139 results on '"Colette Joy Browning"'
Search Results
2. The Development of a Competency Assessment Standard for General Practitioners in China
- Author
-
Xin Rao, Jinming Lai, Hua Wu, Yang Li, Xingzhi Xu, Colette Joy Browning, and Shane Andrew Thomas
- Subjects
competency standard ,curriculum ,general practitioners ,China ,GP training ,Public aspects of medicine ,RA1-1270 - Abstract
This paper describes the development of a competency assessment standard for General Practitioners in Shenzhen, China. The standard is to be used for developing and delivering the training curriculum for General Practitioners and to enable rigorous assessment of the mastery of the standards by GP trainees. The requirement for the training of General Practitioners in China is mandated by government policy requires an international standard curriculum to meet the needs of patients and the community. A modified Delphi process was employed to arrive at a curriculum consensus. An expert panel and 14 expert working groups derived from the expert panel were established to review and evaluate national and international competency standards for General Practice and develop a set of standards, through a modified Delphi methodology. Forty three experts were involved in the project. The project resulted in a detailed curriculum statement. The curriculum was then used in 2017 and 2018 where pilot examinations of GP trainees (n = 298 and n = 315, respectively) were conducted to assess the trainee's competencies against the Standards. The examination included two modules, a written test (Module A) and a practical test (Module B). The success rate for participants was relatively low with the majority not successfully completing the assessments. The assessments will be further refined in subsequent work. The project achieved its goal of developing a rigorously evaluated standard to support clinical practice and the training and assessment of GPs.
- Published
- 2020
- Full Text
- View/download PDF
3. Non-communicable Diseases and Cognitive Impairment: Pathways and Shared Behavioral Risk Factors Among Older Chinese
- Author
-
Vasoontara Sbirakos Yiengprugsawan and Colette Joy Browning
- Subjects
aging ,China ,cognitive decline ,chronic conditions ,lifestyle risk factors ,Public aspects of medicine ,RA1-1270 - Abstract
Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.
- Published
- 2019
- Full Text
- View/download PDF
4. Perspectives on the Training of Chinese Primary Health Care Physicians to Reduce Chronic Illnesses and Their Burden
- Author
-
Wenmin Sun, Yang Li, Yiting Hu, Xin Rao, Xingzhi Xu, Colette Joy Browning, and Shane Andrew Thomas
- Subjects
Chinese primary health care physicians ,training ,chronic illness ,China ,burden of disease ,Public aspects of medicine ,RA1-1270 - Abstract
This paper is a commentary on the training of Chinese Primary Health Care Doctors to reduce chronic illness and its burden. First, we will consider the policy position of the Chinese government concerning the development of a competent and enlarged primary physician workforce to deliver the proposed primary health care system reforms. We then turn to a review of the drivers of the high burden of chronic illnesses especially in older people in China. We argue that the curriculum for the training of primary health care medical practitioners should match the demonstrated high prevalence chronic illnesses and their risk factors and that there needs to specific competencies in prevention and mitigation of the diseases and their risk factors.
- Published
- 2019
- Full Text
- View/download PDF
5. Culture and age influences upon gambling and problem gambling
- Author
-
Mythily Subramaniam, Edimansyah Abdin, Shazana Shahwan, Janhavi Ajit Vaingankar, Louisa Picco, Colette Joy Browning, Shane Andrew Thomas, and Siow Ann Chong
- Subjects
Survey ,Composite international diagnostic interview ,South oaks gambling screen ,Chronic physical conditions ,Psychology ,BF1-990 ,Social pathology. Social and public welfare. Criminology ,HV1-9960 - Abstract
Objective: This study aimed to (i) examine the prevalence and types of gambling, (ii) establish prevalence of ‘pathological’ gambling, (iii) explore the correlates of gambling, and (iv) establish psychiatric and physical comorbidity in a sample of older adult gamblers (≥60 years) in contrast to younger gamblers in a representative population sample in Singapore. Method: This paper reports the results of a secondary analysis of data from a representative community survey of 6616 participants, of which 2252 had engaged in gambling activities at least once in their lifetime. Results: 48.9% of older adults reported lifetime gambling. Older gamblers were more likely to be males, married or widowed (vs. never married), with pre-primary, primary and secondary education (vs. university), economically inactive (vs. employed) and had personal annual income of SGD $19,999 and below (vs. SGD $50,000 and above). Older gamblers had significantly higher rates of betting on horses, playing numbers or betting on lotteries, and playing Mahjong. After adjusting for demographic variables in multiple logistic regression analyses, gamblers aged 60 years and older had significantly lower odds of having pathological gambling than those in the younger age group (OR = 0.4). Older gamblers had significantly higher odds of having diabetes (OR = 3.2), hypertension (OR = 4.9), and any comorbid chronic physical condition assessed in this study. Conclusions: For the majority of older adults, gambling remains a recreational activity that is entertaining and a way of socialization. However, one must remain cognizant of the possible risks for some to develop disordered gambling.
- Published
- 2015
- Full Text
- View/download PDF
6. Psychological interventions for the management of glycemic and psychological outcomes of type 2 diabetes mellitus in China: A systematic review and meta-analyses of randomized controlled trials
- Author
-
Anna eChapman, Shuo eLiu, Stephanie eMerkouris, Joanne C Enticott, Hui eYang, Colette Joy Browning, and Shane Andrew Thomas
- Subjects
China ,Meta-analysis ,therapy ,cognitive behavioral therapy ,Motivational Interviewing ,psychological intervention ,Public aspects of medicine ,RA1-1270 - Abstract
IntroductionChina has the largest number of type 2 diabetes mellitus (T2DM) cases globally and T2DM management has become a critical public health issue in China. Individuals with T2DM have an increased risk of developing mental health disorders, psychological disturbances and functional problems associated with living with their condition. Previous systematic reviews have demonstrated that, generally, psychological interventions are effective in the management of T2DM related outcomes; however these reviews have predominantly included studies conducted within English speaking countries, and have not determined the efficacy of the varying types of psychological interventions. As such, this paper aims to synthesize evidence and quantify the efficacy of psychological therapies for the management of glycemic and psychological outcomes of T2DM in China, relative to control conditions. MethodsA systematic search (MEDLINE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, CNKI, Wangfang Data) for all years to December 2014 identified all available literature. Eligibility criteria included: Peer reviewed journal articles; RCTs assessing the efficacy of a psychological therapy for the management of T2DM; adults diagnosed with T2DM or non-insulin dependent diabetes mellitus; Chinese speaking participants (in mainland China). Outcome measures were glycated hemoglobin, blood glucose concentration, depression, anxiety and quality of life. Effect sizes were pooled using a random effects model. Negative effect sizes corresponded to positive outcomes favoring the intervention. Results45 RCTs were eligible for the meta-analyses. Cognitive behavioral therapy (CBT) and motivational interviewing (MI) were more effective than the control condition in the reduction of glycated hemoglobin (CBT: -0·97 [95% CI -1·37 to -0·57]; MI -0·71 [95% CI -1·00 to -0·43]). CBT and client-centered therapy (CCT) were also associated with reductions in depression and blood glucose concentration, and CBT with reductions in anxiety.ConclusionPsychological interventions, namely, CBT, MI and CCT are effective in improving certain T2DM related outcomes in China. Considerable levels of heterogeneity and unclear risk of bias associated with most included RCTs suggest caution when interpreting results. In China, where the burden of T2DM is increasing, psychological interventions may provide promising approaches to assist in the management of T2DM to delay the progression of T2DM related outcomes.
- Published
- 2015
- Full Text
- View/download PDF
7. Effectiveness of personalised feedback alone or combined with peer support to improve physical activity in sedentary older Malays with type 2 diabetes: A randomised controlled trial
- Author
-
Shariff-Ghazali eSazlina, Colette Joy Browning, and Shajahan eYasin
- Subjects
physical activity ,type 2 diabetes mellitus ,peer support ,Personalised feedback ,elderly Malays ,Public aspects of medicine ,RA1-1270 - Abstract
Introduction: Regular physical activity is an important aspect of self management among older people with type 2 diabetes but many remain inactive. Interventions to improve physical activity levels have been studied but few studies have evaluated the effects of personalised feedback or peer support; and there was no study on older people of Asian heritage. Hence, this trial evaluated whether personalised feedback (PF) only or combined with peer support (PS) improves physical activity among older Malays with type 2 diabetes (T2DM) compared to usual care only. Materials and methods: A three arm randomised controlled trial was conducted in a primary healthcare clinic in Malaysia. 69 sedentary Malays aged 60 years and older with T2DM who received usual diabetes care were randomised to PF or PS interventions or as controls for 12 weeks with follow-ups at weeks 24 and 36. Intervention groups performed unsupervised walking activity and received written feedback on physical activity. The PS group also received group and telephone contacts from trained peer mentors. The primary outcome was pedometer steps. Secondary outcomes were self-reported physical activity, cardiovascular risk factors, cardiorespiratory fitness, balance, quality of life and psychosocial wellbeing. Results: 52 (75.4%) completed the 36-week study. The PS group showed greater daily pedometer readings than the PF and controls (p=0.001). The PS group also had greater improvement in weekly duration (p
- Published
- 2015
- Full Text
- View/download PDF
8. Implementing a Chronic Disease Self-Management Program into China: Happy Life Club
- Author
-
Colette Joy Browning, Hui eYang, Tuohong eZhang, Anna eChapman, Shuo eLiu, Joanne eEnticott, and Shane Andrew Thomas
- Subjects
China ,Primary Health Care ,diabetes ,Motivational Interviewing ,older people ,chronic disease self management ,Public aspects of medicine ,RA1-1270 - Published
- 2015
- Full Text
- View/download PDF
9. Implementing chronic disease self management approaches in Australia and the United Kingdom
- Author
-
Colette Joy Browning and Shane Andrew Thomas
- Subjects
Australia ,self management policy and practice ,chronic illness prevalence ,training and workforce needs ,United Kingdom ,Public aspects of medicine ,RA1-1270 - Published
- 2015
- Full Text
- View/download PDF
10. Health, lifestyle and gender influences on aging well: An Australian longitudinal analysis to guide health promotion
- Author
-
Hal eKendig, Colette Joy Browning, Shane Andrew Thomas, and Yvonne eWells
- Subjects
psychological well-being ,healthy aging ,Functional independence ,self-rated health ,life style factors ,prospective design ,Public aspects of medicine ,RA1-1270 - Abstract
A primary societal goal for aging is enabling older people to continue to live well as long as possible. The evidence base around aging well (‘healthy’, ‘active’ and ‘successful’ aging) has been constructed mainly from academic and professional conceptualizations of mortality, morbidity, functioning, and psychological well-being with some attention to lay views. Our study aims to inform action on health promotion to achieve aging well as conceptualized by qualitative research identifying what older Australians themselves value most: continuing to live as long as possible in the community with independence in daily living, and good self-rated health and psychological well-being. Multivariate survival analyses from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) program found that important threats to aging well for the total sample over a 12 year period were chronological age, multi-morbidity, low perceived social support, low nutritional score, and being underweight. For men, threats to aging well were low strain, perceived inadequacy of social activity, and being a current smoker. For women, urinary incontinence, low physical activity and being underweight were threats to aging well. The findings indicate that healthy lifestyles can assist aging well, and suggest the value of taking gender into account in health promotion strategies.
