University of San Diego

Depression among children and adolescents is linked to a variety of negative outcomes, but many causes of depression are either difficult or impossible to alter. It is vital to identify the controllable causes of depressive symptoms, including time spent on screen media. Many studies demonstrate associations between time spent on social media and depressive symptoms. Time-lag evidence also demonstrates an association, with rates of adolescent depression doubling during the period when smartphone and social media use became common. Experimental evidence indicates that cutting back on social media use diminishes depressive symptoms. Social media time may cause depressive symptoms via several mechanisms including displacing time spent on healthy activities, increased body image concerns, cyberbullying, reinforcing spirals of negative content, and interference with sleep. Future research should include experimental trials among adolescents, determine which types of screen activities and social media platforms are most strongly linked to depressive symptoms, explore which populations are most impacted, and determine effective interventions. Recommendations include educating parents and adolescents to keep devices out of their bedrooms overnight, not allowing children and younger teens to use social media, and encouraging parents to model appropriate limits around screen devices.

Multiparametric magnetic resonance imaging (mpMRI) is used by clinicians for the diagnosis of clinically significant prostate cancer (csPCa) prior to biopsy in men suspected of having the disease. MRI has shown high sensitivity for identifying csPCa lesions and consequently MRI targeted biopsies (MRTB) have a superior cancer detection rate compared to systematic TRUS biopsy (STRB). However, some csPCa can remain invisible to mpMRI resulting in false negative interpretations because of inadequate negative predictive value (NPV) to safely rule out such lesions. False positive interpretations of mpMRI can also lead to misdiagnosis of csPCa because of anatomical structures and other benign prostatic conditions mimicking csPCa lesions. A subset of mpMRI invisible lesions may also remain undetected by STRB. PCa biomarkers have demonstrated their abilities to noninvasively diagnose some of these mpMRI invisible csPCa. However, the template-guided transperineal mapping biopsy (TPMB) technique is the only method currently available for accurate histopathological diagnosis and staging of csPCa, including those that remain invisible to mpMRI. This chapter examines the diagnosis, localization, and treatment of mpMRI invisible csPCa also remains undetected by STRB employing a shared decision-making approach between primary care physician, patient, and urologist.

Former Dean of Students shares seven key restorative principles he used to help students struggling in college. It didn’t matter what the struggle was, it was how the student made meaning of the struggle. The key was students finding a restorative way to share their struggles and their authentic self. Restorative journaling, mentoring, circles, and groups were used to help students increase their resiliency, GRIT, and self-care habits. When students find a way to share their struggles they change the story they tell themselves. This changes their self-talk habits and increases their ability to face the next challenge. Being aware of negative self-talk and taking steps to change it in the moment can help students manage anxiety and new challenges. This chapter shares stories of using seven practices to rise stronger and wiser from the setbacks of life.

This chapter reviews the research on restorative justice in higher education. It begins with a brief review of restorative justice in criminal justice and K–12 education and its origins in higher education. It then summarizes various applications of restorative justice across student and academic affairs. It reviews the literature, including more than 140 articles, book chapters, and books, sharing what we know about campus implementation, and offers suggestions for future research. Primarily, research on restorative justice in higher education focuses on the philosophy and practice of restorative approaches to student misconduct, with a small number of empirical studies demonstrating its effectiveness. Responses to campus sexual harm have received the most attention. Studies also have explored applications of restorative justice for faculty misconduct, diversity/equity/inclusion/belonging, community building in residential life and orientation, faculty teaching about restorative justice as a subject, and restorative practice as classroom pedagogy.

Restorative practices are a pathway to healing from the Indian Boarding Schools and Indian Residential Schools. Each person who is impacted will have a unique story to share. My cousin, Edi Cornelius Grosskopf, taught me circles to address intergenerational trauma and intergenerational love around the Indian Boarding Schools. My Great, Great Uncle Joshua was killed at Carlisle Indian Boarding School. Carlisle Indian Boarding School was used as an archetype for an estimated 523+ Indian Boarding Schools in the United States as well as a model for over 150 Indian Residential Schools in Canada. Each Indian Boarding School and Residential School had a cemetery on the campus for the children murdered. I use restorative practice to address intergenerational trauma and intergenerational strength among Native youth and others. This wound not only hurts Native peoples, but is a wound we, as all people of this world, need to heal from.

