Blood alcohol content

Blood alcohol content (BAC) or blood alcohol concentration is the concentration of alcohol in blood. It is usually measured as mass per volume. For example, a BAC of 0.02% means 0.2 ‰ (permille) or 0.02 grams of alcohol per 100 grams of individual's blood, or 0.2 grams of alcohol per 1000 grams of blood. Blood alcohol concentration is measured in many different units and in many different fashions, but they are all relatively synonymous for each other. In many countries, BAC is reported as grams of alcohol per liter of blood (g/L). Because the specific gravity of blood is close to 1, the numerical value of BAC measured as mass per volume and that of BAC measured as mass per mass do not differ to any consequential degree other than the placement of the decimal point. For example, 1 g/L is equivalent to 0.94 g/kg. In the UK, BAC is reported as milligrams of alcohol per 100 millilitres of blood. For example, a BAC of 0.08% is legally given as a limit of 80 mg per 100 ml. It is also reported in grams per litre, which is an equivalent measurement. The number of drinks consumed is a very poor measure of intoxication largely because of variation in physiology and individual alcohol tolerance. However, it is generally accepted that the consumption from sober of two standard drinks (containing a total of 20 grams) of alcohol will increase the average person's BAC roughly 0.05% (a single standard drink consumed each hour after the first two will keep the BAC at approximately 0.05%), but there is much variation according to body weight, sex, and body fat percentage. Furthermore, neither BAC nor the number of drinks consumed are necessarily accurate indicators of the level of impairment. Tolerance to alcohol varies from one person to another, and can be affected by such factors as genetics, adaptation to chronic alcohol use, and synergistic effects of drugs. http://en.wikipedia.org/wiki/Blood_alcohol_content

Mahjong

Mahjong, sometimes spelled Mah Jongg, is a game that originated in China, commonly played by four players with some three-player variations found in Korea and Japan. The four player table version should not be confused with the popular Western single player tile matching computer game Mahjong solitaire, which is a recent invention and completely different from the table game. Similar to the Western card game rummy, mahjong is a game of skill, strategy and calculation and involves a certain degree of chance. In Asia, mahjong is also popularly played as a gambling game though it may just as easily be played recreationally.

The game is played with a set of 136 tiles based on Chinese characters and symbols, although some regional variations use a different number of tiles. In most variations, each player begins by receiving thirteen tiles. In turn players draw and discard tiles until they complete a legal hand using the fourteenth drawn tile to form four groups melds and a pair head. There are fairly standard rules about how a piece is drawn, stolen from another player melded, the use of basic numbered tiles and honours winds and dragons, the kinds of melds, and the order of dealing and play. However there are many regional variations in the rules; in addition, the scoring system, the minimum hand necessary to win varies significantly based on the local rules being used.

All tiles are placed face down on the table and are shuffled. By convention all players should participate in shuffling using both hands moving the pieces around the table, loudly, for a lengthy period. There is no fixed rule on how to deal or how to treat tiles which flip over during shuffle, though possible solutions include turning back over the pieces at the moment they are seen, turning over all revealed pieces at intervals or doing so at the end of the shuffling and forming of the wall.

Each player then stacks a row of 18 tiles two tiles high in front of him for a total of 36 tiles. Players then push each side of their tiles together to form a square wall.

The dealer throws three dice and sums up the total. Counting counterclockwise so that the dealer is 1 or 5, 9, 13, 17, so that south is 2 or 6, 10, 14, 18, etc., a player's quarter of the wall is chosen. Using the same total on the dice, the player then counts the stacks of tiles from right to left. Starting from the left of the stacks counted, the dealer takes four tiles to himself, and players in counterclockwise order take blocks of four tiles until all players have 12 tiles, so that the stacks decrease clockwise. Each player then takes one last tile to make a 13-tile hand. Dealing does not have to be this formal and may be done quite differently based on house rules.

Each player now sets aside any flowers or seasons they may have drawn and takes replacement pieces from the wall.

The dealer takes the next piece from the wall, adds it to his hand. If this does not complete a legal hand, he then discards a piece throwing it into the middle of the wall with no particular order in mind.

Local play on the street in Lanzhou

Each player takes a turn picking up a tile from the wall and then discarding a tile by throwing it into the centre and, if desired, announcing out loud what the piece is. Play continues this way until one player has a legal hand. At this point a player will call out mahjong and reveal their hand. There are four different ways that this order of play can be interrupted which is mentioned below.

During play, the number of tiles maintained by each player should always be thirteen tiles meaning in each turn a tile must be picked up and another discarded. Not included in the count of thirteen tiles are flowers and seasons set to the side and the fourth added piece of a kong mentioned below. If a player is seen to have more or less than thirteen tiles in their hand outside of their turn they are penalised.

