Tag Archives: older people

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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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Community and Health Research Unit & NHS Health Research Forum, June 2017

sunflowerThe latest CaHRU/NHS Research Forum took place on 7th June 2017 at the University of Lincoln. The Research Forum, which takes place three times a year, is an opportunity for colleagues to showcase their research particularly focussing on studies conducted within Lincolnshire. The meeting began with a lunch and was attended by NHS staff, university staff and students, and colleagues interested in health and social care research.

At the forum three researchers presented their work: Helene Markham (the University of Lincoln & United Lincolnshire Hospitals); Michael Toze, PhD student at CaHRU and Dr Murray Smith, Research Fellow in Econometrics and Health Economics in CaHRU.

mtozeHelene was first to present on her doctoral study entitled: ‘Evaluating follow-up and complexity in cancer clinical trials’. Helene explained that her study seeks to develop an objective methodology to define and quantify trial complexity, intensity and workload to improve operational management and enhance models of trial delivery.

Next, Michael Toze presented his doctoral work on older Lesbian, Gay, Bisexual and Transsexual (LGBT) people’s experiences of primary care. His study sought to elicit older LGBT people’s experience of healthcare when consulting with their GP or primary care staff.

murraysmith1Last but not the least was Dr Murray Smith who discussed his work relating to ‘Value of specialist shoulder physiotherapy in the perspective of cost effectiveness’ which involved a cost analysis of extended scope physiotherapy.

All three speakers gave excellent presentations of their work, and there was a lively discussion and response to questions following each. Professor Niro Siriwardena, Director of the Community and Health Research Centre (CaHRU) thanked the speakers and the attendees for helping to make the forum a successful event.

By Joseph Akanuwe

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CaHRU hosts second East Midlands Research into Ageing Network regional seminar at University of Lincoln

Emran-png-250The Community and Health Research Unit, as part of the work of the centre’s Healthier Aging programme of research, recently hosted the second East Midlands Research into Ageing Network (EMRAN) seminar that took place at the University of Lincoln on 25 November 2015 and which focused on the care of older people in the community. The seminar started with a brief presentation by Professor John Gladman and Chris Craig on EMRAN’s purpose to facilitate collaborative applied research into ageing and older people research across the East Midlands and a brief update on EMRAN’s progress, including recent publications and projects which are being developed thanks to EMRAN’s intervention.

jo1The first part of the seminar included four ‘Elevator Pitches’. Dr Carlos Rodriguez Pascual (University of Lincoln; Lincoln County Hospital) presented his project on frailty and cardiovascular disease, exploring how a combination of a comprehensive geriatric assessment (CGA) score and frailty is a predictor of cardiovascular disease in an older person. The second pitch, presented by Dr Jo Middlemass (CaHRU, University of Lincoln), outlined findings from the ‘CArers of people with Dementia: Empowerment and Efficacy via Education’ (CAD: E3) project that aims to improve carer and patient well-being by offering carers of people with dementia a multicomponent intervention (focusing on education and skill-building). The third pitch, presented by Dr Fiona Marshall (University of Nottingham), looked at a project aimed at creating more dementia friendly areas, by gathering local information (through geo-spatial mapping) of what health, social, religious groups, community and voluntary services (amongst others) there are for older people living in the Peak District of Derbyshire. Finally, Dr Gill Garden (United Lincolnshire Hospitals NHS Trust) presented the very successful Bromhead Care Home service, which involved training care home staff so they can more confidently and effectively deliver care in care homes and reduce admissions to hospitals.

EMAS - PTS 7Professor Niro Siriwardena (Director of CaHRU, University of Lincoln) delivered the second part of the seminar, presenting the work of CaHRU and ideas for developing new projects involving ambulance services: ‘Pathways for Older People from Ambulance Services to Safe Community Care’. The aim of the presentation was to show that paramedics, apart from safely transporting patients, can also offer important treatment and refer patients who don’t require hospitalisation to community services that are often more adequately equipped to care or support them. After the successful SAFER-2 trial (Support and Assessment for Fall and Emergency Referrals), exploring how ambulance staff could assess and divert older people who had suffered a fall to appropriate community-based services, Prof Siriwardena and his colleagues at the East Midlands Ambulance Service (EMAS) are currently interested in exploring other conditions, such as hypoglycaemia, epilepsy and COPD (chronic obstructive pulmonary disease) which may also be amenable to community pathways.

After a quick recess for some much needed tea and coffee, the attendees split into small groups to discuss the projects presented earlier, focusing on possible challenges and solutions to the design and conduct of each study, and consider ideas for further research and exciting collaborations. The seminar came to a close with Chris Craig and Prof John Gladman thanking everyone for their participation and with a promise for more similar events and innovative seminars.

Despina Laparidou

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SAFER 2 (Support and Assessment for Fall Emergency Referrals) trial protocol published

The SAFER 2 study is a randomised controlled trial of the clinical and cost effectiveness of new protocols for emergency ambulance personnel to assess and refer older people who fall to appropriate community based care.  The protocol for the study, led by Prof Helen Snooks at Swansea University and including Prof. Niro Siriwardena of the CaHRU and East Midlands Ambulance Service NHS Trust as a collaborator, has recently been published in BMJ Open:

Snooks H, Anthony R, Chatters R, Cheung WY, Dale J, Donohoe R, Gaze S, Halter M, Koniotou M, Logan L, Lyons R, Mason S,  Nicholl J, Phillips C, Phillips J, Russell I, Siriwardena AN, Wani M, Watkins A, Whitfield R, Wilson L. Support and assessment for fall emergency referrals (SAFER 2) research protocol: cluster randomised trial of the clinical and cost effectiveness of new protocols for emergency ambulance paramedics to assess and refer to appropriate community-based care. BMJ Open 2012;2: e002169. doi:10.1136/bmjopen-2012-002169

The study measured the costs and benefits of a novel protocol implemented by emergency ambulance paramedics caring for older people who had fallen, allowing the paramedic to assess and refer appropriate patients to a community based falls service. The study involved ambulance services in London,Wales,East Midlands. Stations were randomly allocated to implement the new protocol (intervention) or continue to provide care according to their standard practice (control).

Paramedics based at the stations selected for the intervention group received additional training, protocols and clinical support to enable them to assess older people and decide whether they need to be taken to the Emergency Department (ED) immediately, or whether they could benefit from being left at home, with a referral to a community falls service. The study compared costs, processes and outcomes of care (particularly subsequent 999 calls and ED attendances for falls) at 1 and 6 months for patients aged 65 or over who had fallen together with other quantitative and qualitative data.

The study was recently been completed and, currently in the final data collection phase, is due to be published next year.