Transdisciplinary approaches to addressing factors that influence antimicrobial use in dairy cattle: A scoping review.

Interest in antimicrobial resistance (AMR) associated with livestock farming is increasing. During the 1990s, 30-40 academic papers a year on the use of antibiotics in dairy farming were indexed on the scientific database PubMed, but this has grown to more than 200 a year in the 2020s. Most (85%) of these papers are published in veterinary or livestock science journals. There has been a corresponding increase in social science interest in why responsible antibiotic stewardship in the livestock sector is so challenging. However, most social science insights are published in journals specific to the lead authors' field(s), missing opportunities for knowledge translation to veterinary and animal science. This threatens to inhibit the transdisciplinary One Health approaches required to tackle the problem. Between 1 June and 31 December 2021, we undertook a scoping review of papers on the use of antibiotics in dairy farming indexed in PubMed, Scopus and Web of Science. Our aim was to identify studies that incorporate social science approaches and methodologies, and to note the main field of the journal in which these studies are published. Papers were most likely to be published in veterinary science, dairy science and/or livestock science journals (61, 29 and 18 respectively out of 127 papers) and were most likely to be concerned with antibiotic use, prescribing practice, and/or diagnosis (94%, 39% and 33% of included papers respectively). Only 27% of papers meeting our inclusion criteria included a qualitative approach to understanding reasons for antibiotic use. Even fewer acknowledged underlying drivers of behaviour, whereas such reasons are frequently highlighted in social science literature. Thus, to address the global health threat from antibiotic resistance, more work is needed to bring together the disparate but equally valid disciplines, methodologies and researchers working on antibiotic use in the livestock sector.

Evaluation of Author Instructions for Inclusive Language Guidance in Highly Cited English Language Medical Journals.

BACKGROUND: Diversity, equity, and inclusion (DEI) are at the core of publication ethics, and language around DEI has been shown to affect patient outcomes. Inclusive language is an important piece of effective communication and is one way to demonstrate and foster a welcoming, respectful, and accessible environment. Non-inclusive terminology in research may represent implicit bias, which is not typically corrected through introspection; thus, a systematic approach is needed in scientific writing. The prevalence of inclusive language guidance in leading medical journals is currently unknown. OBJECTIVE: Investigators assess the prevalence and quality of inclusive language guidelines in author instructions in highly cited English language medical journals. DESIGN: A cross-sectional review of author instructions from a convenience sample of 100 highly cited medical journals was completed in January 2023. SUBJECTS: Each journal's author instructions were reviewed for presence of inclusive language guidelines for manuscript submissions. MAIN MEASURES: Guidelines that included specific examples of inclusive language were defined as "strong." Author instructions were also reviewed for the Sex and Gender Equity in Research (SAGER) checklist, and each journal's publisher and impact factor (IF) were recorded. KEY RESULTS: The 100 journals reviewed had an IF range of 3.0-202.7 with a median IF = 19.5 (IQR 11.95, 38.68), and 28 unique publishers were represented. Inclusive language guidance was provided in 23% of medical journals reviewed. Of those, 20 (86.9%) provided strong guidance. Seven journals also recommended use of the SAGER checklist. CONCLUSION: Significant gaps still exist in ensuring use of inclusive language in medical journals.

Social Psychological Perspectives on Political Polarization: Insights and Implications for Climate Change.

Political polarization is a barrier to enacting policy solutions to global issues. Social psychology has a rich history of studying polarization, and there is an important opportunity to define and refine its contributions to the present political realities. We do so in the context of one of the most pressing modern issues: climate change. We synthesize the literature on political polarization and its applications to climate change, and we propose lines of further research and intervention design. We focus on polarization in the United States, examining other countries when literature was available. The polarization literature emphasizes two types of mechanisms of political polarization: (1) individual-level psychological processes related to political ideology and (2) group-level psychological processes related to partisan identification. Interventions that address group-level processes can be more effective than those that address individual-level processes. Accordingly, we emphasize the promise of interventions leveraging superordinate identities, correcting misperceived norms, and having trusted leaders communicate about climate change. Behavioral interventions like these that are grounded in scientific research are one of our most promising tools to achieve the behavioral wedge that we need to address climate change and to make progress on other policy issues.

Addressing vaccine concerns through the spectrum of vaccine acceptance.

