Recovery Principles Research Articles

Sustainable Sanitation: an appropriate solution in rural areas

In Morocco, reuse of treated wastewater can reduce the negative effects of drought in the agricultural sector. However, it is necessary to adopt a sustainable sanitation in order to reduce the risk of this type of water on public health and environment. This new sanitation concept is based on the principle of separation, recovery and reuse of wastewater and taking in consideration the social, economic, environmental, and institutional of the local conditions. The aim of this article is: to give the main results of a survey conducted in 2017 at Dayet Ifrah village which housed the first pilot ecological sanitation project in Morocco concerning appreciation and attitude of the population towards this new system of sanitation; and on the other hand to study the efficiency of a pilot scale system composed on three filters used to treat domestic wastewater coming from a single house in Meknes. In general, ecological sanitation is appreciated by the population of the village and showed its effectiveness to improve sanitation in Moroccan context. The pilot scale system proved his effectiveness to trait organic pollution and nutrients, faecal pollution and parasites.

Recovery Colleges Characterisation and Testing in England (RECOLLECT): rationale and protocol

BackgroundRecovery Colleges are a relatively recent initiative within mental health services. The first opened in 2009 in London and since then numbers have grown. They are based on principles of personal recovery in mental health, co-production between people with lived experience of mental health problems and professionals, and adult learning. Student eligibility criteria vary, but all serve people who use mental health services, with empirical evidence of benefit. Previously we developed a Recovery College fidelity measure and a preliminary change model identifying the mechanisms of action and outcomes for this group, which we refer to as service user students. The Recovery Colleges Characterisation and Testing (RECOLLECT) study is a five-year (2020–2025) programme of research in England. The aim of RECOLLECT is to determine Recovery Colleges’ effectiveness and cost-effectiveness, and identify organisational influences on fidelity and improvements in mental health outcomes. MethodsRECOLLECT comprises i) a national survey of Recovery Colleges, ii) a prospective cohort study to establish the relationship between fidelity, mechanisms of action and psychosocial outcomes, iii) a prospective cohort study to investigate effectiveness and cost-effectiveness, iv) a retrospective cohort study to determine the relationship between Recovery College use and outcomes and mental health service use, and v) organisational case studies to establish the contextual and organisational factors influencing fidelity and outcomes. The programme has been developed with input from individuals who have lived experience of mental health problems. A Lived Experience Advisory Panel will provide input into all stages of the research.DiscussionRECOLLECT will provide the first rigorous evidence on the effectiveness and cost effectiveness of Recovery Colleges in England, to inform their prioritising, commissioning, and running. The validated RECOLLECT multilevel change model will confirm the active components of Recovery Colleges. The fidelity measure and evidence about the fidelity-outcome relationship will provide an empirically-based approach to develop Recovery Colleges, to maximise benefits for students. Findings will be disseminated through the study website (researchintorecovery.com/recollect) and via national and international Recovery College networks to maximise impact, and will shape policy on how Recovery Colleges can help those with mental health problems lead empowered, meaningful and fulfilling lives.

Psychiatry and/or recovery: a critical analysis.

This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co-opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered.

Realist evaluation of the impact, viability and transferability of an alcohol harm reduction support programme based on mental health recovery: the Vitae study protocol

IntroductionAddiction is considered a chronic disease associated with a high rate of relapse as a consequence of the addictive condition. Most of the current therapeutic work focuses on the notion...

Measuring the Concept of Restoration in Criminal Justice System

Regarding the restoration concept such as restorative justice, alternative dispute resolution, circle sentencing, and ishlah, Indonesia’s Criminal Justice System is not yet familiar with this concept. Generally, the concept of restoration is not known in Criminal Procedure Law (KUHAP) which adheres to the principle of legality. Based on this situation, it is interesting to study the concept of restoration, especially the functionalization of restoration concepts and the readiness of the Indonesian Criminal Justice System to implement the restoration concept. This research used a qualitative research method that discusses the concept and implications of restoration associated with the applicable rules or principles. The results show that the restoration concept, such as alternative dispute resolution, circle sentencing, and ishlah, is a concept that prioritizes the interests of the parties involved, namely the principle of win-win solution and recovery. This concept has long been practiced by the community, especially indigenous peoples and in the Criminal Justice System. It has been functionalized to resolve criminal cases that meet the requirements of both the level of investigation and prosecution as a way of resolving criminal cases. The implications of these concepts on the Indonesian Criminal Justice System are deviations from the principle of legality in the KUHAP. However, these implications are logically acceptable to the community in the framework of equitable and definite legal manifestations. It is recommended that the mechanism for implementing the restoration concept, such as alternative dispute resolution, circle sentencing, ishlah, can be included in the Draft Criminal Procedure Code (RKUHAP). Thus, in the implementation, the restoration concept can be juridically and formally accepted as a principle of the Indonesian Criminal Justice System.

