Recovery Priorities Research Articles

What Outcomes Matter Most to Paediatric Burn Patients and Their Caregivers: A Comparison of Short-Term and Long-Term Priorities

Identifying outcomes that matter most is key in driving specialized paediatric burn care. The aim of this study was to discover the most important outcomes for paediatric burns. Parents of children (0–3 year and 4–11 years old) and adolescents (12–17 yearss old) completed surveys to identify outcomes that matter most in the short-term (<6 months postburn) and long-term (6–24 months postburn). The percentage of patients scoring an outcome as ‘very important’ was used to rank the outcomes. Fifty-four parents/adolescents participated (response rate: 27%). Children had a median TBSA burned of 5.0% (IQR: 2.0–7.0%). In the short-term, ‘good wound healing’ and ‘no wound infection’ (both at 71.4–100%) were very important for all children. ‘Not having pain’ (90.3–93.8%) was ranked highest for children ≤11 years old, whereas ‘walking or moving around’ (85.7%) was most important for older children. In the long-term, more variation was seen in outcome priorities; however, both ‘not having pain’ (53.6–85.7%) and ‘flexibility of scar(s)’ (60.7–71.4%) were considered very important by all three groups. Patient- and parent-derived priorities are important for developing consumer-centric, highest-value care pathways. The priority of the outcomes identified is a starting point to discuss treatment options and recovery priorities in a family-centric approach to guide high-value, individualized care.

Patient experiences and desires for recovery after ankle fracture surgery

ObjectiveThis study investigates patients’ experiences of commencing weight-bearing after ankle fracture surgery and their recovery priorities to inform a new rehabilitation intervention. MethodsEmbedded within the Weight bearing in Ankle Fractures (WAX) trial, this qualitative study conducted semi-structured interviews with patients following ankle fracture surgery. The Behaviour Change Wheel (BCW) framework guided the interview questions to ensure comprehensive domain coverage. A purposive, maximum variation sampling strategy was used for participant selection. Data analysis employed a combined deductive and inductive approach. ResultsA total of 29 patients were interviewed, revealing five key themes: understanding the recovery journey, navigating the healthcare system, understanding personal physical capabilities, building confidence for weight-bearing, and resuming daily activities. Themes emphasised the variability in healthcare access, the impact of non-weight-bearing on independence, and the role of self-efficacy in recovery. ConclusionsThe study highlighted the diversity in patient experiences and recovery challenges post-ankle fracture surgery. Patients’ recovery was influenced by access to consistent healthcare advice, self-efficacy, and the physical and psychological impact of non-weight-bearing. The findings suggest a need for tailored, patient-centred rehabilitation interventions that consider individual recovery trajectories and promote self-management. These insights provide a foundational understanding for developing interventions that more effectively address patient priorities and barriers to recovery.

Exploring the impact of thiol collectors system on copper sulfide flotation through machine learning-driven modeling

Collector selection is a critical step in flotation, as it has a direct impact on product quality, flotation recovery, and selectivity. Collectors can consist of different components, and their effectiveness can vary depending on the type of ore being processed. The general practice in both literature and in industry is to use a mixture of collectors rather than a single collector. However, the use of a collector mixture introduces several complex issues. It is challenging to determine the specific effects of each collector on different minerals, as well as to understand the synergistic effects of mixed collectors in flotation. This study presents a novel investigation focusing on the impact of blends of NAX, AEROPHINE® 3422, and AERO® MX 5149, in varying dosages and combinations, on the flotation performance of Kupferschiefer copper ore. Kinetics flotation tests were conducted using a mechanical flotation cell with various combinations and dosages of listed collectors. For this investigation, different predictive models such as machine-learning (ML) and conventional regression analyses were developed. For model construction, a database including the results of comprehensive experimental results was constructed. The best performing model was selected considering statistical performance indicators and their performance on unseen data. A sensitivity analysis was conducted on the model to justify contributions of collectors on the copper recovery and grade. The results showed that the ML-based models provide compatible results with the expert opinions and have higher statistical performance than conventional modelling tools. According to the experimental results and models’ findings, it has shown that AEROPHINE® 3422 (a blend of isopropyl ethyl thionocarbamate and dithiophosphinate) was the most influential collector for the copper recovery. In addition, two ternary graphs were generated from the modeled data to formulate mixtures for different grades and recovery priorities.