RATIONALE/OBJECTIVE: Several studies have examined attitudes towards COVID-19 vaccines, giving prominence to hesitancy and conceptual models that seek to explain its prevalence, mostly in high-income contexts. An alternative conceptual approach that prioritises an understanding of vaccine concerns, the rationality of the questions people have, the political and media ecologies that raise them, will help recommend ways in which such concerns can be addressed. This current study employs the Spectrum of Vaccine Acceptance as a conceptual framework to explain vaccine concerns, in a low-income context. METHODS: A cross-sectional survey was designed by drawing on the extant literature on indirect impacts of COVID-19 pandemic. The survey was administered face to face to a stratified random sample of 459 healthcare professionals in Uganda, from 1st to July 31, 2021. Key findings from the survey were explored using focus group interviews. Descriptive analysis was performed to quantify key responses on socio-demographic characteristics, feelings and views about COVID-19 and vaccines. Qualitative themes from the survey and focus groups were explained through the framework of the Spectrum of Vaccine Acceptance. RESULTS: Vaccine acceptance was the most dominant attitude among healthcare professionals, with 74.9% of all respondents (N = 224) having been vaccinated. The findings highlight a relationship between vaccine acceptance, vaccine questioning and vaccine hesitancy, in that nearly 60% (N = 127) of those that were already vaccinated had several concerns about the vaccines they had received, suggesting that questions do not necessarily equate to refusal. This led to a partial reframing of the Spectrum of Vaccine Acceptance. CONCLUSION: Factors which determine and differentiate vaccine concerns among healthcare professionals in a low-income context show that rational concerns far outweigh non-sensical and conspiratorial views. The findings will act as a useful input into the importance of understanding and addressing vaccine concerns, and the role of managing information voids in pandemic management.

Task-dependent pitch auditory feedback control in cerebellar ataxia.

Purpose: The purpose of this study was to investigate how ataxia affects the task-dependent role of pitch auditory feedback control in speech. In previous research, individuals with ataxia produced over-corrected, hypermetric compensatory responses to unexpected pitch and formant frequency perturbations in auditory feedback in sustained vowels and single words (Houde et al., 2019; Li et al., 2019; Parrell et al., 2017). In this study, we investigated whether ataxia would also affect the task-dependent role of the auditory feedback control system, measuring whether pitch-shift responses would be mediated by speech task or semantic focus pattern as they are in neurologically healthy speakers. Methods: Twenty-two adults with ataxia and 29 age- and sex-matched control participants produced sustained vowels and sentences with and without corrective focus while their auditory feedback was briefly and unexpectedly perturbed in pitch by +/-200 cents. The magnitude and latency of the reflexive pitch-shift responses were measured as a reflection of auditory feedback control. Results: Individuals with ataxia produced larger reflexive pitch-shift responses in both the sustained-vowel and sentence-production tasks than the control participants. Additionally, a differential response magnitude was observed by task and sentence focus pattern for both groups. Conclusion: These findings demonstrate that even though accuracy of auditory feedback control correction is affected by cerebellar damage, as evidenced by the hypermetric responses, the system still retains efficiency in utilizing the task-dependent role of auditory feedback.

Semantic focus mediates pitch auditory feedback control in phrasal prosody.

This study investigated the effect of semantic focus on pitch auditory feedback control in the production of phrasal prosody through an experiment using pitch-shifted auditory feedback. We hypothesized that pitch-shift responses would be mediated by semantic focus because highly informative focus types, such as corrective focus, impose more specific constraints on the prosodic form of a phrase and require greater consistency in the production of pitch excursions compared to sentences with no such focus elements. Twenty-eight participants produced sentences with and without corrective focus while their auditory feedback was briefly and unexpectedly perturbed in pitch by +/-200 cents at the start of the sentence. The magnitude and latency of the reflexive pitch-shift responses were measured as a reflection of auditory feedback control. Our results matched our prediction that corrective focus would elicit larger pitch-shift responses, supporting our hypothesis that auditory feedback control is mediated by semantic focus.

Effects of steroid stewardship on glycemic control in acute exacerbations of chronic obstructive pulmonary disease patients.