Gambling is the wagering of money or something of material value as the stakes on an event with an uncertain outcome with the primary intent of winning additional money and or material goods. Typically, the outcome of the wager is evident within a short period. Gaming refers to instances in which the law permits the type of gambling. Gaming and gambling are not mutually exclusive. A gaming company offers legal gambling activities to the public and a gaming control board may regulate the gaming company, like the Nevada Gaming Control Board. However, the English-speaking world does not acknowledge this distinction often. For instance, in the UK, the regulator of gambling activities is called the Gambling Commission not the Gaming Commission. In addition, the word gaming describes activities that do not involve wagering, especially online. Gambling is also a major international commercial activity, with the legal gambling market totaling an estimated $335 billion in 2009. Under United States federal law, gambling is legal in the country and states are free to regulate or prohibit the practice. Gambling has been legal in Nevada since 1931, forming the backbone of the economy of the state. The city of Las Vegas is perhaps the best known gambling destination in the world. In 1976, gambling became legal in Atlantic City, New Jersey and in 1990, under state law, gambling became permissible in Tunica, Mississippi; both of those cities have developed extensive casino and resort areas since then. Since a favorable United State Supreme Court decision in 1987, many American Indian tribes have built their own casinos on tribal lands as a way to provide revenue for the tribe. Because the tribes are sovereign nations, they are often exempt from state laws that restrict gambling and are instead regulated under federal law.

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When the Stakes Turn Toxic

Anyone who’s bought a lottery ticket or played bingo has gambled. Gambling is any game of chance in which money changes hands. It’s common in most cultures around the world. Many people enjoy gambling as recreation without causing harm to themselves or others. Yet some people can’t control their impulse to gamble, even when it takes a terrible toll on their lives.         

For these gamblers and their families, researchers have been making progress in several areas. Scientists are learning why people have problems with gambling: how common it is, what goes on inside the gambler’s brain, which is at risk and what kinds of treatment can help.

Problem gambling is defined by some researchers as gambling that causes harm to the gambler or someone else, in spite of a desire to stop. Between 2% and 4% of Americans struggle with this condition. Problem gambling can progress to a recognized psychiatric diagnosis called pathological gambling.

Pathological gambling may affect from 0.4% to 2% of Americans. “Pathological gambling comes with a constellation of problems that contribute to chaos,” says Dr. Donald Black of the University of Iowa. “It’s associated with worse physical health, excessive smoking, excessive drinking, not exercising, not seeing primary care doctors and worse dental care. It also fuels depression, family dysfunction, crime, bankruptcy and suicide.”

Together, pathological and problem gambling may affect up to 5% of Americans. That number may rise, though. Laws in many states are creating more options for legal gambling, and internet gambling is becoming more common.

Still, gambling is often done in family settings, condoned or encouraged by parents. And the younger you start, the more likely you are to get into trouble later on. From 3% to 8% of adolescents have a problem with gambling.

Dr. John Welte of the University of Buffalo has found that, across the lifespan, gambling problems are even more common than alcohol dependence. They are also much more common in males, in young people, and in people who live in relatively poor neighborhoods. “That’s not true of the prevalence of alcoholism,” says Welte. “Alcoholism is much more democratic. So think about motives for gambling. People are hoping that winning will improve their lot. That makes them more vulnerable to developing a gambling problem.”

In a study of mostly African-American inner-city youth, Dr. Silvia Martins of Johns Hopkins University has found that about 15% have some form of problem gambling. Most at-risk were adolescents and young adults who began showing symptoms of depression at age 12. They were highly impulsive, although not hyperactive or aggressive. As the African-American boys developed into their teens and early adulthood, gambling appeared to be a separate risk factor for early fatherhood and criminal arrest.

“We are following up with these inner-city kids every single year as they enter adulthood,” says Martins.

But why is gambling irresistible to some folks and not others? Using advanced imaging techniques, Dr. Alexander Neumeister of Mount Sinai School of Medicine looked at the brains of people with gambling problems and alcohol problems. He measured the number of special receptors involved in regulating impulse control and other factors.          

“A key feature of addiction is impaired impulse control,” says Neumeister. “Abnormal function of the forebrain leads to reduced tolerance to waiting.” The resulting impatience may cause people to act without considering the consequences. “Our imaging clearly points toward the importance of impaired forebrain function in addiction.”

Pinpointing areas in the brain’s reward center, Neumeister’s team found that people with alcohol addiction and gambling problems show different functioning of these special receptors compared to healthy people. The differences were related to the severity of addiction. Other researchers are trying to develop drugs that could treat the affected areas.

Talk therapy can also help. Dr. Nancy Petry at the University of Connecticut Health Center works with pathological gamblers and people seeking treatment for drug use disorders. Gambling problems arise in about 10% to 20% of substance abusers. Petry compared the use of different types of talk therapy, including very brief interventions and cognitive-behavioral therapy CBT. CBT teaches people how to think differently about problems and then act on that knowledge.

“We found very brief interventions and CBT were effective in reducing gambling and gambling-related problems,” Petry says. “There was a significant improvement relative to usual care or standard forms of treatment like Gamblers Anonymous [a 12-step program].”

Anybody can have a gambling problem, and no one should feel ashamed or be afraid to seek treatment. “Pathological gambling is a medical disorder, not a sin or a vice,” says Dr. Carlos Blanco of Columbia University and the New York State Psychiatric Institute. “There is no stereotype. The main predictor of outcome is really motivation.”

In other words, what counts most is a strong drive or desire to take action. Blanco offers gamblers motivational interviewing, which helps them explore their mixed feelings about trying to quit gambling. This primes them to be ready and willing to begin CBT. Using both therapies together can be very effective.

If you have concerns about your gambling, ask for help. Your health provider can work with you to find the treatment that’s best for you.