Impact of Legalization on Cannabis Use, Attitudes, and Purchasing Preferences: A Repeated Cross-Sectional Survey of Canadian Young Adults.

Objective: The Government of Canada legalized recreational cannabis use in October of 2018 with the implementation of the Cannabis Act. The act aimed to reduce the illicit cannabis market, improve consumer health outcomes, and reduce youth access to cannabis. However, little is known about the attitudes and behaviors of young adults, who have been shown to have a high prevalence of cannabis use, towards cannabis after legalization. Method: In this descriptive study, we examined cannabis use, attitudes, and purchasing preferences among Canadian university-attending young adults both before and after the legalization of cannabis. Participants were recruited from a large Canadian university from 2017 to 2021. Results: Our findings showed that there was an increase in cannabis use immediately following legalization that subsequently decreased in later years. Additionally, attitudes about the legalization of cannabis became more favorable in later years (following legalization), particularly among those who did not use cannabis. Most young adults were also keen to purchase cannabis from a government-owned store before legalization. However, with the exception of past-month consumers, this preference decreased substantially following legalization. Conclusions: The current research adds to the knowledge base about changes in cannabis-related attitudes and use after legalization and focuses on a key population - young adults.

Uncovering the metabolite complexity and variability of cultivated hemp (Cannabis sativa L.): A first phytochemical diversity mapping in Greece.

The high value of fiber-type Cannabis sativa L. (hemp) due to its phytochemicals has yet to be fully recognized and leveraged. Besides cannabidiol (CBD), which is the most prevalent non-psychoactive cannabinoid, hemp contains numerous other cannabinoids with unexplored bioactivities, in addition to various compound classes. Previous works have aimed to correlate chemical profiles of C. sativa inflorescences with important parameters, mostly based on experiments under controlled conditions. However, mapping studies that explore the phytochemical diversity of hemp in a more realistic context are crucial to guide decisions at multiple levels, especially in areas where hemp cultivation was recently re-authorized, including Mediterranean countries. In this work, a powerful strategy was followed to map the phytochemical diversity of cultivated hemp in Greece, being the first study of its kind for this environment. A panel of 98 inflorescence samples, covering two harvesting years, eleven geographical regions and seven commonly used EU varieties, were studied using a combination of targeted and untargeted approaches. Quantitative results based on UPLC-PDA revealed relatively constant CBD/THC (total) ratios, while profiling by LC-HRMS effectively probed the phytochemical variability of samples, and led to the annotation of 88 metabolites, including a multitude of minor cannabinoids. Multivariate analysis substantiated a strong effect of harvesting year in sample discrimination and related biomarkers were revealed, belonging to fatty acids and flavonoids. The effect of geographical region and, especially, variety on chemical variation patterns was more intricate to interpret. The results of this work are envisioned to enhance our understanding of the real-world phytochemical complexity of C. sativa (hemp), with a view to maximized utilization of hemp for the promotion of human well-being.

Guidelines for tuberculosis screening and preventive treatment among pregnant and breastfeeding women living with HIV in PEPFAR-supported countries.

BACKGROUND: Tuberculosis (TB) preventive treatment (TPT) is recommended by the World Health Organization (WHO) for persons living with HIV, including pregnant and breastfeeding women. Given the President's Emergency Plan for AIDS Relief (PEPFAR)'s investment in TPT services for persons living with HIV as a strategy to prevent TB as well as uncertainty in guidelines and policy regarding use of TPT during pregnancy and the postpartum period, we conducted a review of current relevant national guidelines among PEPFAR-supported countries. METHODS: Our review included 44/49 PEPFAR-supported countries to determine if TB screening and TPT are recommended specifically for pregnant and breastfeeding women living with HIV (WLHIV). National guidelines reviewed and abstracted included TB, HIV, prevention of vertical HIV transmission, TPT, and any other relevant guidelines. We abstracted information regarding TB screening, including screening tools and frequency; and TPT, including timing, regimen, frequency, and laboratory monitoring. RESULTS: Of 44 PEPFAR-supported countries for which guidelines were reviewed, 66% were high TB incidence countries; 41% were classified by WHO as high TB burden countries, and 43% as high HIV-associated TB burden countries. We found that 64% (n = 28) of countries included TB screening recommendations for pregnant WLHIV in their national guidelines, and most (n = 35, 80%) countries recommend TPT for pregnant WLHIV. Fewer countries included recommendations for breastfeeding as compared to pregnant WLHIV, with only 32% (n = 14) mentioning TB screening and 45% (n = 20) specifically recommending TPT for this population; most of these recommend isoniazid-based TPT regimens for pregnant and breastfeeding WLHIV. However, several countries also recommend isoniazid combined with rifampicin (3RH) or rifapentine (3HP). CONCLUSIONS: Despite progress in the number of PEPFAR-supported countries that specifically include TB screening and TPT recommendations for pregnant and breastfeeding WLHIV in their national guidelines, many PEPFAR-supported countries still do not include specific screening and TPT recommendations for pregnant and breastfeeding WLHIV.