- Published
- 2014
- Full Text
- View/download PDF
11. Mental health and dual sensory loss in older adults: A systematic review
- Author
-
Colette Joy Browning and Chyrisse eHeine
- Subjects
Depression ,Mental Health ,Ageing ,Dual sensory loss ,hearing and visual sensory loss ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Mental health is a core component of quality of life in old age. Dual Sensory Loss (DSL; combined vision and hearing loss) is prevalent in older adults and has been correlated with decreased levels of well-being. This systematic review aimed to critically review and summarize the evidence from studies that examined the mental health of older adults with DSL. In accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement, specific databases were searched and eight articles were selected for final review. Seven studies investigated the association between DSL and depression or depressive symptoms, whilst one study explored the relationship between DSL and quality of life. No studies investigated the impact of DSL on anxiety. Overall, results of this review suggested that there is a significant relationship between DSL and decreased mental health with those with DSL either displaying depressive symptoms or being at risk for developing depression. Future research should focus on comparative studies of older people with and without sensory loss, as well as targeted studies of older people with dual sensory loss, that incorporate well-defined and valid measures of sensory loss and mental health.
- Published
- 2014
- Full Text
- View/download PDF
12. Interventions to promote physical activity in older people with type 2 diabetes mellitus: A systematic review
- Author
-
Sazlina eShariff-Ghazali, Colette Joy Browning, and Shajahan eYasin
- Subjects
Health Promotion ,physical activity ,Geriatric medicine ,older people ,type 2 diabetes mellitus ,Public aspects of medicine ,RA1-1270 - Abstract
Introduction: Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with type 2 diabetes mellitus. Methods: A literature search was conducted using OvidMEDLINE, PubMed, EMBASE, SPORTDiscus and CINAHL databases to retrieve articles published between January 2000 and December 2012. Randomised controlled trials and quasi-experimental designs comparing different strategies to increase physical activity level in persons aged 65 years and older with T2DM were included. The methodological quality of studies was assessed.Results: Twenty-one eligible studies were reviewed, only six studies were rated as good quality and only one study specifically targeted persons aged 65 years and older. Personalised coaching, goal setting, peer support groups, use of technology and physical activity monitors were proven to increase the level of physical activity. Incorporation of health behaviour theories and follow-up supports also were successful strategies. However, the methodological quality and type of interventions promoting physical activity of the included studies in this review varied widely across the eligible studies.Conclusion: Strategies that increased level of physical activity in persons with T2DM are evident but most studies focused on middle-aged persons and there was a lack of well-designed trials. Hence, more studies of satisfactory methodological quality with interventions promoting physical activity in older people are required.
- Published
- 2013
- Full Text
- View/download PDF
13. Predisposing factors for occasional and multiple falls in older Australians who live at home
- Author
-
Meg E. Morris, Hal Kendig, Keith D. Hill, Deborah Osborne, Colette Joy Browning, Jane Reid, and Birgitta Lundgren-Lindquist
- Subjects
Male ,Gerontology ,medicine.medical_specialty ,Activities of daily living ,Health Status ,Pain ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,Comorbidity ,Suicide prevention ,Occupational safety and health ,Age Distribution ,Occupational Therapy ,Recurrence ,Residence Characteristics ,Risk Factors ,Activities of Daily Living ,Injury prevention ,medicine ,Humans ,Sex Distribution ,Physical Therapy (Specialty) ,Life Style ,Aged ,Aged, 80 and over ,Geriatrics ,business.industry ,Incidence ,Incidence (epidemiology) ,Australia ,medicine.disease ,Health Surveys ,Causality ,Female ,Accidental Falls ,business - Abstract
This study, which was part of a larger study on the Health Status of Older People conducted in Melbourne, Australia, aimed to identify factors that discriminate between multiple and occasional falls amongst older people living at home. It used a survey of 1000 Australians aged 65 years and over. Subjects were classified as multiple fallers (two or more falls in the past year), occasional fallers (one fall in the past year), or non-fallers. Twenty-nine percent of older people who lived at home reported falling once or more in the previous 12 months. Nearly 20% of older people fell once in the previous 12 months and just under 10% fell more than once. Occasional fallers were more likely to be women (OR 1.75, 95% CI 1.26 to 2.45), to have reported back pain (OR 1.54, 95% CI 1.10 to 2.16) and were nearly twice as likely to have more than three medical conditions compared to non-fallers (OR 1.88, 95% CI 1.22 to 2.90). Multiple fallers were also more likely to be women (OR 1.61, 95% CI 1.03 to 2.51). More multiple fallers (17%) than occasional fallers (9%) reported being very afraid of falling. Intervention strategies should take into account these differing predisposing factors for multiple and occasional falls.
- Published
- 2023
- Full Text
- View/download PDF
14. Use of medical services by older Australian women with dementia: a longitudinal cohort study
- Author
-
Jamie Bryant, Colette Joy Browning, Sally O'Loughlin, Dominic Cavenagh, Danielle Mazza, Julie Byles, and Rob Sanson-Fisher
- Subjects
medicine.medical_specialty ,Longitudinal study ,National Health Programs ,Gee ,Odds ,Cohort Studies ,Health care ,Humans ,Medicine ,Dementia ,Longitudinal Studies ,health service use ,Aged ,general practice ,business.industry ,Public health ,Australia ,longitudinal study ,Public Health, Environmental and Occupational Health ,Attendance ,medicine.disease ,health assessments ,Family medicine ,Needs assessment ,Female ,Public aspects of medicine ,RA1-1270 ,business ,dementia - Abstract
Objective: To assess the use of Medicare‐subsidised health services by women with and without dementia. Methods: Data from women of the 1921–26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. Results: A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non‐emergency GP attendances (short [30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. Conclusions: The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs).
- Published
- 2021
15. The relationship between diabetes distress, medication taking, glycaemic control and self-management
- Author
-
Catarina Samorinha, Colette Joy Browning, Hamzah Alzubaidi, Hana Sulieman, and Kevin Mc Namara
- Subjects
Pharmacology ,Gerontology ,Self-management ,business.industry ,Medical record ,Ethnic group ,Pharmaceutical Science ,Pharmacy ,Type 2 diabetes ,Toxicology ,medicine.disease ,Distress ,Diabetes mellitus ,medicine ,Pharmacology (medical) ,business ,Psychosocial - Abstract
Background Diabetes distress (DD) has broad-ranging effects on type 2 diabetes (T2DM) management and outcomes. DD research is scarce among ethnic minority groups, particularly Arabic-speaking immigrant communities. To improve outcomes for these vulnerable groups, healthcare providers, including pharmacists, need to understand modifiable predictors of DD. Aim To assess and compare DD and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants and English-speaking patients of Anglo-Celtic background with diabetes, and determine DD predictors. Setting Various healthcare settings in Australia. Method A multicentre cross-sectional study was conducted. Adults with T2DM completed a survey comprised of validated tools. Glycated haemoglobin, blood pressure, and lipid profile were gathered from medical records. Multiple linear regression models were computed to assess the DD predictors. Main outcome measure Diabetes distress level. Results Data was analysed for 696 participants: 56.3% Arabic-speaking immigrants and 43.7% English-speaking patients. Compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self-efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. Conclusion Results provided new insights to guide healthcare providers on reducing the apparent excess burden of DD among Arabic-speaking immigrants and potentially improve medication adherence, glycaemic control, and self-management.
