scholarly journals Using “Markers of Harm” to Track Risky Gambling in Two Cohorts of Online Sports Bettors

2021 ◽  
Author(s):  
William H.B. McAuliffe ◽  
Eric R. Louderback ◽  
Timothy Edson ◽  
Debi LaPlante ◽  
Sarah E Nelson
Keyword(s):  
Online Gambling ◽  
Risk Scores ◽  
Average Risk ◽  
Detection Systems ◽  
Risk Detection ◽  
Younger Age ◽  
User Data ◽  
Risk Thresholds ◽  
Behavioral Markers ◽  
Related Harm

Online gambling poses novel risks for problem gambling, but also unique opportunities to detect and intervene with at-risk users. A consortium of gambling companies recently committed to using nine behavioral "Markers of Harm'' that can be calculated with online user data to estimate risk for gambling-related harm. The current study evaluates these markers in two independent samples of sports bettors, collected ten years apart. We find over a two-year period that most users never had high enough overall risk scores to indicate that they would have received an intervention. This observation is partly due to characteristics of our samples that are associated with lower risk for gambling-related harm, but might also be due to overly high risk thresholds or flaws in the design of some markers. Users with higher average risk scores had more intraindividual variability in risk scores. Younger age and male gender were not associated with higher average risk scores. The most active users were more likely than other users to have ever exceeded risk thresholds. Several risk scores significantly predicted proxies of gambling-related harm (e.g., account closure). Overall, the current Markers of Harm system has some correctable limitations that future risk detection systems should consider adopting.

scholarly journals Assessing the clinical utility of genetic risk scores for targeted cancer screening

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Carly A. Conran ◽  
Zhuqing Shi ◽  
William Kyle Resurreccion ◽  
Rong Na ◽  
Brian T. Helfand ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
High Risk ◽  
Risk Score ◽  
Genetic Risk ◽  
Clinical Utility ◽  
Low Risk ◽  
Risk Scores ◽  
Average Risk ◽  
Genetic Risk Scores

Abstract Background Genome-wide association studies have identified thousands of disease-associated single nucleotide polymorphisms (SNPs). A subset of these SNPs may be additively combined to generate genetic risk scores (GRSs) that confer risk for a specific disease. Although the clinical validity of GRSs to predict risk of specific diseases has been well established, there is still a great need to determine their clinical utility by applying GRSs in primary care for cancer risk assessment and targeted intervention. Methods This clinical study involved 281 primary care patients without a personal history of breast, prostate or colorectal cancer who were 40–70 years old. DNA was obtained from a pre-existing biobank at NorthShore University HealthSystem. GRSs for colorectal cancer and breast or prostate cancer were calculated and shared with participants through their primary care provider. Additional data was gathered using questionnaires as well as electronic medical record information. A t-test or Chi-square test was applied for comparison of demographic and key clinical variables among different groups. Results The median age of the 281 participants was 58 years and the majority were female (66.6%). One hundred one (36.9%) participants received 2 low risk scores, 99 (35.2%) received 1 low risk and 1 average risk score, 37 (13.2%) received 1 low risk and 1 high risk score, 23 (8.2%) received 2 average risk scores, 21 (7.5%) received 1 average risk and 1 high risk score, and no one received 2 high risk scores. Before receiving GRSs, younger patients and women reported significantly more worry about risk of developing cancer. After receiving GRSs, those who received at least one high GRS reported significantly more worry about developing cancer. There were no significant differences found between gender, age, or GRS with regards to participants’ reported optimism about their future health neither before nor after receiving GRS results. Conclusions Genetic risk scores that quantify an individual’s risk of developing breast, prostate and colorectal cancers as compared with a race-defined population average risk have potential clinical utility as a tool for risk stratification and to guide cancer screening in a primary care setting.

scholarly journals Testosterone-Lowering Medication and Its Association With Recidivism Risk in Individuals Convicted of Sexual Offenses

