Prevalence and molecular epidemiology of carbapenemase-producing Enterobacterales isolated from dog and cat faeces submitted to veterinary laboratories in the USA.

AIMS: To estimate the prevalence of carbapenemase-producing Enterobacterales (CPE) carriage among pets using faecal specimens submitted to veterinary diagnostic laboratories throughout the US. A secondary aim was to employ whole-genome sequencing (WGS) to characterize isolates of CPE from companion animals and compare them to publicly available CPE genomes. METHODS AND RESULTS: To estimate the prevalence of CPE in companion animals in the USA, a multicenter surveillance study including 8 different veterinary diagnostic laboratories from across the USA was conducted. Briefly, remnant faecal specimens from dogs and cats were screened using two selective agar plates (CHROMID Carba and MacConkey with 1 mg/L cefotaxime and 0.125 mg/L meropenem) and presumptive CPE isolates screened by the modified carbapenemase inactivation method for carbapenemase production. A total of 2393 specimens were screened and yielded 196 isolates for carbapenemase screening. A total of 5 isolates from 4 dogs and 1 cat at 3 different veterinary diagnostic laboratories were confirmed to produce a carbapenemase (0.21%). Whole-genome sequencing (WGS) revealed two E. coli (ST167) isolates that both produced an NDM-5 carbapenemase, two Enterobacter hormaechei (ST171) isolates that produced an NDM-5 carbapenemase and a KPC-4 carbapenemase respectively and one Klebsiella oxytoca (ST199) that produced an Oxa-48-type carbapenemase. Both E. coli isolates were found to be within at least 22 SNPs of previously characterized canine and human CPE isolates. CONCLUSIONS: This study demonstrates that the prevalence of CPE among companion animals is relatively low (0.21%) but that given the genetic relatedness of animal isolates to human isolates, additional surveillance is needed.

A systematic review on the impact of alcohol warning labels.

Findings on the effects of alcohol warning labels (AWLs) as a harm reduction tool have been mixed. This systematic review synthesized extant literature on the impact of AWLs on proxies of alcohol use. PsycINFO, Web of Science, PubMED, and MEDLINE databases and reference lists of eligible articles. Following PRISMA guidelines, 1,589 articles published prior to July 2020 were retrieved via database and 45 were via reference lists (961 following duplicate removal). Article titles and abstracts were screened, leaving the full text of 96 for review. The full-text review identified 77 articles meeting inclusion/exclusion criteria which are included here. Risk of bias among included studies was examined using the Evidence Project risk of bias tool. Findings fell into five categories of alcohol use proxies including knowledge/awareness, perceptions, attention, recall/recognition, attitudes/beliefs, and intentions/behavior. Real-world studies highlighted an increase in AWL awareness, alcohol-related risk perceptions (limited findings), and AWL recall/recognition post-AWL implementation; these findings have decreased over time. Conversely, findings from experimental studies were mixed. AWL content/formatting and participant sociodemographic factors also appear to influence the effectiveness of AWLs. Findings suggest conclusions differ based on the study methodology used, favoring real-world versus experimental studies. Future research should consider AWL content/formatting and participant sociodemographic factors as moderators. AWLs appear to be a promising approach for supporting more informed alcohol consumption and should be considered as one component in a comprehensive alcohol control strategy.

The Building Emotional Awareness and Mental health (BEAM) program developed with a community partner for mothers of infants: protocol for a feasibility randomized controlled trial.

BACKGROUND: Drastic increases in the rates of maternal depression and anxiety have been reported since the COVID-19 pandemic began. Most programs aim to improve maternal mental health or parenting skills separately, despite it being more effective to target both concurrently. The Building Emotional Awareness and Mental health (BEAM) program was developed to address this gap. BEAM is a mobile health program aiming to mitigate the impacts of pandemic stress on family well-being. Since many family agencies lack infrastructure and personnel to adequately treat maternal mental health concerns, a partnership will occur with Family Dynamics (a local family agency) to address this unmet need. The study's objective is to examine the feasibility of the BEAM program when delivered with a community partner to inform a larger randomized controlled trial (RCT). METHODS: A pilot RCT will be conducted with mothers who have depression and/or anxiety with a child 6-18 months old living in Manitoba, Canada. Mothers will be randomized to the 10 weeks of the BEAM program or a standard of care (i.e., MoodMission). Back-end App data (collected via Google Analytics and Firebase) will be used to examine feasibility, engagement, and accessibility of the BEAM program; cost-effectiveness will also be examined. Implementation elements (e.g., maternal depression [Patient Health Questionnaire-9] and anxiety [Generalized Anxiety Disorder-7]) will be piloted to estimate the effect size and variance for future sample size calculations. DISCUSSION: In partnership with a local family agency, BEAM holds the potential to promote maternal-child health via a cost-effective and an easily accessible program designed to scale. Results will provide insight into the feasibility of the BEAM program and will inform future RCTs. TRIAL REGISTRATION {2A}: This trial was retrospectively registered with ClinicalTrial.gov ( NCT05398107 ) on May 31st, 2022.

