73 research outputs found

    Tackling dementia together via the Australian dementia network (ADNeT): A summary of initiatives, progress and plans

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    In 2018, the Australian Dementia Network (ADNeT) was established to bring together Australia\u27s leading dementia researchers, people with living experience and clinicians to transform research and clinical care in the field. To address dementia diagnosis, treatment, and care, ADNeT has established three core initiatives: the Clinical Quality Registry (CQR), Memory Clinics, and Screening for Trials. Collectively, the initiatives have developed an integrated clinical and research community, driving practice excellence in this field, leading to novel innovations in diagnostics, clinical care, professional development, quality and harmonization of healthcare, clinical trials, and translation of research into practice. Australia now has a national Registry for Mild Cognitive Impairment and dementia with 55 participating clinical sites, an extensive map of memory clinic services, national Memory and Cognition Clinic Guidelines and specialized screening for trials sites in five states. This paper provides an overview of ADNeT\u27s achievements to date and future directions. With the increase in dementia cases expected over coming decades, and with recent advances in plasma biomarkers and amyloid lowering therapies, the nationally coordinated initiatives and partnerships ADNeT has established are critical for increased national prevention efforts, co-ordinated implementation of emerging treatments for Alzheimer\u27s disease, innovation of early and accurate diagnosis, driving continuous improvements in clinical care and patient outcome and access to post-diagnostic support and clinical trials. For a heterogenous disorder such as dementia, which is now the second leading cause of death in Australia following cardiovascular disease, the case for adequate investment into research and development has grown even more compelling

    Synthesis, Characterization, X-ray Structural Analysis and Study of Oxidative Properties of Propyltriphenylphosphonium Bromochromate

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    The complex of propyltriphenylphosphonium bromochromate(VI), PrPh3P[CrO3Br] is easily synthesized in nearly quantitative yield using a direct reaction of chromium(VI) oxide and propyltriphenylphosphonium bromide. This compound is a versatile reagent for the efficient and selective oxidation of organic substrates, in particular for alcohols to their corresponding aldehydes or ketones, under mild conditions. This compound was characterized by IR, UV/Visible, 13C-n.m.r. and 1H-n.m.r. techniques. It crystallized in the monoclinic form and its crystal and molecular structure have been determined by X-ray crystallography.link_to_subscribed_fulltex

    Synthesis, Characterization, X-ray Structural Analysis and Study of Oxidative Properties of Tetraethylammonium Chlorochromate

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    Tetraethylammonium chlorochromate(VI), Et4N[CrO3Cl] is easily synthesized in nearly quantitative yield using a direct reaction of chromium(VI) oxide and tetraethylammonium chloride and characterized by elemental analysis, IR, UV/Visible, 1H-NMR and 13C-NMR techniques and single-crystal X-ray diffraction analysis (monoclinic system, space group C2(#5), with a = 12.023(3), b = 7.998(2), c = 14.527(4) ƅ, Ī² = 114.187(4)Ā°, V = 1274.4(6) ƅ3 and Z = 4). X-ray data determined the CH Ā·Ā·Ā· O hydrogen bond that forms between the ethyl hydrogen of the cation and oxygen of the anion. This compound is a versatile reagent for efficient and selective oxidation of organic substrates, in particular for alcohols to their corresponding aldehydes or ketones, under mild conditions.link_to_subscribed_fulltex

    Organisational aspects and assessment practices of Australian memory clinics: an Australian Dementia Network (ADNeT) Survey

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    Objectives Conducting a national survey of clinicians and administrators from specialised dementia assessment services (memory clinics) in Australia to examine their current organisational aspects and assessment procedures and inform clinical tool harmonisation as part of the Australian Dementia Networkā€”memory clinics project.Design A cross-sectional survey.Setting Public and private memory clinics across Australia.Participants 150 individual clinicians completed the survey between May and August 2019. Responses could be given anonymously. Most clinics were publicly funded services (83.2%) and in metropolitan regions (70.9%).Outcome measures Descriptive data on organisational aspects of memory clinics (eg, waiting times, staffing); the three most commonly used assessment tools per assessment type (eg, self-report) and cognitive domain (eg, attention).Results Since the last national survey in 2009, the number of memory clinics across Australia has increased substantially but considerable variability has remained with respect to funding structure, staffing and assessment procedures. The average clinic employed 2.4 effective full-time staff (range 0.14ā€“14.0). The reported waiting time for an initial assessment ranged from 1 week to 12 months with a median of 7 weeks. While most clinics (97%) offered follow-up assessments for their clients, only a few (31%) offered any form of cognitive intervention. We identified over 100 different cognitive assessment tools that were used at least ā€˜sometimesā€™, with widespread use of well-established core screening tools and a subset of common neuropsychological tests.Conclusion This paper presents a current snapshot of Australian memory clinics, showing considerable heterogeneity with some common core elements. These results will inform the development of national memory clinic guidelines. Furthermore, our data make a valuable contribution to the international comparison of clinical practice standards and advocate for greater harmonisation to ensure high-quality dementia care

    Type of cell death and the role of acetylcholinesterase activity in neurotoxicity induced by paraoxon in cultured rat hippocampal neurons

