Matthew N. Hall

Estimating the prevalence of disordered gambling behavior in the United States and Canada : A research synthesis

OBJECTIVES This study developed prevalence estimates of gambling-related disorders in the United States and Canada, identified differences in prevalence among population segments, and identified changes in prevalence over the past 20 years. METHODS A meta-analytic strategy was employed to synthesize estimates from 119 prevalence studies. This method produced more reliable prevalence rates than were available from any single study. RESULTS Prevalence estimates among samples of adolescents were significantly higher than estimates among samples of adults for both clinical (level 3) and subclinical (level 2) measures of disordered gambling within both lifetime and past-year time frames (e.g., 3.9% vs 1.6% for lifetime estimates of level 3 gambling). Among adults, prevalence estimates of disordered gambling have increased significantly during the past 20 years. CONCLUSIONS Membership in youth, treatment, or prison population segments is significantly associated with experiencing gambling-related disorders. Understanding subclinical gamblers provides a meaningful opportunity to lower the public health burden associated with gambling disorders. Further research is necessary to determine whether the prevalence of disordered gambling will continue to increase among the general adult population and how prevalence among adolescents will change as this cohort ages.

Estimating the Prevalence of Adolescent Gambling Disorders: A Quantitative Synthesis and Guide Toward Standard Gambling Nomenclature

This article reviews the extant published and unpublished studies that estimate the prevalence of adolescent gambling problems in North America. The nine nonduplicative studies identified by our literature search included data collected from more than 7700 adolescents from five different regions of the United States and Canada. In addition to comparing the conceptual and methodological differences that exist among these studies, this article employed a meta-analytic strategy to synthesize prevalence estimates from the existing studies. This analysis revealed that within a 95 percent confidence interval, between 9.9% and 14.2% of adolescents are at risk of developing or returning to serious gambling problems. Similarly, between 4.4% and 7.4% of adolescents exhibit seriously adverse compulsive or pathological patterns of gambling activity. Finally, the discussion proposes a generic multi-level classification scheme to reconcile the divergent classification methods and data reporting strategies. This new multi-level approach to reporting gambling prevalence will facilitate interstudy comparisons among existing estimates of gambling prevalence and help to provide a general data reporting system for future research.

The Natural History of Gambling and Drinking Problems Among Casino Employees

Abstract From an eligible population of 9,943 casino employees, 6,067 volunteered to participate in this study. Of this sample, 1,176 provided data at 3 observation points approximately 12 months apart. Using the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. B. Blume, 1987) and the CAGE (J. A. Ewing, 1984) questionnaire, the authors prospectively examined the prevalence and patterns of alcohol and gambling problems among those employees. Among the casino employees with gambling and drinking problems, a segment displayed the capacity to diminish those problems even when the difficulties had reached disordered levels. The authors also examined the comorbidity of gambling and drinking as well as the relationships among changes in SOGS scores and CAGE scores and changes in demographic and biological variables. The women were more likely to decrease their problem-drinking scores, but not their gambling scores, when compared with the men. In addition, 2 key variables (i.e., disabling depression and dissatisfaction with ones personal life) emerged as predictors of transitions to healthier levels of disordered gambling. The authors cautiously suggest, in light of the results taken together, that more fluctuation is associated with gambling and drinking problems than previously thought and that the conventional wisdom about disordered gambling as “always progressive” needs reconsideration.

A Steric-Inhibition Model for Regulation of Nucleotide Exchange via the Dock180 Family of GEFs

CDM (CED-5, Dock180, Myoblast city) family members have been recently identified as novel, evolutionarily conserved guanine nucleotide exchange factors (GEFs) for Rho-family GTPases . They regulate multiple processes, including embryonic development, cell migration, apoptotic-cell engulfment, tumor invasion, and HIV-1 infection, in diverse model systems . However, the mechanism(s) of regulation of CDM proteins has not been well understood. Here, our studies on the prototype member Dock180 reveal a steric-inhibition model for regulating the Dock180 family of GEFs. At basal state, the N-terminal SH3 domain of Dock180 binds to the distant catalytic Docker domain and negatively regulates the function of Dock180. Further studies revealed that the SH3:Docker interaction sterically blocks Rac access to the Docker domain. Interestingly, ELMO binding to the SH3 domain of Dock180 disrupted the SH3:Docker interaction, facilitated Rac access to the Docker domain, and contributed to the GEF activity of the Dock180/ELMO complex. Additional genetic rescue studies in C. elegans suggested that the regulation of the Docker-domain-mediated GEF activity by the SH3 domain and its adjoining region is evolutionarily conserved. This steric-inhibition model may be a general mechanism for regulating multiple SH3-domain-containing Dock180 family members and may have implications for a variety of biological processes.

