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Mark Ragins, award-winning past medical director of the MHALA Village and long-term Recovery Movement leader reflects upon the progress and disappointments of the last 30 years developing and promoting recovery. He describes the Recovery Model as a true "Thomas Kuhn" revolution built on three paradigm shifts (from illness-centered to person-centered, from professionally-driven to client-driven, and from deficit-based to strengths-based). Since it has always been an outsider movement, it has grown up in isolated "bubbles". Despite considerable accomplishments - in values, services, structures, outcomes, and tools - it has never been free to fully blossom into the full system it likely can be. Also, these bubbles have been more likely to compete with each other than to coalesce. A number of serious outside events in the last 15 years, from recessions to housing unaffordability to a pandemic may have limited Recovery?s ability to truly challenge and even replace the Medical Model system. True revolutions are always challenging and take time, but the "force" of the Recovery Movement is worth passing forwards to the next generation to create their own "spin-offs". [ABSTRACT FROM AUTHOR]

To improve ore recovery ratio and the quality of medium-length hole blasting in non-pillar sublevel caving method, this study first investigated the effects of brow line failure on rock movement and ore recovery indexes based on rock blasting fragmentation mechanisms, the granular dynamics theory and ore drawing theory. Subsequently, control strategies to enhance blasting quality and reduce brow line failure were explored through energy impact crushing experiments, experiments on the radial rock-breaking effects of blast holes with different detonation velocities, and underground physical simulation experiments using full blast hole length detonating cord blasting. The experimental results indicate that as the degree of brow line failure increases, the ore recovery ratio gradually decreases, while the waste ratio gradually increases. Bottom initiation and the use of the full blast hole length detonating cord were identified as the optimal initiation method and charging structure for medium-length hole blasting in non-pillar sublevel caving method, effectively improving blasting quality and reducing damage to the brow line. [ABSTRACT FROM AUTHOR]

Rubble is ubiquitous on coral reefs and can aggregate into fields, forming a significant component of the reef substrate. Rubble fields often remain unconsolidated, with the component rubble pieces subject to movement that is dependent on hydrodynamic forcing, rubble size, shape, and other factors. Settlement of corals to rubble fields has long been assumed, but the dynamic movement of rubble pieces has been presumed to deter settlement and is thought to contribute to high post-settlement mortality. Rubble often forms on coral reefs following severe disturbances, and is predicted to increase under climate change, with the potential to impact settlement and recruitment-dependent recovery processes. Through a series of laboratory and field experiments, we demonstrate that corals from broadcast spawning species on the Great Barrier Reef will settle on unstable substrates, even those in constant motion. We also observed more coral spat on settlement tiles suspended in the water column than those fixed to the reef using a common approach to censusing settlement. Sampling of natural rubble on the reef 50 days after a mass-spawning event confirmed the presence of similar numbers of coral settlers on rubble and on tiles fixed to the reef. These results suggest that rubble fields are places of significant settlement for broadcast spawning corals. Suspended tiles were also surprisingly effective in collecting coral settlers, demonstrating that a change in sampling protocol can produce significant variation in settlement data and strengthening the argument for standardisation of settlement-monitoring protocols, particularly at a time of growing need for reliable metrics. These results also suggest that movement of rubble is not precluding settlement outright, but rather post-settlement processes (i.e. competition, predation, shading or burial by shifting rubble) are limiting recruitment to rubble patches. Consequently, rubble stabilisation may increase the survival of spat that have settled in these environments. [ABSTRACT FROM AUTHOR]

Purpose: Trigger finger (TF) is a common hand condition that can be treated with surgery. We conducted a systematic review and meta-analysis to assess whether ultrasound-guided (US-guided) percutaneous surgery is superior to other conventional surgical methods. Methods: We conducted a comprehensive search in Medline, Embase, and the Cochrane Library to identify relevant studies. We included randomized clinical trials (RCTs) and observational studies comparing US-guided TF release with blind percutaneous or open approaches. We combined Risk Ratios (RR) and Mean Differences (MD) with 95% Confidence Intervals (CI) across studies. Data processing and analysis were conducted using R software, version 4.3.1. Results: Our analysis included eight RCTs and two observational studies with 555 patients. US-guided surgery significantly reduced postoperative DASH scores (MD -3.75 points; 95% CI = -7.48, -0.02; p < 0.01), shortened time to resume activities (MD -11.52 days; 95% CI = -16.13, -6.91; p < 0.01), hastened discontinuation of oral analgesics (MD -4.44 days; 95% CI = -8.01, -0.87; p < 0.01), and improved patient satisfaction scores (RR 1.13; 95% CI = 1.04, 1.23; p = 0.75). There were no significant differences in VAS scores, time to movement recovery, or surgical success rate. Conclusion: Ultrasound-guided percutaneous release is a safe, effective, and superior alternative for treating TF compared to other methods, leading to improved DASH scores, quicker recovery, faster cessation of oral analgesics, and enhanced patient satisfaction. [ABSTRACT FROM AUTHOR]

