The Russia-Ukraine war generates fear, depression, loneliness, burnout, and the search for coping strategies that can alleviate the impact of war on mental health among civilians. In wartime, online gaming can become a coping strategy and/or a source of risk for internet gaming disorder (IGD). Our study examines the association of online gaming use and mental health among 1,170 Ukrainian university students in wartime conditions. Survey respondents were from six cities divided into two clusters. The first cluster included Kyiv, Kharkiv, and Chernihiv with much damage; and the second cluster of cities-Lviv, Rivne, and Ternopil with less damage. Respondent average age was 19.3 years, 30.4% secular and 31.7% married/partnered. Most respondents (66.2%) used online gaming during the past year. Statistical analysis does not show significant gaming disorder differences among university cluster students; however, first cluster students evidenced significant fear of war, depression, and burnout. Additional analysis shows a positive association between IGD, depression, burnout, and loneliness as well as a negative association with resilience and life satisfaction. Research findings confirm online game use as a resource that maintains or promotes resilience. Internet gaming, used as a therapeutic intervention for disaster conditions, calls for further research conducted over time with different groups of people and locations.

BACKGROUND:Medical cannabis use is expanding globally, yet knowledge gaps persist among both patients and healthcare professionals. This study aimed to examine age-related differences in medical cannabis use patterns, sources of education and training, and perceptions of physician competencies among medical cannabis patients in Israel. METHODS:A cross-sectional survey of 233 Israeli medical cannabis patients assessed use patterns, education and training sources, and perceptions of physician competencies. Data were analyzed by age groups (18-33, 34-48, 49-64, 65+) using descriptive statistics, chi-square tests, and ANOVA. RESULTS:Use patterns differed significantly by age. Smoking was common among participants aged 18-33 (40%) and 34-48 (37.8%) but less common in the 49-64 group (16.7%) and the 65+ group (10%; p<.001). Conversely, ingestion-based methods were reported by 65.5% of participants aged 65+ and by 72.2% in the 49-64 group, but only by 45.9% and 50% in younger groups (p<.01). Among 57.6% of participants who knew the THC/CBD concentration of their cannabis, mean THC concentration decreased with age (p<0.05), while mean CBD concentration increased with age (p<0.01). Most participants (89.8%) received education on medical cannabis, primarily from physicians (74.7%), but 35.4% used internet sources, and 20.1% reported peer networks. CONCLUSION:This study identifies age-related differences in medical cannabis use patterns, information sources, and perceptions of physician competencies. Future research should explore how tailored patient education and clinician training can address these differences and improve guidance for medical cannabis use.

The use of medical cannabis continues to expand rapidly across the US, yet most health care practitioners and trainees report feeling unprepared to counsel patients or integrate cannabis into care. Despite its clinical relevance, standardized education on medical cannabis remains absent from most medical school curricula. To develop a consensus-based set of core competencies for educating medical students about medical cannabis, including its clinical utility, risks, legal landscape, and evidence base. Between February and October 2023, a modified Delphi process was conducted with 23 experts representing a broad range of clinical and academic expertise. Through 2 rounds of anonymous, web-based surveys, panelists provided quantitative ratings and qualitative feedback on draft competencies. Competencies and subcompetencies were iteratively revised by the research team and re-evaluated by the panel. Final inclusion of competencies required a mean score of 4 or higher (on a 1 to 5 scale) on both importance and wording appropriateness. Subcompetencies were reviewed for comprehensiveness and educational value. The expert panel included 14 physicians across multiple specialties, along with nurses, a pharmacist, and individuals with leadership roles in academic medicine. An initial list of 9 competencies was refined and consolidated into 6 core competencies: (1) understand the basics of the endocannabinoid system; (2) describe the main components of the cannabis plant and their biological effects; (3) review the legal and regulatory landscape of cannabis in the US; (4) describe the evidence base for health conditions that are commonly managed with cannabis; (5) understand the potential risks of medical cannabis use; and (6) understand basic clinical management with medical cannabis. Each competency is supported by 2 to 7 subcompetencies, resulting in 26 subcompetencies reflecting granular topics, such as patient safety, vulnerable populations, structural inequities, and interdisciplinary care. These consensus-derived competencies provide a structured, evidence-informed foundation to guide the integration of medical cannabis into undergraduate medical education. Aligned with competency-based education principles, the implementation of the proposed framework can help ensure that future clinicians are equipped to provide informed, evidence-based, and patient-centered guidance on medical cannabis use.

