The Preference Clause Revisited: Central Lincoln Peoples\u27 Utility District v. Johnson and the Pacific Northwest Electric Power Planning and Conservation Act

This article analyzes the legislative development of the preference clause to its inclusion in the Pacific Northwest Electric Power Planning and Conservation Act (Northwest Power Act). This analysis demonstrates the Northwest Power Act\u27s reaffirmation of the supply preference traditionally included in federal power marketing legislation. The analysis also reveals a unique price discount for customers entitled to a supply preference under the Northwest Power Act. Additionally, the article considers recent Ninth Circuit decisions applying the preference clause to various forms of power allocation by federal agencies. The analysis identifies legislative and judicial adherence to the preference concept based on congressional confidence in the principles underlying the preference concept. The article concludes that Congress and the federal courts have strengthened the priority given to public utilities in the Pacific Northwest to federally generated electric power despite attempts to circumvent or erode preference rights

Sustaining anti-littering behavior within coastal and marine environments: through the macro-micro level lenses

Being regarded as a problem of global dimensions, marine litter has been a growing concern that affects human beings, wildlife and the economic health of coastal communities to varying degrees. Due to its involvement with human behavior, marine littering has been regarded as a cultural matter encompassing macro and micro level aspects. At the micro or individual level, behavior and behavioral motivation of an individual are driven by perception of that person while at the macro or societal level, aspects including policies and legislations influence behavior. This paper investigates marine littering through the macro-micro level lenses in order to analyze and recommend how anti-littering behavior can be improved and sustained. Using Coleman's model of micro-macro relations, research questions are formulated and investigated through a social survey. Results showed important differences in perceptions among participating groups and to address key issues, potential actions are proposed along with a framework to sustain anti-littering behavior

Developing an Evidence-Based Epilepsy Risk Assessment eHealth Solution: From Concept to Market

INTRODUCTION: Sudden unexpected death in epilepsy (SUDEP) is possibly the most common cause of death as a result of complications from epilepsy. The need to educate and regularly review risk for all patients with epilepsy is paramount, but rarely delivered in actual clinical practice. Evidence suggests that education around SUDEP and modifiable risk variables translate into better self-management of epilepsy. OBJECTIVE: We aimed to develop and implement an eHealth solution to support education and self-management of risks, in epilepsy. METHODS: We undertook an innovation pathways approach, including problem identification, feasibility assessment, design, implementation, and marketing. People with epilepsy were provided a smartphone-based app (Epilepsy Self-Monitor, EpSMon), which translates the clinical risk assessment tool into an educational and self-monitoring platform, for the self-management of epilepsy. RESULTS: Results include the success of the marketing campaign, and in what areas, with an estimated reach of approximately 38 million people. EpSMon has proved a success in academic and clinical circles, attracting awards and nominations for awards. The number of users of EpSMon, after 3 months, turned out to be lower than expected (N=221). A 4-month trial of the app in use in the United Kingdom, and the success of the marketing strategy, point to necessary changes to the model of delivery and marketing, summarized in this paper. These include the marketing message, user cost model, and need for the availability of an Android version. CONCLUSIONS: EpSMon has proven a success in respect to its reception by academics, clinicians, stakeholder groups, and the patients who use it. There is work needed to promote the model and increase its acceptability/attractiveness, including broadening the marketing message, increasing its availability, and reducing its cost. Future development and promotion of the tool will hopefully inform iterative design of its core features for a receptive audience and lead to increased uptake as it is launched worldwide in 2016

Extra-terrestrial Habitat Systems: Safety, Reliability, and Resilience

Developing a resilient extra-terrestrial habitat with regards to long-term reliability and safety from hazards including radiation, meteorites, and quakes is necessary to ensure human survival during interplanetary exploration. The objective of this study is to examine conventional aerospace safety and reliability analysis techniques to investigate whether they are sufficient to achieve resilience in extra-terrestrial habitats. These results will be obtained to complete a strengths, weaknesses, opportunities, and threats (SWOT) analysis of compiled techniques to design a sustainable habitat system. Failure modes, effects, and criticality analysis (FMECA) and probabilistic risk assessment (PRA) with their past applications will be assessed to provide the SWOT analysis to define the requirements for a resilient analysis technique capable of measuring safety and reliability. An in-depth analysis of aerospace engineering analysis techniques will be performed for historical successes and failures and then applied to a simple case study. The research findings are intended to be used as one step toward determining the feasibility of living in other extra-terrestrial environments, including different settlement concepts in surface habitats or lunar lava tubes, by refining conventional safety and reliability analysis procedures. Techniques including FMECA and PRA can determine necessary improvements to increase safety but may lack long-term resiliency. For this reason, there is a need to merge existing risk-based techniques and other design considerations to assess long-term reliability and resilience

Keeping patients with epilepsy safe: a surmountable challenge?