Changes in Maternal Substance Use During the COVID-19 Pandemic.

OBJECTIVE: Maternal stress and mental health challenges have increased since the coronavirus disease 2019 (COVID-19) pandemic began. Experts are concerned about elevated substance use given its well-known association with negative emotions, but existing research has not examined substance use among mothers during the COVID-19 pandemic. This is a crucial next step to inform policy and service supports given links between maternal substance use and adverse family experiences. METHOD: Data were collected online between April 14 and 28, 2020. A total of 508 mothers (mean age = 34.8 years, SD = 5.1) with children 0-8 years old participated via the Parenting During the Pandemic study. Mothers self-reported substance use change and motivations for using substances, as well as mental health symptoms. RESULTS: Of participating mothers, 54.9% did not change, 39.2% increased, and 5.9% decreased their substance use. Findings indicated that mothers with an anxiety disorder or elevated anxiety symptoms were more likely to report increased substance use during the pandemic. Using substances to cope with anxiety, depression, and boredom was elevated among mothers self-reporting increased substance use during the pandemic versus those reporting no change or a decrease in usage. Using substances to cope with anxiety was a risk factor for increased substance use. CONCLUSIONS: Many mothers have increased their substance use since the onset of the COVID-19 pandemic. Results highlight the need to treat maternal anxiety and the importance of teaching mothers coping strategies, other than using substances, to reduce the incidence of increased substance use among mothers and its negative sequelae.

The impact of depressed mood and coping motives on cannabis use quantity across the menstrual cycle in those with and without pre-menstrual dysphoric disorder.

BACKGROUND AND AIMS: Reported rates of cannabis use among Canadian females are increasing. Female cannabis users progress to cannabis use disorder more rapidly than males (telescoping) and have higher rates of emotional disorder comorbidity. Addictive behaviors may change, along with mood and motivations, across the menstrual cycle (MC), particularly for females with pre-menstrual dysphoric disorder (PMDD). This study aimed to determine whether increases in depressed mood and coping motives would predict increased cannabis use pre-menstrually/menstrually, particularly among females with PMDD. We also assessed positive mood and enhancement motive ratings to establish specificity of predicted depressed mood and coping motive results. DESIGN: Observational study using data collected across 32 days using electronic daily diary methods. SETTING: Nova Scotia, Canada. PARTICIPANTS: Sixty-nine naturally cycling female cannabis users (Mean (M) age = 29.25, Standard Deviation  (SD) = 5.66) with and without retrospectively identified PMDD (via structured clinical interview) and prospectively identified PMDD (via elevated pre-menstrual depressed mood). Self-reported MC phase was validated using salivary progesterone concentrations. MEASUREMENTS: Depressed/positive mood, coping-/enhancement-motivated cannabis use, and cannabis use quantity. FINDINGS: Coping motives explained heightened cannabis use pre-menstrually/menstrually in those with retrospectively identified PMDD. Depressed mood explained increased cannabis use menstrually in those with retrospectively/prospectively identified PMDD. Moreover, prospectively identified PMDD significantly moderated the relationship between depressed mood and cannabis use quantity menstrually. In those with prospectively identified PMDD, positive mood and enhancement motives were associated with decreased cannabis use during the follicular/ovulatory phases. Females with versus without retrospectively identified PMDD also displayed greater overall cannabis use quantity (M [SD] = 3.44[2.84] standard joint equivalents versus 1.85[1.82], respectively; U = 277.50, P = 0.008). CONCLUSIONS: Depressed mood may explain heightened cannabis use menstrually in females with pre-menstrual dysphoric disorder. Coping motives may explain heightened cannabis use pre-menstrually/menstrually in females with retrospectively identified with pre-menstrual dysphoric disorder.

Addictive behaviors across the menstrual cycle: a systematic review.

