Monday, 6 October 2025

Dominant and submissive relationships


by Meg-John Barker



Welcome to my website! You’ve found my most popular post, and in a second you can read more about Dominant/submissive relationships. If you want to find out more, check out my books and zines which cover this topic in more depth. If you like this, please do consider supporting my Patreon.

Why do people sometimes prefer Dom/sub relationships?

D/s is one aspect of the wider category of BDSM (Bondage and Discipline, Dominance and Submission, and Sadomasochism), sometimes also known as kink. Some people are into all of the things listed under BDSM, and some only some of them. D/s is generally distinguished from SM because it is more about power than about physical sensation (although some use these terms more interchangeably).

In D/s activities one person generally dominates the other, or has power over them, therefore people tend to prefer D/s if they find a power dynamic to be exciting in some way. Of course it is pretty common for sex and power to be mixed together in our culture. For example, a lot of romance fiction involves people being rescued from peril or being swept away by somebody more powerful, and a lot of people fantasise about having the power of being utterly desirable to their partner.

What is involved in a Dom/sub relationship?

If somebody identifies as being into D/s, or having a D/s relationship, then they probably include power play in their sex life, and perhaps in other aspects of their relationship. People can identify as dominant, submissive, or switch (which means that they are sometimes dominant and sometimes submissive). It might be that people stick to the same roles each time they play together, or that they take different roles on different occasions.

For most people, being D/s will be something that they only do some of the time (for example, just in pre-arranged scenes – often, but not always, involving sex). Such scenes could involve any kind of exchange of power. For example, the submissive person might serve the dominant one food, or give them a massage; the dominant person might order the submissive one around or restrain them or punish them in some way; people might act out particular power-based role-plays such as teacher and student, cop and robber, or pirate and captive.

Some people who are into D/s might have longer periods, such as a holiday, where they maintain their power dynamic. And a few have lifestyle or 24/7 arrangements, where one person always takes the dominant, and the other the submissive, role. However, even in such cases much of their everyday life will probably not seem that different to anybody else’s.
How does it differ to the traditional ‘vanilla’ relationship?

This depends very much on how important it is in the lives of those involved. Some D/s relationships would look very much like a vanilla relationship but just with a bit more power-play involved when people have sex. Others would have something of the D/s dynamic in other parts of the relationship. However, it should be remembered that most vanilla relationships have specific roles (e.g. one person takes more responsibility for the finances, one person is more outgoing socially, one person does more of the looking after, one person takes the lead in sex). In D/s relationships those things tend to be more explicit, but perhaps not hugely different.

So perhaps the main difference is in the amount of communication. Most people involved in BDSM stress the importance of everything being ‘consensual‘ so there will probably be much negotiation at the start about the things people do and do not enjoy, and the ways in which the relationship will be D/s. Checklists and contracts can be useful ways of clarifying this. So, for example, there may be limits about the kinds of activities and sensations people like, whether they enjoy role-play or not, and which aspects of the relationship will have a D/s element.

Why do so many people have misconceptions of this type of relationship?

The media portrayal of BDSM has tended to be very negative, often associating it with violence, danger, abuse, madness and criminality. Research has shown that actually people who are into BDSM are no different from others in terms of emotional well-being or upbringing, and that they are no more likely to get serious injuries from their sex lives, or to be criminal, than anybody else.

Often the media also focuses on the most extreme examples, such as very heavy and/or 24/7 D/s arrangements, rather than the more common relationships where there are elements of D/s. For these reasons people may well have misconceptions about D/s relationships. This is why it is useful to get a range of experiences out there in the media – so people can have more awareness of the diversity of things involved and the continuum (e.g. from light bondage and love bites to more scripted scenes and specifically designed toys).
How do couples go about beginning a relationship like this?

A good idea for all people in relationships, whether or not they are interested in D/s, is to communicate about what they like sexually early on, and more broadly about what roles they like to take in the relationship. Often people just assume what they other person will enjoy or how they would like the relationship to be.