Individuals with psychiatric illness believe that voting is important. However, these individuals have lower rates of voting when compared to the general population. A survey of psychiatrically hospitalized adult patients was conducted to assess perceptions of and barriers to voting in patients with psychiatric illness. Data from 113 surveys was analyzed. A majority of survey participants agreed that they cared about voting, that their vote made a difference, and that their vote was important. 74% of individuals reported previously experiencing at least one barrier when exercising their right to vote. The most commonly experienced barriers reported were not having enough information to make an informed choice, not knowing where to vote, not having transportation, and not being registered to vote. Individuals who encountered a higher number of barriers in the past had a higher chance of encountering barriers more often. In conclusion, a high percentage of individuals with mental illness severe enough to warrant hospitalization have experienced barriers to voting, with many experiencing multiple barriers. Reduction of these barriers is important, as voting and the resultant public policies can directly affect this population's mental health and access to both mental and physical healthcare services. [ABSTRACT FROM AUTHOR]

Purpose: Facial nerve dysfunction (FND) is a frequent and serious parotidectomy outcome. Intraoperative facial nerve monitoring (IFNM) is an increasingly used technique to identify the facial nerve (FN) and minimize its injury. This study aimed to evaluate the determinant factors in the presence and severity of FND after parotidectomy, including IFNM. Study design, setting and methods: A total of 48 patients consecutively submitted to parotidectomy between 2005 and 2020 in a tertiary hospital were retrospectively analyzed. The House–Brackmann Scale (HBS) was used to assess the severity of FND. Results: There was a mean age of 54.2 ± 17.8 years, 50% were male. Pleomorphic adenoma (41.7%) and Warthin's tumor (25.0%) were most common. From the 23 patients (47.9%) who developed some degree of FND (HBS score of 3.41 ± 1.53), 19 (82.6%) showed facial movement recovery, with a mean recovery time of 4.78 ± 2.53 months. IFNM was performed in 39.6% of the surgeries. The use of IFNM (p = 0.514), the type of surgery—partial or total parotidectomy—(p = 0.853) and the type of histology—benign or malignant lesion—(p = 0.852) did not significantly influence the presence of FND in the postoperative period. However, in the subgroup of patients who developed FND, the HBS value was significantly lower in cases of benign pathology (p = 0.002) and in patients who underwent IFNM (p = 0.017), denoting a significantly lower severity. Conclusion: In the present study, IFNM and the existence of a benign lesion have been shown to be associated with lower severity of FND. [ABSTRACT FROM AUTHOR]

The aim of this research was to study the dependence of poststroke motor impairments of paretic and non-paretic arm on lesion lateralization, and paresis severity. The influence of lesion lateralization and paresis severity on the recovery of motor functions (MFs) after rehabilitation using a hand exoskeleton controlled by a brain–computer interface was also investigated. The study included 24 patients, 12 with left and 12 with right hemispheric lesions. Each group included six patients with moderate paresis and six patients with severe paresis. Isolated movements in the joints of paretic and non-paretic arms were used as motor tests performed before and after the course of rehabilitation. Joint torque and movement isolation degree were used to assess MFs. It was shown that the joint torques of the non-paretic arm were greater in the case of left hemispheric lesions, characterized by more pronounced asymmetry of joint torques than in right hemispheric lesions. This might be due to a greater imbalance in the activity of hemispheres. The effectiveness of rehabilitation was manifested in: (1) an increase in joint torques in both paretic and non-paretic arms and (2) an increase in the symmetry of biomechanical parameters of paretic and non-paretic arms, potentially indicating the restoration of balance in the hemispheric activity. The biomechanical analysis of isolated movements suggested the pronation–supination movement in a vertical forearm position as a sensitive indicator of MF recovery after stroke. [ABSTRACT FROM AUTHOR]

Foreign bodies in the intra-orbital area are a rare occurrence. It can be metallic or non-metallic. Intra-orbital foreign bodies can present with a variety of complications depending upon its size and location. We report a case of intra-orbital foreign body which was successfully removed by trans-nasal endoscopic approach.A 12 year old boy with an intra-orbital wooden foreign body in the medial extra-conal space was presented three days post trauma. He had normal visual acuity but there was painful restriction of eye movement. Foreign body was removed and pus drained by trans-nasal endoscopic approach. Post operatively he gradually regained his eye movements. Post operatively patient had complete recovery of eye movements. Traditionally intra-orbital foreign bodies were removed by external approach. With advancement in technology medial intra-orbital foreign bodies can be removed by trans-nasal endoscopic approaches. [ABSTRACT FROM AUTHOR]