Compliance Trends in a 14-Week Ecological Momentary Assessment Study of Undergraduate Alcohol Drinkers.

High compliance is a priority for successful ecological momentary assessment (EMA) research, but meta-analyses of between-study differences show that reasons for missed prompts remain unclear. We examined compliance data from a 14-week, 182-survey EMA study of undergraduate alcohol use to test differences over time and across survey types between participants with better and worse compliance rates, and to evaluate the impact of incentives on ongoing participation. Participants were N = 196 students (65.8% female; Mage = 20.6). Overall compliance was 76.5%, declining gradually from 88.9% to 70% over 14 weeks. Declines were faster in participants with lower overall compliance, but we found no demographic, personality, mental health, or substance use differences between participants with better versus worse compliance rates. Compliance varied by survey type, and unannounced bonus incentives did not impact compliance rates. Participants completed fewer surveys the week after winning a gift card. We offer recommendations for designing future EMA studies.

Stress and Mood Associations With Smartphone Use in University Students: A 12-Week Longitudinal Study.

The current study used device-logged screen-time records to measure week-to-week within-person associations between stress and smartphone use in undergraduate students (N = 187; mean age = 20.1 years). The study was conducted during fall 2020 and focused on differences across types of app used and whether accumulated screen use each week predicted end-of-week mood states. Participants uploaded weekly screenshots from their iPhone "Screen Time" settings display and completed surveys measuring stress, mood, and COVID-19 experiences. Results of multilevel models showed no week-to-week change in smartphone hours of use or device pickups. Higher stress levels were not concurrently associated with heavier smartphone use, either overall or by type of app. Heavier smartphone use in a given week did not predict end-of-week mood states, but students who tended to spend more time on their phones in general reported slightly worse moods-a between-persons effect potentially reflecting deficits in well-being that are present in students' off-line lives as well. Our findings contribute to a growing scholarly consensus that time spent on smartphones tells us little about young people's well-being.

The daily association between affect and alcohol use: A meta-analysis of individual participant data.

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Association Between Stimulant Treatment and Substance Use Through Adolescence Into Early Adulthood.