For example, one good activity from sex therapy and from the BDSM community is to create a list as a couple of all of the sexual practices that either of you is aware of, and then to go down it writing ‘yes’, ‘no’, or ‘maybe’ about whether it is something that interests you, and sharing your thoughts. It can also be good to share sexual fantasies or favourite images/stories and to talk about whether (and, if so, how) they might be incorporated into your sex life (the Nancy Friday and Emily Dubberley collections of sexual fantasies can be helpful with this). It is very important that people only do things that they really want to try (rather than feeling coerced into certain activities) and that it is accepted that there will likely to be areas which aren’t compatible as well as those that are.

BDSM communities and websites are a great place to look for more information from those who have been involved in these kinds of practices and relationships. Also local fetish fairs and kink events often include demonstrations and workshops. There is more in my books Enjoy Sex and Rewriting the Rules about communicating about sex and relationships.
Some people have a BDSM relationship outside of an existing ‘vanilla’ relationship. What effect can this have on a marriage or couple relationship?

Again this varies. Although it isn’t always out in the open, many couples have arrangements where they are open to some extent (e.g. monogamish couples, the ‘new monogamy’, open relationships, swinging, polyamory, and ‘don’t ask don’t tell’ agreements).

Having different sexual desires is one reason why some couples open up their relationship to one or both of them being sexual with another person. If this is communicated about clearly, kindly and thoughtfully, it can work perfectly well. The important thing again is kindness and communication.

In regards to the hit book 50 Shades of Grey, many husbands have bought this for their wives and girlfriends. What does this say to them, and how would you help a couple who want to get more involved in this sort of lifestyle but don’t know how, or they are too shy to approach it?

The kinds of conversations and activities mentioned above are a great idea. One of the good things about 50 Shades of Grey is that it has opened up this kind of conversation for many people. However, it is important not to assume that the only form of BDSM is the one described in the book. In a heterosexual couple it may well be that the woman is more dominant, for example, or that both people switch roles, and the things that they enjoy may well be different to the ones which Ana and Christian engage in in the book.

If you want to read more about different practices and how to do them, then there are lots of good books available about BDSM. Dossie Easton and Janet Hardy’s books The New Topping Book and The New Bottoming Book are great places to start, as is Tristan Taormino’s The Ultimate Guide to Kink.

For couples who are really struggling to communicate about sex, or who have very different desires and are finding it hard to reconcile this, it might well be useful to see a sex and relationship therapist for a few sessions. The Pink Therapy website includes many kink-friendly therapists.


SOURCE:

Sunday, 5 October 2025

Considering digital change alongside planetary health



Sarah Lake and Dr Penny Trayner argue they are two sides of the same coin.

01 October 2025


The next generation of applied psychologists have a dual inheritance: a planet in crisis, with its profound psychological impacts, and a healthcare system in the midst of digital change. Against this background, the British Psychological Society (BPS) recently approved new standards for the accreditation of doctoral programmes in clinical psychology, with some notable updates reflecting contemporary clinical practice in these two areas.

The publication of 'Clinical psychology and planetary health: Changing course in the storm' (BPS, 2004b) is both a call to action and a resource for psychologists. It positions planetary health as fundamental to psychological wellbeing, offering evidence and direction for clinicians while urging the profession to take an active role in both mitigating and adapting to climate change.

As an aspiring Clinical Psychologist (Sarah) and a Clinical Psychologist and Paediatric Clinical Neuropsychologist, and Academic Director on the Liverpool Doctorate (Penny), these new competencies are highly relevant to us. We are involved in digital change through Kompass Health, a rehabilitation data platform that tracks patient assessments, goals, activities, and outcomes to support personalised recovery and service evaluation. To us, planetary health is intrinsically connected to digital change. Technologies have a material footprint, including energy use and data centre demands. This lens makes a response to the climate emergency feel immediate and practical: it is not only a matter of advocacy; it is about how we design, procure, and use the systems that underpin everyday healthcare.