In a paper published recently in this journal, Buben attempted to show the philosophical relevance of Unamuno's philosophical works when addressing the current debate on whether an endless existence would be something desirable—a debate which is nowadays commonly known as "The Makropulos Debate" since it was Bernard Williams's "The Makropulos Case: Reflections on the Tedium of Immortality" (1973) that aroused interest in this question among contemporary analytic philosophers. Unfortunately, Buben's paper fails to capture or even outline the reasoning behind Unamuno's claim that we all naturally (and so, inevitably) long for an endless existence —and consequently it also fails to clarify how Unamuno's position may (if so) contribute to the current philosophical debate on the question as to whether an endless existence would be something desirable. In this paper I will point out that Unamuno's affirmation that we all, without exception, long for an endless existence is grounded in his metaphysical claim that the most basic and natural inclination of all singular things is to increase their own singularity. In doing so, I will also be showing that Unamuno's proposal is not philosophically relevant when addressing the current debate on the question as to whether living an endless existence would be something desirable. [ABSTRACT FROM AUTHOR]

To evaluate and compare the efficacy of two techniques for the treatment of acute acromioclavicular joint dislocation, the charts of 60 patients diagnosed with acute Rockwood type IV and V acromioclavicular joint dislocation that undergone arthroscopic fixation procedure with single tunnel technique (N = 30, 30.7 ± 5.7 years old) or coracoid sling technique (N = 30, 30.1 ± 5.4 years old) fixation were retrospectively reviewed. The Visual Analog Scale pain score, Constant shoulder functionality score, Karlsson acromioclavicular joint score, the time of return to sports and activity, and plain radiographs of the affected shoulder at different time points of follow-up were recorded for a minimum of 2 years post-op. The majority of the patients recovered to their preoperative activity levels with few complications. The average postoperative acromioclavicular and coracoclavicular distances were significantly narrower than preoperative measurements in both groups without significant difference between the two groups at 2 years post-op (P < 0.05). The coracoid sling technique group had reduced operative time, shorter time of recovery of shoulder movements, higher Constant functionality scores and Karlsson acromioclavicular joint scores, and fewer complications than the single tunnel technique group at the last follow-up (P < 0.05). Therefore, coracoid sling technique achieved superior clinical outcomes with fewer complications compared to the traditional single tunnel technique in arthroscopic treatment of acute acromioclavicular joint dislocation. [ABSTRACT FROM AUTHOR]

The recovery movement in mental health emphasizes holistic and individualized treatment through many pathways to recovery, though the majority of mental health treatment and existing literature emphasize pharmacotherapy and medication adherence for major mental health conditions. The reimbursement system and research literature are oriented around formal diagnostic categories based in a biomedical perspective of mental health problems, but diagnostic labels also carry stigma and influence how clients perceive themselves and their mental health problems. To investigate the influence of labeling and perception in alternate pathways to recovery, this qualitative study explores the lived experience of diagnostic labeling and self-perception among persons in sustained recovery without ongoing medication use. The study used a grounded theory approach to analyze data from in-depth interviews with 19 participants. Participants had previously received diagnoses of schizophrenia, bipolar disorder, and/or major depression, met criteria for functional recovery, and were no longer taking psychotropic medications for 12 months. The participants identified positive perceptions—externalization of the problem and hope for an external "cure"—and negative perceptions—stigma and powerlessness—following a diagnostic label. Notably, the theme of powerlessness related to the initially positive themes as the diagnosis placed the problem outside their control and some participants experienced treatments as unhelpful. Participants succeeded in overcoming powerlessness by finding internalized solutions and redefining their mental health experience as transformative. Rather than pressing clients to accept their diagnosis or "illness," mental health providers can support multiple pathways to recovery by emphasizing empowerment and personal meaning-making in the recovery process. [ABSTRACT FROM AUTHOR]

Maintaining balance is an essential skill regulated by the central nervous system (CNS) that helps humans to function effectively. Developing a physiologically motivated computational model of a neural controller with good performance is a central component for a large range of potential applications, such as the development of therapeutic and assistive devices, diagnosis of balance disorders, and designing robotic control systems. In this paper, we characterize the biomechanics of postural control system by considering the musculoskeletal dynamics in the sagittal plane, proprioceptive feedback, and a neural controller. The model includes several physiological structures, such as the feedforward and feedback mechanism, sensory noise, and proprioceptive feedback delays. A high-gain observer (HGO)-based feedback linearization controller represents the CNS analog in the modeling paradigm. The HGO gives an estimation of delayed states and the feedback linearization control law generates the feedback torques at joints to execute postural recovery movements. The whole scheme is simulated in MATLAB/Simulink. The simulation results show that our proposed scheme is robust against larger perturbations, sensory noises, feedback delays and retains a strong disturbance rejection and trajectory tracking capability. Overall, these results demonstrate that the nonlinear system dynamics, the feedforward and feedback mechanism, and physiological latencies play a key role in shaping the motor control process. [ABSTRACT FROM AUTHOR]

