Diagnosis and therapy of male gamblers in a university psychiatric hospital

From 1980 to mid-1990 fifty-one gamblers were evaluated and treated at the psychiatric university hospital of Homburg/Saar in Germany. All were men with a mean age of 33.7 years. Gambling had lasted 5.2 years on average. Most patients were motivated to undergo therapy by members of their family. The majority of them had been in psychotherapeutic treatment before. Thirty-six of the 51 patients had committed punishable acts including fraud and embezzlement and, in 7 cases, robbery. The sample could be divided into three clinical subgroups. The first group consisted of patients with severe psychiatric diseases such as schizophrenia, manic-depressive illness or organic brain disorder. Patients of the second group suffered from serious personality disorders. Those of the third group showed deep-rooted problems in their current relationships.This article is an extension of the special issue on Gambling in Europe edited by Iver Hand, M.D.     

Russki adventures

This case study, by Paul Beamish, was a prize-winner in the EFMD 1992 Annual Case Writing Competition, in the section entitled, ‘Entrepreneurship’. It concerns a daring new business venture in the Russian Caucasus Mountains.In mid-1991, Guy Crevasse and Andrei Kakov, the two major partners in Russki Adventures contemplated their next move. They had spent the last year and a half exploring the possibility of starting a helipcopter skiing operation in Russia.Their plan was to bring clients from Europe, North America, and Japan to the Caucasus Mountains to ski the vast areas of secluded mountain terrain made accessible by the use of helicopters and the recent business opportunities offered by ‘glasnost’.Three options for proceeding were being considered. The first was to proceed with the venture on their own, in the Caucasus Mountains area that had been made available to them by a Soviet government agency. The second was to accept the offer of partnership with Extreme Dreams, a French tour operator that had begun operations in the Caucasus region during the 1991 season. The final option was to wait, save their money and not proceed with the venture at this time.The data presented in the case includes information on: the company founders the helicopter skiing industry the Russian environment proposed market positioning of the business the potential alliance partners forecast financial analysis, under several scenarios.     

Rates of pathological gambling in publicly funded outpatient substance abuse treatment

Rates of problem or probable pathological gambling were assessed in substance abusers seeking outpatient treatment in a publicly funded outpatient substance abuse treatment program. The South Oaks Gambling Screen (SOGS) was administered to 467 consecutive admissions at three different sites. Problem gamblers comprised 6.2 percent of the total (n=29), and 4.5 percent scored as probable pathological gamblers (n=21). These rates are two and one-half times greater than would be expected according to a recent state survey using the SOGS. Implications for assessment and treatment of problem gambling are discussed.The author expresses his appreciation to John Ramsay and the staff of Epoch Counseling Center for data collection; to Les Franklin for computational analysis; and Dr. Rachel Volberg for providing supplemental data from her Maryland State Gambling Survey.     

Defining the linear portion of a sigmoid‐shaped curve: bend points

Formulae are provided that define the ‘bend points’, the beginning and end of the essentially linear dose–response region, for the four‐parameter logistic model. The formulae are expressed in both response and dose units. The derivation of the formulae is shown in order to illustrate the general nature of the methodology. Examples are given that describe how the formulae may be used while planning and conducting bioassays. Copyright © 2003 John Wiley & Sons, Ltd.     

Pathways between education and health: a causal modelling approach

Summary.  The association of poor education and poor health has been consistently observed in many studies and in various countries. Thus far, studies examining the mechanisms underlying this association have looked at only a limited set of potential pathways. This study simultaneously examines six distinctive pathways, which have been hypothesized to link education and health and found support from previous studies. A causal analysis of education and health was performed using structural equation models. Data were used from six phases of the National Child Development Study, which is based on following up an initial sample of 17416 children who were born in 1958. The association between education and health appears to be explained by a combination of mechanisms: adolescent health and adult health behaviours for men and women, adult social class among men and parental social class among women. We conclude that improvements in population educational attainment may not automatically lead to improvements in population health, and that health policies for improving health and reducing health inequalities need to target specific causal pathways.     

