due to a lack of multi-disciplinary collaboration. We now understand that there are modifiable risk factors for neurodegenerative diseases, that successful management of common comorbidities (such as diabetes and hypertension) can reduce the incidence of neurodegenerative disease, and that disease processes begin (and, crucially, can be detected, reduced, and delayed, prevented, or treated) decades earlier in life than had previously been appreciated. Brain Health Scotland, established by Scottish Government and working in partnership with Alzheimer Scotland, propose far-reaching public health and clinical practice approaches to reduce neurodegenerative disease incidence. Focusing here on Brain Health Scotland's clinical offerings, we present the Scottish Model for Brain Health Services. To our knowledge, the Scottish Model for Brain Health, built on foundations of personalised risk profiling, targeted risk reduction and prevention, early disease detection, equity of access, and harnessing comprehensive data to assist in clinical decision-making, marks the first example of a nationwide approach to overhauling clinical, societal, and political approaches to the prevention, assessment, and treatment of neurodegenerative disease.
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Funding: Brain Health Scotland, who are overseeing the development of Brain Health Services within NHS Scotland, are funded through a grant from the Scottish Government. Brain Health Scotland is hosted legally within Alzheimer Scotland who received this grant ; Peer reviewed ; Publisher PDF
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Introduction: To understand the potential influence of diversity on the measurement of functional impairment in dementia, we aimed to investigate possible bias caused by age, gender, education, and cultural differences. Methods: A total of 3571 individuals (67.1 ± 9.5 years old, 44.7% female) from The Netherlands, Spain, France, United States, United Kingdom, Greece, Serbia, and Finland were included. Functional impairment was measured using the Amsterdam Instrumental Activities of Daily Living (IADL) Questionnaire. Item bias was assessed using differential item functioning (DIF) analysis. Results: There were some differences in activity endorsement. A few items showed statistically significant DIF. However, there was no evidence of meaningful item bias: Effect sizes were low (ΔR2 range 0-0.03). Impact on total scores was minimal. Discussion: The results imply a limited bias for age, gender, education, and culture in the measurement of functional impairment. This study provides an important step in recognizing the potential influence of diversity on primary outcomes in dementia research ; The development of the Amsterdam IADL Questionnaire is supported by grants from Stichting VUmc Fonds and Innovatiefonds Zorgverzekeraars. The Amsterdam Alzheimer Center is supported by Stichting Alzheimer Nederland and Stichting VUmc Fonds. The present study is supported by a grant from Memorabel (733050205), which is the research program of the Dutch Deltaplan for Dementia. The chair of WMF is supported by the Pasman stichting. The clinical database structure for the Amsterdam Dementia Cohort was developed with funding from Stichting Dioraphte. DF, CLB and AXPR are supported by FEDER grant PSI2014-55316-C3-1-R, the Spanish National Research Agency grant PSI2017-89389-C2-1-R and the Galician Government GI-1807-USC: Ref. ED431-2017/27. GSB, JLM and the ALFA+ project has received funding from "la Caixa" Foundation (ID 100010434), under agreement LCF/PR/GN17/50300004 and the Alzheimer's Association and an international anonymous ...
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The Dementias Platform UK Data Portal is a data repository facilitating access to data for 3 370 929 individuals in 42 cohorts. The Data Portal is an end-to-end data management solution providing a secure, fully auditable, remote access environment for the analysis of cohort data. All projects utilising the data are by default collaborations with the cohort research teams generating the data. The Data Portal uses UK Secure eResearch Platform infrastructure to provide three core utilities: data discovery, access, and analysis. These are delivered using a 7 layered architecture comprising: data ingestion, data curation, platform interoperability, data discovery, access brokerage, data analysis and knowledge preservation. Automated, streamlined, and standardised procedures reduce the administrative burden for all stakeholders, particularly for requests involving multiple independent datasets, where a single request may be forwarded to multiple data controllers. Researchers are provided with their own secure 'lab' using VMware which is accessed using two factor authentication. Over the last 2 years, 160 project proposals involving 579 individual cohort data access requests were received. These were received from 268 applicants spanning 72 institutions (56 academic, 13 commercial, 3 government) in 16 countries with 84 requests involving multiple cohorts. Projects are varied including multi-modal, machine learning, and Mendelian randomisation analyses. Data access is usually free at point of use although a small number of cohorts require a data access fee.
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The Dementias Platform UK Data Portal is a data repository facilitating access to data for 3 370 929 individuals in 42 cohorts. The Data Portal is an end-to-end data management solution providing a secure, fully auditable, remote access environment for the analysis of cohort data. All projects utilising the data are by default collaborations with the cohort research teams generating the data. The Data Portal uses UK Secure eResearch Platform infrastructure to provide three core utilities: data discovery, access, and analysis. These are delivered using a 7 layered architecture comprising: data ingestion, data curation, platform interoperability, data discovery, access brokerage, data analysis and knowledge preservation. Automated, streamlined, and standardised procedures reduce the administrative burden for all stakeholders, particularly for requests involving multiple independent datasets, where a single request may be forwarded to multiple data controllers. Researchers are provided with their own secure 'lab' using VMware which is accessed using two factor authentication. Over the last 2 years, 160 project proposals involving 579 individual cohort data access requests were received. These were received from 268 applicants spanning 72 institutions (56 academic, 13 commercial, 3 government) in 16 countries with 84 requests involving multiple cohorts. Projects are varied including multi-modal, machine learning, and Mendelian randomisation analyses. Data access is usually free at point of use although a small number of cohorts require a data access fee.