Here, we summarise the BPS's position on planetary health, explore digital change and investigate the climate effects of different aspects of it.
Planetary health

We live in an era of unprecedented human-driven environmental change. Global temperatures have already risen ~1.1°C above pre-industrial levels, fuelling more frequent extreme weather events and posing threats to both physical and mental health. Whether that is the direct psychological impact of climate disasters such as hurricanes or wildfires, or the indirect effects of the changing climate on socioeconomic and political status and climate anxiety, the mental health impacts are both ranging and growing with the issue itself.

Growing awareness of climate change, though valuable for public knowledge and campaigning, is also driving climate anxiety, fear and hopelessness about the future shaped by the climate crisis (Boluda-Verdú et al., 2022). Younger generations are disproportionately affected, as those who will most directly face its consequences. Surveys report sadness, anxiety, and powerlessness, with 45 per cent stating these feelings negatively impact daily life (Hickman et al., 2021). Distress is compounded by a perception that governments are not doing enough. The BPS (2024a) recognises this anxiety as a rational response to an existential threat, but warns that without support it can become debilitating (Clayton & Karazsia, 2020). Without activism and change, which foster agency and social support (Schwartz et al., 2023; Stanley et al., 2021), young people are left with their rational worries, to see little being done about it.

The BPS publication also emphasises that the climate emergency's mental health effects are starkly unequal. Those in the poorest communities, who contribute least to emissions, experience the greatest burdens (Lobell et al., 2008; Pourmotabed et al., 2020). In lower-income countries, repeated trauma from climate-exacerbated disasters combines with limited recovery resources. In wealthier nations, disadvantaged groups, including low-income families, indigenous peoples, and individuals with disabilities, face higher risks due to barriers in adapting to heatwaves, evacuating from storms, or accessing mental health care (World Health Organization, 2023). Thus, climate change intertwines with social injustice: those least responsible bear the heaviest toll.

Underscoring the whole publication is the reality that human well-being is inseparable from the health of our planet. This is the principle of planetary health – the idea that human health depends on natural systems doing well. Clean air, safe drinking water, stable climates, and biodiverse ecosystems form the foundation for healthy communities. Their degradation directly harms mental health, whether through increased disaster trauma, food and water insecurity leading to chronic stress, or the loss of green spaces that normally support psychological well-being. Thus, the climate emergency calls psychology to broaden our scope to consider the larger ecosystems that support our collective health.

Consequently, the Standards for the Accreditation of Doctoral Programmes in Clinical Psychology (BPS, 2024a) frame sustainability and planetary health as integral to training. It is considered as both a moral and professional responsibility, tightly linked to sustainability, social justice, and health equity – and thus extremely important to future clinical psychologists.
Digital change

With the use of technology in healthcare steadily increasing across services worldwide (Rittenhouse et al., 2017), such innovations are set to play a pivotal role in advancing planetary health, simultaneously reducing the sector's ecological impact and promoting high-quality, effective care. This expansion reflects the broader reality that healthcare is constantly transformed by technological innovation, a trend set to continue at pace in coming years (Thimbleby, 2013). The regulatory landscape recognises this, with the Health and Care Professions Council's updated Standards of Proficiency (September 2023) requiring practitioner psychologists to 'use information, communication and digital technologies appropriate to their practice' (Standard 7.7) and to adopt digital record-keeping tools where required (Standard 9.3).

In clinical practice more broadly, emerging technologies are advancing far faster than is often appreciated, requiring clinicians and policymakers to think 'exponentially' and 'expansively' about how to integrate them into both pre-clinical and clinical interventions (Hategan et al., 2019). This growth has also been driven by significant financial investment in health technology (Chandra & Skinner, 2012), and was further accelerated by the Covid-19 pandemic, which exposed the need for rapid digital transformation (Clipper, 2020; Hammers et al., 2020). However, the pandedmic also revealed enduring gaps in digital skills and confidence, often due to limited time and structured support amidst competing clinical demands.

