Aim: To investigate the association between subjective memory impairment (SMI) and objective cognitive impairment in later life, and to ascertain whether this is modified by level of social ...activity, education or living alone.
Methods: Data were analyzed from three French community surveys carried out in Bordeaux, Dijon and Montpellier. Representative samples of 9294 residents aged 65 years and over were included in the study. SMI was ascertained and investigated in relation to performance on the Benton Visual Retention Test (BVRT), the Isaac Set Test (IST) and Trail Making Test B (TMT). Adjustments were made for age, sex, education, depressive symptoms (Centre for Epidemiological Depression scale), site where study was carried out and living alone. Stratified analyses investigated modification by high or low social activity, education or living arrangement.
Results: SMI was reported by 21.9% of the sample, and was significantly associated with lower scores on BVRT and TMT after adjustment for age, sex, education, depressive symptoms, site and living alone. These associations were not significantly modified by social activity, education or living alone.
Conclusion: Worse subjective memory was associated independently with worse performance on two tests of cognitive function; however, in these cohorts, no evidence was found for modification of associations by social activity/support or education. Geriatr Gerontol Int 2013; 13: 139–145.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
To explore the experiences of emergency workers dealing with incidents in which section 136 of the Mental Health Act 1983 is invoked by the police. Data from interviews with police officers and ...ambulance workers in a London locality were subject to interpretative phenomenological analysis.
Participants felt they were the first port of call and that training should be improved to help them deal with those experiencing mental health crises in the community. Police participants noted time pressures trying to gain individuals' trust and described section 136 detention as sometimes feeling like a betrayal of the individual. Most participants had negative experiences of admissions to the 136 suite; several suggested ways of improving the admissions system. Several went beyond their expected duties to ensure that distressed individuals were supported before accessing mental healthcare services.
Improving training of emergency workers in dealing with mental health crises would also help with aftercare decision-making. Learning identified from the participants' experiences lends support to collaboration between emergency and mental health services, an important step towards improving the section 136 process so that detainees can access help without unnecessary delay.
Section 136 (S136) of the Mental Health Act (England and Wales) empowers the police in the UK to detain and bring people suspected of a mental illness to a place of safety for assessment. Following ...assessment, individuals may either be admitted into hospital for treatment discharged and receive support in the community. The current study builds on the limited qualitative research evidence by examining the ways in which stakeholders (detained persons, carers and professionals) involved in S136 make sense of their lived experiences of the provision. Group and multiple one to one interviews were conducted with: service users, carers, police officers, ambulance workers, and mental health professionals. An analytic framework guided by Interpretative Phenomenological Analysis (IPA) showcases individual, group and shared experiences. This research has a patient and public involvement (PPI) element. Advisory contribution from service user/carer researcher has played a role in shaping data collection and analysis. The findings of this study revealed insights on S136 from the perspective of five stakeholder groups. Psychological factors such as thoughts, feelings and beliefs associated with lived experiences embedded in experiences emerged in the findings. Whilst most of the participants reported difficult experiences, some were positive: from engaging therapeutically in public space, through to an inclusive quality of care for service user, relative and professionals, that is in keeping with the concept of Triangle of Care (Carers Trust, 2010). Being detained or supporting someone who has been detained meant that service users/carers acquired a good understanding of the provision than they thought they would. Participants made pertinent suggestions for developments they would like to see happening. The findings also revealed that ambulance workers play an important role together with police in supporting individuals in a pre-hospital context. Ambulance worker participants in this study were keen to be more involved in S136 as a professional group. This was evident by their efforts to seek out practical solutions to the dilemmas they encountered. This study has shown that utilising lived experiences can be beneficial for training, practice, maximising the quality of care and future developments for S136. According to the World Health Organisation, it is envisaged that emergency workers are likely to have greater involvement in incidents in public places involving mental health. In light of this, it would be highly beneficial if mental health training be stepped up for ambulance and paramedic workers.
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