Sexual Abuse ◽  
2020 ◽  
pp. 107906322091072
Author(s):  
Julia Sauter ◽  
Daniel Turner ◽  
Peer Briken ◽  
Martin Rettenberger
Keyword(s):  
Self Regulation ◽  
Criminal History ◽  
Risk Scores ◽  
Average Risk ◽  
Dynamic Risk Factors ◽  
Psychopathy Checklist ◽  
Sex Drive ◽  
Psychopathy Checklist Revised ◽  
Quasi Experimental ◽  
Paraphilic Disorders

For a particular subgroup of individuals with severe paraphilic disorders and a high risk of sexual recidivism, the combination of sex drive–reducing medications and psychotherapy is a promising treatment approach. The present quasi-experimental study aims at comparing differences in clinical characteristics and dynamic risk factors between persons receiving (+TLM, n = 38) versus not receiving (−TLM, n = 22) testosterone-lowering medications (TLMs). Individuals receiving TLM were more frequently diagnosed with paraphilic disorders. Neither the criminal history nor average risk scores differed between the two groups. In the +TLM, Stable-2007 scores showed a stronger decrease after TLM treatment was started. This accounted especially for the general and sexual self-regulation subscales. Individual variations in risk, however, were not predicted by TLM but were significantly related to treatment duration and Psychopathy Checklist–Revised (PCL-R) Factor I. Paraphilic patients with problems in self-regulatory abilities seem to profit most from pharmacological sex drive–reducing treatment. Furthermore, therapists seem to underestimate deviant sexual fantasies in medicated patients.

scholarly journals Assessing the geographical distribution of comorbidity among commercially insured individuals in South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cristina Mannie ◽  
Hadi Kharrazi
Keyword(s):  
Public Health ◽  
South Africa ◽  
Geographical Distribution ◽  
Healthcare Utilization ◽  
Risk Score ◽  
Disease Burden ◽  
Risk Scores ◽  
Individual Risk ◽  
Average Risk ◽  
Healthcare Needs

Abstract Background Comorbidities are strong predictors of current and future healthcare needs and costs; however, comorbidities are not evenly distributed geographically. A growing need has emerged for comorbidity surveillance that can inform decision-making. Comorbidity-derived risk scores are increasingly being used as valuable measures of individual health to describe and explain disease burden in populations. Methods This study assessed the geographical distribution of comorbidity and its associated financial implications among commercially insured individuals in South Africa (SA). A retrospective, cross-sectional analysis was performed comparing the geographical distribution of comorbidities for 2.6 million commercially insured individuals over 2016–2017, stratified by geographical districts in SA. We applied the Johns Hopkins ACG® System across the insurance claims data of a large health plan administrator in SA to measure comorbidity as a risk score for each individual. We aggregated individual risk scores to determine the average risk score per district, also known as the comorbidity index (CMI), to describe the overall disease burden of each district. Results We observed consistently high CMI scores in districts of the Free State and KwaZulu-Natal provinces for all population groups before and after age adjustment. Some areas exhibited almost 30% higher healthcare utilization after age adjustment. Districts in the Northern Cape and Limpopo provinces had the lowest CMI scores with 40% lower than expected healthcare utilization in some areas after age adjustment. Conclusions Our results show underlying disparities in CMI at national, provincial, and district levels. Use of geo-level CMI scores, along with other social data affecting health outcomes, can enable public health departments to improve the management of disease burdens locally and nationally. Our results could also improve the identification of underserved individuals, hence bridging the gap between public health and population health management efforts.

scholarly journals Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost

2016 ◽  
Vol 4 ◽  
pp. 205031211667092
Author(s):  
Evan S. Cole ◽  
Carla Willis ◽  
William C Rencher ◽  
Mei Zhou
Keyword(s):  
Acute Care ◽  
Diagnosis Related Groups ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Risk Scores ◽  
Average Risk ◽  
Care Hospital ◽  
Hospital Patients ◽  
Medicaid Population

Objectives: Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals. Methods: We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores. Results: We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes) and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%). Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0), lengths of stay (61 versus 38 days), costs (US$143,898 versus US$115,056), but fewer discharges to the community (28.4% versus 51.8%). Conclusion: We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that state Medicaid programs should carefully consider reimbursement policies for long-term acute care hospitals, including bundled payments that cover both the original hospitalization and long-term acute care hospital admission.