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    Organophosphate (Ops) neurotoxicity is attributed both to its well-known cholinergic and non-cholinergic effects. In the present study we compared enzymatic and morphologic changes in neurons exposed to paraoxon during one day and one week. The effect of exposure time is important in neurotoxicity of Ops. The longer the exposure time is the more damage is observed in neurons, although there are few investigations about the effect in the post-exposure period. Hippocampal cells were obtained from rat neonates and cultured in Neurobasal/B27. Paraoxon at 50 and 100 Ī¼M were added. Inverted microscope and electron microscope were used to study cell morphology and Neutral Red staining was used to measure viability. We also assayed caspase-3 and (acetylcholinesterase) AChE activity. Hoechst staining was utilized to determine the type of cell death. Culture medium was replaced after 24 h in one-day group, however, tests were all carried out at the end of the first week in both group.The results indicate that paraoxon reduced the viability in a dose-dependent manner. Our results do not confirm apoptosis in either group; it seems that the cell death in one-day exposure group was not AChE dependent. In conclusion, present data imply that the toxicity of paraoxon is both dose and duration dependent, which may even remain after the cessation of exposure

    The beta-amyloid protein of Alzheimer's disease does not bind to the alpha7 nicotinic acetylcholine receptor

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    Accumulation of the amyloid protein (AƟ) in the brain is an important step in the pathogenesis of Alzheimer's disease. However, the mechanism by which AƟ exerts its neurotoxic effect is largely unknown. It has been suggested that the peptide can bind to the a7 nicotinic acetylcholine receptor (a7nAChR). In this study, we examined the binding of AƟ1-42 to endogenous and recombinantly expressed a7nAChRs. AƟ1-42 did neither inhibit the specific binding of a7nAChR ligands to rat brain homogenate or slice preparations, nor did it influence the activity of a7nAChRs expressed in Xenopus oocytes. Similarly, AƟ1-42 did not compete for a-bungarotoxin-binding sites on SH-SY5Y cells stably expressing a7nAChRs. The effect of the AƟ1-42 on tau phosphorylation was also examined. Although AƟ1-42 altered tau phosphorylation in a7nAChR-transfected SH-SY5Y cells, the effect of the peptide was unrelated to a7nAChR expression or activity. Binding studies using surface plasmon resonance indicated that the majority of the AƟ bound to membrane lipid, rather than to a protein component. Fluorescence anisotropy experiments indicated that AƟ may disrupt membrane lipid structure or fluidity. We conclude that the effects of AƟ are unlikely to be mediated by direct binding to the a7nAChR. Instead, we speculate that AƟ may exert its effects by altering the packing of lipids within the plasma membrane, which could, in turn, influence the function of a variety of receptors and channels on the cell surface. Ā© 2007 The Author

    Characterising Australian memory clinics: current practice and service needs informing national service guidelines

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    Abstract Background Memory clinics (MCs) play a key role in accurate and timely diagnoses and treatment of dementia and mild cognitive impairment. However, within Australia, there are little data available on current practices in MCs, which hinder international comparisons for best practice, harmonisation efforts and national coordination. Here, we aimed to characterise current service profiles of Australian MCs. Methods The ā€˜Australian Dementia Network Survey of Expert Opinion on Best Practice and the Current Clinical Landscapeā€™ was conducted between August-September 2020 as part of a larger-scale Delphi process deployed to develop national MC guidelines. In this study, we report on the subset of questions pertaining to current practice including wait-times and post-diagnostic care. Results Responses were received from 100 health professionals representing 60 separate clinics (45 public, 11 private, and 4 university/research clinics). The majority of participants were from clinics in metropolitan areas (79%) and in general were from high socioeconomic areas. While wait-times varied, only 28.3% of clinics were able to offer an appointment within 1-2ā€‰weeks for urgent referrals, with significantly more private clinics (58.3%) compared to public clinics (19.5%) being able to do so. Wait-times were less than 8ā€‰weeks for 34.5% of non-urgent referrals. Only 20.0 and 30.9% of clinics provided cognitive interventions or post-diagnostic support respectively, with 7.3% offering home-based reablement programs, and only 12.7% offering access to group-based education. Metropolitan clinics utilised neuropsychological assessments for a broader range of cases and were more likely to offer clinical trials and access to research opportunities. Conclusions In comparison to similar countries with comprehensive government-funded public healthcare systems (i.e., United Kingdom, Ireland and Canada), wait-times for Australian MCs are long, and post-diagnostic support or evidence-based strategies targeting cognition are not common practice. The timely and important results of this study highlight a need for Australian MCs to adopt a more holistic service of multidisciplinary assessment and post-diagnostic support, as well as the need for the number of Australian MCs to be increased to match the rising number of dementia cases

    Tackling Dementia Together via The Australian Dementia Network (ADNeT): A Summary of Initiatives, Progress and Plans

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    In 2018, the Australian Dementia Network (ADNeT) was established to bring together Australiaā€™s leading dementia researchers, people with living experience and clinicians to transform research and clinical care in the field. To address dementia diagnosis, treatment, and care, ADNeT has established three core initiatives: the Clinical Quality Registry (CQR), Memory Clinics, and Screening for Trials. Collectively, the initiatives have developed an integrated clinical and research community, driving practice excellence in this field, leading to novel innovations in diagnostics, clinical care, professional development, quality and harmonization of healthcare, clinical trials, and translation of research into practice. Australia now has a national Registry for Mild Cognitive Impairment and dementia with 55 participating clinical sites, an extensive map of memory clinic services, national Memory and Cognition Clinic Guidelines and specialized screening for trials sites in five states. This paper provides an overview of ADNeTā€™s achievements to date and future directions. With the increase in dementia cases expected over coming decades, and with recent advances in plasma biomarkers and amyloid lowering therapies, the nationally coordinated initiatives and partnerships ADNeT has established are critical for increased national prevention efforts, co-ordinated implementation of emerging treatments for Alzheimerā€™s disease, innovation of early and accurate diagnosis, driving continuous improvements in clinical care and patient outcome and access to post-diagnostic support and clinical trials. For a heterogenous disorder such as dementia, which is now the second leading cause of death in Australia following cardiovascular disease, the case for adequate investment into research and development has grown even more compelling
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