The story we often tell about artists is fiction. We tend to imagine the starving artists toiling alone in their studio when, in fact, creativity and imagination are often relational and communal. Through interviews with artistic collectives and first-hand experience building large scale installations in public spaces and at art events like Burning Man, Choi-Fitzpatrick and Hoople take the reader behind the scenes of a rather different art world. Connective Creativity leverages these experiences to reveal what artists can teach us about collaboration and teamwork and focuses in particular on the importance of embracing playfulness, cultivating a bias for action, and nurturing a shared identity. This Element concludes with an invitation to apply lessons from the arts to promote connective creativity across all our endeavors, especially to the puzzle of how we can foster more connective creativity with other minds, including other artificial actors.

In response to the ethical and societal challenges of emerging technologies, there is a growing commitment to integrative socio-technical research. One such approach is embedded ethics and social science, which embeds the analysis of ethical, social, and legal aspects into the entire innovation process through direct collaboration between ethicists, social scientists, legal scholars, technical researchers, and experts in the field of application. We offer reflections on our experiences from the approach's pilot project, Responsible Robotics, where we were integrated into a research project on service robotics for senior care. Drawing on more than four years of embedded research, we present practices through which peer-to-peer relationships develop. These relationships challenge disciplinary identities and serve as grounds for mutual learning and capacity-building. Our insights contribute to the discourse on how science and technology studies (STS), ethics, and law can integrate with technological research to ensure ethically and socially responsible practices.

We developed an infographic intervention to augment HIV-related education in the Dominican Republic (DR), which demonstrated preliminary success in pilot studies. We then partnered with the United States Agency for International Development’s (USAID) HIV Services and Systems Strengthening program in the DR to scale up the intervention. We used a two-tier Training-of-Trainer (TOT) method to teach intervention administration. N = 12 program leaders completed the tier-1 training and subsequently taught N ~ 102 clinical staff to use infographics with people with HIV (PWH) (tier-2 trainings). Study Aim 1 was to assess implementation outcomes; Aim 2 was to explore infographic influences on program-level health outcomes. We conducted a hybrid type 3 effectiveness-implementation study with three data components: (1) Surveys bookending tier-1 and tier-2 trainings; (2) Focus groups with tier-1 and tier-2 trainees; and (3) program-level data. We designed surveys according to Kirkpatrick’s Training Evaluation Model and analyzed responses with descriptive statistics and/or Fisher’s exact tests. We led four focus groups with a theory-driven guide and analyzed transcripts with conventional qualitative content analysis. We analyzed program-level data by comparing outcomes before and after infographic use with advanced statistical modeling. All 12 program leaders completed tier-1, and 36 staff completed tier-2 surveys; focus groups comprised eight tier-1 and 27 tier-2 trainees; program-level data pertained to 4,318 PWH. Surveys and focus groups indicated the TOT method is feasible, acceptable, and sustainable. Program-level findings showed PWH were more likely to attend scheduled visits and be virally suppressed following infographic implementation. Results indicate our intervention can likely enhance HIV education at large scale.

This research delves into the diverse effects of mass shootings on the real estate market, specifically examining the gender dynamics at play. We use a difference-in-differences identification strategy in the context of the mass shooting in 2000, in Wakefield, Massachusetts. Our primary finding indicates that, following the mass shooting, house prices in Wakefield decline by about 4.7% and that males are in a better advantageous position with respect to negotiations in comparison to their female counterparts. Our investigation unveils that the bargaining power of a male seller exceeds that of a male buyer. Additionally, possessing prior transactional experience positively correlates with enhanced outcomes in housing transactions.