Importance: Possible associations between stimulant treatment of attention-deficit/hyperactivity disorder (ADHD) and subsequent substance use remain debated and clinically relevant. Objective: To assess the association of stimulant treatment of ADHD with subsequent substance use using the Multimodal Treatment Study of ADHD (MTA), which provides a unique opportunity to test this association while addressing methodologic complexities (principally, multiple dynamic confounding variables). Design, Setting, and Participants: MTA was a multisite study initiated at 6 sites in the US and 1 in Canada as a 14-month randomized clinical trial of medication and behavior therapy for ADHD but transitioned to a longitudinal observational study. Participants were recruited between 1994 and 1996. Multi-informant assessments included comprehensively assessed demographic, clinical (including substance use), and treatment (including stimulant treatment) variables. Children aged 7 to 9 years with rigorously diagnosed DSM-IV combined-type ADHD were repeatedly assessed until a mean age of 25 years. Analysis took place between April 2018 and February 2023. Exposure: Stimulant treatment of ADHD was measured prospectively from baseline for 16 years (10 assessments) initially using parent report followed by young adult report. Main Outcomes and Measures: Frequency of heavy drinking, marijuana use, daily cigarette smoking, and other substance use were confidentially self-reported with a standardized substance use questionnaire. Results: A total of 579 children (mean [SD] age at baseline, 8.5 [0.8] years; 465 [80%] male) were analyzed. Generalized multilevel linear models showed no evidence that current (B [SE] range, -0.62 [0.55] to 0.34 [0.47]) or prior stimulant treatment (B [SE] range, -0.06 [0.26] to 0.70 [0.37]) or their interaction (B [SE] range, -0.49 [0.70] to 0.86 [0.68]) were associated with substance use after adjusting for developmental trends in substance use and age. Marginal structural models adjusting for dynamic confounding by demographic, clinical, and familial factors revealed no evidence that more years of stimulant treatment (B [SE] range, -0.003 [0.01] to 0.04 [0.02]) or continuous, uninterrupted stimulant treatment (B [SE] range, -0.25 [0.33] to -0.03 [0.10]) were associated with adulthood substance use. Findings were the same for substance use disorder as outcome. Conclusions and Relevance: This study found no evidence that stimulant treatment was associated with increased or decreased risk for later frequent use of alcohol, marijuana, cigarette smoking, or other substances used for adolescents and young adults with childhood ADHD. These findings do not appear to result from other factors that might drive treatment over time and findings held even after considering opposing age-related trends in stimulant treatment and substance use.

Integrating 3HP-based tuberculosis preventive treatment into Zimbabwe's Fast Track HIV treatment model: experiences from a pilot study.

INTRODUCTION: Tuberculosis (TB) causes one-third of HIV-related deaths worldwide, making TB preventive treatment (TPT) a critical element of HIV programmes. Approximately 16% of people living with HIV (PLHIV) on antiretrovirals in Zimbabwe are enrolled in the Fast Track (FT) differentiated service delivery model, which includes multi-month dispensing of antiretrovirals and quarterly health facility (HF) visits. We assessed the feasibility and acceptability of utilizing FT to deliver 3HP (3 months of once-weekly rifapentine and isoniazid) for TPT by aligning TPT and HIV visits, providing multi-month dispensing of 3HP, and using phone-based monitoring and adherence support. METHODS: We recruited a purposive sample of 50 PLHIV enrolled in FT at a high-volume HF in urban Zimbabwe. At enrolment, participants provided written informed consent, completed a baseline survey, and received counselling, education and a 3-month supply of 3HP. A study nurse mentor called participants at weeks 2, 4 and 8 to monitor and support adherence and side effects. When participants returned for their routine 3-month FT visit, they completed another survey, and study staff conducted a structured medical record review. In-depth interviews were conducted with providers who participated in the pilot. RESULTS: Participants were enrolled between April and June 2021 and followed through September 2021. Median age = 32 years (IQR 24,41), 50% female, median time in FT 1.8 years (IQR 0.8,2.7). Forty-eight participants (96%) completed 3HP in 13 weeks; one completed in 16 weeks, and one stopped due to jaundice. Most participants (94%) reported "always" or "almost always" taking 3HP correctly. All reported they were very satisfied with the counselling, education, support and quality of care they received from providers and FT service efficiency. Almost all (98%) said they would recommend it to other PLHIV. Challenges reported included pill burden (12%) and tolerability (24%), but none had difficulty with phone-based counselling or wished for additional HF-based visits. DISCUSSION: Using FT to deliver 3HP was feasible and acceptable. Some reported tolerability challenges but 98% completed 3HP, and all appreciated the efficiency of aligning TPT and HIV HF visits, multi-month dispensing and phone-based counselling. CONCLUSIONS: Scaling up this approach could expand TPT coverage in Zimbabwe.

Core components of infection prevention and control programs at the facility level in Kazakhstan: key challenges and opportunities.

