Objectives: Pain is a common symptom in prehospital emergency care and pain treatment in this context can be challenging. While previous research has assessed the use of morphine and other synthetic opioids for pain management in this setting, the evaluation of alfentanil is limited. The objective of this study was to evaluate the safety and effect of intravenous alfentanil when administered by ambulance nurses in prehospital emergency care.

Methods: This retrospective observational study consecutively included patients suffering from pain, treated with alfentanil in a Swedish EMS service from September 2011 to 31 September 2022. Data regarding occurrence of adverse events (AE), serious adverse events (SAE)–were used for safety evaluation and pain scores with a visual analogue scale (VAS) before and after treatment were used for evaluation of pain treatment. These data were extracted from the electronic patients’ medical records database for analysis. Univariate logistic regression analysis was used to identify significant predictors of AE following injection of alfentanil by nurses in prehospital emergency care.

Results: During the evaluation period 17,796 patients received pain relief with alfentanil. Adverse events affected 2.5% of the patients, while serious adverse events were identified in 25 cases (0.01%). Out of the 5970 patients with a complete VAS score for pain, the median VAS score was 8 (IQR 3) before treatment and 4 (IQR 3) after treatment. The mean reduction in pain measured by VAS was −4.1 ± 2.6 from the time before, to the evaluation after alfentanil administration. The administration frequency increased during the first year up to a steady level during the later part of the evaluation period.

Conclusions: This study proposes that alfentanil represents a safe and efficacious alternative for addressing urgent pain relief within the prehospital emergency context. Alfentanil demonstrates efficacy in alleviating pain across various conditions, with a relatively low risk of adverse events or serious adverse events when administered cautiously.

IMPORTANCE: Cannabis use disorders (CUD) are associated with adverse health effects, including mental disorders and motor vehicle collision-related injuries. However, little is known about whether CUDs are associated with increased mortality risk.

OBJECTIVE: To examine whether individuals receiving incident hospital-based care (an emergency department visit or hospitalization) for a CUD is associated with increased risk of death.

DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective cohort study included all individuals aged 15 to 105 years living in Ontario, Canada, between 2006 and 2021 (n = 11 622 571 individuals). Overall and cause-specific mortality were compared between individuals with incident hospital-based CUD care and age- and sex-matched members of the general population or individuals with hospital-based care for other substance use disorders using cause-specific hazard models adjusted for comorbid mental health, substance use, and chronic health conditions. Statistical analysis was performed from September to December 2024.

EXPOSURE: Incident hospital-based CUD care.

MAIN OUTCOMES AND MEASURES: Overall and cause-specific mortality identified using vital statistics.

RESULTS: The matched analysis included 527 972 individuals (mean [SD] age, 29.9 [13.6] years; 330 034 [62.5%] female) with a median (IQR) follow-up of 5 (3-9) years; 106 994 had incident CUD. Within 5 years of incident hospital-based CUD care, 3770 individuals (3.5%) died compared with 3770 (0.6%) of matched general population members. After adjusting for comorbid conditions, individuals with incident hospital-based CUD care were at increased risk of death relative to the general population (adjusted hazard ratio [aHR], 2.79 [95% CI, 2.62-2.97]). Individuals with hospital-based CUD care were at increased risk of all investigated types of death and particularly elevated risk of death by suicide (aHR, 9.70 [95% CI, 6.04-15.57]), trauma (aHR, 4.55 [95% CI, 3.55-5.82]), opioid poisoning (aHR, 5.03 [95% CI, 2.86-8.84]), other drug poisonings (aHR, 4.56 [95% CI, 3.11-6.68]), and lung cancer (aHR, 3.81 [95% CI, 2.39-6.07]) relative to the general population. Compared with an individual with hospital-based care for CUD, individuals with hospital-based care for alcohol (aHR, 1.30 [95% CI, 1.26-1.34]), stimulants (aHR, 1.69 [95% CI, 1.62-1.75]), and opioids (aHR, 2.19 [95% CI, 2.10-2.27]) were at relatively increased risk of death within 5 years.

