What do medical trainees think is so difficult about communicating with patients?

Objective: To identify the communication skills medical trainees perceive themselves to avoid or use during initial clinical encounters and the areas of communication learning need they identify.

Methods: 446 2nd year undergraduate medical students were invited to take part in the study. Details of four encounters with patients were entered into a web-based electronic logbook by the student.

Challenges of long-term nutrition intervention studies on cognition: discordance between observational and intervention studies of vitamin B12 and cognition.

Conducting long-term nutrition intervention studies on cognition can be challenging. The gaps in current methodology are addressed via a case study of the relationship between vitamin B(12) and cognition in people aged 60 and older. There is robust evidence from many observational studies, both cross-sectional and longitudinal, showing that a deficit of the vitamin is associated with poor or declining cognition in this age group, but supplementation of the vitamin in trials does not bring about improved cognition.

Severity of depression and risk for subsequent dementia: cohort studies in China and the UK.

Background: Depression and dementia often exist concurrently. The associations of depressive syndromes and severity of depression with incident dementia have been little studied.

Aims: To determine the effects of depressive syndromes and cases of depression on the risk of incident dementia.

Reasons for substance use in dual diagnosis bipolar disorder and substance use disorders: a qualitative study.

Background: Few systematic studies have examined the reasons why patients with bipolar disorder and substance use disorders misuse alcohol and drugs of abuse. Such reasons may depend heavily on context so qualitative research methods that made no prior theoretical assumptions were employed. We explored the reasons patients give for misusing drugs and alcohol and how these relate to their illness course.

Methylmalonic acid and cognitive function in the Medical Research Council Cognitive Function and Ageing Study.

Background: An elevated blood concentration of homocysteine is an established risk factor for cognitive impairment and dementia, but associations between cognition and methylmalonic acid (MMA), a related metabolic marker of vitamin B-12 deficiency, are less clear.

Objective: The aim was to determine the utility of serum MMA and holotranscobalamin as markers of vitamin B-12 status in relation to cognitive function and to investigate their association with discrete cognitive domains.

Design: This was a cross-sectional survey of 84 nondemented elderly participants (aged >69 y) from the Welsh cohort of the Medical Research Council's Cognitive Function and Ageing Study.

Health service use by adults with depression: community survey in five European countries. Evidence from the ODIN study.

Background: Little is known about patterns of healthcare use by people with depression in Europe.

Aims: To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors.

Method: People aged 18-65 years with depressive or adjustment disorders (n=427) in Ireland, Finland, Norway, Spain and the UK provided information on predisposition (demographics, social support), enablement (country, urban/rural, social function) and need (symptom severity, perceived health status) for services.

A systematic review of prevalence and incidence studies of dementia with Lewy bodies.

Background: Substantial variation in the prevalence of Dementia with Lewy Bodies (DLB) has been reported with estimates ranging from 0 to 26.3% of all dementia cases, potentially making it the second most common dementia subtype.

Objectives: The aim of this study was to review systematically and critically for the first time previous studies of the clinical prevalence and incidence of DLB in the population.

Attrition and bias in the MRC cognitive function and ageing study: an epidemiological investigation.

Background: Any hypothesis in longitudinal studies may be affected by attrition and poor response rates. The MRC Cognitive Function and Ageing study (MRC CFAS) is a population based longitudinal study in five centres with identical methodology in England and Wales each recruiting approximately 2,500 individuals. This paper aims to identify potential biases in the two-year follow-up interviews.