Human Right to Water and Sanitation: Water for All vs. Full Cost Recovery

The present work starts from the definition of the concept “human right to water and sanitation” (HRWS). Then, it delimits its content, in a strict sense, to finally argue that it is an autonomous and subjective right. In other words, it is a right of immediate applicability, which means that it binds both the State and the private sector—that is, public or private supply and sanitation companies. Therefore, there is a minimum that cannot be denied to anyone, especially to individuals or families who cannot afford to pay their water bills. Next, I propose possible solutions for water and sanitation companies to ensure HRWS—avoiding water cuff-off—without compromising their economic and financial sustainability. Finally, I conclude that to comply with the principle of full cost recovery (FCR)—established by the EU Water Framework Directive (FWD)—the water bill will have to progressively increase—especially in regions where water is scarce and (due to the effects of climate change) will become an increasingly precious good. But, for those who cannot afford to pay the water bill, State will have to subsidize to guarantee the minimum service, per person and per day, which is a human right.

Separation of antimony from lead-antimony alloy by molten salt electrolysis

Lead-acid batteries (LABs) are widely used in electric motorcycles, uninterruptible power systems, and stationary energy storage devices. However, spent LABs should be recycled to reuse lead (Pb) and thereby close the Pb cycle and avoid Pb contamination. In order to reuse the recovered Pb, the purity of recovered Pb should meet the required standard. Since antimony (Sb) is a common alloying element in Pb alloy grid such as the Pb-Sb alloy, separating Sb from the recovered Pb is necessary. In this paper, we proposed a molten salt electrolysis method to separate Sb from liquid Pb-Sb alloys in terms of forming a solid Ca-Sb intermetallic at the top of the liquid Pb-Sb cathode. The electrochemical separation process was performed in molten NaCl-CaCl2. The content of Sb (atomic percent) in the Pb-Sb alloy was reduced from 1% to less than 0.01% (atomic ratio). The recovery principle lies in the different alloying potentials between Ca-Sb and Ca-Pb. Hence, molten salt electrolysis is a promising separation method to recover pure Pb from spent Sb-containing Pb alloys.

Transplantation of the Horseshoe Kidneys: A Model for Dual Adult Kidney Transplantation

Background: The shortage of organs has called for the use of two marginal adult kidneys (MAKs) with a low nephron mass as dual adult kidneys transplanted to a single recipient. The operative techniques of the transplantation of these kidneys are still debated. Since the horseshoe kidneys have been transplanted as early as 1975, it is theorized that the technique of the en bloc transplantation of the horseshoe kidney may be applied to the MAKs. Material and Methods: The world literature search during the period 1975–2021 on the use of deceased-donor horseshoe kidneys was reviewed. The selection of the donors, the anatomy of the kidneys, the principles of organ recovery, the transplantation procedure, and the results were discussed. Finally, this technique of en bloc transplantation was applied successfully to seven pairs of MAKs and is described herein. The dual adult kidneys were simultaneously vascularized by the donor aorta and vena cava, which were anastomosed, respectively, to the recipient iliac artery and vein. Results: A total of 131 case reports of deceased horseshoe kidney donors were reviewed, of which 53 en bloc kidneys were transplanted successfully to a single recipient, and the remaining 78 were divided and transplanted as single units to 131 recipients. Twenty-five single kidneys were discarded. At the time of publication, all horseshoe kidneys had a good renal function. In the series of seven pairs of MAKs transplanted en bloc, the operative time was 3 h. There were no primary nonfunctions, no vascular thromboses, no urinary leakages, and no wound infections. Only two patients required temporary dialysis despite an average of 28.4 h of cold ischemia time. No hydronephrosis and lymphocele was experienced. Both patient and graft survival were 100%. At the time of follow-up at 36 months, serum creatinine levels averaged 1.8 mg/dL (range 1.4–1.9). Conclusions: This technique of en bloc renal transplantation using the donor aorta and vena cava for revascularization can be applied to both the horseshoe kidneys and the MAK, and improve organ utilization.