In rehabilitation, technological developments have expanded the scope and effectiveness of the discipline (Anderson et al., 2019; Schreyögg et al., 2006), while adoption of such tools has been linked to policy initiatives aimed at tackling healthcare inequalities (Chishtie et al., 2022; Joynt et al., 2017). Policy mandates, such as the forthcoming NICE 2025 rehabilitation guidelines, reinforce this shift by embedding digital care pathways into best practice, aligning with the UK government's aim to achieve full digital maturity within the NHS by 2025 (UK Parliament, 2023). At the same time, digital tools are increasingly recognised for their role in empowering patients (Fitzpatrick, 2023).

The Standards for the Accreditation of Doctoral Programmes in Clinical Psychology (BPS, 2024a) therefore recognise the need for psychologists to adapt and lead digital change, being able to understand and utilise digital platforms and methods within their work. Digital competency is embedded not just as a practical skillset but as a fundamental shift in clinical governance, communication, education, and research.
Technology and its effect on planetary health

The Health and Care Act 2022 made the NHS in England the world's first health system to legislate for a net zero strategy. This sets two milestones: achieving net zero by 2040 for directly controlled emissions (with an 80 per cent reduction by 2028–2032), and by 2045 for supply chain emissions (with an 80 per cent reduction by 2036–2039). Operationally, this embeds net zero into procurement, infrastructure, care delivery, and travel. Suppliers are now required to consider carbon footprints in the tendering process, cascading an environmental responsibility across the entire supply chain.

This shows how planetary health and digital change also represent two sides of the same coin. Operationally, they have to be considered in tandem. And the workforce are open to this: conversations with clinical psychologists and rehabilitation professionals highlight a strong openness to innovation, underscoring the broader shift toward digital solutions (Hategan et al., 2019; Trayner et al., 2023).

Here are some areas that need to be considered as part of that shift.

Electronic patient records

Electronic patient records (EPRs) are replacing paper systems in contemporary practice, offering environmental benefits such as reduced paper use, less physical storage, and more efficient information sharing (Clarke et al., 2018; Kwon et al., 2024; Turley et al., 2011). Cloud back-ups also strengthen disaster resilience, ensuring data is preserved during events such as floods or fires.

Unfortunately, EPRs are not impact-free. Their footprint lies in energy use: powering servers, data centres, and networks requires significant electricity, while the manufacture of hardware involves resource-intensive mining and processing, contributing to pollution and depletion. In some cases, EPRs may even produce higher greenhouse gas emissions per patient than paper records, largely due to server demands (Eyesustain, 2025; Kwon et al., 2024). However, if powered by renewable energy, digital records retain their eco-efficiency.

Telerehabilitation

The Covid-19 pandemic rapidly accelerated telehealth across medicine and psychology, with video consultations, app-based condition management, and online appointment systems becoming routine. This shift came with a compelling climate benefit, the lack of transportation required. Studies show that the small emissions from data use are negligible compared to the savings from reduced journeys (Hantel et al., 2024; Nordtug et al., 2022; Rahimi-Ardabili et al., 2022; Vidal-Alaball et al., 2021). At scale, widespread telehealth adoption could reduce national healthcare travel emissions by nearly one-third, preventing tens of millions of kilograms of CO₂ annually (Nordtug et al., 2022; Vidal-Alaball et al., 2021). With this climate benefit, comes accessibility benefits too.

Digital care does, however, carry an energy cost: running video calls, transmitting data, and powering servers all consume electricity. While per-appointment use is minimal, system-wide adoption increases demand on data centres, and if coal-powered, some travel savings are offset. Encouragingly, many centres are transitioning to renewable energy, and streaming efficiency continues to improve. This positions telehealth as a strong example of digital change that advances planetary health.

Artificial intelligence

AI is increasingly integrated into clinical psychology, from clinical decision-making and conversational tools to administrative tasks like minute taking and record management. However, unlike telehealth, the environmental cost of AI is substantial, particularly in the training of models (Strubell et al., 2019; Truhn et al., 2024). While deployment has relatively low emissions, training is energy-intensive (Truhn et al., 2024), and as AI applications expand and become more complex, training demands and their climate burden will grow (Morand et al., 2024). At the same time, AI could mitigate healthcare's environmental impact by streamlining processes, reducing waste, and enabling low-carbon alternatives such as virtual care (Ueda et al., 2024). This duality highlights AI as both a potential climate solution and a significant environmental risk.