- Published
- 2021
16. Boundary Crossers: How Providers Facilitate Ethnic Minority Families’ Access to Dementia Services
- Author
-
Samantha Croy, Mike Kent, Bianca Brijnath, Andrew Simon Gilbert, Josefine Antoniades, Jon Adams, Katie Ellis, Dianne Goeman, and Colette Joy Browning
- Subjects
Male ,Social Work ,Social Psychology ,Social Determinants of Health ,Social Stigma ,Ethnic group ,Stigma (botany) ,Social Welfare ,Health Services Accessibility ,Social Skills ,03 medical and health sciences ,0302 clinical medicine ,Professional boundaries ,Professional-Family Relations ,medicine ,Humans ,Dementia ,030212 general & internal medicine ,Community development ,Aged ,Service (business) ,030214 geriatrics ,business.industry ,Communication Barriers ,Australia ,Public relations ,medicine.disease ,Culturally Competent Care ,Clinical Psychology ,Ethnic and Racial Minorities ,Workforce ,Female ,Geriatrics and Gerontology ,business ,Psychology ,Gerontology - Abstract
Objectives Providers who work closely with ethnic minority people with dementia and their families are pivotal in helping them access services. However, few studies have examined how these providers actually do this work. Using the concept of “boundary crossers,” this article investigates the strategies applied by these providers to facilitate access to dementia services for ethnic minority people with dementia and their families. Methods Between 2017 and 2020, in-depth video-recorded interviews were conducted with 27 health, aged care, and community service providers working with ethnic minority people living with dementia across Australia. Interviews were conducted in one of seven languages and/or in English, then translated and transcribed verbatim into English. The data were analyzed thematically. Results Family and community stigma associated with dementia and extra-familial care were significant barriers to families engaging with services. To overcome these barriers, participants worked at the boundaries of culture and dementia, community and systems, strategically using English and other vernaculars, clinical and cultural terminology, building trust and rapport, and assisting with service navigation to improve access. Concurrently, they were cognizant of familial boundaries and were careful to provide services that were culturally appropriate without supplanting the families’ role. Discussion In negotiating cultural, social, and professional boundaries, providers undertake multidimensional and complex work that involves education, advocacy, negotiation, navigation, creativity, and emotional engagement. This work is largely undervalued but offers a model of care that facilitates social and community development as well as service integration across health, aged care, and social services.
- Published
- 2021
17. Diabetes Distress, Medication Taking, Glycaemic Control and Self-Management: Comparing a Minority Migrant Group With Mainstream Society
- Author
-
Colette Joy Browning, Kevin Mc Namara, Catarina Samorinha, Hana Sulieman, and Hamzah Alzubaidi
- Subjects
Distress ,medicine.medical_specialty ,Medication taking ,Self-management ,business.industry ,Diabetes mellitus ,Control (management) ,medicine ,Mainstream ,medicine.disease ,Psychiatry ,business - Abstract
Background Diabetes distress (DD) has broad-ranging effects on type 2 diabetes (T2DM) management and outcomes. DD research is scarce among ethnic minority groups, particularly Arabic-speaking immigrant communities. To improve outcomes for these vulnerable groups, healthcare providers, including pharmacists, need to understand modifiable predictors of DD. Objective To assess and compare DD and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants and English-speaking patients of Anglo-Celtic background with diabetes, and determine DD predictors. Setting: Various healthcare settings in Australia. Method: A multicentre cross-sectional study was conducted. Adults with T2DM completed a survey comprised of validated tools. Glycated haemoglobin, blood pressure, and lipid profile were gathered from medical records. Multiple linear regression models were computed to assess the DD predictors. Main outcome measure: Diabetes distress level. Results Data was analysed for 696 participants: 56.3% Arabic-speaking immigrants and 43.7% English-speaking patients. Compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self-efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. Conclusion Results provided new insights to guide healthcare providers on reducing the apparent excess burden of DD among Arabic-speaking immigrants and potentially improve medication adherence, glycaemic control, and self-management.
- Published
- 2021
18. Factors associated with self-reported dental visits among older Melbournians. The MELSHA study 2008 data collection
- Author
-
Colette Joy Browning, Maryam Ferooz, Julian He, Ryuun Fujihara, Hugo Hancock, Rodrigo Mariño, Rachel Etzion, Hall Kendig, Joanne Enticott, and Mahmoud Elsamman
- Subjects
Gerontology ,Pension ,Government ,Data collection ,Multivariate analysis ,business.industry ,melsha participants ,australia ,Oral health ,Logistic regression ,elderly ,lcsh:RK1-715 ,lcsh:Dentistry ,health services for the aged ,dental health services ,Medicine ,longitudinal studies ,Healthy ageing ,business ,Older people ,General Dentistry - Abstract
Objective: To describe self-reported oral health-care visits and associated factors in older adults in Melbourne, Australia. Material and Methods: 201 older adults, 79-96 years, took part in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) in 2008. Participants who visited a dentist within 12-months prior were identified. Logistic regression examined factors associated with the 12-month visits. Results: 47.7% reported visits to the dentist in the previous 12 months. Multivariate analyses showed dentate participants (OR=11.27; 95% CI: 4.38-29.00) were more likely to have a 12-month visit, and; those receiving a government pension or benefit were less likely to have a 12-month visit (OR=0.38; 95% CI 0.18-0.79). Conclusion: Compared with existing data on the oral health of older Australians, MELSHA participants appear to have lower dental attendance. Findings highlight the need to increase older people sl eeking oral health-care, and the need to collect information to identify influencers of oral health service usage.
- Published
- 2019
19. Cross-cultural conceptualizations of ageing in Australia
- Author
-
Colette Joy Browning, Farzad Sharifian, Harriet Lindsay Radermacher, Susan Ellen Feldman, Hui Huang, and Hui Yang
- Subjects
050101 languages & linguistics ,Mechanical Engineering ,media_common.quotation_subject ,05 social sciences ,Ethnic group ,Energy Engineering and Power Technology ,Management Science and Operations Research ,Focus group ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Ageing ,Perception ,Cross-cultural ,0501 psychology and cognitive sciences ,030212 general & internal medicine ,Ethnolinguistics ,Aged care ,Older people ,Psychology ,media_common - Abstract
In this paper, the framework of Cultural Linguistics is employed to examine how older people from two different ethnic backgrounds in Australia conceptualize ageing and their own experience of ageing. The paper employs a qualitative method for the instantiations of interviews from two focus groups of Australian women. The results indicated that women of Anglo-Celtic background had a more self-oriented perception of ageing, aged care and self, while women of Chinese background had a more relational outlook. However, the evidence indicated that changes were taking place in both traditions despite a certain degree of continuity.
- Published
- 2018
20. Challenges of providing collaborative care for comorbid depression and hypertension in low resource settings in China
- Author
-
Shane Thomas and Colette Joy Browning
- Subjects
Gerontology ,Rural Population ,China ,business.industry ,Low resource ,Depression ,education ,Collaborative Care ,Article ,Psychiatry and Mental health ,Clinical Psychology ,Hypertension ,Medicine ,Humans ,Geriatrics and Gerontology ,business ,Depression (differential diagnoses) ,Aged - Abstract
BACKGROUND. Depression often coexists with other chronic conditions in older people. The COACH study is an ongoing RCT to test the effectiveness of a primary care-based collaborative care approach to treat comorbid hypertension and depression in Chinese rural elders. In the COACH model, a team—village doctor (VD), aging worker (AW), and psychiatrist consultant—provides collaborative care to enrolled subjects in each intervention village for 12 months. This study examines how COACH was implemented, and identifies facilitators and barriers for its more widespread implementation. METHODS. Five focus groups were conducted, two with VDs, two with AWs, and one with psychiatrists, for a total of 38 participants. Transcripts were analyzed using qualitative content analysis. RESULTS. COACH care team members showed shared understanding and appreciation of the team approach and integrated management of hypertension and depression. Team collaboration was smooth. All members regarded COACH to be effective in reducing depressive symptoms and improving patient health. Facilitators to implementation include training, leaders’ support, geographic proximity between VD and AW pairs, preexisting relationships among care team members, comparability of COACH activities and existing practices of VDs and AWs, and care team members’ caring about older members of their villages. Barriers to sustainability include frustration of some VDs related to their low wages and feelings of overload of some AWs. CONCLUSIONS. COACH was positively perceived and successfully implemented. The findings offer guidance for planning primary care-based collaborative depression care in low- and middle-income countries.
- Published
- 2020
21. Beyond crisis: Enacted sense-making among ethnic minority carers of people with dementia in Australia
- Author
-
Andrew Simon Gilbert, Mike Kent, Josefine Antoniades, Jon Adams, Colette Joy Browning, Bianca Brijnath, Dianne Goeman, and Katie Ellis
- Subjects
Sociology and Political Science ,media_common.quotation_subject ,Ethnic group ,Literacy ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Agency (sociology) ,Ethnicity ,medicine ,Humans ,Dementia ,Narrative ,030212 general & internal medicine ,Aged care ,Minority Groups ,Aged ,media_common ,Australia ,General Social Sciences ,General Medicine ,medicine.disease ,Negotiation ,Caregivers ,Geriatrics ,Psychology ,1103 Clinical Sciences, 1110 Nursing, 1702 Cognitive Sciences ,030217 neurology & neurosurgery ,Hindsight bias - Abstract
The ‘family crisis’ narrative is frequently used in dementia studies to explain ethnic minority families’ pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers’ agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families’ pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the ‘family crisis’ narrative as it illuminates the agency of carers’ in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy campaigns as well as initiatives that address structural inequities.
