If Supply-Oriented Drug Policy is Broken, Can Harm Reduction Help Fix It?—Melding Disciplines and Methods to Advance International Drug Control Policy

Critics of the international drug control regime contend that supply-oriented policy interventions are not just ineffective, but they also produce unintended adverse consequences. Research suggests their claims have merit. Lasting local reductions in opium production are possible, albeit rare; but, unless global demand shrinks, production will shift elsewhere, with little or no effect on the aggregate supply of heroin and, potentially, at some expense to exiting and newly emerging suppliers. The net consequences of the international drug control regime and related national policies are as yet unknown. In this paper, we consider whether “harm reduction,” a subject of intense debate in the demand-oriented drug policy community, can provide a unifying foundation for supply-oriented drug policy, one capable of speaking more directly to policy goals. Despite substantial conceptual and technical challenges, we find that harm reduction can provide a basis for assessing the net consequences of supply-oriented drug policy, choosing more rigorously among policy options, and identifying new policy options. In addition, we outline a practical path forward for assessing harms and policy options.

Competing Explanations of U.S. Defense Industry Consolidation in the 1990s and Their Policy Implications

Was the consolidation of defense industry in the 1990s driven by U.S. Department of Defense (DOD) directives, or was it driven instead by the same forces that drove consolidation in many other sectors of the U.S. economy in the 1990s? To better understand the roles of DOD policy and economy-wide forces in shaping the U.S. defense industry, we test for structural breaks in defense industry and spending data and compare our findings to those relating to other sectors and the general economy. We identify structural breaks in the defense-related data in the early 1980s and throughout the 1990s, roughly consistent with changes in the U.S. economy, including broader merger trends. Overall, our results are more consistent with the view that economy-wide factors drove defense industry consolidation, largely independent of the DOD policy changes that occurred early in the 1990s.

Experiences of postpartum anxiety during the COVID-19 pandemic: A mixed methods study and demographic analysis.

IntroductionThe first wave of the COVID-19 pandemic saw the reconfiguration of perinatal and maternity services, national lockdowns, and social distancing measures which affected the perinatal experiences of new and expectant parents. This study aimed to explore the occurrence of postpartum anxieties in people who gave birth during the pandemic.MethodsAn exploratory concurrent mixed-methods design was chosen to collect and analyse the quantitative and qualitative data of an online survey during the first UK lockdown. The survey included the Postpartum Specific Anxiety Scale-Research Short Form-for use in global Crises [PSAS-RSF-C] psychometric tool, and open-ended questions in relation to changes in birth plans and feelings about those changes and giving birth in a pandemic. Differences in measured scores were analysed for the participant's ethnicity, sexual orientation and disability using independent Student's t-tests, and for age, the analysis was completed using Pearson's correlation. Qualitative data from open-ended questions were analysed using a template analysis.ResultsA total of 1,754 new and expectant parents completed the survey between 10th and 24th April 2020, and 381 eligible postnatal women completed the psychometric test. We found 52.5% of participants reported symptoms consistent with a diagnosis of postnatal anxiety-significantly higher than the rates usually reported. Younger women and sexual minority women were more likely to score highly on the PSAS-RSF-C than their older or heterosexual counterparts (pDiscussionPostpartum anxiety is under-reported, and demographic differences in the rates of postpartum anxiety are under-researched. This research demonstrates for the first time a difference in postpartum anxiety rates amongst sexual minority women

A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

Introduction: The COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal) were exposed to a number of risk factors for mental ill health, including alterations to the way in which their perinatal care was delivered. Methods: A consensus statement was derived from a cross-disciplinary collaboration of experts, whereby evidence from collaborative work on perinatal mental health during the COVID-19 pandemic was synthesised, and priorities were established as recommendations for research, healthcare practice, and policy. Results: The synthesis of research focused on the effect of the COVID-19 pandemic on perinatal health outcomes and care practices led to three immediate recommendations: what to retain, what to reinstate, and what to remove from perinatal mental healthcare provision. Longer-term recommendations for action were also made, categorised as follows: Equity and Relational Healthcare; Parity of Esteem in Mental and Physical Healthcare with an Emphasis on Specialist Perinatal Services; and Horizon Scanning for Perinatal Mental Health Research, Policy, & Practice. Discussion: The evidence base on the effect of the pandemic on perinatal mental health is growing. This consensus statement synthesises said evidence and makes recommendations for a post-pandemic recovery and re-build of perinatal mental health services and care provision

