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Background and aims Substantial research has examined the role of personality in disordered gambling. The predominant model in this work has been the five-factor model (FFM) of personality. In this study, we examined the personality correlates of gambling engagement and gambling severity using a six-dimensional framework known as the HEXACO model of personality, which incorporates FFM characteristics with the addition of honesty-humility. In addition, the potential mediating role of gambling motives in the personality and gambling severity relationship was explored. Methods A sample of undergraduate gamblers (n = 183) and non-gamblers (n = 143) completed self-report measures of the Problem Gambling Severity Index (PGSI) and the Gambling Motives Questionnaire-Financial, as well as self- and observer report forms of the HEXACO-100. Results Logistic regression results revealed that scores on honesty-humility were positively associated with non-gambling over gambling status. Furthermore, it was also found that honesty-humility, agreeableness, and conscientiousness were each uniquely associated with PGSI severity scores. The results of the mediational analyses suggest that each personality factor has different gambling motivational paths leading to PGSI gambling severity. Discussion and conclusions The findings of this study contribute to the literature on behavioral addictions by providing an increased understanding of individual personality factors associated with likelihood of gambling, overall gambling severity, and gambling motives. Ultimately, these findings suggest that the honesty-humility dimension may be a target for the prevention efforts against problematic gambling outcomes.

Over the past decade, several motivational models have been proposed to explain the role of motives in gambling disorder. In the model captured by the four-factor Gambling Motives Questionnaire Financial (GMQ-F), gamblers are described as being primarily motivated to gamble for 'coping', 'enhancement', 'social', and 'financial' reasons. Although this model has received significant empirical support; to date, research assessing the role of motives in gambling disorder has been primarily cross-sectional in nature. Thus, the extent to which gambling motives remain stable over time has yet to be explored. In the current study, the stability versus fluidity of self-assessed gambling motives was investigated using the Quinte Longitudinal Study, a longitudinal dataset of gambling behaviour collected over 5 years. Gambling motives of 2795 gamblers were examined over all five annual assessments. The total proportion of gamblers who stayed in the same primary motive category across each of the 5 consecutive assessments was 22%, indicating substantial fluidity in category membership. Substantial movement between categories was seen for each GMQ-F group, as well as an additional group of non-classified motives. Logistic regression analyses suggest that greater resistance to gambling fallacies significantly predicted stability between the baseline assessment and a follow-up 1 year later, but gambling severity did not. Potential limitations in the study design and opportunities for future research are discussed.

A growing body of research indicates that gamblers develop an attentional bias for gambling-related stimuli. Compared to research on substance use, however, few studies have examined attentional biases in gamblers using eye-gaze tracking, which has many advantages over other measures of attention. In addition, previous studies of attentional biases in gamblers have not directly matched type of gambler with personally-relevant gambling cues. The present study investigated the specificity of attentional biases for individual types of gambling using an eye-gaze tracking paradigm. Three groups of participants (poker players, video lottery terminal/slot machine players, and non-gambling controls) took part in one test session in which they viewed 25 sets of four images (poker, VLTs/slot machines, bingo, and board games). Participants' eye fixations were recorded throughout each 8-second presentation of the four images. The results indicated that, as predicted, the two gambling groups preferentially attended to their primary form of gambling, whereas control participants attended to board games more than gambling images. The findings have clinical implications for the treatment of individuals with gambling disorder. Understanding the importance of personally-salient gambling cues will inform the development of effective attentional bias modification treatments for problem gamblers.

