Training Gamblers to Re-Think Their Gambling Choices: How Contextual Analytical Thinking May Be Useful in Promoting Safer Gambling

Background and aims: Harmful gambling has been associated with the endorsement of fallacious cognitions that promote excessive consumption. These types of beliefs stem from intuitively derived assumptions about gambling that are fostered by fast-thinking and a lack of objective, critical thought. The current paper details an experiment designed to test whether a four-week online intervention to strengthen contextual analytical thinking in gamblers is effective in changing gamblers cognitions and encouraging safer gambling consumption. Methods: Ninety-four regular gamblers who reported experiencing gambling-related harm were randomly allocated to either an experimental (n = 46) or control condition (n = 48), including 45 males, ranging from 19 to 65 years of age (M = 36.61; SD = 9.76). Following baseline measurement of gambling beliefs and prior week gambling consumption, participants in the experimental condition were required to complete an adaption of the Gamblers Fallacy Questionnaire designed to promote analytical thinking by educating participants on common judgement errors specific to gambling once a week for four weeks. Post-intervention measures of beliefs and gambling consumption were captured in week five. Results: The experimental condition reported significantly fewer erroneous cognitions, greater endorsement of protective cognitions, and reduced time spent gambling post-intervention compared to baseline. The control group also reported a reduction in cognitions relating to predicting and controlling gambling outcomes. Conclusion: Cognitive interventions that encourage gamblers to challenge gambling beliefs by reflecting on gambling involvement and promoting critical thinking may be an effective tool for reducing the time people invest in gambling activities

Legacy gambling harms: What are they and how long do they last?

Background and aims: Legacy gambling harms are negative consequences of gambling that extend past periods of low risk, moderate risk and problem gambling. Gambling harm is typically measured within a 12-month timeframe and is often restricted to examining harm amongst active gamblers. The present research aimed to explore whether people experienced gambling harms 12 months or more after the resolution of at-risk or problem gambling, and how long these legacy harms lasted. Methods: An online survey was conducted in New Zealand with past and current gamblers and concerned significant others (CSOs) of gamblers, N 5 1,240 (50.8% female), that asked them about both past and current gambling harms. Results: A majority of both gamblers and CSOs of gamblers indicated that they still suffered from gambling harm even after most of their behavioural issues with gambling had been resolved, 12þ months ago. Legacy gambling harms reduced over time, with harms diminishing most quickly in the early years, and having an average half-life of 4 years. Harms involving community-relationships, church involvement, and domestic and other violence resolved more quickly than others. Discussion and conclusions: Legacy harms are common among ex-problem gamblers and should be considered in any full accounting of the impacts of gambling. Conclusion: Understanding the time course and persistence of legacy harms from gambling can provide gamblers, treatment professionals and public health experts with insights into how to address gambling’s long-term consequences

Prevalence and risk factors for Hepatitis C and HIV-1 infections among pregnant women in Central Brazil

<p>Abstract</p> <p>Background</p> <p>Hepatitis C (HCV) and human immunodeficiency virus (HIV) infections are a major burden to public health worldwide. Routine antenatal HIV-1 screening to prevent maternal-infant transmission is universally recommended. Our objectives were to evaluate the prevalence of and potential risk factors for HCV and HIV infection among pregnant women who attended prenatal care under the coverage of public health in Central Brazil.</p> <p>Methods</p> <p>Screening and counselling for HIV and HCV infections was offered free of charge to all pregnant women attending antenatal clinic (ANC) in the public health system, in Goiania city (~1.1 million inhabitants) during 2004–2005. Initial screening was performed on a dried blood spot collected onto standard filter paper; positive or indeterminate results were confirmed by a second blood sample. HCV infection was defined as a positive or indeterminate sample (EIA test) and confirmed HCV-RNA technique. HIV infection was defined according to standard criteria. Factors associated with HIV and HCV infections were identified with logistic regression. The number needed to screen (NNS) to prevent one case of infant HIV infection was calculated using the Monte Carlo simulation method.</p> <p>Results</p> <p>A total of 28,561 pregnant women were screened for HCV and HIV-1 in ANC. Mean maternal age was 23.9 years (SD = 5.6), with 45% of the women experiencing their first pregnancy. Prevalence of HCV infection was 0.15% (95% CI 0.11%–0.20%), and the risk increased with age (p < 0.01). The prevalence of anti-HIV infection was 0.09% (95% CI 0.06%–0.14%). Black women had a 4.9-fold (95% CI 1.42–16.95) greater risk of HIV-1 infection compared to non-black women. NNS to prevent one case of infant HIV infection ranged from 4,141 to 13,928.</p> <p>Conclusion</p> <p>The prevalence of HIV and HCV infections were low among pregnant women, with high acceptability rates in the opt-in strategy in primary care. Older maternal age was a risk factor for HCV and antenatal HCV testing does not fulfill the requirements for screening recommendation. The finding of higher risk of HIV-1 infection among black women despite being in consonance with the HIV-1 ethnic pattern in some American regions cannot be ruled out to be a surrogate marker of socio-economic condition.</p