CONCLUSIONS AND RELEVANCE: In this cohort study of all residents of Ontario, Canada, individuals with incident hospital-based CUD care were at markedly increased risk of death compared with the general population. These findings suggest important clinical and policy implications, given global trends toward cannabis legalization and market commercialization accompanied by increasing cannabis use and CUDs.

Background: Gerascophobia, or excessive fear of aging, is thought to be caused by a mixture of cognitive, experiential, and physiological factors acting on a person at particular time points. Measurement tools for evaluating geraschophobia remain insufficiently developed, despite this commonplace fear's distress.

Objective: The objective of the current study was to develop and validate the Gerascophobia or Excessive Fear of Aging Scale (GEFAS) and analyze its psychometric properties.

Methods: Three successive investigations were carried out with a total of 1594 participants. Exploratory and confirmatory factor analyses were conducted to evaluate the construct validity of the GEFAS. Convergent and discriminant validity was assessed by examining relationships with measures of depression, anxiety, stress, death anxiety, psychosocial illness, and life satisfaction. Multiple linear regression was used to investigate factors that predict fear of aging.

Results: The GEFAS demonstrated high reliability (Cronbach alpha >0.8). Factor analysis supported a single-factor solution for the scale (fitness indices CFI, TLI, NNFI, NFI, RFI, and MFI all > 0.95; RMSEA=0.06. Significant positive correlations were found between fear of aging and depression (r = 0.270; p < 0.01), anxiety (r = 0.311; p < 0.01), stress (r = 0.285; p < 0.01), death anxiety (r = 0.600; p < 0.01), and psychosocial illness (r = 0.243; p < 0.01). A significant inverse correlation was observed with life satisfaction. Gender differences were also noted, with women exhibiting greater fear of aging than men (p < 0.01; d = 0.488).

Conclusion: The GEFAS fills a significant gap in the psychological/psychiatric literature as a useful tool for evaluating the fear of aging. The study concludes that the excessive fear of aging contributes to poor mental health.

The present study utilized advanced psychometric methods (i.e., Rasch analysis and confirmatory factor analysis [CFA]) to evaluate the factor structure of the Multiple Intelligence Scale (MIS) and its validity among Taiwanese older adults.

METHODS: A cross-sectional study design using convenience sampling was conducted among 200 community-dwelling participants aged 65 years or older.

RESULTS: The Rasch analyses showed that the MIS had good structure validity and unidimensionality. Among various CFA models testing the MIS factor structure, exploratory structural equation modelling performed the best given its parsimonious and excellent fit indices.

CONCLUSIONS: The MIS can be used among older adults in a culturally-fair way for understanding their multiple intelligences. Using the MIS, healthcare providers could encourage older people to assess their own strengths and weaknesses of intelligence. The results suggest that more research on older adults' MI is needed to tailor bespoke therapeutic programs to individual needs in community settings.

INTRODUCTION: The Big Five Inventory (BFI) is a popular measure that evaluates personality on the Big-Five model. Apart from its utilization across cultures, the literature did not reveal any meta-analysis for the reliability of the different versions of the BFI and its translations. The current study carried out a reliability generalization meta-analysis (REGEMA) to establish the reliability of the BFI across cultures and languages.

METHODS: We searched 30 databases for the relevant studies from 1991 to mid-November 2024. The studies that we intended to include in our meta-analysis required to have utilized the BFI (44 items) and the BFI-2 (60 items) and have reported Cronbach's alpha or McDonald's omega reliability estimates. Our coded variables included BFI version, sample size, population type, age, gender, clinical state, and reliability. A total of 57 studies (datapoints) published in 34 research articles (involving 43,715 participants; 60.24% women; Mean age = 30.08) from various cultures and languages were finally included. These studies used BFI and BFI-2 in Arabic, Chinese, Croatian, Czech, Danish, Dutch, English, French, German, Indonesian, Italian, Japanese, Malay, Norwegian, Polish, Portuguese, Russian, Serbian, Spanish, Swahili, and Turkish. Data analysis was conducted using the metafor and meta packages in R. The average correlation was computed using a random-effects model and reliability coefficients indicated effect size. I² and Cochran's Q tests were used to examine heterogeneity, with prediction intervals suggesting genuine influences around the pooled estimate. Using funnel plots, regression-based tests (e.g., Egger's regression, rank correlation), and trim-and-fill imputation, publication bias was adjusted to estimate unbiased effects.