The training programs in marriage and family therapy have received criticism for providing multicultural counseling to diverse populations from White and Western perspectives. Training programs provide less focus on the training needs around cultural competency and cultural humility for students of color. This research study is a phenomenological approach to understand the experiences of students of color in their MFT training programs and during their early clinical experiences, as they developed their multicultural counseling competencies. After interviewing eight participants about their lived experience, data was analyzed via a thematic analysis and resulted in identifying three themes. (1) There are specific multicultural counseling skills that participants frequently use (2) Learning in a White environment means learning without adequate representation, without diverse content and research, and without discussions focusing on diversity. (3) MFT programs need to incorporate a more diverse training approach including increased diversity in its faculty, literature, and general content.

In this article, we provide an overview of our panel presentation at the American Epilepsy Society meeting in December2023. Our presentation reviewed functional mapping methods for epilepsy surgery including well-established and newer methods, focusing mostly on language and memory. Dr Leigh Sepeta (Chair) and Dr Jana Jones (Chair) organized the presentation, which included 5 presenters. Dr Christopher Benjamin discussed the history and current and future mapping practices using functional magnetic resonance imaging; Ms. Freya Prentice reviewed functional mapping of language and memory in pediatric epilepsy; Dr Marla Hamberger compared pros and cons of functional mapping between subdural electrodes and stereoelectroencephalography (SEEG); Dr Donald J. Bearden presented a brief how-to guide on cognitive mapping using SEEG; and Dr Alena Stasenko discussed the complexities of functional mapping of bilingual patients. We have included references for more detailed information on the content of our presentation.

Advanced technologies, such as artificial intelligence (AI) and robotics, are increasingly common, but often come with significant tradeoffs and effects which may elude initial observations. Among these, the term “soft impacts” has come to signify the qualitative implications of a technological device or intervention. How can these sorts of effects be addressed, and what role do they have in the development phases of emerging technologies? In this paper, we outline our interdisciplinary Responsible Robotics project, which harnesses and builds upon an embedded ethics framework. We describe the embedded ethics approach, summarize some of its challenges, and highlight a key benefit. In short, by addressing the so-called “soft impacts” of technology, embedded ethics may stand to benefit not only the users of emerging systems, but also the developers. Although confirming this with a great degree of confidence will call for substantive longitudinal studies, we believe the aims and current roll-out of the embedded ethics approach provide grounds for optimism concerning the intended benefits described here. Accordingly, the mere prospect of increasing social and ethical sensitivity in development settings can serve to encourage a wider adoption of embedded ethics programs worldwide.

Objectives The mantram repetition program (MRP) is an accessible mindfulness-based intervention involving meditation practice, aimed at slowing down thoughts and developing one-pointed attention. The MRP was modified for a population with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD). This cohort study aimed to evaluate the preliminary evidence of MRP’s efficacy in changing PTSD symptoms, substance use, mood symptoms, and perceived stress over 8 weeks compared to baseline in noncomparative groups of individuals with PTSD and SUD. Method This longitudinal study involved an 8-week intervention with a follow-up at week 12. Sixty-six individuals with PTSD and SUD participated in weekly virtual MRP sessions over 8 weeks in small groups. A multilevel model was used to assess the mean PTSD and SUD outcomes at different time points (baseline, Week 8, and Week 12). Results There was a significant decrease in PTSD severity as measured by the self-reported Posttraumatic Checklist for DSM-5 (PCL-5) scale (p < 0.01) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) (p < 0.01) at Week 8 and Week 12 compared to baseline (Week 0). There was also a significant decrease in substance cravings (p < 0.01) and frequency of problematic substance use (p = 0.04) at Week 8 and Week 12. Conclusions The preliminary effectiveness of the MRP in individuals with PTSD and SUD suggests that its potential applications extend to various demographic and clinical categories and via virtual platforms. The MRP should be explored in comparison to other therapies to further evaluate its effectiveness. Preregistration This study was preregistered on clinicaltrial.gov with registration number NCT05058963.