Network-level Method for Road Infrastructure Maintenance Decision Making

In South Korea, the aging of road infrastructures exceeding 30 years and susceptibility to natural disasters emphasize the imperative for improved maintenance. A novel method was developed to incorporate social factors, such as traffic flow, into maintenance strategies. This method evaluated the significance of road infrastructures within the network by considering changes in network performance resulting from changes in their condition. This method, anticipated to enhance maintenance efficiency, was envisaged for determining regular maintenance and recovery priorities of damaged infrastructures in the wake of natural disasters.

Criteria for and Policy Implications of Setting Recovery Priorities of National Functions during Disruptions by Disasters

National functions are categories of operations prioritised for restoration when disrupted by emergencies such as disasters. However, the simultaneous restoration of all national functions when some or all are paralysed is limited by time and resources. Delays in the restoration of key functions can lead to public dissatisfaction. Thus, it is necessary to broadly classify national functions and analyse their restoration priorities based on criticality. This study identifies 19 national functions from Republic of Korea’s comprehensive Business Reference Model. A survey was conducted among citizens and officials to determine the criticality of each function. Statistical analyses verified the consistency (Cronbach’s alpha = 0.860) and correlation (average Cramer’s V = 0.107) of the criticality responses across regions. The null hypothesis of no regional differences in the criticality of national functions was accepted, validating their universality. Restoration priorities were derived from these criticality values, with ‘Disaster Safety Response’ as the highest priority and ‘Regional Development’ as the lowest. These results provide foundational data for the post-disaster restoration priorities of national functions and emphasise the need to consider public opinion, needs, and government resource limitations in disaster management planning.

Resilience-based post-earthquake recovery strategies for substation systems

Electrical substation systems require significant manpower and material resources for repair after an earthquake; thus, repair efficiency directly affects economic loss. To quantify the functional recovery process of substation systems, this study proposes a seismic resilience assessment framework based on the functional characteristics of substation systems. Reliability models of the equipment and systems were constructed to characterise the structural connection features and power transmission paths of substation systems, and the system functional state matrix was obtained through a seismic simulation. Moreover, factors influencing functional recovery and repair path control parameters were proposed to determine efficient post-earthquake recovery strategies. The Monte Carlo method was used to construct a post-earthquake recovery strategy analysis framework for a substation system. By analysing a typical 220 kV substation using static-based repair strategies, we obtained the functional recovery process and seismic resilience level. Furthermore, based on the actual functional requirements, a dynamic recovery strategy analysis method was proposed based on an improved genetic algorithm. Notably, optimal recovery strategies for different earthquake intensities and recovery priorities were obtained through iterative reproduction analysis.

Recovery and Increasing the Preparedness of Communities Around Mount Merapi in Facing the Spread of Volcanic Ash

In March 2023, Mount Merapi's activity increased by releasing hot clouds and producing volcanic ash (volcanic ash rain). The distribution of volcanic ash to the northwest and north in varying intensity. Furthermore, there are three villages that have the most severe impacts from the distribution of volcanic ash, namely Krinjing, Klakah, and Tlogolele Villages. Moreover, immediate action from all stakeholders is needed to minimize the impacts of the volcanic ash. In addition, a combination of all parties is also required so that it can increase community preparedness in dealing with the spread of volcanic ash. Then, the spread of volcanic ash in the future will only have a slight negative impact. In this article, the researcher used a descriptive approach as a research methodology. Data collection techniques used observation, interviews, and questionnaires, as well as Focus Group Discussion (FGD). The research sample collection method used purposive sampling with simple statistics in data analysis. In addition, the results of the FGD are also used as a result to formulate recovery priorities after the spreading of volcanic ash and strategies for increasing preparedness in dealing with volcanic ash. The data analyzed in this research also shows that the people in Krinjing, Klakah, and Tlogolele villages have a moderate level of preparedness, a score of 266 from 750 or 35.47%. Furthermore, there are four strategies for increasing community preparedness. They are 1) suggesting wearing masks when volcanic ash spreads, 2) preparing a routine budget for handling volcanic ash, 3) providing reserves for animal feed, and 4) procuring water reservoirs for each head of the family. In determining of recovering section, FGD suggests preparing the mobilization of resources, focusing on cleaning public facilities, supplying clean water, distributing masks, procuring animal feed, and socializing the dangers of volcanic ash.