- Published
- 2020
22. Editorial: Chronic Illness and Ageing in China
- Author
-
Anna Chapman, Shuo Liu, Colette Joy Browning, Zeqi Qiu, and Shane Thomas
- Subjects
Gerontology ,China ,behavior change ,business.industry ,Behavior change ,aging ,health ,Editorial ,Ageing ,well-being ,Chronic Disease ,Medicine ,Humans ,Public Health ,business ,chronic illness - Published
- 2020
23. Design of an evidence-based diversity workshop to support participation of older people in their community care
- Author
-
Colette Joy Browning, Sally McMillan, Arti Appannah, Claudia Meyer, and Rajna Ogrin
- Subjects
Gerontology ,animal structures ,030505 public health ,Evidence-based practice ,Activities of daily living ,Praxis ,Community education ,business.industry ,media_common.quotation_subject ,respiratory system ,Education ,03 medical and health sciences ,0302 clinical medicine ,Andragogy ,Health care ,030212 general & internal medicine ,Geriatrics and Gerontology ,0305 other medical science ,business ,Older people ,Psychology ,human activities ,Diversity (politics) ,media_common - Abstract
Diversity is what makes a person unique, with the intersection of diversity characteristics potentially a strength or a barrier to accessing healthcare, and thereby affecting health and well-being ...
- Published
- 2018
24. ‘One size does not fit all’: Perspectives on diversity in community aged care
- Author
-
Claudia Meyer, Rajna Ogrin, Arti Appannah, Sally McMillan, and Colette Joy Browning
- Subjects
Aging ,Health Knowledge, Attitudes, Practice ,Inservice Training ,Attitude of Health Personnel ,Health Services for the Aged ,media_common.quotation_subject ,Judgement ,Health outcomes ,Ageism ,Interviews as Topic ,Judgment ,03 medical and health sciences ,Diversity training ,0302 clinical medicine ,Health care ,Humans ,Community Health Services ,030212 general & internal medicine ,Aged care ,Healthcare Disparities ,Empowerment ,Qualitative Research ,media_common ,Community Health Workers ,Community and Home Care ,Health Services Needs and Demand ,Medical education ,030505 public health ,Equity (economics) ,business.industry ,Health condition ,Age Factors ,General Medicine ,Culturally Competent Care ,Geriatrics ,Curriculum ,Geriatrics and Gerontology ,0305 other medical science ,Psychology ,business ,human activities - Abstract
OBJECTIVES: Typically, older people are viewed via a single health condition, yet health outcomes are likely impacted by the intersection of many individual characteristics. Promoting inclusive health care is underpinned by reducing bias, respectful communication and supporting individual needs and preferences. This study explores perspectives of community aged care workers on diversity training and implementing training into practice. METHODS: Ninety community aged care workers were telephone-interviewed three months after a one-day diversity training workshop. Interviews were audio-recorded, transcribed verbatim and analysed thematically. RESULTS: Five themes emerged: 'raising awareness'; 'reserving judgement'; 'confidence and empowerment to embed diversity into practice'; 'communicating effectively'; and 'thinking about change … but'. CONCLUSIONS: Diversity concepts were positively received, but applying diversity principles into practice is more difficult. Recommendations to promote inclusive health care included raising awareness of bias, communicating with inclusive language and embedding diversity concepts into community aged care practice by addressing individual, organisational and wider system constraints.
- Published
- 2018
25. Emergency demand, repeat and frequent presentations by older patients in metropolitan Melbourne: A retrospective cohort study using routinely collected hospital data
- Author
-
Judith Lowthian, Danielle Mazza, Colette Joy Browning, Marianne Shearer, Bianca Brijnath, Angela Joe, Christopher Pearce, and Lyle Turner
- Subjects
Geriatrics ,education.field_of_study ,medicine.medical_specialty ,Exacerbation ,business.industry ,Population ,030208 emergency & critical care medicine ,Retrospective cohort study ,Metropolitan area ,03 medical and health sciences ,0302 clinical medicine ,Older patients ,Health care ,Emergency medicine ,Public hospital ,Emergency Medicine ,Medicine ,030212 general & internal medicine ,business ,education - Abstract
OBJECTIVE To describe patterns for potentially avoidable general practice (PAGP)-type and non-PAGP-type ED presentations by older patients during 2008 and 2012. METHODS Retrospective analysis of ED presentations by patients ≥70 years for 2008 and 2012. Metropolitan Melbourne public hospital data were obtained from the Victorian Emergency Minimum Dataset. Outcomes were characteristics of PAGP-type and non-PAGP-type presentations as defined by the Australian Institute of Health and Welfare; numbers and rates per 1000 population ≥70 years of repeat (×2-3/year) and frequent (≥ ×4/year) PAGP-type and non-PAGP-type presentations. RESULTS The older metropolitan Melbourne population increased by 10.3% between 2008 and 2012, whereas the number of ED presentations increased by 12.7%. The volume of PAGP-type presentations decreased by 2.6%, with declining rates per 1000 population ≥70 years of repeat (7.2-6.2) and frequent (0.7-0.4) presentation. In contrast, the volume of non-PAGP-type presentations grew by 15.4%, with increasing repeat (57.6-60.7) and frequent (13.1-14.2) presentation rates per 1000 population ≥70 years. The majority (39%) of non-PAGP-type presentations by frequent ED attenders were due to cardiovascular or respiratory problems. CONCLUSION The rate of repeat and frequent PAGP-type presentations by older people decreased in 2012 compared with 2008, suggesting that initiatives implemented to reduce avoidable presentations may have had an effect. However, an increase in the rate of frequent non-PAGP-type presentations, predominately for acute exacerbation of cardiovascular and respiratory conditions, has important implications for planning future healthcare delivery; hence, the importance of initiatives such as the Health Care Home.
- Published
- 2018
26. Professor Hal Kendig's Legacy: A fierce advocate for the rights and contributions of older people
- Author
-
Colette Joy Browning and Kate O'Loughlin
- Subjects
Community and Home Care ,Policy making ,Political science ,Media studies ,MEDLINE ,Historical Article ,Biography ,General Medicine ,Geriatrics and Gerontology ,Older people ,Introductory Journal Article - Published
- 2019
27. Diversity training for the community aged care workers: A conceptual framework for evaluation
- Author
-
Sally McMillan, Colette Joy Browning, Elizabeth Barrett, Claudia Meyer, Arti Appannah, and Rajna Ogrin
- Subjects
Program evaluation ,Aging ,Native Hawaiian or Other Pacific Islander ,Social Psychology ,Health Services for the Aged ,Service delivery framework ,Health Personnel ,Strategy and Management ,education ,Geography, Planning and Development ,Health Services Accessibility ,Formative assessment ,03 medical and health sciences ,Diversity training ,Nursing ,Cultural diversity ,0502 economics and business ,Health care ,Homes for the Aged ,Humans ,Medicine ,Business and International Management ,Behavior ,Medical education ,030505 public health ,business.industry ,05 social sciences ,Australia ,Public Health, Environmental and Occupational Health ,Cultural Diversity ,Conceptual framework ,Needs assessment ,0305 other medical science ,business ,Delivery of Health Care ,Needs Assessment ,050203 business & management ,Program Evaluation - Abstract
Older Australians are an increasingly diverse population, with variable characteristics such as culture, sexual orientation, socioeconomic status, and physical capabilities potentially influencing their participation in healthcare. In response, community aged care workers may need to increase skills and uptake of knowledge into practice regarding diversity through appropriate training interventions. Diversity training (DT) programs have traditionally existed in the realm of business, with little research attention devoted to scientifically evaluating the outcomes of training directed at community aged care workers. A DT workshop has been developed for community aged care workers, and this paper focuses on the construction of a formative evaluative framework for the workshop. Key evaluation concepts and measures relating to DT have been identified in the literature and integrated into the framework, focusing on five categories: Training needs analysis; Reactions; Learning outcomes, Behavioural outcomes and Results The use of a mixed methods approach in the framework provides an additional strength, by evaluating long-term behavioural change and improvements in service delivery. As little is known about the effectiveness of DT programs for community aged care workers, the proposed framework will provide an empirical and consistent method of evaluation, to assess their impact on enhancing older people's experience of healthcare.
- Published
- 2017
28. Responsible gambling among older adults: a qualitative exploration
- Author
-
Pratika Satghare, Shane Thomas, Colette Joy Browning, Mythily Subramaniam, Siow Ann Chong, Janhavi Ajit Vaingankar, and Louisa Picco
- Subjects
Male ,lcsh:RC435-571 ,media_common.quotation_subject ,Ethnic group ,030508 substance abuse ,Delayed gratification ,Help-seeking ,Pleasure ,Self-Control ,Nonprobability sampling ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Psychiatry ,Humans ,Self-exclusion ,Family intervention ,Qualitative Research ,media_common ,Aged ,Singapore ,Limit setting ,Middle Aged ,030227 psychiatry ,Psychiatry and Mental health ,Harm ,Gambling ,Marital status ,Female ,0305 other medical science ,Psychology ,Qualitative research ,Clinical psychology ,Research Article - Abstract
Background Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one’s gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Methods Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. Results This global theme of RG comprised two organising themes: self –developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. Conclusions The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important. Electronic supplementary material The online version of this article (doi:10.1186/s12888-017-1282-6) contains supplementary material, which is available to authorized users.
- Published
- 2017
29. Preferences and Predictors of Aging in Place: Longitudinal Evidence from Melbourne, Australia
- Author
-
Colette Joy Browning, Lisa Cannon, Hal Kendig, and Cathy Honge Gong
- Subjects
Gerontology ,Longitudinal study ,Public Administration ,Aging in place ,business.industry ,Human factors and ergonomics ,Poison control ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,030502 gerontology ,Injury prevention ,Medicine ,030212 general & internal medicine ,0305 other medical science ,Life-span and Life-course Studies ,business ,Baseline (configuration management) - Abstract
This article reports older Australians' preferences for aging in place and predictors of their subsequent experiences drawing on a longitudinal study in Melbourne over 16 years. At baseline, 40% ha...
