Primary peer-reviewed sources across all 15 NSAG modules. Every claim in the NSAG framework — every tier criterion, every dimension rationale, every governance implication — traces back to a source in this library. It is open to anyone — practitioner, student, patient, or curious reader; every citation links to its primary source. All citations are in APA format with verified source links.
McKenna, N. C., & Holtfreter, K. (2021). Trauma-informed courts: A review and integration of justice perspectives and gender responsiveness. Journal of Aggression, Maltreatment & Trauma, 30(4), 450–470.
Up to 75% of adults in the US criminal legal system report at least one traumatic childhood event. Trauma-informed judicial practices reduce recidivism and PTSD symptoms.
Dierkhising, C. B., Ko, S. J., Woods-Jaeger, B., Briggs, E. C., Lee, R., & Pynoos, R. S. (2013). Trauma histories among justice-involved youth. European Journal of Psychotraumatology, 4, 20274.
Up to 90% of justice-involved youth report at least one traumatic event; 23.6% meet criteria for PTSD. Primary source for the 90% adolescent statistic.
Felitti, V. J., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258.
The ACE Study. Dose-response relationship between adverse childhood experiences and the leading causes of adult death.
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach (HHS Publication No. SMA 14-4884). SAMHSA.
The Four R's (Realize, Recognize, Respond, Resist re-traumatization) and six key principles of trauma-informed practice. Foundational framework document.
Dressel, J., & Farid, H. (2018). The accuracy, fairness, and limits of predicting recidivism. Science Advances, 4(1), eaao5580.
COMPAS accuracy: 65.2% vs. untrained lay prediction: 67.0%. Black defendants incorrectly flagged as high-risk at approximately 2× the rate of white defendants.
Berk, R. A., Kuchibhotla, A. K., & Tchetgen Tchetgen, E. (2024). Improving fairness in criminal justice algorithmic risk assessments using optimal transport and conformal prediction sets. Sociological Methods & Research, 53(4), 1629–1675.
The bias-in-bias-out problem: training data encodes racially disparate policing practices before the algorithm runs. Technical fairness corrections cannot solve data-origin bias.
Chouldechova, A. (2017). Fair prediction with disparate impact. Big Data, 5(2), 153–163.
Formal mathematical proof that calibration and equal false-positive rates cannot simultaneously hold when base rates differ across groups.
Lin, Z. J., Jung, J., Goel, S., & Skeem, J. (2020). The limits of human predictions of recidivism. Science Advances, 6(7), eaaz0652.
Algorithms outperform untrained humans on 3 of 4 datasets. An important counterpoint for a complete understanding of the evidence base.
Johnson, M. W., Richards, W. A., & Griffiths, R. R. (2008). Human hallucinogen research: Guidelines for safety. Journal of Psychopharmacology, 22(6), 603–620.
First comprehensive clinical psychedelic safety guidelines. Set, setting, and supervision are the primary adverse-event determinants. Persisting adverse reactions rare when guidelines followed.
Davis, A. K., et al. (2021). Effects of psilocybin-assisted therapy on major depressive disorder. JAMA Psychiatry, 78(5), 481–489.
MADRS response rate 71% vs. 48% control. Structured session protocol governance central to safety profile.
Carhart-Harris, R., et al. (2021). Trial of psilocybin versus escitalopram for depression. New England Journal of Medicine, 384(15), 1402–1411.
No serious adverse events under structured session protocols. Landmark NEJM comparison trial.
Sajdeya, R., Goodin, A. J., & Tighe, P. J. (2021). Cannabis use assessment and documentation in healthcare. Preventive Medicine, 153, 106798.
Six structural barriers to cannabis documentation. All are institutional design failures.
Boehnke, K. F., Litinas, E., & Clauw, D. J. (2016). Medical cannabis use is associated with decreased opiate medication use. Journal of Pain, 17(6), 739–744.
64% decrease in opioid use among 244 medical cannabis patients. Clinically significant and pharmacologically invisible to providers without screening.
