Digital Commons Network^™

Never Cool Enough: Legal And Policy Challenges To Keeping Data Centers And Communities Empowered In A Warming World, Cristina M. Banahan, Diana B. Wilkinson

Lewis & Clark Law Review

In a rapidly evolving world, artificial intelligence (AI) and cryptocurrency are two technologies at the forefront of the future. Although these developments promise many potential societal benefits and revenue, they come with a price. The data processing required to operate these new technologies demands a large amount of energy, using water to cool the systems and enable them to run without overheating. With such high water and energy demands, the benefits from these technological advancements come at a steep environmental cost. Despite the negative environmental impacts of these data centers, the Trump Administration continues to roll back environmental protections. The …

Making The Implicit Explicit: Leadership In Primary Care Dental Practice, Sally Hanks, Debby R.E. Cotton

Peninsula Dental School

Objectives: This paper reports on research aimed at understanding leadership activities in primary care dental practice, an under-explored area within the extant literature. Methods: The research employed a qualitative, exploratory paradigm, using Video Reflexive Ethnography (VRE) and Activity Theory (AT) to capture the lived experiences of seven participating dentists. Results: The research outlines the ways in which dentists demonstrate leadership skills in their daily work, identifying three interacting activity systems that define leadership in this setting: Patient Care (PC), Running the Surgery (RS), and Running the Practice (RP). Findings emphasise that leadership is directly related to patient care and is …

A Pilot Study Assessing The Oral Microbiome In Women Of Menopausal Age: Do Oral Nitrate–Reducing Bacteria Play A Role?, Katie Muddiman, Amazon Doble, Abish Stephen, Raul Bescos Garcia, Charlotte Illsley, Tomas Nicholas, Sally Hanks, Lisa Du Toit, Zoe Brookes

Peninsula Dental School

Introduction The links between oral health and female ageing are poorly understood, but many changes occur in the oral cavity of menopausal women that affect quality of life, and few current oral health interventions consider gender as part of their approach. The aim of this pilot study was to test the hypothesis that the oral microbiome and microenvironment change during female ageing and are thus worthy of further consideration both experimentally and clinically. Methods This observational pilot study retrospectively assessed women aged 18 to 89 years (n = 60) attending a UK primary care dental school facility for blood pressure …

Training Healthcare Professionals To Deliver A Group-Based Intervention For People Living With Severe Obesity: Lessons From The Progroup Feasibility Trial, Shokraneh Moghadam, Mark Tarrant, Lily Hawkins, Dawn Swancutt, Rod Sheaff, Laura Hollands, Raff Calitri, Jonathan Pinkney, Jenny Lloyd

School of Psychology

Introduction: Group-based programmes are increasingly adopted to support people living with obesity, as they have the potential to reduce staff time and costs and enhance motivation and capability for behaviour change. Group-based programmes could also provide members with opportunities to form meaningful social connections. As such, training should equip healthcare professionals to deliver group interventions successfully and be accessible and feasible for them to complete. This study presents how mixed-methods process evaluation data from the feasibility randomised controlled trial of PROGROUP (a group-based weight management intervention for people living with severe obesity) informed optimisation of the PROGROUP training programme. Methods: …

Degrees Of Separation: Grandchildren's Experiences Of Grandparental Brain Tumor Or Stroke, Emily Sapsford, Alyson Norman, Sue Jackson, Josh Deacon, Emily Ravenhill, Pete Keohane

School of Psychology

The impact of acquired brain injury on family members is far reaching. Research has identified experiences of trauma, ambiguous loss and burden of care. Limited research has addressed the ripple effect of brain injury across the wider family. The study aimed to gain a detailed insight into the lived experiences of grandchildren of those who have experienced stroke or brain tumor. Ten participants (eight female and two males aged between 18 and 29) took part in semi-structured interviews about their experiences of grandparental stroke or brain tumor. Data were analyzed using interpretive phenomenological analysis (IPA). Four themes were identified. The …

Lower Suicidal Ideation Linked To Easier Access To Urban Green Spaces During The Covid-19 Pandemic: A Nationwide Study In Japan, Zheng Xian, Tomoki Nakaya, Clive E. Sabel, Ryo Okubo, Kun Liu, Jinguang Zhang, Takahiro Tabuchi

