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Banerjee S.,Brighton and Sussex Medical School
Archives of Medical Research

Background: Health is firmly on the economic radar. It is big business. In 2009, the proportion of the Gross Domestic Product spent on health care varied between 6.4% in Mexico and 17.4% in the U.S., with the UK at 9.8% and Germany, Switzerland and Canada ∼11%. These are considerable amounts of money and they are growing. With all projections pointing to a growth in the numbers of older people, the pressure on budgets will only increase. In this paper we will consider the role of dementia in this. Methods: Demographic and economic data were combined and policy implications developed. Results: The costs of dementia dwarf those of the illnesses that are currently prioritized at a national and international level such as HIV, cancer, heart disease, stroke and diabetes. Based on simple demographics, the costs of dementia are set to increase by 85% by 2030, with developing countries bearing an increasing share of the economic burden. Conclusions: The data suggest that dementia is a clear and present economic challenge for the world from the macro level down to the individual. Before the crisis, governmental structural primary deficits were generally improving and this would have given time and resource to meet the challenges of ageing in general and dementia in particular. However, increasing government debt over the past 3 years has had the effect of our needing to implement reforms to contain the risks to sovereign budgets sooner rather than later. This is not an issue that can be ignored. Inaction will only lead to further debt accumulation in the medium term and the death of systems of care in the long term. Across the developed world, the main long-term fiscal challenges come from health care costs, and dementia is a major driver of those costs. There is a need for budgetary consolidation and pension reform more generally. But, given that dementia is the highest ticket health and social care item that we have, making up 60% of long term care spending according to some estimates, then targeted investment in early intervention and in research (into causes, cure and care) are likely to be of major value in personal, societal, political, and economic terms. © 2012 IMSS. Source

Medford N.,Brighton and Sussex Medical School
Brain structure & function

There is now a wealth of evidence that anterior insular and anterior cingulate cortices have a close functional relationship, such that they may be considered together as input and output regions of a functional system. This system is typically engaged across cognitive, affective, and behavioural contexts, suggesting that it is of fundamental importance for mental life. Here, we review the literature and reinforce the case that these brain regions are crucial, firstly, for the production of subjective feelings and, secondly, for co-ordinating appropriate responses to internal and external events. This model seeks to integrate higher-order cortical functions with sensory representation and autonomic control: it is argued that feeling states emerge from the raw data of sensory (including interoceptive) inputs and are integrated through representations in conscious awareness. Correspondingly, autonomic nervous system reactivity is particularly important amongst the responses that accompany conscious experiences. Potential clinical implications are also discussed. Source

Mabvuure N.T.,Brighton and Sussex Medical School
Medical Teacher

Background: Medical students claim to have inadequate opportunities to conduct research, whilst some do not know how to make the initial steps. There is a need for medical educators to not only direct students to research opportunities but also to counsel them on the attitudes required for the student's success in a research environment. Aim: This article gives educators 12 tips on guidance that might help motivated medical students when starting their research careers. The various opportunities for students to participate in research are also identified. Method: Tips were devised from personal experience and a review of the literature. Results: The 12 tips are: (1) Educate students on the benefits of research. (2) Encourage students to take the initiative to create opportunities for themselves. (3) Encourage students to undertake extracurricular research. (4) Encourage students to network with other researchers. (5) Encourage students to engage with student-selected components of their courses. (6) Encourage students to apply for summer research programmes. (7) Encourage students to attend scientific conferences. (8) Advise students to consider intercalated degrees. (9) Encourage students to do research during elective placements. (10) Make students aware of the MBPhD courses. (11) Emphasise research as a learning process and reduce focus on output. (12) Advise students to balance their academic and research interests. Conclusions: The 12 tips highlight important attitudes for students to take in research as well as highlighting various opportunities for research. © 2012 Informa UK Ltd All rights reserved. Source

Cohen J.,Brighton and Sussex Medical School
Journal of Antimicrobial Chemotherapy

The re-emergence of infection due to multidrug-resistant Gram-negative bacteria in critically ill patients presents particular challenges to clinicians, given the lack of a pipeline of new antibiotics active against these resistant strains. Infected patients have a worse outcome than non-infected patients, although the additional contribution of antimicrobial resistance is less easy to define. Newer and better antibiotics would be welcome, but are unlikely alone to make a major impact on clinical outcomes. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. Source

De Visser R.O.,University of Sussex | Birch J.D.,Brighton and Sussex Medical School
Drug and Alcohol Review

Introduction and Aims. If young people are to consume alcohol in accordance with government guidelines, they must possess the relevant knowledge and skills. No previous research has examined correlations between different forms of knowledge of alcohol guidelines or how they are related to personality variables and beliefs. Design and Methods. Two samples were recruited in South-East England: 309 secondary school students aged 16-18, and 125 university students aged 18-25. All participants completed a computer-administered survey of knowledge and beliefs. University students also reported their alcohol consumption and completed tasks in which they poured their 'usual' drinks, and what they believed to be 'units' of alcohol. Results. Most respondents lacked the knowledge and skills required to drink in accordance with government guidelines. Participants' usual drinks were substantially larger than one unit, and participants tended to underestimate the unit content of drinks. There was little evidence that possession of accurate knowledge of one aspect of alcohol units and guidelines was related to accurate knowledge in other domains. Discussion and Conclusions. Many young people may lack the knowledge required to monitor their alcohol consumption or give accurate self-reports in research. Future research should evaluate using a drink-pouring task as part of interventions designed to improve knowledge and skills and encourage moderate consumption of alcohol.[de Visser RO, Birch JD. My cup runneth over: Young people's lack of knowledge of low-risk drinking guidelines. Drug Alcohol Rev 2012;31:206-212]. © 2011 Australasian Professional Society on Alcohol and other Drugs. Source

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