Targeting patient recovery priorities in degenerative cervical myelopathy: design and rationale for the RECEDE-Myelopathy trial—study protocol

IntroductionDegenerative cervical myelopathy (DCM) is a common and disabling condition of symptomatic cervical spinal cord compression secondary to degenerative changes in spinal structures leading to a mechanical stress injury of...

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background.

IntroductionSpinal cord injury (SCI) causes significant and permanent disability affecting motor, sensory and autonomic functions. We conducted a survey on the priorities of functional recovery and preferences for community rehabilitation services in a cohort of Chinese individuals with SCI as well as the primary caregivers. The study also investigated their views on advanced technology and research.MethodsAn online platform with a self-administered questionnaire was used to collect the opinions of clients that received services from an SCI follow-up clinic, a self-help association, or a non-government organization from 1 September−31 December 2021.ResultsEighty-seven subjects (74 individuals with SCI−48 tetraplegic, 26 paraplegic, and 13 caregivers) responded to the survey. Recovery of arm/hand function was given the highest priority among tetraplegics, followed by upper trunk/body strength and balance, and bladder/bowel function. Sexual function had a significant lower ranking than all priority areas except normal sensation (p < 0.05). Paraplegics viewed bladder/bowel function as the most important area of functional recovery, followed by walking movement, upper trunk/body strength and balance, elimination of chronic pain, and regaining normal sensation. There was no statistically significant difference among the top priority areas (p > 0.05). In contrast to previous studies done in Western populations, the study revealed that sexual function was ranked as the lowest by all 3 groups of respondents (tetraplegics, paraplegics, and caregivers). The majority of participants thought community rehabilitation services were inadequate. Most of the respondents were interested to try advanced technology which would facilitate their daily life and rehabilitation. About half of the individuals with SCI thought advance in technology and research could bring significant improvement in their quality of life in the coming 10 years.ConclusionThis survey is the first study specifically looking into the recovery and rehabilitation priorities of a Chinese population of individuals with SCI. This is also the first study to investigate the priorities of the primary caregivers of SCI individuals. The findings are useful as a reference for planning of future research and provision of rehabilitation services for the SCI community locally and in other parts of China.

Asia–Pacific tourism futures emerging from COVID-19 recovery responses and implications for sustainability

PurposeThe purpose of this paper is to provide contrasting narratives of what the future of Asia Pacific tourism may look like, and to identify how current policy interventions and recommendations made for coronavirus disease 2019 (COVID-19) recovery shape the system's trajectory.Design/methodology/approachDrawing on a set of four possible futures emerging from COVID-19, tourism policy responses are analysed and a link to their potential contribution to the Sustainable Development Goals is made.FindingsA system goal is presented for each scenario, and what this means for the tourism system. Existing policies indicate that tourism is moving towards a “Discipline” future, although evidence for all four trajectories could be identified. Whilst the “Transform” scenario is most aligned with a sustainable future, the findings highlight that sustainability outcomes are possible in the other scenarios as well, if risks are managed adequately.Research limitations/implicationsThe limitation is that the core structure of the four futures was not specifically developed for tourism. However, given that tourism is firmly embedded in national and global economies, this limitation is not material.Practical implicationsThis paper supports decision-makers to develop adaptability in the face of great uncertainty and complexity. Risks and opportunities associated with each of the four tourism futures are identified, and examples are provided how sustainability outcomes can be maximised in each.Social implicationsSustainability is a safe and necessary strategy regardless of the trajectory to any of the four scenarios. The long-term health of the tourism system and anyone involved in it depends on significant progress along the Sustainable Development Goals.Originality/valueThis paper explores pathways for system change and how different COVID-19 policy approaches contribute to shaping the system's trajectory. It highlights the risks associated with certain trajectories, and also identifies how short-term recovery priorities might undermine long-term sustainability.

Energy inequality and clientelism in the wake of disasters: From colorblind to affirmative power restoration

Do social vulnerabilities and ruling party support shape government responsiveness in times of disasters? The 2017 hurricane María territory-wide power outage, the second longest in world history, is a tragic natural experiment that provides a unique opportunity to examine the determinants of government responsiveness during disaster recovery processes. We use data on power restoration crew deployments (N = 18,614 deployments), a novel measure of government responsiveness, and a new social vulnerability index to assess the determinants of government responsiveness in the wake of disasters. We find that communities with ties to the ruling party elicit greater government responsiveness while socially vulnerable communities are less likely to be prioritized during the disaster relief efforts, controlling for disaster damage as well as logistical, economic, and essential service recovery priorities. Existing power restoration policies place larger burdens on marginalized communities, motivating the need for including power restoration to vulnerable communities among restoration priorities.

