Urge to Gamble in Problem Gamblers Exposed to a Casino Environment

Cue-reactivity has received increased attention in addiction research, though not for gambling in particular. We examined cue reactivity in 18 problem gamblers by accompanying them to a gaming casino and measuring their subjective urge to gamble over a 1-h period. Half of the sample was additionally exposed to a gambling-specific negative mood induction (NMI) manipulation via guided imagery. Overall, about two-thirds of the sample reported moderate to high-gambling urges during the casino exposure. Additionally, the NMI reduced cue-reactivity. Finally, gambling urges in both groups decreased over the course of the exposure sessions. These findings suggest that a majority of problem gamblers experience the urge to gamble when exposed to gambling cues and that the intensity of these urges decrease with time, especially in the presence of a gambling-relevant NMI. Cue exposure should be studied further as a potential tool in the treatment of problem gambling.     

Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

Staying safe while consuming alcohol: a qualitative study of the protective strategies and informational needs of college freshmen

OBJECTIVE: In this qualitative study, the authors examined how students attempt to minimize harm to themselves and others when drinking. PARTICIPANTS: The authors recruited freshmen at a large, mid-Atlantic US public university during the fall semester of 2005 to participate in 8 focus groups. METHODS: The moderator's guide was developed through an iterative process that included input from experts and pilot testing. The researchers audiotaped focus group conversations, transcribed them, and subjected them to an interrater reliability check. Analysis was based on the framework of Information-Motivation-Behavioral Skills Model and a phenomenological approach. RESULTS: College students have a repertoire of coping strategies they use in an attempt to safeguard themselves and their friends from harm when drinking. Strategies encompass planning a safe context for drinking, using safety measures to minimize harm when drinking, and taking care of someone who has consumed too much alcohol. CONCLUSIONS: A harm-reduction focus that acknowledges and builds on existing protective strategies may be a promising avenue for alcohol interventions.     

Social inequalities in intimate partner violence: a study of women in Kenya

This study examines social inequalities in intimate partner violence (IPV) among women of reproductive age in Kenya. A sample comprising 3,696 women was retrieved from the Kenyan Demographic and Health Survey of 2003. The study design was cross-sectional. Chi-square tests and logistic regression were used to analyze the data. Results indicated that while high education among women reduced the risk of IPV exposure, both being employed and having a higher education/occupational status than her partner increased a woman's vulnerability to IPV. Age differences between the partners, illiteracy, and lack of autonomy and access to information increased the likelihood of IPV. Finally, being in polygamous relationships was associated with IPV exposure. The findings indicate demographic, social, and structural differences in exposure to IPV with important implications for interventions.     

Fatigue and sleep quality in nurses

Fatigue is a critical issue for nurses that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor in fatigue that nurses experience. Therefore, the purpose of this study was to examine the differences in perceptions of fatigue between night-shift and day-shift nurses, as measured by scores on the Brief Fatigue Inventory (BFI) and to examine differences in sleep quality between the two groups, as measured by responses on the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis of variance showed significant differences between the two groups on the BFI, with the night-shift cohort reporting higher mean scores on the BFI. Significant differences were also found between the two groups on PSQI mean scores, with the night-shift cohort reporting higher mean scores. Findings from this study suggest that night-shift nurses, compared with day-shift nurses, perceived a much higher level of fatigue and had poorer sleep quality. Further research is needed to evaluate interventions that might decrease fatigue in nurses and improve their sleep quality.     

Pearls and pitfalls in evaluating a Student Assistance Program: a five-year case study

This article presents data from a five-year evaluation-research case study of a large urban schools district's internal Student Assistance Program (SAP). The district employed specially trained and licensed school-based counselors to implement an internal SAP expanded to include tertiary prevention, and modeled after an employee assistance program established for adults. From the population of more than 10,000 students who received some type of program assistance for at-risk behaviors, a stratified random sample of 2,238 cases, over a five year period, were reviewed. Results indicate a statistically significant decline (p < .05) in students' drug use and a significant improvement in internal locus of control occurred each year. While not statistically significant, the average number of student discipline referrals was less than the year prior to program admission; however, there was no significant change in academic performance. A significant correlation between students' drug use and the amount of time in program, the type of assistance received, and the student's custody status was also found.     

Environmental changes to increase physical activity: perceptions of older urban ethnic-minority women

Despite the numerous benefits of physical activity, older adults continue to be more sedentary than their younger counterparts, and sedentary behavior is more prevalent among older racial and ethnic minorities than among Whites. This study used the nominal group technique (NGT) to examine participants' perceptions of what neighborhood environmental changes would encourage greater physical activity for older African American and Hispanic women. Participants age 50-75 years were recruited from 2 urban community health clinics. Nine NGT sessions (45 participants) were conducted. The women were asked what changes in their neighborhood environment would encourage them to become more physically active. Responses to the research question were tabulated, and qualitative analysis was used to identify themes and categories. Major categories were physical environment changes, safety, and activities/social support. Although the physical environment received the greatest number of points, concerns for personal safety cut across categories. Participants indicated the need for more facilities in which to be active.