Research examining relations between menstrual cycle phase and female addictive behaviors is accumulating. Theories suggest addictive behaviors may increase during specific phases of the menstrual cycle resulting from cyclical fluctuations in hormones and affect. In line with self-medication theory, we predicted that addictive behaviors would increase premenstrually and menstrually, phases marked by elevations in negative affect, relative to the follicular and luteal phases. We also hypothesized, coinciding with reward-sensitivity theory, that addictive behaviors may increase during ovulation, a phase characterized by increased positive affect, compared to the same phases. This systematic review summarizes extant literature examining the menstrual cycle phase-addictive behavior relationship and underlying motivations. Articles pertaining to menstrual cycle phase and addictive behaviors within the PsycINFO, CINAL, and PubMED databases were screened to determine eligibility following PRISMA guidelines (n = 1568). Thirty-four articles examining alcohol use, cannabis use, nicotine use, caffeine use, and gambling behavior across menstrual cycle phase met inclusion criteria. Consistent with self-medication theory, strong evidence indicated that nicotine use increased premenstrually and menstrually. Other factors increasing both nicotine and alcohol use premenstrually and menstrually include having a premenstrual dysphoric disorder diagnosis or having premenstrual syndrome. Motivations for using alcohol and nicotine may too vary by menstrual cycle phase. Results were less consistent or understudied for other addictive behaviors and thus conclusions cannot be drawn. Menstrual cycle phase appears to be a female-specific factor affecting some addictive behaviors, particularly nicotine use, and should be considered when conducting addictive behavior research or clinical interventions for reproductive-aged females with addictive disorders.

Reactivity to Daily Self-Monitoring of Cannabis Use in Biological Females.

Assessment reactivity involves changes to behaviours from self-monitoring those behaviours (Nelson & Hayes, 1981). In the substance use field, reactivity has been identified both as a potential confound in daily diary research (Cohn et al., 2015) and as a possible intervention tool in clinical practice (Cohn et al., 2018). Reactivity to daily self-monitoring of alcohol and tobacco use has been inconsistent in prior research. Reactivity to daily self-monitoring of cannabis use quantity has received far less study. This study involved secondary analyses of data from N = 88 females who self-monitored their cannabis use for 32 days. We examined objective reactivity of cannabis use to daily self-monitoring by assessing changes in daily cannabis use over 32 days. We also explored participants' perceptions of the impact daily self-monitoring had on their cannabis use at study completion (i.e., subjective reactivity). In hurdle models testing objective reactivity, neither probability of cannabis use, nor quantity of cannabis use, changed significantly over the study period. Many respondents (45%) reported no subjective reactivity, though a slight majority (55%) reported some subjective reactivity. Subjective reactivity did not moderate objective reactivity over time; however, higher subjective reactivity was significantly associated with increased variability (interquartile range [IQR]) in cannabis use across the self-monitoring period. Overall, reactivity appears unlikely to confound research utilizing daily diary cannabis measures, and daily self-monitoring of cannabis use may be unlikely to serve as a useful stand-alone intervention for reducing cannabis use in non-treatment-seeking individuals. Potential clinical implications of the novel finding of a link between subjective reactivity and objective cannabis use variability are discussed.

Maternal psychological distress & mental health service use during the COVID-19 pandemic.

BACKGROUND: Mental health problems are increasingly recognized as a significant and concerning secondary effect of the COVID-19 pandemic. Research on previous epidemics/pandemics suggest that families, particularly mothers, may be at increased risk, but this population has yet to be examined. The current study (1) described prevalence rates of maternal depressive and anxiety symptoms from an online convenience sample during the COVID-19 pandemic, (2) identified risk and protective factors for elevated symptoms, and (3) described current mental health service use and barriers. METHODS: Participants (N = 641) were mothers of children age 0-8 years, including expectant mothers. Mothers completed an online survey assessing mental health, sociodemographic information, and COVID-19-related variables. RESULTS: Clinically-relevant depression was indicated in 33.16%, 42.55%, and 43.37% of mothers of children age 0-18 months, 18 months to 4 years, and 5 to 8 years, respectively. Prevalence of anxiety was 36.27%, 32.62%, and 29.59% for mothers across age groups, respectively. Binary logistic regressions indicated significant associations between risk factors and depression/anxiety across child age groups. LIMITATIONS: Cross-sectional data was used to describe maternal mental health problems during COVID-19 limiting the ability to make inferences about the long-term impact of maternal depression and anxiety on family well-being. CONCLUSIONS: Maternal depression and anxiety appear to be elevated in the context of COVID-19 compared to previously reported population norms. Identified risk factors for depression and anxiety across different child age ranges can inform targeted early intervention strategies to prevent long-term impacts of the COVID-19 pandemic on family well-being and child development.

Retrospective and prospective assessments of gambling-related behaviors across the female menstrual cycle.