VanDolah, H. J., Bauer, B. A., & Mauck, K. F. (2019). Clinicians' guide to cannabidiol and hemp oils. Mayo Clinic Proceedings, 94(9), 1840–1851.
CYP450 pathways (CYP3A4, CYP2C9, CYP2C19, CYP1A2) shared with warfarin, antiepileptics, antidepressants. Clinically significant interaction risk.
Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224(4647), 420–421.
Nine-year matched cohort. Natural window view → fewer hospitalization days, fewer analgesic doses, fewer complications. Identical treatment.
Ulrich, R. S. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11(3), 201–230.
Psychophysiological measurements confirming faster stress recovery in natural environments. Foundational theoretical framework with DOI.
Al Khatib, I., Samara, F., & Ndiaye, M. (2024). A systematic review of the impact of therapeutical biophilic design. Frontiers in Built Environment, 10, 1467692.
2010–2023 systematic review. Biophilic design reduces hospitalization time, patient mortality, pain, and staff stress.
Razani, N., et al. (2018). Effect of park prescriptions with and without group visits to parks on stress reduction. PLOS ONE, 13(2), e0192921.
SHINE randomized trial (n=78). Park prescriptions reduce perceived stress. Nature access is a governable health intervention.
Fooks, G., Gilmore, A., Collin, J., Holden, C., & Lee, K. (2013). The limits of corporate social responsibility. Journal of Business Ethics, 112(2), 283–299.
Three-stage CSR neutralization model using British American Tobacco internal documents. Civic institutions become participants in neutralization strategies regardless of intent.
Fabbri, A., Lai, A., Grundy, Q., & Bero, L. A. (2018). The influence of industry sponsorship on the research agenda. American Journal of Public Health, 108(11), e9–e16.
Scoping review of 36 articles. Industry sponsorship consistently drives research agendas away from public-health-relevant questions.
Lundh, A., Lexchin, J., Mintzes, B., Schroll, J. B., & Bero, L. (2017). Industry sponsorship and research outcome. Cochrane Database of Systematic Reviews, 2, MR000033.
Cochrane systematic review. Industry-sponsored drug and device studies more likely to have favorable outcomes and conclusions.
Evans, G. W. (2003). The built environment and mental health. Journal of Urban Health, 80(4), 536–555.
Comprehensive review. Neighborhood disorder, housing quality, noise, and green space are documented mental health determinants independent of socioeconomic factors.
Sarkar, C., Webster, C., & Gallacher, J. (2018). Residential greenness and prevalence of major depressive disorders. The Lancet Planetary Health, 2(4), e162–e173.
n=94,879 UK Biobank participants. Greenness associated with lower MDD odds; largest protective effect in lower-income populations.
Münzel, T., Gori, T., Babisch, W., & Basner, M. (2014). Cardiovascular effects of environmental noise exposure. European Heart Journal, 35(13), 829–836.
Noise produces cortisol elevation, sleep architecture fragmentation, HPA axis activation. Noise governance is a physiological governance obligation.
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.
Three burnout dimensions; six person-job mismatch domains: workload, control, reward, community, fairness, values. Foundational framework for organizational intervention.
Kiratipaisarl, W., Surawattanasakul, V., & Sirikul, W. (2024). Individual and organizational interventions to reduce burnout in resident physicians. BMC Medical Education, 24.
2024 systematic review and meta-analysis. Organizational interventions produce significantly greater and more durable burnout reductions than individual interventions.
Thomas Craig, K. J., et al. (2021). The burden of the digital environment. Journal of the American Medical Informatics Association, 28(5), 985–997.
Organization-directed EHR/workflow interventions improved burnout in 68% of eligible studies.
Lapham, G. T., et al. (2022). Comparison of medical cannabis use reported on a confidential survey vs documented in the EHR. JAMA Network Open, 5(5), e2211677.
35.1% of primary care patients reported implicit medical cannabis use; EHR documented rate: 4.8%. Verified 7:1 gap from same patient population.
