SMS is simple, inexpensive and a convenient method of delivering interventions to people with problem gambling, but there are currently no trials investigating its feasibility or impact. This study ...explores the feasibility of SMS for people with problem gambling accessing an e-mental health service (i.e. chat, email, forums and brief self-help). The study randomized 198 gamblers to bi-weekly SMS (versus treatment-as-usual TAU) over a 12-week period. SMS involved a series of behaviour change techniques as well as a call-back for further help. Recruitment and randomization workflow, SMS implementation and the impact of text messages on engagement at 12-week follow-up evaluation were also examined. Four out of five gamblers accessing e-mental health were willing to take part and very few withdrew from the study. Furthermore, 10% accessed the new outbound service (text for immediate HELP). There was a significant decrease in gambling symptoms and time and money spent post-treatment, but there was not a significant difference between SMS and TAU (i.e. SMS did not increase the effect of e-mental health). Gamblers accessed an average of 2.5 e-mental health offerings at their initial visit and it could be that this mixture of service supports more than met current needs.
Background and aim
Bromazolam, a novel designer benzodiazepine (NBD), exhibits potent sedative, hypnotic and anxiolytic effects, raising concerns regarding its potential for misuse and fatal ...outcomes, particularly when combined with opioids such as fentanyl. Despite limited documented fatalities globally, its use poses a significant threat, exacerbated by under‐reporting and a lack of routine testing. This study analysed NBD‐related deaths in a major US city over a 4‐year period.
Methods
Analysis of accidental overdose deaths involving NBDs in San Francisco, CA, USA from 2020 to 2023, was performed utilizing medico‐legal death investigations including comprehensive forensic toxicology, pathology and demographic information. San Francisco conducts thorough investigations into all non‐natural and sudden unexpected deaths, including routine alcohol and drug testing of decedents under its jurisdiction, including etizolam, flualprazolam, flubromazolam and bromazolam analysis.
Results
There was a sudden surge in bromazolam‐related deaths, with 44 fatalities documented in 2023, contrasting with relatively fewer deaths related to other NBDs. Bromazolam fatalities frequently involved co‐ingestion with opioids, primarily fentanyl, and stimulants such as methamphetamine and cocaine. Demographic characteristics indicated a predominance of males, with a significant proportion lacking fixed addresses. Blood concentrations of bromazolam increased during the study period, suggesting heightened availability and/or purity in the community.
Conclusion
There was a surge in bromazolam‐related deaths during 2023 in San Francisco, CA, USA, contrasting with relatively stable numbers of deaths associated with other NBDs over the preceding years. The findings underscore the urgency for enhanced death investigation, testing and reporting to facilitate targeted harm reduction strategies for individuals at risk of bromazolam‐related morbidity and mortality.
Personalized Normative Feedback (PNF) may help address addictive disorders. PNF highlights discrepancies between perceived and actual peer norms, juxtaposed against self-reported behavior. PNF can be ...self-directed and cost-efficient. Our study estimates the efficacy of PNF alone, and in combination with other self-directed interventions, to address frequency and symptom severity of hazardous alcohol use, problem gambling, illicit drug and tobacco use. We searched electronic databases, grey literature, and reference lists of included articles, for randomized controlled trials published in English (January 2000-August 2019). We assessed study quality using the Cochrane Risk of Bias tool. Thirty-four studies met inclusion criteria (k = 28 alcohol, k = 3 gambling, k = 3 cannabis, k = 0 tobacco). Thirty studies provided suitable data for meta-analyses. PNF alone, and with additional interventions, reduced short-term alcohol frequency and symptom severity. PNF with additional interventions reduced short-term gambling symptom severity. Effect sizes were small. PNF did not alter illicit drug use. Findings highlight the efficacy of PNF to address alcohol frequency and symptom severity. The limited number of studies suggest further research is needed to ascertain the efficacy of PNF for gambling and illicit drug use. Cost-effectiveness analyses are required to determine the scale of PNF needed to justify its use in various settings.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Internet delivered interventions are accessible and easy to access and can be used to deliver brief interventions. These interventions can be tailored according to individual need for the prevention ...and minimisation of gambling harm or early intervention for those that are displaying some signs of problems. The objective of this review was to summarise the existing literature on the effectiveness of prevention, harm reduction and early intervention programs when delivered online. A systematic review was conducted for peer-reviewed studies that evaluated internet delivered interventions for the prevention, harm reduction or early intervention for gambling problems. Four electronic databases were consulted in the past 20 years (2000–2020) resulting in a total of 15 included studies. Across identified studies just one study provided prevention with 7 harm reduction and 7 early interventions. The quality of the literature was variable with just 8 randomised controlled trials with the remainder matched controls or longitudinal cohort studies. The target group was predominantly gamblers accessing betting and casino websites (n = 8). Studies administered four types of interventions which included personalised and normative feedback, limit setting, self-directed cognitive and behavioural therapy and self-exclusion. These were delivered via customer gaming accounts, email, and self-learning packages. The available literature shows promise in the effectiveness of internet delivered interventions. However, the limited number of studies included in this review highlight significant lost opportunities to leverage technology in the prevention and reduction of gambling harm.
Species distribution models are often used to characterize a species' native range climate, so as to identify sites elsewhere in the world that may be climatically similar and therefore at risk of ...invasion by the species. This endeavor provoked intense public controversy over recent attempts to model areas at risk of invasion by the Indian Python (Python molurus). We evaluated a number of MaxEnt models on this species to assess MaxEnt's utility for vertebrate climate matching.
Overall, we found MaxEnt models to be very sensitive to modeling choices and selection of input localities and background regions. As used, MaxEnt invoked minimal protections against data dredging, multi-collinearity of explanatory axes, and overfitting. As used, MaxEnt endeavored to identify a single ideal climate, whereas different climatic considerations may determine range boundaries in different parts of the native range. MaxEnt was extremely sensitive to both the choice of background locations for the python, and to selection of presence points: inclusion of just four erroneous localities was responsible for Pyron et al.'s conclusion that no additional portions of the U.S. mainland were at risk of python invasion. When used with default settings, MaxEnt overfit the realized climate space, identifying models with about 60 parameters, about five times the number of parameters justifiable when optimized on the basis of Akaike's Information Criterion.
When used with default settings, MaxEnt may not be an appropriate vehicle for identifying all sites at risk of colonization. Model instability and dearth of protections against overfitting, multi-collinearity, and data dredging may combine with a failure to distinguish fundamental from realized climate envelopes to produce models of limited utility. A priori identification of biologically realistic model structure, combined with computational protections against these statistical problems, may produce more robust models of invasion risk.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Loot boxes can provide a competitive advantage to gamers, but there is limited information on how to self-regulate purchases. This study aimed to identify the behaviour change techniques (BCTs) for ...the self-regulation of loot boxes. A thematic analysis was applied to 777 statements obtained from a systematic search of websites containing real-world experiences. Eleven BCTs and 47 strategies were identified for self-regulation including antecedents (avoidance, environmental restructuring), substitution (spending game credits not money), identity (purchasing loot boxes is a waste of money and inconsistent with values), self-control (use of willpower), and a comparison of risk versus out-right purchases. A further eight BCTs and 38 strategies were identified that could be administered by parents including environmental restructuring (removing stored credit cards, limiting access to games), persuasion (better ways to spend money, budgeting), and monitoring (observing play or expenditure). Multi-faceted support for self-regulation may be needed for children and adult consumers of loot boxes.
Background and Aims
Multiple studies have examined barriers and facilitators to help‐seeking, but the prevalence of help‐seeking for problem gambling (PG) is not well established. We aimed to ...estimate the international prevalence of help‐seeking for PG among the general population and among subgroups of people at risk for PG (i.e. low‐risk, moderate‐risk and PG).
Methods
Systematic search of grey literature (through gambling repositories, gambling research institutes and Google) and peer‐reviewed literature (through ProQuest, PsycINFO, PubMed and Scopus) for gambling prevalence studies that reported on help‐seeking for PG. This review adhered to the Preferred Reporting Items for Systematic Review and Meta‐Analyses. Studies used representative sampling methods to determine the prevalence of gambling participation and data collection 2010 onward. Twenty‐four studies met the inclusion criteria. The main outcome was population prevalence of help‐seeking for PG. Help‐seeking was defined as any intentional action to change gambling behaviours, including professional services (inclusive of in‐person or distance help), non‐professional help (e.g. from family and friends) and self‐help. Subgroup analyses were conducted to explain variability in help‐seeking prevalence estimates.
Results
Measurement of help‐seeking was inconsistent across included studies and, overall, there was high risk of bias. We estimated a general population help‐seeking prevalence for PG of 0.23% (95% CI, 0.16–0.33). Prevalence estimates were significantly higher in studies assessing lifetime (0.50%; 95% CI, 0.35–0.71) compared with current help‐seeking (0.14%; 95% CI, 0.10–0.20, P < 0.001), but there was no evidence of difference in prevalence estimates by gambling participation, region, type of help‐seeking, or year of data collection. Compared with people with low‐risk gambling (0.27%; 95% CI, 0.07%–1.04%), prevalence estimates were significantly higher in those with moderate‐risk (3.73%; 95% CI, 2.07%–6.63%) and problem gambling (20.63%; 95% CI, 12.89%–31.35%, P < 0.001).
Conclusions
One in 25 moderate‐risk gamblers and 1 in 5 people with problem gambling have sought help for problems related to their gambling.
Background: Gamblers engage in a range of “soft” financial options to limit access to money or cash for gambling (e.g., family looks after cash). Such barriers are easily overturned, resulting in a ...demand for financial systems and tools that offer “hard” restrictions on access to money and cash in a gambling context. The aim of this scoping review was to determine the attitudes and preferences of gamblers and their families on systems or tools to restrict access to money and cash, as well as the effectiveness of systems and tools that can be used to accomplish that goal. Methods: A systematic search of articles related to financial restrictions and gambling was conducted. Eligibility criteria included samples of gamblers or affected others and interventions targeted at money or cash restrictions in a gambling context. Soft financial barriers such as family involvement were excluded, as were limit-setting systems which focused on gambling expenditure in gambling venues. Results: Nine studies met the eligibility criteria, with three focused on financial systems (e.g., ban on credit betting) and six focused on removal of cash machines from gambling venues. The included literature was generally of low quality, with just two pre-post studies and seven cross-sectional or qualitative ones. Conclusions: The included studies provided strong support for financial mechanisms to support gamblers and their families. Future studies need to involve multiple stakeholders to provide this type of support as well as to evaluate the holistic impact that such hard barriers can have on gambling and gambling-related harms.
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