Alcohol consumption and sport: a cross-sectional study of alcohol management practices associated with at-risk alcohol consumption at community football clubs

BackgroundExcessive alcohol consumption is responsible for considerable harm from chronic disease and injury. Within most developed countries, members of sporting clubs participate in at-risk alcohol consumption at levels above that of communities generally. There has been limited research investigating the predictors of at-risk alcohol consumption in sporting settings, particularly at the non-elite level. The purpose of this study was to examine the association between the alcohol management practices and characteristics of community football clubs and at-risk alcohol consumption by club members.MethodsA cross sectional survey of community football club management representatives and members was conducted. Logistic regression analysis (adjusting for clustering by club) was used to determine the association between the alcohol management practices (including alcohol management policy, alcohol-related sponsorship, availability of low- and non-alcoholic drinks, and alcohol-related promotions, awards and prizes) and characteristics (football code, size and location) of sporting clubs and at-risk alcohol consumption by club members.ResultsMembers of clubs that served alcohol to intoxicated people [OR: 2.23 (95% CI: 1.26-3.93)], conducted &lsquo;happy hour&rsquo; promotions [OR: 2.84 (95% CI: 1.84-4.38)] or provided alcohol-only awards and prizes [OR: 1.80 (95% CI: 1.16-2.80)] were at significantly greater odds of consuming alcohol at risky levels than members of clubs that did not have such alcohol management practices. At-risk alcohol consumption was also more likely among members of clubs with less than 150 players compared with larger clubs [OR:1.45 (95% CI: 1.02-2.05)] and amongst members of particular football codes.ConclusionsThe findings of this study suggest a need and opportunity for the implementation of alcohol harm reduction strategies targeting specific alcohol management practices at community football clubs.<br /

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Contractors on the Battlefield: When and How? Using the US Military Risk Management Framework to Learn from the Balkans Support Contract

Proceedings Paper (for Acquisition Research Program)For centuries, the US military has wrestled with decisions about when and how to use private contractors, especially ''Contractors on the Battlefield.'' Reports of mixed performance, inexperienced contracting officers, miscommunication, and profiteering date back to the Revolutionary War. History may be ''living history,'' in part, because decision-makers have lacked adequate means of systematically anticipating future outcomes and harvesting lessons from the past. The US military''s risk-management framework, a familiar tool in other operational settings, may fill that void. To illustrate, this paper applies the framework to the Army''s Balkans Support Contract (BSC); the contract covers a variety of life support, transportation, and maintenance services and has registered a substantial track record in deployment. The application demonstrates the utility of the risk-management framework and draws general lessons from the BSC experience for selecting service providers and for contract development, management, and oversight. Four deceptively simple lessons emerge from the analysis: first, not all risks are inherently contractual; most are environmental or activity-based. Second, risk is dynamic; appropriate responses change over time. Third, a contract is only as good as its customer; design and execution determine outcomes. And fourth, risk management is not risk elimination; not all risk can or should be eliminated.Naval Postgraduate School Acquisition Research ProgramApproved for public release; distribution is unlimited

The Changing Shape of the Defense Industry and Implications for Defense Acquisitions and Policy

Proceedings Paper (for Acquisition Research Program)In the mid-1990s, the US defense industry experienced a dramatic wave of consolidation. This paper seeks to establish the statistical facts of defense industry consolidation, including the ways in which it reshaped the industry in the 1990s; the ways in which it may continue to reshape the industry; and the forces that promote or discourage it. It also seeks to consider the implications of consolidation for defense acquisitions and policy. The paper places the events of the 1990s in the broad context of economic and industrial activity spanning almost five decades: 1958-2006. It draws primarily''and in new ways''from a contracting data set known as the DD350 and applies standard economic models and tools. The paper finds that consolidation has had its most pronounced effects at the highest levels of the industry; that the process of consolidation has abated, if not reversed itself, in recent years; and that larger domestic and international economic force have been at least as important as DoD budget decisions and policy in promoting consolidation. The DoD has a significant say in what happens in the defense industry but cannot control it.Naval Postgraduate School Acquisition Research ProgramApproved for public release; distribution is unlimited

The Changing Shape of the Defense Industry and Implications for Defense Acquisitions and Policy

Symposium Presentation (for Acquisition Research Program)Symposium PresentationNaval Postgraduate School Acquisition Research ProgramApproved for public release; distribution is unlimited