INTRODUCTION: The adverse effects of corticosteroids are dose-dependent, and guidance is to use the lowest effective dose in most disease states. The study facility recently reported a steroid stewardship program that reduced steroid dosing in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients by 50%. The purpose of this post-hoc analysis was to evaluate the effect of this intervention on glycemic control in hospitalized AECOPD before and after cohorts. METHODS: This was a retrospective post-hoc review of hospitalized patients in a before and after study design (n = 27 in each group). The primary endpoint was the proportion of glucose readings >180 mg/dL. Baseline characteristics, mean glucose levels, and corrective insulin were also collected. Continuous variables were compared with a Student's t-test (or Mann-Whitney U where appropriate) and nominal variables with a chi-square test in R Studio. RESULTS: There was a significantly higher proportion of glucose >180 mg/dL readings in the pre-intervention cohort: 38% vs. 25% (p = 0.007). The mean glucose levels were numerically lower post-intervention but did not reach statistical significance (160 mg/dL vs. 145 mg/dL, p = 0.27) both in diabetics (192 mg/dL vs. 181 mg/dl, p = 0.69) and non-diabetics (142 mg/dL vs. 125 mg/dL, p = 0.08). The use of correctional insulin was similar: a median of 25 units vs. 24.5 units (p = 0.92). CONCLUSION: A stewardship program focused on steroid reduction in AECOPD significantly lowered the proportion of hyperglycemic readings but did not significantly affect mean glucose and corrective insulin usage while hospitalized.

Psychosocial Effects of COVID-19 pandemic on Yemeni healthcare workers: A Web-based, Cross-sectional Survey.

Yemeni healthcare workers (HCWs) experience high levels of psychosocial stress. The current study provides a psychosocial assessment of Yemeni HCWs during the COVID19 pandemic and the factors that influence this. Between 6 November 2020, and 3 April 2021, 1220 HCWs inside Yemen self-reported levels of stress, anxiety, insomnia, depression and quality of life using a web-based, cross-sectional survey. According to the findings, 73.0%, 57.3%, 49.8%, 53.2%, and 85.2% of all HCWs reported moderate or severe stress, insomnia, anxiety, depression, and a lower quality of life, respectively. Significant positive correlations were found between stress and anxiety, insomnia, and depression scores, as well as anxiety and insomnia and depression, and insomnia and depression (p < 0.001). There was also a significant inverse relationship between wellbeing scores and stress, anxiety, insomnia, and depression scores (p < 0.001). A high percentage of respondents (85.8%) were 40 years old or younger and 72.7% had fewer than 10 years' experience, suggesting that experienced medics leave Yemen for safer and more secure jobs elsewhere. Psychosocial support to assist in building resilience to the prevailing conditions may need to be embedded in medical school training and continuing professional development to help support HCWs within Yemen and prevent even more from leaving the country.

An automated method for detecting F 0 measurement jumps based on sample-to-sample differences.

An algorithm for detecting sudden jumps in measured F0, which are likely to be inaccurate measures, is introduced. The method computes sample-to-sample differences in F0 and, based on a user-defined threshold, determines whether a difference is larger than naturally produced F0 velocities, thus, flagging it as an error. Various parameter settings are evaluated on a corpus of 30 American English speakers producing different intonational patterns, for which F0 tracking errors were manually checked. The paper concludes in recommending settings for the algorithm and ways in which it can be used to facilitate analyses of F0 in speech research.

Solidarity, not charity: Learning the lessons of the COVID-19 pandemic to reconceptualise the radicality of mutual aid.

The COVID-19 pandemic has significantly ruptured our global society. We have seen health care systems, governments and commerce buckle under the strain of disease, lockdowns and unrest, but the rupture has also created space for radical (and anarchist) politics of mutual aid, as societal organising principles, to move into a more prominent position (and offers potential for this shift to remain after the crisis has subsided). However, in the short time since mutual aid has been thrust into the limelight, we have seen a multiplicity and spectrum of geographies, applications and approaches. Indeed, we have also seen its appropriation by government(s) that takes advantage of mutual aid's rallying cry of "solidarity not charity"; absolving the state's responsibilities to sufficiently fund social welfare when good neighbours will do it for free. In this paper we map out how mutual aid has been enacted during the COVID-19 pandemic by charity, contributory and radical groups to address specific and novel forms of vulnerabilities, and the opportunities and challenges this offers for the future. In particular we highlight potential tensions between the enacting of mutual aid practices and the political activism (or not) of the mutual aid actors. Our contribution is to reconceptualise mutual aid to (i) show where the real "mutualism" of mutual aid is, and (ii) create a better understanding of how mutual aid can be mobilised in future emergencies which will inevitably arise in the current climate emergency.

