What are the most important dimensions of quality for addiction and mental health services from the perspective of its users?

There is a need to better engage service users in improving their experience with the care received in Addiction and Mental Health (A&MH). Dimensions of patient experience that are most salient to A&MH service users still remain to be properly defined from the patient perspective. This research focuses on identifying key domains of service experience important to patients of Addiction and Mental Health using patient focus groups. In addition, through a patient and family advisory committee, patients were also engaged as co-partners of the research team. The patient advisors had a major role in overseeing the research project, assisting with the thematic analysis and identifying the service domains. A total of 48 individuals (60% female; mean age = 45 years) with lived experience using A&MH services participated in the focus groups. The major themes that emerged from the focus groups led to the identification of seven dimensions of service quality: 1) access, 2) humanity of care, 3) skill and quality of staff, 4) patient engagement, 5) internal and external program communication, 6) individualized treatment and 7) continuity of care. We found that these domains were similar across all service settings including addictions. Patient advisors provided a unique “insider” perspective on the data. Identifying common aspects of service is the first phase of this study. These findings will form the framework for the development of a patient experience survey for Addiction and Mental Health

Shooting Straight: What TV Stories Tell Us About Gun Safety, How These Depictions Affect Audiences, and How We Can Do Better

On average, 110 people are killed by guns every day in the United States, with Black Americans disproportionately impacted. Young Black men are 20 times more likely to be killed by a gun than young white men, and between 2019 and 2020, deaths by guns increased by 39.5% among Black people. In 2021, for the first time, the director of the Centers for Disease Control and Prevention declared gun violence a "serious public threat."Firearms are the leading cause of death among children and teens, increasing by 29% from 2019 to 2020 alone. School shootings receive disproportionate media and policy attention and are a major source of fear, but 85% of child victims of gun homicide die in their homes, and over 80% of child gun suicides involve a gun owned by a family member. In addition, myths persist, such as the belief that gun violence is primarily caused by mental illness, or that a civilian "good guy" can intervene in an active shooting and save lives if they are allowed to carry a loaded gun.The prevalence and impact of gun violence in entertainment media has been the subject of extensive research. Little is known, however, about how often gun safety and prevention measures are portrayed or discussed, in what contexts, or the impact of such portrayals on audiences. To address this gap, the USC Annenberg Norman Lear Center's Media Impact Project (MIP) conducted a research project with support from Everytown for Gun Safety Support Fund. This included:-A content analysis of popular, scripted television dramas from the 2019-2020 and 2020-2021 seasons.-An experimental study examining the impact of two major gun safety storylines on audiences' knowledge, beliefs, and policy support

Session 1-3-F: The Alberta Cohorts of Gambling Behaviors An Update

Objectives 1.Experience with recruitment & retention of five cohorts 2.Patterns of continuity & discontinuity in gambling behaviors as well as patterns of recovery from problems? 3. Biopsychosocial variables (risks & resilience) predicting the spectrum of gambling behaviors from responsible to problematic

Prevention of problem gambling: Lessons learned from two Alberta programs

National Association for Gambling Studies (Australia) 2003 Conference ProceedingsThe development of effective problem gambling prevention programs is in its infancy. The present paper discusses results of randomized control trials of two programs that have been implemented in Alberta, Canada. The first is a 10 session program delivered to several classes of university students taking Introductory Statistics. This program focused primarily on teaching the probabilities associated with gambling and included several hands-on demonstrations of typical casino table games. The second is a 5 session program delivered to high school students at several sites in southern Alberta. This program was more comprehensive, containing information and exercises on the nature of gambling and problem gambling, gambling fallacies, gambling odds, decisionmaking, coping skills, and social problem-solving skills. Data concerning gambling attitudes, gambling fallacies and gambling behaviour at 3 and 6-months postintervention are presented. The findings of these studies are somewhat counter-intuitive and have important implications for the design of effective prevention programs.Alberta Gaming Research Institut

Program findings that inform curriculum development for the prevention of problem gambling

The development of effective problem gambling prevention programs is in its infancy. The present paper discusses results of randomized control trials of two programs that have been implemented in Alberta, Canada. The first is a 10 session program delivered to several classes of university students taking Introductory Statistics. This program focused primarily on teaching the probabilities associated with gambling and included several hands-on demonstrations of typical casino table games. The second is a 5 session program delivered to high school students at several sites in southern Alberta. This program was more comprehensive, containing information and exercises on the nature of gambling and problem gambling, gambling fallacies, gambling odds, decision-making, coping skills, and social problem-solving skills. Data concerning gambling attitudes, gambling fallacies and gambling behaviour at 3 and 6-months post-intervention are presented. The findings of these studies are somewhat counter-intuitive and have important implications for the design of effective prevention programs.Alberta Gaming Research InstituteYe

In search of lower risk gambling levels using behavioral data from a gambling monopolist