Executive Summary We examine the deaths of undocumented migrants in southern California (i.e., San Diego and Imperial counties) for fiscal years (FYs) 2018–2023 using data obtained from the San Diego County Medical Examiner’s Office (SDCMEO) and Imperial County Coroner’s Office (ICCO). We recorded 314 deaths of undocumented migrants, with 157 in San Diego County (SDC) and 157 in Imperial County (IC). We describe trend fluctuations in migrant deaths and both the overall and county-specific proportions as they relate to causes of death and demographic characteristics (biological sex and age at death). Additionally, to capture the potential effects of the 2019 border wall expansion and COVID-19 pandemic on migrant deaths, we examined differences in these factors between two periods: FY 2018–2019 and FY 2020–2023. We conclude by comparing migrant deaths reported by the medicolegal authorities to estimates published by US Customs and Border Protection’s (CBP) Border Patrol for southern California. From 2018 to 2020, there were approximately 30 known migrant fatalities annually in California. This increased to about 88 deaths per year in 2021 and 2022 before dropping to 50 in 2023. Across the study period, the leading causes of death were drowning (35.4 percent), environmental exposure (23.6 percent), and blunt force trauma (16.9 percent), with the latter cause being largely associated with falls from the border wall. However, we found significant differences between SDC and IC. For instance, 51.6 percent of migrant deaths in IC were due to drowning, compared to 19.1 percent in SDC. Conversely, 21.7 percent of deaths in SDC were due to blunt force trauma, while just 12.1 percent of deaths in IC occurred in this manner. Overall, we found that 75.2 percent of decedents were male, 20.4 percent were female, and 4.5 percent were of unknown sex. Among cases in which a precise age at death was listed, the average age was 34.6 years. Nevertheless, sex and age differed by county in that SDC had a higher proportion of female decedents (28 percent in SDC vs. 12.7 percent in IC) and a higher average age at death (SDC x¯ = 36.8 vs. IC x¯ = 32.0). We also found significant differences between the two periods examined. Perhaps most striking, deaths due to blunt force trauma increased from 3.4 percent of cases in FY 2018–2019 to 19.9 percent of cases in FY 2020–2023. Decedent characteristics also appear to have changed across time. The share of male decedents decreased from 84.5 percent to 73.0 percent, while the share of females increased from 5.2 percent to 23.8 percent between the two periods, while the proportion of decedents ages 50 to 64 years increased significantly (from 4.7 percent to 12.7 percent). Finally, for FYs 2018–2022, CBP reported 25.6 percent fewer migrant deaths than medicolegal authorities in southern California. High numbers of migrant deaths in 2021 and 2022 can be attributed to circumstances during and following the COVID-19 pandemic, including a Trump Administration policy aimed at blocking access to the US asylum system. The expansion of the border wall during the Trump era may also explain increased migrant mortality in 2021 and 2022. Decreases in deaths in California in 2023 may be because of a novel entry location in the San Judas Break or result from a shift in migration trends toward other border states (i.e., Arizona, New Mexico, and Texas). County differences in drowning and blunt force trauma deaths were likely due to the presence of the All-American Canal in IC (drowning), and greater coverage of the pedestrian border wall in SDC (blunt force trauma), respectively. Although speculatory, the higher percentage of female decedents and older age of decedents in SDC may be because these vulnerable individuals perceive San Diego to be a safer route. Changes between FYs 2018–2019 and FYs 2020–2023 in blunt force trauma deaths (3.4 percent to 19.9 percent) are a result of falls from the newly expanded and constructed border wall. We suggest that after more than 30 years of implementation, the United States should eliminate the use of “deterrence” strategies to prevent further and unnecessary loss of life. Additionally, the following actions could reduce migrant mortality in California: installing buoys or other anti-drowning devices in the All-American Canal, making potentially life-saving resources (e.g., blankets and water) available on known migrant routes, and reducing the height of or removing the border barrier. We call for both CBP and medicolegal authorities to provide disaggregated data on migrant fatalities, which would facilitate an accurate accounting these deaths, increase understanding of where and why deaths occur, and therefore be used to support policy changes.