Case report of a phencyclidine false positive due to lamotrigine use with confirmatory testing.

BACKGROUND: Urine toxicology screens are useful in diagnosing patients who present with acute psychosis with a history of substance abuse. Being aware of potential false positive reactants is paramount in diagnostic accuracy. Currently, lamotrigine is not listed among common cross-reactants with phencyclidine (PCP). CASE REPORT: A 49 year old male (98 kg) was brought to the ED by a family member for worsening confusion and agitation. He had a history of Bipolar I, PTSD, schizoaffective disorder, hypertension, and cannabis/opioid abuse. His home medications included paliperidone, duloxetine, lamotrigine, tizanidine, hydroxyzine, and lisinopril. Upon examination, he denied intentional overdose or illicit substances, but largely mumbled incoherently. Blood pressure was 140/90 mmHg, pulse 113. A urine toxicology screen was positive for PCP and cannabinoids. Other labs were unremarkable, co-ingestants negative. By day three, his mental status vacillated but he largely gave unintelligible responses. Given the short half-life of PCP, false positives were investigated. A confirmatory blood test (collected upon admission) for PCP was found to be negative, and a serum lamotrigine level was confirmed to be positive (1.5µg/ml). Once more lucid, the patient admitted to taking large quantities of mirtazapine and tizanidine, making serotonin syndrome the more likely diagnosis. DISCUSSION: There is little in the medical literature describing cross-reactivity of lamotrigine and PCP on urine drug screens. This can be especially difficult to deduce in a known drug abuser who presents psychotic and non-contributory in their work up.

Social norms explain prioritization of climate policy.

Most people in the United States recognize the reality of climate change and are concerned about its consequences, yet climate change is a low priority relative to other policy issues. Recognizing that belief in climate change does not necessarily translate to prioritizing climate policy, we examine psychological factors that may boost or inhibit prioritization. We hypothesized that perceived social norms from people's own political party influence their climate policy prioritization beyond their personal belief in climate change. In Study 1, a large, diverse sample of Democratic and Republican participants (N = 887) reported their prioritization of climate policy relative to other issues. Participants' perceptions of their political ingroup's social norms about climate policy prioritization were the strongest predictor of personal climate policy prioritization-stronger even than participants' belief in climate change, political orientation, environmental identity, and environmental values. Perceptions of political outgroup norms did not predict prioritization. In Study 2 (N = 217), we experimentally manipulated Democratic and Republican descriptive norms of climate policy prioritization. Participants' prioritization of climate policy was highest when both the political ingroup and the outgroup prioritized climate policy. Ingroup norms had a strong influence on personal policy prioritization whereas outgroup norms did not. These findings demonstrate that, beyond personal beliefs and other individual differences, ingroup social norms shape the public's prioritization of climate change as a policy issue. Supplementary Information: The online version contains supplementary material available at 10.1007/s10584-022-03396-x.

Verbal entrainment in autism spectrum disorder and first-degree relatives.

Entrainment, the unconscious process leading to coordination between communication partners, is an important dynamic human behavior that helps us connect with one another. Difficulty developing and sustaining social connections is a hallmark of autism spectrum disorder (ASD). Subtle differences in social behaviors have also been noted in first-degree relatives of autistic individuals and may express underlying genetic liability to ASD. In-depth examination of verbal entrainment was conducted to examine disruptions to entrainment as a contributing factor to the language phenotype in ASD. Results revealed distinct patterns of prosodic and lexical entrainment in individuals with ASD. Notably, subtler entrainment differences in prosodic and syntactic entrainment were identified in parents of autistic individuals. Findings point towards entrainment, particularly prosodic entrainment, as a key process linked to social communication difficulties in ASD and reflective of genetic liability to ASD.

Genetic Deficiency of Indoleamine 2,3-dioxygenase Aggravates Vascular but Not Liver Disease in a Nonalcoholic Steatohepatitis and Atherosclerosis Comorbidity Model.