A multidimensional framework for disaster recovery: Longitudinal qualitative evidence from Puerto Rican households

Research on household disaster recovery has principally applied quantitative methods to explain, in a correlative way, the speeds at which households recover. Yet there are limited explanatory models of household recovery. This study adopts a qualitative, longitudinal methodology to develop a model of how and why household recovery pathways and speeds are heterogenous. Data was collected over five field visits to Puerto Rico during the first year after Hurricane Maria in 2017. Households mobilise their agency to leverage their assets and recovery priorities to mitigate and/or adapt to four major societal conditions (disaster support; public services; markets; employment and public financial assistance). These societal conditions and household characteristics act as enablers and barriers, which vary over time, and interact to shape households’ capacity to recover. The paper also proposes a new definition of disaster recovery, which reflects households’ pursuit of recovery needs that do not directly adapt to, reduce or avoid the impacts from disasters.

Recovery priorities of people with psychosis in acute mental health in-patient settings: a Q-methodology study.

Personal recovery from psychosis has been explored extensively in community samples but there has been little exploration with people currently receiving care from an acute mental health in-patient setting. The aim of this study was to explore the personal recovery priorities of people experiencing psychosis who are currently receiving care from an acute mental health in-patient ward. A Q-methodology mixed-methods approach was adopted. Thirty-eight participants were recruited from an outer London acute mental health hospital. They were required to sort 54 statements regarding personal recovery from most important to least important to reflect their recovery priorities. Thirty-six were included in the final analysis. Analysis revealed four distinct viewpoints relating to factors that promote recovery in the acute mental health in-patient setting. These were: stability, independence and 'keeping a roof over your head'; hope, optimism and enhancing well-being; personal change, self-management and social support; and symptom reduction through mental health support. Acute mental health in-patient wards need to ensure that they are considering the personal recovery needs of in-patients. Symptom reduction was valued by some, but broad psychosocial factors were also of priority.

Build Back Better? Effects of Crisis on Climate Change Adaptation Through Solar Power in Japan and the United States

Do communities struck by disaster build back better, or not? Recent small- and medium- N studies have shown mixed effects. This mixed-methods study tests the effect of disasters on the adoption of solar power as a key form of building back better and adapting to climate change. To test this effect, we applied a large- N longitudinal matching experiment on cities affected and unaffected by disaster paired with qualitative case studies, focusing on the 2011 triple disaster in Japan and Hurricane Sandy in 2012 in the United States. We find that disaster-hit cities adopt more solar farms and rooftop solar than cities unaffected by crisis and that the social capital of these disaster-hit communities shapes their adoption patterns. By clarifying the effects of disasters on the build-back-better phenomenon in comparative cases, this article aims to guide recovery priorities after large-scale shocks.

Patients Place More of an Emphasis on Physical Recovery Than Return to Work or Financial Recovery.

Patients Place More of an Emphasis on Physical Recovery Than Return to Work or Financial Recovery.

Assessment of priorities in critical material recovery from Waste Electrical and Electronic Equipment

A major problem in developing environmental management systems for assessing recovery priorities for high added-value materials such as critical metals from wastes is that the input data required are contained in a variety of databases compiled for different purposes with different levels of content and accuracy. To deal with decision-making priorities for environmental issues where uncertainties and inconsistencies are inherent in input data sources a Multi-Criteria Decision Analysis (MCDA) approach using an Analytic Hierarchy Process (AHP) to determine weights and fuzzy numbers to account for input data uncertainties is developed and is illustrated for determination of critical metal recovery priorities from Waste Electrical and Electronic Equipment (WEEE) in Europe. A spreadsheet programme with many user-friendly input and output features is developed to aid data-handling and the calculations required in the MCDA approach. Where data uncertainties exist, weighted input parameters for the critical metals are determined by an absolute judgement panel of key stakeholders and include data on: recovery potential, geographical supply concentration and stability, end use substitution, future metal demand and economic importance in key industrial sectors. Sensitivity analyses can be carried out on results of recovery priority outputs by simple numerical variation of input parameters and/or by the use of specialist input decision panels representing stakeholder groups with differing priorities, and the results suggest that recovery priorities in the European situation should concentrate on gallium, indium and germanium. The spreadsheet-MCDA program set up in developing the methodology for criticality has wide general application in environmental decision-making analysis particularly where uncertainties exist in the input data required.