Evaluation: Stakeholder-focused Criteria

Identifying and selecting suitable criteria is an important consideration in evaluating the performance of public sector organizations. Which criteria are chosen, and how they are weighted, will depend largely on the perspective being taken; different stakeholders (for example, clients, providers or commissioners) are likely to emphasize different criteria. In this paper a number of criteria are identified and an argument is developed to indicate which criteria are likely to be valued by various stakeholders. Furthermore, a number of approaches and mechanisms for evaluation are identified and the links between these, the criteria appropriate to them and the various stakeholders are made explicit. Finally, the issue of politics and the distribution of power between the stakeholders is addressed with a call for greater explicitness in using and balancing criteria (for example, as between professionals and the intended beneficiaries of services). In this way, while recognizing the inherent political nature of performance evaluation, the planning and implementation of services may be improved by a more mutually informed approach to evaluation.     

The Ecology of Family Guidance in Low-Income Mexican-American and European-American Families*

This two-part study applied an ecocultural perspective to socialization of daily and long-term goals in low-income Mexican-American and European-American families with children in third, fifth, and seventh grades. The first part of the study examined family members' participation and parents' socialization goals and guidance strategies for their children's daily household chores and homework activities. The second part of the study examined parents' long-term aspirations and guidance strategies for their children's educational, vocational, and moral development. For daily activities, results showed that in Mexican-American families both parents and siblings played important roles, whereas in European-American families parents were the primary socialization agents. As predicted, in both groups parents' expertise influenced their guidance strategies. Finally, Mexican-American and European-American parents differed in their relative endorsement of gender, relational, and self-reliance goals for household chores. For long-term goals, parents in both groups held high educational, vocational, and moral aspirations for their children. However, some parents of seventh-graders had lower educational and vocational aspirations than those of fifth- and third-graders. Although expertise consistently influenced Mexican-American parents' guidance strategies, the pattern for European-American parents was mixed. The discussion highlights between- and within-group differences in daily and long-term socialization practices with an emphasis on resources and vulnerabilities in the families.     

The U.S. legalization program: a preliminary final report

The Immigration Reform and Control Act (IRCA) of 1986 made 4 types of aliens eligible to receive legalization benefits: 1) those who resided "continuously" in the US since January 1, 1982; 2) those who had worked in the US perishable-crop agriculture for 90 "man-days" in specified time periods (Special Agricultural Workers [SAWS]); 3) those who were in the US since before January 1, 1972; and 4) those classified as Cuban/Haitian entrants and who had been in the US since January 1, 1982. Estimates of the number of aliens eligible for legalization, not including SAWS, ranges from 1.834 million to 2.56 million. Estimates of undercounts of undocumented aliens are 10% for those who entered before 1975 and 37.5% for those who arrived after 1975. Other refinements in the estimates of undocumented aliens include adjustments for 1) ethnic group and location, 2) the growth of the undocumented population between the census date and the legalization eligibility date under IRCA, and 3) emigration and deportation rates. Out of the 1,581,800 applicants entered into the Immigration and Naturalization Service (INS) computers (from a total of 2.15 million applicants) as of May 20, 1988, 73.7% were Mexican nationals. Only 5 other countries contributed more than 1%: El Salvador (6.5%), Haiti (2.3%), Guatemala (2.2%), the Philippines (1%), and Colombia (1%). The Mexican percentage was unexpectedly high, perhaps because the legalization had been much more successful in the Southwest than anywhere else in the country. Reasons that Mexicans have a higher legalization participation rate than other nationalities include 1) the distant eligibility date; 2) ethnic differences among non-Mexican nationalities; 3) particularly in the northeast, fears of exposing one's illegal status to INS; 4) the difficulty of information reaching ethnic communities, 5) the reluctance of those already undergoing the naturalization process to risk the legalization process; and 6) the reluctance of employees to admit employment of undocumented aliens. In the end, more than 90% of applicants are expected to be granted temporary resident alien status (and about 70% of agricultural workers), for a total of more than 2 million people. Researchers estimate that 2.5 - 3 million more persons remain in an undocumented status in the US.