- Published
- 2017
30. Exercise interventions for the improvement of falls-related outcomes among older adults with diabetes mellitus: A systematic review and meta-analyses
- Author
-
Colette Joy Browning, Claudia Meyer, Anna Chapman, Emma Renehan, and Keith D. Hill
- Subjects
Gerontology ,Aging ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Poison control ,030209 endocrinology & metabolism ,Suicide prevention ,Occupational safety and health ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Diabetic Neuropathies ,Randomized controlled trial ,law ,Diabetes mellitus ,Injury prevention ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Exercise ,Postural Balance ,Gait Disorders, Neurologic ,Aged ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,Evidence-Based Medicine ,Muscle Weakness ,business.industry ,Human factors and ergonomics ,Evidence-based medicine ,medicine.disease ,Lower Extremity ,Sensation Disorders ,Physical therapy ,Accidental Falls ,business - Abstract
Introduction Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people; however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. Methods A systematic search for all years to September 2015 identified available literature. Eligibility criteria included: appropriate exercise intervention/s; assessed falls-related outcomes; older adults with DM. Effect sizes were pooled using a random effects model. Positive effect sizes favoured the intervention. Results Ten RCTs were eligible for the meta-analyses. Exercise interventions were more effective than the control condition for static balance (0.53, 95% CI: 0.13 to 0.93), lower-limb strength (0.63, 95% CI: 0.09 to 1.18), and gait (0.59, 95% CI: 0.22 to 0.96). No RCTs assessed falls-risk; one RCT reported 12month falls-rate, with no differential treatment effect observed. Conclusion Exercise interventions can improve certain falls-related outcomes among older adults with DM. Substantial heterogeneity and limited numbers of studies should be considered when interpreting results. Among older adults, where DM burden is increasing, exercise interventions may provide promising approaches to assist the improvement of falls-related outcomes.
- Published
- 2017
31. Diversity training for community aged care workers: An interdisciplinary meta-narrative review
- Author
-
Elizabeth Barrett, Colette Joy Browning, Claudia Meyer, Rajna Ogrin, Sally McMillan, Arti Appannah, and Hamzah Alzubaidi
- Subjects
030505 public health ,business.industry ,media_common.quotation_subject ,Public policy ,Education ,03 medical and health sciences ,Diversity training ,0302 clinical medicine ,Nursing ,Health care ,Workforce ,Medicine ,030212 general & internal medicine ,Geriatrics and Gerontology ,0305 other medical science ,business ,human activities ,Inclusion (education) ,Cultural competence ,Cultural pluralism ,Diversity (politics) ,media_common - Abstract
Population ageing signals the need for a responsive community aged care workforce respectful of older people’s diverse healthcare needs. Person-centered care premises individual needs and preferences to enhance participation in health care. Training for diversity does not yet exist for this workforce, but is necessary to ensure appropriate care for diverse community-dwelling older people. This article aims to review the range of research traditions for conceptualizing diversity training, theoretical approaches, and empirical findings to understand the relevance for the community aged care sector. Using a meta-narrative approach, research from health, education, psychology, sociology, and business literature was reviewed for meaningful contribution to supporting training for community aged care workers. Meta-narrative review principles included: planning, searching, mapping, appraisal/synthesis, and recommendations. Six meta-narratives were identified, consolidated into three areas: person-centered...
- Published
- 2017
32. Living well with chronic disease for those older adults living in the community
- Author
-
Hal Kendig, Richard Burns, and Colette Joy Browning
- Subjects
Male ,Gerontology ,Aging ,Health Status ,Vulnerability ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Activities of Daily Living ,Humans ,Medicine ,Longitudinal Studies ,030212 general & internal medicine ,Geriatric Assessment ,Aged ,Aged, 80 and over ,Successful aging ,business.industry ,Australia ,Psychiatry and Mental health ,Clinical Psychology ,Cross-Sectional Studies ,Logistic Models ,Chronic disease ,Chronic Disease ,Quality of Life ,Normative ,Female ,Healthy ageing ,Risk of death ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery - Abstract
Background:Definitions of successful aging that incorporate dimensions of physical capacity and medical conditions are limited owing to the normative nature of experiencing medical conditions with age. We examine the capacity for older adults living in the community to live well with or without chronic disease as they age.Method:Participants (n = 1,001) were from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) study who were aged 65+ years at baseline, were living in the community and followed for 16 years.Results:Aging was associated with not living well (OR = 1.21; p < 0.001) and having a chronic disease (OR = 1.09; p < 0.001). There was increasing proportion of older adults not living well with chronic disease as they aged. Those not living well were at a substantial risk of death with (OR = 3.63; p < 0.001) or without (OR = 3.59; p < 0.001) chronic disease.Discussion:The defining normative experience for older adults is that they are more likely to have a chronic disease and importantly not be living well with chronic disease as they age. However, it was the state of not living well that reflected the most substantial vulnerability for mortality, not chronic disease.
- Published
- 2017
33. After‐hours medical deputising services: patterns of use by older people
- Author
-
Marianne Shearer, Angela Joe, Bianca Brijnath, Judy Lowthian, Christopher Pearce, Lyle Turner, Danielle Mazza, and Colette Joy Browning
- Subjects
Male ,Gerontology ,Attitude of Health Personnel ,Health Services for the Aged ,education ,03 medical and health sciences ,0302 clinical medicine ,After-Hours Care ,Retrospective analysis ,Homes for the Aged ,Humans ,Medicine ,030212 general & internal medicine ,Aged care ,Aged ,Quality of Health Care ,Retrospective Studies ,Aged, 80 and over ,Service (business) ,Primary Health Care ,business.industry ,Australia ,Outcome measures ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Emergency department ,Contract Services ,Home visits ,Female ,business ,Older people - Abstract
OBJECTIVES To examine how older people use an after-hours medical deputising service that arranges home visits by locum general practitioners; to identify differences in how people who live in the community and those who live in residential aged care facilities (RACFs) use this service. DESIGN, SETTING AND PARTICIPANTS Retrospective analysis of routinely collected administrative data from the Melbourne Medical Deputising Service (MMDS) for the 5-year period, 1 January 2008 - 31 December 2012. Data for older people (≥ 70 years old) residing in greater Melbourne and surrounding areas were analysed. MAIN OUTCOME MEASURES Numbers and rates of MMDS bookings for acute after-hours care, stratified according to living arrangements (RACF v community-dwelling residents). RESULTS Of the 357 112 bookings logged for older patients during 2008-2012, 81% were for RACF patients, a disproportionate use of the service compared with that by older people dwelling in the community. Most MMDS bookings resulted in a locum GP visiting the patient. During 2008-2012, the booking rate for RACFs increased from 121 to 168 per 1000 people aged 70 years or more, a 39% increase; the booking rate for people not living in RACFs increased from 33 to 40 per 1000 people aged 70 years or more, a 21% increase. CONCLUSIONS After-hours locum GPs booked through the MMDS mainly attended patients living in RACFs during 2008-2012. Further research is required to determine the reasons for differences in the use of locum services by older people living in RACFs and in the community.
- Published
- 2016
34. The inter-relationship of diversity principles for the enhanced participation of older people in their care: a qualitative study
- Author
-
Arti Appannah, Sally McMillan, Claudia Meyer, Rajna Ogrin, and Colette Joy Browning
- Subjects
Male ,medicine.medical_specialty ,Victoria ,Service delivery framework ,03 medical and health sciences ,Diversity training ,0302 clinical medicine ,030502 gerontology ,medicine ,Nursing Services ,Humans ,030212 general & internal medicine ,Aged care ,Health policy ,Qualitative Research ,Aged ,Intersectionality ,Aged, 80 and over ,Medical education ,Diversity ,lcsh:Public aspects of medicine ,Health Policy ,Public health ,Research ,Public Health, Environmental and Occupational Health ,Health services research ,Participation ,lcsh:RA1-1270 ,Professional-Patient Relations ,Home Care Services ,Service delivery ,Self Care ,Workforce ,Female ,0305 other medical science ,Psychology ,Attitude to Health ,Qualitative research - Abstract
BackgroundThe health and aged care workforce must understand and support the diverse needs of older people to enhance their care experience. We previously identified five principles of diversity training for this workforce: awareness of unconscious bias and prejudice; promotion of inclusion; access and equity; appropriate engagement; and intersectionality. This study aims to explore how these principles are considered from the perspectives of older Australians.MethodsOlder people (≥65 years) receiving home care and nursing services based in Victoria, Australia were invited to participate in a home-based semi-structured interview about their experience of, or with, diversity. Interviews were thematically analysed using a priori categories based on our previous work on principles of diversity training, and themes were interpreted and expanded upon based on the participants’ experiences and understanding of diversity concepts and their care needs.ResultsFifteen older people (seven female, eight male), mean age 76 years (range 71–85 years), were interviewed. Five themes were drawn from the data. It was found that human connection through building (1)trust and rapportwas highly valued as an approach by older people, crucial as a first step to understanding what is important to the older person. Identifying with (2)intersectionality, that is, the different intersecting aspects of who they are and their experiences was understood by the participants as an important framework to meet their needs. The participants were aware of (3)unconscious bias and prejudiceby health professionals and its impact on their care. Participants also noted that (4)promotion of inclusion through languagewas important to for a positive relationship with the healthcare worker. The participants understood that to facilitate human connection, these four principles of human interaction were critical, underpinned by (5)access and equityof the system. A model articulating these relationships was developed.ConclusionHealth and aged care training should incorporate the five diversity principles to support older people to participate in their own care.