Many regions of human movement capturing are commonly used. Still, it includes a complicated capturing method, and the obtained information contains missing information invariably due to the human's body or clothing structure. Recovery of motion that aims to recover from degraded observation and the underlying complete sequence of motion is still a difficult task, because the nonlinear structure and the filming property is integrated into the movements. Machine learning model based two-dimensional matrix computation (MM-TDMC) approach demonstrates promising performance in short-term motion recovery problems. However, the theoretical guarantee for the recovery of nonlinear movement information lacks in the two-dimensional matrix computation model developed for linear information. To overcome this drawback, this study proposes MM-TDMC for human motion and dance recovery. The advantages of the machine learning-based Two-dimensional matrix computation model for human motion and dance recovery shows extensive experimental results and comparisons with auto-conditioned recurrent neural network, multimodal corpus, low-rank matrix completion, and kinect sensors methods. [ABSTRACT FROM AUTHOR]

Spinal reciprocal inhibition (RI) and intracortical inhibition are important physiological mechanisms for voluntary movement control and functional recovery of voluntary movement in patients with stroke. Spasticity, which impairs motor performance, is one of the major manifestations of stroke. RI may be involved in reducing spasticity. This might allow finger extension, and, therefore, better hand function by reducing co-contraction with finger extensors. One potential mechanism of functional reorganization of the motor cortex is that pre-existing masking pathways are unmasked by decreased intracortical inhibition. The inhibitory neurotransmitter GABA plays an important role in this process. Changes in RI might be mediated through unmasking of cortical pathways through decreased inhibition, with the neurotransmitter GABA. These changes can be assessed using short-latency intracortical inhibition (SICI) and RI. Functional recovery in the chronic phase of stroke induced by rehabilitation was accompanied by SICI and spinal RI changes. Cortical reorganization and spinal plasticity might play important roles in functional recovery induced by rehabilitation, even in patients with chronic severe hemiparesis. This review aims to provide a focused overview of neuroplasticity of spinal RI and intracortical inhibition associated with functional motor recovery from stroke. [ABSTRACT FROM AUTHOR]

Objectives. To study the characteristics of the movement stereotype in the early recovery period of ischemic stroke in the basin of the internal carotid artery and the vertebrobasilar system. Materials and methods. Eleven patients (five men, six women, mean age 57.2 ± 5.2 years) were studied 4–6 weeks after ischemic stroke. Initial scores on the NIHSS averaged 6.2 ± 0.8, with 3.9 ± 0.7/3.7 ± 0.8 points for arm/hand paresis and 4.3 ± 0.6/4.0 ± 0.5 points for leg/foot paresis. Foci were located in the basin of the internal carotid artery in seven patients and in the vertebrobasilar system in four. Investigations were run on admission and after 2–2.5 weeks. Changes on the FIM and Ashworth spasticity scales, a hand dexterity test (nine hole peg test, NHPT), and the Timed Up and Go test (TUG) were evaluated, along with changes on the Berg balance test and the 20-point vertigo scale, the MMSE, and the Beck and Spielberger questionnaires. Video analysis of movements was carried out using a Physiomed Smart system (Physiomed, Germany) using the Davis protocol. Results. On the background of rehabilitation measures, all patients showed decreases in the severity of paresis, improvements on the FIM, Ashworth, and Berg scales and on the NHPT and TUG tests. Patients with foci in the vertebrobasilar system, in contrast to those with foci in the basin of the internal carotid artery, had impairments to balance detected on the 20-point vertigo scale. On video analysis, all patients showed changes in the movement stereotype in the form of shortening of the length and increases in the width of the gait, with decreases in speed and lengthening of the stepping cycle; these changes were more marked for foci in the vertebrobasilar system. A distinguishing feature for foci located in the vertebrobasilar system was forward tilting of the pelvis, while lateral tilting of the pelvis was seen with foci located in the basin of the internal carotid artery. Conclusions. Focus location in mild ischemic stroke can affect the features of recovery and movement stereotypy, and this should be considered in rehabilitating these patients. [ABSTRACT FROM AUTHOR]

