Mid-morning Break and Poster Sessions: Application of the Theory of Planned Behaviour within School-Based Prevention Programs for Adolescent Gambling

The theory of planned behaviour (TPB) and the concept of anticipatory negative emotions have attracted considerable research attention in the formulation of effective preventive interventions. This approach has identified several key constructs (i.e., attitudes, subjective norms, perceptions of control, anticipation of negative emotions) as valid predictors of gambling intentions and behaviour. However, no empirical investigation has utilized these constructs in the design or evaluation of a youth problem gambling prevention initiative. Objectives. The current research aims to assess the effects of a prevention video on gambling-related attitudes, subjective norms, control perceptions, anticipated negative emotions, and intentions. The video focuses on a problem gambler’s testimonial and includes dramatic vignettes depicting the potential risks and consequences associated with excessive gambling. Methodology. A sample of 328 high school students were randomly assigned to either a video or control group. Participants were assessed at pre- and post-intervention. Results. Preliminary results reveal that the video produced changes in students’: (i) attitudes towards; (ii) perceptions of control over and; (iii) negative anticipatory emotions following excessive participation in gambling. Individuals receiving the intervention were observed to have a significant decreases in positive attitudes toward gambling as well as perceptions of control over gambling, and a significant increase in their anticipation of negative emotions for becoming over-involved in gambling. Conclusions. Positive effects of the video were found. Recommendations for future research are discussed

Exploring the Utility of an Extended Theory of Planned Behaviour Framework for School-Based Gambling Prevention Programs

The theory of planned behaviour (TPB) and the concept of negative anticipated emotions (NAE) have attracted research attention in the formulation of effective preventive interventions. This approach has identified several key constructs of the TPB (i.e., intentions, attitudes, subjective norms, perceptions of behavioural control) and NAE as valid predictors of gambling behaviours and problems among young people (Martin et al., 2010, 2011; St-Pierre et al., 2015). However, no empirical investigation has utilized all of these constructs in the design or evaluation of an adolescent problem gambling preventive intervention. The current research aimed to assess the efficacy of targeting NAE and key TPB constructs in a prevention video for modifying gambling beliefs, intentions and behaviours. A sample of 280 high school students were randomly assigned to either an intervention or control condition. Participants were assessed at pre-intervention, post-intervention, and at three-month follow-up. Results suggest that the video, delivered as a universal preventive intervention, may be insufficient for modifying NAE and other TPB key constructs, or for changing gambling behaviours over time. Important implications of the findings for future research and prevention work are discussed

Early Initiation into Gambling Among Boys and Girls with Conduct Problems: A Prospective Study

Context. Both early initiation into gambling (Rahman et al., 2012; Slutske et al., 2014) and conduct problems (Welte et al., 2009, 2011) have been identified as independent risk factors for later gambling problems. However, few longitudinal studies have examined the associations between these two risk factors, as well as their predictive relationship with gambling initiation among children and adolescents. Research Question. Are conduct problems a risk factor for early initiation into gambling, over and above other known risk factors? Method. This study used data from an ongoing prospective, longitudinal study at the Université de Sherbrooke in order to examine gambling initiation among primary school-aged boys and girls with early conduct problems. Children ages 6 -9 years were recruited from several low-SES public schools in several regions of Quebec, Canada. A strength of the study is the roughly equal proportion of boys and girls with conduct problems, as well as the presence of a matched control group of children with no conduct problems. Gambling initiation was measured between 2 - 4 years later. Results. Regression analyses showed that the relationship between conduct problems and initiation into gambling remained even after child internalizing problems, child academic performance, child executive functioning, and parental and child substance use were controlled for. Implications. Results confirm that both boys and girls with conduct problems are a high risk group for early initiation into gambling. Given these findings, implications for future research and prevention activities specifically for young children with early conduct problems will be discussed

Missing Data in Randomized Clinical Trials for Weight Loss: Scope of the Problem, State of the Field, and Performance of Statistical Methods