BACKGROUND: Kazakhstan is developing a National Roadmap to strengthen its Infection Prevention and Control (IPC), but until recently has lacked a country-wide facility-level assessment of IPC performance gaps. METHODS: In 2021, the World Health Organization (WHO)'s IPC Core Components and Minimal Requirements were assessed at 78 randomly selected hospitals across 17 administrative regions using adapted WHO tools. The study included site assessments, followed by structured interviews with 320 hospital staff, validation observations of IPC practices, and document reviews. RESULTS: All hospitals had at least one dedicated IPC staff member, 76% had IPC staff with any formal IPC training; 95% established an IPC committee and 54% had an annual IPC workplan; 92% had any IPC guidelines; 55% conducted any IPC monitoring in the past 12 months and shared the results with facility staff, but only 9% used monitoring data for improvements; 93% had access to a microbiological laboratory for HAI surveillance, but HAI surveillance with standardized definitions and systematic data collection was conducted in only one hospital. Adequate bed spacing of at least 1 m in all wards was maintained in 35% of hospitals; soap and paper towels were available at the hand hygiene stations in 62% and 38% of hospitals, respectively. CONCLUSIONS: Existing IPC programs, infrastructure, IPC staffing, workload and supplies present within hospitals in Kazakhstan allow for implementation of effective IPC. Development and dissemination of IPC guidelines based on the recommended WHO IPC core components, improved IPC training system, and implementation of systematic monitoring of IPC practices will be important first steps towards implementing targeted IPC improvement plans in facilities.

Social cognition in youth with a first-degree relative with schizophrenia: A systematic scoping review.

Social-cognitive deficits are present in individuals at familial high-risk (FHR) for schizophrenia and may play a role in the onset of the illness. No literature review has examined the social-cognitive profiles of youth at FHR who are within the peak window of risk for developing schizophrenia, which could provide insight on the endophenotypic role of social cognition. This systematic scoping review (1) summarizes the evidence on social-cognitive deficits in youth at FHR, (2) explores brain correlates, and (3) describes social-cognitive deficits and prodromal symptom associations. We searched PsycInfo and PubMed for studies investigating social cognition in FHR youth aged 35 or younger and included 19 studies (FHR=639; controls=689). Studies report that youth at FHR have difficulty recognizing negative emotions, particularly fear. Youth at FHR also have difficulty performing complex theory of mind tasks. Abnormality in corticolimbic and temporoparietal regions are observed in youth at FHR during social-cognitive tasks, but results are inconsistent. Finally, there is evidence for negative associations between prodromal symptoms and performance on emotion regulation and theory of mind tasks, but the research is scarce. This review highlights the need for studies on youth at FHR using longitudinal designs and extensive social-cognitive, brain imaging and clinical measures.

Evaluation of the anti-inflammatory effects of selected cannabinoids and terpenes from Cannabis Sativa employing human primary leukocytes.

Cannabis is well established as possessing immune modulating activity. The objective of this study was to evaluate the anti-inflammatory properties of selected cannabis-derived terpenes and cannabinoids. Based on their activity in cannabis-chemovar studies, α-pinene, trans-nerolidol, D-limonene, linalool and phytol were the selected terpenes evaluated. The cannabinoid compounds evaluated included cannabidivarin, cannabidiol, cannabinol, cannabichromene, cannabigerol and delta-9-tetrahydrocannabinol. Human PBMC were pretreated with each compound, individually, at concentrations extending from 0.001 to 10 µM and then stimulated with CpG (plasmacytoid dendritic cell), LPS (monocytes), or anti-CD3/CD28 (T cells). Proliferation, activation marker expression, cytokine production and phagocytosis, were quantified. Of the 21 responses assayed for each compound, cannabinoids showed the greatest immune modulating activity compared to their vehicle control. Delta-9-tetrahydrocannabinol possessed the greatest activity affecting 11 immune parameters followed by cannabidivarin, cannabigerol, cannabichromene, cannabinol and cannabidiol. α-Pinene showed the greatest immune modulating activity from the selected group of terpenes, followed by linalool, phytol, trans-nerolidol. Limonene had no effect on any of the parameters tested. Overall, these studies suggest that selected cannabis-derived terpenes displayed minimal immunological activity, while cannabinoids exhibited a broader range of activity. Compounds possessing anti-inflammatory effects may be useful in decreasing inflammation associated with a range of disorders, including neurodegenerative disorders.

