Showing posts with label Gambling. Show all posts
Showing posts with label Gambling. Show all posts

Sunday, August 5, 2018

Reno Nevada after IDAA

I loved Cheryl’s Sunday Morning Spirituality talk. Hope and redemption.  Then it was farewells, hugs all round.  Maybe another whole year before seeing people that uplift and sustain me.  We talked of attending other meetings, so many had, a similar one in Melbourne next year, the annual one of the British Doctors, New England doctors and Western conference.  I must make room for this in my schedule if only to keep perspective. Judy smiled knowingly at me when we talked of detaching from the politics of the profession.  So much has been about recognizing our fears.  Aging and the proximity to dying has touched me in ways I’d not noticed before.
My missionary doctor friend organized a workshop on trauma. I didn’t know where to begin.  An ER doctor was unable to get the image of one gunshot wound in LA out of his head. He’d seen so many stabbings and gunshots but this one touched him. I keep seeing thelittle girl who overdosed with her boyfriend last year, taking a year off from college.  He lived. She died. The face on the disease
I’m sitting here in the Reno Outdoor Cafe Campo. It’s on the Riverwalk and gives are really special face to the city.  The main street is casinos while here is this witness to elegance and fine living. The promenade.  Truckee River. A lovely stream with rapids and boulders, yet here and there some depth.  No doubt a happy place for some species of fish.  Hanging potted plants are all  along the way.  A Latin busker sang a sweet song while a young man jogged past the well dressed young lady pushing her baby buggy.
The sun is hot here.  The city has let artists paint the outside of buildings. Across the way a pretty wall of clouds and sky. More eye candy. A many faceted whale is sculpted  in a deep dive a long way from home in Nevada.  
The city is known for it’s restaurants and cuisine. Staying at the Peppermill Resort I loved all the meals they prepared. The smorgasboard brunch with John was a treat with Mexican and Chinese offerings beside the roast beef and all day breakfast items..  Obviously gamblers like to eat too.
The gambling machines in the airport when I arrived were a surprise but then later I told a friend that I expect every home in Reno has it’s own gambling machine shrine. The city is to gambling what Napa is to wine.  
My work with addiction skews my view. Mostly 80 to 90% of people can enjoy pleasurable activities without stealing from their grandmothers or selling their bodies for cash in the pursuit of pleasure to fuel some activity.  Dr. Nady el Guebaly, founder of the International Society of Addiction Medicine spent his life time studying gambling seeking to prevent those small few who simply couldn’t stop. It’s a deep field for research with advances occurring all the time in the study of genetics, Neuro chemistry, social and psychological factors. 
It’s nice sitting here reflecting on all the other activities that occur in a major city regardless of the primary industry. Here tourism is increasingly important but once the town was a centre for ranching and hub of migrations and transportation. The bridge a ways down had a sign recording the history of the development of Reno in the Gold Rush days as a resting point and transit point on the way to the California mines.
I”m just thankful to have been here.  The IDAA conference has taken me to so many American cities I might otherwise not have known. I love these settings of IDAA and the resorts.  Lake Tahoe is close and many chose to take a dinner cruise on Friday evening.  I tried to arrange a horseback ride with Heavenly Hooves but they were booked a week a head.  Sierra Adventures also was booked full, the popularity of the outdoor adventure that apparent.  
I’d only stopped in the past passing through Reno driving from Western Canada down to California.  I was travelling with a wife and Mustang car then but would love to come through here on my Harley. There’s that Wild West flavour here and Hollywood made it’s share of western movies in Nevada at one time.
The airport is calling now.  It’s been a great conference and I’m thankful to Reno for being here to host such events so well.  Till next I come, hopefully with more time and a motorbike or kayak.  















Friday, November 22, 2013

Treatment Insights from Behavioural Addiction - Nady el-Guebaly

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Dr. el-Guebaly opened with a discussion of what research had proven over the last couple of decades about gambling. It had been projected to be and increasing phenomena but some 'immunological' process had limited it's growth.  The difficulty however was a steady percentage of 'problem gamblers'.  Governments were aware that they could keep from raising taxes by relying instead on the revenue from gambling.  This lead to several considerations which he discussed. Later he showed that the behaviour diagnosis, listed under DSM5 as Impulse Control Disorders had common roots but differences Using slides he presented a summary of the best research to date in the area of genetics, neuroimaging, neurotransmitter research and psychosocial studies regarding the behavioural addictions.  He went on to discuss which bio, psycho, social treatments were most effective and the limits of efficacy.  Always an original thinker commonly ahead of his time, he looked to cultural considerations as the future of understanding and treating behavioural addictions. It was a brilliant talk, well received by doctors and researchers from around the world.

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Saturday, September 28, 2013

Behavioural addiction - Gambling - in people living with Disabilities

Behavioural Addiction

In people living with disability: disordered  gambling and health functioning

Sept. 28, 2013

Sandra Cortina, RN, MPH, MD candidate
Nady el-Guebaly, MD 
Department of Psychiatry, University of Calgary

Fascinating Study presented by Sandra Cortina at the Canadian Society of Addiction Medicine Annual Conference, Vancouver, BC 2013.  These are my rough notes of this excellent presentation which included many pertinent slides I can’t reproduce here. I trust this helps someone to appreciate the depth and breadth of information available.

Problem Gambling - gambling behaviour that creates negative consequences for the gambler, their social network, or community
-up to 3.8% of Canadians have symptons of moderate risk or problem gambling

Higher rates of pathological gambling found in US among people with disability

Disability
Largest category of Canada Pension Plan disability
-mental illness 22%
-musculoskeletal 21%
-neoplasm 20%

Gambling and Health Function
-direction of association between disability and gambling not known

This association can be especially deterimental to people living with disability who may already suffere from pre existing health deficits related to their disability

Objectives
problem gamling, disability and health function
-measure prevalence in gambling in people with disability in canadian sample
-association between two

Methodology
Gambling Prevalence
-Leisure, Lifestyle and Lifecycle Project (W4)
-prospect study

Demographices 
-disability - 18-59 - Canada/Quebec Pension Plan, Worker’s Compensation or both in last 12 months
Canadian Problem Gambling Index (CPGI ) (non,non problem, low risk, moderate-risk, problem)
-Disordered CPGI greater than or equal to 4


Short-Form 8 Health Survy
-Mental Health Burden - vitality, social, emotional, 
-physical health burden - general, physical, function

Results

Gambling prevalence -

Sample 769 participants from Alberta
39 received disability benefits (PRDB)
Characteristics and Behaviours of PRDB
-pretty similiar groups except
-Older participants 66.7% vs 50.6%
Income -less than $50,000  51.3% versus 23 %
Video terminals/slots last 12 months (63 % versus 42.1 %

PRDB found to have a greater proportion of DIsordered Gamblers
15.8 % versus 3.5% 
  
Gambling and Health Function

Physical burden: Well being
  • gambling status was predictive of decreased health function
  • as gambling status became more severe increased physical burden

Summary
People receiving disability have higher prevalence of disordered gambling versus sample remainder and general Canadian population
-small sample - accuracy, confounding, generalizability
-disability definitiion - exclusive, indirect, etiology

Couldn’t differentiate mental or physical disability
And we couldn’t exclude the fact that some disability people don’t receive disability

Increased gambling severity found to significantly predict higher burdens on physical health but couldn’t predict direction

Future Research Directions
-need large sample size
-control confounders
-increase estimate precision, and representation of disordered gambling among people living with disability

Prospective design, monitors health function and problem gambling over time