School of Geography, Earth and Environmental Sciences

Urban green spaces (UGSs) have been linked to improved mental health and lower suicide rates, yet their protective role during large-scale crises remains underexplored. We examined associations of UGS accessibility with long-term and pandemic induced new-onset suicidal ideation during the early phase of the COVID-19 pandemic in urban Japan, using data from a nationwide health survey of 17,376 participants (August 2020). Modified Poisson regression models estimated prevalence ratios (PRs) for suicidal ideation by UGS accessibility (area, number, and type) within 5, 10, and 15-minute walking thresholds from home, controlling for individual and area-level confounders. UGS accessibility exhibited dose-response relationships with …

From Passive To Powerful: Creating Engaging Resident-As-Teacher Modules, Anna E Rueda, Stephanie V Sherman, Sherita J Love, Glenn C Bridges, Wesley A Mayer, Mark J Harbott, Teri L Turner, Bani M Ratan

Faculty and Staff Publications

Background: We aimed to design, implement, and evaluate three novel institutional resident-as-teacher (RAT) e-modules for postgraduate year (PGY) 1, 2, and 3 and compare them to previously utilized online trainings.

Methods: We utilized PICRAT, a model examining both students' relationship with technology (passive, interactive, creative) and instructors' use of technology (replaces, amplifies, or transforms) to create interactive experiences that amplified teaching methodologies. We compared evaluations of the previous and new trainings with an unpaired t test. New modules were assessed with one-way analysis of variance for specialty-based acceptability and content analysis of two open-ended questions.

Results: Response rates averaged 93.2% …

Anything But Endo: Diagnostic Buck-Passing In Endometriosis Diagnosis, Rita Dexter, Megan Kitts, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

People living with endometriosis, a disease in which tissue similar to the lining of the uterus grows elsewhere in the body, often experience prolonged diagnostic journeys because of symptom variability, normalisation of period pain and other symptoms, and lack of awareness of the condition. In this article, we analyse the endometriosis diagnostic journey through the lens of epistemic injustice. Drawing on in-depth interviews with 52 people living with endometriosis in the United States, we introduce the concept of diagnostic buck-passing to characterise the phenomenon wherein individuals who seek treatment for their symptoms end up stuck in a cycle of seeing …

Can I Get A Witness? The Ethical Dimensions Of Family Presence In Patient Suffering, Jennifer Blumenthal-Barby, Trevor M Bibler, Holland Kaplan, Adam Omelianchuk, Joanna Smolenski

Center for Medical Ethics and Health Policy Staff Publications

For patients who are suffering, the bedside presence of a family member can provide comfort, and many people hold that there is moral value in being present with a conscious, suffering patient. Yet what is the moral significance of the absence of family members when a patient is minimally conscious or unconscious and not aware of their absence? Clinicians are often troubled when family members and surrogate decision-makers who are able to spend a significant amount of time at an unconscious, seriously ill patient's bedside do not do so. Clinicians feel frustrated that they must bear the burden of witnessing …

Imagining Genomics And Population Health In 2050: Anticipating Future Research, Policy, And Governance Needs, Bartha Maria Knoppers, Yann Joly, Ma Apos N H Zawati, Habiba Alsafar, Jeffrey C Barrett, Laura Blackburn, Brian Hon-Yin Chung, Martina C Cornel, Edward S Dove, David Glazer, Calvin Wai-Loon Ho, Muin J Khoury, Anna C F Lewis, Anneke Lucassen, Peter F R Mills, Colin Mitchell, Nicola Mulder, Ainsley J Newson, Anthony Ng, Paul D P Pharoah, Vasiliki Rahimzadeh, Megan C Roberts, Saskia C Sanderson, Jeffrey M Skopek, Ron Zimmern, Eric M Meslin

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Taking Off The “Blindfold”: Exploring Montana’S Public Trust Doctrine And The Right To A Clean And Healthful Environment After Held V. Montana, Lizzy Gazeley

Lewis & Clark Law Review

As global average temperatures continue to rise, the threat of climate change looms closer. To evade climate catastrophe, greenhouse gas emissions will need to be substantially reduced. Despite climate change’s imminent risks, in the United States, both the federal government and states remain resistant to transitioning away from fossil fuel energy sources. To combat this government inaction, some litigants have turned to an ancient doctrine. The public trust doctrine provides that sovereigns must protect natural resources from substantial impairment to ensure the public’s right to use those resources.