RESULTS: We calculated the individual and combined reliability of the BFI and BFI-2 across languages and cultures. The results revealed the reliability of all five factors used in the BFI/BFI-2. The BFI estimates provide the following results: openness is estimated at 0.77 (95% CI: 0.75; 0.80); conscientiousness is estimated at 0.80 (95% CI: 0.78; 0.82); extraversion is also estimated at 0.80 (95% CI: 0.79; 0.82); agreeableness is estimated at 0.73 (95% CI: 0.71; 0.76); and neuroticism is estimated at 0.80 (95% CI: 0.79; 0.82). The BFI-2 estimates are as follows: openness is estimated at 0.83 (95% CI: 0.82; 0.84); conscientiousness is estimated at 0.86 (95% CI: 0.85; 0.87); extraversion is estimated at 0.85 (95% CI: 0.84; 0.86); agreeableness is also estimated at 0.80 (95% CI: 0.79; 81); and neuroticism is estimated at 0.89 (95% CI: 0.88; 0.89).

CONCLUSION: The current meta-analysis represents the first reliability analysis of the BFI and the first comparison between its two different versions, the BFI (44 items) and the BFI-2 (60 items). The generalized reliability of both the BFI and BFI-2 were established. The findings confirm that the BFI and BFI-2 have good reliability across all five factors.

The 7.7- and 7.6-magnitude earthquakes that struck T & uuml;rkiye on 6 February 2023 generated considerable material and moral damage. Traumas, such as earthquakes, often lead to posttraumatic stress disorder (PTSD) in individuals; however, trauma may have the effect of transforming individuals in a positive sense, promoting post-traumatic growth (PTG). Although it is not possible to prevent trauma, reducing the adverse effects of trauma and focusing on positive opportunities and outcomes may help individuals to progress in more healthy ways. This study focused on the relationship between PTSD and PTG among earthquake survivors. It examined the potential mediating roles of self-compassion and spiritual well-being and their effects on PTG. Data were obtained from 390 survivors one year after the earthquake. Participants completed scales assessing PTSD (earthquake-related), PTG, self-compassion, and spiritual well-being. The results indicated that PTSD symptoms often persisted one year after earthquake-related trauma. Individuals with high PTSD scores also had high PTG scores. Self-compassion and spiritual well-being in coping with traumatic events mediated the relationship between PTSD and PTG. Thus, while the adverse psychological effects of the earthquake often persisted a year later, high levels of self-compassion and spiritual well-being after trauma appeared to exert positive effects and reduce PTSD. The findings may help guide future efforts of mental health professionals to reduce the traumatic effects of earthquakes.

Food addiction (FA) is linked to eating disorders and obesity. The Yale Food Addiction Scale (YFAS), which has various versions in different languages, is widely used to assess FA worldwide. This meta-analysis aimed to assess the YFAS through reliability generalization meta-analysis (REGEMA). From their inception until April 2024, a comprehensive systematic review across more than 30 databases was conducted to identify studies reporting reliability measures (e.g., Cronbach's alpha and McDonald's omega) of the YFAS. Sixty-five studies were included in this meta-analysis, with a median sample size of 451 participants. The results of the random-effects meta-analysis showed a high pooled reliability coefficient (α = 0.85, 95% CI: 0.83 to 0.86 p < 0.001). Test-retest reliability was also estimated using a random-effects meta-analysis of 10 studies, resulting in a pooled test-retest correlation coefficient of intraclass coefficients of (ICC = 0.77, 95% CI: 0.70 to 0.84, p < 0.001). These findings highlight the consistency and robustness of the YFAS in detecting FA across studies, suggesting its reliability for screening for FA-related disordered eating.

