The psychometric evaluation of the Revised Exercise Addiction Inventory: Improved psychometric properties by changing item response rating.

BACKGROUND: The Exercise Addiction Inventory (EAI) is a short, valid, and reliable instrument used to assess the risk for exercise addiction, and has already been used in numerous published studies. The EAI contains six items, rated on a 5-point scale (strongly agree to strongly disagree), which are based on the components model of addiction. The middle of the original scale (scoring 3 out of 5) reflects neither agreement nor disagreement, which conveys neutrality. However, the present authors believe that individual who provides a neutral opinion on each item (i.e., scoring 3) is a conceptual dilemma because it artificially increases the total score obtainable on the scale without yielding agreement or disagreement with a particular item. Indeed, the six items of the EAI are phrased in such way that respondents can either agree or disagree in the slightly to strongly range. METHODS: This study modified the EAI from a 5-point rating scale to a 6-point one, so that it eliminated a middle neutral response. A total of 277 exercising participants completed the Revised Exercise Addiction Inventory (EAI-R) and Exercise Dependence Scale. RESULTS: All psychometric properties of the EAI-R were superior to the originally published scale. CONCLUSION: Considering these findings, it is recommended that scholars now use the EAI-R in the future research if they need to assess the risk of exercise addiction.

Are frailty scales better than anesthesia or surgical scales to determine risk in cardiac surgery? / 대한마취과학회지

BACKGROUND: In the last year there has been an increasing interest for using frailty scales for risk stratification of elderly patients undergoing major surgery. We planned to compare two frailty scales with risk scales already used in cardiac surgery, to study which of these scores have better prognostic value predicting postoperative outcome in open heart surgery. METHODS: We conducted a prospective clinical trial, including 57 patients over 65 years. We calculated Cardiac Anesthesia Risk Evaluation score, EuroScore II, Clinical Frailty Scale, Edmonton Frail Scale for each patient and followed the postoperative complications, length of mechanical ventilation, length of stay in the intensive care unit and hospital, and in-hospital death related to these risk and frailty scores. RESULTS: Postoperative complications occurred in 25 patients (43.9%), while four patients (7%) died with multiple organ failure. All scales had low predictability for postoperative complications, but for length of mechanical ventilation we obtained positive correlations with EuroScore II, Edmonton Frail Scale and Clinical Frailty Scale. EuroScore II can also predict the length of stay in the intensive care unit. For postoperative deaths, the highest sensitivity had EuroScore II, followed by Clinical Frailty Scale and Edmonton Frail Scale. CONCLUSIONS: EuroScore II and the frailty scales have an increased prognostic value regarding the postoperative outcome of patients (length of mechanical ventilation and in-hospital mortality), the EuroScore II can predict the length of stay in the intensive care unit as well.

Basics of the medical use of ayahuasca: physiology of dimethyltryptamine.

Ayahuasca is a brew made of two admixture plants containing dimethyltryptamine (DMT) and b-carbolines (harmine and tetrahydroharmine). The indigenous groups of the Amazonas basin have been using it for centuries as an ethnomedical substance in healing and spiritual-religious rituals. During the last two decades the brew has raised increased scientific and public interest worldwide about its healing effects. Present paper addresses the therapeutic potentials of ayahuasca use and outlines the cellular mechanisms behind - in focus of the Q-1 receptor mediated action of DMT. The scientific investigation of ayahuasca is complicated by methodical problems, legal issues, and sociocultural pre-conceptions.