Rethinking UCITA: Lessons from the Open Source Movement

For those within the information technology (IT) industry, the phrase “open source” has been as prominent at water cooler and boardroom discussions over the last several years as the phrase “out source.” Open source is at once a software development model, a business model, a social movement, and a philosophy that has recently garnered attention from outside of the IT sphere. As such, the topic has become increasingly fertile ground for academic scholarship from several disciplines. Economists, legal academics and practitioners, computer engineers, and social commentators have offered their varying perspectives on open source software. Whether or not this attention is warranted, and whether or not this is truly “an idea whose time has finally come,” remains unclear. The National Conference of Commissioners on Uniform State Laws (NCCUSL) recently proposed the Uniform Computer Information Transactions Act (UCITA) for adoption by all the states. At present, only two states have adopted UCITA and the prevailing logic suggests that further adoption will be an uphill struggle. In large part, UCITA was controversial because it was perceived as overly protective of large commercial computer software developers–most notably, Microsoft. A diverse and energetic collection of interests, aligned against UCITA, has succeeded thus far in derailing its progress. Although the argument that Microsoft is hampered by a lack of uniformity and certainty in the law is not likely to engender a great deal of sympathy, that same argument in the context of open source software might be more convincing. In this Comment, I argue that the open source movement necessitates a rethinking of UCITA, or at least a UCITA-like uniform code to govern software licensing transactions. If UCITA benefits the open source movement, then former opponents may be willing to take another look at the statute. For a number of reasons, a rethinking of UCITA, in light of the open source movement as well as some important amendments to UCITA itself, leads to the conclusion that UCITA should now be adopted by the states

Listening to Unheard Voices: Nurses’ Communication Experiences with the NRS Pain Scale

This study examines nurses’ experiences with the Numeric Rating Scale (NRS). These responses characterize the communication trials that nurses face with pain diagnosis, pain management, and overall patient care. Interviews with 20 nurses reveal three themes: subject dissatisfaction, feeling limited, and subjective satisfaction. An analysis of these themes reveals the need for renewed discussion about the way pain is communicated and the challenging expectations nurses must regularly confront. Implications for listening to important, but often quiet, even silent, voices in pain management and clinical practice are discussed

SIGNS INSCRIBED ON A GATE: THE IMPACT OF VAN BUREN V. UNITED STATES ON CIVIL CLAIMS UNDER THE COMPUTER FRAUD AND ABUSE ACT

This Article addresses the impact of the U.S. Supreme Court’s June 2021 decision in Van Buren v. United States on what constitutes“ authorization” to access a computer under the Federal Computer Fraud and Abuse Act (CFAA)—a law that imposes both criminal and private civil liability for violations—and concludes that, so far, the Van Buren decision has not rendered the CFAA toothless. The Introduction briefly explains the history of the CFAA, a summary of why it was enacted, how organizations have relied upon it as an important tool to protect themselves from computer hackers and increased cybersecurity risks, and a Circuit of Appeals split about what it means to “exceed authorization.” The Article then, in a section titled “Exceeding Authorized Access: All That Is Not Permitted Is Forbidden,” tells the sordid tale of what happened to Van Buren and how the U.S. Supreme Court resolved his case, ultimately by reversing the Court of Appeals’s ruling affirming his CFAA conviction in an attempt to resolve the circuit split. It concludes in “Protecting Systems with a Sign on the Doorposts” by examining the two cases that, through December 2021, considered the authorization issue and what they indicate about the future of the post-Van Buren CFAA

Identifying Barriers to Mental Health Services Utilization for Black Youth in the United States: A Qualitative Study

Mental health in Black communities and racial/ethnic disparities in mental health service utilization remain growing concerns. Evidence suggests that psychotic disorders may be more prevalent among Black individuals than white individuals and the Black community faces barriers to care that can negatively influence outcomes. To better understand these barriers, we interviewed mental healthcare providers (n = 11) and Black young adults with first-person experience of psychosis (n = 13) about the experiences of minority young adults with mental health treatment. We analyzed interview transcripts and, consistent with constructivist grounded theory methods, identified iterative patterns across individuals about barriers to care. From the 11 mental healthcare providers and 13 Black young adults in the present analyses, five overarching themes emerged: lack of knowledge about mental health helpseeking, material resource unavailability, stigma, lack of family support, and trauma. These themes represented factors that dissuaded individuals from seeking care and must be addressed to improve engagement and outcomes for minority young adults. Innovative approaches to improving mental health literacy and decreasing stigma, along with systemic, policy-based economic changes, may provide starting points for effectively addressing these barriers

Neural signatures of cognitive flexibility and reward sensitivity following nicotinic receptor stimulation in dependent smokers : a randomized trial

IMPORTANCE Withdrawal from nicotine is an important contributor to smoking relapse. Understanding how reward-based decision making is affected by abstinence and by pharmacotherapies such as nicotine replacement therapy and varenicline tartrate may aid cessation treatment. OBJECTIVE To independently assess the effects of nicotine dependence and stimulation of the nicotinic acetylcholine receptor on the ability to interpret valence information (reward sensitivity) and subsequently alter behavior as reward contingencies change (cognitive flexibility) in a probabilistic reversal learning task. DESIGN, SETTING, AND PARTICIPANTS Nicotine-dependent smokers and nonsmokers completed a probabilistic reversal learning task during acquisition of functional magnetic resonance imaging (fMRI) in a 2-drug, double-blind placebo-controlled crossover design conducted from January 21, 2009, to September 29, 2011. Smokers were abstinent from cigarette smoking for 12 hours for all sessions. In a fully Latin square fashion, participants in both groups underwent MRI twice while receiving varenicline and twice while receiving a placebo pill, wearing either a nicotine or a placebo patch. Imaging analysis was performed from June 15, 2015, to August 10, 2016. MAIN OUTCOME AND MEASURES A well-established computational model captured effects of smoking status and administration of nicotine and varenicline on probabilistic reversal learning choice behavior. Neural effects of smoking status, nicotine, and varenicline were tested for on MRI contrasts that captured reward sensitivity and cognitive flexibility. RESULTS The study included 24 nicotine-dependent smokers (12 women and 12 men; mean [SD] age, 35.8 [9.9] years) and 20 nonsmokers (10 women and 10 men; mean [SD] age, 30.4 [7.2] years). Computational modeling indicated that abstinent smokers were biased toward response shifting and that their decisions were less sensitive to the available evidence, suggesting increased impulsivity during withdrawal. These behavioral impairments were mitigated with nicotine and varenicline. Similarly, decreased mesocorticolimbic activity associated with cognitive flexibility in abstinent smokers was restored to the level of nonsmokers following stimulation of nicotinic acetylcholine receptors (familywise error-corrected P<.05). Conversely, neural signatures of decreased reward sensitivity in smokers (vs nonsmokers; familywise error-corrected P<.05) in the dorsal striatum and anterior cingulate cortex were not mitigated by nicotine or varenicline. CONCLUSIONS AND RELEVANCE There was a double dissociation between the effects of chronic nicotine dependence on neural representations of reward sensitivity and acute effects of stimulation of nicotinic acetylcholine receptors on behavioral and neural signatures of cognitive flexibility in smokers. These chronic and acute pharmacologic effects were observed in overlapping mesocorticolimbic regions, suggesting that available pharmacotherapies may alleviate deficits in the same circuitry for certain mental computations but not for others