Tavabi, N., et al. (2023). Disparities in cannabis use and documentation in EHRs. npj Digital Medicine, 6(1), 138.
370,087 patients, 23+ million notes. Documentation <2% with racial and socioeconomic disparities independent of use prevalence.
Sajdeya, R., Goodin, A. J., & Tighe, P. J. (2021). Cannabis use assessment and documentation in healthcare. Preventive Medicine, 153, 106798.
Six structural barriers taxonomy. Documentation gap is an institutional design failure.
Beiler, D., et al. (2024). Medical marijuana documentation practices in patient EHRs. JMIR Formative Research, 8(1), e65957.
Structured data fields produce 93.6% documentation completion vs. 30.8% without. Infrastructure determines documentation.
Ulrich, R. S., Zimring, C., Zhu, X., et al. (2008). A review of the research literature on evidence-based healthcare design. HERD: Health Environments Research & Design Journal, 1(3), 61–125.
~600 studies synthesized. Single-patient rooms reduce infections 10–50%. Noise >45 dBA produces physiological stress. Natural light reduces length of stay and staff sick days.
Al Khatib, I., Samara, F., & Ndiaye, M. (2024). Systematic review of therapeutical biophilic design. Frontiers in Built Environment, 10, 1467692.
Biophilic hospital design reduces hospitalization time, mortality, pain levels, and staff stress.
Münzel, T., Gori, T., Babisch, W., & Basner, M. (2014). Cardiovascular effects of environmental noise. European Heart Journal, 35(13), 829–836.
The physiological mechanism for acoustic governance standards.
Obermeyer, Z., Powers, B., Vogeli, C., & Mullainathan, S. (2019). Dissecting racial bias in an algorithm used to manage the health of populations. Science, 366(6464), 447–453.
~200 million patients. Remedying disparity would raise Black patients receiving extra help from 17.7% to 46.5%. Algorithm used healthcare cost as proxy for health need.
Chang, W., Owusu-Mensah, P., Everson, J., & Richwine, C. (2025). Hospital trends in the use, evaluation, and governance of predictive AI, 2023–2024 (ASTP/ONC Data Brief No. 80). HHS.
71% of hospitals use EHR-integrated predictive AI. 57% evaluate all or most models for bias. Most do not evaluate all models. 74% have distributed accountability with no single governance owner.
Fields, C. T., et al. (2025). Governance for anti-racist AI in healthcare. Frontiers in Digital Health, 7, 1492736.
Racism-related stress produces racial heteroscedasticity in health outcomes. AI governance must go beyond race-only approaches.
Daneshjou, R., et al. (2022). Disparities in dermatology AI performance. Science Advances, 8(31), eabq6147.
AI dermatology tools underperform on darker-skin tones. Demographic performance disparities are systematic across contexts.
Immordino-Yang, M. H., & Damasio, A. (2007). We feel, therefore we learn. Mind, Brain, and Education, 1(1), 3–10.
Physiological threat states suppress prefrontal cortical access required for higher-order learning. Psychological safety is a neurobiological prerequisite for academic function.
Barrett, P., Davies, F., Zhang, Y., & Barrett, L. (2015). The impact of classroom design on pupils' learning. Building and Environment, 89, 118–133.
HEAD Project. Seven design parameters explain 16% of learning progress variation. n=3,766 pupils, 153 classrooms. Light, Temperature, Air Quality, Ownership, Flexibility, Complexity, Colour.
Cantor, P., Osher, D., Berg, J., Steyer, L., & Rose, T. (2019). Malleability, plasticity, and individuality. Applied Developmental Science, 23(4), 307–337.
Educational environment decisions during critical developmental periods literally shape neural architecture. Brain development is experience-dependent.
Felitti, V. J., et al. (1998). Relationship of childhood abuse and household dysfunction to many causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258.
Dose-response relationship between adverse childhood experiences and adult health outcomes. Foundation for trauma-aware educational governance.
