73 research outputs found
Cognitive versus exposure therapy for problem gambling: randomised controlled trial
No full textAbstract not availableDavid P. Smith, Malcolm W. Battersby, Peter W. Harvey, Rene G. Pols, Robert Ladouceu
Health reform through coordinated care: SA HealthPlus
No full textCopyright © 2005 BMJ Publishing Group Ltd.Malcolm W Battersby and the SA HealthPlus Tea
The Gambling Urge Scale: reliability and validity in a clinical population
No full textThe aim of this study was to establish reliability and validity of the Gambling Urge Scale (GUS) in a clinical population of problem gamblers. This cohort study was conducted in South Australia between March 2008 and March 2009. Participants were problem gamblers aged ≥18 years (n = 158) who were seeking treatment from a range of gambling help services. Measures included gambling urge, problem gambling screening, gambling behaviour and problems caused by gambling, such as personal health and relationships. The psychometric properties investigated were internal reliability, criterion-related validity, concurrent validity and construct validity. Results showed high internal consistency for GUS (α = 0.93) and significant item-rest correlations ranging from 0.72 to 0.86. For criterion-related validity, a GUS cut score of three correctly classified 81.13% of participants as problem gambling with sensitivity 84.75% and specificity 76.6%. Concurrent validity was significant with a number of gambling-related symptoms and problems including psychological disturbance, work and social functioning and gambling-related cognitions (p < 0.001). An insignificant correlation was found between gambling urge and sensation seeking traits (p = 0.663). When controlling for gender and age the instrument was shown to have significant predictive properties for different levels of gambling severity (p < 0.001). A principal component analysis for the one component showed an overall explained variance of 75.54%. These findings indicate that GUS is a valid and reliable instrument for problem gambling screening, to measure treatment outcomes and may predict relapse in problem gambling.David P. Smith, Rene G. Pols, Malcolm W. Battersby, and Peter W. Harve
A self‐management support program for older Australians with multiple chronic conditions: a randomised controlled trial
No full textObjective: To determine whether a clinician-led chronic disease self-management support (CDSMS) program improves the overall self-rated health level of older Australians with multiple chronic health conditions. Design: Randomised controlled trial: participants were allocated to a clinician-led CDSMS group (including clientcentred goal setting and the development of individualised care plans) or to a control group in which they received positive attention only. Setting and participants: Patients aged 60 years or more with at least two chronic conditions, recruited between September 2009 and June 2010 from five general practices in Adelaide. Main outcome measures: The primary outcome was self-rated health. Secondary outcome measures related to health status (fatigue, pain, health distress, energy, depression, illness intrusiveness), health behaviour (exercise, medication adherence), and health service utilisation. Results: 254 participants were randomised to the CDSMS and control groups, of whom 231 (117 control and 114 CDSMS participants) completed the 6-month programs and provided complete outcomes data (91%). An intention-to-treat analysis found that CDSMS participants were more likely than control participants to report improved self-rated health at 6 months (odds ratio, 2.50; 95% confidence interval, 1.13e5.50; P = 0.023). Between-group differences for secondary outcomes were not statistically significant. Conclusion: CDSMS may benefit some older people with multiple chronic conditions to a greater extent than positive attention and health education. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12609000726257.Richard L Reed, Leigh Roeger, Sara Howard, Jodie M Oliver-Baxter, Malcolm W Battersby, Malcolm Bond, Richard H Osborn
Seminal plasma and prostaglandin E2 up-regulate fibroblast growth factor 2 expression in endometrial adenocarcinoma cells via E-series prostanoid-2 receptor-mediated transactivation of the epidermal growth factor receptor and extracellular signal-regulated kinase pathway
No full textProstaglandin E(2) (PGE(2)) has been shown to modulate angiogenesis and tumour progression via the E-series prostanoid-2 (EP2) receptor. Endometrial adenocarcinomas may be exposed to endogenous PGE(2) and exogenous PGE(2), present at high concentration in seminal plasma