Kazakhstan is a large Central Asian country of the former Soviet republic with a population of 19 million, the majority being Muslim with moderate religious practices. Despite considerable economic growth, most university students remain pressed to address higher education and living costs. This cross-sectional study of 2,065 students examined living conditions and its association with burnout, loneliness and substance use. Female students, and those using harmful substances, were more likely to report burnout and loneliness. Gender status did not differentiate student substance use. However, students who live on or off campus evidence more substance use including alcohol binge drinking. Regardless of gender status and living conditions, religious students reported less substance use. Study findings contribute to usable information for promoting university student psychological well-being through policy and prevention practices associated with substance use over time and across locations in the country.

The dramatic rise in high-speed internet access and smartphone usage has made multiplayer online gaming increasingly prevalent among young adults. While moderate gaming can confer cognitive benefits, excessive gaming is linked to sleep disruption, addiction, and a spectrum of adverse mental health outcomes—including depression, anxiety, stress, and impaired academic performance. In 2018, the World Health Organization formally recognized Gaming Disorder (GD) as an addictive mental health condition, before that Internet Gaming Disorder (IGD) had been added to DSM-5 in 2013. Despite growing concern, data remain scarce on IGD’s prevalence and psychological correlates in Georgian university students. This study therefore assessed the relationship between IGD, gaming duration, and key psychosocial variables (burnout, loneliness, life satisfaction, religiosity, and substance use) in a representative Georgian student sample. From November 2024–January 2025, an anonymous online survey was administered to students at four major Georgian universities, yielding 506 responses (157 complete). Participants reported weekly gaming hours and completed validated scales: Internet Gaming Disorder Scale, Burnout Scale, Loneliness Scale (emotional/social), Satisfaction with Life Scale, and Financial Wellbeing Scale. Self-reported religiosity, substance use patterns, and demographic data were collected. Statistical analyses (SPSS v26) included Pearson correlations, independent samples t-tests, ANOVA, chi-square tests, and eta coefficients; significance was set at p < 0.05. Among 506 respondents (mean age 22.1; 33.4

Kazakhstan is a large Central Asian country of the former Soviet republic with a population of Kazakhstan is a large Central Asian country of the former Soviet republic with a population of nearly 21 million, the majority being Muslim with moderate religious practices. Despite considerable economic growth, significant portion of students remain pressed to address higher education and living costs. This cross-sectional study of 2065 students examined their housing condition and its association with burnout, loneliness, financial well-being, and substance use. Respondents' mean age was 18.6 (SD = 3.2), 71.0% female and 29.0% male. Stepwise multiple regression, Pearson's chi-squared test, the Mann-Whitney U test, Kruskal-Wallis H test, t test, as well as one and two-way ANOVA were used for data analysis. Female students, and those using harmful substances, were more likely to report burnout and loneliness. Gender status did not differentiate student substance use. No significant difference was found for burnout and loneliness based on respondent housing condition. One-way ANOVA shows better financial well-being among students who live with parents/relatives; however, students who live on or off campus evidence more substance use including alcohol binge drinking. Regardless of housing conditions, the substance use among Kazakhstani students is significantly lower than that of students from many other countries. This study provides usable information for promoting psychological well-being among students in the country and elsewhere.

The Russia-Ukraine war generates fear, depression, loneliness, burnout and substance misuse among civilians. Our study examines mental health among Ukrainian university female students during 3 years of war. A total of 3,467 students were surveyed on three occasions: August to October 2022 (T1, n = 1,416), March to July 2023 (T2, n = 747) and September to November 2024 (T3, n = 1,304). The respondent's average age was 19.3 years, 25.3% identified as secular and 36.9% were married/partnered. The respondents included 81.2% who were not relocated, 10.7% who were internally displaced and 8.1% who were refugees. Valid and reliable survey instruments were used to gather data. One-way analysis of variance (ANOVA) shows a significant decrease in fear of war, depression and burnout in 2023 compared to 2022; however, there was a marked increase in 2024. Regardless of the survey period, one-way ANOVA shows a significant difference in fear of war and burnout scores associated with depression and loneliness levels. Stepwise regression analysis shows fear of war, depression and loneliness associated with burnout. This study provides usable information for mental health services planning and intervention purposes associated with young women affected by war in Ukraine. Additionally, it has relevance for training to address client and service personnel needs, for academic curriculum development and course instruction, and as a reference source for mental health personnel addressing student needs.