Moving forward, the focus must be on sustainable AI: reducing the energy required for training, using renewable power, and demanding transparency from vendors about carbon footprints and offsetting practices. For psychology and rehabilitation, aligning AI adoption with planetary health is essential.
Practice points

Considering the effects, both positive and negative, that digital change can have on our planet, the discipline must act. Consequently, psychologists must embrace digital innovation in ways that actively protect and promote planetary health, ensuring technology is a tool for sustainability, not a new source of harm.

Some practical ideas of how to do this include:Adopt sustainable digital systems: Choose electronic patient record (EPR) platforms hosted on renewable-powered servers, implement device recycling schemes, and extend hardware lifespans through repair and refurbishment rather than replacement. Evaluate platforms not only for clinical utility and usability, but also for energy efficiency and supplier alignment to NHS carbon targets.
Align with policy: Prepare for NICE's digital maturity targets (2025) by embedding environmental criteria into procurement, service design, and commissioning. Psychologists should advocate for sustainability to be built into the digital standards their services adopt.
Embed equity and climate justice: Ensure digital health solutions do not widen inequalities (such as by perpetuating digital exclusion) and design interventions that specifically support vulnerable populations affected by climate-related crises.
Teach sustainable digital literacy: Incorporate training for psychologists to critically assess the environmental costs and benefits of digital tools, helping the workforce see sustainability as integral to clinical effectiveness. Build in protected time for digital upskilling and reflective discussion within teams.
Make positive everyday digital choices: Reduce the hidden carbon footprint of digital work by sharing files via cloud links instead of email attachments, regularly deleting old emails and clearing spam, avoiding unnecessary printing, and using digital notepads and secure recording systems. Where clinically appropriate, use low carbon defaults such as remote supervision and paper-light workflows. Even small changes, such as streamlining email habits, can have measurable impact. Using a carbon calculator can make these savings visible, motivating behaviour change across services.
Far-reaching transitions

The challenges of climate change demand that clinical psychology 'change course', rethinking our practices, priorities, and use of technology in light of the planetary emergency. Both digital change and planetary health are key changes affecting our discipline, and should not be considered as isolated factors, especially as they both directly contribute to the discipline that future professionals will inherit.

Technology will undoubtedly be a part of the path forward in tackling the climate emergency. Its potential to shrink healthcare's carbon footprint, whilst present, must be tackled thoughtfully to avoid unintended environmental consequences. Thus, a mindset of sustainable innovation is required, embracing digital change whilst considering the full lifecycle environmental impact and ways to mitigate any climate downsides of developments. This is why the two considerations are two sides of the same coin, as they must be acted on concurrently. Psychologists are well positioned to advocate for this, bringing a human-centric lens to ensure that technology best serves human well-being without undermining environmental health.

Finally, a tone of advocacy and reflection is fitting. There is no denying that both the climate crisis, and the rate of digital change can feel overwhelming, and it is easy for healthcare providers to feel that their individual actions are a mere drop in the ocean. Yet, as the BPS (2024a) paper emphasises, collective action and leadership from professionals are indispensable for the 'far-reaching transitions' required, and digital change is no different.Sarah Lake is a Research Assistant working with Kompass Health. Sarahlake@kompass.health
Dr Penny Trayner is a Clinical Psychologist and Paediatric Clinical Neuropsychologist, and the Founder of Kompass Health, a rehabilitation data platform that tracks patient assessments, goals, activities, and outcomes to support personalised recovery and service evaluation. Penny is also joint Academic Director of the DClinPsy at the University of Liverpool.

Inspired by:

British Psychological Society. (2024b). Clinical psychology and planetary health: Changing course in the storm. Leicester, UK: British Psychological Society.

