Revising the Pathways Model of Problem Gambling: Two Decades of Lessons Learned

The Pathways Model is a highly cited etiological model of problem gambling. Over the past two decades, a number of studies have found support for the model’s utility in classifying gambling subtypes. In addition, empirical research conducted by the original authors has suggested key revisions in the original model to maintain its stability over time. This presentation will provide an overview of the original model, related findings in the past 20 years, and introduce the revised model. A convenience sample of 1,168 treatment-seeking problem gamblers in the U.S., Canada, and Australia completed the Problem Gambling Severity Index and the Gambling Pathways Questionnaire. Empirically validated risk factors were analyzed using latent class analyses, identifying a three-class solution as the best-fitting model. Those in the largest class (Pathway 1) reported the lowest levels of all etiological risk factors. Participants in class 2 (Pathway 2) reported the highest rates of anxiety and depression, both before and after gambling became a problem, as well as childhood maltreatment, and a high level of gambling for stress-coping. Those in class 3 (Pathway 3) reported high levels of impulsivity; risk-taking, including sexual risk-taking; antisocial traits; and coping to provide meaning in life and to alleviate stress. Implications: The revised model provides an evidence-based, parsimonious summary of key risk factors that may variously predispose individuals to develop gambling problems. Those factors provide a “road-map” to guide clinicians in individualizing treatment to address the most important predictors of relapse

Evaluation of the DSM-5 Internet Gaming Disorder Measures: A COSMIN Systematic Review and Meta-Analysis

Due to the rising concern of problem video gaming, the DSM-5 has suggested including Internet Gaming Disorder (IGD) as a possible new behavioral addiction and proposed nine criteria to assess IGD. In response, a number of measurement instruments have been developed based on the DSM-5 IGD criteria. This presentation will discuss results from a systematic review that evaluated psychometric properties of these measures. Systematic search identified 22 measures. Meta-analysis revealed that 3.1% of the general population and 6.4% of video gamers had IGD. The estimated prevalence rates largely varied across different measures. Although many measures demonstrated satisfactory structural and construct validities, these measures accounted for an average \u3c 50% of the variance of the items. This suggests that measures do not fully operationalize the DSM-5 criteria and other symptoms should be considered. Measurement invariance and test-retest reliability were established for \u3c 50% of these measures. Diagnostic performance were only examined for two measures using data from clinical structured interviews. While much more work is needed to accurately conceptualize and measure IGD, the present review indicates that the Internet Gaming Disorder Scale – Short Form is the most optimal DSM-5 measure of IGD currently available. Implications: This work is conducted in response to the call for rigorous research on Internet gaming disorder (IGD). Findings have important implications for implementing uniform, psychometrically sound measures that accurately conceptualize, assess, and identify IGD in both research and clinical settings

The Nuance of Mindfulness among Gamblers and Video Game Players: Empirical Findings from Latent Profile Analysis and Links to Intervention for Problem Gambling and Problem Video Gaming

Abstract: This presentation reviews two studies that investigate different profiles of gamblers and video gamers across five facets of mindfulness and nonattachment using latent profile analyses. Study 1 identified four profiles among 843 adults who gamble (59.9% male, Mage=39 years): High, Moderate and Low Mindfulness, as well as a Judgmentally Unaware profile, characterized by low levels of nonjudging and acting with awareness. Gamblers with the Judgmentally Unware profile demonstrated more frequent gambling, stronger gambling motivations and gambling-related cognitions, more severe problem gambling, and poorer mental health compared to other profiles. Study 2 identified a different four-profile model among 629 adults who play video games (62.8% male, Mage=38 years): High and Moderate Mindfulness, Judgmentally Unware profile, and Reactive and Attached profile, characterized by high non-reacting and low nonattachment. Video gamers with the Judgmentally Unware profile evidenced the most severe problem gaming, followed by the Reactive and Attached profile. The Judgmentally Unware profile reported stronger gaming motivations and higher emotion-based impulsivity; in contrast, the Reactive and Attached profile demonstrated greater psychological inflexibility and escapism motivation relative to the other profiles. Implications of mindfulness profiles as risk and protective factors will be discussed in light of reducing harm for both gambling and video gaming. Implications: Findings suggest a variety of ways in which gamblers and video gamers might be mindful. Given the overlap between gambling and gaming and the Judgmentally Unaware profile, mindfulness-based harm reduction intervention could be particularly useful for addressing problem gambling/video gaming and decreasing future harms from these activities

The JCMT BISTRO Survey: Studying the Complex Magnetic Field of L43

We present observations of polarized dust emission at 850 μm from the L43 molecular cloud, which sits in the Ophiuchus cloud complex. The data were taken using SCUBA-2/POL-2 on the James Clerk Maxwell Telescope as a part of the BISTRO large program. L43 is a dense (NH 10 22 2 ~ –1023 cm−2) complex molecular cloud with a submillimeter-bright starless core and two protostellar sources. There appears to be an evolutionary gradient along the isolated filament that L43 is embedded within, with the most evolved source closest to the Sco OB2 association. One of the protostars drives a CO outflow that has created a cavity to the southeast. We see a magnetic field that appears to be aligned with the cavity walls of the outflow, suggesting interaction with the outflow. We also find a magnetic field strength of up to ∼160 ± 30 μG in the main starless core and up to ∼90 ± 40 μG in the more diffuse, extended region. These field strengths give magnetically super- and subcritical values, respectively, and both are found to be roughly trans-Alfvénic. We also present a new method of data reduction for these denser but fainter objects like starless cores

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The JCMT BISTRO Survey: Revealing the Diverse Magnetic Field Morphologies in Taurus Dense Cores with Sensitive Submillimeter Polarimetry