Nonalcoholic steatohepatitis (NASH) is a chronic liver disease that increases cardiovascular disease risk. Indoleamine 2,3-dioxygenase-1 (IDO1)-mediated tryptophan (Trp) metabolism has been proposed to play an immunomodulatory role in several diseases. The potential of IDO1 to be a link between NASH and cardiovascular disease has never been investigated. Using Apoe-/-and Apoe-/-Ido1-/- mice that were fed a high-fat, high-cholesterol diet (HFCD) to simultaneously induce NASH and atherosclerosis, we found that Ido1 deficiency significantly accelerated atherosclerosis after 7 weeks. Surprisingly, Apoe-/-Ido1-/- mice did not present a more aggressive NASH phenotype, including hepatic lipid deposition, release of liver enzymes, and histopathological parameters. As expected, a lower L-kynurenine/Trp (Kyn/Trp) ratio was found in the plasma and arteries of Apoe-/-Ido1-/- mice compared to controls. However, no difference in the hepatic Kyn/Trp ratio was found between the groups. Hepatic transcript analyses revealed that HFCD induced a temporal increase in tryptophan 2,3-dioxygenase (Tdo2) mRNA, indicating an alternative manner to maintain Trp degradation during NASH development in both Apoe-/- and Apoe-/-Ido1-/mice-. Using HepG2 hepatoma cell and THP1 macrophage cultures, we found that iron, TDO2, and Trp degradation may act as important mediators of cross-communication between hepatocytes and macrophages regulating liver inflammation. In conclusion, we show that Ido1 deficiency aggravates atherosclerosis, but not liver disease, in a newly established NASH and atherosclerosis comorbidity model. Our data indicate that the overexpression of TDO2 is an important mechanism that helps in balancing the kynurenine pathway and inflammation in the liver, but not in the artery wall, which likely determined disease outcome in these two target tissues.

Factors Influencing Antibiotic Prescribing Behavior and Understanding of Antimicrobial Resistance Among Veterinarians in Assam, India.

This study investigates factors influencing veterinarians' antibiotic prescribing behaviors and their understanding of antimicrobial resistance (AMR). The study used a telephone survey of 50 veterinarians conducted in five districts in Assam state, India. The survey sought information on the most prevalent animal diseases, veterinarians' awareness of potential preventive measures, including factors determining antimicrobial prescribing; the types of antimicrobials used for different health conditions in different species, and possible options to reduce antimicrobial use (AMU). The majority (86%) of respondents worked for the government, 98% reported having no written policy for the use of veterinary health products, and 58% have no on-site diagnostic facilities. Ceftriaxone, Enrofloxacin, and Oxytetracycline were the antibiotics (ABX) most frequently prescribed, by 76, 68, and 54% of veterinarians, respectively. These ABX were prescribed mainly for respiratory health problems and mastitis in cattle, and gastrointestinal infections in buffaloes, sheep, goat, and pigs. Severity of clinical symptoms, economic status of the livestock owner, and withdrawal period for ABX were ranked as very important factors for giving ABX. Less than two thirds (64%) were aware of the government ban for Colistin and only 2% were aware of a national plan for AMR. This study highlighted that ABX prescription is mostly based on tentative diagnosis given the lack of diagnostic facilities in most veterinary clinics. There is a need to enhance veterinary healthcare and to improve communication between policy makers and field veterinarians and, importantly, a need to disseminate clear prescribing guidelines on prudent AMU.

Interferon regulatory factor-5-dependent CD11c+ macrophages contribute to the formation of rupture-prone atherosclerotic plaques.

AIMS: Inflammation is a key factor in atherosclerosis. The transcription factor interferon regulatory factor-5 (IRF5) drives macrophages towards a pro-inflammatory state. We investigated the role of IRF5 in human atherosclerosis and plaque stability. METHODS AND RESULTS: Bulk RNA sequencing from the Carotid Plaque Imaging Project biobank were used to mine associations between major macrophage associated genes and transcription factors and human symptomatic carotid disease. Immunohistochemistry, proximity extension assays, and Helios cytometry by time of flight (CyTOF) were used for validation. The effect of IRF5 deficiency on carotid plaque phenotype and rupture in ApoE-/- mice was studied in an inducible model of plaque rupture. Interferon regulatory factor-5 and ITGAX/CD11c were identified as the macrophage associated genes with the strongest associations with symptomatic carotid disease. Expression of IRF5 and ITGAX/CD11c correlated with the vulnerability index, pro-inflammatory plaque cytokine levels, necrotic core area, and with each other. Macrophages were the predominant CD11c-expressing immune cells in the plaque by CyTOF and immunohistochemistry. Interferon regulatory factor-5 immunopositive areas were predominantly found within CD11c+ areas with a predilection for the shoulder region, the area of the human plaque most prone to rupture. Accordingly, an inducible plaque rupture model of ApoE-/-Irf5-/- mice had significantly lower frequencies of carotid plaque ruptures, smaller necrotic cores, and less CD11c+ macrophages than their IRF5-competent counterparts. CONCLUSION: Using complementary evidence from data from human carotid endarterectomies and a murine model of inducible rupture of carotid artery plaque in IRF5-deficient mice, we demonstrate a mechanistic link between the pro-inflammatory transcription factor IRF5, macrophage phenotype, plaque inflammation, and its vulnerability to rupture.