Identification of minimum essential therapeutic mixtures from cannabis plant extracts by screening in cell and animal models of Parkinson's disease.

Medicinal cannabis has shown promise for the symptomatic treatment of Parkinson's disease (PD), but patient exposure to whole plant mixtures may be undesirable due to concerns around safety, consistency, regulatory issues, and psychoactivity. Identification of a subset of components responsible for the potential therapeutic effects within cannabis represents a direct path forward for the generation of anti-PD drugs. Using an in silico database, literature reviews, and cell based assays, GB Sciences previously identified and patented a subset of five cannabinoids and five terpenes that could potentially recapitulate the anti-PD attributes of cannabis. While this work represents a critical step towards harnessing the anti-PD capabilities of cannabis, polypharmaceutical drugs of this complexity may not be feasible as therapeutics. In this paper, we utilize a reductionist approach to identify minimal essential mixtures (MEMs) of these components that are amenable to pharmacological formulation. In the first phase, cell-based models revealed that the cannabinoids had the most significant positive effects on neuroprotection and dopamine secretion. We then evaluated the ability of combinations of these cannabinoids to ameliorate a 6-hydroxydopmamine (OHDA)-induced change in locomotion in larval zebrafish, which has become a well-established PD disease model. Equimolar mixtures that each contained three cannabinoids were able to significantly reverse the OHDA mediated changes in locomotion and other advanced metrics of behavior. Additional screening of sixty-three variations of the original cannabinoid mixtures identified five highly efficacious mixtures that outperformed the original equimolar cannabinoid MEMs and represent the most attractive candidates for therapeutic development. This work highlights the strength of the reductionist approach for the development of ratio-controlled, cannabis mixture-based therapeutics for the treatment of Parkinson's disease.

Social and structural determinants of health associated with police violence victimization: A latent class analysis of female sex workers who use drugs in Kazakhstan.

INTRODUCTION: Punitive legal environments remain a challenge to HIV prevention efforts in Central Asia, and female sex workers who use drugs are vulnerable to police violence. Little is known about the heterogeneity of police violence against female sex workers who use drugs and factors associated with HIV risk in Central Asia, despite the growing HIV epidemic. METHODS: We recruited a community-based sample of 255 female sex workers who use drugs in Almaty, Kazakhstan between February 2015 and May 2017. We used latent class analysis to differentiate women into distinct classes of police violence victimization, and multinomial logistic regression to identify individual-level health outcomes, HIV risk behaviors, and social and structural factors within the risk environment associated with class membership. RESULTS: A three-class model emerged: Low Victimization (51%), Discrimination and Extortion (15%), and Poly-Victimization (34%). Relative to Low Victimization, factors associated with Poly-Victimization included being positive for HIV and/or sexually-transmitted infections (STI) (aOR: 1.78 (95% CI: 1.01, 3.14)), prior tuberculosis diagnosis (2.73 (1.15, 6.50)), injection drug use (IDU) (2.00 (1.12, 3.58)), greater number of unsafe IDU behaviors (1.21 (1.08, 1.35)), homelessness (1.92 (1.06, 3.48)), greater drug use (1.22 (1.07, 1.39)) and sex work stigma (1.23 (1.06, 1.43)), greater number of sex work clients (2.40 (1.33, 4.31)), working for a boss/pimp (2.74 (1.16, 6.50)), client violence (2.99 (1.65, 5.42)), economic incentives for condomless sex (2.77 (1.42, 5.41)), accessing needle/syringe exchange programs (3.47 (1.42, 8.50)), recent arrest (2.99 (1.36, 6.55)) and detention (2.93 (1.62, 5.30)), and negative police perceptions (8.28 (4.20, 16.3)). Compared to Low Violence, Discrimination and Extortion was associated with lower odds of experiencing intimate partner violence (aOR= 0.26 (0.12, 0.59)), but no other significant associations with the risk environment upon adjusting for socio-demographic characteristics. CONCLUSION: Police violence against female sex workers who use drugs is pervasive in Kazakhstan. Patterns of police violence vary, with greater HIV susceptibility associated with a higher probability of experiencing multiple forms of police violence. Police sensitization workshops that integrate policing and harm reduction, and drug policy reforms that decriminalize drug use may help mitigate the HIV epidemic in Kazakhstan.