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In: Bauermeister , S , Orton , C , Thompson , S , Barker , R A , Bauermeister , J R , Ben-Shlomo , Y , Brayne , C , Burn , D , Campbell , A , Calvin , C , Chandran , S , Chaturvedi , N , Chêne , G , Chessell , I P , Corbett , A , Davis , D H J , Denis , M , Dufouil , C , Elliott , P , Fox , N , Hill , D , Hofer , S M , Hu , M T , Jindra , C , Kee , F , Kim , C H , Kim , C , Kivimaki , M , Koychev , I , Lawson , R A , Linden , G J , Lyons , R A , Mackay , C , Matthews , P M , McGuiness , B , Middleton , L , Moody , C , Moore , K , Na , D L , O'Brien , J T , Ourselin , S , Paranjothy , S , Park , K S , Porteous , D J , Richards , M , Ritchie , C W , Rohrer , J D , Rossor , M N , Rowe , J B , Scahill , R , Schnier , C , Schott , J M , Seo , S W , South , M , Steptoe , M , Tabrizi , S J , Tales , A , Tillin , T , Timpson , N J , Toga , A W , Visser , P J , Wade-Martins , R , Wilkinson , T , Williams , J , Wong , A & Gallacher , J E J 2020 , ' The Dementias Platform UK (DPUK) Data Portal ' , European Journal of Epidemiology , vol. 35 , no. 6 , pp. 601-611 . https://doi.org/10.1007/s10654-020-00633-4
The Dementias Platform UK Data Portal is a data repository facilitating access to data for 3 370 929 individuals in 42 cohorts. The Data Portal is an end-to-end data management solution providing a secure, fully auditable, remote access environment for the analysis of cohort data. All projects utilising the data are by default collaborations with the cohort research teams generating the data. The Data Portal uses UK Secure eResearch Platform infrastructure to provide three core utilities: data discovery, access, and analysis. These are delivered using a 7 layered architecture comprising: data ingestion, data curation, platform interoperability, data discovery, access brokerage, data analysis and knowledge preservation. Automated, streamlined, and standardised procedures reduce the administrative burden for all stakeholders, particularly for requests involving multiple independent datasets, where a single request may be forwarded to multiple data controllers. Researchers are provided with their own secure 'lab' using VMware which is accessed using two factor authentication. Over the last 2 years, 160 project proposals involving 579 individual cohort data access requests were received. These were received from 268 applicants spanning 72 institutions (56 academic, 13 commercial, 3 government) in 16 countries with 84 requests involving multiple cohorts. Projects are varied including multi-modal, machine learning, and Mendelian randomisation analyses. Data access is usually free at point of use although a small number of cohorts require a data access fee.
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In: Bauermeister , S , Orton , C , Thompson , S , Barker , R A , Bauermeister , J R , Ben-Shlomo , Y , Brayne , C , Burn , D , Campbell , A , Calvin , C , Chandran , S , Chaturvedi , N , Chêne , G , Chessell , I P , Corbett , A , Davis , D H J , Denis , M , Dufouil , C , Elliott , P , Fox , N , Hill , D , Hofer , S M , Hu , M T , Jindra , C , Kee , F , Kim , C H , Kim , C , Kivimaki , M , Koychev , I , Lawson , R A , Linden , G J , Lyons , R A , Mackay , C , Matthews , P M , McGuiness , B , Middleton , L , Moody , C , Moore , K , Na , D L , O'Brien , J T , Ourselin , S , Paranjothy , S , Park , K S , Porteous , D J , Richards , M , Ritchie , C W , Rohrer , J D , Rossor , M N , Rowe , J B , Scahill , R , Schnier , C , Schott , J M , Seo , S W , South , M , Steptoe , M , Tabrizi , S J , Tales , A , Tillin , T , Timpson , N J , Toga , A W , Visser , P J , Wade-Martins , R , Wilkinson , T , Williams , J , Wong , A & Gallacher , J E J 2020 , ' The Dementias Platform UK (DPUK) Data Portal ' , European Journal of Epidemiology , vol. 35 , no. 6 , pp. 601-611 . https://doi.org/10.1007/s10654-020-00633-4
The Dementias Platform UK Data Portal is a data repository facilitating access to data for 3 370 929 individuals in 42 cohorts. The Data Portal is an end-to-end data management solution providing a secure, fully auditable, remote access environment for the analysis of cohort data. All projects utilising the data are by default collaborations with the cohort research teams generating the data. The Data Portal uses UK Secure eResearch Platform infrastructure to provide three core utilities: data discovery, access, and analysis. These are delivered using a 7 layered architecture comprising: data ingestion, data curation, platform interoperability, data discovery, access brokerage, data analysis and knowledge preservation. Automated, streamlined, and standardised procedures reduce the administrative burden for all stakeholders, particularly for requests involving multiple independent datasets, where a single request may be forwarded to multiple data controllers. Researchers are provided with their own secure 'lab' using VMware which is accessed using two factor authentication. Over the last 2 years, 160 project proposals involving 579 individual cohort data access requests were received. These were received from 268 applicants spanning 72 institutions (56 academic, 13 commercial, 3 government) in 16 countries with 84 requests involving multiple cohorts. Projects are varied including multi-modal, machine learning, and Mendelian randomisation analyses. Data access is usually free at point of use although a small number of cohorts require a data access fee.
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