Background and aims: Lower-risk recommendations for avoiding gambling harm have been developed as a primary prevention measure, using self-reported prevalence survey data. The aim of this study was to conduct similar analyses using gambling company player data. Methods: The sample (N 5 35,753) were Norsk Tipping website customers. Gambling indicators were frequency, expenditure, duration, number of gambling formats and wager. Harm indicators (financial. social, emotional, harms in two or more areas) were derived from the GamTest self-assessment instrument. Receiver operating characteristics (ROC) curves were performed separately for each of the five gambling indicators for each of the four harm indicators. Results: ROC areas under the curve were between 0.55 and 0.68. Suggested monthly lower-risk limits were less than 8.7 days, expenditure less than 54 V, duration less than 72–83 min, number of gambling formats less than 3 and wager less than 118–140V. Most risk curves showed a rather stable harm level up to a certain point, from which the increase in harm was fairly linear. Discussion: The suggested lower-risk limits in the present study are higher than limits based on prevalence studies. There was a significant number of gamblers (5–10%) experiencing harm at gambling levels well below the suggested cut-offs and the risk increase at certain consumption levels. Conclusions: Risk of harm occurs at all levels of gambling involvement within the specific gambling commercial environment assessed in an increasingly available gambling market where most people gamble in multiple commercial environments, minimizing harm is important for all customers

Lower-risk gambling limits : linked analyses across eight countries

The Lower Risk Gambling Guidelines project was funded by a grant to the Canadian Centre on Substance Use and Addiction from Mise sur Tois a now defunct, independent, not-for-profit organization that received an annual contribution to conduct safer gambling initiatives from the Quebec crown corporation in charge of conducting and managing gambling in the province of Quebec, Canada. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.A common public health initiative in many jurisdictions is provision of advice to people to limit gambling to reduce the risk of gambling-related harm. The purpose of this study is to use consistent methodology with existing population-based prevalence surveys of gambling and related harms from different countries to identify quantitative limits for lower risk gambling. Risk curve analyses were conducted with eleven high quality data sets from eight Western countries. Gambling indicators were monthly expenditure, percentage of income spent on gambling, monthly frequency, and number of different types of gambling. Harm indicators included financial, emotional, health, and relationship impacts. Contributing data sets produced limit ranges for each gambling indicator and each harm indicator, which were compared. Gender differences in limit ranges were minor. Modal analysis, an assessment of the mean of the upper and lower range limits, indicated that the risk of harm increases if an individual gambles at these levels or greater: $60 to$120 CAD monthly, five to eight times monthly, spends more than 1 to 3% of gross monthly income or plays three to four different gambling types. This study provides further evidence that lower-risk gambling guidelines can be based upon empirically derived limits.Peer reviewe

Hubble Space Telescope WFPC2 Imaging of M16: Photoevaporation and Emerging Young Stellar Objects

We present Hubble Space Telescope WFPC2 images of elephant trunks in the H II region M16. There are three principle results of this study. First, the morphology and stratified ionization structure of the interface between the dense molecular material and the interior of the H II region is well understood in terms of photoionization of a photoevaporative flow. Photoionization models of an empirical density profile capture the essential features of the observations, including the extremely localized region of [S II] emission at the interface and the observed offset between emission peaks in lower and higher ionization lines. The details of this structure are found to be a sensitive function both of the density profile of the interface and of the shape of the ionizing continuum. Interpretation of the interaction of the photoevaporative flow with gas in the interior of the nebula supports the view that much of the emission from H II regions may arise in such flows. Photoionization of photoevaporative flows may provide a useful paradigm for interpreting a wide range of observations of H II regions. Second, we report the discovery of a population of small cometary globules that are being uncovered as the main bodies of the elephant trunks are dispersed. Several lines of evidence connect these globules to ongoing star formation, including the association of a number of globules with stellar objects seen in IR images of M16 or in the continuum HST images themselves. We refer to these structures as evaporating gaseous globules, or "EGGs." These appear to be the same type of object as the nebular condensations seen previously in M42. The primary difference between the two cases is that in M16 we are seeing the objects from the side, while in M42 the objects are seen more nearly face-on against the backdrop of the ionized face of the molecular cloud. We find that the "evaporating globule" interpretation naturally accounts for the properties of objects in both nebulae, while avoiding serious difficulties with the competing "evaporating disk" model previously applied to the objects in M42. More generally, we find that disk-like structures are relatively rare in either nebula. Third, the data indicate that photoevaporation may have uncovered many EGGs while the stellar objects in them were still accreting mass, thereby freezing the mass distribution of the protostars at an early stage in their evolution. We conclude that the masses of stars in the cluster environment in M16 are generally determined not by the onset of stellar winds, as in more isolated regions of star formation, but rather by disruption of the star forming environment by the nearby O stars

A Roadmap for HEP Software and Computing R&D for the 2020s

Particle physics has an ambitious and broad experimental programme for the coming decades. This programme requires large investments in detector hardware, either to build new facilities and experiments, or to upgrade existing ones. Similarly, it requires commensurate investment in the R&D of software to acquire, manage, process, and analyse the shear amounts of data to be recorded. In planning for the HL-LHC in particular, it is critical that all of the collaborating stakeholders agree on the software goals and priorities, and that the efforts complement each other. In this spirit, this white paper describes the R&D activities required to prepare for this software upgrade.Peer reviewe