Background: Sleep distrurbances involves daytime preoccupation about sleep, which plays a critical role in perpetuating sleep disturbances. Recent cognitive models highlight the importance of daytime processes, like processing sleep-related information and interpretations during waking hours, in influencing sleep quality and quantity. The Sleep Preoccupation Scale (SPS) quantifies this daytime cognitive activity related to sleep. This study aimed to translate and validate an Arabic version of the SPS for assessing sleep preoccupation among Arabic speakers. Methods: 523 Arabic speakers (mean age 23.6 years, 75% female) from four countries completed the Arabic SPS alongside the Athens Insomnia Scale, Generalized Anxiety Disorder-7 Scale, and the Anxiety and Preoccupation about Sleep Questionnaire (APSQ). The sample repeated the SPS after two weeks for test-retest reliability. Confirmatory factor analysis evaluated the SPS's two-factor structure. Internal consistency, item response theory, and convergent validity with the other scales were examined. Results: Confirmatory factor analysis supported the two-factor model's fit. Measurement invariance results suggest that the SPS exhibits a similar basic factor structure across both insomnia and non-insomnia groups. The Arabic SPS demonstrated good internal consistency (Cronbach's alpha = 0.92, McDonald's omega = 0.92) and two-way mixed effects, consistency, single rater/measurement intraclass correlation coefficient (ICC) test-retest reliability (ICC = 0.95). Most items exhibited satisfactory item response theory fit statistics and discrimination. The SPS total score showed strong positive correlations with insomnia severity (r = 0.48, p < 0.001), generalized anxiety (r = 0.57, p < 0.001), and sleep-related anxiety/preoccupation (r = 0.79, p < 0.001), demonstrating convergent validity. Conclusion: The Arabic version of the SPS demonstrated good psychometric properties and validity, supporting its use for assessing sleep preoccupation among Arabic speakers. This culturally-adapted version enhances sleep assessment capabilities for improving insomnia understanding and treatment within Arabic-speaking populations.

The present study aimed to use a novel method (i.e., network analysis) to examine if the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) has its unidimensional structure supported across different subgroups, including gender groups, continent groups, and age groups. Participants from five continents (n = 545 in Africa; n = 27,910 in Americas; n = 4640 in Asia; n = 88,835 in Europe; and n = 1633 in Oceania) completed the IGDS9-SF. The IGDS9-SF items showed a positively correlated network with moderate-to-high predictability (mean of R2 = 0.338, SD = 0.068). Moreover, the network analysis results suggested that the IGDS9-SF is very likely to have a one-factor model. This one-factor model was further found to be invariant across gender groups (men vs. women), continent groups (Africa, Americas, Asian, Europe, and Oceania), and age groups (minor aged under 18 years, young adults aged between 18 and 30 years, and adults aged 30 years or above).

Biphasic sleep, characterized by nighttime sleep plus daytime napping, has demonstrated some cognitive, health and performance impacts when compared with consolidated monophasic sleep. This motivated the development and validation of the Biphasic Sleep Scale, reported in this paper. Scale development involved a literature review, expert input and individual interviews. The 16-item Biphasic Sleep Scale was then administered to an international online sample (n = 6965) alongside well-established validated sleep scales. To ensure a robust evaluation of the Biphasic Sleep Scale, the sample was divided into two parts: with 15% (n = 1000) of the participants allocated to the exploratory analytic phase; and the remaining 85% (n = 5965) reserved for confirmatory analyses. Psychometric evaluation included both exploratory and confirmatory factor analysis, reliability analysis, correlations, network analysis, and item response theory. Exploratory factor analysis indicated a three-factor structure assessing daytime napping as to likelihood, consequences and effect on nighttime sleep. Confirmatory factor analysis largely confirmed this model with no sex invariance. The three-factor structure showed adequate fit. The Biphasic Sleep Scale demonstrated good internal consistency (alpha = 0.88, Omega = 0.89). Network analysis revealed varying centrality and connectivity of items. Item response theory found items covering a range of biphasic sleep levels. Significant positive correlations with sleep criteria provided evidence for convergent validity. Further testing is warranted to confirm the factor structure, refine model parsimony, and establish clinical utility. With additional validation, it is hoped that the Biphasic Sleep Scale will become a widely utilized tool.