Abstract: We have obtained sensitive dust continuum polarization observations at 850 μm in the B213 region of Taurus using POL-2 on SCUBA-2 at the James Clerk Maxwell Telescope as part of the B-fields in STar-forming Region Observations (BISTRO) survey. These observations allow us to probe magnetic field (B-field) at high spatial resolution (∼2000 au or ∼0.01 pc at 140 pc) in two protostellar cores (K04166 and K04169) and one prestellar core (Miz-8b) that lie within the B213 filament. Using the Davis–Chandrasekhar–Fermi method, we estimate the B-field strengths in K04166, K04169, and Miz-8b to be 38 ± 14, 44 ± 16, and 12 ± 5 μG, respectively. These cores show distinct mean B-field orientations. The B-field in K04166 is well ordered and aligned parallel to the orientations of the core minor axis, outflows, core rotation axis, and large-scale uniform B-field, in accordance with magnetically regulated star formation via ambipolar diffusion taking place in K04166. The B-field in K04169 is found to be ordered but oriented nearly perpendicular to the core minor axis and large-scale B-field and not well correlated with other axes. In contrast, Miz-8b exhibits a disordered B-field that shows no preferred alignment with the core minor axis or large-scale field. We found that only one core, K04166, retains a memory of the large-scale uniform B-field. The other two cores, K04169 and Miz-8b, are decoupled from the large-scale field. Such a complex B-field configuration could be caused by gas inflow onto the filament, even in the presence of a substantial magnetic flux

Filamentary Network and Magnetic Field Structures Revealed with BISTRO in the High-mass Star-forming Region NGC 2264: Global Properties and Local Magnetogravitational Configurations

We report 850 μm continuum polarization observations toward the filamentary high-mass star-forming region NGC 2264, taken as part of the B-fields In STar forming Regions Observations large program on the James Clerk Maxwell Telescope. These data reveal a well-structured nonuniform magnetic field in the NGC 2264C and 2264D regions with a prevailing orientation around 30° from north to east. Field strength estimates and a virial analysis of the major clumps indicate that NGC 2264C is globally dominated by gravity, while in 2264D, magnetic, gravitational, and kinetic energies are roughly balanced. We present an analysis scheme that utilizes the locally resolved magnetic field structures, together with the locally measured gravitational vector field and the extracted filamentary network. From this, we infer statistical trends showing that this network consists of two main groups of filaments oriented approximately perpendicular to one another. Additionally, gravity shows one dominating converging direction that is roughly perpendicular to one of the filament orientations, which is suggestive of mass accretion along this direction. Beyond these statistical trends, we identify two types of filaments. The type I filament is perpendicular to the magnetic field with local gravity transitioning from parallel to perpendicular to the magnetic field from the outside to the filament ridge. The type II filament is parallel to the magnetic field and local gravity. We interpret these two types of filaments as originating from the competition between radial collapsing, driven by filament self-gravity, and longitudinal collapsing, driven by the region's global gravity

The JCMT BISTRO Survey: Studying the Complex Magnetic Field of L43

We present observations of polarized dust emission at 850 μm from the L43 molecular cloud, which sits in the Ophiuchus cloud complex. The data were taken using SCUBA-2/POL-2 on the James Clerk Maxwell Telescope as a part of the BISTRO large program. L43 is a dense ( NH2∼1022 –1023 cm−2) complex molecular cloud with a submillimeter-bright starless core and two protostellar sources. There appears to be an evolutionary gradient along the isolated filament that L43 is embedded within, with the most evolved source closest to the Sco OB2 association. One of the protostars drives a CO outflow that has created a cavity to the southeast. We see a magnetic field that appears to be aligned with the cavity walls of the outflow, suggesting interaction with the outflow. We also find a magnetic field strength of up to ∼160 ± 30 μG in the main starless core and up to ∼90 ± 40 μG in the more diffuse, extended region. These field strengths give magnetically super- and subcritical values, respectively, and both are found to be roughly trans-Alfvénic. We also present a new method of data reduction for these denser but fainter objects like starless cores

The JCMT BISTRO Survey: An 850/450 μ m Polarization Study of NGC 2071IR in Orion B

Abstract: We present the results of simultaneous 450 μm and 850 μm polarization observations toward the massive star-forming region NGC 2071IR, a target of the BISTRO (B-fields in STar-forming Region Observations) Survey, using the POL-2 polarimeter and SCUBA-2 camera mounted on the James Clerk Maxwell Telescope. We find a pinched magnetic field morphology in the central dense core region, which could be due to a rotating toroidal disklike structure and a bipolar outflow originating from the central young stellar object IRS 3. Using the modified Davis–Chandrasekhar–Fermi method, we obtain a plane-of-sky magnetic field strength of 563 ± 421 μG in the central ∼0.12 pc region from 850 μm polarization data. The corresponding magnetic energy density of 2.04 × 10−8 erg cm−3 is comparable to the turbulent and gravitational energy densities in the region. We find that the magnetic field direction is very well aligned with the whole of the IRS 3 bipolar outflow structure. We find that the median value of polarization fractions is 3.0% at 450 μm in the central 3′ region, which is larger than the median value of 1.2% at 850 μm. The trend could be due to the better alignment of warmer dust in the strong radiation environment. We also find that polarization fractions decrease with intensity at both wavelengths, with slopes, determined by fitting a Rician noise model of 0.59 ± 0.03 at 450 μm and 0.36 ± 0.04 at 850 μm, respectively. We think that the shallow slope at 850 μm is due to grain alignment at the center being assisted by strong radiation from the central young stellar objects