Personality and Alcohol Use across College: Examining Context-Dependent Pathways toward Alcohol Problems.

BACKGROUND: College life is characterized by marked increases in alcohol consumption. Extraversion and neuroticism are associated with alcohol use problems in college and throughout adulthood, each with alcohol use patterns consistent with an externalizing and internalizing pathway respectively. Students higher in extraversion drink more frequently and consume more alcohol, while neuroticism is paradoxically not consistently associated with elevated alcohol use. OBJECTIVE: This study examined whether students higher in neuroticism may drink the day before stressors, namely tests and assignment deadlines. METHOD: Multilevel generalized linear models were performed using data from a longitudinal study of first-time, first-year undergraduates assessing alcohol use across four years of college, with daily diary bursts each semester. RESULTS: Students higher in extraversion had heavier alcohol use and greater alcohol use problems in their fourth year of college. Neuroticism was not associated with drinking behaviors or with drinking before a test or assignment, but was associated with greater fourth year alcohol problems. Students lower in extraversion who reduced heavy drinking the day before academic events had fewer alcohol use problems at the fourth year of college relative to students higher in extraversion. CONCLUSIONS: Students higher in extraversion appear to exhibit a continuity of established alcohol use patterns from adolescence, predisposing them to a more hazardous trajectory of college alcohol use. Characteristics of low extraversion may afford some protection from alcohol-positive college culture. High neuroticism appears associated with a hazardous trajectory of college alcohol use, but continued research into situational factors of alcohol use in high neuroticism is warranted.

Paths to postsecondary education enrollment among adolescents with and without childhood attention-deficit/hyperactivity disorder (ADHD): A longitudinal analysis of symptom and academic trajectories.

We examined developmental trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms, standardized achievement, and school performance for adolescents with and without ADHD who did and did not enroll in postsecondary education (PSE; N = 749; 79% boys; 63% White, 17% non-Hispanic Black, 10% Hispanic, and 10% other ethnicities). In a multisite study (recruitment based in New York, North Carolina, Pennsylvania, California, and Quebec), participants were originally enrolled between 1994 and 1998 at ages 7 to 9.9 and followed up through 2012 (Mage = 25 at final follow-up). Adolescents who eventually enrolled in PSE had less severe symptoms, but differences were modest and trajectories were similar over time. For all adolescents, standardized achievement trajectories declined up to two thirds of a standard deviation from ages 9 to 17. By the end of high school, the average GPA of adolescents with ADHD was three quarters of a point higher for those who eventually enrolled in PSE compared to those who did not. Overall, school performance mattered more than academic achievement for understanding eventual enrollment of adolescents with ADHD.

Potential use for chronic pain: Poly(Ethylene Glycol)-Poly(Lactic-Co-Glycolic Acid) nanoparticles enhance the effects of Cannabis-Based terpenes on calcium influx in TRPV1-Expressing cells.

The objective of these in vitro studies was to investigate the impact of the encapsulation of three cannabis-based terpenes, namely ß-myrcene (MC), ß-caryophyllene (CPh), and nerolidol (NL), on their potential efficacy in pain management. Terpene-encapsulated poly(ethylene glycol)-poly(lactic-co-glycolic acid) nanoparticles (PEG-PLGA NPs) were prepared by an emulsion-solvent evaporation method. The terpene-loaded NPs were examined in HEK293 cells that express the nociceptive transient receptor potential vanilloid-1 (TRPV1), an ion channel involved in pain perception. TRPV1 activation was assessed by monitoring calcium influx kinetics over 1 h in cells pre-treated with the fluorescent indicator Fluo-4. In addition, the fluorescence intensity changes induced by the NPs in living cells were also explored by a fluorescence microscope. Furthermore, the cytotoxicity of the terpene-loaded NPs was evaluated by the 3-(4,5-dimethylthiazol-2-yl)-3,5-diphenyl tetrazolium bromide (MTT) proliferation assay. The terpene-loaded NPs had a diameter in the range of 250-350 nm and a zeta potential of approximately -20 mV. The encapsulation efficiency was 18.5%, 51.3%, and 60.3% for MC, NL, and CPh NPs, respectively. The nano-formulations significantly increased the fluorescence intensity in comparison with free terpenes. Furthermore, combinations of terpene-loaded NPs produced significantly higher calcium responses when compared to combinations of free terpenes. Similar findings were shown by the fluorescence images. In conclusion, the terpene-PLGA NPs can be promising therapeutics for more effective pain management.

