Health care risks and access within the community of Michigan over-the-road truckers

This mixed methods study explored health care access problems faced by long-distance truck drivers. Thirty trucking professionals were interviewed at truck-stops in Michigan about health status and health care access. Thirty of the 88 drivers approached participated. The most common illnesses they reported concerned the eye, back, excessive stress at work and painful joints or arthritis. Most respondents had a family doctor; for those who did not, cost was a major contributing factor. More than one third stated their health is "not excellent" because of poor accessibility to healthcare on the road. Almost unanimously, drivers desired to have access to health care clinics in truck-stop areas and described particular access problems; the solution may be as simple as making the existing health care system more amenable to those driving large truck rigs.     

Self-perception of Gambling Problems among Adolescents Identified as At-risk or Problem Gamblers

The relative influence of perceived familial addictive behaviors and personal gambling behaviors on adolescents' self-perceptions of gambling problems was examined. Students from five high schools in Connecticut (N = 3,886) were surveyed. Of those between the ages of 14 and 17 who scored two or more on the South Oaks Gambling Screen--Revised for Adolescents (n = 532; 72% male; 43% Caucasian), 14.3% reported having a current or past problem with gambling. Wagering larger amounts in a single day, gambling on a daily basis, and perceived presence of a family member with a gambling problem were associated with increased odds of self-perception of a gambling problem. Thus, adolescents who may be less likely to be identified for prevention efforts (due to lack of engagement in high stakes gambling or the real/perceived absence of a problematic gambler in the home) appear less likely to perceive a gambling problem. To advance prevention and treatment strategies, the apparent discrepancy between adolescents' self-perceptions and objective reports of problem gambling behaviors warrants further investigation.     

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.     

Assessing the Playing Field: A Prospective Longitudinal Study of Internet Sports Gambling Behavior

Internet gambling is growing rapidly, as is concern about its possible effect on the public’s health. This paper reports the results of the first prospective longitudinal study of actual Internet sports gambling behavior during eight study months. Data include recorded fixed-odds bets on the outcome of sporting contests and live-action bets on the outcome of events within contests for 40,499 Internet sports gambling service subscribers who enrolled during February 2005. We tracked the following primary gambling behaviors: daily totals of the number of bets made, money bet, and money won. We transformed these variables into measures of gambling involvement. We analyzed behavior for both fixed-odds and live-action bets. The median betting behavior of the 39,719 fixed-odds bettors was to place 2.5 bets of €4 (approximately $5.3 US) every fourth day during the median 4 months from first to last bet. This typical pattern incurred a loss of 29% of the amount wagered. The median betting behavior of the 24,794 live-action bettors was to place 2.8 wagers of €4 every fourth day during the median duration of 6 weeks at a loss of 18% of the amount wagered. We also examined the behavior of empirically determined groups of heavily involved bettors whose activity exceeded that of 99% of the sample.     

Dopamine Genes and Pathological Gambling in Discordant Sib-Pairs

Pathological gambling (PG) is an impulse control disorder that has been considered as a behavioral addiction. Recent studies have suggested the involvement of the dopaminergic system in addictions and impulse control disorders and associations of dopamine receptor genes (DRD1, DRD2, and DRD4) and PG have been reported. In the present study, 140 sib-pairs discordant for the diagnosis of PG (70 males and 70 females on each group) were recruited through the Gambling Outpatient Unit at the Institute of Psychiatry, University of Sao Paulo and were assessed by trained psychiatrists. A family-based association design was chosen to prevent population stratification. All subjects were genotyped for dopamine receptor genes (DRD1 -800 T/C, DRD2 TaqIA RFLP, DRD3 Ser9Gly, DRD4 48bp exon III VNTR, DRD5 (CA) repeat) and the dopamine transporter gene (SCL6A3 40 bp VNTR). Our results suggest the association of PG with DRD1 -800 T/C allele T (P = .03).     

The Four Es 1-Year Later: A Tool for Predicting the Development of Gambling Problems

The Four Es is a 40-item scale measuring psychological risk for the development of problem gambling behavior. One-year follow-up interviews (n = 395) from a previously reported phone survey in Queensland, Australia (n = 2,577) (Rockloff & Dyer, 2006) tested the ability of the Four Es instrument to prospectively identify persons who would later develop gambling problems. Two groups of participants were selected for the 1-year follow-up interviews, including (1) persons who had gambling problems, high-risk alcohol abuse problems, and/or substance abuse problems (abuse group); and (2) a random selection of other persons from the original survey (random group). The results indicated that the “Excess” trait, which measures impulsive behavior, was predictive of relative increases in gambling problems for both groups over the 1-year period. Additionally, the Four Es questionnaire showed good psychometric properties in the surveys, with a test-retest reliability of r = .70 and a Cronbach’s alpha reliability of α = .90 and .92 in the original and follow-up interviews, respectively.     

Quality of life among lifetime victimized men

Quality of life was compared for lifetime victimized (n = 353) and nonvictimized men (n = 167) for demographic and quality of life variables by a cross-sectional design. The univariate analyses showed that victims compared to nonvictims had a lower quality of life, were younger, more often had upper secondary school education, and were more often blue-collar/low white-collar workers, on student allowances, on unemployment, financially strained, and smokers. The regressions revealed that unemployment, financial strain, smoking, depression, and home/public abuse were associated with reduced quality of life among victimized men. Being a blue-collar/low/intermediate white-collar worker and social support were related to increased quality of life. This study may have provided new insights into the experiences of quality of life of victimized men.     

Effectiveness of a Web-based alcohol-misuse and harm-prevention course among high- and low-risk students

OBJECTIVE: In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers. PARTICIPANTS: The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not. METHOD SUMMARY: The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later. RESULTS: Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects. CONCLUSIONS: Results suggest that College Alc may be an effective program for students with a history of alcohol use.     

A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff

There is a need to investigate novel interventions that promote worksite physical activity and wellness. OBJECTIVE: The authors' purpose in this study was to evaluate the effectiveness of a 12-week walking program supplemented with a pedometer, computer educational program, and weekly e-mails. METHODS: College faculty and staff participated in a one-group pre-posttest study to determine whether the 12-week walking intervention had an effect on body mass index (BMI), blood pressure, blood glucose, and cholesterol. The authors also determined participant-perceived wellness effects. RESULTS: The authors observed differences between baseline and follow-up in BMI (p = .024), blood glucose (p = .06), and total cholesterol (p = .09). The program had a moderate effect on fitness, mood, health awareness, nutrition, and health. CONCLUSIONS: It is incumbent that experts develop innovative worksite physical activity and wellness programs. A pedometer-monitored walking program is one way that a worksite health initiative can improve the health and wellness of its employees and simultaneously reduce health-care costs.     

Relationship of interpersonal behaviors and health-related control appraisals to patient satisfaction and compliance in a university health center

OBJECTIVE: The authors' aim was to evaluate patient-provider relationships in a college health center. PARTICIPANTS: Eighty student patients and their health-care providers. METHODS: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. RESULTS: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. CONCLUSION: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.