This quality improvement project was inspired as an answer to a problem that intellectual disability teams have been struggling to manage whilst caring for people with epilepsy (PWE). The issue was that despite guidance to discuss the possibility of sudden unexpected death in epilepsy (SUDEP) be discussed with a newly diagnosed PWE this is rarely done. Additionally when, how, and what to discuss about SUDEP and reduce its risk is arbitrary, non-person centred, and with no structured evidence. Prior to initiating changes a discussion of SUDEP was recorded in just 10% of PWE. We introduced a check-list to help identify risk factors for SUDEP. We then modified the check-list, and then used it via telehealth, a way of contacting patients and their carers over the phone using the check-list approach. Following interventions, discussions of SUDEP are now recorded in 80% of PWE. Feedback from patients, carers and primary and secondary care professionals has been positive. We are now developing an app so that patients and carers can monitor their own risk factors, thus empowering them and increasing their knowledge and awareness of SUDEP

Sudden unexpected death in epilepsy: measures to reduce risk

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Age Appropriate Wisdom? Ethnobiological Knowledge Ontogeny in Pastoralist Mexican Choyeros

We investigate whether age profiles of ethnobiological knowledge development are consistent with predictions derived from life history theory about the timing of productivity and reproduction. Life history models predict complementary knowledge profiles developing across the lifespan for women and men as they experience changes in embodied capital and the needs of dependent offspring. We evaluate these predictions using an ethnobiological knowledge assessment tool developed for an off-grid pastoralist population, known as Choyeros, from Baja California Sur, Mexico. Our results indicate that while individuals acquire knowledge of most dangerous items and edible resources by early adulthood, knowledge of plants and animals relevant to the age and sex divided labor domains and ecologies (e.g., women’s house gardens, men’s herding activities in the wilderness) continues to develop into middle adulthood but to different degrees and at different rates for men and women. As the demands of offspring accumulate for parents with age, reproductive aged adults continue to develop their knowledge to meet their children’s needs. After controlling for vision, post-reproductive adults’ show the greatest ethnobiological knowledge. These findings extend our understanding of the evolved human life history by illustrating how changes in embodied capital and the needs of dependent offspring predict the development of men’s and women’s ethnobiological knowledge across the lifespan

UK framework for basic epilepsy training and oromucosal midazolam administration.

BACKGROUND: UK wide Oromucosal Midazolam is used as an emergency treatment in community for seizures administered by family/carers with the right training. The Joint Epilepsy Council (JEC) UK which produced the training guidelines disbanded in 2016. PURPOSE: Provide standards for basic epilepsy education and rescue medication (Midazolam) administration. METHODS: The Epilepsy Nurses Association (ESNA), The International League against Epilepsy, British Chapter (ILAE) and the Royal college of Psychiatrists (RCPsych), used the Delphi process to update guidelines for the administration of oromucosal midazolam including developing a voluntary on-line test for carers. During 2017-2019 a facilitator worked with two ESNA committees to update the existing guidance and another to develop a question-bank. Both committee outputs were circulated to the ESNA membership, then ILAE and RCPsych for review. Patient-facing organizations and charities' opinions were solicited. All feedback was assimilated. A private provider was contracted to deliver the test. RESULTS: A consensus process involving two task and finish groups of 19 people each compared, reflected, debated, and engaged with stakeholders across three stages. The updated ratified guidelines were circulated nationally. The Delphi process highlighted many regions and individuals had local assessment tools and procedures in place, while others (around 50%) had no assessment provision. 278 carers with a 95% pass-rate and 100% positive feedback have undertaken the online test (10/2020). CONCLUSION: The UK-wide care provision gap in basic epilepsy-training and safe rescue medication administration is now addressed. A two-yearly update to the guidelines and test is planned

Improving nocturnal event monitoring in people with intellectual disability in community using an artificial intelligence camera

There is higher prevalence of epilepsy and SUDEP in people with intellectual disability (PwID) compared to general population. Accurate seizure recording particularly at night can be challenging in PwID. Neuro Event Labs seizure monitoring (Nelli) uses high-quality video based artificial intelligence to detect and record possible nocturnal seizures. This study looks to evaluate the clinical utility and acceptability of Nelli in PwID and epilepsy. Family/carers of PwID and drug resistant epilepsy with suspicions of nocturnal seizures who had not tolerated routine or ambulatory EEGs were invited to evaluate Nelli. Relevant demographics and clinical characteristics were collected. Nelli's impact, it's facilitators, barriers and feedback quality was captured from patient and professional stakeholders. Quantitative and thematic analysis was undertaken. Fifteen PwID and epilepsy and four health professionals were involved. Nelli recorded 707 possible seizure events across the study cohort of which 247 were not heard or recognised by carers. Carers recorded 165 episodes of 'restless' or "seizure behaviour" which the Nelli did not deem to be seizures. There was 93% acceptability. Thematic analysis revealed three broad themes of device acceptability, result implementation and possible seizure recognition ability. Nelli allowed for improved communication and care planning in a hitherto difficult to investigate population

Variation in the Microbiota of Ixodes Ticks with Regard to Geography, Species, and Sex

Ixodes scapularis is the principal vector of Lyme disease on the East Coast and in the upper Midwest regions of the United States, yet the tick is also present in the Southeast, where Lyme disease is absent or rare. A closely related species, I. affinis, also carries the pathogen in the South but does not seem to transmit it to humans. In order to better understand the geographic diversity of the tick, we analyzed the microbiota of 104 adult I. scapularis and 13 adult I. affinis ticks captured in 19 locations in South Carolina, North Carolina, Virginia, Connecticut, and New York. Initially, ticks from 4 sites were analyzed by 454 pyrosequencing. Subsequently, ticks from these sites plus 15 others were analyzed by sequencing with an Illumina MiSeq machine. By both analyses, the microbiomes of female ticks were significantly less diverse than those of male ticks. The dissimilarity between tick microbiomes increased with distance between sites, and the state in which a tick was collected could be inferred from its microbiota. The genus Rickettsia was prominent in all locations. Borrelia was also present in most locations and was present at especially high levels in one site in western Virginia. In contrast, members of the family Enterobacteriaceae were very common in North Carolina I. scapularis ticks but uncommon in I. scapularis ticks from other sites and in North Carolina I. affinis ticks. These data suggest substantial variations in the Ixodes microbiota in association with geography, species, and sex