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Pathways for intervention on both individual and systemic levels are discussed.Transcranial direct current stimulation (tDCS) over the dorsolaterateral prefrontal cortex (DLPFC) has been indicated as a promising treatment for several addictions, while its contribution for smoking cessation was less investigated. In particular, the role of motivation to quit and the nicotine dependence level as possible mediators of tDCS effect needs to be deepened. In the present study, we recruited twenty smokers who did not look for a treatment to quit most of them presented a mild level of nicotine addiction, and they were randomly assigned to active or sham group for receiving bilateral tDCS over the DLPFC. tDCS was provided for five consecutive days with anode over the right hemisphere in the first and the last day the craving level was evaluated through a specific evoking procedure, and the daily cigarette consumption was recorded. Results showed that the active tDCS decreased by about 50% the cigarette craving, while the number of cigarettes smoked remained unchanged and no differences emerged in the sham group. selleck The present study indicates the tDCS of the DLPFC as a possible treatment for smoking addiction because of its effectiveness in reducing craving. Further, as we recruited smokers with no motivation to quit, and the nicotine dependence level was a moderator of the tDCS effect, we suggest that its efficacy might be even greater in the severe smokers looking for a treatment.

Cocaine is the most commonly reported illicit stimulant used in the U.S., yet limited research has examined recent changes in cocaine use patterns and co-occurring substance use and mental health characteristics among adults using cocaine.

Self-report data from adults (age 18years or older) participating in the 2006 to 2019 National Surveys on Drug Use and Health (NSDUH) were used to estimate trends in prevalence of past-year cocaine use by demographic characteristics, cocaine use disorder, cocaine injection, frequency of use. For 2018-2019, prevalence of co-occurring past-year use of other illicit and prescription substances and mental health characteristics were estimated. Multivariable logistic regression examined demographic, substance use, and mental health characteristics associated with past-year cocaine use in 2018-2019.

The annual average estimated prevalence of past-year cocaine use among adults was highest in 2006-2007 (2.51%), declined to 1.72% in 2010-2011, and then increased to 2.14% in 2018-2019. The annual average estimated prevalence of past-year cocaine use disorder was highest in 2006-2007 (0.71%) and declined to 0.37% in 2018-2019. Characteristics associated with higher adjusted odds of past-year cocaine use included males; ages 18-49; Hispanic ethnicity; income <$20,000; large or small metro counties; use of other substances (nicotine, alcohol, marijuana, sedative/tranquilizers, prescription opioids, prescription stimulants, heroin, and methamphetamine); and serious psychological distress and suicidal ideation or attempt.

Additional efforts to support prevention and response capacity in communities, expand linkages to care and retention for substance use and mental health, and enhance collaborations between public health and public safety are needed.

Additional efforts to support prevention and response capacity in communities, expand linkages to care and retention for substance use and mental health, and enhance collaborations between public health and public safety are needed.This study evaluated how individuals' own substance use and their perception of peers' substance use predict each other across development from early adolescence to middle adulthood. Participants were from two longitudinal studies Fast Track (FT; N = 463) and Child Development Project (CDP; N = 585). Participants reported on their own and peers' substance use during early and middle adolescence and early adulthood, and their own substance use in middle adulthood. From adolescence to early adulthood, individuals' reports of their own substance use in a given developmental period predicted reports of their peers' substance use in the next developmental period more than peers' substance use in a given developmental period predicted individuals' own substance use in the next. In the higher-risk FT sample, individuals' own substance use in early adulthood predicted alcohol, cannabis, and other substance use in middle adulthood, and peers' substance use in early adulthood predicted cannabis use in middle adulthood. In the lower-risk CDP sample, participants' own substance use in early adulthood predicted only their own cannabis use in middle adulthood, whereas peers' substance use in early adulthood predicted participants' alcohol, cannabis, opioid, and other substance use in middle adulthood. The findings suggest that peer substance use in early adulthood may indicate a greater propensity for subsequent substance use in lower-risk groups, whereas those in higher-risk groups may remain more stable in substance use, with less variability explained by peer contexts.

There has been little attempt to date to narrow the education-practice gap in naturopathic medicine. A framework that brings naturopathic medicine education and practice closer together could help codify the knowledge of naturopathic medicine by providing simultaneous guidance on curriculum development and clinical decision-making in the discipline.

To develop, refine and validate the Advancing Naturopathic Education and Practice (ADVANCER) framework.

Published literature and pertinent government, professional association and institutional websites were scoped to identify key constructs for the ADVANCER framework. The constructs were grouped into ten domains, with each domain defined and translated into teaching and clinical practice outcomes. A two-round e-Delphi method, comprising international experts in naturopathic medicine education, was used to refine and validate the framework definitions and outcomes.

Sixteen academics, from five different countries, participated in the Delphi study. In round one, nine of the ten domains of the ADVANCER framework were rated as either very important or extremely important by 81.