First-Year University Students' Mental Health Trajectories Were Disrupted at the Onset of COVID-19, but Disruptions Were Not Linked to Housing and Financial Vulnerabilities: A Registered Report.

This study modeled disruptions in first-year undergraduates' trajectories of mental health associated with the COVID-19 pandemic, testing whether disruptions were worse for students who moved residences, reported low family income, or were food insecure. Participants (n = 510) at a large Canadian university reported depression, anxiety, and stress in September, November, January, and March. In March 2020, in tandem with COVID-related campus closures, students also reported for each mental health measure whether their responses were influenced by personal experiences surrounding the pandemic. As hypothesized, students who reported feeling more COVID-related disruption reported poorer mental health in March. Contrary to hypotheses, mental health disruptions were not more pronounced for students who moved, had low income, or were food insecure. Survey administration at an early stage of COVID-19 combined with supports afforded by moving in with parents and near-universal government income assistance may have mitigated the incremental distress we hypothesized for vulnerable students.

Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe.

As Zimbabwe expands tuberculosis preventive treatment (TPT) for people living with HIV (PLHIV), the Ministry of Health and Child Care is considering making TPT more accessible to PLHIV via less-intensive differentiated service delivery models such as Community ART Refill Groups (CARGs). We designed a study to assess the feasibility and acceptability of integrating TPT into CARGs among key stakeholders, including CARG members, in Zimbabwe. We conducted 45 key informant interviews (KII) with policy makers, implementers, and CARG leaders; 16 focus group discussions (FGD) with 136 PLHIV in CARGs; and structured observations of 8 CARG meetings. KII and FGD were conducted in English and Shona. CARG observations were conducted using a structured checklist and time-motion data capture. Ninety six percent of participants supported TPT integration into CARGs and preferred multi-month TPT dispensing aligned with ART dispensing schedules. Participants noted that the existing CARG support systems could be used for TB symptom screening and TPT adherence monitoring/support. Other perceived advantages included convenience for PLHIV and decreased health facility provider workloads. Participants expressed concerns about possible medication stockouts and limited knowledge about TPT among CARG leaders but were confident that CARGs could effectively provide community-based TPT education, adherence monitoring/support, and TB symptom screening provided that CARG leaders received appropriate training and supervision. These results are consistent with findings from pilot projects in other African countries that are scaling up both differentiated service delivery for HIV and TPT and suggest that designing contextually appropriate approaches to integrating TPT into less-intensive HIV treatment models is an effective way to reach people who are established on ART but who may have missed out on access to TPT.

People prefer to diversify across different types of prosocial behaviour.

People have multiple opportunities to act prosocial any given day but only limited resources to do so (e.g. time, effort and money they are willing to invest). We test whether people prefer to diversify their prosocial efforts across different types of help: casual help, direct help, indirect help and emotional support. In two daily diary studies (total N = 711), we examine whether previous prosocial behaviour affects subsequent prosocial behaviour for the same or other types of prosocial behaviour. We found that day-to-day prosocial behaviours reflected a diversified helping pattern. Participants were less likely to help the same way (i.e. the same type of prosocial behaviour) on subsequent days and more likely to help in different ways (i.e. a different type of prosocial behaviour). This tendency did not extend to casual help in Study 2, implying that the next day reduction in doing the same type of prosocial behaviour is limited to prosocial behaviours that are at least somewhat effortful or time consuming.