Most studies of major disasters focus on the impacts of the event and the short-term responses. Some evaluate the underlying causes of vulnerability, but few follow-up events years later to evaluate the consequences of early framings of the recovery process. The objective of this study was to improve understanding of the influence that recovery narratives have had on how decisions and actions are undertaken to recover from a disaster, and what influence this has had in turn, on long-term resilience. The study drew on comparisons and insights from four case studies in Southeast Asia: (1) local innovations that led to new policies for living with floods in the Mekong Delta in Vietnam following the 2001 Mekong River floods; (2) livelihood and infrastructure responses in Prey Veng, Cambodia, after the 2001 and 2011 Mekong River floods; (3) the role of the Panglima Laot, a traditional fisheries management institution, in the recovery process following the 2004 Indian Ocean tsunami in Aceh province, Indonesia; and (4) the challenges faced by small and medium enterprises in a market area following the 2011 floods in Bangkok, Thailand. This study identified alternative narratives on the purpose and means of ‘recovery’ with implications for who ultimately benefits and who remains at risk. The study also found both formal and informal loss and damage systems were involved in recoveries. The findings of this study are important for improving the performance of loss and damage systems, both existing and planned, and, ultimately, supporting more climate resilient development that is inclusive. [ABSTRACT FROM AUTHOR]

In the aftermath of Tropical Storm Irene, recovery groups emerged throughout Vermont to assist victims with needs remaining after personal savings, insurance payments, and government assistance were depleted. This research links the concepts of 'the strange attractor' and 'butterfly effect' from chaos theory with theories of social capital to examine how initial conditions influence the emergence of recovery groups and subsequent recovery processes. In many communities, recovery group formation was driven by informal community efforts via bonding and bridging social capital. In areas with less social capital, governmental actors from within the state and federal disaster framework facilitated the formation of recovery groups via linking social capital. Formation pathways had cascading impacts on recovery group ability to acquire resources for group administration and victim recovery. Recovery groups driven by informal community actors experienced proliferating social capital and access to high-value resources. However, linking social capital with the state and federal disaster framework ensured all recovery groups had adequate resources for victim recovery and equalized growing inequalities across them. All recovery groups were closing their remaining victim cases within 2 years after the disaster. Vermont's success points to how the state and federal disaster framework can coordinate with informal community efforts to create an adaptive recovery process that leverages their complementary strengths. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this prospective study was to describe the course of health status (HS), health-related quality of life, and quality of life (QOL) in patients with lower extremity fractures (LEF) up to 6 months post-fracture.Methods: Patients (n = 171; age range 18-100 years) completed the World Health Organization Quality of Life assessment instrument-Bref (WHOQOL-Bref) and the Short Musculoskeletal Function Assessment questionnaire (SMFA) at time of diagnosis (i.e., pre-injury status), 1 week, and 6 months post-fracture. Linear mixed modeling was performed.Results: Interaction effects of time with treatment were detected for the WHOQOL-Bref facet Overall QOL and General health (p = .002) and Physical health (p = .003). Patients did not return to their pre-injury Physical health, Psychological health, and Environment 6 months post-fracture (p < .05). No effects were found for Social relationships. The SMFA subscale Lower extremity dysfunction showed main effects for time and treatment (p < .0001) with full recovery at 6 months (p = .998). An interaction effect of time with treatment was found for Daily life consequences (p < .0001) with nonoperatively treated patients showing full recovery (p = 1.00), whereas surgically treated patients did not (p = .002).Conclusions: Six months after LEF, patients still experienced impaired physical and psychological health on the WHOQOL-Bref compared to their pre-injury status. However, patients showed full recovery on SMFA Lower extremity dysfunction, indicating that the choice of the questionnaire influences the derived conclusions. LEF did not affect satisfaction with social relationships. [ABSTRACT FROM AUTHOR]

Rationale: Dysregulated reward processing is a hallmark feature of drug addiction; however, scant research has evaluated restructuring reward processing in the context of addiction treatment. Objectives: We examined effects of Mindfulness-Oriented Recovery Enhancement (MORE) on reward responsiveness (RR) and opioid cue-reactivity in a sample of chronic pain patients with opioid use problems. We previously reported that MORE decreased pain, opioid misuse, and craving relative to a social support control group (SG). Here, we examined whether these outcomes were linked to changes in RR in a subset of participants. Methods: Participants were chronic pain patients (71 % women, age 46.6 ± 13.9) who received MORE ( n = 20) or SG ( n = 29). RR was measured before and after 8 weeks of treatment via heart rate (HR) and heart rate variability (HRV) responses during a dot probe task that included opioid-related, pain-related, and natural reward stimuli, as well as craving ratings. Results: The MORE group, who reported decreased opioid misuse and opioid craving during treatment, evidenced less subjective opioid cue-reactivity, greater HR decelerations, and greater increases in HRV to all cues after treatment compared to the SG; HR and HRV effects were most pronounced for natural reward cues. Within the MORE group, HR deceleration to natural reward cues was correlated with increased subjective arousal to the cues, whereas HR deceleration to opioid cues was correlated with decreased subjective arousal. Effects of MORE on craving were mediated by enhanced RR. Conclusions: Results suggest that during treatment with MORE, cardiac-autonomic responsiveness to non-drug reward increases, while reactivity to opioid reward decreases. Studies are needed to discern whether changes in RR were a result or a determinant of reductions in opioid misuse and craving. RR may play a role in addiction treatment. [ABSTRACT FROM AUTHOR]