Importance:The use of medical cannabis continues to expand rapidly across the US, yet most health care practitioners and trainees report feeling unprepared to counsel patients or integrate cannabis into care. Despite its clinical relevance, standardized education on medical cannabis remains absent from most medical school curricula. Objective:To develop a consensus-based set of core competencies for educating medical students about medical cannabis, including its clinical utility, risks, legal landscape, and evidence base. Evidence Review:Between February and October 2023, a modified Delphi process was conducted with 23 experts representing a broad range of clinical and academic expertise. Through 2 rounds of anonymous, web-based surveys, panelists provided quantitative ratings and qualitative feedback on draft competencies. Competencies and subcompetencies were iteratively revised by the research team and re-evaluated by the panel. Final inclusion of competencies required a mean score of 4 or higher (on a 1 to 5 scale) on both importance and wording appropriateness. Subcompetencies were reviewed for comprehensiveness and educational value. Findings:The expert panel included 14 physicians across multiple specialties, along with nurses, a pharmacist, and individuals with leadership roles in academic medicine. An initial list of 9 competencies was refined and consolidated into 6 core competencies: (1) understand the basics of the endocannabinoid system; (2) describe the main components of the cannabis plant and their biological effects; (3) review the legal and regulatory landscape of cannabis in the US; (4) describe the evidence base for health conditions that are commonly managed with cannabis; (5) understand the potential risks of medical cannabis use; and (6) understand basic clinical management with medical cannabis. Each competency is supported by 2 to 7 subcompetencies, resulting in 26 subcompetencies reflecting granular topics, such as patient safety, vulnerable populations, structural inequities, and interdisciplinary care. Conclusions and Relevance:These consensus-derived competencies provide a structured, evidence-informed foundation to guide the integration of medical cannabis into undergraduate medical education. Aligned with competency-based education principles, the implementation of the proposed framework can help ensure that future clinicians are equipped to provide informed, evidence-based, and patient-centered guidance on medical cannabis use.

Gaming is a popular leisure activity with an increasing number of participants worldwide. It has positive aspects as well as a problematic side—Internet Gaming Disorder (IGD). This behavior attracts concern among mental health and education professionals because of possible negative psycho-emotional factors. This study aimed to assess IGD among Japanese and Israeli university students and other young adults. We explored the association of culture and IGD based on gender, burnout, and loneliness. It was hypothesized that IGD would differentiate based on the respondent country (i.e., Japan or Israel) and gender, with males reporting higher levels. Furthermore, IGD would be associated with higher levels of loneliness and burnout, regardless of country. Qualtrics and Excel platforms were used to collect responses to the Internet Gaming Disorder Scale–Short Form, De Jong Gierveld Loneliness Scale, and Short Burnout Measure (SBM). Data was gathered from a cross-cultural sample of 1318 male and female university students and other young adults in Japan and Israel, between 2022 and 2023. Japanese gamers showed less IGD (p < 0.05); and males evidenced higher levels regardless of their country (p < 0.001). IGD was significantly associated with loneliness (p < 0.001) and burnout (p < 0.001). However, multiple regression analysis showed that IGD is predicted only by burnout and gender (p < 0.001), Adjusted R2 = 0.234. This study provides information for policy, prevention, and intervention purposes targeting burnout particularly among males who are a high-risk group. Additionally, this study contributes to possible joint online program development to reduce IGD among Japanese and Israeli gamers. Further research should examine the association between IGD and loneliness, controlling gender and other factors such as substance use, religiosity, eating behavior, depression, game genre, and motivation to play.

