Total Synthesis of Cochlearol B via a Catellani- and Visible Light-Enabled [2+2]-Cycloaddition Approach

A new, twelve-step approach towards the meroterpenoid cochlearol B is reported. This strategy takes advantage of a palladium-catalyzed Catellani reaction of a complex chromenyl triflate and a subsequent visible light-mediated [2+2]-cycloaddition to form the central bicyclo[3.2.0]heptane core of cochlearol B. Notably, careful selection and tuning of the photocycloaddition precursor proved crucial to differentiate between cyclopropanation reactions, [4+2] cycloadditions, and selective [2+2]-photocycloadditions.

Medicated-Assisted Treatment and 12-Step Programs: Evaluating the Referral Process

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT. Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected from a database before project implementation. Eligible participants were diagnosed with OUD, receiving buprenorphine (opiate agonist), and at least 18. Participants were provided with temporary sponsors to attend Narcotics Anonymous, Alcoholics Anonymous, and Medication-Assisted Recovery meetings together. The primary endpoint was the change in positive opiate urine drug screens over 6 months between participants and controls. Results Between March 29, 2021, and April 16, 2021, 166 patients were scheduled at the clinic. Of those scheduled, 146 were established patients, and 123 were scheduled for face-to-face visits. Of these, 64 appeared for the appointment, 6 were screened, and 3 were enrolled. None of the participants attended a 12-step meeting. Enrollment barriers included excluding new patients and those attending virtual visits, the high percentage of patients who missed appointments, and lack of staff referrals. The low incidence of referrals was due to time constraints by both staff and patients. Implications for Nursing Practice Low enrollment limited our ability to determine whether combining medication management with a 12-step program improves abstinence. Failure to keep appointments is common among patients with OUD, and virtual meetings are becoming more prevalent post-COVID. Although these factors are unlikely to be controllable, developing strategies to expedite the enrollment process for staff and patients could hasten recruitment.

The Holy Trinity

Decades of research have identified three effective treatments for substance use disorders. This chapter explores the three most studied and proven evidence-based interventions: Motivational Interviewing, Cognitive Behavioral Therapy, and Twelve-Step Facilitation. The inconsistency or infrequency with which evidence-based interventions are used in the treatment of addictions is finally getting some attention at the national level, and there are new recommendations regarding the deployment of treatment approaches. It is important for the reader to understand the roots of these three interventions and why, despite being easy to learn and likely to work, they are not regularly being deployed inside of treatment centers.

Overeaters Anonymous: An Overlooked Intervention for Binge Eating Disorder

The purpose of this communication is to provide an overview as well as the strengths and weaknesses of Overeaters Anonymous (OA) as an intervention for binge eating disorder treatment. Binge eating disorder is associated with low remission rates, high relapse rates, treatment dissatisfaction, and high rates of failure to receive treatment attributed to stigma, misconceptions, lack of diagnosis, access to care, and inadequate insurance coverage. New interventions are needed that can overcome these barriers. OA is a twelve-step program and established fellowship for individuals who self-identify as having problematic relationships with food or eating. OA can be referred clinically or sought out by an individual confidentially, without a diagnosis, and free of charge. OA’s Nine Tools, Twelve Steps, and Twelve Traditions can provide structure, social support, and open, anonymous sharing that fosters a sense of connection and belonging. This may provide benefit to individuals who value structure and social support in their recovery. The tradition of anonymity may also create some challenges for conducting research and may explain the shortage of empirical support. This commentary reviews existing research findings on the effectiveness of twelve-step interventions and OA. Common misunderstandings about and within OA are also addressed and OA’s limitations are discussed. Overall, OA provides a promising option for binge eating disorder treatment that warrants clinical research on its feasibility and efficacy in a way that respects and protects its tradition of anonymity.

The Circle of Societal Death

This chapter illustrates the twelve-step process known as the Circle of Societal Death. Assume some externally caused source of economic decline. This will lower governmental functioning by lowering tax revenues. Low government revenues and performance demoralize government functionaries. When government officials are powerless and irrelevant, there is no reason for them not to become corrupt; corruption in the police and the judiciary leads to crime. Once people become genuinely worried about personal security, networks of social cooperation contract. This means they delegitimize everything outside the group, especially the state, and everything becomes defined in ethnic terms. As both crime and ethnic conflict escalate, young people are drawn into self-defense activity. The movement of youth from investment in the future to coercion in the present mortgages the economic growth of the future. As youth are pulled out of education, society becomes less intellectually capable. Fundamental engineering, business, and technological skills become lost, and projects of large-scale coordination suffer. As projects of large-scale coordination become nonviable, economic growth declines. This circle of death also works in reverse.