Steel, A., et al. (2025). Integration of TCIM in the institutionalization of evidence-informed decision-making: WHO meeting report. Journal of Integrative and Complementary Medicine, 31(4), 388–394.
WHO Bangkok 2024. The primary barrier is the absence of governance infrastructure to evaluate and integrate TCIM evidence.
Kawakami, K. L., et al. (2022). The lives of Native Hawaiian elders and their experiences with healthcare. Frontiers in Public Health, 10, 787215.
lāʻau lapaʻau as a living practice among Native Hawaiian elders. Specific institutional governance implications for Hawaiian health systems.
Tabish, S. A. (2008). Complementary and alternative healthcare: Is it evidence-based? International Journal of Health Sciences, 2(1), V–IX. PMID: 21475465.
RCT frameworks cannot adequately evaluate individualized, relationship-based, meaning-embedded CAM modalities. Foundation for multi-epistemic evidence integration.
Treaty on Principles Governing the Activities of States in the Exploration and Use of Outer Space, including the Moon and Other Celestial Bodies (1967). 610 U.N.T.S. 205.
States bear international responsibility for national activities in space regardless of whether carried out by governmental or non-governmental entities. No provision addresses individual crew rights, medical ethics, or intra-mission governance. Foundational governance gap that M14 addresses.
National Aeronautics and Space Administration. (2020). The Artemis Accords: Principles for Cooperation in the Civil Exploration and Use of the Moon, Mars, Comets, and Asteroids for Peaceful Purposes. NASA.
Bilateral agreements addressing transparency, interoperability, heritage site protection, and orbital debris mitigation. Does not address crew rights, medical authority, conflict resolution, or commercial accountability beyond federal licensing. Current governance ceiling for most missions.
Kanas, N., & Manzey, D. (2008). Space Psychology and Psychiatry (2nd ed.). Springer/Praxis.
Interpersonal conflict, communication difficulties with mission control, and inadequate autonomy are among the most significant predictors of mission risk in long-duration spaceflight. None of these risk factors is addressed by current legal governance frameworks. Primary evidence base for M14 crew rights dimensions.
Stuster, J. (2010). Behavioral Issues Associated with Long-Duration Space Expeditions: Review and Analysis of Astronaut Journals. NASA TM-2010-216130.
Governance structures that preserve crew autonomy, provide independent accountability mechanisms, and establish clear authority boundaries produce significantly better behavioral health outcomes in analog environments. Four decades of Antarctic station, submarine, and polar expedition data.
Stuster, J. (2010). Behavioral Issues Associated with Long-Duration Space Expeditions. NASA TM-2010-216130.
Interpersonal issues, monotony, and inadequate autonomy are the three most consistent predictors of adverse behavioral health across analog environments. All three are governable institutional design variables. Primary evidence base for M15.
Kanas, N., & Manzey, D. (2008). Space Psychology and Psychiatry (2nd ed.). Springer/Praxis.
Displacement of negative emotions from mission control to crewmates (“Earth-out” phenomenon) is a documented governance risk in long-duration missions. Governance structures that reduce communication friction and preserve crew autonomy significantly reduce this risk.
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.
The six person-job mismatch domains (workload, control, reward, community, fairness, values) that produce burnout on Earth produce analogous degradation in isolated confined environments. Organizational design is the intervention. Cross-references M8.
Ulrich, R. S., Zimring, C., Zhu, X., DuBose, J., Seo, H.-B., Choi, Y.-S., Quan, X., & Joseph, A. (2008). A review of the research literature on evidence-based healthcare design. HERD: Health Environments Research & Design Journal, 1(3), 61–125.
Acoustic environment above 45 dBA produces measurable physiological stress. Natural light reduces length of stay. In isolated confined environments where there is no option to exit the stressor, every environmental variable is a governance choice. Cross-references M10.
Every source in this library has a governance implication. The NSAG Brief synthesizes them into practitioner-ready summaries. The framework foundation shows how they operationalize into tier criteria. The assessments help you apply them to your institution.