Alzheimer's Disease Biomarkers, 2009

This report gives a comprehensive and up-to-date review of Alzheimer's disease biomarkers. Recent years have seen significant advances in this field. Whilst considerable effort has focused on A�_ and tau related markers, a substantial number of other molecules have been identified, that may offer new opportunities.This Report : Identifies 60 candidate Alzheimer's (AD) biomarkers and their associated studies. Of these, 49 are single species or single parameters, 7 are combinations or panels and 4 involve the measurement of two species or parameters or their ratios. These include proteins (n=34), genes (n=11), image-based parameters (n=7), small molecules (n=3), proteins + genes (n=2) and others (n=3). Of these, 30 (50%) relate to species identified in CSF and 19 (32%) were found in the blood. These candidate may be classified on the basis of their diagnostic utility, namely those which i) may allow AD to be detected when the disease has developed (48 of 75†= 64%), ii) may allow early detection of AD (18 of 75† = 24%) and iii) may allow AD to be predicted before the disease has begun to develop (9 of 75†= 12%). † Note: Of these, 11 were linked to two or more of these capabilities (e.g. allowed both early-stage detection as well as diagnosis after the disease has developed).Biomarkers: AD biomarkers identified in this report show significant diversity, however of the 60 described, 18 (30%) are associated with amyloid beta (A�_) and 9 (15%) relate to Tau. The remainder of the biomarkers (just over half) fall into a number of different groups. Of these, some are associated with other hypotheses on the pathogenesis of AD however the vast majority are individually unique and not obviously linked with other markers. Analysis and discussion presented in this report includes summaries of the studies and clinical trials that have lead to the identification of these markers. Where it has been calculated, diagnostic sensitivity, specificity and the capacity of these markers to differentiate patients with suspected AD from healthy controls and individuals believed to be suffering from other neurodegenerative conditions, have been indicated. These findings are discussed in relation to existing hypotheses on the pathogenesis of the AD and the current drug development pipeline. Many uncertainties remain in relation to the pathogenesis of AD, in diagnosing and treating the disease and many of the studies carried out to identify disease markers are at an early stage and will require confirmation through larger and longer investigations. Nevertheless, significant advances in the identification of AD biomarkers have now been made. Moreover, whilst much of the research on AD biomarkers has focused on amyloid and tau related species, it is evident that a substantial number of other species may provide important opportunities.Purpose of Report: To provide a comprehensive review of important and recently discovered candidate biomarkers of AD, in particular those with potential to reliably detect the disease or with utility in clinical development, drug repurposing, in studies of the pathogenesis and in monitoring drug response and the course of the disease. Other key goals were to identify markers that support current pipeline developments, indicate new potential drug targets or which advance understanding of the pathogenesis of this disease.Drug Repurposing: Studies of the pathogenesis of AD have identified aberrant changes in a number of other disease areas including inflammation, diabetes, oxidative stress, lipid metabolism and others. These findings have prompted studies to evaluate some existing approved drugs to treat AD. This report identifies studies of 9 established drug classes currently being investigated for potential repurposing.Alzheimer’s Disease: In 2005, the global prevalence of dementia was estimated at 25 million, with more than 4 million new cases occurring each year. It is also calculated that the number of people affected will double every 20 years, to 80 million by 2040, if a cure is not found. More than 50% of dementia cases are due to AD. Today, approximately 5 million individuals in the US suffer from AD, representing one in eight people over the age of 65. Direct and indirect costs of AD and other forms of dementia in the US are around $150 billion annually. Worldwide, costs for dementia care are estimated at $315 billion annually. Despite significant research into this debilitating and ultimately fatal disease, advances in the development of diagnostic tests for AD and moreover, effective treatments, remain elusive.Background: Alzheimer's disease is the most common cause of dementia, yet its clinical diagnosis remains uncertain until an eventual post-mortem histopathology examination is carried out. Currently, therapy for patients with Alzheimer disease only treats the symptoms; however, it is anticipated that new disease-modifying drugs will soon become available. The urgency for new and effective treatments for AD is matched by the need for new tests to detect and diagnose the condition. Uncertainties in the diagnosis of AD mean that the disease is often undiagnosed and under treated. Moreover, it is clear that clinical confirmation of AD, using cognitive tests, can only be made after substantial neuronal cell loss has occurred; a process that may have taken place over many years. Poor response to current therapies may therefore, in part, reflect the fact that such treatments are generally commenced only after neuronal damage has occurred. The absence of tests to detect or diagnose presymptomatic AD also means that there is no standard that can be applied to validate experimental findings (e.g. in drug discovery) without performing lengthy studies, and eventual confirmation by autopsy.These limitations are focusing considerable effort on the identification of biomarkers that advance understanding of the pathogenesis of AD and how the disease can be diagnosed in its early stages and treated. It is hoped that developments in these areas will help physicians to detect AD and guide therapy before the first signs of neuronal damage appears. The last 5-10 years have seen substantial research into the pathogenesis of AD and this has lead to the identification of a substantial number of AD biomarkers, which offer important insights into this disease. This report brings together the latest advances in the identification of AD biomarkers and analyses the opportunities they offer in drug R&D and diagnostics.��

Investing Effectively in Information and Communication Technology in Schools, 2008-2013

Learning is changing. A pivotal force in bringing about this change is the use of information and communications technology (ICT) which provides richer, more immediate, world-relevant educational resources and opportunities. When used well, ICT enriches learning and enhances teaching. It invigorates classroom activities and is a powerful motivational tool that encourages learners to progress in more personalised and self-directed ways. Ireland has achieved rapid change and growth in the past decade, but to sustain this we must prepare the next generation for the knowledge society in which they will live. The challenge we face is to ensure that the emphasis on ICT in schools shifts, in the immediate future, from technology provision to a focus on its deliberate use by the learner. Fostering personal creativity has always been a desirable educational value. The pursuit of creativity and inventiveness are now pivotal skills in a knowledge economy and the embedding of ICT in learning can greatly facilitate their development. Web 2.0 will facilitate greater interactivity and enable greater levels of user-generated content. It is crucial that young people acquire the ICT and related skills to support these new opportunities.

Consumer Focused Review of Men's Food Behaviour

Increasing attention has been paid to the burden of ill-health experienced by men in many Western countries. In Europe and internationally, the Republic of Ireland has been leading the way by developing a national policy for men’s health. In most countries around the world, women now have a longer life expectancy than men. Similarly, on the island of Ireland, in spite of recent increases in men’s life expectancy, men continue to have higher death rates at all ages and from all leading causes of death. In Northern Ireland, in 2010, men’s life expectancy at birth was 77.08 years (81.53 years for women), while in the Republic of Ireland, figures published in 2009 revealed that men’s life expectancy at birth was 76.8 years (compared to 81.6 years for women). Key health issues for men include circulatory diseases, cancers and respiratory diseases. In relation to food and health, obesity has been highlighted as a major concern in relation to men’s health. While physiological difference between men and women explain some of the variation in the rate and/or onset of disease (e.g., protective effects of oestrogen in relation to the onset of cardiovascular diseases), other factors, such as socio-cultural influences, which are the main focus of this report, also play an important role. It is acknowledged that men and women experience different influences and motivations with respect to their knowledge and attitudes of and behaviours towards food and health. The purpose of this report is therefore not to compare men with women or to encourage men to model themselves on women in relation to their food and health behaviour. Rather, the goal is to provide recommendations to improve communications, resources, interventions, education and services targeted at boys and men in relation to food.

ASIST training helping to tackle suicide

Work to help communities prevent suicide has taken a further step forward with over 50 ASIST Trainers from across Northern Ireland completing the new ASIST 11 upgrader trainer course.The Applied Suicide Intervention Skills Training (ASIST) enables people in a position of trust to recognise risk and learn how to intervene to prevent the immediate risk of suicide.The Public Health Agency (PHA) funded the upgrading training as part of their ongoing commitment to supporting quality training for a range of individuals, communities and organisations.Madeline Heaney, the PHA's strategic lead for Suicide Prevention, explained: "This programme enables people who have been trained to become more willing, ready and able to help those at risk of suicide, which can be vital in a crisis situation.�"We want to empower people who are in position of responsibility and care to know what to do if they find themselves in a situation where someone is at risk of taking their own lives."�ASIST has been delivered in Northern Ireland since 2003 and the course is designed for all caregivers or any person in a position of trust, making it useful for a range of people. The training is suitable for mental health professionals, nurses, doctors, pharmacists, teachers, counsellors, youth workers, police and prison staff, school support staff, clergy, community volunteers and the general public.This most recent training, which ASIST Trainers must complete, builds on previous editions and offers advances that help meet current challenges and provides new opportunities in helping to reduce suicides within communities.The intensive Trainer Upgrade was held in Derry/ Londonderry.More information on looking after your mental health and the support which is available across Northern Ireland can be found at www.mindingyourhead.info��You can also talk to your GP for advice.If you or someone you know is in distress or despair, call Lifeline on 0808 808 8000. This is a confidential service, where trained counsellors will listen and help immediately on the phone and follow up with other support if necessary. The helpline is available 24 hours a day, seven days a week. You can also access the Lifeline website at www.lifelinehelpline.info