Has gambling changed after major amendments of gambling regulations in Germany? A propensity score analysis

Aims: This study examined changes in general population gambling in the light of two major amendments of the German gambling regulation, the Fifth Amendment of the German Gambling Ordinance (AGO) for commercial amusement machines with prizes (AWP) and the State Treaty on Gambling (STG) for gambling activities subject to the state monopoly. Methods: Applying cross-sectional data from the 2006 and 2009 Epidemiological Survey of Substance Abuse (ESA), propensity-score-matched samples of 7,970 subjects and 3,624 12-month gamblers aged 18–64 years were used for analyses. Logistic regression was employed to examine changes in gambling controlling for possible confounding variables. Results: Overall participation in state gambling activities, participation in lotto as well as TV lottery decreased and gambling on Internet card games increased. No changes were found for any other gambling activity, 12-month prevalence of any gambling and pathological gambling. While weekly gambling declined, overall multiple gambling increased. Effects were similar in the total sample and among current gamblers. Conclusions: Prohibiting specific gambling activities, e.g., Internet gambling, seem to be insufficient approaches to change gambling behavior. Supply reduction might need to be enhanced by changes in game characteristics and implementation of early intervention measures. However, long-term consequences are uncertain and further monitoring is needed

Gamblers seeking treatment: Who does and who doesn't?

Abstract Background and aims As only a minority of pathological gamblers (PGr) presents for treatment, further knowledge about help-seeking behavior is required in order to enhance treatment utilization. The present study investigated factors associated with treatment participation in gamblers in Germany. As subclinical pathological gamblers (SPGr, fulfilling one to four DSM-IV-criteria) are target of early intervention due to high risk of transition to pathological gambling, they were subject of special interest. Methods The study analyzed data from a general population survey (n = 234, SPGr: n = 198, PGr: n = 36) and a treatment study (n = 329, SPGr: n = 22, PGr: n = 307). A two-step weighting procedure was applied to ensure comparability of samples. Investigated factors included socio-demographic variables, gambling behavior, symptoms of pathological gambling and substance use. Results In PGr, regular employment and non-German nationality were positively associated with being in treatment while gambling on the Internet and gaming machines and fulfilling more DSM-IV-criteria lowered the odds. In SPGr, treatment attendance was negatively associated with married status and alcohol consumption and positively associated with older age, higher stakes, more fulfilled DSM-IV criteria and regular smoking. Conclusions In accordance to expectations more severe gambling problems and higher problem awareness and/or external pressure might facilitate treatment entry. There are groups with lower chances of being in treatment: women, ethnic minorities, and SPGr. We propose target group specific offers, use of Internet-based methods as possible adaptions and/or extensions of treatment offers that could enhance treatment attendance

Test validation, method comparison and reference range for the measurement of β-hydroxybutyrate in peripheral blood samples

Introduction: The measurement of β-hydroxybutyrate (βOHB) concentrations is a corner stone of the diagnosis of diabetic ketoacidosis and other ketonic states. The aim of this study was to perform a validation of a peripheral blood βOHB assay (Randox) on a Roche cobas c502 analyser and to establish a βOHB reference range for the validated assay. Materials and methods: Precision, linearity and limit of detection and blank (LoD, LoB) were determined according to Clinical and Laboratory Standards Institute (CLSI) EP05-A3, EP 06-A and EP17-A2 guidelines, using commercial control material and residual patient sample pools. As method comparison, for 190 semi-quantitative measurements of urine ketones we determined the corresponding βOHB blood concentration. The reference range was based on the CLSI C28-A3 guideline, using 304 randomly selected serum samples from population based German National Cohort (GNC) study. Results: Coefficients of variation for the validated assay ranged from 1.5% for high concentrations (3.1 mmol/L) to 6.5% for low concentrations (0.1 mmol/L). Detection capacity was LoB = 0.011 mmol/L and LoD = 0.037 mmol/L. Linearity of the assay ranged from 0.10 to 3.95 mmol/L. The agreement between the semi-quantitative urine ketone test and the βOHB blood test was moderate (Kappa = 0.66). The obtained 95% serum reference range was estimated as 0.02 to 0.28 mmol/l βOHB. Conclusions: The Ranbut βOHB assay showed good precision and analytical performance. Our results confirm that βOHB measurement in peripheral blood is indeed a preferable alternative to the semi-quantitative measurement of urine ketones

What do they tell us about drinking cultures in European countries?

Aim: A drinking pattern is not only a major drinking variable, but is also one indicator of a country’s drinking culture. In the present study, we examine drinking patterns within and across the neighbouring countries of Denmark and Germany. The aim of the research is to determine to what extent drinking patterns differ or are shared at the sub-national level in the two countries. Method: Data came from the German 2012 Epidemiological Survey of Substance Use (n = 9084) 18–64 years (response rate 54%), and the Centre for Alcohol and Drug Research’s 2011 Danish national survey (n = 5133) 15–79 years (response rate 64%), which was reduced to a common age range, producing a final n = 4016. The drinking pattern variable included abstention, moderate drinking, heavy drinking, risky single occasion drinking (RSOD), and was investigated with bivariate statistics and gender-specific hierarchical cluster analysis. Results: For men three clusters emerged: one highlighting abstention and RSOD, moderate/heavy drinking, RSOD and RSOD + heavy drinking. For women, two clusters appeared: one highlighting abstention and moderate/heavy drinking and the other highlighting RSOD and RSDO + heavy drinking. The clusters revealed different geographical patterning: for men, a west vs. east divide; for women, a north–south gradient. Conclusions: The analysis could identify for each gender clusters representing both separate and shared drinking patterns as well as distinctive geographical placements. This new knowledge can contribute to a new understanding of the dynamics of drinking cultures and could indicate new approaches to prevention efforts and policy initiatives