This study compared a purposive sample of secular and religious female social work students during four years of the pandemic. The objective of this study was to assess the association between COVID-19 fear, religiosity, well-being, and substance use in Israel. The Fear of COVID-19 Scale (FCV-19S) was used for study purposes. A total of 1790 students completed an online survey from May 2020 to April 2023. Findings evidence deterioration of student well-being, as well as increased substance use and alcohol binge drinking over 4 years of the pandemic. Regression analysis shows that the predictors associated with substance use are most evident during the first 2 years of COVID-19. The last 2 years of COVID-19 evidence less fear and substance use due to possible student adjustment to health conditions. Present findings do not evidence religiosity as a protective factor. Additional research is needed over time, academic study profession and location to further understand the possible impact of fear on healthcare students during and after disaster conditions including those related to war and violence.

During COVID-19, interest in video games increased and it continues to escalate. Excessive video gaming, common throughout the world, attracts concern among mental health professionals. Most internet gamers are youth and young adults. Persistent and recurrent gaming can lead to disorder, which may be associated with significant impairments of daily work and/or education activities. This comparative study examined gaming disorders among Russian and Kazakh university students and its association with gender, religiosity, loneliness, substance use, and eating behavior. Data were collected from a cross-sectional sample of 1464 university students from Russia and Kazakhstan, 33.3

Click to increase image sizeClick to decrease image size Data availability statementThe data presented in this study are available on request from the corresponding author. The data are not publicly available due to local restrictions.AcknowledgmentsThe coauthors of this paper acknowledge the support and cooperation of the Ukrainian women who participated in the survey during difficult war conditions that up to now show no respite. Gratitude is expressed to Drs. Toby and Mort Mower (Z”L) for their generous support of the Ben Gurion University of the Negev–Regional Alcohol and Drug Abuse Research Center (RADAR) Center.Additional informationNotes on contributorsValentyna PavlenkoValentyna Pavlenko is a professor in the Applied Psychology Department, V. N. Karazin Kharkiv National University, and received her PhD from the M. V. Lomonosov Moscow State University in Clinical Psychology. She is author of more than 160 scientific publications on social, developmental, and cultural psychology.Anton KurapovAnton Kurapov is an assistant professor in the Department of Experimental and Applied Psychology, Taras Shevchenko Kiev National University, and received his PhD from the Taras Shevchenko Kiev National University. He is author of scientific publications on cross-cultural, personality, and cognitive psychology.Alexander DrozdovAlexander Drozdov is an associate professor and head of the Department of General, Developmental, and Social Psychology, T. H. Shevchenko National University “Chernihiv Colehium.” He received his PhD from the Institute of Social and Political Psychology.Nataliia KorchakovaNataliia Korchakova is a professor in the Department of Developmental and Educational Psychology, Rivne State University of Humanities, and received her PhD from National Pedagogical Dragomanov University, Ukraine. She is author of several books and more than 100 scientific publications in the field of social and development psychology.Iuliia PavlovaIuliia Pavlova is a professor in the Department of Theory and Methods of Physical culture, Lviv State University of Physical Culture, and received her PhD from Lviv State University of Physical Culture. She is author of 10 books and more than 140 scientific publications on social sciences, pedagogy and cross-cultural psychology.Alexander ReznikAlexander Reznik is a senior research associate of the Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben-Gurion University of the Negev, and received his PhD from Institute of Psychology of Russian Academy of Sciences, Moscow, Russia. He is author of six books and more than 100 scientific publications on substance abuse among high-risk populations including immigrants and school dropouts as well as the issue of cross-cultural psychology and acculturation.Richard IsralowitzRichard Isralowitz is director of the Regional Alcohol and Drug Abuse Research (RADAR) Center and Professor (Emeritus), Ben Gurion University of the Negev. He has received recognition from the US National Institute on Drug Abuse (NIDA) for his “Contributions to Scientific Diplomacy through Outstanding Efforts in International Collaborative Research” and has served as a NIDA Distinguished International Scientist as well as a Fulbright Scholar.

Isralowitz, Richard PhD, MSc; Findley, Patricia A. DrPH, MSW, LCSW; Reznik, Alexander PhD Author Information