- Published
- 2019
35. Self-assessed impact of oral health on the psychological well-being and depressive symptoms of older adults living in Melbourne
- Author
-
Joanne Enticott, Ryuun Fujihara, Maryam Ferooz, Rodrigo Mariño, Colette Joy Browning, Julian He, Hal Kendig, Hugo Hancock, Mahmoud Elsamman, and Rachel Etzion
- Subjects
Multivariate analysis ,Cross-sectional study ,media_common.quotation_subject ,Oral Health ,Human physical appearance ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Medicine ,Humans ,General Dentistry ,Depression (differential diagnoses) ,media_common ,Aged ,030505 public health ,business.industry ,Depression ,Public Health, Environmental and Occupational Health ,Australia ,030206 dentistry ,Cross-Sectional Studies ,Feeling ,Psychological well-being ,Quality of Life ,0305 other medical science ,business ,Independent living ,Clinical psychology - Abstract
OBJECTIVES: This study aimed to investigate oral health-related factors affecting the self-assessed psychological well-being (PW) and depressive symptoms of independent-living Australians aged 79 years and over living in the community in metropolitan Melbourne. METHODS: The Melbourne Longitudinal Studies on Healthy Aging (MELSHA) program was used as the data source in this study and includes data on the health and well-being of older participants. The MELSHA baseline data collection occurred in 1994, the current study used data from the 2008 data collection and included 201 participants, who remained in the study. Data were analyzed using multiple linear regression (MLR) analysis with a stepwise procedure to identify the variables that accounted for a significant proportion of the variance in the participants' PW scores. RESULTS: Present findings indicate that oral health may play a significant mediating role in PW through maintaining a presentable and acceptable physical appearance. Some 16.4 percent of participants reported feeling concerned about their dental appearance, either "Sometimes," "Often," or "Very often." Multivariate analysis showed significantly influences on PW positive and negative affect scores (P
- Published
- 2019
36. Dual Sensory Loss, Mental Health, and Wellbeing of Older Adults Living in China
- Author
-
Chyrisse Heine, Cathy Honge Gong, and Colette Joy Browning
- Subjects
Gerontology ,Longitudinal study ,China ,Activities of daily living ,Hearing loss ,medicine.medical_treatment ,Population ,03 medical and health sciences ,0302 clinical medicine ,sensory loss ,wellbeing ,medicine ,030212 general & internal medicine ,education ,life satisfaction ,Original Research ,education.field_of_study ,Rehabilitation ,lcsh:Public aspects of medicine ,030503 health policy & services ,Public Health, Environmental and Occupational Health ,Life satisfaction ,lcsh:RA1-1270 ,dual sensory loss ,medicine.disease ,Comorbidity ,Mental health ,depression ,Public Health ,medicine.symptom ,0305 other medical science ,Psychology ,mental health - Abstract
Introduction: Deterioration in vision and hearing commonly occurs as adults age. Existing literature shows that Dual Sensory Loss (DSL) is a prevalent condition amongst older adults. In China, it has been estimated that 57.2% of the population experience DSL. Based on a small number of research papers, it has been identified that DSL influences mental health and wellbeing. The aims of this study were to explore the relationship between DSL and mental health and wellbeing in a sample of older adults residing in China; and investigate whether the comorbidities of functional dependency [Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL)] and chronic diseases influence the impacts of DSL on mental health and wellbeing. Method: The China Health and Retirement Longitudinal Study Wave 2, 2013 data collection of a sample of people aged 60 years and over (n=8,268) was used in this study. The sensory loss variables selected for analysis included a combined variable of self-reported vision and hearing loss (DSL). Mental health was measured by depression, and general wellbeing was measured by life satisfaction. In addition, chronic diseases and limitations in IADL and ADL were used to test how their comorbidities with DSL influence mental health and wellbeing. Results were analysed descriptively and using regression and modelling techniques. Results and Discussion: DSL was significantly and positively associated with advanced age, having difficulty in any ADL or IADL and experiencing depression and less life satisfaction. The observed negative associations between DSL and mental health or wellbeing, are indirect and could be partially explained by its comorbidity with chronic diseases and relationship to functional limitations. It is recommended that health services in China screen for DSL in older people and develop integrated services to assist with appropriate management and rehabilitation of older people with DSL focussing on both functional and mental health issues.
- Published
- 2019
37. Diversity training evaluation for community aged care: Tool development
- Author
-
Arti Appannah, Sally McMillan, Colette Joy Browning, Rajna Ogrin, and Claudia Meyer
- Subjects
Male ,Delphi Technique ,media_common.quotation_subject ,education ,Delphi method ,Education ,03 medical and health sciences ,Diversity training ,0302 clinical medicine ,Cronbach's alpha ,Surveys and Questionnaires ,Health care ,Humans ,030212 general & internal medicine ,General Nursing ,Reference group ,media_common ,Aged ,Medical education ,030504 nursing ,business.industry ,Reproducibility of Results ,General Medicine ,Culturally Competent Care ,Exploratory factor analysis ,Attitude ,Sexual orientation ,Female ,0305 other medical science ,business ,Psychology ,Delivery of Health Care ,Diversity (politics) - Abstract
Diversity characteristics such as culture, sexual orientation, and social situation potentially impact the participation of older individuals in healthcare. An awareness of diversity characteristics and their potential to impact on older people's access to health and aged care by professionals through training is important. This paper outlines the development and initial validation of a survey using adapted Delphi methodology and distribution to 195 health and aged care professionals pre- and post-diversity training. An initial pool of 31 items were developed with an expert reference group and reduced to 21 through exploratory factor analysis. A two-factor solution was extracted, measuring skills and attitudes of professionals relative to providing services to older people with diverse characteristics. Internal consistency of the items yielded a Cronbach alpha of 0.78. T-tests conducted on the pre- and post-survey data showed significantly higher scores on the domains of skills and attitudes following the training. Knowledge was not effectively captured using this method, with true-false or free-recall questions being a more appropriate approach. This tool fills a gap in the evaluation literature, providing an important first step to assess outcomes of diversity training in community aged care. Further validation is necessary for the tool to be used more widely in the sector.
- Published
- 2019
38. Non-communicable Diseases and Cognitive Impairment: Pathways and Shared Behavioral Risk Factors Among Older Chinese
- Author
-
Vasoontara Sbirakos Yiengprugsawan and Colette Joy Browning
- Subjects
Gerontology ,China ,medicine.medical_specialty ,Population ageing ,Mini Review ,Primary health care ,Behavioral risk ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,Cognitive decline ,Cognitive impairment ,business.industry ,lcsh:Public aspects of medicine ,030503 health policy & services ,Public health ,aging ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Cognition ,cognitive decline ,chronic conditions ,lifestyle risk factors ,Ageing ,Public Health ,0305 other medical science ,business - Abstract
Population ageing has brought about a number of challenges for public health and primary health care systems, including increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive and mild cognitive impairment (CI/MCI) through common risk factors. Identiyfing risk factors is important for the prevention and management of theses chronic conditions. The review also identifies the role of primary health care services in reducing behavioural risk factors for NCDs and CI/MCI. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCDs biomarkers and behavioural risk factors could also be beneficial for the cognitive health among older Chinese.
- Published
- 2018
39. Predictors of outcomes of psychological treatments for disordered gambling: A systematic review
- Author
-
Stephanie S Merkouris, Shane Thomas, Colette Joy Browning, and Nicki A. Dowling
- Subjects
050103 clinical psychology ,medicine.medical_specialty ,medicine.medical_treatment ,Ethnic group ,030508 substance abuse ,Impulsivity ,Severity of Illness Index ,03 medical and health sciences ,Sex Factors ,Severity of illness ,medicine ,Humans ,0501 psychology and cognitive sciences ,Treatment outcome ,Big Five personality traits ,Psychiatry ,05 social sciences ,Age Factors ,Attendance ,Patient Acceptance of Health Care ,Psychotherapy ,Cognitive behavioral therapy ,Clinical Psychology ,Psychiatry and Mental health ,Gambling ,Systematic review ,Anxiety ,medicine.symptom ,0305 other medical science ,Psychology ,Psychosocial ,Predictor ,Clinical psychology - Abstract
This systematic review aimed to synthesise the evidence relating to pre-treatment predictors of gambling outcomes following psychological treatment for disordered gambling across multiple time-points (i.e., post-treatment, short-term, medium-term, and long-term). A systematic search from 1990 to 2016 identified 50 articles, from which 11 socio-demographic, 16 gambling-related, 21 psychological/psychosocial, 12 treatment, and no therapist-related variables, were identified. Male gender and low depression levels were the most consistent predictors of successful treatment outcomes across multiple time-points. Likely predictors of successful treatment outcomes also included older age, lower gambling symptom severity, lower levels of gambling behaviours and alcohol use, and higher treatment session attendance. Significant associations, at a minimum of one time-point, were identified between successful treatment outcomes and being employed, ethnicity, no gambling debt, personality traits and being in the action stage of change. Mixed results were identified for treatment goal, while education, income, preferred gambling activity, problem gambling duration, anxiety, any psychiatric comorbidity, psychological distress, substance use, prior gambling treatment and medication use were not significantly associated with treatment outcomes at any time-point. Further research involving consistent treatment outcome frameworks, examination of treatment and therapist predictor variables, and evaluation of predictors across long-term follow-ups is warranted to advance this developing field of research.