Motivational models have been shown to usefully describe reasons for engaging in addictive behaviors including gambling disorder. Although most scales designed to measure motives have been derived statistically, self-generated open-ended responses have also shown utility for identifying unique motives for gambling. While the motivational structure for gambling disorder has been extensively explored, there has been a paucity of research examining motives for choosing not to gamble. This is not the case for other addictive behaviors such as alcohol use where motives for abstaining from drinking have been well defined. The primary goal of this study was to qualitatively explore and identify motives for not gambling in a sample of young adult non-gamblers using open-ended responses. A sample (N = 196) of undergraduate current non-gamblers, defined as no gambling activity over the previous 12 months, completed a series of questionnaires on demographics, gambling behavior, and alcohol consumption. Furthermore, they were asked to provide their top three reasons for not gambling in rank order. The results revealed eight specific motives for why participants chose not to gamble: 'financial reasons and risk aversion'; 'disinterest and other priorities'; 'personal and religious convictions'; 'addiction concerns'; 'influence of others' values'; 'awareness of the odds'; 'lack of access, opportunity, or skill'; and 'emotional distress'. Personal and religious convictions reasons were also related to lifetime non-drinking, suggesting that these motives are associated with decreased addictive behaviors in general. Ultimately, these results may help to inform the design of prevention strategies for gambling disorder.

Introduction: Colorectal cancer commonly metastasises to the liver, peritoneum and lungs. Bony metastases are uncommon in colorectal cancer and in particular metastases to the hands or feet (acrometastasis) are an extremely rare occurrence., Case Presentation: A 65-year-old male with a colonic malignancy underwent elective anterior resection. Intra-operatively he was found to have a pelvic collection necessitating an end colostomy. Histology confirmed complete Dukes B tumour excision with no evidence of lymph node metastases. The patient underwent chemo-radiotherapy but was unsuitable for reversal of Hartmann's due to elevated CEA levels and asymmetrical thickening of the rectal stump with a solitary lung nodule identified at a one-year surveillance CT. The lung nodule was resected revealing metastatic adenocarcinoma and biopsies from the rectal stump showed chronic inflammatory changes. The patient was offered further chemotherapy. However, six years after his original surgery the patient presented with an acutely painful left foot with radiographic appearances of an infiltrative sclerotic and lucent lesion confirmed as a calcaneal acrometastasis on Magnetic Resonance Imaging (MRI)., Discussion: Diagnosis of acrometastasis is challenging and generally constitutes a wider metastatic process with poor prognosis. Patients are often asymptomatic or present with symptoms mimicking benign lesions such as arthritis, infection or ligamentous sprains of the hands or feet. Therefore, there should be a high index of suspicion and prompt radiological investigation is warranted in order to exclude disease recurrence., Conclusion: Although acrometastasis may indicate a poor prognosis, timely diagnosis and intervention may facilitate improvement of long-term survival and symptomatic management., (Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Evidence from alcohol self-administration studies suggests that nicotine replacement therapy may influence subjective and behavioral responses to alcohol. However, its effect on alcohol cue-reactivity is unknown. The present study examined the impact of acutely administered nicotine on subjective responses to alcohol-focused pictorial stimuli. In a mixed within/between-subjects design, nondependent smokers (n = 51) and dependent smokers (n = 45) who socially drink were assigned to either a nicotine (4 mg) or placebo lozenge condition following overnight tobacco abstinence. Following lozenge absorption, participants viewed neutral images followed by alcohol-focused pictures. Craving measures for alcohol and tobacco were completed at baseline, following lozenge absorption, following neutral cues, and following alcohol cues. The presentation of alcohol cues increased alcohol-related craving relative to neutral cues, especially among men, but the administration of nicotine did not influence the magnitude of these effects. Nicotine lozenges were found to decrease intentions to smoke and withdrawal-related craving in dependent but not in nondependent smokers. Finally, the presentation of alcohol cues was found to increase intentions to smoke relative to neutral cues across participants regardless of lozenge condition. Findings suggest that although the presentation of alcohol cues can increase alcohol- and tobacco-related cravings in smokers, such effects do not appear to be affected by acute nicotine administration., (PsycINFO Database Record (c) 2015 APA, all rights reserved.)