The aim of this longitudinal study was to compare two recovery modes (active vs. passive) during a seven-week high-intensity interval training program (SWHITP) aimed to improve maximal oxygen uptake ( $$ \dot{V}{\text{O}}_{{ 2 {\text{max}}}} $$), maximal aerobic velocity (MAV), time to exhaustion ( t) and time spent at a high percentage of $$ \dot{V}{\text{O}}_{{ 2 {\text{max}}}} $$, i.e., above 90 % ( t90 $$ \dot{V}{\text{O}}_{{ 2 {\text{max}}}} $$) and 95 % ( t95 $$ \dot{V}{\text{O}}_{{ 2 {\text{max}}}} $$) of $$ \dot{V}{\text{O}}_{{ 2 {\text{max}}}} $$. Twenty-four adults were randomly assigned to a control group that did not train (CG, n = 6) and two training groups: intermittent exercise (30 s exercise/30 s recovery) with active (IE, n = 9) or passive recovery (IE, n = 9). Before and after seven weeks with (IE and IE) or without (CG) high-intensity interval training (HIT) program, all subjects performed a maximal graded test to determine their $$ \dot{V}{\text{O}}_{{ 2 {\text{max}}}} $$ and MAV. Subsequently only the subjects of IE and IE groups carried out an intermittent exercise test consisting of repeating as long as possible 30 s intensive runs at 105 % of MAV alternating with 30 s active recovery at 50 % of MAV (IE) or 30 s passive recovery (IE). Within IE and IE, mean t and MAV significantly increased between the onset and the end of the SWHITP and no significant difference was found in t90 VO and t95 VO. Furthermore, before and after the SWHITP, passive recovery allowed a longer t for a similar time spent at a high percentage of VO. Finally, within IE, but not in IE, mean VO increased significantly between the onset and the end of the SWHITP both in absolute ( p < 0.01) and relative values ( p < 0.05). In conclusion, our results showed a significant increase in VO after a SWHITP with active recovery in spite of the fact that t was significantly longer (more than twice longer) with respect to passive recovery. [ABSTRACT FROM AUTHOR]

Research on engagement within community-based psychiatric services in the UK has mainly focussed on factors related to those 'at risk' of non-attendance or non-compliance, with the tacit assumption that those in regular attendance are largely content and hence not a priority. The present study systematically explored the experiences and views of 25 people with severe and enduring mental illness who had regularly attended out-patient settings for more than 5 years. Regular attendance at consultations was not synonymous with satisfaction-in fact it masked varying levels of unmet needs and 'de-humanisation'. In order to establish and maintain non-coercive community services that prioritise 'recovery' above illness and 'risk' containment, it is essential that the experiences of people in established and apparently 'less troublesome' therapeutic relationships are also taken into account and integrated into policy and practice. [ABSTRACT FROM AUTHOR]

In this article, we look at how an addicted person can through the therapeutic process replace the addiction 'short cut' counterfeit quest for wholeness with an authentic quest for wholeness using Wilber' transpersonal spectrum of development model by working through different developmental levels during three stages of recovery. The first stage of recovery focuses on abstinence. A second stage of recovery beyond abstinence is called for of embracing and working through the emotional underbelly beneath the addictive process. Eventually, a third phase of recovery can be worked on which entails letting go of the addiction to the separate self and the mind by embracing nondual living. Wilber's transpersonal model of development is utilized including ten stages, and three overall phases of development including: prepersonal, personal, and transpersonal. Possible pathologies and treatment interventions are reviewed for each level including specific addiction and recovery implications for. Throughout this article, case studies and anecdotal accounts from past clients will be used to better exemplify this process. [ABSTRACT FROM AUTHOR]

In addiction research it is imperative to explore, not only motivations that precipitate drug use and abuse, but also the changes which take place in the social environment that enable individuals suffering from an addictive disorder to 'break the cycle' and reach a position of recovery. Therefore the main aims of the study were to explore the idiosyncratic experiences of female heroin addicts. Five female participants were recruited. Open ended, semi-structured interviews were performed; their narratives were then analysed according to the principles of Interpretative Phenomenological Analysis (IPA; Smith et al. ). Three recurrent super-ordinate themes were developed including: childhood experiences, physiological and psychological effects and perceptions of recovery. Our interpretation of the data suggests that the significant experiences of these women, as children, included: damaged relationships, unreasonable responsibilities, anxiety and victimisation. New relationships, new responsibilities and new opportunities appear to be significant motives in relation to attempting to reduce drug consumption. These findings are discussed in relation to the potential contributing factors for heroin addiction in women and their transition to recovery. [ABSTRACT FROM AUTHOR]