Time scale, objectivity and irreversibility in quantum mechanics

It is argued that setting isolated systems as primary scope of field theory and looking at particles as derived entities, the problem of an objective anchorage of quantum mechanics can be solved and irreversibility acquires a fundamental role. These general ideas are checked in the case of the Boltzmann description of a dilute gas.Comment: 13 pages, latex, no figures, to appear in the Proceedings of the XXI International Colloquium on Group Theoretical Methods in Physics, 1996 (Goslar, Germany

An extension of a characterization of the automorphisms of Hilbert space effect algebras

The aim of this paper is to show that if an order preserving bijective transformation of the Hilbert space effect algebra also preserves the probability with respect to a fixed pair of mixed states, then it is an ortho-order automorphism. A similar result for the orthomodular lattice of all sharp effects (i.e., projections) is also presented.Comment: 12 pages, to appear in Rep. Math. Phy

Physics of a microsystem starting from non-equilibrium quantum statistical mechanics

In this paper we address the problem to give a concrete support to the idea, originally stemming from Niels Bohr, that quantum mechanics must be rooted inside the physics of macroscopic systems. It is shown that, starting from the formalism of the non-equilibrium statistical operator, which is now a consolidated part of quantum statistical mechanics, particular correlations between two isolated systems can be singled out and interpreted as microsystems. In this way also a new framework is established in which questions of decoherence can be naturally addressed.Comment: 14 pages, latex, no figures, contribution to the Proceedings of the XXXIII Symposium on Mathematical Physics (Torun, Poland

Alcohol Consumption Levels and Health Care Utilization in Germany: Results from the GEDA 2014/2015-EHIS Study

Abstract:Aims: Due to large inconsistencies in previous studies, it remains unclear how alcohol use is related to health care utilization. The aim of this study was to examine associations between alcohol drinking status with utilization of outpatient and inpatient health care services in Germany. Methodology: Survey data of the GEDA 2014/2015-EHIS study with n = 23,561 German adults were analyzed (response rate: 27 %). Respondents were categorized as lifetime abstainers, former drinkers, and non-weekly drinkers, as well as weekly low-risk drinkers and risky drinkers. Outpatient services included GP, specialist, and hospital visits; inpatient services included hospital overnight stays in the last 12 months. For both settings, binary logistic regression models were applied, adjusted for possible confounders. Results: For specialist visits, elevated odds were found among former drinkers (odds ratio (OR) = 1.93, 95 % confidence interval (95 % CI) = 1.50-2.49), non-weekly drinkers (OR = 1.24, 95 % CI = 1.05-1.47), weekly low-risk drinkers (OR = 1.39, 95 % CI = 1.17-1.67), and risky drinkers (OR = 1.28, 95 % CI = 1.04-1.57) compared to lifetime abstainers. In contrast, lower odds for inpatient service use were found among non-weekly drinkers (OR = 0.76, 95 % CI = 0.62-0.93), low-risk drinkers (OR = 0.66, 95 % CI = 0.53-0.81), and risky drinkers (OR = 0.65, 95 % CI = 0.51-0.84). No differences were observed for GP and outpatient hospital visits. Conclusions: While the increased odds of consulting a specialist are consistent with higher health care needs among former and current drinkers, the lower use of inpatient care among current drinkers is contrary to known health risks associated with alcohol consumption and evidence from hospitalized populations. The findings also highlight the need to differentiate between lifetime abstainers and former drinkers in their use of health services

Quantum Mechanics of Successive Measurements with Arbitrary Meter Coupling

We study successive measurements of two observables using von Neumann's measurement model. The two-pointer correlation for arbitrary coupling strength allows retrieving the initial system state. We recover Luders rule, the Wigner formula and the Kirkwood-Dirac distribution in the appropriate limits of the coupling strength

Electron-lattice interactions strongly renormalize the charge transfer energy in the spin-chain cuprate Li2_2CuO2_2

Strongly correlated insulators are broadly divided into two classes: Mott-Hubbard insulators, where the insulating gap is driven by the Coulomb repulsion $U$ on the transition-metal cation, and charge-transfer insulators, where the gap is driven by the charge transfer energy $\Delta$ between the cation and the ligand anions. The relative magnitudes of $U$ and $\Delta$ determine which class a material belongs to, and subsequently the nature of its low-energy excitations. These energy scales are typically understood through the local chemistry of the active ions. Here we show that the situation is more complex in the low-dimensional charge transfer insulator Li$_\mathrm{2}$CuO$_\mathrm{2}$, where $\Delta$ has a large non-electronic component. Combining resonant inelastic x-ray scattering with detailed modeling, we determine how the elementary lattice, charge, spin, and orbital excitations are entangled in this material. This results in a large lattice-driven renormalization of $\Delta$, which significantly reshapes the fundamental electronic properties of Li$_\mathrm{2}$CuO$_\mathrm{2}$.Comment: Nature Communications, in pres