In Held v. Montana, youth plaintiffs alleged that the State of Montana …

A Scope For Survival: Creating A Path For The Pregnant Workers Fairness Act Under A Conservative Administration And Supreme Court Bench, Emily Easton

Lewis & Clark Law Review

The Pregnant Workers Fairness Act (PWFA) requires employers to provide reasonable accommodations for known limitations related to pregnancy, childbirth, or related medical conditions, representing a bipartisan congressional effort to fill the gaps in workplace protections afforded to pregnant workers. However, the Equal Employment Opportunity Commission’s (EEOC) final rules interpreting the PWFA have generated significant legal and political controversy—especially around the broad interpretation of the definition of related medical conditions to include lactation, “elective” abortions, menstruation, infertility, and contraception.

Given the current political and legal climate presented by a conservative federal administration and Supreme Court bench, this Note proposes a pragmatic …

Designing A Mobile App For Post Traumatic Stress Disorder: Insights From Lived Experience And Clinical Practice, Rohit Shankar, Richard Laugharne, Michael Loizou, Marius Varga, Sivia Lin, Bojana Daw Srdanovic, Roger Farrell

Peninsula Medical School

Post-traumatic stress disorder (PTSD) is a disabling anxiety disorder precipitated by severe trauma. Many people with this condition have little access to clinical interventions, especially in low-middle-income countries. For the development of any digital health intervention, it is vital to know the opinions of PLE and clinicians to guide the developers. We conducted two focus groups, one with clinicians (n = 5) and one with people with lived experience (PLE) (n = 11), to gain knowledge of their views on the development of a PTSD App. Transcripts of both focus groups were coded and thematically analysed. The key themes that …

Royal College Of Psychiatrists College Report 244: Optimising Psychotropic Medication Prescribing For People With Intellectual Disability, Rohit Shankar

Peninsula Medical School

No abstract provided.

The Cognitive-Affective Social Processing And Emotion Regulation (Casper) Model, M Catalina Camacho, Elina Deshpande, Michael T Perino

2020-Current year OA Pubs

Humans are intensely social creatures. It is therefore not surprising that many psychiatric disorder criteria include social dysfunctions; however, overlapping presentations and diverse, complex etiologies make treating social dysfunctions difficult. Here, we introduce the Cognitive Affective Social Processing and Emotion Regulation (CASPER) model. CASPER integrates research from social psychology, cognitive neuroscience, and developmental science to describe how real-world social processing unfolds and is associated with differing psychiatric social cognitive neurophenotypes. Briefly, social processing can be broken down into the following cognitive steps: identifying relevant social cues, attending to related cues, interpreting cues, and adjusting behavior appropriately. Each of these steps …

Beyond Restless Sleep: A Cross-Sectional Study Of Obstructive Sleep Apnea Risk, Aging Biomarkers, And Chronic Low Back Pain, Khalid W Freij, Fiona Bat Agbor, Philemon Domoyeri, Kiari R Kinnie, Asia M Wiggins, Demario S Overstreet, Tammie L Quinn, Shivraj S Grewal, S Justin Thomas, Walid W Freij, Shameka L Cody, Michael A Owens, Robert E Sorge, Burel R Goodin, Edwin N Aroke

2020-Current year OA Pubs

This secondary data analysis aimed to determine the nature of the relationship between obstructive sleep apnea (OSA) risk, biological age acceleration, and nonspecific chronic low back pain (CLBP). In total, 199 adults aged 18-82 years who filled both STOPBANG and pain questionnaires subsetted for secondary analysis. Based on the STOPBANG questionnaire, 104 had a low OSA risk and 95 had an intermediate or high OSA risk. Dunedin Pace of Aging Computed from the Epigenome (DunedinPACE), Horvath's, Hannum's, PhenoAge, and GrimAge clocks were used to determine biological age and pace of biological aging. Individuals with low OSA risk reported increased DunedinPACE …

Lost Before Forgetting: Objective Driving Metrics Track Navigation Deficits Tied To Preclinical Alzheimer's Disease, Yiqi Zhu, Ramkrishna K Singh, Semere Bekena, David C Brown, Chen Chen, Matthew Blake, Jean-François Trani, Ganesh M Babulal

2020-Current year OA Pubs

BACKGROUND AND OBJECTIVES: Navigation is a complex, multisensory process in which subtle changes may emerge before the onset of symptomatic Alzheimer's disease (AD). This study investigated whether navigation abilities were associated with amyloid and tau pathology in cognitively normal older adults.