Obstructive sleep apnoea in adults: a common chronic condition in need of a comprehensive chronic condition management approach
No full textObstructive sleep apnoea (OSA) is a common disorder that has all the characteristics of a chronic condition. As with other chronic conditions, OSA requires ongoing management of treatments and problems, such as residual symptoms, deficits and co-morbidities. Also, many OSA patients have modifiable lifestyle factors that contribute to their disease, which could be improved with intervention. As health systems are in the process of developing more comprehensive chronic care structures and supports, tools such as chronic condition management programs are available to enable OSA patients and their health care providers to further engage and collaborate in health management. This review explains why the OSA patient group requires a more comprehensive approach to disease management, describes the chronic care model as a platform for management of chronic conditions, and assesses the suitability of particular chronic disease management programs in relation to the needs of the OSA population. Implementation of an evidence-based health-professional-led chronic condition management program into OSA patient care is likely to provide a context in which health risks are properly acknowledged and addressed. Such programs present an important opportunity to enable more optimal health outcomes than is possible by device-focused management alone.Emer M. Heatley, Melanie Harris, Malcolm Battersby, R. Doug McEvoy, Ching Li Chai-Coetzer, Nicholas A. Anti
The influence of depression and other co-occurring conditions on treatment outcomes for problem gamblers: a cohort study
No full textOBJECTIVE: To examine the influence of co occurring conditions on gambling treatment outcomes. DESIGN, SETTING AND PARTICIPANTS: Prospective cohort study of problem gamblers. Participants were recruited from consecutive referrals to a gambling therapy service in 2008. Inclusion criteria were: (i) assessed as a problem gambler based on a screening interview including DSM-IV criteria for pathological gambling, and (ii) suitable for admission to a treatment program. Cognitive-behavioural therapy was based on graded exposure-to-gambling urge. One-to-one treatment was conducted with 1-hour sessions weekly for up to 12 weeks. MAIN OUTCOME MEASURES: Problem gambling screening and co-occurring conditions including depression, anxiety and alcohol use. RESULTS: Of 127 problem gamblers, 69 were males (54%), mean age was 43.09 years, and 65 (51%) reported a duration of problem gambling greater than 5 years. Median time for participants’ enrolment in the study was 8.9 months. Results from mixed effects logistic regression analysis indicated that individuals with higher depression levels had a greater likelihood (13% increase in odds [95% CI, 1%–25%]) of problem gambling during treatment and at follow-up. CONCLUSIONS: Addressing depression may be associated with improved treatment outcomes in problem gambling; conversely, treatment of problem gambling improves affective instability. We therefore recommend a dual approach that treats both depression and problem gambling.David P. Smith, Malcolm W. Battersby, Peter W. Harvey, Rene G. Pols, Michael F. Baigent and Jane E. Oakeshttps://www.mja.com.au/journal/2011/195/3/influence-depression-and-other-co-occurring-conditions-treatment-outcomes-problem?0=ip_login_no_cache%3D0b57eeaaac86728690536c55c350f82
Predictors of relapse in problem gambling: a prospective cohort study
No full textPublished online: 25 September 2013To explore the variation of predictors of relapse in treatment and support seeking gamblers. A prospective cohort study with 158 treatment and support seeking problem gamblers in South Australia. Key measures were selected using a consensus process with international experts in problem gambling and related addictions. The outcome measures were Victorian Gambling Screen (VGS) and behaviours related to gambling. Potential predictors were gambling related cognitions and urge, emotional disturbance, social support, sensation seeking traits, and levels of work and social functioning. Mean age of participants was 44 years (SD = 12.92 years) and 85 (54 %) were male. Median time for participants enrollment in the study was 8.38 months (IQR = 2.57 months). Patterns of completed measures for points in time included 116 (73.4 %) with at least a 3 month follow-up. Using generalised mixed-effects regression models we found gambling related urge was significantly associated with relapse in problem gambling as measured by VGS (OR 1.29; 95 % CI 1.12-1.49) and gambling behaviours (OR 1.16; 95 % CI 1.06-1.27). Gambling related cognitions were also significantly associated with VGS (OR 1.06; 95 % CI 1.01-1.12). There is consistent association between urge to gamble and relapse in problem gambling but estimates for other potential predictors may have been attenuated because of methodological limitations. This study also highlighted the challenges presented from a cohort study of treatment and support seeking problem gamblers.David P. Smith, Malcolm W. Battersby, Rene G. Pols, Peter W. Harvey, Jane E. Oakes and Michael F. Baigen