This cultural case study investigates one U.S. psychosocial rehabilitation organization’s (Horizons) attempt to implement the recovery philosophy of the U.S. Recovery Movement and offers lessons from this local attempt that may inform global mental health care reform. Horizons’ “recovery-oriented” initiatives unwittingly mobilized stressful North American discourses of valued citizenship. At times, efforts to “empower” people diagnosed with schizophrenia to become esteemed self-made citizens generated more stressful sociocultural conditions for people whose daily lives were typically remarkably stressful. A recovery-oriented mental health system must account for people diagnosed with schizophrenia’s sensitivity to stress and offer consumers contextually relevant coping mechanisms. Any attempt to export U.S. mental health care practices to the rest of the world must acknowledge that (1) sociocultural conditions affect schizophrenia outcomes; (2) schizophrenia outcomes are already better in the developing world than in the United States; and (3) much of what leads to “better” outcomes in the developing world may rely on the availability of locally relevant techniques to address stress. [ABSTRACT FROM AUTHOR]

There has been increasing commentary about the degree to which Assertive Community Treatment (ACT) teams provide recovery-oriented services, often centered around the question of the use of coercion. The present study was designed to contribute to this discussion through an examination of recovery-oriented service provision and ACT fidelity among 67 teams in the province of Ontario, Canada. The findings indicated a moderate to high degree of recovery orientation in service provision, with no significant relationship between ACT fidelity and consumer and family/key support ratings of recovery orientation. A significant relationship was found, however, between the ‘nature of services’ domain of the Dartmouth Assertive Community Treatment Scale (DACTS) and ratings of recovery orientation provided by staff and ACT coordinators. These findings extend the existing dialogue regarding the evaluation of ACT intervention process factors and indicate that current measures of fidelity may not be adequately addressing dimensions of recovery-oriented service provision. [ABSTRACT FROM AUTHOR]

The mental health recovery movement promotes patient self-determination and opposes coercive psychiatric treatment. While it has made great strides towards these ends, its rhetoric impairs its political efficacy. We illustrate how psychiatry can share recovery values and yet appear to violate them. In certain criminal proceedings, for example, forensic psychiatrists routinely argue that persons with mental illness who have committed crimes are not full moral agents. Such arguments align with the recovery movement’s aim of providing appropriate treatment and services for people with severe mental illness, but contradict its fundamental principle of self-determination. We suggest that this contradiction should be addressed with some urgency, and we recommend a multidisciplinary collaborative effort involving ethics, law, psychiatry, and social policy to address this and other ethical questions that arise as the United States strives to implement recovery-oriented programs. [ABSTRACT FROM AUTHOR]

Of current interest to the field are clinical frameworks that foster recovery. The authors offer a psycho-developmental model that parallels Erik Erikson’s theory of human development, and theorize that the process of psychiatric recovery involves a psychic reworking of these fundamental steps. Understanding recovery in this context allows the client and the practitioner of psychiatric rehabilitation to design and implement a coherent treatment strategy. [ABSTRACT FROM AUTHOR]

With the increasing prominence of the notions of “recovery” and “recovery-oriented practice,” practitioners, program managers, and system leaders are increasingly asking about the relationship between “evidence-based practices” and recovery. After reviewing the concepts of recovery from mental illness, being in recovery with a mental illness, recovery-oriented care, and evidence-based medicine, the authors argue for a complementary relationship between recovery and evidence-based practices. This relationship is neither simple nor straightforward, but results in a whole that is greater than the sum of its parts through which each element benefits from the influence of the other. [ABSTRACT FROM AUTHOR]

The article focuses on the issues discussed by the Betty Ford Institute Consensus Panel regarding their own definition of recovery in the field of alcohol and drug addiction. The Betty Ford Institute has formed a panel of professionals in September 2006 to define recovery, and a second conference has followed after years to reexamine the initial definition created by the original panel. Among the issues discussed include the recovery process, and issues of sobriety and citizenship.

This study examines the prevalence of endorsing the twelve step approach and the use of prayer, meditation, and holistic techniques in a national sample of 139 substance abuse treatment centers. Ninety one percent of the programs endorsed a twelve step orientation. Twenty six percent of the programs actively used prayer and 58% used meditation as a component of treatment. Thirty three percent of the programs used some form of a self-designated holistic technique. There was a divergent range of techniques that were used by programs, falling into four broad categories: (1) nutrition, exercise, relaxation and physical health; (2) recreation and adventure-based activities; (3) religious and spiritual practices; and (4) the use of specific therapy modalities. [ABSTRACT FROM AUTHOR]

