Mental health service acceptability for the armed forces veteran community.

BACKGROUND: Despite developments in mental health services for armed forces veterans and family members, barriers to access associated with poor levels of acceptability regarding service provision remain. Adapting a Step 2 mental health service based on low-intensity cognitive behavioural therapy (CBT) interventions to represent a familiar context and meet the needs of the armed forces veteran community may serve to enhance acceptability and reduce help-seeking barriers. AIMS: To examine acceptability of a Step 2 low-intensity CBT mental health service adapted for armed forces veterans and family members provided by a UK Armed Forces charity. METHODS: Qualitative study using individual semi-structured interviews with armed forces veterans and family members of those injured or becoming unwell while serving in the British Armed Forces. Data analysis was undertaken using thematic alongside disconfirming case analysis. RESULTS: Adapting a Step 2 mental health service for armed forces veterans and family members enhanced acceptability and promoted help-seeking. Wider delivery characteristics associated with Step 2 mental health services within the Improving Access to Psychological Therapies (IAPT) programme also contributed to service acceptability. However, limitations of Step 2 mental health service provision were also identified. CONCLUSION: A Step 2 mental health service adapted for armed forces veterans and family members enhances acceptability and may potentially overcome help-seeking barriers. However, concerns remain regarding ways to accommodate the treatment of post-traumatic stress disorder and provide support for family members.

Areca nut use amongst South Asian schoolchildren in Tower Hamlets, London: the extent to which the habit is engaged in within the family and used to suppress hunger.

OBJECTIVES: To examine the extent to which an areca nut habit is engaged in within the family and degree to which the habit may be used to suppress hunger amongst South Asian schoolchildren with a view to informing health promotion campaigns. RESEARCH DESIGN: Self-administered questionnaire. SETTING: Two comprehensive schools (one mixed, one all girls) in the Tower Hamlets district of East London, UK. PARTICIPANTS: 341 (285 girls; 56 boys) children of self-reported South Asian origin (Bangladeshi 286, Pakistani 4, Asian, 51) who reported currently engaging in an areca nut habit. RESULTS: Areca nut habits were mainly used in a family context. Smaller proportions of children reported predominant use alone or with peers. A substantial minority reported using their habit to suppress hunger. CONCLUSION: The family plays a crucial role in maintaining areca nut use. This implies effective health promotion campaigns must operate at the family and even community levels rather than being targeted at the children directly.

Temporal-spatial memory: retrieval of spatial information does not reduce recency.

Factors influencing the shape of serial position curves in non-verbal serial short-term memory were examined, using a task testing memory for the position of dots. Similar recency slopes were found when both position and order were recalled (Experiment 1A) and when order only was required (Experiment 1B). This observation was confirmed and tested further in conditions requiring the same encoding but different amounts of spatial information at retrieval (Experiment 2). However, Experiment 2 also revealed an effect of spatial information retrieval on the overall level of memory for recency items. Overall, the results indicate that spatial items produce bow-shaped serial positions curves in tasks requiring the maintenance of order information and that recency is affected by the demand on spatial information retrieval in terms of the overall level of performance but not in terms of the recency slope. These findings are contrary to what is found in the literature on serial verbal recall when both item and order information are required.

Prevalence, age of onset and demographic relationships of different areca nut habits amongst children in Tower Hamlets, London.

OBJECTIVE: To examine prevalence and demographic relationships of different areca nut habits amongst children. DESIGN: Self-administered questionnaire. SUBJECTS: Children aged between 11 and 15. Of 800 questionnaires distributed, 704 were fully completed (88%). SETTING: Two secondary schools in the London district of Tower Hamlets. MEASURES: Demographic, areca nut habits used, age first used, still using, frequency of use. RESULTS: Users of any areca nut habit were exclusively from the South Asian population. Of this population, 77% had engaged in a habit, and dependent upon habit between 54 and 92% of these still remained current users. The highest prevalence of current use for boys and girls respectively was for areca nut alone (36%, 43%), followed by mistee pan (35%, 29%), betel-quid (27%, 26%) and pan masala (14%, 16%). Of the current users, 44% engaged in one habit only, 24% two, 20% three and 13% all four. The highest period of risk for starting to use areca nut alone, betel-quid and mistee pan was between ages 5 and 12, whilst for pan masala it was after 10. Boys had a significantly higher risk of beginning use before 10 (P < .001) and a higher frequency of use for pan masala (P< .01), areca nut alone (P< .05) and betel-quid (P = .06) than girls. The frequency of using each habit was between 3 and 5 episodes per week, however boys use pan masala approximately 10 times per week. CONCLUSION: South Asian children may already be experienced users of areca nut. Greater attention should be directed towards identifying signs of oral submucous fibrosis, oral cancer and other potentially malignant lesions within the South Asian population.

Direction of report in spatial and verbal serial short-term memory.

Four experiments examined the role played by item and order information in determining the effects of order of report of a sequence from short-term memory. Experiments in which list items were re-presented prior to recall so that only their order had to be reported showed no differences in performance between the forward and backward direction of report. This result was found with lists of auditory-verbal, visual-verbal, and spatial stimuli. When the list items were not re-presented, so that recall of both items and order was required, recall in the backward direction of report was significantly worse than in the forward direction of report, both in spatial and verbal tasks. The results point to the symmetry of inter-item associations, though only equivocally so, but they suggest strongly that the processes of spatial and verbal serial recall share many functional characteristics.

Functional equivalence of verbal and spatial information in serial short-term memory.

Performance on a test of serial memory for the spatial position of a sequence of dots showed similarities to typical results from the serial recall of verbal material: a marked increase in error with increasing list length, a modest rise in error as retention interval increased, and bow-shaped serial position curves. This task was susceptible to interference from both a spatial task (rote tapping) and a verbal task (mouthed articulatory suppression) and also from the presence of irrelevant speech. Effects were comparable to those found with a serial verbal task that was generally similar in demand characteristics to the spatial task. As a generalization, disruption of the serial recall of visuospatial material was more marked if the interference conditions involved a changing sequence of actions or materials, but not if a single event (tap, mouthed utterance, or sound) was repeated.