Secular Trends in Substance Use: The Conflict and Young People in Northern Ireland

The resolution of political conflict has led some to suggest that Northern Ireland will now face a range of social problems that have been ignored or suppressed by the Troubles. One such area is adolescent drug use. In this article, a review of a range of data sources shows that drug use, with few exceptions, has increased since the emergence of the ongoing peace process. Social and political changes and enhanced paramilitary involvement in the drugs trade appear to have somehow created an environment where drug use has flourished. In reviewing current drug policy and practice, the article highlights the lack of prevention, treatment, and harm reduction services established in Northern Ireland as a cause for concern .     

A Comparison of Unconstraining Methods to Improve Revenue Management Systems

Asuccessful revenue management system requires accurate demand forecasts for each customer segment. The forecasts are used to set booking limits for lower value customers to ensure an adequate supply for higher value customers. The very use of booking limits, however, constrains the historical demand data needed for an accurate forecast. Ignoring this interaction leads to substantial penalties in a firm's potential revenues. We review existing unconstraining methods and propose a new method that includes some attractive properties not found in the existing methods. We evaluate several of the common unconstraining methods against our proposed method by testing them on intentionally constrained simulated data. Results indicate our proposed method outperforms other methods in two of three data sets. We also test the revenue impact of our proposed method, expectation maximization (EM), and “no unconstraining” on actual booking data from a hotel/casino. We show that performance varies with the initial starting protection limits and a lack of unconstraining leads to significant revenue losses.     

Comparison of older adult performance during the functional-reach and limits-of-stability tests

Despite widespread use of the functional-reach (FR) and limits-of-stability (LOS) tests, comparisons of postural strategies and postural limits for these tests have not been previously reported. The purpose of this study was to compare postural strategies as determined by cross-correlation analyses of trunk and lower leg angular displacements and postural limits as assessed by maximum center-of-gravity (COG) excursions as older adults at low fall risk completed the FR and LOS tests. Fourteen older adults completed three FR and LOS trials while standing on a Balance Master force platform. Results indicated that despite relatively similar instructions to reach or lean as far as possible without losing balance or altering the base of support, their performance differed with regard to postural strategies employed and maximum COG excursions produced. These findings suggest that because of differences in task constraints, FR and LOS tests should not be used interchangeably.     

Identifying Gaps in Health Research among Refugees Resettled in Canada

While the global number of resettled refugees rises annually, the summaries of research on refugee health needs in countries of asylum remain sparse. We conducted a systematic review of published research on refugee health in Canada in order to: (i) identify studies addressing health outcomes among refugees recently resettled in Canada; (ii) identify general trends in health research conducted in Canada among refugee populations; (iii) identify significant gaps in current knowledge of health‐related issues among refugees recently resettled in Canada; (iv) evaluate the quality and consistency of available information; (v) develop a summary of available research results; and (vi) identify priorities for future research. A search of several major citation indices resulted in the analysis of 196 research reports after reviewing more than 5,000 articles. This review is timely, systematic and inclusive; furthermore, potential biases in methodology are clearly assessed. The results indicate an immediate need to address specific gaps in health knowledge for refugee populations and lead us to draw five primary conclusions. First, mental health outcomes dominate the research landscape. Second, cross‐sectional studies are most commonly the study design of choice. Third, studies examining some aspect of health among refugees from Asia dominate the literature. Fourth, there is a notable lack of information on cardiovascular diseases and its antecedents. Fifth, indications show that screenings for pre‐existing conditions are biased towards communicable diseases. These findings have implications for health monitoring, evaluation and policy affecting the health of refugees resettled in Canada and elsewhere.     

Leveraging risk assessment for foodborne outbreak investigations: The Quantitative Risk Assessment-Epidemic Curve Prediction Model

Root cause analysis can be used in foodborne illness outbreak investigations to determine the underlying causes of an outbreak and to help identify actions that could be taken to prevent future outbreaks. We developed a new tool, the Quantitative Risk Assessment-Epidemic Curve Prediction Model (QRA-EC), to assist with these goals and applied it to a case study to investigate and illustrate the utility of leveraging quantitative risk assessment to provide unique insights for foodborne illness outbreak root cause analysis. We used a 2019 Salmonella outbreak linked to melons as a case study to demonstrate the utility of this model (Centers for Disease Control and Prevention [CDC], 2019). The model was used to evaluate the impact of various root cause hypotheses (representing different contamination sources and food safety system failures in the melon supply chain) on the predicted number and timeline of illnesses. The predicted number of illnesses varied by contamination source and was strongly impacted by the prevalence and level of Salmonella contamination on the surface/inside of whole melons and inside contamination niches on equipment surfaces. The timeline of illnesses was most strongly impacted by equipment sanitation efficacy for contamination niches. Evaluations of a wide range of scenarios representing various potential root causes enabled us to identify which hypotheses, were likely to result in an outbreak of similar size and illness timeline to the 2019 Salmonella melon outbreak. The QRA-EC framework can be adapted to accommodate any food–pathogen pairs to provide insights for foodborne outbreak investigations.