Social science approaches to infodemiology: understanding the social, political, and economic context of information.

Embedded within the COVID-19 pandemic is the spread of a new pandemic of information - some accurate, some not - that can challenge the public health response. This has been termed an 'infodemic' and infodemic management is now a major feature of the World Health Organization's work on health emergencies. This commentary highlights political, social, and economic aspects of infodemics and posits social science as critical to mitigating the current infodemic and preventing future ones. Infodemic managers should address the wider context of infodemics if we are to understand narratives, help to craft positive ones, and confront the root causes of misinformation rather than just the symptoms.

Chronic Health Crises and Emergency Medicine in War-torn Yemen, Exacerbated by the COVID-19 Pandemic.

INTRODUCTION: Much of Yemen's infrastructure and healthcare system has been destroyed by the ongoing civil war that began in late 2014. This has created a dire situation that has led to food insecurity, water shortages, uncontrolled outbreaks of infectious disease and further failings within the healthcare system. This has greatly impacted the practice of emergency medicine (EM), and is now compounded by the coronavirus disease 2019 (COVID-19) global pandemic. METHODS: We conducted a systematic review of the current state of emergency and disaster medicine in Yemen, followed by unstructured qualitative interviews with EM workers, performed by either direct discussion or via phone calls, to capture their lived experience, observations on and perceptions of the challenges facing EM in Yemen. We summarize and present our findings in this paper. RESULTS: Emergency medical services (EMS) in Yemen are severely depleted. Across the country as a whole, there are only 10 healthcare workers for every 10,000 people - less than half of the WHO benchmark for basic health coverage - and only five physicians, less than one third the world average; 18% of the country's 333 districts have no qualified physicians at all. Ambulances and basic medical equipment are in short supply. As a result of the ongoing war, only 50% of the 5056 pre-war hospitals and health facilities are functional. In June 2020, Yemen recorded a 27% mortality rate of Yemenis who were confirmed to have COVID-19, more than five times the global average and among the highest in the world at that time. CONCLUSION: In recent years, serious efforts to develop an advanced EM presence in Yemen and cultivate improvements in EMS have been stymied or have failed outright due to the ongoing challenges. Yemen's chronically under-resourced healthcare sector is ill-equipped to deal with the additional strain of COVID-19.

Firearm-related threat exposure and associated factors among men and women entering a supportive housing substance use disorder recovery program.

Background: Exposure to firearm victimization has often been overlooked as a sequela of substance use disorders (SUD).Objectives: The overall objective of this study was to explore firearm-related victimization and associated factors among men and women entering a supportive housing SUD recovery program.Methods: This study used program intake information from men (n = 1,758) and women (n = 1,066) clients entering a SUD recovery program.Results: Results found that almost half (49.3%) of the clients entering the program had ever been threatened with a firearm or held at gunpoint, and one-quarter of those clients had experienced firearm-related threats in the 6 months before entering the program. Economic vulnerability, mental health problems, polysubstance use, interpersonal victimization, and early use of drugs and alcohol were associated with firearm-related threat exposure. Many of the factors associated with firearm-related threat exposure were similar for men and women. Multivariate results found that polysubstance use (OR 1.16 men and 1.13 women), number of adverse childhood events (OR 1.13 men and 1.09 women), and interpersonal victimization (OR 3.41 men and 2.05 women) in the 6 months before program entry were significantly associated with ever being threatened with a firearm. Suicidality (OR 1.53 men and 1.80 women) and interpersonal victimization (OR 6.38 men and 6.08 women) were associated with being threatened with a firearm in the 6 months before program entry for both men and women.Conclusion: Results suggest there is a need for firearm-related risk reduction interventions for individuals in SUD recovery programs.