RESEARCH DESIGN AND METHODS: Among 285 cognitively unimpaired older adults, navigation and objective driving behaviors were assessed using the self-reported Santa Barbara Sense of Direction Scale (SBSOD) and a datalogger, respectively. Amyloid and tau burden were quantified using PET-MRI 2 years post-initial driving data collection. Linear mixed-effects models were used to evaluate the associations between biomarker status and longitudinal …

Perception Of Dementia Risk Among Black Adults: An Ecological Analysis Of Causal Loop Diagrams With A Structural And Social Determinant Of Health Composite Index, Jean-Francois Trani, Ramkrishna K Singh, Alexis Ib Walker, Semere Bekena, Yiqi Zhu, Ganesh M Babulal, Robbie Hart

2020-Current year OA Pubs

INTRODUCTION: To investigate drivers of dementia risk disparities among older Black Americans using a community-based system dynamics (CBSD) approach.

METHODS: Over 18 months, 234 participants created 36 causal loop diagrams (CLDs) on dementia risk. An ecological analysis compared structural differences across groups based on scores on a structural and social determinants of health composite index (S/SDOH-CI).

RESULTS: Groups in the highest SDOH-CI quantile were more likely to identify key protective pathways linking mental health, substance use, exercise, medication, and community support to reduce dementia risk. In contrast, fewer than 25% of low-SDOH-CI groups identified these connections, and under 15% recognized …

The Impact Of Congenital Heart Disease On The Timing Of Alzheimer's Disease In Down Syndrome, Julianne G Clina, Beau Ances, Et Al.

2020-Current year OA Pubs

INTRODUCTION: The incidence of Alzheimer's disease (AD) in Down syndrome (DS) exceeds 90%. Approximately 50% of people with DS have congenital heart disease (CHD). Having CHD increases risk for early-onset AD in populations without DS, but it is unclear if CHD influences AD in DS.

METHODS: Data from the Alzheimer Biomarker Consortium-Down Syndrome (ABC-DS) were used. Participants with CHD (

RESULTS: People with CHD scored lower for visuospatial ability (

DISCUSSION: Presence of CHD may influence AD progression in DS.

HIGHLIGHTS: In adults with Down syndrome (DS), those with congenital heart disease (CHD) had higher amyloid beta and reached the …

Participatory Systems Modeling In Implementation Research: Exploring Benefits, Facilitators, And Future Needs, Natalie Riva Smith, Jennifer L Cruz, Jessica Gannon, Stephanie Mazzucca-Ragan

2020-Current year OA Pubs

BACKGROUND: Implementation science increasingly uses participatory systems modeling (PSM) approaches to handle the complexity inherent to implementation science issues. To support the process of integrating PSM with implementation science, we aimed to understand and explicate the benefits, facilitators, and future needs of applying PSM to implementation research.

METHODS: We conducted semi-structured qualitative interviews with 23 researchers (n = 18) and practitioners (n = 5). We purposively sampled participants and identified additional participants through recommendations. Interviews were inductively analyzed. Key concepts were identified via iterative description, comparison, and conceptualization.

RESULTS: Engagement with people in the system was typically focused in earlier …

Neurofilament Light Chain But Not Glial Fibrillary Acidic Protein Serum Levels Are Elevated In Wolfram Syndrome, Matthew J Jansen, Heather M Lugar, Cris M Brown, Abby F Tang, Liam J Oiknine, Ling Chen, Jonathan M Koller, Brian A Gordon, Bess A Marshall, Fumihiko Urano, Tamara Hershey

2020-Current year OA Pubs

BACKGROUND: Wolfram syndrome is a rare genetic disorder caused by pathogenic variants in the

OBJECTIVE: To determine if serum NfL and/or GFAP levels are elevated in Wolfram syndrome compared to controls and whether they can serve as monitoring biomarkers.

METHODS: Serum NfL and GFAP levels were log

RESULTS: NfL levels were higher in the Wolfram group relative to all control groups (

CONCLUSION: Serum NfL elevation in Wolfram syndrome may reflect the ongoing, relatively slow neurodegeneration occurring in this disorder. However, without any correspondence between serum levels and currently used clinical and neuroimaging metrics, it has limited utility as a …