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Premigration trauma and postmigration stressors put refugees at high risk for mental health concerns, including substance use. However, there is limited systematic research on substance use in refugee communities exists. We conducted exploratory qualitative research to examine Bhutanese and Iraqi refugee perspectives related to the use of recreational substances after resettlement in the United States. Data were collected through separate focus groups with 28 Bhutanese and 22 Iraqi adult men. Focus groups were facilitated by an experienced clinician with an in-person interpreter, audiorecorded, and transcribed. Transcripts were checked for accurate translation and then analyzed using a conventional content analysis approach. Findings revealed similarities and differences between the two refugee groups with regard to recognizing excessive use, triggers for use, and preferred modes of outreach and intervention. Findings also revealed postmigration changes in substance use behaviors stemming from issues related to access, cost, and perceived legal ramifications.

ObjectivesTo map the existing literature and describe interventions aimed at building the capacity of patients to participate in care during hospitalisation by: (1) describing and categorising the aspects of care targeted by these interventions and (2) identifying the behaviour change techniques (BCTs) used in these interventions. A patient representative participated in all aspects of this project.DesignScoping review.Data sourcesMEDLINE, Embase and CINAHL (Inception −2017).Study selectionStudies reporting primary research studies on building the capacity of hospitalised adult patients to participate in care which described or included one or more structured or systematic interventions and described the outcomes for at least the key stakeholder group were included.Data extractionTitle and abstract screening and full text screening were conducted by pairs of trained reviewers. One reviewer extracted data, which were verified by a second reviewer. Interventions were classified according to seven aspects of care relevant to hospital settings. BCTs identified in the articles were assigned through consensus of three reviewers.ResultsDatabase searches yielded a total 9899 articles, resulting in 87 articles that met the inclusion criteria. Interventions directed at building patient capacity to participate in care while hospitalised were categorised as those related to improving: patient safety (20.9%); care coordination (5.7%); effective treatment (5.7%) and/or patient-centred care using: bedside nursing handovers (5.7%); communication (29.1%); care planning (14%) or the care environment (19.8%). The majority of studies reported one or more positive outcomes from the defined intervention. Adding new elements (objects) to the environment and restructuring the social and/or physical environment were the most frequently identified BCTs.ConclusionsThe majority of studies to build capacity for participation in care report one or more positive outcomes, although a more comprehensive analysis is warranted.

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An Appalachian-oak forest in a small montane watershed was sampled to calibrate and test an existing forest dynamics simulation model. Indices developed in earlier studies by Whittaker were used to estimate the response of different tree species to soil moisture. As is the case in many forest modeling applications, neither detailed environmental data at a micro-spatial scale nor quantitative historical stand data were available for the study.A protocol of both model parameter estimation and simulation output evaluation is developed. The method involves simulation experiments under which the model parameters are allowed to vary systematically with respect to environmental control variables, allowing one to generate a field of potential simulation results that can be searched for patterns shared by the observed data. The degree to which common patterns emerge provides a measure of model sensitivity to patterns at the scale of interest. This protocol can provide an appraisal of the appropriateness of a simulation model to the system of interest and can be used to assess the performance of the model in future applications.

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