scholarly journals Current Addiction in Youth: Online Sports Betting

2021 ◽  
Vol 11 ◽  
Author(s):  
Núria Aragay ◽  
Laia Pijuan ◽  
Àngela Cabestany ◽  
Irene Ramos-Grille ◽  
Gemma Garrido ◽  
...  
Keyword(s):  
Gambling Disorder ◽  
Smoking Habit ◽  
Gambling Behavior ◽  
Education Level ◽  
Sports Betting ◽  
University Education ◽  
Online Gambling ◽  
Clinical Predictors ◽  
Younger Age ◽  
Online Sports Betting

Background: Gambling landscape has changed in recent years with the emergence of online gambling (OG). Greater accessibility and availability of this betting modality can increase the risk of developing a gambling disorder (GD). Online sports betting (OSB) is currently the most common type of OG, but little is known about the clinical characteristics of OSB compared to slot-machine (SM) gamblers, the most common offline gambling disorder.Methods: This was a prospective study conducted between October 2005 and September 2019, and included outpatients diagnosed with GD seen in a Pathological Gambling and Behavioral Addictions referral unit. Only patients with OSB and SM disorders were included. The main objective was to assess the clinical profile of OSB compared to SM gamblers, and to define clinical predictors for developing OSB gambling disorder. Logistic regression was performed to determine the effects of variables on the likelihood of this disorder.Results: Among 1,186 patients attended in our Unit during the study period, 873 patients were included; 32 (3.7%) were OSB gamblers and 841 (96.3%) were SM gamblers. Overall, mean age was 45 ± 13 years and 94.3% were men. Compared to SM patients, OSB patients were younger (34.9 ± 9.5 vs. 45.3 ±13), more frequently single (43.8 vs. 20.6%) and had a university education level (43.8 vs. 4.5%); they were also more frequently non-smokers (18.7 vs. 66.7%) and had fewer psychiatric comorbidities (12.5 vs. 29.4%) than SM gamblers. GD duration before treatment initiation was shorter in OSB patients than in SM gamblers, most of them (81.3 vs. 42.4%) with ≤ 5 years of GD duration. OSB gamblers showed significant differences in weekly gambling expenditure, spending higher amounts than SM patients. Younger age (OR: 0.919; 95% CI: 0.874–0.966), university education level (OR: 10.658; 95% CI: 3.330–34.119), weekly expenditure >100€ (OR: 5.811; 95% CI:1.544–21.869), and being a non-smoker (OR:13.248; 95% CI:4.332–40.517) were associated with an increased likelihood of OSB gambling behavior.Conclusions: We identified different profiles for OSB and SM gamblers. Younger age, university education level, higher weekly expenditure, and non-smoking habit were associated with OSB compared to SM disorders. Prevention strategies should help young people become aware of the severe risks of OSB.

scholarly journals Risk Perception Evaluation of Hazardous Occupational Workers in a Steel Company of Khuzestan Province

2019 ◽  
Vol 2 (3) ◽  
pp. 40-48
Author(s):  
Ali Alboghobeish ◽  
Ehsan Heidari Farsani ◽  
Mehrdad Jaberi ◽  
Syd Amin Jazayeri
Keyword(s):  
Risk Perception ◽  
Perceived Risk ◽  
Positive Impact ◽  
Personal Characteristics ◽  
Risk Scores ◽  
Average Risk ◽  
Safety Behavior ◽  
Continuous Training ◽  
Khuzestan Province ◽  
Occupational Risks

Behavior, practice and how to carry out safe tasks by workers and industrial personnel who exposure to injuries and incidents, Depending on their understanding of the real risks in the workplace. The empirical definition of risk is expressed by calculating the probability of an incident and the magnitude of the consequences of an incident. Employee perceptions of occupational risks have a significant impact on their safety behavior in the workplace. Therefore, research on risk perception is an issue that has attracted many researchers' attention. This descriptive-analytical study was carried out in the winter of 2017 on workers of 10 technical workshops of one of the steel companies of Khuzestan province. Risk perception of workers was assessed using risk perception questionnaire with Cronbach's alpha 0.73. One-way ANOVA, One Sample T-Test and Post Hoc test were used to analyze the data. All perceived risk scores for people were at acceptable levels. The category of individuals in the marital status had the highest score and the experience of the people was the lowest score. Among demographics specification, only education is associated with an average risk perception score. The present study shows that none of the individuals' personal characteristics have a direct and positive impact on risk perception. In order to increase the level of risk perception of workers, planning and developing continuous training programs should be used.  