Development of a System for Recycling Used Batteries and Lead-Containing Batteries: Assessment of the Economic Effect with Minimising Damage to the Environment

The relevance of the subject under study is determined by the issues of practical application of charging batteries and accumulators after the completion of the declared technical lifetime, in connection with the pollution problems due to lack of potential for normal disposal. The purpose of this study is to investigate the prospects of development and practical implementation of a system of recycling used batteries and lead-containing batteries, in the context of assessing the potential economic impact of minimising environmental damage while fully implementing the objective. The methodological framework of this study comprises a combination of quantitative and qualitative methods. The application of methods of analysis, synthesis, induction, and deduction in this paper provides sufficient information about the existing principles of recovery of lead-containing batteries and accumulators. The method of generalisation involves the implementation of a qualitative assessment of the data obtained in this study. The method of modelling provides the display of the results obtained using appropriate schemes and diagrams. The available publications of several researchers engaged in scientific development of the issues of disposal of spent lead batteries and accumulators were analysed. The factors of the economic effect that can be achieved by the high-quality recycling of lead-containing batteries were investigated. An approximate assessment of the economic effect with a given direction to minimise damage to the environment was formed. The results obtained in this paper and the conclusions formulated on their basis have practical significance in terms of the prospects of increasing the volume of production of secondary lead by recycling of used batteries and reducing damage to the environment, when it is uncontrollably contaminated by secondary products of their use

Developing a Trauma-Informed and Recovery-Oriented Alternative to ‘Aggression Management’ Training for a Metropolitan and Rural Mental Health Service

For clinicians working in mental health services, ‘aggression management’ training is generally prioritised, and often mandated. Traditional ‘aggression management’ training has the potential to reinforce the perception that violence and aggression are inevitable, and thus defensive and coercive practices are needed. This paper outlines the principles and processes that underpinned the development of two training programs designed as recovery-oriented and trauma-informed alternatives to traditional ‘aggression management’ training. The focus of the paper is on exploring how ‘aggression management’ training can be aligned with best practice principles. The programs were developed in a metropolitan and rural mental health service and aimed to reduce the need for defensive and coercive practices by promoting therapeutic engagement. A key feature of both programs is an orientation towards safety rather than risk. By embedding the principles of recovery and trauma-informed care in their development and orienting training towards enhancing safety, clinicians are provided with a new way of conceptualising and responding to ‘aggression’. Experiential methods in the delivery of the training, and the co-design and co-delivery with peer (consumer) educators were important in supporting attitudinal change. To promote safety, the language and content of training programs must reflect contemporary principles and approaches such as trauma-informed care and recovery. This paper illustrates that to be effective, these principles and approaches must not just be described, but modelled in the development, design, and delivery of the training.

"How do you try to have anyone comply or at least be pliable with you if that person's not even medicated?": Perspectives on the use of psychiatric medication within recovery-oriented practice.

Objective: Medication is particularly important to advocates within the mental health recovery movement and this movement is founded upon a resistance to coercive treatment. Given this history, we explored the perspectives of providers and service users engaged in the recovery-oriented practice Person-Centered Care Planning (PCCP) to understand (a). How providers trained in PCCP understand the role of psychiatric medication and (b). How service users receiving services from providers trained in PCCP understand and experience the role of psychiatric medication in treatment. Method: This study comprises data from the qualitative phase of an NIMH-funded randomized trial of PCCP, an evidence-based recovery-oriented practice. Data were collected from 22 focus groups of providers and service users across seven community mental health centers. Interviews were analyzed using thematic analysis. Results: Qualitative themes from the provider focus groups included "promoting adherence" and "medication as a precondition." Providers expressed that service users need to be adherent to medication and their symptoms managed before recovery-oriented practices could be pursued. Service user themes included "we were cattle" and medication as "my saving grace." While many experienced medication as helpful, they found providers' focus on adherence to be inflexible and, at times, coercive. Conclusion and Implications for Practice: These results suggest that even within agencies actively implementing recovery-oriented practices, there are aspects of treatment, namely medication management, that are more impervious to recovery principles. Agency level trainings in PCCP and other recovery-oriented practices would benefit from the inclusion of all staff, including psychiatrists and other prescribers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups.