BACKGROUND AND AIMS: Despite increases in female gambling, little research investigates female-specific factors affecting gambling behavior (GB). Although research suggests that some addictive behaviors may fluctuate across menstrual cycle phase (MCP), gambling requires further investigation. In two studies, we examined associations between MCP and three risky GBs: time spent gambling, money spent gambling, and the probability of consuming alcohol while gambling. Associations between MCP and negative affect were also examined in Study 2. We predicted that, consistent with self-medication theory, increases in negative affect (Study 2) and risky GBs (Studies 1 and 2) would occur premenstrually/menstrually relative to other phases. METHODS: Data were obtained from 33 female gamblers using a retrospective timeline followback procedure (Study 1) and from 20 female gamblers using a prospective 32-day, daily diary method (Study 2). In Study 2, salivary progesterone levels verified self-reported MCP validity. RESULTS: Findings revealed significant, but somewhat inconsistent, MCP effects on GBs across studies. The self-medication hypothesis was partially supported. Increases relative to another MCP(s) were found for alcohol consumption while gambling premenstrually, time spent gambling menstrually/premenstrually, money spent gambling menstrually, and negative affect premenstrually. Unexpectedly, findings more consistently indicated that GBs increased during ovulation, suggestive of enhanced reward sensitivity. Progesterone assays validated self-reported MCP (Study 2). DISCUSSION AND CONCLUSIONS: The results suggest a role of ovarian hormones on negative affect and GBs in females. This research could lead to the identification of female-specific factors affecting gambling and the development of more effective interventions for females with, or at risk for, problematic gambling.

Too little, too much or just right: Injury/illness sensitivity and intentions to drink as a basis for alcohol consumer segmentation.

BACKGROUND: Although alcohol is the most socially accepted drug, little is known about the classification of alcohol consumers into clusters influencing drinking outcomes. Past research has demonstrated that injury/illness sensitivity predicts health protecting behaviors. OBJECTIVES: The present study explored whether alcohol consumers can be classified based on injury/illness sensitivity and intentions to reduce drinking, and whether the identified clusters exhibited meaningful differences in negative affect and drinking levels. METHODS: Four-hundred and eighty-six participants (54.3% male; mean [SD] age = 26.5 [7.2] years) completed online questionnaires between July and October of 2017. Questions were asked pertaining to injury/illness sensitivity, intentions to reduce drinking, negative affect, and heavy drinking behavior. A k-means cluster analysis was performed on illness/injury sensitivity and intentions to reduce drinking scores. We then examined whether clusters varied according to negative affect or drinking variables. RESULTS: The k-means cluster analysis identified four clusters: Insensitive non-internalizers, Insensitive internalizers, Sensitive non-internalizers, and Sensitive internalizers. Sensitive internalizers reported the highest, whereas Insensitive non-internalizers reported the lowest, negative affect. Sensitive internalizers also had the lowest percentage of heavy drinkers. Conclusion/importance: Current findings add to the alcohol literature by indicating that high sensitivity to illnesses/injuries and the internalization of sensitivities via behavior change intentions may provide the best protection against high alcohol consumption levels.

Changes in coping and social motives for drinking and alcohol consumption across the menstrual cycle.

BACKGROUND: Alcohol use has been reported to fluctuate over women's menstrual cycles (MCs), with increased intake occurring premenstrually/menstrually (phases characterized by heightened negative affect) and during the ovulatory phase (a phase characterized by positive affect). This suggests women may drink for particular emotion-focused reasons at specific points in their cycles. However, no research had yet examined MC variability in drinking motives, or links between cycle-related changes in drinking motives and alcohol consumption. METHODS: Ninety-four normally cycling women (Mage  = 22.9 years old, SDage  = 4.7) completed daily diary measures (via Smartphone surveys), with questions pertaining to state drinking motives and quantity of alcohol consumed for the course of a full MC. RESULTS: Drinking motives differed by cycle phase. Women reported a slight increase in drinking to self-medicate for negative affect premenstrually, with drinking to cope peaking in the menstrual phase and declining mid-cycle. Women reported a slight increasing trend across the cycle in social motives for drinking, while enhancement motives remained relatively stable across the cycle. Cycle-related changes in drinking motives predicted increases in the quantity of alcohol consumed. Drinking to cope with negative affect predicted a greater number of drinks menstrually (days 1-5). While social motives predicted a greater number of drinks during the follicular and ovulatory phases (days 5-16), enhancement motives were unrelated to drinking quantity across cycle phase. CONCLUSIONS: Clinicians should be attentive to cycle phase when treating reproductive-aged women with alcohol disorders (e.g., encouraging the use of healthier means of coping with negative affect during menses).