scholarly journals Assessment of Polygenic Architecture and Risk Prediction based on Common Variants Across Fourteen Cancers

2019 ◽  
Author(s):  
Yan Zhang ◽  
Amber N. Wilcox ◽  
Haoyu Zhang ◽  
Parichoy Pal Choudhury ◽  
Douglas F. Easton ◽  
...  
Keyword(s):  
Association Studies ◽  
Disease Incidence ◽  
Effect Sizes ◽  
European Ancestry ◽  
Risk Scores ◽  
Average Risk ◽  
Genome Wide Association Studies ◽  
Lymphoid Leukemia ◽  
Polygenic Risk ◽  
Wide Range

AbstractWe analyzed summary-level data from genome-wide association studies (GWAS) of European ancestry across fourteen cancer sites to estimate the number of common susceptibility variants (polygenicity) contributing to risk, as well as the distribution of their associated effect sizes. All cancers evaluated showed polygenicity, involving at a minimum thousands of independent susceptibility variants. For some malignancies, particularly chronic lymphoid leukemia (CLL) and testicular cancer, there are a larger proportion of variants with larger effect sizes than those for other cancers. In contrast, most variants for lung and breast cancers have very small associated effect sizes. For different cancer sites, we estimate a wide range of GWAS sample sizes, required to explain 80% of GWAS heritability, varying from 60,000 cases for CLL to over 1,000,000 cases for lung cancer. The maximum relative risk achievable for subjects at the 99th risk percentile of underlying polygenic risk scores, compared to average risk, ranges from 12 for testicular to 2.5 for ovarian cancer. We show that polygenic risk scores have substantial potential for risk stratification for relatively common cancers such as breast, prostate and colon, but limited potential for other cancer sites because of modest heritability and lower disease incidence.

Genetic liability to suicide attempt, suicide death, and psychiatric and substance use disorders on the risk for suicide attempt and suicide death: a Swedish national study

2021 ◽  
pp. 1-10
Author(s):  
Kenneth S. Kendler ◽  
Henrik Ohlsson ◽  
Eve K. Mościcki ◽  
Jan Sundquist ◽  
Alexis C. Edwards ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Psychiatric Disorders ◽  
Genetic Risk ◽  
Risk Scores ◽  
National Study ◽  
Multivariate Models ◽  
Genetic Liability ◽  
Suicide Death ◽  
Younger Age ◽  
The Impact

Abstract Background How does genetic liability to suicide attempt (SA), suicide death (SD), major depression (MD), bipolar disorder (BD), schizophrenia (SZ), alcohol use disorder (AUD), and drug use disorder (DUD) impact on risk for SA and SD? Methods In the Swedish general population born 1932–1995 and followed through 2017 (n = 7 661 519), we calculate family genetic risk scores (FGRS) for SA, SD, MD, BD, SZ, AUD, and DUD. Registration for SA and SD was assessed from Swedish national registers. Results In univariate and multivariate models predicting SA, FGRS were highest for SA, AUD, DUD, and MD. In univariate models predicting SD, the strongest FGRS were AUD, DUD, SA, and SD. In multivariate models, the FGRS for SA and AUD were higher in predicting SA while the FGRS for SD, BD, and SZ were higher in predicting SD. Higher FGRS for all disorders significantly predicted both younger age at first SA and frequency of attempts. For SD, higher FGRS for MD, AUD, and SD predicted later age at SD. Mediation of FGRS effects on SA and SD was more pronounced for SD than SA, strongest for AUD, DUD, and SZ FGRS and weakest for MD. Conclusions FGRS for both SA and SD and for our five psychiatric disorders impact on risk for SA and SD in a complex manner. While some of the impact of genetic risk factors for psychiatric disorders on risk for SA and SD is mediated through developing the disorders, these risks also predispose directly to suicidal behaviors.

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