- Published
- 2016
- Full Text
- View/download PDF
40. Patterns of social engagement in the transition to later life
- Author
-
Lorraine Dennerstein, Katherine F. Burn, Colette Joy Browning, and Cassandra Szoeke
- Subjects
Employment ,Male ,Volunteers ,Gerontology ,Aging ,Context (language use) ,General Biochemistry, Genetics and Molecular Biology ,social engagement ,03 medical and health sciences ,Interpersonal relationship ,0302 clinical medicine ,Humans ,Medicine ,Family ,Interpersonal Relations ,Prospective Studies ,030212 general & internal medicine ,Social Behavior ,Social identity theory ,Retirement ,030214 geriatrics ,business.industry ,Social change ,Obstetrics and Gynecology ,Loneliness ,Middle Aged ,Social engagement ,ageing ,Ageing ,Female ,women ,medicine.symptom ,business ,Retirement age - Abstract
As social roles in later life are shaped by significant life events and changes occurring in the late-life transition, examining social engagement in midlife may provide a context for interpreting the ageing social identity. This is particularly important for women, who are heavily dependent on social relationships and are more influenced by social losses and change. Objective To examine major social changes occurring in the decade prior to late-life, starting from approximately 45–55 years of age. Study design The study accessed data from the longitudinal prospective Women’s Healthy Ageing Project (WHAP). Participants were 493 women who had completed at least one assessment in the first 12 years of the study. Results Living with a partner was common and stable amongst participants, while the proportion with children still at home decreased markedly (79–44%). Full-time employment also decreased as participants approached the average retirement age (40–13%). Volunteer work was popular throughout the study, increasing slightly with age, and minding grandchildren was common at the end of the study period (80%). Conclusions Taken together, these findings suggest a notable deficit in participants’ social lives as they transition into later life, but with some evidence of compensation by increasing other social activities.
- Published
- 2016
41. Social inclusion and the Fatosphere: the role of an online weblogging community in fostering social inclusion
- Author
-
Samantha L. Thomas, Marissa Dickins, Susan Ellen Feldman, and Colette Joy Browning
- Subjects
Adult ,Male ,Health (social science) ,Blogging ,Social stigma ,media_common.quotation_subject ,Social Stigma ,Judgement ,Stigma (botany) ,050109 social psychology ,Space (commercial competition) ,03 medical and health sciences ,0302 clinical medicine ,Perception ,Humans ,0501 psychology and cognitive sciences ,Inclusion–exclusion principle ,Obesity ,030212 general & internal medicine ,Qualitative Research ,media_common ,Internet ,Social Identification ,Health Policy ,05 social sciences ,Public Health, Environmental and Occupational Health ,Female ,Psychology ,Social psychology ,Inclusion (education) ,Qualitative research - Abstract
Overweight and obesity are one of the most salient issues within society today, and the stigmatisation of overweight individuals is prevalent and widespread. Utilising interviews with 44 individuals who blog within an online fat acceptance community known as the Fatosphere, participants' perceptions of inclusion and exclusion were examined within their offline and online environments. Additionally, the effect this had on their offline lives was examined. Participants described a profound sense of exclusion within their offline lives through three agencies: the medicalisation of 'fatness', the weight loss industry and the media, which echoed descriptions of moral judgement. Furthermore, a sense of inclusion was described within the Fatosphere through the protection and support that they found within this 'safe space'. The effects of the Fatosphere influenced their lives in both negative and positive ways, allowing them to better deal with stigma and discrimination, but sometimes effecting their offline relationships in a negative manner. The Fatosphere provides a unique opportunity for corpulent individuals to engage in a community that is removed from the prominent weight-related discourse within modern society.
- Published
- 2016
42. Older Women in Australia: Facing the Challenges of Dual Sensory Loss
- Author
-
Colette Joy Browning, Chyrisse Heine, Susan Ellen Feldman, and Cathy Honge Gong
- Subjects
Male ,Gerontology ,Aging ,Health, Toxicology and Mutagenesis ,Population ,Vision Disorders ,lcsh:Medicine ,Poison control ,australia ,Suicide prevention ,Article ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,well-being ,030502 gerontology ,Injury prevention ,Humans ,Medicine ,older women ,Longitudinal Studies ,030212 general & internal medicine ,Social determinants of health ,Hearing Loss ,education ,social health ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,lcsh:R ,Public Health, Environmental and Occupational Health ,dual sensory loss ,Sensory loss ,Middle Aged ,3. Good health ,Logistic Models ,quality of life ,Female ,0305 other medical science ,business ,physical health ,mental health - Abstract
With the increase in longevity, the number of women living into old age is rising and higher than that of men. Data was derived from the Melbourne Longitudinal Studies on Healthy Ageing Program, which included 533 women and 467 men aged 65 years and older, in Australia, over 10 years. Logistic regression modeling was used to investigate the prevalence of dual sensory loss and the unmet needs for vision and hearing devices in older women (compared to men) over time, as well as its impacts on self-reported general health, depression, perceived social activities, community service use and ageing in place. Results suggested that the prevalence of dual sensory loss increased for women from the age of 75 years and over. Dual sensory loss was higher for older women and men who were living alone, with government benefits as their main income source or were divorced, separated or widowed. Dual sensory loss had significant impacts on poor general health, perceived inadequate social activities and community service use for women and men and on depression for women only. Early identification of dual sensory loss is essential to minimize its effects, ensuring continued well-being for this population.
- Published
- 2019
43. HOspitals and patients WoRking in Unity (HOW R U?): telephone peer support to improve older patients’ quality of life after emergency department discharge in Melbourne, Australia—a multicentre prospective feasibility study
- Author
-
Cate Rosewarne, Debra O'Brien, Colette Joy Browning, Lee Boyd, Judy Lowthian, Alyse Lennox, De Villiers Smit, Peter Cameron, Gillian Wilson, Andrea J. Curtis, Cathie Smith, and Jeremy Dale
- Subjects
Male ,medicine.medical_specialty ,gerontology ,social isolation ,post-discharge ,Frail Elderly ,volunteer-peer ,030204 cardiovascular system & hematology ,Peer support ,03 medical and health sciences ,Social support ,0302 clinical medicine ,HV ,Quality of life ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Social isolation ,telephone-support ,Aged ,Aged, 80 and over ,business.industry ,Depression ,Research ,Loneliness ,Australia ,Social Support ,General Medicine ,Emergency department ,Patient Discharge ,Telephone ,Mood ,ZA ,Physical therapy ,Quality of Life ,Feasibility Studies ,Geriatric Depression Scale ,Female ,Health Services Research ,Independent Living ,medicine.symptom ,business ,Emergency Service, Hospital ,RA - Abstract
Objectives: To ascertain the feasibility and acceptability of the HOW R U? programme, a novel volunteer-peer postdischarge support programme for older patients after discharge from the emergency department (ED).\ud \ud Design: A multicentre prospective mixed-methods feasibility study.\ud \ud Setting: Two tertiary hospital EDs in metropolitan Melbourne, Australia.\ud \ud Participants: A convenience sample of 39 discharged ED patients aged 70 years or over, with symptoms of social isolation, loneliness and/or depression.\ud \ud Intervention: The HOW R U? intervention comprised weekly social support telephone calls delivered by volunteer peers for 3 months following ED discharge.\ud \ud Primary and secondary outcome measures: The primary outcomes were feasibility of study processes, intervention acceptability to participants and retention in the programme. Secondary outcomes were changes in loneliness level (UCLA-3—3-item Loneliness Scale), mood (5-item Geriatric Depression Scale) and health-related quality of life (EQ-5D-5L and EQ-VAS) postintervention.\ud \ud Results: Recruitment was feasible, with 30% of eligible patients successfully recruited. Seventeen volunteer peers provided telephone support to patient participants, in addition to their usual hospital volunteer role. HOW R U? was well received, with 87% retention in the patient group, and no attrition in the volunteer group.\ud \ud The median age of patients was 84 years, 64% were female, and 82% lived alone. Sixty-eight per cent of patients experienced reductions in depressive symptoms, and 53% experiencing reduced feelings of loneliness, and these differences were statistically significant Patient feedback was positive and volunteers reported great satisfaction with their new role.\ud \ud Conclusion: HOW R U? was feasible in terms of recruitment and retention and was acceptable to both patients and volunteers. The overall results support the potential for further research in this area and provide data to support the design of a definitive trial to confirm the observed effects.\ud \ud Trial registration number: ANZCTRN12615000715572; Results.
- Published
- 2018
44. Gambling and family: A two-way relationship
- Author
-
Pratika Satghare, Colette Joy Browning, Mythily Subramaniam, Siow Ann Chong, and Shane Thomas
- Subjects
Male ,Secondary education ,family ,Full-Length Report ,Ethnic group ,030508 substance abuse ,Medicine (miscellaneous) ,03 medical and health sciences ,0302 clinical medicine ,Help-Seeking Behavior ,Humans ,gambling initiation ,Qualitative Research ,Aged ,Singapore ,Lived experience ,Perspective (graphical) ,help-seeking ,Role ,Mean age ,General Medicine ,Help-seeking ,gambling-related harm ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Harm ,Attitude ,Thematic network ,Gambling ,Female ,Family Relations ,0305 other medical science ,Psychology ,Clinical psychology - Abstract
Background and aims Families play an important role in the evolution of gambling and are also adversely affected by the disordered gambling of any one of their members. The aims of this study were to explore both the role families play in gambling initiation, maintenance, and help-seeking, and the harm caused to families by the gambling behavior using a qualitative approach. Methods Regular older adult gamblers were included in the study. In-depth interviews were conducted with 25 older adults to gain an understanding of gambling from their perspective. Older adult gamblers described their lived experience of gambling ranging from initiation to harm and attempts to cut down or limit gambling. Data were analyzed using thematic network analysis. Results The mean age of the 25 participants was 66.2 years. The majority were male (n = 18), of Chinese ethnicity (n = 16), had secondary education (n = 9), were married (n = 20), and currently employed (n = 15). Four organizing themes related to the role of families in initiation and maintenance of gambling, harm caused to family members, and their role in help-seeking were identified. Discussion and conclusions The study emphasizes the role of Asian families in both initiation and maintenance of gambling. Hence, families must be involved in prevention and outreach programs. Family members must be educated, so that they can encourage help-seeking to ensure early treatment and recovery. There is a need for interventional studies for reducing stress and improving coping among family members.