RecovUS: An Agent-Based Model of Post-Disaster Household Recovery

The housing sector is an important part of every community. It directly affects people, constitutes a major share of the building market, and shapes the community. Meanwhile, the increase of developments in hazard-prone areas along with the intensification of extreme events has amplified the potential for disaster-induced losses. Consequently, housing recovery is of vital importance to the overall restoration of a community. In this relation, recovery models can help with devising data-driven policies that can better identify pre-disaster mitigation needs and post-disaster recovery priorities by predicting the possible outcomes of different plans. Although several recovery models have been proposed, there are still gaps in the understanding of how decisions made by individuals and different entities interact to output the recovery. Additionally, integrating spatial aspects of recovery is a missing key in many models. The current research proposes a spatial model for simulation and prediction of homeowners’ recovery decisions through incorporating recovery drivers that could capture interactions of individual, communal, and organizational decisions. RecovUS is a spatial agent-based model for which all the input data can be obtained from publicly available data sources. The model is presented using the data on the recovery of Staten Island, New York, after Hurricane Sandy in 2012. The results confirm that the combination of internal, interactive, and external drivers of recovery affect households’ decisions and shape the progress of recovery.

Valuing the Recovery Priorities of Orthopaedic Trauma Patients After Injury: Evidence From a Discrete Choice Experiment Within 6 Weeks of Injury.

To determine the recovery priorities of extremity fracture patients during the subacute phase and the patient factors associated with variation in recovery priorities. Discrete choice experiment. Academic trauma center. One hundred ninety-eight patients with a fracture to the appendicular skeleton. Patients with severe traumatic brain injuries, spinal cord injuries, and non-English-speaking patients were excluded. The relative importance of clinical recovery, work-related recovery, and obtaining disability benefits after injury. In the subacute period, clinical recovery was the main priority for fracture patients (mean: 62%, SD: 5.3). Work-related recovery (mean: 27%, SD: 3.9) and the receipt of other disability benefits (mean: 11%, SD: 6.4) were each of significantly less importance. Heterogeneity was observed across these estimates based on the physical demands of preinjury employment, preinjury physical health, preinjury work status, health insurance type, and the severity of the fracture. Clinical recovery was of paramount importance for fracture patients during the subacute recovery phase. However, patients also valued resuming work and access to disability benefits. Understanding a patient's recovery priorities early in the clinical care pathway will enable the development of multidisciplinary care plans that are responsive to these priorities and, hence, deliver value-based health care. Level V. See Instructions for Authors for a complete description of levels of evidence.

Potential territorial risk in eastern Ukraine

The research presented here is focused on assessment of potential territorial risk in the East part of Ukraine, where the military conflict has been going on for five years. Such kind of risk can be classed as a complex risk level of hazardous facilities or territories. This study determines the boundaries of territorial risk distribution with defined levels of danger. The practical implementation is reflected in the web-based geographic information system (web-GIS) for displaying environmental information in Donetsk and Luhansk regions in real time. The research defines an opportunity for further practical application of this development considering the military conflict in the Donbas. The Donbas Environmental Information System (DEIS) is an interactive map of Donetsk and Luhansk Regions. It was developed within the framework of the Project “Environmental Assessment and Recovery Priorities for Eastern Ukraine” by the OSCE Project Co-ordinator in Ukraine upon the request of the Ministry of Ecology and Natural Resources of Ukraine. The supporting of the system is carried out by the State Ecological Academy of Postgraduate Education and Management (DEA) of the Ministry of Ecology and Natural Resources of Ukraine, in particular the Center for Environmental and Resource Restoration of the Donbas within the framework of the Project of the OSCE Project Co-ordinator in Ukraine “Assisting the Ministry of Ecology and Natural Resources of Ukraine in improving environmental monitoring mechanisms”.The main task of this study is to implement the software for collecting, processing and visualization of the information about the environment and factors that may affect it. This will make it possible to increase the effectiveness of environmental management in order to meet the environmental safety requirements in Donetsk and Luhansk regions.

Recovery priorities in degenerative cervical myelopathy: a cross-sectional survey of an international, online community of patients

ObjectivesTo establish the recovery priorities of individuals suffering with degenerative cervical myelopathy (DCM).DesignA cross-sectional, observational study.SettingPatients from across the world with a diagnosis of DCM accessed the survey over an...