The prevalence rates of pathological gambling: A look at methods

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease would enable policy planners to evaluate both the state's responsibility for an epidemic and the adequacy of publicly funded treatment programs. The purpose of this paper is to examine the methods which underlie three different estimates of the prevalence rate of pathological gambling and to critique them in the light of sound epidemiological procedure. In 1975, the Institute for Social Research (ISR) of the University of Michigan conducted a national survey and a survey of the state of Nevada on behalf of the U.S. Commission on a National Policy Toward Gambling. Using discriminant function analysis coupled with subjective inspection of cases in the at-risk pool, the researchers estimated rates of probable and potential pathological gamblers. In 1984 and 1985, this author surveyed residents in the Delaware Valley and the state of Ohio using the cumulative clinical signs method which also posited rates of probable and potential pathological gamblers. In 1986, researchers at the Office of Mental Health for the State of New York employed a formal screening device to survey residents and proposed a rate of probable pathological gamblers and a rate of problem — although not pathological — gamblers. All three approaches produced different estimates. The utility of prevalence and incidence rate research in this field is threatened by a lack of consensus about the proper epidemiological procedure to be employed in arriving at these estimates. There is also confusion about the distinction between a probable and a potential pathological gambler. The planning purpose, method, validity and reliability of prevalence rate research about pathological gambling are addressed in this paper.     

Book reviews

Nathan Glazer Ethnic Dilemmas Harvard, Harvard University Press. 1985

Giddens, Anthony The Constitution of Society, Berkeley, University of California, 1985, pp.XXXVII, 402. Notes, glossary, diagrams, bibliographic notes and index.

Jeremy Rifkin Declaration of a Heretic. Boston. London, Melbourne and Henley, Routledge and Kegan Paul, 1985, pp.X,140.

Ted Benton The Rise and Fall of Structural Marxism: Althusser and his Influence, New York, St.Martin's Press, 1984, pp. VII,259.

Raymond L. Garthoff Détente and Confrontation Washington, The Brookings Institution, 1985, pp.XVI,1126.

Joseph J. Collins The Soviet Invasion of Afghanistan. A Study in the Use of Force in Soviet Foreign Policy, Massachusetts/Toronto, D.C. Heath and Company/Lexington, 1986, pp. XV, 195.

Jan Shipps Mormonism: The Story of a New Religious Tradition, Chicago, University of Illinois Press, 1985, pp.211.

Robert Jay Lifton Home from the War: Vietnam Veterans: Neither Victims nor Executioners, New York, Basic Books, 1985, pp.478     

From quality assurance to continuous quality improvement

To change from punitive and legalistic QA to positive and productive CQI, both attitudes and methods must change. This is a difficult challenge, but potential rewards for both the organization and its individual members suggest that the effort is worthwhile and deserves high priority. Members of the executive/management team will likely turn to physician executives for guidance on how to proceed.     

Estimating the National High School Dropout Rate

Recent interest has focused on the high school dropout rate as one indicator of the national education picture. Empirical estimates of this "rate" vary considerably, because these estimates are poorly defined. This article reviews some of the current measures and presents a new measure of the high school dropout rate--the proportion of high school students who drop out in a defined period of time (1 year). The estimates show that the national yearly high school dropout rate was about the same in 1985 as it was in 1968. Improvement has occurred, however, since 1968 for specific racial groups as well as for some grade levels.     

Psycho-social impacts of terrorism and organized crime: The counterfinality of the practico-inert

The phrase, the counterfinality of the practico-inert is from Sartre with reference to implications of modern technology as a shorthand for that enormous properly human and anti-natural power of dead human labor stored up in our machinery — an alienated power, which turns back on and against us in unrecognizable forms and can symbolize the massive dystopian horizon of organized crime as well as individual terrorist praxis (Jean-Paul Sartre (1948).Situations II. Paris: Gallimard).     

Coherent decision analysis with inseparable probabilities and utilities

This article explores the extent to which a decision maker's probabilities can be measured separately from his/her utilities by observing his/her acceptance of small monetary gambles. Only a partial separation is achieved: the acceptable gambles are partitioned into a set of belief gambles, which reveals probabilities distorted by marginal utilities for money, and a set of preference gambles, which reveals utilities reciprocally distorted by marginal utilities for money. However, the information in these gambles still enables us to solve the decision maker's problem: his/her utility-maximizing decision is the one that avoids arbitrage (i.e., incoherence or Dutch books).     

Comparing developmental outcomes for children in care with those for other children in Canada

This study assessed the test–retest reliability and convergent validity of single items from the Assessment and Action Record (AAR), from Looking After Children (Ward, 1995). It also compared developmental outcomes of 43 children cared for by a Canadian child welfare agency and those of an approximate comparison group of 1,600 children from the National Longitudinal Survey of Children and Youth (Statistics Canada, 1995). High and low reliability and validity were found for different AAR items. The children in care had worse outcomes than the comparison children on indicators of educational success and negative behaviour, but not on measures of identity, social and family relationships, or prosocial behaviour.     

A Significant Shift: A Pentadic Analysis of the Two Rhetorics of the Post-Vatican II Roman Catholic Church Regarding Homosexuality

This paper argues that, since the Second Vatican Council (Vatican II), there has been a significant shift in the rhetorical stance of the Roman Catholic Church toward homosexuality in which the pre-council rhetoric, which condemned both act (i.e., homosexual behavior) and actor (i.e., the homosexual) has been replaced by two distinctly different rhetorics: a moral rhetoric, which continues the Church's long-standing condemnation of homosexual acts as sins, and a pastoral rhetoric, which argues that homosexuals should be ministered to and embraced. A Burkean pentadic analysis is used to define how the two rhetorics differ from each other and from the earlier rhetoric. The three major influences (i.e., Scripture, Tradition, and Catholic theology/philosophy) that have shaped, and continue to shape, the Church's position regarding homosexuality are described. Some of the socio-political implications of this shift are emphasized.