Author Archives: Niroshan Siriwardena

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New study on health-related causes of gambling in older adults

Courtesy of Wellcome Images

Courtesy of Wellcome Images

Dr Julie Pattinson from the Community and Health Research Unit (CaHRU) at University of Lincoln, recently published an article in the Journal of Behavioral Addictions. The article, entitled ‘Age-related physical and psychological vulnerability as pathways to problem gambling in older adults’, was co-authored by, Dr Adrian Parke, University of Lincoln, Professor Mark Griffiths, Nottingham Trent University and Dr David Keatley, University of Lincoln. This is Julie’s third publication following her PhD thesis on ‘British older adult gambling behaviour; evaluating psychological and physical health as predictive risk for problem gambling.’

JuliePattinsonThe study background discussed clinical treatment and preventative efforts, and highlights the need to understand the pathways to late-life gambling disorder. The study assesses the association between age-related physical health, social networks, and problem gambling in adults aged over 65 years and assesses the mediating role of affective disorders in this association. In total, 595 older adults aged 64-94 years were interviewed using a structured questionnaire to assess physical frailty, geriatric pain, loneliness, geriatric depression, geriatric anxiety, and problem gambling.

Courtesy of Wellcome Images

Courtesy of Wellcome Images

Pathway analysis demonstrated associations between these variables and gambling problems, providing a good fit for the data, but these relationships were mediated by both anxiety and depression symptoms. The study indicated that late-life problem gambling may develop as vulnerable individuals gamble to escape anxiety and depression consequent upon deteriorating physical well-being and social support. Furthermore, when individuals develop late-life problem gambling, it is recommended that the treatment primarily focuses upon targeting and replacing avoidant coping approaches. Full text available at: http://akademiai.com/doi/pdf/10.1556/2006.7.2018.18

By Dr Julie Pattinson

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Laura Simmons presents systematic review on sickness absence interventions

warwick2Laura Simmons, PhD student in CaHRU and the Lincoln Institute for Health, recently attended the Division of Occupational Psychology Annual Conference on the 10th-12th January in Stratford-upon-Avon.

The conference’s main theme surrounded the notion of “Evolution +/or Revolution”, focussing on the contribution of new research whilst strengthening existing evidence. LauraSimmons2Keynote speakers included colleagues with expertise in leadership (Dr Edwin A. Locke) and employee wellbeing (Professor Karina Nielsen). Speaking about his experience of using the P value in Psychology, Andy Field presented an interesting session on the use of research methods within Psychology. There were a mixture of oral presentations, discussions and symposiums on a wide range of topics focused on applying research to an organisational setting. Laura attended sessions on workplace resilience and adventurous training (Nicola Bass) and Schwartz Rounds as an intervention to support employee wellbeing (Imelda McCarthy).

warwick1Laura also presented the results of the review, which was conducted alongside her colleagues Prof Christopher Bridle, Prof Niro Siriwardena and Dr Arwel Jones. The review focused on synthesising evidence on interventions that aimed to reduce sickness absence among healthcare workers. The poster was received well among delegates and sparked conversation regarding the applicability to healthcare systems within the United Kingdom.

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New CaHRU study on Community First Responders in Lincolnshire published

vhp2An interview study exploring the experiences of Community First Responders (CFRs) in Lincolnshire as well as their relationship with patients and the ambulance service (http://rdcu.be/GkCl) was published this month in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine The study entitled, ‘Perceptions and experiences of community first responders on their role and relationships: qualitative interview study‘ was undertaken by Viet-Hai Phung, Ian Trueman, Fiona Togher, Dr Roderick Ørner and Professor Niro Siriwardena, with valuable input from Dr Simon Topham, medical director of LIVES. It follows on from a scoping review of CFR schemes that was published in the same journal in 2017.’

The interviews reinforced the themes that the scoping review identified. Participants became CFRs mainly for altruistic Nreasons, to help others and put something back into their community. Ths contributed to their sense of personal satisfaction and helped maintain their involvement over time. CFRs valued scenario-based training and while some were keen to access additional training to enable them to attend a greater variety of incidents, others stressed the importance of maintaining existing practice and improving their communication skills. They were often first on scene, which they recognised could take an emotional toll, but for which they found informal support mechanisms helpful. Participants felt a lack of public recognition and sometimes were undervalued by ambulance staff, which they thought arose from a lack of clarity over their purpose and responsibilities.

