High Time for Conservation: Adding the Environment to the Debate on Marijuana Liberalization

The liberalization of marijuana policies, including the legalization of medical and recreational marijuana, is sweeping the United States and other countries. Marijuana cultivation can have significant negative collateral effects on the environment that are often unknown or overlooked. Focusing on the state of California, where by some estimates 60% -- 70% of the marijuana consumed in the United States is grown, we argue that (a) the environmental harm caused by marijuana cultivation merits a direct policy response, (b) current approaches to governing the environmental effects are inadequate, and (c) neglecting discussion of the environmental impacts of cultivation when shaping future marijuana use and possession policies represents a missed opportunity to reduce, regulate, and mitigate environmental harm

Inclusion of bedrock vadose zone in dynamic global vegetation models is key for simulating vegetation structure and function

Across many upland environments, soils are thin and plant roots extend into fractured and weathered bedrock where moisture and nutrients can be obtained. Root water extraction from unsaturated weathered bedrock is widespread and, in many environments, can explain gradients in vegetation community composition, transpiration, and plant sensitivity to climate. Despite increasing recognition of its importance, the “rock moisture” reservoir is rarely incorporated into vegetation and Earth system models. Here, we address this weakness in a widely used dynamic global vegetation model (DGVM; LPJ-GUESS). First, we use a water flux-tracking deficit approach to more accurately parameterize plant-accessible water storage capacity across the contiguous United States, which critically includes the water in bedrock below depths typically prescribed by soil databases. Secondly, we exploit field-based knowledge of contrasting plant-available water storage capacity in weathered bedrock across two bedrock types in the Northern California Coast Ranges as a detailed case study. For the case study in Northern California, climate and soil water storage capacity are similar at the two study areas, but the site with thick weathered bedrock and ample rock moisture supports a temperate mixed broadleaf–needleleaf evergreen forest, whereas the site with thin weathered bedrock and limited rock moisture supports an oak savanna. The distinct biomes, seasonality and magnitude of transpiration and primary productivity, and baseflow magnitudes only emerge from the DGVM when a new and simple subsurface storage structure and hydrology scheme is parameterized with storage capacities extending beyond the soil into the bedrock. Across the contiguous United States, the updated hydrology and subsurface storage improve annual evapotranspiration estimates as compared to satellite-derived products, particularly in seasonally dry regions. Specifically, the updated hydrology and subsurface storage allow for enhanced evapotranspiration through the dry season that better matches actual evapotranspiration patterns. While we made changes to both the subsurface water storage capacity and the hydrology, the most important impacts on model performance derive from changes to the subsurface water storage capacity. Our findings highlight the importance of rock moisture in explaining and predicting vegetation structure and function, particularly in seasonally dry climates. These findings motivate efforts to better incorporate the rock moisture reservoir into vegetation, climate, and landscape evolution models.</p

Value of intraoperative neurophysiological monitoring to reduce neurological complications in patients undergoing anterior cervical spine procedures for cervical spondylotic myelopathy

The primary aim of this study was to conduct a systematic review of reports of patients with cervical spondylotic myelopathy and to assess the value of intraoperative monitoring (IOM), including somatosensory evoked potentials, transcranial motor evoked potentials and electromyography, in anterior cervical procedures. A search was conducted to collect a small database of relevant papers using key words describing disorders and procedures of interest. The database was then shortlisted using selection criteria and data was extracted to identify complications as a result of anterior cervical procedures for cervical spondylotic myelopathy and outcome analysis on a continuous scale. In the 22 studies that matched the screening criteria, only two involved the use of IOM. The average sample size was 173 patients. In procedures done without IOM a mean change in Japanese Orthopaedic Association score of 3.94 points and Nurick score by 1.20 points (both less severe post-operatively) was observed. Within our sub-group analysis, worsening myelopathy and/or quadriplegia was seen in 2.71% of patients for studies without IOM and 0.91% of patients for studies with IOM. Variations persist in the existing literature in the evaluation of complications associated with anterior cervical spinal procedures. Based on the review of published studies, sufficient evidence does not exist to make recommendations regarding the use of different IOM modalities to reduce neurological complications during anterior cervical procedures. However, future studies with objective measures of neurological deficits using a specific IOM modality may establish it as an effective and reliable indicator of injury during such surgeries

Evidence-based patient choice: a prostate cancer decision aid in plain language

BACKGROUND: Decision aids (DA) to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer. METHODS: Document development steps included preparing an evidence-based DA in standard medical parlance, iteratively translating it to emphasize shared decision making and plain language in three formats (booklet, Internet, and audio-tape). Scientific review of medical content was integrated with expert health literacy review of document structure and design. Formative evaluation methods included focus groups (n = 4) and survey of a new sample of men newly diagnosed with prostate cancer (n = 60), compared with historical controls (n = 184). RESULTS: A transparent description of the development process and design elements is reported. Formative evaluation among newly diagnosed prostate cancer patients found the DA to be clear and useful in reaching a decision. Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy. CONCLUSION: The plain language DA presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men

High time for conservation: adding the environment to the debate on marijuana liberalization

The liberalization of marijuana policies, including the legalization of medical and recreational marijuana, is sweeping the United States and other countries. Marijuana cultivation can have significant negative collateral effects on the environment that are often unknown or overlooked. Focusing on the state of California, where by some estimates 60%–70% of the marijuana consumed in the United States is grown, we argue that (a) the environmental harm caused by marijuana cultivation merits a direct policy response, (b) current approaches to governing the environmental effects are inadequate, and (c) neglecting discussion of the environmental impacts of cultivation when shaping future marijuana use and possession policies represents a missed opportunity to reduce, regulate, and mitigate environmental harm.Published versio