Non-daily smokers commonly smoke cigarettes following the consumption of alcohol, yet the reason(s) for this remains poorly understood. The present study examined the impact of alcohol consumption on responses in tobacco salient cues 49 male and 50 female non-daily smokers. After the administration of an alcohol, placebo, or control beverage, participants were exposed to series neutral video clips and tobacco smoking salient video clips, and their subjective states and heart rates were monitored. The timing of the exposure to the tobacco smoking clips was randomly determined to coincide with the timing of either the ascending limb or the descending limb of the blood alcohol concentration (BAC) curve of the alcohol beverage condition. The tobacco smoking clips were found to increase cigarette craving regardless of beverage condition or timing of exposure (p = .002). Alcohol consumption was associated with increased ratings of intoxication (p < .001), increased heart rate across participants (p < .001), and increased cigarette craving in female participants specifically (p = .017). Alcohol did not influence responses to the smoking videos. These results suggest that smoking salient cues and alcohol may impact cigarette craving in non-daily smokers through independent processes., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Evidence indicates that tobacco use and gambling often co-occur. Despite this association, little is known about how tobacco use affects the propensity to gamble. Nicotine, the putative addictive component of tobacco, has been reported to potentiate the hedonic value of other nonsmoking stimuli. Environmental cues have been identified as an important contributor to relapse in addictive behavior; however, the extent to which nicotine can affect the strength of gambling cues remains unknown. This study examined whether nicotine influences subjective ratings for gambling following gambling cues. In a mixed within/between-subjects design, 30 (20 men) video lottery terminal (VLT) gamblers ('moderate-risk' or 'problem' gamblers) who smoke daily were assigned to nicotine (4 mg deliverable) or placebo lozenge conditions. Subjective and behavioral responses were assessed at baseline, following lozenge, following neutral cues, and following presentation of gambling cues. Nicotine lozenge was found to significantly reduce tobacco-related cravings (P<0.05) but did not affect gambling-related cravings, the choice to play a VLT, or other subjective responses. These results suggest that a low dose of acutely administered nicotine does not increase cue-induced craving for gambling in at-risk VLT gamblers who smoke.

Introduction: Numerous epidemiological and clinical studies have found that tobacco use and gambling frequently cooccur. Despite high rates of smoking among regular gamblers, the extent to which tobacco potentially influences gambling behavior and vice versa is poorly understood. The current study aimed to provide more insight into this relationship by directly comparing nonsmoking and smoking gamblers on gambling behavior, problem gambling indices, and reasons for gambling., Methods: The data for this study came from the 2005 Newfoundland and Labrador Gambling Prevalence Study. Gamblers identified as nonsmokers (N = 997) were compared with gamblers who smoke (N = 622) on numerous gambling-related variables. Chi-square analyses were used to compare groups on demographic variables. Associations between smoking status and gambling criteria were assessed with a series of binary logistic regressions., Results: The regression analyses revealed several significant associations between smoking status and past 12-month gambling. Higher problem gambling severity scores, use of alcohol/drugs while gambling, amount of money spent gambling, use of video lottery terminals, and reasons for gambling which focused on positive reinforcement/reward and negative reinforcement/relief were all associated with smoking., Conclusions: The findings suggest an association between smoking and potentially problematic gambling in a population-based sample. More research focused on the potential reinforcing properties of tobacco on the development and treatment of problematic gambling is needed.

Rationale: A growing body of evidence suggests that gambling frequently co-occurs with smoking, yet little is known about the degree to which nicotine and/or tobacco use influences gambling behavior. Nonetheless, an increasing number of studies suggest that acute administration of nicotine may alter other reinforcing behaviors in both animal and human models, raising the possibility that nicotine may also influence gambling behavior and craving., Objectives: The purpose of this study was to examine the acute effects of nicotine on subjective and behavioral gambling responses., Methods: Twenty-eight (15 male) regular gamblers who smoke daily completed two double-blind laboratory sessions where their subjective and behavioral responses to video lottery terminal (VLT) gambling were assessed, following the administration of nicotine inhalers (NI; 4 mg deliverable) or placebo inhalers., Results: NI significantly decreased tobacco-related cravings (p < 0.05) but did not affect gambling-related cravings, VLT betting patterns, or subjective responses (ps > 0.1)., Conclusions: NI were found to acutely suppress tobacco-related cravings without influencing gambling. These results suggest that use of nicotine replacement therapies may be a safe option for gamblers who are attempting to quit smoking.

