Planning for the future development of mental health services requires an understanding of the changing demographics of local populations. It is argued that the demographic transition faced by the UK requires mental health services to adopt an approach more typical of public health in responding to the needs of an increasingly ageing population.

Various research approaches try to solve the puzzles related to dementia or healthy brain ageing. Neurogenetic, neuroimaging and neuropharmacological research are the most visible of these. Psychological research in dementia has been instrumental in improving familial or institutional care. However, it has not been regarded as basic research. Recent psychological research into the mechanisms of co-forming or shaping the clinical presentation of dementias can be counted as truly basic research. The ‘cognitive or brain reserve’ concept has been fruitful in implementing psychological knowledge on plasticity factors in dementia. The new concept of ‘motivational reserve capacity’ extends these psychological concepts. In particular, it provides a basis for integrating various findings on how lifestyle factors effectively shape clinical dementia presentations – or lead to healthy brain ageing.

Motivational reserve is being proposed as an additional component of reserve capacities which may prevent, or ameliorate the effects of, cognitive impairment in later life. This is consistent with an understanding of the presentation of dementia which goes beyond neuropathological and neuropsychological changes. The construct may help make sense of findings relating to the potentially preventative qualities of a diverse range of ‘cognitive’ activities and of social networks, as well as of education. However, caution is required in relation to how cognitive impairment is evaluated and defined, to avoid confounds such as has been the case with level of education.

This paper takes a broad view of the challenges to parenting faced by adults with attention-deficit hyperactivity disorder (ADHD). Issues in risk assessment are discussed. We place these in the context of the published UK national guidelines on child safeguarding for professionals working with parents who have mental disorders, and consider how this may inform practice in this field.

The enactment of Part II of the Medical Practitioners Act 2007 in Ireland heralds a move from voluntary to statutory provision of professional competence and marks an important advance in medical professionalism in the country. This formalises consultant psychiatrists' existing commitment to updating their knowledge and skills and compels basic and higher specialist trainees to actively engage in the process. The relevance of reflective practice for professional and personal development of trainee psychiatrists is discussed and the role of existing trainee learning activities in the process of lifelong learning is explored in this context.