BACKGROUND: Dropouts and missing data are nearly-ubiquitous in obesity randomized controlled trails, threatening validity and generalizability of conclusions. Herein, we meta-analytically evaluate the extent of missing data, the frequency with which various analytic methods are employed to accommodate dropouts, and the performance of multiple statistical methods. METHODOLOGY/PRINCIPAL FINDINGS: We searched PubMed and Cochrane databases (2000-2006) for articles published in English and manually searched bibliographic references. Articles of pharmaceutical randomized controlled trials with weight loss or weight gain prevention as major endpoints were included. Two authors independently reviewed each publication for inclusion. 121 articles met the inclusion criteria. Two authors independently extracted treatment, sample size, drop-out rates, study duration, and statistical method used to handle missing data from all articles and resolved disagreements by consensus. In the meta-analysis, drop-out rates were substantial with the survival (non-dropout) rates being approximated by an exponential decay curve (e(-lambdat)) where lambda was estimated to be .0088 (95% bootstrap confidence interval: .0076 to .0100) and t represents time in weeks. The estimated drop-out rate at 1 year was 37%. Most studies used last observation carried forward as the primary analytic method to handle missing data. We also obtained 12 raw obesity randomized controlled trial datasets for empirical analyses. Analyses of raw randomized controlled trial data suggested that both mixed models and multiple imputation performed well, but that multiple imputation may be more robust when missing data are extensive. CONCLUSION/SIGNIFICANCE: Our analysis offers an equation for predictions of dropout rates useful for future study planning. Our raw data analyses suggests that multiple imputation is better than other methods for handling missing data in obesity randomized controlled trials, followed closely by mixed models. We suggest these methods supplant last observation carried forward as the primary method of analysis

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Retailer compliance with youth access policies

Despite the implementation of legal prohibitions and regulatory policies to limit the commercial availability of lottery products to minors, published research continues to document a high prevalence of participation in and ease of access to lottery playing amongst adolescents. This study systematically investigated the influence of individual-level factors in vendor compliance with youth access statutes and policies for lottery and alcohol products. Six underage youths each attempted to purchase a lottery ticket, a beer, or both products together in the same 313 convenience stores, for a total of 1,219 purchase attempts. The results revealed that only a moderate proportion of vendors surveyed in this study were compliant with existing statutes and policies, and that gender and vendor age variables playa significant role in youth purchasing of lottery tickets and alcohol. These findings were interpreted in terms of their implications for strengthening regulatory policies and future research

Cloning and characterisation of novel cystatins from elapid snake venom glands

Snake venoms contain a complex mixture of polypeptides that modulate prey homeostatic mechanisms through highly specific and targeted interactions. In this study we have identified and characterised cystatin-like cysteine-protease inhibitors from elapid snake venoms for the first time. Novel cystatin sequences were cloned from 12 of 13 elapid snake venom glands and the protein was detected, albeit at very low levels, in a total of 22 venoms. One highly conserved isoform, which displayed close sequence identity with family 2 cystatins, was detected in each elapid snake. Crude Austrelaps superbus (Australian lowland copperhead) snake venom inhibited papain, and a recombinant form of A. superbus cystatin inhibited cathepsin L ≅ papain > cathepsin B, with no inhibition observed for calpain or legumain. While snake venom cystatins have truncated N-termini, sequence alignment and structural modelling suggested that the evolutionarily conserved Gly-11 of family 2 cystatins, essential for cysteine protease inhibition, is conserved in snake venom cystatins as Gly-3. This was confirmed by mutagenesis at the Gly-3 site, which increased the dissociation constant for papain by 10-fold. These data demonstrate that elapid snake venom cystatins are novel members of the type 2 family. The widespread, low level expression of type 2 cystatins in snake venom, as well as the presence of only one highly conserved isoform in each species, imply essential housekeeping or regulatory roles for these proteins

Gender Differences in the Association between Sleep Duration and Body Composition: The Cardia Study

Sleep duration has been inversely associated with body mass index (BMI). We examined the relationship between self-reported sleep duration and BMI, waist circumference, and percent body fat in Black and White individuals from the CARDIA study. Box-Tidwell regression models were adjusted for age and race (Model 1), additional lifestyle and demographic variables (Model 2), and physical activity (Model 3). There were significant interactions between sleep and gender for the main outcome variables. In men, there was a trend for an inverse relationship between reported sleep duration and BMI in Model 2  (β=−0.20,P=.053) but not model 3  (β=−0.139,P=.191). In women, inverse relationships were observed between sleep duration and BMI (β=−0.294,P=.005) and waist circumference (β=−0.442,P=.059), in Model 2. These associations became nonsignificant in model 3 (BMI: β=−0.172,P=.084; waist circumference: β=−0.161,P=.474). Our results are consistent with previous findings that sleep is associated with BMI and other body composition variables. However, the relationship between self-reported sleep duration and body composition may be stronger in women than in men