Issues: Evidence suggests that tobacco smoking and gambling frequently co-occur. Although high rates of comorbid smoking and gambling have been documented in studies with clinical populations of pathological gamblers in treatment, in studies using samples drawn from the community, and in large-epidemiological surveys, little empirical attention has been directed towards investigating the exact nature of this relationship., Approach: In this review, we stress the literature that has examined the epidemiology, aetiology and environmental factors implicated in comorbid smoking and gambling. Publications included in the review were identified through PsycInfo, PubMed and Medline searches., Key Findings: Although conclusive evidence is lacking, a growing body of literature suggests that smoking and gambling might share similar neurobiological, genetic and/or common environmental influences., Implications: Comorbid tobacco smoking and gambling are highly prevalent at the event and syndrome levels. However, research investigating how smoking might affect gambling or vice versa is currently lacking., Conclusion: More studies that examine the impact of this comorbidity on rates of tobacco dependence and problem gambling, as well as implications for treatment outcomes, are needed.

Background: The evidence for a relationship between patient outcomes and clinician and hospital volume is increasing. The National Colorectal Cancer Care Survey was undertaken to determine the management patterns in Australia for individuals newly diagnosed with colorectal cancer in a 3 month period in the year 2000., Methods: All new cases of colorectal cancer registered at each Australian State Cancer Registry were entered into the survey. This generated a questionnaire that was sent to the treating surgeon. Chi-squared tests and logistic regression analyses were used to determine levels of statistical significance., Results: Of 2,383 surgical questionnaires generated, 2,015 (85%) were completed. The majority (58%) of surgeons treated one or two patients with colorectal cancer over the 3 months of the survey. There was variation across surgeon cohorts for preoperative measures including the use of deep vein thrombosis prophylaxis. Patients seen by low volume surgeons were most likely to be given a permanent stoma (P < 0.0001). Patients with rectal cancer who were operated on by high volume surgeons were significantly more likely to receive a colonic pouch (P < 0.0001)., Conclusion: This nationwide population-based survey of the treatment of colorectal cancer patients suggests that the delivery of care by surgeons (the majority) who treat patients with rectal cancer infrequently should be evaluated.

Multiple colonic polyps, almost guaranteed colorectal cancer by the age of forty-five and an increased risk of non-colonic cancers characterise the autosomal dominant condition Familial Adenomatous Polyposis (FAP) 1. The patients and families faced with such a diagnosis present many difficult management challenges, both surgical and non-surgical. We discuss the current surgical options for treatment of the more significant manifestations of FAP arising in the colorectum and duodenum as well as desmoid disease.

Background: The National Colorectal Cancer Care Survey was undertaken to determine the management patterns for individuals newly diagnosed with colorectal cancer in Australia., Methods: Between 1 February and 30 April 2000, all new cases of colorectal cancer registered at each Cancer Registry within Australia were entered into the survey. This generated a questionnaire that was sent to the treating surgeons. Chi-squared and logistic regression analyses were used to determine levels of statistical significance for the various comparisons of interest., Results: Of 2383 surgical questionnaires generated, 2015 (85%) were completed. A total of 1911 patients (95% of those who responded to the questionnaire) had an operation. Of the 86 guidelines for the management of colorectal cancer published by the National Health and Medical Research Council, the survey allowed for comparison between 18 of these, which covered a spectrum of surgical management. Thromboembolic prophylaxis was given to 1843 patients (96.4%) undergoing surgery. Prophylactic antibiotics were commonly used, but there appear to be issues regarding the best regimen to use. Curative resections were carried out in 1563 patients (81.8%), with anterior resections being the most commonly performed procedure. Adjuvant therapy was regularly used, but not all eligible patients were offered such treatment., Conclusion: With the considerable resources required to develop clinical practice guidelines, studies like this are essential to monitor the impact of the guidelines. To ensure that the guidelines are in line with current evidence, regular reviews of the guideline recommendations are required.