Mental health nurses aim to provide high‐quality care that is safe and person‐centred. Service users require individualized care, responsive to their preferences, needs, and values. The views of service users, mental health nurses, nurse academics, psychiatrists, and nurse managers about the core competencies of mental health nurses have not been explored. Our study aimed to describe and contrast the views of multiple stakeholder groups on the core competencies of mental health nurses. Concept mapping is a six‐step mixed‐methods study design that combines qualitative data with principal component analysis to produce a two‐dimensional concept map. Forty‐eight people participated in the study from five stakeholder groups that included service users and clinicians. The final concept map had eight clusters: assessment and management of risk; understanding recovery principles; person‐ and family‐centred care; good communication skills; knowledge about mental disorders and treatment; evaluating research and promoting physical health; a sense of humour; and physical and psychological interventions. There were important differences in how service users and health professionals ranked the relative importance of the clusters. Service users reported the understanding recovery principles cluster as the most important, whilst health professionals ranked the assessment and management of risk group the most important. There may be a disconnect between what service users and other stakeholders perceive to be the core competencies of mental health nurses. There is a need for more research to examine the differing perspectives of service users and health professionals on the core competencies of mental health nurses.

Collaborative community mental health and aged care services with peer support to prevent late-life depression: study protocol for a non-randomised controlled trial

BackgroundLate-life depression is common, modifiable, yet under-treated. Service silos and human resources shortage contribute to insufficient prevention and intervention. We describe an implementation research protocol of collaborative stepped care and peer support model that integrates community mental health and aged care services to address service fragmentation, using productive ageing and recovery principles to involve older people as peer supporters to address human resource issue.Methods/designThis is a non-randomised controlled trial examining the effectiveness and cost-effectiveness of the “Jockey Club Holistic Support Project for Elderly Mental Wellness” (JC JoyAge) model versus care as usual (CAU) in community aged care and community mental health service units in 12 months. Older people aged 60 years and over with mild to moderate depressive symptoms or risk factors for developing depression will be included. JoyAge service users will receive group-based activities and psychoeducation, low-intensity psychotherapy, or high-intensity psychotherapy according to the stepped care protocol in addition to usual community mental health or aged care, with support from an older peer supporter. The primary clinical outcome, depressive symptoms, and secondary outcomes, self-harm risk, anxiety symptoms, and loneliness, will be measured with the Patient Health Questionnaire-9 (PHQ-9), Self-Harm Inventory, Generalized Anxiety Disorder 7-item scale (GAD-7), and UCLA Loneliness 3-item scale (UCLA-3) respectively. Cost-effectiveness analysis will assess health-related quality of life using the EQ-5D-5L and service utilisation using the Client Service Receipt Inventory (CSRI). We use multilevel linear mixed models to compare outcomes change between groups and calculate the incremental cost-effectiveness ratio in terms of quality-adjusted life years.DiscussionThis study will provide evidence about outcomes for older persons with mental health needs receiving collaborative stepped care service without silos and with trained young-old volunteers to support engagement, treatment, and transitions. Cost-effectiveness findings from this study will inform resource allocation in this under-treated population.Trial registrationClinicalTrials.gov NCT03593889. Registered on 20 July 2018.

Possibilities of domestic individual oral care products in eliminating dental manifestations of the consequences of a new coronavirus infection COVID-19

Since the fourth quarter of 2019, the new coronavirus infection (COVID-19) has become an integral part of everyday life not only for Russians, but for people all over the world. Despite the extremely in-depth study of the new coronavirus infection, the periodic change in recommendations for the treatment and rehabilitation of patients, many issues of pathogenesis, the clinical picture and the principles of complex treatment and recovery require improvement on a scientific basis. That is why interest in the treatment and rehabilitation of people who have had a new coronavirus infection (COVID-19) is not waning at present.

Cohen’s Comprehensive Thoracic Anesthesia

Cohen’s Comprehensive Thoracic Anesthesia

Assessing the outcome of admissions: Pilot study in a High Intensity Psychiatric Residential Facility