- Published
- 2017
45. Dual Sensory Loss in Older Adults: A Systematic Review
- Author
-
Colette Joy Browning and Chyrisse Heine
- Subjects
Gerontology ,Activities of daily living ,Hearing loss ,Population ,Vision Disorders ,Quality of life (healthcare) ,Activities of Daily Living ,Humans ,Medicine ,Hearing Loss ,education ,Aged ,education.field_of_study ,business.industry ,Sensory loss ,General Medicine ,medicine.disease ,Comorbidity ,Systematic review ,Digital subscriber line ,Quality of Life ,Female ,Geriatrics and Gerontology ,medicine.symptom ,business - Abstract
PURPOSE OF THE STUDY Combined vision and hearing loss [dual sensory loss (DSL)] is commonly experienced by older adults. The literature on comorbidities and outcomes associated with DSL in older adults is limited and thus a systematic review was conducted to explore the existing research and identify gaps in the evidence base. DESIGN AND METHODS A review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews. Forty-two articles were selected for review. RESULTS Although several studies evaluated DSL and its comorbidities and impacts, few fully met the criteria for good study design. Reviewed studies primarily investigated DSL and its comorbidities using cross-sectional methods and varying methods of vision and hearing assessment. Many of the studies were large population studies that did not provide sufficient information to draw valid conclusions about the impact of DSL in older adults. IMPLICATIONS Studies focusing specifically on sensory loss in older people across a broad age range are needed to inform clinical practice so that DSL and its impacts in older adults can be identified and managed, leading to improved quality of life for this population.
- Published
- 2015
46. Culture and age influences upon gambling and problem gambling
- Author
-
Siow Ann Chong, Louisa Picco, Shane Thomas, Colette Joy Browning, Edimansyah Abdin, Mythily Subramaniam, Janhavi Ajit Vaingankar, and Shazana Shahwan
- Subjects
medicine.medical_specialty ,Secondary education ,lcsh:Social pathology. Social and public welfare. Criminology ,Socialization ,lcsh:BF1-990 ,Logistic regression ,medicine.disease ,Comorbidity ,South oaks gambling screen ,Article ,Chronic physical conditions ,Odds ,lcsh:HV1-9960 ,Psychiatry and Mental health ,lcsh:Psychology ,Secondary analysis ,medicine ,Composite international diagnostic interview ,Community survey ,Psychiatry ,Psychology ,Survey ,Pathological ,Behavioral Sciences ,Demography - Abstract
Objective This study aimed to (i) examine the prevalence and types of gambling, (ii) establish prevalence of ‘pathological’ gambling, (iii) explore the correlates of gambling, and (iv) establish psychiatric and physical comorbidity in a sample of older adult gamblers (≥ 60 years) in contrast to younger gamblers in a representative population sample in Singapore. Method This paper reports the results of a secondary analysis of data from a representative community survey of 6616 participants, of which 2252 had engaged in gambling activities at least once in their lifetime. Results 48.9% of older adults reported lifetime gambling. Older gamblers were more likely to be males, married or widowed (vs. never married), with pre-primary, primary and secondary education (vs. university), economically inactive (vs. employed) and had personal annual income of SGD $19,999 and below (vs. SGD $50,000 and above). Older gamblers had significantly higher rates of betting on horses, playing numbers or betting on lotteries, and playing Mahjong. After adjusting for demographic variables in multiple logistic regression analyses, gamblers aged 60 years and older had significantly lower odds of having pathological gambling than those in the younger age group (OR = 0.4). Older gamblers had significantly higher odds of having diabetes (OR = 3.2), hypertension (OR = 4.9), and any comorbid chronic physical condition assessed in this study. Conclusions For the majority of older adults, gambling remains a recreational activity that is entertaining and a way of socialization. However, one must remain cognizant of the possible risks for some to develop disordered gambling., Highlights • 48.9% of older adults in Singapore reported lifetime gambling. • Older gamblers were more likely to be males, married or widowed, and had lower education. • Older gamblers had significantly lower odds of having pathological gambling.
- Published
- 2015
47. Examining the 16-year trajectories of mental health and wellbeing through the transition into widowhood
- Author
-
Richard Burns, Hal Kendig, and Colette Joy Browning
- Subjects
Male ,Gerontology ,De facto ,Victoria ,Gee ,Sex Factors ,Humans ,Longitudinal Studies ,Generalized estimating equation ,Depression (differential diagnoses) ,Aged ,Aged, 80 and over ,Psychiatric Status Rating Scales ,Depression ,Australia ,Widowhood ,Mental health ,Psychiatry and Mental health ,Clinical Psychology ,Mental Health ,Quality of Life ,Regression Analysis ,Female ,Healthy ageing ,Geriatrics and Gerontology ,Psychology ,Bereavement ,Clinical psychology - Abstract
Background:Becoming widowed is a significant event. There is considerable evidence that surviving partners report substantial changes in their wellbeing and mental health. Changes can occur prior to partner's death as an anticipatory effect and consequently during the period after partner's death. For most, declines in wellbeing and mental health dissipate over time. However, there is a limited long-term evidence to compare age-normative trajectories in mental health and wellbeing with the trajectories of those who transition into widowhood.Methods:Participants (n= 652) were older adults (aged 65–94 years at baseline) from the 16-year Melbourne Longitudinal Studies on Healthy Ageing project who were either married orde facto(n= 577), or recently widowed (n= 75). Generalized Estimating Equations (GEE) examined the immediate and long-term impact of widowhood. GEE piecewise regression analyses examined the trajectories of wellbeing and mental health in those who transitioned into widowed with time centered at time of partner's death. Analyses were stratified by gender.Results:For both men and women, becoming widowed was strongly related to a strong decline in positive affect post partner's death. Otherwise, no long-term impact of widowhood on negative affect or depressive symptomology was reported.Conclusions:The impact of widowhood reports differential impacts on different indicators of wellbeing and mental health, which were inconsistent between men and women.
- Published
- 2015
48. Prevalence and determinants of gambling disorder among older adults: A systematic review
- Author
-
Mythily Subramaniam, Pauline Soh, Siow Ann Chong, Janhavi Ajit Vaingankar, Shane Thomas, Peizhi Wang, and Colette Joy Browning
- Subjects
Male ,Younger age ,media_common.quotation_subject ,Medicine (miscellaneous) ,Toxicology ,Limited access ,Age Distribution ,Risk Factors ,Prevalence ,Humans ,Sex Distribution ,Aged ,media_common ,Marital Status ,Earnings ,Incidence (epidemiology) ,Addiction ,Middle Aged ,Psychiatry and Mental health ,Clinical Psychology ,Systematic review ,Socioeconomic Factors ,Gambling ,Gambling disorder ,Female ,Psychology ,Systematic search ,Clinical psychology - Abstract
Aims This paper aims to systematically review studies on the prevalence of gambling disorder among older adults aged 60 years and above and to summarize the evidence on the determinants, risk factors as well as the comorbidities associated with it. Methods A systematic search was conducted for peer-reviewed, journal articles between 1st January 1995 and 1st May 2013. Only original studies which were published in English, included participants older than 60 years of age and provided prevalence figures specifically among them, and where participants were assessed to have a gambling disorder by a validated instrument in non-treatment seeking/non-clinical setting were included. Results 25 eligible studies were identified from the literature. The prevalence of lifetime gambling disorder ranged from 0.01% to 10.6% across studies. Prevalence of gambling disorder is higher among the younger age groups (of older adults) and among males as compared to females. Those with gambling disorder were more likely to be single or divorced/separated. Findings indicate that older adults may gamble more in an effort to ameliorate negative emotional states; they may have limited access to other exciting activities or they may be unable to participate in activities that they were previously able to and they might attempt to fill this gap with gambling. Conclusions Gambling disorder among older adults is a significant problem. Fixed incomes and limited prospects of future earnings make them an extremely vulnerable group. There is an urgent need to understand the phenomenon of gambling disorder in older adults.
- Published
- 2015
49. Systematic Review of Diabetes Self-Management: Focusing on the Middle-Aged Population of Pakistan and Saudi Arabia
- Author
-
Rashid M Ansari, Colette Joy Browning, and John Dixon
- Subjects
Gerontology ,education.field_of_study ,Coping (psychology) ,Traditional medicine ,business.industry ,education ,Population ,MEDLINE ,PsycINFO ,Cochrane Library ,Social support ,Health care ,Medicine ,business ,Qualitative research - Abstract
The aim is to synthesize the most contemporary qualitative research on the self-management of type 2 diabetes with specific interest in the population of Pakistan and Saudi Arabia. The electronic databases searched include the Cochrane library, MEDLINE, PubMed, EMBASE and PsycINFO, between the year 1993 and 2013. The inclusion criteria was the middle-aged population aged 40 - 60 years. Studies must report qualitative research on diabetes self-management, diabetic complications, quality of life, and patient-doctor relationship or interaction. Out of the 36 identified studies, 30 studies from the literature search representing self-management in context suggest that the multiple contextual factors identified are the fertile ground for further research, and the context which is useful for health care professionals suggests that coping with diagnosis and living with diabetes are affected by a complex constellation of factors, including life circumstances, social support, gender roles and economy. Three conceptual themes were identified from the analysis. The review has revealed that there is a lack of studies in literature on self-management of type 2 diabetes in both the countries.
- Published
- 2015
50. Ageing in Australia
- Author
-
Hal Kendig, Colette Joy Browning, and Kate O'Loughlin
- Subjects
Gerontology ,Ageing ,Sociology - Published
- 2017
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.