An overview of digital and online strategies to reduce gambling harm.

ISSUE ADDRESSED: Advancements in mobile- and web-based technologies proliferate everyday opportunities to gamble. The increased availability, popularity and intensity of online gambling platforms and interactive gaming activities also changes the way we construct gambling harm reduction interventions. Information and communication technologies (ICT) provide potential opportunities to reduce harm from online gambling through harm minimisation initiatives and currently available services. The aim of this review was to firstly understand the scope of peer-reviewed evidence on ICT-based strategies to reduce online gambling harm, and secondly, what evidence exists specifically in relation to ICT-based harm reduction initiatives for people who gamble online. METHODS: Scoping review methods and a five-stage model of analysis were used to: identify the published literature on ICT-based harm minimisation activities for online gambling; distil models appropriate to address gambling harm in this setting; and synthesise all available evidence, noting gaps and patterns. RESULTS: Sixteen gambling-specific ICT-based interventions were reviewed in depth. The majority of included studies focused on different components of computer-assisted or online therapy programs for disordered gambling, specifically the development of individual skills in managing problematic gambling behaviour. CONCLUSIONS: The review found that despite the widespread potential ICT represent for addressing gambling harm there has been only limited published research to date. SO WHAT: There is a clear need for further investigation into uptake, usage, focus and effectiveness of all online gambling interventions on offer. The dearth of gambling-specific empirical knowledge potentially indicates a serious resourcing and reporting issues in this area.

On punctate white matter lesions in preterm infants: Is ultrasound diagnosis feasible?

OBJECTIVES: To observe hyperechoic nodular or punctate white matter lesions (HNPL) in a population of preterm infants using routine cranial ultrasound (cUS), to describe the characteristics of HNPL, and to compare them with punctate white matter lesions (PWML) detected in magnetic resonance imaging (MRI). DESIGN: Retrospective observational single-center cohort study. SETTING: Level 2B neonatal unit in France. PATIENTS: 307 infants born <33 weeks gestation undergoing routine cUS with a total of 961 cUS performed. MAIN OUTCOME MEASURES: Description of lesions (HNPL/PWML): presence or absence, number, size, location, and structural distribution. RESULTS: Among the 307 included infants, 63 (20.5%) had at least one cerebral lesion, with 453 HNPL for 63 infants. HNPL were numerous (more than three in 66.6% of cases), primarily grouped in clusters (76.2%), located near the lateral ventricles (96.8%), and measuring more than 2 mm (79%). HNPL were diagnosed on day 29 on average and persisted until term. Overall, 43 MRI were performed in 307 infants, on average 18.9 days after last cUS, in 21 of those the indication was presence of HPNL on cUS. Of these 21 MRI, 14/21 presented 118 PWML compared to 173 HNPL on cUS. In the remaining MRI (7/21), no PWML were detected compared to 47 HNPL on cUS. CONCLUSIONS: In our population of 307 preterm infants, cUS allowed the diagnosis of HNPL, with a large similarity to PWML in MRI and a better sensitivity. But in the absence of data on inter-observer variability, we cannot exclude overdiagnosis of HNPL.

Ultrasound of the normal canine supraspinatus tendon: comparison with gross anatomy and histology.

BACKGROUND: This study aimed to compare the ultrasonographic and histological features of the supraspinatus tendon (ST) and its peculiar appearance in contrast with the biceps brachii tendon. METHODS: For this purpose, 19 non-lame dog cadavers were subjected to an ultrasonographic and histologic evaluation of both shoulders after postmortem examination. RESULTS: Close to their insertion on the greater tubercle, all STs displayed a widened portion with a deep central hypoechoic area lacking a fibrillar pattern, when compared with its more proximal aspect and adjacent biceps brachii. Histologically this deep portion corresponded to poorly organised collagen bundles interspersed within a myxoid substance mainly composed of mucopolysaccharides. This central myxoid area with collagen disarray was responsible for the reduced echogenicity on ultrasound. CONCLUSION: The focal widening of the ST insertion and its central mucopolysaccharidic composition could be an anatomical adaptation to marked forces specifically applied to this tendon. However, the ultrasound and histological appearances are very similar to those described in tendinosis, which represents a confounding factor in diagnosing tendonitis at the insertion of the supraspinatus. In the absence of other ultrasonographic criteria of tendinopathy, a hypoechoic central area in the ST near its insertion should be considered normal.

The immediate effect of soleus trigger point pressure release on restricted ankle joint dorsiflexion: A pilot randomised controlled trial.

OBJECTIVES: The primary aim of this study was to investigate the immediate effect on restricted active ankle joint dorsiflexion range of motion (ROM), after a single intervention of trigger point (TrP) pressure release on latent soleus myofascial trigger points (MTrPs). The secondary aim was to assess aspects of the methodological design quality, identify limitations and propose areas for improvement in future research. DESIGN: A pilot randomised control trial. PARTICIPANTS: Twenty healthy volunteers (5 men and 15 women; mean age 21.7±2.1 years) with a restricted active ankle joint dorsiflexion. INTERVENTION: Participants underwent a screening process to establish both a restriction in active ankle dorsiflexion and the presence of active and latent MTrPs in the soleus muscle. Participants were then randomly allocated to an intervention group (TrP pressure release) or control group (no therapy). RESULTS: The results showed a statistically significant (p=0.03) increase of ankle ROM in the intervention compared to the control group. CONCLUSION: This study identified an immediate significant improvement in ankle ROM after a single intervention of TrP pressure release on latent soleus MTrPS. These findings are clinically relevant, although the treatment effect on ankle ROM is smaller than a clinical significant ROM (5°). Suggestions for methodological improvements may inform future MTrP research and ultimately benefit clinical practice in this under investigated area.