Background: The Italian health system related to mental disorders is currently experiencing a period of radical reforms. This process began in 1978 with the adoption of the law 180 which produced a radical reform in mental health care. The problems of the continuous confrontation with increasing levels of expenditure are reflected in the search for models to improve both the efficiency and effectiveness of the health care system. Among these, the value creation model proposes to optimize the relationship between effectiveness, quality, and appropriateness of care on the one hand, and efficiency, cost and how resources are used on the other. The intervention involves redesigning services on the principles of recovery; implementing treatments supported by scientific evidence; encouraging processes of social inclusion. The proposed rehabilitation interventions are recovery oriented that place the person at the center of his rehabilitation path, motivating him in assuming responsibility for the treatment proposed during hospitalization. Objective: Evaluate the impact of the organisational reorganisation of the DSM S.R.R Regional Health Service of Ancona Area Vasta 2 by introducing evidence-based and recovery-oriented practices through the evaluation of clinical outcomes and psychosocial functioning. Methods: Longitudinal descriptive observational study with evaluation of a cohort of 13 patients, hospitalized in residential and semi-residential care at SRP1 “Casa Rossa” Area Vasta 2 of Ancona, by administration of a questionnaire (HoNOS) at the time of recruitment (February 2019), at 6 months (August 2019) and at 12 months (February 2020). The 12 items of the questionnaire were grouped into four subsets: behavioural problems (items 1-3), deficits and disabilities (items 4-5), psychopathological symptoms (items 6-8) and relational/environmental problems (items 9-12). Results: Survey results show a reduction in mean scores at 6 and 12 months compared to baseline in all subscales. Conclusions: Intensive mental health residential facilities need to put more effort into evaluating effectiveness in practice, using appropriate tools for outcome assessment and analysis of results. It is possible, in daily clinical practice, to evaluate the outcome of admissions in order to satisfactorily describe the changes induced during the period of hospitalization.

Enhanced Recovery After Cardiac Surgery.

The aims of "Fast track" cardiac anesthesia including shortening time to tracheal extubation and to hospital discharge in selected patients. The evidence is weak and recommendations are mostly based on observational, nonrandomized data and expert opinion. The majority of outcomes studied include: time to tracheal extubation, hospital/ICU length of stay, procedure-related financial costs, and the type/amount of opioids used in the peri-operative period. There should be a shift in focus to generating higher quality evidence supporting the use of enhanced recovery protocols in cardiac surgical patients and finding ways to tailor enhanced recovery principles to all cardiac surgical patients. Research should focus on the quality of care for individual patients and the delivery of health care to the public.

New membrane and electrode assembly concept to improve salinity energy harvesting.

The recovery of energy generated from the mixing of fresh and salt water is a new form of renewable energy. However, current processes for energy harvesting from salt gradients remain inefficient mainly because commercial selective membranes have low performances. Hopes for non-selective membranes with nanofluidic channels which have been designed to lower the internal resistance of the cell seem to be in vain. We present a new combination of reverse electrodialysis and capacitive double layer expansion for salinity gradient energy harvesting. Our originality consists in the use of a single selective membrane and two capacitive layers that adsorb ions. The assembly of these elements allows us to double the potential of the open circuit of the cell and thus to multiply by 4 the potentially recoverable power. We present a complete study of a device of a few square centimetres. Contrary to what is generally done, we directly measure the energy and power recovered from the salt gradients in a load resistor. We measure a net power of 2 W.m−2 which is twice the best results presented in the literature to date. Our device makes the principle of energy recovery from salt gradients economically viable.

A Narrative Review of Factors Influencing Peer Support Role Implementation in Mental Health Systems: Implications for Research, Policy and Practice.

With increasing calls to incorporate recovery principles into conventional mental health care, the importance of peer support worker (PSW) services has gained attention. However, studies consistently show that PSWs remain underutilized. Although research addresses several factors that influence formal implementation of their role, there is lack of a comprehensive framework that synthesizes the factors and addresses their interlevel interactions. This paper provides a narrative review and synthesis of literature on multilevel factors that influence formal PSW role implementation in mental health systems. We conducted a search of literature and reviewed 38 articles that met inclusion criteria. Our thematic analysis involved identifying first and second order categories that applied across studies, and developing third order interpretations through iterations. We synthesized the findings in a multilevel framework consisting of macro, meso and micro level influences. Influencing factors at the macro level include broader socio-cultural factors (medical model, recovery values, professional power dynamics, training and certification), regulatory and political factors (policy mandates, political commitment), and economic and financial factors (funding, affordability of services). Factors at the meso level include organizational culture, organizational leadership, change management, and human resource management policies. Micro level influences pertain to relationships between PSWs and team members, and PSW wellbeing. Interlevel interactions are also outlined. Limitations and implications for research, policy and practice are addressed.

Harmony in the Light of Computational Ludics

Prawitz formulated the so-called inversion principle as one of the characteristic features of Gentzen's intuitionistic natural deduction. In the literature on proof-theoretic semantics, this principle is often coupled with another that is called the recovery principle. By adopting the Computational Ludics framework, we reformulate these principles into one and the same condition, which we call the harmony condition. We show that this reformulation allows us to reveal two intuitive ideas standing behind these principles: the idea of "containment" present in the inversion principle, and the idea that the recovery principle is the "converse" of the inversion principle. We also formulate two other conditions in the Computational Ludics framework, and we show that each of them is equivalent to the harmony condition.