Two-group randomised, parallel trial of cognitive and exposure therapies for problem gambling: a research protocol
No full textBACKGROUND: Problem gambling is a serious public health concern at an international level where population prevalence rates average 2% or more and occurs more frequently in younger populations. The most empirically established treatments until now are combinations of cognitive and behavioural techniques labelled cognitive behaviour therapy (CBT). However, there is a paucity of high quality evidence for the comparative efficacy of core CBT interventions in treating problem gamblers. This study aims to isolate and compare cognitive and behavioural (exposure-based) techniques to determine their relative efficacy. METHODS: A sample of 130 treatment-seeking problem gamblers will be allocated to either cognitive or exposure therapy in a two-group randomised, parallel design. Repeated measures will be conducted at baseline, mid and end of treatment (12 sessions intervention period), and at 3, 6 and 12 months (maintenance effects). The primary outcome measure is improvement in problem gambling severity symptoms using the Victorian Gambling Screen (VGS) harm to self-subscale. VGS measures gambling severity on an extensive continuum, thereby enhancing sensitivity to change within and between individuals over time. DISCUSSION: This article describes the research methods, treatments and outcome measures used to evaluate gambling behaviours, problems caused by gambling and mechanisms of change. This study will be the first randomised, parallel trial to compare cognitive and exposure therapies in this population. ETHICS AND DISSEMINATION: The study was approved by the Southern Adelaide Health Service/Flinders University Human Research Ethics Committee. Study findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN 12610000828022.David P Smith, Malcolm W Battersby, Peter W Harvey, Rene G Pols, Robert Ladouceu
Assessing randomised clinical trials of cognitive and exposure therapies for gambling disorders: a systematic review
No full textAims: Problem or pathological gambling is associated with significant disruption to the individual, family and community with a range of adverse outcomes, including legal, financial and mental health impairment. It occurs more frequently in younger populations, and comorbid conditions are common. Cognitive–behaviour therapy (CBT) is the most empirically established class of treatments for problematic gambling. This article reports on a systematic review and evaluation of randomised clinical trials (RCTs) concerning two core techniques of CBT: cognitive and behavioural (exposure-based) therapies. Methods: PsycINFO, MEDLINE and the Cochrane library were searched from database inception to December 2012. The CONsolidated Standards Of Reporting Trials (CONSORT) for nonpharmacological treatments was used to evaluate each study. Results: The initial search identified 104 references. After two screening phases, seven RCTs evaluating either cognitive (n = 3), exposure (n = 3) or both (n = 1) interventions remained. The studies were published between 1983 and 2003 and conducted across Australia,Canada, and Spain.On average, approximately 31% ofCONSORTitems were rated as ‘absent’ for each study and more than 52% rated as ‘present with some limitations’. For all studies, 70.83% of items rated as ‘absent’ were in the methods section. Conclusions: The findings from this review of randomised clinical trials involving cognitive and exposure-based treatments for gambling disorders show that the current evidence base is limited. Trials with low risk of bias are needed to be reported before recommendations are given on their effectiveness and clinicians can appraise their potential utility with confidence.David P. Smith, Kirsten I. Dunn, Peter W. Harvey, Malcolm W. Battersby,
and Rene G. Pol
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