Spirituality and religiousness have long been associated with physical and mental health. The scientific treatment of religiosity as a multi-dimensional phenomenon is well established, especially in relation to chemical dependence treatment. Indeed, over 100 instruments are available for measuring various dimensions of religiosity. The more recent emergence of spirituality as an accepted construct in research has seen the development of a growing number of instruments to measure aspects of spirituality. The authors selected ten spirituality scales for review and discussion, and provided information relating to the scales’ development, psychometrics, format, scoring, and availability. The scales are then conceptualized in terms of their aggregate and overlapping usefulness for research and practice, and suggestions are made concerning the salient dimensions of spirituality measured by each scale. The scales are presented as defining an increased sense of internalized spirituality that contributes to positive psychological and emotional outcomes underpinning recovery from chemical dependence. [ABSTRACT FROM AUTHOR]

In this paper, we propose Self-Adapting Recovery Net (SARN), an extended Petri net model, for specifying exceptional behavior in business processes. SARN adapts the structure of the underlying Petri net at run time to handle exceptions while keeping the Petri net design easy. The proposed framework caters for the specification of high-level recovery policies that are incorporated either with a single task or a set of tasks, called a Recovery Region. These recovery policies are generic directives that model exceptions at design time together with a set of primitive operations used at run time to handle the occurrence of exceptions. We identified a set of recovery policies that are useful .and commonly needed in many practical situations. A tool has been developed to illustrate the viability of the proposed exception handling technique. [ABSTRACT FROM AUTHOR]

The goal of this study was to examine the efficacy of minimal treatment interventions for concerned significant others (CSOs) of problem gamblers. One hundred and eighty-six participants (82% females, 56% spouses) were randomly assigned to one of three groups: the first minimal intervention group received a self-help workbook [based on behavioral principles, modified from the Community Reinforcement and Family Therapy (CRAFT) model] and the second minimal intervention group received the workbook plus telephone support. The control condition received a treatment resource information package. Overall, all participants reported significant improvement in personal and relationship functioning and gambling behavior and consequences at the 3- and 6-month follow-up. The data demonstrated differences in favor of the interventions in three areas: days gambling, satisfaction with the program, and number who had their needs met. There was no difference in the number who had entered treatment. It may be that CSOs require more guidance and follow-up support to achieve these goals using the CRAFT procedures and strategies. [ABSTRACT FROM AUTHOR]

When a group of 20 college students and seven adult leaders traveled to the Gulf Coast to repair houses damaged by Hurricane Katrina, they did not realize the multiple ways that they themselves would be renewed. Finding God in the struggle, celebrating diversity, and living with gratitude became the result that subtly changed many lives. [ABSTRACT FROM AUTHOR]

Relapse rates among pathological gamblers are high with as many as 75% of gamblers returning to gambling shortly after a serious attempt to quit. The present study focused on providing a low cost, easy to access relapse prevention program to such individuals. Based on information collected in our ongoing study of the process of relapse, a series of relapse prevention booklets were developed and evaluated. Individuals who had recently quit gambling (N = 169) were recruited (through media announcements) and randomly assigned to a single mailing condition in which they received one booklet summarizing all of the relapse prevention information or a repeated mailing condition in which they received the summary booklet plus 7 additional booklets mailed to them at regular intervals over the course of a year period. Gambling involvement over the course of the 12-month follow-up period, confirmed by family or friends, was compared between the two groups. Results indicated that participants receiving the repeated mailings were more likely to meet their goal, but they did not differ from participants receiving the single mailing in frequency of gambling or extent of gambling losses. The results of this project suggest that providing extended relapse prevention bibliotherapy to problem gamblers does not improve outcome. However, providing the overview booklet may be a low cost, easy to access alternative for individuals who have quit gambling. [ABSTRACT FROM AUTHOR]

This study explores the constructed meanings of falling in love in midlife. In depth interviews were conducted with 12 participants, all of whom had experienced falling in love in midlife. Analysis of the interview data suggest that midlife forms the prism through which the experience of falling in love is perceived: it provides the context, colors the experience, and characterizes its unique nature. The uniqueness is created primarily through dialectic between affirmations (compatibility with the notion of love) and negations (contrasting experiences). [ABSTRACT FROM AUTHOR]

Focuses on the link among social support, recovery status and personal well-being in individuals with dual diagnosis. Importance of social support in influencing human behavior; Role of spirituality in the recovery process of drug addicted persons; Difficulties experienced by drug addicted persons in managing their emotions; Benefits provided by support resources.

Jealousy often interferes with the recovery process for alcoholic families. Recovery for such families requires that external boundaries shift from rigid and closed to open and more permeable. Jealousy often erupts as families struggle with shifting boundaries. When jealousy is recognized as a system dynamic, necessary to the process of recovery, it is manageable. The key to the treatment of jealousy in recovering families is recognizing the crucial role of boundaries in both the development and recovery processes. [ABSTRACT FROM AUTHOR]