NIn terms of future development, CFR schemes should consider the varying training, development and support needs of staff. CFRs wanted schemes to be complementary but distinct from ambulance services. Further information on outcomes and costs of the CFR contribution to prehospital care is needed to inform future how schemes operate. It is important that they maintain their local identity. To do so, they will need to respond to local needs.

By Viet-Hai Phung

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Comparing national multimorbidity policies and guidelines

CaHRU_logotypePeople living with a long-term condition often have more than one condition to contend with. This is known as ‘multimorbidity’, commonly defined as the co-occurrence of two or more chronic conditions within one person. In this situation it is important that the person, not the disease, is the focus. Policies referring to multimorbidity are considered a crucial element in safe health systems.

NadeekaChandraratneThe CaHRU team of Dr Nadeeka Chandraratne and Dr Ravindra Pathirathna, international visiting fellows attached to CaHRU from the Postgraduate Institute of Medicine at the University of Colombo, Sri Lanka, together with Prof Niro Siriwardena and Dr Christopher Harrison from the University of Sydney conducted a content analysis of policy documents and guidelines on multimorbidity from the UK, Australia and Sri Lanka. Despite considerable differences in healthcare structure and financing, all three countries face the challenge of multimorbidity. An understanding of how each country is addressing this challenge was considered important for identifying policy initiatives, gaps and opportunities for further improvement.

RavindraPathirathneThe article describing the study and its findings, ‘A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka‘, was published this month in the first issue of the Australian Journal of General Practice 2018 with an accompanying editorial on Multimorbidity written by Niro Siriwardena and Christopher Harrison.

The team found overall a lack of health policy and guidance for multimorbidity: the guideline ‘Multimorbidity: Clinical assessment and management’ from The National Institute for Health and Care Excellence (NICE), UK was the only specific guideline on multimorbidity. Australia and Sri Lanka lack specific national documents addressing multimorbidity. The promising features observed in Australia were policies that are directly concerned with the health of socially disadvantaged groups, which are at higher risk of multimorbidity. Policies in Sri Lanka were more concerned with preventing chronic conditions, and on community mobilisation and empowerment.

lilyThe paper highlights that Sri Lanka needs to focus on policies that emphasise integration and patient-centred healthcare delivery for people with multimorbidity, whereas in the UK and Australia, policies on community-based approaches to address determinants of multimorbidity are needed.

By Dr. Nadeeka Chandraratne

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Professor Graham Law gives inaugural lecture on ‘Sleep, sugar and statistics’ to a packed audience

GrahamLawinauguralProfessor Graham Law delivered his inaugural lecture on 30 January 2018 to a full audience of members of academic staff and the general public. The lecture included an outline of Graham’s academic career from posts at York and Leeds Universities to his current professorship at the University of Lincoln where he is a senior member of the Community and Health Research Unit and School of Health and Social Care. During the course of his career, Graham has published almost 100 research papers, many of which have been highly cited, including papers in the prestigious New England Journal of Medicine and American Journal of Epidemiology.

brayfordnight750The lecture continued with a discussion of what epidemiology is, and its origin’s with Dr John Snow’s discovery that cholera is waterborne, through his removal of the water pump handle at Broad Street in the Soho area of London which halted the epidemic. Graham spoke about his groundbreaking work on functional data analysis which involves complex analysis of large longitudinal data over time. This has included studies on a huge range of topics including the epidemiology of diabetes, sleep, gastrointestinal and a variety of other conditions. He has also supervised 10 doctoral students to completion of their PhD and has run programmes in epidemiological statistics at Leeds University, for medical and master’s students. More recently he has been investigating the relationship between poor sleep and the risk of developing diabetes.

Desk1Another aspect of Graham’s work which was very evident during his entertaining and informative lecture was his interest in increasing the public understanding of science. He has done his through engaging in many public lectures, television, radio and popular books such as his recent publication with Dr Shane Pascoe, ‘Sleep Better: The Science and the Myths’. Graham ended by explaining why he loved Lincoln University – his new colleagues, the lack of bureacracy and the ambition of Lincoln to develop as a world-class university.