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Free-Breathing Radial Magnetic Resonance Imaging Quantification of Fat and R2*

PurposeMagnetic resonance imaging (MRI) can non-invasively quantify fat and the transverse relaxation rate (R2*) in the human body. This quantitative information can provide further insight about diseases such as non-alcoholic fatty liver disease (NAFLD), obesity, and ischemic placental disease (IPD). Conventional MRI methods for quantifying fat and R2* require breath-holding, which limits the spatial resolution, volumetric coverage, and signal-to-noise ratio that may be achieved. Moreover, several subject populations, including sick, elderly, and mentally impaired patients, as well as children, infants, and pregnant women, may have difficulty performing a breath-hold or are unable to breath-hold. The purpose of this work is to develop and evaluate a new free-breathing 3D stack-of-radial MRI technique (FB radial) for fat and R2* quantification at 3 Tesla (T) that overcomes the aforementioned limitations of conventional breath-holding MRI.MethodsTo enable free-breathing MRI, a multiecho golden-angle ordered 3D stack-of-radial radiofrequency-spoiled gradient echo sequence with gradient calibration and correction (FB radial) was developed. First, to evaluate FB radial without motion, fat quantification accuracy using FB radial was compared to conventional Cartesian and reference single-voxel magnetic resonance spectroscopy (SVS) sequences using a fat fraction phantom and in the pelvis of five healthy subjects at 3 T. To evaluate FB radial fat quantification accuracy in subjects capable of breath-holding, a population consisting of eleven healthy adults were recruited and imaged at 3 T. The fat quantification accuracy of FB radial was compared to conventional breath-held Cartesian (BH Cartesian) MRI and reference breath-held SVS (BH SVS).The feasibility and repeatability of FB radial for hepatic fat quantification was evaluated in children, which represents a population that may have limited breath-hold ability or may have difficulty complying with operator instructions. Ten healthy children and nine overweight children with NAFLD, 7-17 years of age, were imaged at 3 T using FB radial, BH Cartesian and BH SVS. Acquisitions were performed twice to assess repeatability. Images and proton-density fat fraction (PDFF) maps were scored for image quality. Liver coverage was measured.Ten healthy infants aged 2-7 months were recruited to evaluate the feasibility of FB radial for quantifying hepatic fat and body composition in a population incapable of breath-holding. The preparation time and scan time (median ± interquartile range) for each non-sedated MRI exam was recorded. Abdominal and head and chest FB radial scans and abdominal Cartesian scans were performed. Abdominal scans were scored for motion artifacts by a radiologist, masked to the trajectory. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and brown adipose tissue (BAT) (volume and PDFF) and hepatic PDFF were measured using FB radial. Repeatability of FB radial hepatic PDFF was assessed.To evaluate the quantitative accuracy of FB radial for R2* mapping without motion, FB radial was compared to a conventional Cartesian sequence using a R2* phantom. To evaluate FB radial R2* mapping in the presence of motion, thirty subjects with normal pregnancies and three subjects with ischemic placental disease (IPD) were scanned twice: between 14-18 and 19-23 weeks gestational age (GA). Feasibility and repeatability of FB radial placental R2* mapping was assessed. The mean and spatial coefficient of variation (CV) of placental R2* was determined for all subjects, and separately for anterior and posterior placentas, at each GA range.For all analyses, quantitative accuracy of fat or R2* quantification was evaluated using linear correlation (Pearson’s correlation coefficient, r; Lin’s concordance correlation coefficient, ρc) and Bland-Altman analyses (mean difference, MD; limits of agreement, LoA = MD ± 1.96 ± standard deviation). The repeatability of FB radial between back-to-back scans for fat or R2* quantification was assessed by calculating the within-technique mean difference (MDwithin) and the coefficient of repeatability (CR). To compare image quality between FB radial and BH Cartesian, differences in the distribution of scores between FB radial and Cartesian were determined using McNemar-Bowker tests. For all statistical analyses, a p-value (P) &lt; 0.05 was considered significant.ResultsIn a fat fraction phantom, FB radial demonstrated accuracy with r and ρc &gt; 0.995 (P &lt; 0.001), absolute MD &lt; 2.2 ± 4.9% compared to SVS and absolute MD &lt; 0.6 ± 3.3% compared to Cartesian. In the pelvis of healthy adults, FB radial demonstrated fat quantification accuracy with absolute MD &lt; 1.2 ± 3.2% in low fat fraction regions (&lt; 5% PDFF) and absolute MD &lt; 4.6 ± 5.6% in high fat fraction regions (&gt; 80% PDFF). In the liver and abdomen, PDFF showed significant correlation (ρ &gt; 0.986, ρc &gt; 0.985), and absolute MD &lt; 1.0 ± 10.6% between FB radial and BH SVS, and significant correlation (r &gt; 0.996, ρc &gt; 0.995), and absolute MD &lt; 0.9 ± 5.7% between FB radial and BH Cartesian.In children with NAFLD, FB radial demonstrated significantly less motion artifacts compared to BH Cartesian (P &lt; 0.05). FB radial PDFF demonstrated a linear relationship (P &lt; 0.001) versus BH SVS PDFF and BH Cartesian PDFF with r = 0.996 and ρc = 0.994, and r = 0.997 and ρc = 0.995, respectively. The absolute MD in PDFF between FB radial, BH Cartesian, and BH SVS was less than 0.7 ± 2.6% Repeated FB radial had MDwithin = 0.25% and CR = 1.53% for PDFF.Ten infants were enrolled, and nine infants completed the study (90% completion). The preparation time and scan time were 32 ± 7 min and 24 ± 11 min, respectively. FB radial MRI demonstrated significantly higher image quality scores compared to Cartesian MRI (P = 0.01). The measurements using FB radial were VAT = 48.2 ± 16.5 cm3; VAT-PDFF = 41.6 ± 3.8%; SAT = 281.6 ± 104.5 cm3; SAT-PDFF = 86.1 ± 4.8%; BAT = 1.5 ± 0.6 cm3; and BAT-PDFF = 28.9 ± 8.8%. Hepatic PDFF measured using FB radial was 3.5 ± 1.1% and had repeatability of MDwithin &lt; 0.25% and CR &lt; 2.0%.For R2* mapping, FB radial demonstrated accurate (ρc ≥ 0.996; P &lt; 0.001; absolute MD &lt; 0.2 ± 4 s-1) and repeatable (MDwithin = 0.23 s-1; CR = 3.9 s-1) quantification in a phantom, and repeatable (MDwithin &lt; 0.5 s-1; CR ≤ 4.6 s-1) quantification in thirty subjects with normal pregnancies. At 3T, placental R2* mean ± standard deviation was 12.9 ± 2.7 s-1 for 14-18 and 13.2 ± 1.9 s-1 for 19-23 weeks GA. The CV was significantly greater (P = 0.043) at 14-18 (0.63 ± 0.12) than 19-23 (0.58 ± 0.13) weeks GA. At 19-23 weeks, the CV was significantly lower (P &lt; 0.001) for anterior (0.49 ± 0.08) than posterior (0.67 ± 0.11) placentas. One IPD subject had a lower mean R2* than normal subjects at both GA ranges (Z ̂ &lt; −2).ConclusionFB radial demonstrated quantitative accuracy compared to BH techniques in a fat fraction phantom and in the pelvis and liver of healthy volunteers. In healthy children and children with NAFLD, non-sedated free-breathing radial MRI provided accurate and repeatable hepatic PDFF measurements and improved image quality, compared to standard breath-held MR techniques. Finally, in a R2* phantom FB radial provided accurate and repeatable three-dimensional R2* mapping and in pregnant subjects FB radial provided repeatable R2* mapping in the entire placenta at 3T during early GA