Cell Migration Is Regulated by Platelet-Derived Growth Factor Receptor Endocytosis

ABSTRACT Cell migration requires spatial and temporal processes that detect and transfer extracellular stimuli into intracellular signals. The platelet-derived growth factor (PDGF) receptor is a cell surface receptor on fibroblasts that regulates proliferation and chemotaxis in response to PDGF. How the PDGF signal is transmitted accurately through the receptor into cells is an unresolved question. Here, we report a new intracellular signaling pathway by which DOCK4, a Rac1 guanine exchange factor, and Dynamin regulate cell migration by PDGF receptor endocytosis. We showed by a series of biochemical and microscopy techniques that Grb2 serves as an adaptor protein in the formation of a ternary complex between the PDGF receptor, DOCK4, and Dynamin, which is formed at the leading edge of cells. We found that this ternary complex regulates PDGF-dependent cell migration by promoting PDGF receptor endocytosis and Rac1 activation at the cell membrane. This study revealed a new mechanism by which cell migration is regulated by PDGF receptor endocytosis.

Smoking behavior among casino employees: Self-report validation using plasma cotinine

The veracity of behavioral self-reports is often challenged, particularly when the motivation to avoid stigma and win social approval holds potential to introduce bias into the data collected. This study employed plasma cotinine tests to validate the self-reports of tobacco use collected from 3,841 casino employees as part of a comprehensive health survey. Rates of discordance were calculated by comparing employee self-reports with results from plasma colinine tests. This study provides evidence that casino employees can provide valid self-report data. Further, discordance rates of self-reported tobacco use vary according to operational definitions of tobacco use. These findings highlight the methodological importance of recognizing the inherent heterogeneity of smoking behavior.

Assessing substance abuse treatment provider training needs: Screening skills

Screening instruments for substance abuse can be expeditious and effective clinical tools. A training needs assessment conducted with a randomly selected sample of substance abuse treatment providers (n = 1684) in licensed facilities in New England identified the adequacy of training, interest in training, clinical skill, and training need in the use of 13 substance abuse screening instruments. The results revealed that New England substance abuse treatment providers are not skilled in the use of screening instruments and have a high level of training need in this area. Differences in screening skill were found among the New England states. In addition, women and those with less treatment experience have lower screening skill; similarly, women, those having less experience in the field, and social workers and nurses evidenced higher training need in screening. The discussion considers skill, adequacy of training, training interest, and training need. The conclusion suggests that one approach to the coexisting increased need for screening skills due to managed care requirements and the lack of interest in these skills is to study managed care marketplace demands to determine training priorities.

An assessment of substance abuse treatment training. needs among nurses (part I): evaluating skiII, knowledge and training characteristics

This article (part I of a two-part paper) presents results of a substance abuse treatment training needs assessment study conducted with 133 nurses who were working in randomly selected New England substance abuse treatment facilities. This sample of nurses was derived from a larger survey sample of 1684 substance abuse treatment providers working in randomly selected New England substance abuse treatment facilities. These needs assessment data show that, compared with drug and alcohol counselors, social workers, and physicians or residents, nurses have the lowest levels of skill or knowledge in 8 of 12 substance abuse-specific treatment areas. Nurses reported that additional training would increase their clinical effectiveness. Without adequate training, nurses cannot fulfill their roles in prevention, intervention and treatment.

An assessment of substance abuse treatment training needs among nurses (part II): Applying an index of training needs

This article (part II of a two-part paper) presents the results of a substance abuse treatment training needs assessment study conducted with 133 nurses who were working in randomly selected New England substance abuse treatment facilities. This sample of nurses was derived from a larger survey sample of 1684 substance abuse treatment providers working in randomly selected New England substance abuse treatment facilities. These needs assessment data show that, compared with drug and alcohol counselors, social workers, and physicians or residents, nurses had the highest levels of training need in the three major substance abuse treatment domains investigated in this study. Without training, nurses cannot fulfill their roles in prevention, intervention and treatment. Agencies and institutions concerned with and committed to training health care providers are encouraged to attend to the demonstrated need for training while interest is high and clinical demand is great.