See also the 'Climate and the environment' collection.
References

Anderson, M., Revie, C. W., Stryhn, H., Neudorf, C., Rosehart, Y., Li, W., Osman, M., Buckeridge, D. L., Rosella, L. C., & Wodchis, W. P. (2019). Defining 'actionable' high- costhealth care use: results using the Canadian Institute for Health Information population grouping methodology. International Journal for Equity in Health, 18(1).

Boluda-Verdú, I., Senent-Valero, M., Casas-Escolano, M., Matijasevich, A., & Pastor-Valero, M. (2022). Fear for the future: Eco-anxiety and health implications, a systematic review. Journal of Environmental Psychology, 84(101904), 101904.

British Psychological Society. (2024a). Standards for the accreditation of doctoral programmes in clinical psychology. Leicester.

Chandra, A., & Skinner, J. (2012). Technology growth and expenditure growth in health care. Journal of Economic Literature, 50(3), 645–680.

Chishtie, J., Bielska, I. A., Barrera, A., Marchand, J.-S., Imran, M., Tirmizi, S. F. A., Turcotte, L. A., Munce, S., Shepherd, J., Senthinathan, A., Cepoiu-Martin, M., Irvine, M., Babineau, J., Abudiab, S., Bjelica, M., Collins, C., Craven, B. C., Guilcher, S., Jeji, T., … Jaglal, S. (2022). Interactive visualization applications in population health and health services research: Systematic scoping review. Journal of Medical Internet Research, 24(2), e27534.

Clarke, D. J., Burton, L. J., Tyson, S. F., Rodgers, H., Drummond, A., Palmer, R., Hoffman, A., Prescott, M., Tyrrell, P., Brkic, L., Grenfell, K., & Forster, A. (2018). Why do stroke survivors not receive recommended amounts of active therapy? Findings from the ReAcT study, a mixed-methods case-study evaluation in eight stroke units. Clinical rehabilitation, 32(8), 1119–1132.

Clayton, S., & Karazsia, B. T. (2020). Development and validation of a measure of climate change anxiety. Journal of Environmental Psychology, 69(101434), 101434.

Clipper, B. (2020). The influence of the COVID-19 pandemic on technology: Adoption in healthcare. Nursing Management, 51(6), 28–35.

EyeSustain. (2025). Exploring the carbon footprint of electronic medical records (EMR). EyeSustain.

Fitzpatrick P. J. (2023). Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Frontiers in digital health, 5, 1264780.

Hammers, C. M., Maibach, H. I., & Cohen, D. E. (2020). Digital transformation in healthcare: Lessons from COVID-19. Journal of the American Academy of Dermatology, 83(1), e29–e30.

Hantel, A., Cernik, C., Walsh, T. P., Uno, H., Larios, D., Slutzman, J. E., & Abel, G. A. (2024). Assessing the environmental and downstream human health impacts of decentralizing cancer care. JAMA Oncology, 10(9), 1245–1252.

Hategan, A., Bourgeois, J. A., & Wong, A. H. (2019). Future directions in psychiatry: The role of technological innovation. Academic Psychiatry, 43(3), 281–285.

Hickman, C., Marks, E., Pihkala, P., Clayton, S., Lewandowski, R. E., Mayall, E. E., Wray, B., Mellor, C., & van Susteren, L. (2021). Climate anxiety in children and young people and their beliefs about government responses to climate change: A global survey. The Lancet Planetary Health, 5(12), e863–e873.

Joynt, K. E., De Lew, N., Sheingold, S. H., Conway, P. H., Goodrich, K., & Epstein, A. M. (2017). Should Medicare value-based purchasing take social risk into account? The New England Journal of Medicine, 376(6), 510–513.

Kwon, C., Essayei, L., Spencer, M., Etheridge, T., Venkatesh, R., Vengadesan, N., & Thiel, C. L. (2024). The environmental impacts of electronic medical records versus paper records at a large eye hospital in India: Life cycle assessment study. Journal of Medical Internet Research, 26(1), e42140.

Lobell, D.B., Burke, M.B., Tebaldi, C., Mastrandrea, M.D., Falcon, W.P. & Naylor, R.L. (2008). Prioritizing climate change adaptation needs for food security in 2030. Science, 319 (5863), 607–610.

Morand, C., Ligozat, A.-L., & Névéol, A. (2024). How green can AI be? A study of trends in machine learning environmental impacts (Preprint). arXiv.

Nordtug, A., Bastola, R., & Grødahl, A. (2022). Carbon footprint and cost of virtual outpatient appointments compared to in-person appointments: A prospective study in Norway. BMJ Open, 12(1), e054210.

Pourmotabbed A, Moradi S, Babaei A. et al. (2020). Food insecurity and mental health: A systematic review and meta-analysis. Public Health Nutrition, 23(10):1778–1790. .

Rahimi-Ardabili, H., Magrabi, F., & Coiera, E. (2022). Digital health for climate change mitigation and response: A scoping review. Journal of the American Medical Informatics Association, 29(12), 2140–2152.

Rittenhouse, D. R., Ramsay, P. P., Casalino, L. P., McClellan, S., Kandel, Z. K., Shortell, S. M., & Rittenhouse, J. K. (2017). Increased health information technology adoption and use over time among federally qualified health centers. Health Affairs, 36(5), 960–967.

Schreyögg, J., Stargardt, T., Tiemann, O., & Busse, R. (2006). Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries. Health Care Management Science, 9(3), 215–223.

Schwartz, S. E. O., Benoit, L., Clayton, S., Parnes, M. F., Swenson, L., & Lowe, S. R. (2022). Climate change anxiety and mental health: Environmental activism as buffer. Current psychology (New Brunswick, N.J.), 1–14. Advance online publication.

Stanley, S.K., Hogg, T.L., Leviston, Z. & Walker, I. (2021). From anger to action: Differential impacts of eco-anxiety, eco-depression, and eco-anger on climate action and wellbeing. The Journal of Climate Change and Health, 1. 100003.

Strubell, E., Ganesh, A., & McCallum, A. (2019). Energy and Policy Considerations for Deep Learning in NLP. Proceedings of the 57th Annual Meeting of the Association for Computational Linguistics, 3645–3650.

Thimbleby, H. (2013). Technology and the future of healthcare. Journal of Public Health Research, 2(1), e28.

Trayner, P., Giblin, C., Lake, S., & Bateman, A. (2023, November). Unlocking rehabilitation insights: Discussing the data dashboard for quantitative analysis [Conference poster]. UKABIF 2023; NR-SIG WFNR 2024; Neuro Convention 2024. ResearchGate.

Truhn, D., Müller‑Franzes, G., & Kather, J. N. (2024). The ecological footprint of medical AI. European Radiology, 34(2), 1176–1178.

Turley, M., Porter, C., Garrido, T., Gerwig, K., Young, S., Radler, L., & Shaber, R. (2011). Use of electronic health records can improve the health care industry's environmental footprint. Health affairs (Project Hope), 30(5), 938–946.

Ueda, D., Walston, S. L., Fujita, S., Fushimi, Y., Tsuboyama, T., Kamagata, K., Yamada, A., Yanagawa, M., Ito, R., Fujima, N., Kawamura, M., Nakaura, T., Matsui, Y., Tatsugami, F., Fujioka, T., Nozaki, T., Hirata, K., & Naganawa, S. (2024). Climate change and artificial intelligence in healthcare: Review and recommendations towards a sustainable future. Diagnostic and Interventional Imaging, 105(11), 453–459.

UK Parliament (2023). Digital transformation in the NHS: Eighth Report of Session 2022-2023. Health and Social Care Committee.

Vidal-Alaball, J., Franch-Parella, J., Lopez Seguí, F., Garcia Cuyàs, F., & Mendioroz Peña, J. (2021). Impact of a telemedicine program on the reduction in the emission of atmospheric pollutants and journeys by road. International Journal of Environmental Research and Public Health, 18(2), 748.

World Health Organization (WHO). (2023, October 12). Climate change. World Health Organization.




SOURCE: