Laboratory investigation of the role of desorption kinetics on americium transport associated with bentonite colloids.

PubMed

Dittrich, Timothy Mark; Boukhalfa, Hakim; Ware, Stuart Douglas; Reimus, Paul William

2015-10-01

Understanding the parameters that control colloid-mediated transport of radionuclides is important for the safe disposal of used nuclear fuel. We report an experimental and reactive transport modeling examination of americium transport in a groundwater-bentonite-fracture fill material system. A series of batch sorption and column transport experiments were conducted to determine the role of desorption kinetics from bentonite colloids in the transport of americium through fracture materials. We used fracture fill material from a shear zone in altered granodiorite collected from the Grimsel Test Site (GTS) in Switzerland and colloidal suspensions generated from FEBEX bentonite, a potential repository backfill material. The colloidal suspension (100 mg L(-1)) was prepared in synthetic groundwater that matched the natural water chemistry at GTS and was spiked with 5.5 × 10(-10) M (241)Am. Batch characterizations indicated that 97% of the americium in the stock suspension was adsorbed to the colloids. Breakthrough experiments conducted by injecting the americium colloidal suspension through three identical columns in series, each with mean residence times of 6 h, show that more than 95% of the bentonite colloids were transported through each of the columns, with modeled colloid filtration rates (k(f)) of 0.01-0.02 h(-1). Am recoveries in each column were 55-60%, and Am desorption rate constants from the colloids, determined from 1-D transport modeling, were 0.96, 0.98, and 0.91 h(-1) in the three columns, respectively. The consistency in Am recoveries and desorption rate constants in each column indicates that the Am was not associated with binding sites of widely-varying strengths on the colloids, as one binding site with fast kinetics represented the system accurately for all three sequential columns. Our data suggest that colloid-mediated transport of Am in a bentonite-fracture fill material system is unlikely to result in transport over long distance scales because

PROCESS FOR SEPARATING AMERICIUM AND CURIUM FROM RARE EARTH ELEMENTS

DOEpatents

Baybarz, R.D.; Lloyd, M.H.

1963-02-26

This invention relates to methods of separating americium and curium values from rare earth values. In accordance with the invention americium, curium, and rare earth values are sorbed on an anion exchange resin. A major portion of the rare earth values are selectively stripped from the resin with a concentrated aqueous solution of lithium chloride, and americium, curium, and a minor portion of rare earth values are then stripped from the resin with a dilute aqueous solution of lithium chloride. The americium and curium values are further purified by increasing the concentration of lithium chloride in the solution to at least 8 molar and selectively extracting rare earth values from the resulting solution with a monoalkylphosphoric acid. (AEC)

Effects of low doses of americium 241 on animals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rudnitskaya, E.I.; Moskalev, Yu.I.

1979-10-01

The long term effects of low doses of americium 241 on dogs and rats were investigated. Americium chloride was administered intravenously to dogs and intraperitoneally to rats in varying doses. The biological radiation effects were determined at autopsy. Survival times were reported.

Rapid Radiochemical Method for Americium-241 in Building ...

EPA Pesticide Factsheets

Technical Fact Sheet Analysis Purpose: Qualitative analysis Technique: Alpha spectrometry Method Developed for: Americium-241 in building materials Method Selected for: SAM lists this method for qualitative analysis of americium-241 in concrete or brick building materials. Summary of subject analytical method which will be posted to the SAM website to allow access to the method.

Distribution of ingested americium in chickens and transport to eggs. Final report, 1975

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mullen, A.A.; Lloyd, S.R.; Mosley, R.E.

1976-05-01

The soluble citrate complex of americium-241 was orally administered to 20 white Leghorn laying hens daily for two weeks. The yolks, whites, and shells from the eggs were analyzed for their americium content. Yolk was the only egg fraction in which radioactivity was observed. The americium-241 activity in yolks reached a maximum on the 14th day of dosing. Biological half-times of 2.00 plus or minus 0.18 days and greater than 33 days were indicated by the average concentration values of americium-241 in yolks laid after the maximum activity was reached. The hens were serially sacrificed at 1, 10, and 20more » days after the final administration of americium-241. Tissue samples were collected and the americium content determined in the edible portions and feathers of the hens. Americium was detected in most tissues shortly after dosing; the main concentrations were found in the liver and the skeleton. The highest concentration per organ (3.03 X 0.001 percent of the dose) occurred in the liver of the hens sacrificed 10 days after final administration of americium-241. (GRA)« less

Radionuclide Basics: Americium-241

EPA Pesticide Factsheets

Americium (chemical symbol Am) is a man-made radioactive metal that is solid under normal conditions. Exposure to a significant amount of Am-241 is generally unlikely. Small amounts are found in the soil, plants and water from nuclear weapons testing.

Behavior of Americium in Simulated Wounds in Nonhuman Primates

DOE PAGES

Poudel, Deepesh; Guilmette, Raymond A.; Bertelli, Luiz; ...

2017-06-01

An americium solution injected intramuscularly into several nonhuman primates (NHPs) was found to behave differently than predicted by the wound models described in the NCRP Report 156. This was because the injection was made along with a citrate solution, which is known to be more soluble than chlorides, oxides, or nitrates on which the NCRP Report was based. We developed a multi-exponential wound model specific to the injected americium solution based on the retention in the intramuscular sites. The model was coupled with the americium systemic model to interpret the urinary excretion data and assess the intake, and it wasmore » determined that the models were adequate to predict early urinary excretion in most cases but unable to predict late urinary excretion. This was attributed to the differences in the systemic handling of americium between humans and nonhuman primates. Furthermore, information on the type of wounds, solubility, particle size, mass, chemical form, etc., should always be considered when performing wound dosimetry.« less

Optimization of Uranium-Doped Americium Oxide Synthesis for Space Application.

PubMed

Vigier, Jean-François; Freis, Daniel; Pöml, Philipp; Prieur, Damien; Lajarge, Patrick; Gardeur, Sébastien; Guiot, Antony; Bouëxière, Daniel; Konings, Rudy J M

2018-04-16

Americium 241 is a potential alternative to plutonium 238 as an energy source for missions into deep space or to the dark side of planetary bodies. In order to use the 241 Am isotope for radioisotope thermoelectric generator or radioisotope heating unit (RHU) production, americium materials need to be developed. This study focuses on the stabilization of a cubic americium oxide phase using uranium as the dopant. After optimization of the material preparation, (Am 0.80 U 0.12 Np 0.06 Pu 0.02 )O 1.8 has been successfully synthesized to prepare a 2.96 g pellet containing 2.13 g of 241 Am for fabrication of a small scale RHU prototype. Compared to the use of pure americium oxide, the use of uranium-doped americium oxide leads to a number of improvements from a material properties and safety point of view, such as good behavior under sintering conditions or under alpha self-irradiation. The mixed oxide is a good host for neptunium (i.e., the 241 Am daughter element), and it has improved safety against radioactive material dispersion in the case of accidental conditions.

Removal of plutonium and americium from alkaline waste solutions

DOEpatents

Schulz, Wallace W.

1979-01-01

High salt content, alkaline waste solutions containing plutonium and americium are contacted with a sodium titanate compound to effect removal of the plutonium and americium from the alkaline waste solution onto the sodium titanate and provide an effluent having a radiation level of less than 10 nCi per gram alpha emitters.

Performance Evaluation of Cloud Service Considering Fault Recovery

NASA Astrophysics Data System (ADS)

Yang, Bo; Tan, Feng; Dai, Yuan-Shun; Guo, Suchang

In cloud computing, cloud service performance is an important issue. To improve cloud service reliability, fault recovery may be used. However, the use of fault recovery could have impact on the performance of cloud service. In this paper, we conduct a preliminary study on this issue. Cloud service performance is quantified by service response time, whose probability density function as well as the mean is derived.

Investigation of factors affecting the quality of americium electroplating.

PubMed

Trdin, M; Benedik, L; Samardžija, Z; Pihlar, B

2012-09-01

Four different electrolyte solutions were used in the electrodeposition of americium and their influences on the quality of the thin layer of deposited americium isotopes in combination with three different cathode disc materials were investigated. The relations between alpha spectral resolution and disc surface properties were established. Copyright © 2012 Elsevier Ltd. All rights reserved.

The role of complaint management in the service recovery process.

PubMed

Bendall-Lyon, D; Powers, T L

2001-05-01

Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.

The role of service recovery in HMO satisfaction.

PubMed

Sarel, D; Marmorstein, H

1999-01-01

Complaint handling and service recovery by HMOs may be more efficient to implement and more determinant of customer satisfaction and retention than other approaches such as improving access to care. The current findings are consistent with research on recovery efforts in other industries. Complaint handling systems must achieve rapid and comprehensive identification and resolution of HMO member problems. Both cultural change and appropriate incentives to re-educate employees within HMO organizations are additional requisites to effective service recovery. The benefits to the HMO of expenditures on service recovery should be more immediate and sustainable than the benefits derived from other methods of increasing member satisfaction.

42 CFR 66.110 - Service, payback, and recovery requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Service, payback, and recovery requirements. 66.110 Section 66.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.110 Service, payback, and recovery...

42 CFR 66.110 - Service, payback, and recovery requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Service, payback, and recovery requirements. 66.110 Section 66.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.110 Service, payback, and recovery...

42 CFR 66.110 - Service, payback, and recovery requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Service, payback, and recovery requirements. 66.110 Section 66.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.110 Service, payback, and recovery...

42 CFR 66.110 - Service, payback, and recovery requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Service, payback, and recovery requirements. 66.110 Section 66.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.110 Service, payback, and recovery...

42 CFR 66.110 - Service, payback, and recovery requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Service, payback, and recovery requirements. 66.110 Section 66.110 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.110 Service, payback, and recovery...

SEPARATION OF CURIUM AND AMERICIUM

DOEpatents

Fields, P.R.; Isaac, N.M.

1962-02-20

Curium and americium are contained in an anhydrous molten salt medium having a low melting point. Curium is preferentially extracted from the molten salt by a hot organic solvent containing preferably less than 10% alkyl phosphate. (AEC)

Recovery-Oriented Services--The Role of Training in Transformation

ERIC Educational Resources Information Center

Nowak, Izabela; Switaj, Piotr; Anczewska, Marta

2015-01-01

Recovery oriented practice/service provision is how workers and services support people in their recovery journey. There are four identified practice domains: promoting citizenship, organizational commitment, supporting personally defined recovery, and working relationship. Professionals might be helpful if they are willing to be open, respectful…

An evaluation of service use outcomes in a Recovery College.

PubMed

Bourne, Philippa; Meddings, Sara; Whittington, Adrian

2017-12-23

Recovery Colleges offer educational courses about recovery and mental health which are co-produced by mental health professionals and experts by lived experience. Previous evaluations have found positive effects of Recovery Colleges on a range of outcomes including wellbeing, recovery and quality of life. To evaluate service use outcomes for Sussex Recovery College students who use mental health services. The study used a controlled-before-and-after design. It used archival data to analyse service use before and after participants registered with the Recovery College (n = 463). Participants acted as their own control. Students used mental health services less after attending the Recovery College than before. Students who attended the Recovery College showed significant reductions in occupied hospital bed days, admissions, admissions under section and community contacts in the 18 months post compared with the 18 months before registering. Reductions in service use were greater for those who completed a course than those who registered but did not complete a course. These findings suggest that attending Recovery College courses is associated with reduced service use. The reductions equate to non-cashable cost-savings of £1200 per registered student and £1760 for students who completed a course. Further research is needed to investigate causality.

Apoptosis of rat kidney cells after 241-americium administration.

PubMed

Labéjof, L; Berry, J P; Duchambon, P; Poncy, J L; Galle, P

1998-01-01

Tumors induction by americium is well known but there are no data on the biological effects of this radionucleide at subcellular level. In order to study the possible ultrastructural lesions induced by this element, a group of rats were injected with 241-Americium-citrate (9 kBq), once a week for five weeks and sacrificed 7 days after the last injection. We describe the alterations observed in the cortex kidney using cytochemical (TUNEL reaction) and histochemical (PAS staining) methods for light microscopy as well as electron microscopy techniques. Various types of lesions were detected: condensation of nuclear chromatine, fragmentation of the nuclei, swollen mitochondria, disappearance of mitochondrial crests and skrinking of the cytoplasm. This study clearly demonstrated the induction of apoptosis by americium in rat cortex kidney cells.

Recovery-oriented service provision and clinical outcomes in assertive community treatment.

PubMed

Kidd, Sean A; George, Lindsey; O'Connell, Maria; Sylvestre, John; Kirkpatrick, Helen; Browne, Gina; Odueyungbo, Adefowope O; Davidson, Larry

2011-01-01

While the term "recovery" is routinely referenced in clinical services and health policy, few studies have examined the relationship between recovery-oriented service provision and client outcomes. The present study was designed to examine the relationship between recovery-orientation of service provision for persons with severe mental illnesses and outcomes in Assertive Community Treatment (ACT). Client, family, staff, and manager ratings of service recovery-orientation and outcomes across a range of service utilization and community functioning indicators were examined among 67 ACT teams in Ontario, Canada. Significant associations were found between ratings of recovery-oriented service provision and better outcomes in the domains of legal involvement, hospitalization days, education involvement, and employment. Results were not uniformly positive or consistent, however, across stakeholder Recovery Self-Assessment (RSA) ratings or outcomes. These findings provide some preliminary support for an association between recovery-oriented service delivery for persons with severe mental illnesses and better outcomes. In line with the current practice commentary, this association would suggest the importance of evaluating and cultivating recovery-oriented values and practices in ACT contexts. This is a particularly salient point given that ACT standards minimally address key domains of recovery-oriented service provision. Further study is required, however, to determine if these findings apply to the implementation of ACT in other jurisdictions or generalize to other community support programs.

Nature and determinants of customer expectations of service recovery in health care.

PubMed

Dasu, S; Rao, J

1999-01-01

Service recovery refers to the service provider's response to a dissatisfied customer. This article proposes a model of customer expectations of service recovery in health care services. The model discusses two types of service recovery expectations: will and should. An exploratory study indicates that industry reputation and personal experiences drive customers' "will-expectations" of service recovery while "should-expectations" can be explained via norm, fairness, social contract and hospitality theories.

Americium alloys with gold and copper

NASA Astrophysics Data System (ADS)

Radchenko, V. M.; Ryabinin, M. A.; Chernakova, T. A.; Tomilin, S. V.

2010-03-01

Presented are results of the production and X-ray examination of micro-samples of americium-241 compounds with gold and copper produced by high-temperature condensation of metal americium vapor onto corresponding substrates. No mutual solubility of the investigated system components was revealed at room temperature. The following three intermetallic compounds were revealed in the Am-Au system: Au6Am with tetragonal lattice of the Au6Sm structural type, AuAm with orthorhombic lattice of the CuCe structural type and AuAm with cubic lattice. The Am-Cu system showed the intermetallic compound Cu5Am (Cu7Am) with a hexagonal lattice of the Cu5Ca(Cu7Tb) structure type. An effect of the 241Am nuclide alpha-activity on the crystal structure of the produced intermetallide was studied.

Postinhalation kinetics of metabolism of americium-241 and absorbed doses in organs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buldakov, L.A.; Kalmykova, Z.I.

1979-12-01

The metabolism of soluble americium-241 compounds administered to dogs by inhalation was studied over a period of 6.5 years. The rate of excretion of americium-241 in feces and urine, organ uptake, and survival were monitored.

Environmental impact of a teratogenic actinide: a case study of americium-241

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, J.; Yang, J.Y.

1985-10-16

Americium-241 is widely used as a radiation source, but it also has some potential risk if taken into the body. Although the radiotoxicity of americium-241 is small compared to other transuranic actinides, its effects on the reproductive system and on development of the placenta are more damaging than the effects of plutonium-239. A previous report based on a worst-case scenario involving a hypothetical fire accident in a contaminated facility indicated that there could have been a significant impact on nearby residents from a unit release of americium-241 via atmospheric dispersion. However, because the facility is located in a rural regionmore » where most drinking water supplies are drawn from private wells, it is believed that deposition of americium-241 from the atmosphere might also have impacts via the groundwater pathway by infiltration of rainwater. In this analysis, a three-dimensional analytical mathematical model is used to assess several aspects of americium-241 contamination of groundwater, including radioactive transformation, advection, dispersion, and soil sorption. Simulation results indicate that no significant radiological impacts would occur to the nearby residents via the groundwater pathway. 15 refs., 2 figs., 2 tabs.« less

Choice, perceived control, and customer satisfaction: the psychology of online service recovery.

PubMed

Chang, Chia-Chi

2008-06-01

Service failures and consequent recoveries have been identified as critical determinants of customer retention. Therefore, effective service recovery programs warrant further exploration, particularly in the online shopping environment, where consumers can receive immediate and tangible service recovery. The results of the present study suggest that by providing a choice of recovery options, customers' sense of control is increased, as is their satisfaction with the particular recovery efforts and their overall satisfaction with the entire service experience. Also, service importance accentuated the impact of choice on perceived control. Specifically, when the service was of greater importance, giving customers a choice of recovery options augmented customers' sense of control more than when the service was of lesser importance. The implications of the findings are also discussed.

Evaluation of a Residential Mental Health Recovery Service in North Queensland.

PubMed

Heyeres, Marion; Kinchin, Irina; Whatley, Elise; Brophy, Lisa; Jago, Jon; Wintzloff, Thomas; Morton, Steve; Mosby, Vinitta; Gopalkrishnan, Narayan; Tsey, Komla

2018-01-01

Evidence shows that subacute mental health recovery occurs best when a person remains active within the community and fulfils meaningful and satisfying roles of their choosing. Several residential care services that incorporate these values have been established in Australia and overseas. This study describes (a) the development of an evaluation framework for a new subacute residential mental health recovery service in regional Australia and (b) reports on the formative evaluation outcomes. Continuous quality improvement and participatory research approaches informed all stages of the development of the evaluation framework. A program logic was established and subsequently tested for practicability. The resultant logic utilizes the Scottish Recovery Indicator 2 (SRI 2) service development tool, Individual Recovery Plans (IRPs), and the impact assessment of the service on psychiatric inpatient admissions (reported separately). Service strengths included a recovery-focused practice that identifies and addresses the basic needs of residents (consumers). The consumers of the service were encouraged to develop their own goals and self-manage their recovery plans. The staff of the service were identified as working effectively in the context of the recovery process; the staff were seen as supported and valued. Areas for improvement included more opportunities for self-management for residents and more feedback from residents and carers.

What are your priorities right now? Identifying service needs across recovery stages to inform service development.

PubMed

Laudet, Alexandre B; White, William

2010-01-01

Substance use disorders (SUD) are, for many, chronic conditions that are typically associated with severe impairments in multiple areas of functioning. "Recovery" from SUD is, for most, a lengthy process; improvements in other areas of functioning do not necessarily follow the attainment of abstinence. The current SUD service model providing intense, short-term, symptom-focused services is ill-suited to address these issues. A recovery-oriented model of care is emerging, which provides coordinated recovery-support services using a chronic-care model of sustained recovery management. Information is needed about substance users' priorities, particularly persons in recovery who are not currently enrolled in treatment, to guide the development of recovery-oriented systems. As a first step in filling this gap, we present qualitative data on current life priorities among a sample of individuals that collectively represent successive recovery stages (N = 356). Findings suggest that many areas of functioning remain challenging long after abstinence is attained, most notably employment and education, family/social relations, and housing. Although the ranking of priorities changes somewhat across recovery stages, employment is consistently the second most important priority, behind working on one's recovery. Study limitations are noted, and the implications of findings for the development and evaluation of recovery-oriented services are discussed.

Americium-241 uptake by Bahiagrass as influenced by soil type, lime, and organic matter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hoyt, G.D.; Adriano, D.C.

1979-07-01

Availability of /sup 241/Am to bahiagrass (Paspalum notatum), a major forage crop in the southeastern US, was studied under greenhouse conditions using two soil types, two rates of lime, and four rates of organic matter. The plants were grown in pots until three clippings were obtained. Americium-241 concentrations in plant tissues from the unlimed Dothan (24% clay) soil were, on the average, approximately twice as high as those from unlimed Troup (10% clay) soil. Lime significantly reduced /sup 241/Am uptake from both soils. The americium concentration ratios (americium concentration in dry plant tissue/average americium concentration in dry soil) for limedmore » treatments were, in general, one order of magnitude lower than those for unlimed treatments. Organic matter, added to the soils as bermuda grass hay, somewhat reduced /sup 241/Am uptake, especially when added at high rates in unlimed soils. The effect of lime on uptake could be attributed to immobilization of americium ions external to the roots as a result of decreased solubility of this radionuclide and/or antagonistic effect of increased calcium ion concentration in the soil solution on americium ions. The effect of organic matter on uptake could be attributed to its fixing capacity for metals.« less

The Most Useful Actinide Isotope: Americium-241.

ERIC Educational Resources Information Center

Navratil, James D.; And Others

1990-01-01

Reviewed is the discovery, nuclear and chemical properties, and uses of an isotope of Americium (Am-241). Production and separation techniques used in industry are emphasized. Processes are illustrated in flow sheets. (CW)

Reduction Rates for Higher Americium Oxidation States in Nitric Acid

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grimes, Travis Shane; Mincher, Bruce Jay; Schmitt, Nicholas C

The stability of hexavalent americium was measured using multiple americium concentrations and nitric acid concentrations after contact with the strong oxidant sodium bismuthate. Contrary to our hypotheses Am(VI) was not reduced faster at higher americium concentrations, and the reduction was only zero-order at short time scales. Attempts to model the reduction kinetics using zero order kinetic models showed Am(VI) reduction in nitric acid is more complex than the autoreduction processes reported by others in perchloric acid. The classical zero-order reduction of Am(VI) was found here only for short times on the order of a few hours. We did show thatmore » the rate of Am(V) production was less than the rate of Am(VI) reduction, indicating that some Am(VI) undergoes two electron-reduction to Am(IV). We also monitored the Am(VI) reduction in contact with the organic diluent dodecane. A direct comparison of these results with those in the absence of the organic diluent showed the reduction rates for Am(VI) were not statistically different for both systems. Additional americium oxidations conducted in the presence of Ce(IV)/Ce(III) ions showed that Am(VI) is reduced without the typical growth of Am(V) observed in the systems sans Ce ion. This was an interesting result which suggests a potential new reduction/oxidation pathway for Am in the presence of Ce; however, these results were very preliminary, and will require additional experiments to understand the mechanism by which this occurs. Overall, these studies have shown that hexavalent americium is fundamentally stable enough in nitric acid to run a separations process. However, the complicated nature of the reduction pathways based on the system components is far from being rigorously understood.« less

The Recovery College: A unique service approach and qualitative evaluation.

PubMed

Newman-Taylor, Katherine; Stone, Nicola; Valentine, Paul; Hooks, Zoe; Sault, Katherine

2016-06-01

This study examined the impact of a Recovery College, an educational service model focusing specifically on health care to engage people's hope, agency, and opportunities for recovery. For the purpose of the study, a qualitative approach was used given the absence of research in this area. Eleven people completed semistructured interviews conducted by an independent researcher. Verbatim transcripts were analyzed using thematic analysis. The analyses yielded themes emphasizing the impact of the organizational structure of the college. Coproduction of service delivery was contrasted with traditional provision and identified as fundamental to personal and professional changes made. Recovery College participants described clear gains. These findings are discussed in relation to the recovery literature and highlight the need for routine coproduction of services to facilitate recovery from the often devastating impact of mental ill-health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Measures of the recovery orientation of mental health services: systematic review.

PubMed

Williams, J; Leamy, M; Bird, V; Harding, C; Larsen, J; Le Boutillier, C; Oades, L; Slade, M

2012-11-01

The review aimed to (1) identify measures that assess the recovery orientation of services; (2) discuss how these measures have conceptualised recovery, and (3) characterise their psychometric properties. A systematic review was undertaken using seven sources. The conceptualisation of recovery within each measure was investigated by rating items against a conceptual framework of recovery comprising five recovery processes: connectedness; hope and optimism; identity; meaning and purpose; and empowerment. Psychometric properties of measures were evaluated using quality criteria. Thirteen recovery orientation measures were identified, of which six met eligibility criteria. No measure was a good fit with the conceptual framework. No measure had undergone extensive psychometric testing and none had data on test-retest reliability or sensitivity to change. Many measures have been developed to assess the recovery orientation of services. Comparisons between the measures were hampered by the different conceptualisations of recovery used and by the lack of uniformity on the level of organisation at which services were assessed. This situation makes it a challenge for services and researchers to make an informed choice on which measure to use. Further work is needed to produce measures with a transparent conceptual underpinning and demonstrated psychometric properties.

An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges.

PubMed

Frost, Barry G; Tirupati, Srinivasan; Johnston, Suzanne; Turrell, Megan; Lewin, Terry J; Sly, Ketrina A; Conrad, Agatha M

2017-01-17

Over past decades, improvements in longer-term clinical and personal outcomes for individuals experiencing serious mental illness (SMI) have been moderate, although recovery has clearly been shown to be possible. Recovery experiences are inherently personal, and recovery can be complex and non-linear; however, there are a broad range of potential recovery contexts and contributors, both non-professional and professional. Ongoing refinement of recovery-oriented models for mental health (MH) services needs to be fostered. This descriptive paper outlines a service-wide Integrated Recovery-oriented Model (IRM) for MH services, designed to enhance personally valued health, wellbeing and social inclusion outcomes by increasing access to evidenced-based psychosocial interventions (EBIs) within a service context that supports recovery as both a process and an outcome. Evolution of the IRM is characterised as a series of five broad challenges, which draw together: relevant recovery perspectives; overall service delivery frameworks; psychiatric and psychosocial rehabilitation approaches and literature; our own clinical and service delivery experience; and implementation, evaluation and review strategies. The model revolves around the person's changing recovery needs, focusing on underlying processes and the service frameworks to support and reinforce hope as a primary catalyst for symptomatic and functional recovery. Within the IRM, clinical rehabilitation (CR) practices, processes and partnerships facilitate access to psychosocial EBIs to promote hope, recovery, self-agency and social inclusion. Core IRM components are detailed (remediation of functioning; collaborative restoration of skills and competencies; and active community reconnection), together with associated phases, processes, evaluation strategies, and an illustrative IRM scenario. The achievement of these goals requires ongoing collaboration with community organisations. Improved outcomes are achievable for

10 CFR 31.8 - Americium-241 and radium-226 in the form of calibration or reference sources.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Americium-241 and radium-226 in the form of calibration or... BYPRODUCT MATERIAL § 31.8 Americium-241 and radium-226 in the form of calibration or reference sources. (a..., americium-241 or radium-226 in the form of calibration or reference sources: (1) Any person in a non...

10 CFR 31.8 - Americium-241 and radium-226 in the form of calibration or reference sources.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Americium-241 and radium-226 in the form of calibration or... BYPRODUCT MATERIAL § 31.8 Americium-241 and radium-226 in the form of calibration or reference sources. (a..., americium-241 or radium-226 in the form of calibration or reference sources: (1) Any person in a non...

10 CFR 31.8 - Americium-241 and radium-226 in the form of calibration or reference sources.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Americium-241 and radium-226 in the form of calibration or... BYPRODUCT MATERIAL § 31.8 Americium-241 and radium-226 in the form of calibration or reference sources. (a..., americium-241 or radium-226 in the form of calibration or reference sources: (1) Any person in a non...

10 CFR 31.8 - Americium-241 and radium-226 in the form of calibration or reference sources.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Americium-241 and radium-226 in the form of calibration or... BYPRODUCT MATERIAL § 31.8 Americium-241 and radium-226 in the form of calibration or reference sources. (a..., americium-241 or radium-226 in the form of calibration or reference sources: (1) Any person in a non...

10 CFR 31.8 - Americium-241 and radium-226 in the form of calibration or reference sources.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Americium-241 and radium-226 in the form of calibration or... BYPRODUCT MATERIAL § 31.8 Americium-241 and radium-226 in the form of calibration or reference sources. (a..., americium-241 or radium-226 in the form of calibration or reference sources: (1) Any person in a non...

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization

PubMed Central

Wu, F.; Fu, L.M.; Hser, Y.H.

2015-01-01

Background This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Methods Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Results Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Conclusions Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. PMID:24990956

Brachytherapy devices and methods employing americium-241

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gray, L. A.

1985-04-16

Sources and methods for radiation therapy, particularly brachytherapy, employing americium-241 (60 keV gamma emission and 433 year half-life) provide major advantages for radiotherapy, including simplified radiation protection, dose reduction to healthy tissue, increased dose to tumor, and improved dose distributions. A number of apparent drawbacks and unfavorable considerations including low gamma factor, high self-absorption, increased activity required and alpha-particle generation leading to helium gas pressure buildup and potential neutron contamination in the generated radiation are all effectively dealt with and overcome through recognition of subtle favorable factors unique to americium-241 among brachytherapy sources and through suitable constructional techniques. Due tomore » an additional amount of radiation, in the order of 50%, provided primarily to nearby regions as a result of Compton scatter in tissue and water, higher dose rates occur than would be predicted by conventional calculations.« less

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization.

PubMed

Wu, F; Fu, L M; Hser, Y H

2015-09-01

This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Promoting recovery: service user and staff perceptions of resilience provided by a new Early Intervention in Psychosis service.

PubMed

Morton, Adrian; Fairhurst, Alicia; Ryan, Rebecca

2010-02-01

The principles and practice of recovery are guiding many changes in mental health service provision. As a new Early Intervention in Psychosis (EIP) service, we were interested in finding out if both staff and users perceive the service as promoting resilience and in turn, recovery. A naturalistic sample of service users and staff completed the Organizational Climate questionnaire to assess the degree to which the service promotes resilience in overcoming a first episode psychosis. The results indicated that both staff and service users similarly perceive the service as positively supporting resilience. The one exception was the staff rated the 'available resources to meet people's needs' as less than service users. The positive rating of resilience indicated that the service is working in a manner consistent with a recovery orientation. The results will act as a benchmark to compare with both other EIP services and future performance.

What Factors Influence Employee Service Recovery Performance and What Are the Consequences in Health Care?

PubMed

Nadiri, Halil; Tanova, Cem

2016-01-01

We analyzed the extent to which the service recovery performance of frontline employees in private health care institutions is influenced by employee perceptions of manager attitudes toward service quality, workplace support, and manager fairness and organizational commitment. We also examined the relationship of service recovery performance to employee job satisfaction and turnover intentions. Partial least square path modeling of data from 178 frontline employees in private health care institutions in North Cyprus was utilized. Although empowerment and role clarity were positively related to service recovery performance, perceived managerial attitudes toward hospital customer service, teamwork, and customer service-oriented training as indicators of workplace support were not related to frontline employees' service recovery performance. Organizational justice was related to affective commitment, which in turn was related to service recovery performance. Although service recovery performance was not related to employee turnover intentions, it was related to job satisfaction. Managerial implications of these study findings are presented in the light of the cognitive evaluation theory. Health services differ from other service organizations in the way that intrinsic and extrinsic rewards influence the service recovery efforts of frontline employees. To ensure high quality services, managers should focus on intrinsic rewards, empower and give more autonomy to staff.

Effect of Americium-241 Content on Plutonium Radiation Source Terms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rainisch, R.

1998-12-28

The management of excess plutonium by the US Department of Energy includes a number of storage and disposition alternatives. Savannah River Site (SRS) is supporting DOE with plutonium disposition efforts, including the immobilization of certain plutonium materials in a borosilicate glass matrix. Surplus plutonium inventories slated for vitrification include materials with elevated levels of Americium-241. The Am-241 content of plutonium materials generally reflects in-growth of the isotope due to decay of plutonium and is age-dependent. However, select plutonium inventories have Am-241 levels considerably above the age-based levels. Elevated levels of americium significantly impact radiation source terms of plutonium materials andmore » will make handling of the materials more difficult. Plutonium materials are normally handled in shielded glove boxes, and the work entails both extremity and whole body exposures. This paper reports results of an SRS analysis of plutonium materials source terms vs. the Americium-241 content of the materials. Data with respect to dependence and magnitude of source terms on/vs. Am-241 levels are presented and discussed. The investigation encompasses both vitrified and un-vitrified plutonium oxide (PuO2) batches.« less

Uptake and effects of americium-241 on a brackishwater amphipod

NASA Astrophysics Data System (ADS)

Hoppenheit, M.; Murray, C. N.; Woodhead, D. S.

1980-03-01

The present paper reports the results of experimental work undertaken using the brackish-water amphipod Gammarus duebeni duebeni and the transuranium nuclide americium-241. Data on the accumulation of this actinide showed that the larger fraction of the total body burden is associated with the exoskeleton. It was found that the body burden remained constant in the range pH 8.0 6.5 even though the water concentrations changed markedly. It would thus appear that the concept of a concentration factor should be re-examined and it is proposed that a factor should be defined in terms of environmental and chemical parameters which represent the bioavailable fraction of the actinide. The effect of americium on survival and moulting was studied at two activity concentrations; the dose rates and absorbed doses under the experimental conditions employed have been estimated. The differences in survival rates between the control and irradiated groups were statistically analyzed and the significant difference at the higher concentration is believed to be due to a synergism between physiological stress and radiotoxicity of americium rather than the chemical toxicity of the element.

Recovery orientation of treatment, consumer empowerment, and satisfaction with services: a mediational model.

PubMed

Barrett, Blake; Young, M Scott; Teague, Gregory B; Winarski, James T; Moore, Kathleen A; Ochshorn, Ezra

2010-01-01

This study explores the relationship between the recovery orientation of treatment and subjective experiences of consumer empowerment and satisfaction with services for individuals with severe and persistent mental illness. Instruments measuring perceptions of empowerment, recovery orientation of treatment, and satisfaction with services were administered to 45 participants enrolled in two demographically similar mental health treatment programs in Tampa, Florida - a community mental health center and an Assertive Community Treatment team. Analyses were conducted according to traditional mediation models. Empowerment was expected to mediate the relationship between the recovery orientation of treatment and consumer satisfaction with services. A recovery-based treatment orientation significantly predicted both consumer empowerment and satisfaction with services. Empowerment mediated the relationship between treatment orientation and consumer satisfaction. These preliminary findings highlight the impact of the recovery orientation of treatment on empowerment and satisfaction with services among individuals with severe and persistent mental illness.

Plutonium-239 and americium-241 uptake by plants from soil. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, K.W.

1979-03-01

Alfalfa was grown in soil contaminated with plutonium-239 dioxide (239PuO2) at a concentration of 29.7 nanocuries per gram (nCi/g). In addition to alfalfa, radishes, wheat, rye, and tomatoes were grown in soils contaminated with americium-241 nitrate (241Am(NO3)3) at a concentration of 189 nCi/g. The length of exposure varied from 52 days for the radishes to 237 days for the alfalfa. The magnitude of plutonium incorporation by the alfalfa as indicated by the concentration ratio, 0.0000025, was similar to previously reported data using other chemical forms of plutonium. The results did indicate, however, that differences in the biological availability of plutoniummore » isotopes do exist. All of the species exposed to americium-241 assimilated and translocated this radioisotope to the stem, leaf, and fruiting structures. The magnitude of incorporation as signified by the concentration ratios varied from 0.00001 for the wheat grass to 0.0152 for the radishes. An increase in the uptake of americium also occurred as a function of time for four of the five plant species. Evidence indicates that the predominant factor in plutonium and americium uptake by plants may involve the chelation of these elements in soils by the action of compounds such as citric acid and/or other similar chelating agents released from plant roots.« less

Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services?

PubMed Central

Laudet, Alexandre B.; Humphreys, Keith

2013-01-01

As both a concept and a movement, “recovery” is increasingly guiding substance use disorder (SUD) services and policy. One sign of this change is the emergence of recovery support services that attempt to help addicted individuals using a comprehensive continuing care model. This paper reviews the policy environment surrounding recovery support services, the needs to which they should respond, and the status of current recovery support models. We conclude that recovery support services (RSS) should be further assessed for effectiveness and cost-effectiveness, that greater efforts must be made to develop the RSS delivery workforce, and that RSS should capitalize on ongoing efforts to create a comprehensive, integrated and patient-centered health care system. As the SUD treatment system undergoes its most important transformation in at least 40 years, recovery research and the lived experience of recovery from addiction should be central to reform. PMID:23506781

Airborne plutonium-239 and americium-241 concentrations measured from the 125-meter Hanford Meteorological Tower

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sehmel, G.A.

1978-01-01

Airborne plutonium-239 and americium-241 concentrations and fluxes were measured at six heights from 1.9 to 122 m on the Hanford meteorological tower. The data show that plutonium-239 was transported on nonrespirable and small particles at all heights. Airborne americium-241 concentrations on small particles were maximum at the 91 m height.

Environmental impacts of the release of a transuranic actinide, americium-241, from a contaminated facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Want, J.; Merry-Libby, P.

1985-10-29

Americium-241 is widely used as a radiation source, but it also has some potential risk if taken into the body because of its high dose conversion factor. Although the radiotoxicity of americium-241 is small compared to other transuranic actinides, its effects on the reproductive system and on development of the placenta are more damaging than the effects of plutonium-239. In Ohio, a gemologist's laboratory was contaminated with americium-241. Prior to decontamination of the laboratory, potential radiological impacts to the surrounding environment were assessed. A hypothetical fire accident resulting in a unit release (1 curie) was assumed. Potential radiological impacts weremore » simulated using an atmospheric dispersion and dosimetry model with local meteorological data, population census data, and detailed information regarding the neighborhood. The results indicate that there could have been a significant impact on nearby residents from americium-241 via atmospheric dispersion if a major catastrophic release had occurred prior to contamination and decommissioning of the laboratory. 14 refs., 3 figs., 2 tabs.« less

The Recovery Knowledge Inventory for Measurement of Nursing Student Views on Recovery-oriented Mental Health Services.

PubMed

Happell, Brenda; Byrne, Louise; Platania-Phung, Chris

2015-01-01

Recovery-oriented services are a goal for policy and practice in the Australian mental health service system. Evidence-based reform requires an instrument to measure knowledge of recovery concepts. The Recovery Knowledge Inventory (RKI) was designed for this purpose, however, its suitability and validity for student health professionals has not been evaluated. The purpose of the current article is to report the psychometric features of the RKI for measuring nursing students' views on recovery. The RKI, a self-report measure, consists of four scales: (I) Roles and Responsibilities, (II) Non-Linearity of the Recovery Process, (III) Roles of Self-Definition and Peers, and (IV) Expectations Regarding Recovery. Confirmatory and exploratory factor analyses of the baseline data (n = 167) were applied to assess validity and reliability. Exploratory factor analyses generally replicated the item structure suggested by the three main scales, however more stringent analyses (confirmatory factor analysis) did not provide strong support for convergent validity. A refined RKI with 16 items had internal reliabilities of α = .75 for Roles and Responsibilities, α = .49 for Roles of Self-Definition and Peers, and α = .72, for Recovery as Non-Linear Process. If the RKI is to be applied to nursing student populations, the conceptual underpinning of the instrument needs to be reworked, and new items should be generated to evaluate and improve scale validity and reliability.

Service Providers’ Experiences and Perspectives on Recovery-Oriented Mental Health System Reform

PubMed Central

Piat, Myra; Lal, Shalini

2016-01-01

Objective With the use of a qualitative approach, this study focuses on service providers’ experiences and perspectives on recovery-oriented reform. Methods Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites. Results Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses. Conclusions and Implications for Practice The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice. PMID:22491368

THE PREPARATION, PROPERTIES, AND USES OF AMERICIUM-241, ALPHA-, GAMMA-, AND NEUTRON SOURCES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Strain, J.E.; Leddicotte, G.W.

1962-09-01

A study was made of the preparation of alpha, gamma, and neutron sources using the long-lived radioisotope of americium, Am/sup 241/. Americium-241 is an artificiallyproduced radioelement which has a half-life of 462 plus or minus 10 years and decays to Np/sup 237/ by alpha emission followed by low-energy gamma emission. The high specific activity of americium-241 (7.0 x 10/sup 9/ d/m/mg) combined with its reasonably long half-life makes it ideally sulted for the preparation of radioactive sources. The chemical and physical properties of Am/ sup 241/ and the physical manipulations involved in fabricating alpha, gamma, and neutron sources are generallymore » described in this report. Uses for each type of source are discussed and data are presented to indicate the respective properties and usefulness of each source type. (auth)« less

Consumer and case manager perspectives of service empowerment: relationship to mental health recovery.

PubMed

Crane-Ross, Dushka; Lutz, Wilma J; Roth, Dee

2006-04-01

This study examines the relationship between service empowerment and recovery. Service empowerment is defined as the extent to which consumers participate in service decisions and the level of reciprocity and respect within the relationship with their case managers. Assessments were made from two perspectives: consumers and their case managers. Structural equation models were developed to examine the direct and indirect effects of service empowerment on four recovery outcomes: Quality of Life, Level of Functioning, Consumer-Reported Symptomatology, and Case Manager-Reported Symptomatology. Consumers' perceptions of service empowerment were the most powerful predictor of recovery outcomes across the four models. Consumers' and case managers' perceptions were related but the magnitude of the relationship was small, indicating that considerable differences exist between their perceptions of service empowerment.

The Place of Social Recovery in Mental Health and Related Services.

PubMed

Ramon, Shulamit

2018-05-23

This article looks at the place of social recovery in mental health and social care services, alongside personal recovery. Despite its conceptual and practice centrality to the new meaning of recovery, social recovery has remained a relatively neglected dimension. This article attempts to provide an updated critical commentary based on findings from fifty nine studies, including a variety of research methodologies and methods. Definitions of social recovery within the new meaning of recovery are looked at. This is followed by outlining the development and significance of this dimension as reflected in the key areas of shared decision making, co-production and active citizenship, re-entering employment after experiencing mental ill health, being in employment, poverty and coping with poverty, the economic and the scientific cases for social recovery. The article highlights the connections between service users' experiencing mental health and social care systems, and the implications of ideologies and policies reflecting positions on social recovery. The complexity of social recovery is indicated in each of these areas; the related conceptual and methodological frameworks developed to research this dimension, and key achievements and barriers concerning everyday practice application of social recovery. The summary indicates potential future development perspectives of this dimension.

Transforming mental health services: a participatory mixed methods study to promote and evaluate the implementation of recovery-oriented services.

PubMed

Park, Melissa M; Zafran, Hiba; Stewart, Janet; Salsberg, Jon; Ells, Carolyn; Rouleau, Suzanne; Estein, Orly; Valente, Thomas W

2014-09-10

Since 2007, the Mental Health Commission of Canada has worked collaboratively across all provinces to publish a framework and strategy for recovery and well-being. This federal document is now mandated as policy for implementation between 2012 and 2017. The proposed strategies have been written into provincial health plans, hospital accreditation standards, and annual objectives of psychiatric departments and community organizations. The core premise is: to empower persons with mental illness and their families to become participants in designing their own care, while meeting the needs of a diverse Canadian population. However, recovery principles do not come with an implementation guide to fit the variability of different local contexts. How can policy recommendations and accreditation standards be effectively tailored to support a diversity of stakeholder values? To our knowledge, there is little evidence indicating the most effective manner to accelerate the uptake of recovery-oriented services among providers in a given/particular mental health treatment setting. This three-year Canadian Institute of Health Research Partnership in Health System Improvement and The Rx&D Health Research Foundation (HRF) Fostering Canadian Innovation in Research study (2013 to 2017) proposed participatory approaches to implementing recovery principles in a Department of Psychiatry serving a highly diverse Canadian and immigrant population. This project will be conducted in overlapping and recursive phases: I) Conduct formative research to (a) measure the current knowledge and attitudes toward recovery and recovery-oriented practices among service providers, while concurrently (b) exploring the experiential knowledge of recovery service-users and family members; II) Collaborate with service-users and the network-identified opinion leaders among providers to tailor Recovery-in-Action Initiatives to fit the needs and resources of a Department of Psychiatry; and III) Conduct a

Australian mental health consumers contributions to the evaluation and improvement of recovery-oriented service provision.

PubMed

Marshal, Sarah L; Oades, Lindsay G; Growe, Trevor P

2010-01-01

One key component of recovery-oriented mental health services, typically overlooked, involves genuine collaboration between researchers and consumers to evaluate and improve services delivered within a recovery framework. Eighteen mental health consumers working with staff who had received training in the Collaborative Recovery Model (CRM) took part in in-depth focus group meetings, of approximately 2.5 hours each, to generate feedback to guide improvement of the CRM and its use in mental health services. Consumers identified clear avenues for improvement for the CRM both specific to the model and broadly applicable to recovery-oriented service provision. Findings suggest consumers want to be more engaged and empowered in the use of the CRM from the outset. Improved sampling procedures may have led to the identification of additional dissatisfied consumers. Collaboration with mental health consumers in the evaluation and improvement of recovery-oriented practice is crucial with an emphasis on rebuilding mental health services that are genuinely oriented to support recovery.

Establishing a recovery orientation in mental health services: Evaluating the Recovery Self-Assessment (RSA) in a Swedish context.

PubMed

Rosenberg, David; Svedberg, Petra; Schön, Ulla-Karin

2015-12-01

Although there has been an emphasis on developing knowledge regarding recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Instruments, which present the components of recovery as measurable dimensions of change, may provide a framework for program development. Involving users is an essential factor in the utilization of such tools. The purpose of this study was to evaluate the psychometric properties of the Recovery Self-Assessment (RSA) measure and its potential for being utilized in a Swedish context. The sample consisted of 78 participants from 6 community mental health services targeting people with serious mental illnesses in a municipality in Sweden. They completed the RSA at the study baseline and two weeks later. User panels participated in the translation and administration of the RSA and the reporting of results. The Swedish version of the RSA had good face and content validity, satisfactory internal consistency, and a moderate to good level of stability in test-retest reliability. The user panels contributed to establishing validity and as collaborators in the study. Establishing the RSA as a valid and reliable instrument with which to focus on the recovery orientation of services is a first step in beginning to study the types of interventions that may effect and contribute to recovery oriented practice in Sweden. (c) 2015 APA, all rights reserved).

The Fort McMurray, Alberta wildfires: Emergency and recovery management of healthcare services.

PubMed

Matear, David

2017-01-01

One of the largest wildfires in Canadian history raged through northern Alberta in May to July 2016, and prompted the largest emergency air evacuation in Canadian history. Central to the challenges were the evacuation of a regional hospital, and the emergency and recovery management associated with healthcare services. This paper describes multiple phases of emergency and recovery management, which employed and adapted the Incident Command System to healthcare services. There were no injuries reported throughout the medical evacuation and recovery of medical services. The leadership and management of healthcare services achieved the goals of evacuating patients and staff effectively, supporting emergency first responders and the re-entry of the population to Fort McMurray.

Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention.

PubMed

Wallace, Genevieve; Bird, Victoria; Leamy, Mary; Bacon, Faye; Le Boutillier, Clair; Janosik, Monika; MacPherson, Rob; Williams, Julie; Slade, Mike

2016-09-01

Policy is increasingly focused on implementing a recovery-orientation within mental health services, yet the subjective experience of individuals receiving a pro-recovery intervention is under-studied. The aim of this study was to explore the service user experience of receiving a complex, pro-recovery intervention (REFOCUS), which aimed to encourage the use of recovery-supporting tools and support recovery-promoting relationships. Interviews (n = 24) and two focus groups (n = 13) were conducted as part of a process evaluation and included a purposive sample of service users who received the complex, pro-recovery intervention within the REFOCUS randomised controlled trial (ISRCTN02507940). Thematic analysis was used to analyse the data. Participants reported that the intervention supported the development of an open and collaborative relationship with staff, with new conversations around values, strengths and goals. This was experienced as hope-inspiring and empowering. However, others described how the recovery tools were used without context, meaning participants were unclear of their purpose and did not see their benefit. During the interviews, some individuals struggled to report any new tasks or conversations occurring during the intervention. Recovery-supporting tools can support the development of a recovery-promoting relationship, which can contribute to positive outcomes for individuals. The tools should be used in a collaborative and flexible manner. Information exchanged around values, strengths and goals should be used in care-planning. As some service users struggled to report their experience of the intervention, alternative evaluation approaches need to be considered if the service user experience is to be fully captured.

Development and validation of attitudes towards Recovery Questionnaire across Chinese people in recovery, their family carers, and service providers in Hong Kong.

PubMed

Mak, Winnie W S; Chan, Randolph C H; Yau, Sania S W

2018-05-29

Considering the lack of existing measures on attitudes toward personal recovery and the need to acknowledge the cultural milieu in recovery attitude assessment, the present study developed and validated the Attitudes towards Recovery Questionnaire (ARQ) in a sample of people in recovery of mental illness, family carers, and mental health service providers in Hong Kong. The ARQ was developed based on existing literature and measures of recovery, and focus group discussions with various stakeholders. Findings of the multi-sample confirmatory factor analyses supported a five-factor structure: (1) resilience as a person in recovery, (2) self-appreciation and development, (3) self-direction, (4) family involvement, and (5) social ties and integration. The ARQ was positively correlated with recovery outcomes, empowerment, recovery knowledge, and recovery orientation of mental health services. As a tool for examining recovery attitudes, the ARQ informs us of the mindset across stakeholders and areas that need enhancement to facilitate the recovery process. Copyright © 2018. Published by Elsevier B.V.

Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website

PubMed Central

Fossey, Ellie; Farhall, John; Foley, Fiona; Thomas, Neil

2018-01-01

Background Digital interventions offer an innovative way to make the experiences of people living with mental illness available to others. As part of the Self-Management And Recovery Technology (SMART) research program on the use of digital resources in mental health services, an interactive website was developed including videos of people with lived experience of mental illness discussing their recovery. These peer videos were designed to be watched on a tablet device with a mental health worker, or independently. Objective Our aim was to explore how service users experienced viewing the lived experience videos on this interactive website, as well as its influence on their recovery journey. Methods In total, 36 service users with experience of using the website participated in individual semistructured qualitative interviews. All participants had experience of psychosis. Data analysis occurred alongside data collection, following principles of constructivist grounded theory methodology. Results According to participants, engaging with lived experience videos was a pivotal experience of using the website. Participants engaged with peers through choosing and watching the videos and reflecting on their own experience in discussions that opened up with a mental health worker. Benefits of seeing others talking about their experience included “being inspired,” “knowing I’m not alone,” and “believing recovery is possible.” Experiences of watching the videos were influenced by the participants’ intrapersonal context, particularly their ways of coping with life and use of technology. The interpersonal context of watching the videos with a worker, who guided website use and facilitated reflection, enriched the experience. Conclusions Engaging with lived experience videos was powerful for participants, contributing to their feeling connected and hopeful. Making websites with lived experience video content available to service users and mental health workers

Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website.

PubMed

Williams, Anne; Fossey, Ellie; Farhall, John; Foley, Fiona; Thomas, Neil

2018-05-08

Digital interventions offer an innovative way to make the experiences of people living with mental illness available to others. As part of the Self-Management And Recovery Technology (SMART) research program on the use of digital resources in mental health services, an interactive website was developed including videos of people with lived experience of mental illness discussing their recovery. These peer videos were designed to be watched on a tablet device with a mental health worker, or independently. Our aim was to explore how service users experienced viewing the lived experience videos on this interactive website, as well as its influence on their recovery journey. In total, 36 service users with experience of using the website participated in individual semistructured qualitative interviews. All participants had experience of psychosis. Data analysis occurred alongside data collection, following principles of constructivist grounded theory methodology. According to participants, engaging with lived experience videos was a pivotal experience of using the website. Participants engaged with peers through choosing and watching the videos and reflecting on their own experience in discussions that opened up with a mental health worker. Benefits of seeing others talking about their experience included "being inspired," "knowing I'm not alone," and "believing recovery is possible." Experiences of watching the videos were influenced by the participants' intrapersonal context, particularly their ways of coping with life and use of technology. The interpersonal context of watching the videos with a worker, who guided website use and facilitated reflection, enriched the experience. Engaging with lived experience videos was powerful for participants, contributing to their feeling connected and hopeful. Making websites with lived experience video content available to service users and mental health workers demonstrates strong potential to support service users' recovery

Can we risk recovery? A grounded theory of clinical psychologists' perceptions of risk and recovery-oriented mental health services.

PubMed

Tickle, Anna; Brown, Dora; Hayward, Mark

2014-03-01

This study sought to explore the views of clinical psychologists towards the concepts of 'risk' and 'recovery' and to set those views against the context of mental health services. An exploratory, social constructionist grounded theory methodology was adopted. Eleven clinical psychologists working in adult mental health services each participated in one individual semistructured interview. The clinical psychologists studied were aware of the emergence of recovery-oriented approaches, but felt unable to incorporate them in practice because of perceptions of being bound by both their own limitations and those of their circumstances, including issues of risk, thus giving rise to dilemmas in professional practice. Narrow definitions of risk as equated to danger dominated over broader conceptualizations of risk with positive consequences. The existing culture of mental health services was seen as emphasizing the need to avoid harmful consequences of taking risks, which in turn was seen to limit innovations in implementing recovery-oriented approaches. Participants' ability to work in a recovery-oriented manner seemed to be limited by the way in which services perceived and responded to risk. Participants did not discuss risks arising from stigma, social exclusion, racism, sexism, or iatrogenic effects of psychiatric treatment. Narrow conceptualizations of risk as related to harm and danger seen in this study contribute to a sense of needing to be risk averse. However, the implications for practice included ideas about what might increase the possibilities for adopting recovery approaches across disciplines. © 2012 The British Psychological Society.

Initial development of the recovery-oriented services assessment: A collaboration with peer-provider consultants.

PubMed

Lodge, Amy C; Kuhn, Wendy; Earley, Juli; Stevens Manser, Stacey

2018-06-01

The Recovery Self-Assessment (RSA) is a reliable and valid tool used to measure recovery-oriented services. Recent studies, however, suggest that the length and reading level of the RSA makes its routine use in service settings difficult. Recognizing the importance of including people with lived experience of a mental health challenge in research processes and the need to enhance the utility of tools that measure recovery-oriented services, this paper describes an innovative researcher-peer provider consultant multistep process used to revise the provider version of the RSA to create a new instrument-the Recovery-Oriented Services Assessment (ROSA). The authors conducted an exploratory factor analysis (EFA) with principal axis factoring extraction and direct oblimin rotation to evaluate the underlying structure of the provider RSA using data from mental health employees (n = 323). To triangulate the findings of the EFA, quantitative and qualitative data were collected from peer provider consultants (n = 9) on the importance of and language of RSA items. EFA results indicated that a 1-factor solution provided the best fit and explained 48% of the total variance. Consultants triangulated EFA results and recommended the addition of 2 items and language revisions. These results were used to develop the ROSA-a 15-item instrument measuring recovery-oriented services with accessible language. Two versions of the ROSA were developed: a staff version and a people-in-services version. The ROSA may provide organizations with a more accessible way to measure the extent to which their services are recovery oriented. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Complete recovery of actinides from UREX-like raffinates using a combination of hard and soft donor ligands. II. soft donor structure variation

DOE PAGES

Zalupski, Peter R.; Klaehn, John R.; Peterman, Dean R.

2015-07-30

The feasibility of simultaneous separation of uranium, neptunium, plutonium, americium, and curium from a simulated dissolved used fuel simulant adjusted to 1.0 M nitric acid is investigated using a mixture of the soft donor bis(bis-3,5-trifluoromethyl)phenyl) dithiophosphinic acid (“0”) and the hard donor synergist trioctylphosphine oxide (TOPO) dissolved in toluene. The results reported in this work are compared to our recent demonstration of a complete actinide recovery from a simulated dissolved fuel solution using a synergistic combination of bis(o-trifluoromethylphenyl)dithiophosphinic acid (“1”) and TOPO dissolved in either toluene or trifluoromethylphenyl sulfone. While the extraction efficiency of americium was enhanced for the liquid-liquidmore » system containing “0”, enabling to accomplish a trivalent An/Ln separation at 1.0 M HNO3, the extraction of neptunium was drastically diminished, relative to “1”. The partitioning behavior of curium was also negatively impacted, introducing an effective opportunity for americium/curium separation. Radiometric and spectrophotometric studies demonstrate that the complete actinide recovery using the solvent based upon “0” and TOPO is not feasible. Additionally, the importance of radiolytic degradation processes is discussed through the comparisons of extraction properties of liquid-liquid systems based on both soft donor reagents.« less

Auger electron and characteristic energy loss spectra for electro-deposited americium-241

NASA Astrophysics Data System (ADS)

Varma, Matesh N.; Baum, John W.

1983-07-01

Auger electron energy spectra for electro-deposited americium-241 on platinum substrate were obtained using a cylindrical mirror analyzer. Characteristic energy loss spectra for this sample were also obtained at primary electron beam energies of 990 and 390 eV. From these measurements PI, PII, and PIII energy levels for americium-241 are determined. Auger electron energies are compared with theoretically calculated values. Minimum detectability under the present condition of sample preparation and equipment was estimated at approximately 1.2×10-8 g/cm2 or 3.9×10-8 Ci/cm2. Minimum detectability for plutonium-239 under similar conditions was estimated at about 7.2×10-10 Ci/cm2.

Socioeconomic assessment of Forest Service American Recovery and Reinvestment Act projects: key findings and lessons learned

Treesearch

Susan Charnley; Pamela Jakes; John Schelhas

2012-01-01

The American Recovery and Reinvestment Act of 2009 (the Recovery Act) aimed to create jobs and promote economic growth while addressing the Nation’s social and environmental needs. The USDA Forest Service received $1.15 billion in economic recovery funding. This report contains key findings and lessons learned from a socioeconomic assessment of Forest Service Recovery...

Higher Americium Oxidation State Research Roadmap

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mincher, Bruce J.; Law, Jack D.; Goff, George S.

2015-12-18

The partitioning of hexavalent Am from dissolved nuclear fuel requires the ability to efficiently oxidize Am(III) to Am(VI) and to maintain that oxidation state for a length of time sufficient to perform the separation. Several oxidants have been, or are being developed. Chemical oxidants include Ag-catalyzed ozone, Ag-catalyzed peroxydisulfate, Cu(III) periodate, and sodium bismuthate. Hexavalent americium has also now successfully been prepared by electrolysis, using functionalized electrodes. So-called auto-reduction rates of Am(VI) are sufficiently slow to allow for separations. However, for separations based on solvent extraction or ion exchange using organic resins, the high valence state must be maintained undermore » the reducing conditions of the organic phase contact, and a holding oxidant is probably necessary. Until now, only Cu(III) periodate and sodium bismuthate oxidation have been successfully combined with solvent extraction separations. Bismuthate oxidation provided the higher DAm, since it acts as its own holding oxidant, and a successful hot test using centrifugal contactors was performed. For the other oxidants, Ag-catalyzed peroxydisulfate will not oxidize americium in nitric acid concentrations above 0.3 M, and it is not being further investigated. Peroxydisulfate in the absence of Ag catalysis is being used to prepare Am(V) in ion exchange work, discussed below. Preliminary work with Ag-catalyzed ozone has been unsuccessful for extractions of Am(VI) from 6.5 M HNO3, and only one attempt at extraction, also from 6.5 M HNO3, using the electrolytic oxidation has been attempted. However, this high acid concentration was based on the highest Am extraction efficiency using the bismuthate oxidant; which is only sparingly soluble, and thus the oxidation yield is based on bismuthate solubility. Lower acid concentrations may be sufficient with alternative oxidants and work with Ag-ozone, Cu(III) and electrolysis is on-going. Two non

The biodistribution and toxicity of plutonium, americium and neptunium.

PubMed

Taylor, D M

1989-07-15

In the nuclear fuel cycle the transuranic radionuclides plutonium-239, americium-241 and neptunium-237 would probably present the most serious hazard to human health if released into the environment. Despite differences in their solution chemistry the three elements exhibit remarkable similarity in their biochemical behaviour, apparently sharing similar transport pathways in blood and cells. After entering the blood the elements deposit predominantly in liver and skeleton, where retention appears to be prolonged, with half-times of the order of years. The principal late effects of all three radionuclides are the induction of cancers of bone, lung or liver. For the latter tumours the induction risk per unit radiation dose appears similar for the three radionuclides. But in bone there are indications that, due to microscopic differences in the distribution of the alpha-particle radiation dose, the efficiency of bone cancer induction may increase in the order americium-241 less than plutonium-239 less than neptunium-237. No case of human cancer induced by these radionuclides is known.

Enhanced ionization efficiency in TIMS analyses of plutonium and americium using porous ion emitters

DOE PAGES

Baruzzini, Matthew L.; Hall, Howard L.; Watrous, Matthew G.; ...

2016-12-05

Investigations of enhanced sample utilization in thermal ionization mass spectrometry (TIMS) using porous ion emitter (PIE) techniques for the analyses of trace quantities of americium and plutonium were performed. Repeat ionization efficiency (i.e., the ratio of ions detected to atoms loaded on the filament) measurements were conducted on sample sizes ranging from 10–100 pg for americium and 1–100 pg for plutonium using PIE and traditional (i.e., a single, zone-refined rhenium, flat filament ribbon with a carbon ionization enhancer) TIMS filament sources. When compared to traditional filaments, PIEs exhibited an average boost in ionization efficiency of ~550% for plutonium and ~1100%more » for americium. A maximum average efficiency of 1.09% was observed at a 1 pg plutonium sample loading using PIEs. Supplementary trials were conducted using newly developed platinum PIEs to analyze 10 pg mass loadings of plutonium. As a result, platinum PIEs exhibited an additional ~134% boost in ion yield over standard PIEs and ~736% over traditional filaments at the same sample loading level.« less

Hypospadias surgery in children: improved service model of enhanced recovery pathway and dedicated surgical team.

PubMed

Wong, Y S; Pang, K K; Tam, Y H

2018-05-21

Children in Hong Kong are generally hospitalised for 1 to 2 weeks after hypospadias repairs. In July 2013, we introduced a new service model that featured an enhanced recovery pathway and a dedicated surgical team responsible for all perioperative services. In this study, we investigated the outcomes of hypospadias repair after the introduction of the new service model. We conducted a retrospective study on consecutive children who underwent primary hypospadias repair from January 2006 to August 2016, comparing patients under the old service with those under the new service. Outcome measures included early morbidity, operative success, and completion of enhanced recovery pathway. The old service and new service cohorts comprised 176 and 126 cases, respectively. There was no difference between the two cohorts in types of hypospadias and surgical procedures performed. The median hospital stay was 2 days in the new service cohort compared with 10 days in the old service cohort (P<0.001). Patients experienced less early morbidity (5.6% vs 15.9%; P=0.006) and had a lower operative failure rate (20.2% vs 44.2%; P<0.001) under the new service than the old service. Multivariable analysis revealed that the new service significantly reduced the odds of early morbidity (odds ratio=0.35, 95% confidence interval=0.15-0.85; P=0.02) and operative failure (odds ratio=0.32, 95% confidence interval=0.17-0.59; P<0.001) in comparison with the old service. Of the new service cohort, 111(88.1%) patients successfully completed the enhanced recovery pathway. The enhanced recovery pathway can be implemented safely and effectively to primary hypospadias repair. A dedicated surgical team may play an important role in successful implementation of the enhanced recovery pathway and optimisation of surgical outcomes.

'Recovery' in the Real World: Service User Experiences of Mental Health Service Use and Recommendations for Change 20 Years on from a First Episode Psychosis.

PubMed

O'Keeffe, Donal; Sheridan, Ann; Kelly, Aine; Doyle, Roisin; Madigan, Kevin; Lawlor, Elizabeth; Clarke, Mary

2018-02-06

Little is known about how recovery oriented policy and legislative changes influence service users' perceptions of mental health care over time. Although the recovery approach is endorsed in many countries, qualitative research examining its impact on service use experiences has been lacking. This study aimed to explore this impact as well as experiences of service utilisation and suggestions for change with people diagnosed with a First Episode Psychosis between 1995 and 1999. Participants had used services during the 10 year period prior to, and 10 years post, policy and legislative shifts to the recovery approach. Semi-structured interviews were conducted with 10 participants who met criteria for 'full functional recovery' and 10 who did not. Data were analysed using Thematic Networks Analysis to develop Basic, Organising, and Global Themes. Over time, recovered participants perceived an improvement in service quality through the 'humanising' of treatment and non-recovered participants experienced their responsibility in recovery being recognised, but felt abandoned to the recovery approach. Findings suggest the importance of viewing service users as demonstrating personhood and having societal value; examining the personal meaning of psychotic experiences; and matching expectations with what services can feasibly provide. The implementation and the principal tenets of the recovery approach warrant further investigation.

The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness.

PubMed

Oliveira-Maia, Albino J; Mendonça, Carina; Pessoa, Maria J; Camacho, Marta; Gago, Joaquim

2016-01-01

Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective

The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness

PubMed Central

Oliveira-Maia, Albino J.; Mendonça, Carina; Pessoa, Maria J.; Camacho, Marta; Gago, Joaquim

2016-01-01

Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective

Metabolism of americium-241 in man: an unusual case of internal contamination of a child and his father

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cohen, N.; Lo Sasso, T.; Wrenn, M.E.

1979-10-05

The metabolism of americium-241 has been studied during an 8-year period in an adult male and his son who, at the ages of 50 and 4 years, respectively, were accidentally and unknowingly contaminated within their home by means of inhalation. Chelation therapy with calcium trisodium pentetate was more effective in enhancing the removal of americium-241 from the child than from the father.

Metabolism of americium-241 in man: an unusual case of internal contamination of a child and his father.

PubMed

Cohen, N; Sasso, T L; Wrenn, M E

1979-10-05

The metabolism of americium-241 has been studied during an 8-year period in an adult male and his son who, at the ages of 50 and 4 years, respectively, were accidentally and unknowingly contaminated within their home by means of inhalation. Chelation therapy with calcium trisodium pentetate was more effective in enhancing the removal of americium-241 from the child than from the father.

[Rapid analysis of the radionuclides plutonium and americium-241 in soils].

PubMed

Egorov, A V; Klochkova, N V

2009-01-01

The paper shows it possible to perform a rapid analysis of the isotopes of plutomium and americium-241. The basis of the developed rapid analysis is X-spectrometric determination of the amount of plutonium isotopes and gamma-spectrometric determination of the radionuclide 241AM.

An experimental investigation of justice-based service recovery on customer satisfaction, loyalty, and word-of-mouth intentions.

PubMed

Shapiro, Terri; Nieman-Gonder, Jennifer M; Andreoli, Nicole A; Trimarco-Beta, Darlene

2006-12-01

Service recovery is related to many important organizational outcomes such as customer satisfaction, loyalty, and profitability. Within the theoretical framework of organizational justice, an experiment using a simulated "live" service failure was used to assess the effects of justice-based service-recovery strategies on customer satisfaction, loyalty, positive word-of-mouth intentions, and negative word-of-mouth intentions. Analysis indicated that strategies including interactional justice, distributive justice, and a combination of these were equally effective in maintaining customer satisfaction, loyalty, and positive word of mouth, and minimizing negative word of mouth after a service failure. No support for the service recovery paradox, that is, increased satisfaction following service failure and recovery compared to never having a problem, was found. Satisfaction and loyalty for those in the failure conditions were equal to, although not higher than, in the no-failure control condition. Practical implications for organizational practices are discussed.

Influence of an americium solid phase on americium concentrations in solutions

NASA Astrophysics Data System (ADS)

Rai, Dhanpat; Strickert, R. G.; Moore, D. A.; Serne, R. J.

1981-11-01

Americium-241 concentrations in solutions contacting contaminated sediments for up to 2 yr were measured as a function of pH. Steady-state concentrations were reached within a few days. The solubility-limited Am concentration was found to decrease approximately 10-fold with one unit increase in pH. The log equilibrium constant for the solubility of Am (soil) solid [Am (soil) + H + ⇌ Am (aq complex)+] was found to be -4.12. The predictions based upon thermodynamic data suggest that Am (aq complex)+ is likely to be Am(OH) 2+. Although the chemical formula of Am (soil) was not determined, it does not appear to be Am(OH) 3(a). Published data on sorption coefficients of Am by different rocks, soils, and minerals were critically evaluated. Final Am solution concentrations calculated from the sorption coefficients of a variety of earth materials with several solutions agreed well with the concentrations predicted from the solubility of Am (soil) solid, indicating that the sorption coefficient data are controlled by Am precipitation.

"Recovery" in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study.

PubMed

Todd, Nicholas J; Jones, Steven H; Lobban, Fiona A

2012-04-01

Bipolar disorder (BD) is a chronic and recurrent affective disorder. Recovery is defined as the process by which people can live fulfilling lives despite experiencing symptoms. To explore how an opportunistically recruited group of service users with BD experience recovery and self-management to understand more about how a service users' recovery may be supported. Twelve service users with BD took part in a series of focus groups. Service users' responses to questions about their personal experiences of self-management and recovery were analysed. Focus groups were transcribed verbatim and thematic analysis ([ Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101]) was employed to identify common themes in the data. Four key themes were identified: (1) Recovery is not about being symptom free; (2) Recovery requires taking responsibility for your own wellness; (3) Self-management: building on existing techniques; (4) Overcoming barriers to recovery: negativity, stigma and taboo. Service users with BD have provided further support for the concept of recovery and have suggested a number of ways recovery can be supported. A self-management approach informed by the recovery literature has been proposed as a way to support service users' recovery.

Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial.

PubMed

Fowler, David; Hodgekins, Jo; French, Paul; Marshall, Max; Freemantle, Nick; McCrone, Paul; Everard, Linda; Lavis, Anna; Jones, Peter B; Amos, Tim; Singh, Swaran; Sharma, Vimal; Birchwood, Max

2018-01-01

Provision of early intervention services has increased the rate of social recovery in patients with first-episode psychosis; however, many individuals have continuing severe and persistent problems with social functioning. We aimed to assess the efficacy of early intervention services augmented with social recovery therapy in patients with first-episode psychosis. The primary hypothesis was that social recovery therapy plus early intervention services would lead to improvements in social recovery. We did this single-blind, phase 2, randomised controlled trial (SUPEREDEN3) at four specialist early intervention services in the UK. We included participants who were aged 16-35 years, had non-affective psychosis, had been clients of early intervention services for 12-30 months, and had persistent and severe social disability, defined as engagement in less than 30 h per week of structured activity. Participants were randomly assigned (1:1), via computer-generated randomisation with permuted blocks (sizes of four to six), to receive social recovery therapy plus early intervention services or early intervention services alone. Randomisation was stratified by sex and recruitment centre (Norfolk, Birmingham, Lancashire, and Sussex). By necessity, participants were not masked to group allocation, but allocation was concealed from outcome assessors. The primary outcome was time spent in structured activity at 9 months, as measured by the Time Use Survey. Analysis was by intention to treat. This trial is registered with ISRCTN, number ISRCTN61621571. Between Oct 1, 2012, and June 20, 2014, we randomly assigned 155 participants to receive social recovery therapy plus early intervention services (n=76) or early intervention services alone (n=79); the intention-to-treat population comprised 154 patients. At 9 months, 143 (93%) participants had data for the primary outcome. Social recovery therapy plus early intervention services was associated with an increase in structured

Antiservice Within the Medical Service Encounter: Lessons for Radiologists Beyond Service Recovery.

PubMed

Hill, Paul Armstrong; Hill, Ronald Paul

2015-12-01

Recent modifications in the metrics for reimbursement have reinforced the importance of radiology service-delivery experiences of patients. Evaluating current radiology practices calls for reflection on the various touch points with patients, as well as their overall satisfaction. If problems occur during encounters, service failure, or lack of satisfactory medical experiences can be transformed through service recovery, whereby patients-as-customers are given chances to voice their concerns, and health care providers across the spectrum can work together to resolve problematic issues. This paper takes a systemic view of the patient experience as embedded in the care continuum, recognizing that different beliefs, attitudes, and behaviors of members of the health care team can negatively affect or sabotage patient satisfaction. Although radiologists are only one of many roles in the care continuum, recommendations are discussed for how they can integrate service satisfaction as a pervasive communal goal among all health care team members. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Development of Measures to Assess Personal Recovery in Young People Treated in Specialist Mental Health Services.

PubMed

John, Mary; Jeffries, Fiona W; Acuna-Rivera, Marcela; Warren, Fiona; Simonds, Laura M

2015-01-01

Recovery has become a central concept in mental health service delivery, and several recovery-focused measures exist for adults. The concept's applicability to young people's mental health experience has been neglected, and no measures yet exist. Aim The aim of this work is to develop measures of recovery for use in specialist child and adolescent mental health services. On the basis of 21 semi-structured interviews, three recovery measures were devised, one for completion by the young person and two for completion by the parent/carer. Two parent/carer measures were devised in order to assess both their perspective on their child's recovery and their own recovery process. The questionnaires were administered to a UK sample of 47 young people (10-18 years old) with anxiety and depression and their parents, along with a measure used to routinely assess treatment progress and outcome and a measure of self-esteem. All three measures had high internal consistency (alpha ≥ 0.89). Young people's recovery scores were correlated negatively with scores on a measure used to routinely assess treatment progress and outcome (r = -0.75) and positively with self-esteem (r = 0.84). Parent and young persons' reports of the young person's recovery were positively correlated (r = 0.61). Parent report of the young person's recovery and of their own recovery process were positively correlated (r = 0.75). The three measures have the potential to be used in mental health services to assess recovery processes in young people with mental health difficulties and correspondence with symptomatic improvement. The measures provide a novel way of capturing the parental/caregiver perspective on recovery and caregivers' own wellbeing. No tools exist to evaluate recovery-relevant processes in young people treated in specialist mental health services. This study reports on the development and psychometric evaluation of three self-report recovery-relevant assessments for young

The meaning of recovery in a regional mental health service: an action research study.

PubMed

Kidd, Susan; Kenny, Amanda; McKinstry, Carol

2015-01-01

To explore the meaning of the term recovery to people with experience providing and receiving mental health services. Internationally, governments have proposed recovery-oriented mental health policy. In practice, people managing mental health difficulties struggle to recover, self-manage, or improve their quality of life. Mental health services increasingly provide acutely focused and poorly coordinated services to people experiencing mental health difficulties, with self-management, wellness and recovery overlooked. A cooperative enquiry, action research design guided the study. Participants were people with experience of mental health difficulties from consumer, carer and clinician perspectives. Data were collected between August 2012-July 2013. Analysis was conducted using an iterative process for the duration of the study. A thematic network was developed that reflected key organizing themes. The overarching theme developed from the participants' group discussions, reflections, actions and observations was recovery as an ongoing quest in life. This global theme was constructed from five organizing themes: 'finding meaning', 'an invisible disability', 'empowerment and agency' 'connection' and 'the passage of time'. Participatory approaches support the inclusion of lived experience perspectives. Structured processes are needed to bring different perspectives together to find solutions, through dialogue, and acknowledge the barriers to participation that people who use mental health services experience. The lack of integration of lived experience perspectives demonstrates forms of discrimination that inhibit consumer participation and prevent the recovery-oriented transformation required in mental health systems. © 2014 John Wiley & Sons Ltd.

Associations between the peer support relationship, service satisfaction and recovery-oriented outcomes: a correlational study.

PubMed

Thomas, Elizabeth C; Salzer, Mark S

2017-12-18

The working alliance between non-peer providers and mental health consumers is associated with positive outcomes. It is hypothesized that this factor, in addition to other active support elements, is also positively related to peer support service outcomes. This study evaluates correlates of the peer-to-peer relationship and its unique association with service satisfaction and recovery-oriented outcomes. Participants were 46 adults with serious mental illnesses taking part in a peer-brokered self-directed care intervention. Pearson correlation analyses examined associations among peer relationship factors, services-related variables and recovery-oriented outcomes (i.e. empowerment, recovery and quality of life). Hierarchical multiple regression analyses evaluated associations between relationship factors and outcomes over time, controlling for other possible intervention effects. The peer relationship was not related to number of contacts. There were robust associations between the peer relationship and service satisfaction and some recovery-oriented outcomes at 24-months, but not at 12-months. These associations were not explained by other possible intervention effects. This study contributes to a better understanding of the positive, unique association between the peer-to-peer relationship and outcomes, similar to what is found in non-peer-delivered interventions. Implications for program administrators and policymakers seeking to integrate peer specialists into mental health service systems are discussed.

Promoting recovery-oriented practice in mental health services: a quasi-experimental mixed-methods study.

PubMed

Gilburt, Helen; Slade, Mike; Bird, Victoria; Oduola, Sheri; Craig, Tom K J

2013-06-13

Recovery has become an increasingly prominent concept in mental health policy internationally. However, there is a lack of guidance regarding organisational transformation towards a recovery orientation. This study evaluated the implementation of recovery-orientated practice through training across a system of mental health services. The intervention comprised four full-day workshops and an in-team half-day session on supporting recovery. It was offered to 383 staff in 22 multidisciplinary community and rehabilitation teams providing mental health services across two contiguous regions. A quasi-experimental design was used for evaluation, comparing behavioural intent with staff from a third contiguous region. Behavioural intent was rated by coding points of action on the care plans of a random sample of 700 patients (400 intervention, 300 control), before and three months after the intervention. Action points were coded for (a) focus of action, using predetermined categories of care; and (b) responsibility for action. Qualitative inquiry was used to explore staff understanding of recovery, implementation in services and the wider system, and the perceived impact of the intervention. Semi-structured interviews were conducted with 16 intervention group team leaders post-training and an inductive thematic analysis undertaken. A total of 342 (89%) staff received the intervention. Care plans of patients in the intervention group had significantly more changes with evidence of change in the content of patient's care plans (OR 10.94. 95% CI 7.01-17.07) and the attributed responsibility for the actions detailed (OR 2.95, 95% CI 1.68-5.18). Nine themes emerged from the qualitative analysis split into two superordinate categories. 'Recovery, individual and practice', describes the perception and provision of recovery orientated care by individuals and at a team level. It includes themes on care provision, the role of hope, language of recovery, ownership and

Recovery in Psychosis from a Service User Perspective: A Systematic Review and Thematic Synthesis of Current Qualitative Evidence.

PubMed

Wood, L; Alsawy, S

2017-11-29

There is a growing number of qualitative accounts regarding recovery from psychosis from a service user perspective. The aim of this study was to conduct a systematic review of these qualitative accounts. A thematic synthesis was utilised to synthesise and analyse seventeen studies included in the review. Studies were included if they used a qualitative methodology to explore service users' experiences of recovery from psychosis as a primary research question. All included studies were subjected to a quality assessment. The analysis outlined three subordinate themes: the recovery journey, facilitators of recovery (e.g. faith and spirituality, personal agency and hope), and barriers to recovery (e.g. stigma and discrimination, negative effects of mental health services and medication). Recovery is an idiosyncratic process but includes key components which are important to people who experience psychosis. These should be explored within clinical practice.

Improving Service Utilization for Parents with Substance Abuse Problems: Experimenting with Recovery Coaches in Child Welfare.

PubMed

Choi, Sam

2015-01-01

Substance abusers often face substantial systematic and personal barriers to receiving required substance abuse treatment services as well as other services; hence, various linkage mechanisms have been proposed for drug abuse treatment programs to overcome such barriers. Although there is a growing interest in the use of case management with a substance abuse background, its effectiveness in child welfare has yet to be explored. In this study the author attempts to investigate the effectiveness of case management in service utilization by systematically evaluating the five-year Alcohol and Other Drug Abuse (AODA) waiver demonstration project with Recovery Coaches in Illinois. A classic experimental design with a control group was used. Random assignment occurs at the agency level. Parents in the experimental group (N = 1562) received recovery coaches in addition to traditional child welfare services while parents in the control group (N = 598) only received traditional child welfare services. Bivariate and multivariate analyses (Ordinary Last Square regressions) were used. Compared to parents in the control group, parents in the experimental group were more likely to utilize substance abuse treatment. The results suggest that gender, education level, employment status, and the number of service needs were significantly associated with service utilization. Controlling other factors, recovery coaches improved overall service utilization. Because the outcome of child welfare often depends on the improvement of risks or resolution, it is important for parents to utilize the needed services. Future studies need to address what aspects of recovery coaches facilitate the services utilization.

A recovery room-based acute pain service.

PubMed

Leykin, Y; Pellis, T; Ambrosio, C; Zanette, G; Malisano, A; Rapotec, A; Casati, A

2007-04-01

Despite routine postoperative pain management improves recovery and reduces postoperative morbidity and overall costs, and the availability of a large armamentarium of analgesic techniques and drugs, a significant portion of patients do not receive adequate postoperative pain control. We describe a recovery room (RR) based acute pain service model. Guidelines on postoperative pain and therapeutic protocols were instituted in January 1999. The analgesic endpoint was a visual analogic scale (VAS) below 4 for all surgical patients for the first 48-72 h. The RR, run by one anesthesiologist and 2 nurses and one assistant, acted as a coordination centre. Discharge from the RR was subject to achieving effective analgesia. Nurses of each ward monitored VAS along with vital signs, administered rescue doses if necessary, and reported to the RR nurse when needed. RR nurses monitored the patient at least twice daily and reported to the anesthesiologist. We have distributed an anonymous questionnaire, within surgical wards, to both surgeons and nurses to evaluate their perception of pain management and of this acute pain service (APS) model. VAS was maintained significantly <4. Analgesic drug consumption increased between 1997, 2000 (first year of APS) and 2004. The auditing process confirmed the desire of all professional figures to be informed and involved in acute pain management as part of a coordinated and systematic approach to the surgical patient. A RR-based APS can effectively act as coordinating centre for acute pain treatment without adjunctive personnel.

Service user engagement: A co-created interview schedule exploring mental health recovery in young adults.

PubMed

McCauley, Claire-Odile; McKenna, Hugh; Keeney, Sinead; McLaughlin, Derek

2017-10-01

The aim of this study was to co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users. Service user involvement in research has been increasingly recognized as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience. A qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users. Two separate engagement groups took place at the premises of the service user organizations, between January - February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them. The lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey. Our findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognizant of the suffering or painful experiences that young adults are encountering. © 2017 John Wiley & Sons Ltd.

Setting up recovery clinics and promoting service user involvement.

PubMed

John, Thomas

2017-06-22

Service user involvement in mental health has gained considerable momentum. Evidence from the literature suggests that it remains largely theoretical rather than being put into practice. The current nature of acute inpatient mental health units creates various challenges for nurses to put this concept into practice. Recovery clinics were introduced to bridge this gap and to promote service user involvement practice within the current care delivery model at Kent and Medway NHS and Social Care Partnership Trust. It has shaped new ways of working for nurses with a person-centred approach as its philosophy. Service users and nurses were involved in implementing a needs-led and bottom-up initiative using Kotter's change model. Initial results suggest that it has been successful in meeting its objectives evidenced through increased meaningful interactions and involvement in care by service users and carers. The clinics have gained wide recognition and have highlighted a need for further research into care delivery models to promote service user involvement in these units.

The New Element Americium (Atomic Number 95)

DOE R&D Accomplishments Database

Seaborg, G.T.; James, R.A.; Morgan, L.O.

1948-01-01

Several isotopes of the new element 95 have been produced and their radiations characterized. The chemical properties of this tripositive element are similar to those of the typical tripositive lanthanide rare-earth elements. Element 95 is different from the latter in the degree and rate of formation of certain compounds of the complex ion type, which makes possible the separation of element 95 from the lanthanide rare-earths. The name americium (after the Americas) and the symbol Am are suggested for the element on the basis of its position as the sixth member of the actinide rare-earth series, analogous to europium, Eu, of the lanthanide series.

Consumer Attitude Towards Service Failure and Recovery in Higher Education

ERIC Educational Resources Information Center

Chahal, Hardeep; Devi, Pinkey

2015-01-01

Purpose: This paper aims to explore consumer attitude towards service failure and recovery in the higher education in general and with respect to teaching, examination, library, computer lab, administration and infrastructure in particular. Design/Methodology/Approach: The data are collected from 120 students of three undergraduate colleges of…

Plutonium and americium in the foodchain lichen-reindeer-man

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jaakkola, T.; Hakanen, M.; Keinonen, M.

1977-01-01

The atmospheric nuclear tests have produced a worldwide fallout of transuranium elements. In addition to plutonium measurable concentrations of americium are to be found in terrestrial and aquatic environments. The metabolism of plutonium in reindeer was investigated by analyzing plutonium in liver, bone, and lung collected during 1963-1976. To determine the distribution of plutonium in reindeer all tissues of four animals of different ages were analyzed. To estimate the uptake of plutonium from the gastrointestinal tract in reindeer, the tissue samples of elk were also analyzed. Elk which is of the same genus as reindeer does not feed on lichenmore » but mainly on deciduous plants, buds, young twigs, and leaves of trees and bushes. The composition of its feed corresponds fairly well to that of reindeer during the summer. Studies on behaviour of americium along the foodchain lichen-reindeer-man were started by determining the Am-241 concentrations in lichen and reindeer liver. The Am-241 results were compared with those of Pu-239,240. The plutonium contents of the southern Finns, whose diet does not contain reindeer tissues, were determined by analyzing autopsy tissue samples (liver, lung, and bone). The southern Finns form a control group to the Lapps consuming reindeer tissues. Plutonium analyses of the placenta, blood, and tooth samples of the Lapps were performed.« less

A Study of the Interrelationships among Service Recovery, Relationship Quality, and Brand Image in Higher Education Industries

ERIC Educational Resources Information Center

Chen, Yu-Chuan

2015-01-01

This study aims to investigate the direction and strength of the relationships among service recovery, relationship quality, and brand image in higher education industries. This research provides a framework for school managers to understand service recovery from an operations perspective. Structural equation models were used to test the proposed…

Solvent Extraction Separation of Trivalent Americium from Curium and the Lanthanides

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jensen, Mark P.; Chiarizia, Renato; Ulicki, Joseph S.

2015-02-27

The sterically constrained, macrocyclic, aqueous soluble ligand N,N'-bis[(6-carboxy-2-pyridyl)methyl]-1,10-diaza-18-crown-6 (H2BP18C6) was investigated for separating americium from curium and all the lanthanides by solvent extraction. Pairing H2BP18C6, which favors complexation of larger f-element cations, with acidic organophosphorus extractants that favor extraction of smaller f-element cations, such as bis-(2-ethylhexyl)phosphoric acid (HDEHP) or (2-ethylhexyl)phosphonic acid mono(2-ethylhexyl) ester (HEH[EHP]), created solvent extraction systems with good Cm/Am selectivity, excellent trans-lanthanide selectivity (Kex,Lu/Kex,La = 108), but poor selectivity for Am against the lightest lanthanides. However, using an organic phase containing both a neutral extractant, N,N,N’,N’-tetra(2-ethylhexyl)diglycolamide (TEHDGA), and HEH[EHP] enabled rejection of the lightest lanthanides during loading ofmore » the organic phase from aqueous nitric acid, eliminating their interference in the americium stripping stages. In addition, although it is a macrocyclic ligand, H2BP18C6 does not significantly impede the mass transfer kinetics of the HDEHP solvent extraction system« less

Total and Compound Formation Cross Sections for Americium Nuclei: Recommendations for Coupled-Channels Calculations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Escher, J. E.

Calculations for total cross sections and compound-nucleus (CN) formation cross sections for americium isotopes are described, for use in the 2017 NA-22 evaluation effort. The code ECIS 2006 was used in conjunction with Frank Dietrich's wrapper `runtemplate'.

A Hybrid Density Functional Study of Atomic Hydrogen and Oxygen Adsorptions on the (0001) Surface of Non-Magnetic DHCP Americium

NASA Astrophysics Data System (ADS)

Amdani-Moten, Shafaq; Atta-Fynn, Raymond; Ray, Asok

2010-03-01

As our group have recently shown^+, hybrid density functional theory (HDFT) which replaces a fraction (40%) of approximate DFT exchange with exact Hartree-Fock exchange yield structural, magnetic, and electronic properties for Americium-I that are in excellent agreement with experimental data. As a natural progression, ab initio calculations for atomic adsorptions on the (0001) surface of non-magnetic americium have been performed using HDFT. The americium surface is modeled by a seven-layer slab using inversion symmetry consisting of one atom per layer and non-magnetic ABAC stacking arrangement of these layers. Top, bridge, hcp and fcc chemisorption sites have been investigated with energies optimized with respect to the adatom distance from the surface. Details of the chemisorptions processes as well as comparisons of different sites will be presented. ^+ R. Atta-Fynn and A. K. Ray, Chemical Physics Letters, 482, 223-227 (2009).

Environmental and human monitoring of Americium-241 utilizing extraction chromatography and alpha-spectrometry.

PubMed

Goldstein, S J; Hensley, C A; Armenta, C E; Peters, R J

1997-03-01

Recent developments in extraction chromatography have simplified the separation of americium from complex matrices in preparation for alpha-spectroscopy relative to traditional methods. Here we present results of procedures developed/adapted for water, air, and bioassay samples with less than 1 g of inorganic residue. Prior analytical methods required the use of a complex, multistage procedure for separation of americium from these matrices. The newer, simplified procedure requires only a single 2 mL extraction chromatographic separation for isolation of Am and lanthanides from other components of the sample. This method has been implemented on an extensive variety of "real" environmental and bioassay samples from the Los Alamos area, and consistently reliable and accurate results with appropriate detection limits have been obtained. The new method increases analytical throughput by a factor of approximately 2 and decreases environmental hazards from acid and mixed-waste generation relative to the prior technique. Analytical accuracy, reproducibility, and reliability are also significantly improved over the more complex and laborious method used previously.

Applying Strengths Model principles to build a rural community-based mental health support service and achieve recovery outcomes.

PubMed

Dunstan, Debra; Anderson, Donnah

2018-02-01

The Personal Helpers and Mentors (PHaMs) service is a non-clinical, community-based Australian Government initiative aimed at increasing opportunities for recovery for people whose lives are severely affected by mental illness. Using a strengths-based recovery model, PHaMs caseworkers support and mentor people 'at risk of falling through the gaps' between state funded clinical treatment services and federally funded social services (such as supported housing, education and employment). While there is evidence that PHaMs realises its aim in metropolitan areas, little is known about how services are developed and function in low resource rural settings and what outcomes are achieved. These questions were addressed in a case study of a PHaMs service in a rural town in the state of New South Wales, Australia. Data were collected from two sources: local service documents prepared for staff orientation and operational purposes, and records and reports of service participants\\' performance and achievements. Participants\\' gains in wellbeing, recovery goals, and the target outcome areas of increased access to services, increased personal capacity and self-reliance, and increased community participation, were gathered from self-reports. The Role Functioning Scale was used as a measure of caseworker ratings of participants\\' adaptive functioning. The qualitative data were examined for semantic content and underlying themes. The quantitative analyses involved repeated measures and between-groups comparisons of uncontrolled pre-test–post-test and retrospective pre-test data. From commencement of the service in October 2009 to June 2014, an estimated 31% of the people living with severe mental illness in the local government area had accessed the PHaMs service (N=126; mean age 31.9 years; 42% male, 27% Aboriginal). The document analysis revealed that despite a lack of detail on how a PHaMs service should be developed or delivered, by focusing on the goal of

The impact of risk management practice upon the implementation of recovery-oriented care in community mental health services: a qualitative investigation.

PubMed

Holley, Jessica; Chambers, Mary; Gillard, Steven

2016-08-01

Recovery-oriented care has become guiding principle for mental health policies and practice in the UK and elsewhere. However, a pre-existing culture of risk management practice may impact upon the provision of recovery-oriented mental health services. To explore how risk management practice impacts upon the implementation of recovery-oriented care within community mental health services. Semi-structured interviews using vignettes were conducted with eight mental health worker and service user dyads. Grounded theory techniques were used to develop explanatory themes. Four themes arose: (1) recovery and positive risk taking; (2) competing frameworks of practice; (3) a hybrid of risk and recovery; (4) real-life recovery in the context of risk. In abstract responses to the vignettes, mental health workers described how they would use a positive-risk taking approach in support of recovery. In practice, this was restricted by a risk-averse culture embedded within services. Mental health workers set conditions with which service users complied to gain some responsibility for recovery. A lack of strategic guidance at policy level and lack of support and guidance at practice level may result in resistance to implementing ROC in the context of RMP. Recommendations are made for policy, training and future research.

Integrating personal medicine into service delivery: empowering people in recovery.

PubMed

MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

2013-12-01

Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Protocol: A grounded theory of 'recovery'-perspectives of adolescent users of mental health services.

PubMed

Palmquist, Lucianne; Patterson, Sue; O'Donovan, Analise; Bradley, Graham

2017-07-20

Policies internationally endorse the recovery paradigm as the appropriate foundation for youth mental health services. However, given that this paradigm is grounded in the views of adults with severe mental illness, applicability to youth services and relevance to young people is uncertain, particularly as little is known about young people's views. A comprehensive understanding of the experiences and expectations of young people is critical to developing youth mental health services that are acceptable, accessible, effective and relevant. To inform development of policy and youth services, the study described in this protocol aims to develop a comprehensive account of the experiences and expectations of 12-17 year olds as they encounter mental disorders and transition through specialist mental health services. Data will be analysed to model recovery from the adolescents' perspective. This grounded theory study will use quantitative and qualitative data collected in interviews with 12-17 year olds engaged with specialist Child/Youth Mental Health Service in Queensland, Australia. Interviews will explore adolescents' expectations and experiences of mental disorder, and of services, as they transition through specialist mental health services, including the meaning of their experiences and ideas of 'recovery' and how their experiences and expectations are shaped. Data collection and analysis will use grounded theory methods. Adolescents' experiences will be presented as a mid-range theory. The research will provide tangible recommendations for youth-focused mental health policy and practice. Findings will be disseminated within academic literature and beyond to participants, health professionals, mental health advocacy groups and policy and decision makers via publications, research summaries, conferences and workshops targeting different audiences. Ethical and research governance approvals have been obtained from relevant Human Research Ethics committees and all

Calcium and zinc DTPA administration for internal contamination with plutonium-238 and americium-241.

PubMed

Kazzi, Ziad N; Heyl, Alexander; Ruprecht, Johann

2012-08-01

The accidental or intentional release of plutonium or americium can cause acute and long term adverse health effects if they enter the human body by ingestion, inhalation, or injection. These effects can be prevented by rapid removal of these radionuclides by chelators such as calcium or zinc diethylenetriaminepentaacetate (calcium or zinc DTPA). These compounds have been shown to be efficacious in enhancing the elimination of members of the actinide family particularly plutonium and americium when administered intravenously or by nebulizer. The efficacy and adverse effects profile depend on several factors that include the route of internalization of the actinide, the type, and route time of administration of the chelator, and whether the calcium or zinc salt of DTPA is used. Current and future research efforts should be directed at overcoming limitations associated with the use of these complex drugs by using innovative methods that can enhance their structural and therapeutic properties.

[Assessment of the distribution in the body and the dose on the respiratory tract and organs after single, short-term and long-term inhalation of americium-241].

PubMed

Malykhin, V M

1991-04-01

On the basis of comparison of publications on accidental human intake of americium-241 and animal experimental studies dosimetric characteristics were obtained reflecting the dynamics of accumulation, formation of the dose on the organs and parts of the respiratory tract, as well as of the 24-hour elimination from the organism of the mentioned radionuclide following single, short- and long-term administration of americium-241 from the air. Results were obtained with the use of computers for quantitative modelling of the most complete metabolic transport scheme of americium.

Transfer of environmental plutonium and americium across the human gut.

PubMed

Hunt, G J; Leonard, D R; Lovett, M B

1986-08-01

Data on gut transfer factors for environmental forms of radionuclides are essential for estimates of public radiation exposures following ingestion, and thus in decisions on controlling waste discharges. Dose estimates for transuranic nuclides are particularly sensitive to uncertainties stemming from gut transfer data being related to non-environmental forms and/or derived from animal experiments. We have measured human gut transfer factors for plutonium and americium in two experiments using marine foods obtained near Sellafield, Cumbria. Firstly, the urine of volunteer members of the critical group of shellfish consumers was analysed for transuranics and the results related to their consumption rates. Secondly, remotely-based volunteers ate single quantities of shellfish obtained near Sellafield, and their urine was analysed. An overall result for the gut transfer factor for environmental plutonium of 0.8 X 10(-4) indicates no need to increase the value of 1 X 10(-4), currently used by the International Commission on Radiological Protection (ICRP) for soluble forms. Results for americium show that the ICRP value of 5 X 10(-4) is maximising, and that a value of 1 X 10(-4) would be supportable. The results from the study of critical group members provide confidence in our habits survey techniques and reassurance that there are no significant pathways for intake of transuranics by these people that have not been recognised.

Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review.

PubMed

Bassuk, Ellen L; Hanson, Justine; Greene, R Neil; Richard, Molly; Laudet, Alexandre

2016-04-01

This systematic review identifies, appraises, and summarizes the evidence on the effectiveness of peer-delivered recovery support services for people in recovery from alcohol and drug addiction. Nine studies met criteria for inclusion in the review. They were assessed for quality and outcomes including substance use and recovery-related factors. Despite significant methodological limitations found in the included studies, the body of evidence suggests salutary effects on participants. Current limitations and recommendations for future research are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

A Longitudinal Analysis of the Influence of a Peer Run Warm Line Phone Service on Psychiatric Recovery.

PubMed

Dalgin, Rebecca Spirito; Dalgin, M Halim; Metzger, Scott J

2018-05-01

This article focuses on the impact of a peer run warm line as part of the psychiatric recovery process. It utilized data including the Recovery Assessment Scale, community integration measures and crisis service usage. Longitudinal statistical analysis was completed on 48 sets of data from 2011, 2012, and 2013. Although no statistically significant differences were observed for the RAS score, community integration data showed increases in visits to primary care doctors, leisure/recreation activities and socialization with others. This study highlights the complexity of psychiatric recovery and that nonclinical peer services like peer run warm lines may be critical to the process.

On the influence of the americium isotopic vector on the cooling time of minor actinides bearing blankets in fast reactors

NASA Astrophysics Data System (ADS)

Kooyman, Timothée; Buiron, Laurent; Rimpault, Gerald

2018-05-01

In the heterogeneous minor actinides transmutation approach, the nuclei to be transmuted are loaded in dedicated targets often located at the core periphery, so that long-lived heavy nuclides are turned into shorter-lived fission products by fission. To compensate for low flux level at the core periphery, the minor actinides content in the targets is set relatively high (around 20 at.%), which has a negative impact on the reprocessing of the targets due to their important decay heat level. After a complete analysis of the main contributors to the heat load of the irradiated targets, it is shown here that the choice of the reprocessing order of the various feeds of americium from the fuel cycle depends on the actual limit for fuel reprocessing. If reprocessing of hot targets is possible, it is more interesting to reprocess first the americium feed with a high 243Am content in order to limit the total cooling time of the targets, while if reprocessing of targets is limited by their decay heat, it is more interesting to wait for an increase in the 241Am content before loading the americium in the core. An optimization of the reprocessing order appears to lead to a decrease of the total cooling time by 15 years compared to a situation where all the americium feeds are mixed together when two feeds from SFR are considered with a high reprocessing limit.

Best practices for basic and advanced skills in health care service recovery: a case study of a re-admitted patient.

PubMed

Hayden, Anna C; Pichert, James W; Fawcett, Jodi; Moore, Ilene N; Hickson, Gerald B

2010-07-01

Service recovery refers to an organizations entire process for facilitating resolution of dissatisfactions, whether or not visible to patients and families. Patients are an important resource for reporting miscommunications, provider inattention, rudeness, or delays, especially if they perceive a connection to misdiagnosis or failed treatment. Health systems that encourage patients to be "the eyes and ears" of individual and team performance capitalize on a rich source of data for quality improvement and risk prevention. Effective service recovery requires organizations (1) to learn about negative perceptions and experiences and (2) to create an infrastructure that supports staff's ability to respond. Service recovery requires the exercise of both basic and advanced skills. We term certain skills as advanced because of the significant variation in their use or endorsement among 30 health care organizations in the United States. On the basis of our work with the 30 organizations, a mnemonic, HEARD, incorporates best practices for basic service recovery processes: Hearing the person's concern; Empathizing with the person raising the issue; Acknowledging, expressing appreciation to the person for sharing, and Apologizing when warranted; Responding to the problem, setting time lines and expectations for follow-up; and Documenting or Delegating the documentation to the appropriate person. Impartiality, chain of command, setting boundaries, and Documentation represent four advanced service recovery skills critical for addressing challenging situations. Using best practices in service recovery enables the organization to do its best to make right what patients and family members experience as wrong.

Whole-body distribution of americium in rats for different pathways of intake.

PubMed

Doyle-Eisele, Melanie; Weber, Waylon; Melo, Dunstana R; Guilmette, Raymond A

2014-11-01

Abstract Purpose: To compare data on the whole-body distribution of americium-241 ((241)Am) in rats following intravenous injection (IV), inhalation, and wound (intramuscular injection, IM). Following exposure, each rat was placed in an individual metabolism cages for the duration of the study, 28 days (d). Urine and feces were collected daily. Tissues and organs were collected and measured. Liver and skeleton were the main sites of deposition for all routes of exposure but the content differed substantially. By 28 d, (241)Am content in liver was similar for IV and IM administrations (12 ± 4% and 14 ± 5%, respectively), which was 3-fold higher compared to inhalation. Americium-241 content in skeleton was 27% by the end of the IV study; which was 50% higher compared to the IM study and 6-fold higher compared to inhalation. The cumulative excretion in 28 d was 54% for IV (44% by feces and 10% by urine); 38% for IM (34% by feces and 4% by urine); and 84% for inhalation (83% by feces and 1% by urine). Unperturbed rat models for the three routes of administration are the baseline for evaluating the efficacy of chelating agents.

Environmental and human monitoring of Americium-241 utilizing extraction chromatography and {alpha}-Spectrometry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldstein, S.J.; Hensley, C.A.; Armenta, C.E.

1997-03-01

Recent developments in extraction chromatography have simplified the separation of americium from complex matrices in preparation for {alpha}-spectroscopy relative to traditional methods. Here we present results of procedures developed/adapted for water, air, and bioassay samples with less than 1 g of inorganic residue. Prior analytical methods required the use of a complex, multistage procedure for separation of americium from these matrices. The newer, simplified procedure requires only a single 2 mL extraction chromatographic separation for isolation of Am and lanthanides from other components of the sample. This method has been implemented on an extensive variety of `real` environmental and bioassaymore » samples from the Los Alamos area, and consistently reliable and accurate results with appropriate detection limits have been obtained. The new method increases analytical throughput by a factor of {approx}2 and decreases environmental hazards from acid and mixed-waste generation relative to the prior technique. Analytical accuracy, reproducibility, and reliability are also significantly improved over the more complex and laborious method used previously. 24 refs., 2 figs., 2 tabs.« less

Getting by, getting back, and getting on: Matching mental health services to consumers' recovery goals.

PubMed

Yarborough, Bobbi Jo H; Yarborough, Micah T; Janoff, Shannon L; Green, Carla A

2016-06-01

The goal of this study was to better understand mental health recovery from the point of view of mental health consumers to identify opportunities for practice improvements that closely align services with consumer goals and consumer-preferred outcomes. As part of an exploratory study of recovery, semistructured interviews were conducted with 177 integrated health plan members diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, or affective psychosis. Transcripts of in-depth interviews were coded using Atlas.ti, and definitions of recovery were further subcoded. A qualitative analysis using a modified grounded theory approach and constant comparative method identified common themes and less common but potentially important recovery-related experiences and perspectives. Three primary and 2 cross-cutting themes emerged. "Getting by" meant coping and meeting basic needs. "Getting back" meant learning to live with mental illness. "Getting on" meant living a life where mental illness was no longer prominent. Regaining control and recouping losses were cross-cutting themes. Mental health recovery is complex and dynamic; individuals' recovery goals can be expected to change over time. Person-centered care must accommodate changing consumer priorities, services must be flexible and responsive, and outcomes need to match consumers' objectives. Clinicians can assist in (a) identifying recovery goals, (b) monitoring progress toward and recognizing movement away from goals, (c) tailoring support to different phases/stages, and (d) supporting transitions between phases/stages. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

National low-level waste management program radionuclide report series, Volume 14: Americium-241

DOE Office of Scientific and Technical Information (OSTI.GOV)

Winberg, M.R.; Garcia, R.S.

1995-09-01

This report, Volume 14 of the National Low-Level Waste Management Program Radionuclide Report Series, discusses the radiological and chemical characteristics of americium-241 ({sup 241}Am). This report also includes discussions about waste types and forms in which {sup 241}Am can be found and {sup 241}Am behavior in the environment and in the human body.

Protocol for a mixed studies systematic review on the implementation of the recovery approach in adult mental health services

PubMed Central

Piat, Myra; Sofouli, Eleni; Sabetti, Judith; Lambrou, Angella; Chodos, Howard; Briand, Catherine; Vachon, Brigitte; Curran, Janet

2017-01-01

Introduction Recovery is integral to mental health planning in G-8 countries including Canada. A recovery-oriented approach to care aims to promote personal empowerment, illness self-management and a life beyond services for people with serious mental illness (SMI), while reducing the financial burden associated with mental illness. Although there is a growing body of literature on recovery, no synthesis of research on the implementation of recovery into mental health services exists. Objectives The objective is to conduct a mixed studies systematic review on the operationalisation of recovery into mental health services for adults with SMI. It will inform the transformation of Canadian services to a recovery orientation, but may be applicable to other countries. Methods and analysis Seven databases including PubMed, Ovid Medline, Ovid Embase, Ovid PsycInfo, CINAHL, the Cochrane Library and Scopus will be searched for peer-reviewed empirical studies published from 1998 to December 2016. Systematic reviews and studies using quantitative, qualitative and mixed methodologies will be included. Secondary searches will be conducted in reference lists of all selected full text articles. Handsearches will also be performed in the tables of contents of three recovery-focused journals for the last 5 years. International experts in the field will be contacted for comments and advice. Data extraction will include identification and methodological synthesis of each study; definition of recovery; information on recovery implementation; facilitators and barriers and study outcomes. A quality assessment will be conducted on each study. The data will be synthesised and a stepwise thematic analysis performed. Ethics and dissemination Ethics approval is not required for this knowledge synthesis. Findings will be disseminated through knowledge translation activities including: (1) a 1-day symposium; (2) presentations in national and international conferences and to local stakeholders

XRD monitoring of α self-irradiation in uranium-americium mixed oxides.

PubMed

Horlait, Denis; Lebreton, Florent; Roussel, Pascal; Delahaye, Thibaud

2013-12-16

The structural evolution under (241)Am self-irradiation of U(1-x)Am(x)O(2±δ) transmutation fuels (with x ≤ 0.5) was studied by X-ray diffraction (XRD). Samples first underwent a preliminary heat treatment performed under a reducing atmosphere (Ar/H2(4%)) aiming to recover the previously accumulated structural defects. Over all measurements (carried out over up to a full year and for integrated doses up to 1.5 × 10(18) α-decay events·g(-1)), only fluorite U(1-x)Am(x)O(2±δ) solid solutions were observed. Within a few days after the end of the heat treatment, each of the five studied samples was slowly oxidized as a consequence of their move to air atmosphere, which is evidenced by XRD by an initial sharp decrease of the unit cell parameter. For the compounds with x ≤ 0.15, this oxidation occurred without any phase transitions, but for U0.6Am0.4O(2±δ) and U0.5Am0.5O(2±δ), this process is accompanied by a transition from a first fluorite solid solution to a second oxidized one, as the latter is thermodynamically stable in ambient conditions. In the meantime and after the oxidation process, (241)Am α self-irradiation caused a structural swelling up to ∼0.8 vol %, independently of the sample composition. The kinetic constants of swelling were also determined by regression of experimental data and are, as expected, dependent on x and thus on the dose rate. The normalization of these kinetic constants by sample α-activity, however, leads to very close swelling rates among the samples. Finally, evolutions of microstrain and crystallite size were also monitored, but for the considered dose rates and cumulated doses, α self-irradiation was found, within the limits of the diffractometer used, to have almost no impact on these characteristics. Microstrain was found to be influenced instead by the americium content in the materials (i.e., by the impurities associated with americium starting material and the increase of cationic charge heterogeneity with

A socioeconomic assessment of Forest Service American Recovery and Reinvestment Act projects: eight case studies

Treesearch

Susan Charnley; Pamela J. Jakes; John Schelhas

2011-01-01

The American Recovery and Reinvestment Act of 2009 aimed to create jobs and jumpstart the economy while addressing the Nation’s social and environmental needs. The U.S. Department of Agriculture, Forest Service, received $1.15 billion in recovery funding to support projects in wildland fire management, capital improvement and maintenance, and biomass utilization. This...

A rapid method for the sequential separation of polonium, plutonium, americium and uranium in drinking water.

PubMed

Lemons, B; Khaing, H; Ward, A; Thakur, P

2018-06-01

A new sequential separation method for the determination of polonium and actinides (Pu, Am and U) in drinking water samples has been developed that can be used for emergency response or routine water analyses. For the first time, the application of TEVA chromatography column in the sequential separation of polonium and plutonium has been studied. This method utilizes a rapid Fe +3 co-precipitation step to remove matrix interferences, followed by plutonium oxidation state adjustment to Pu 4+ and an incubation period of ~ 1 h at 50-60 °C to allow Po 2+ to oxidize to Po 4+ . The polonium and plutonium were then separated on a TEVA column, while separation of americium from uranium was performed on a TRU column. After separation, polonium was micro-precipitated with copper sulfide (CuS), while actinides were micro co-precipitated using neodymium fluoride (NdF 3 ) for counting by the alpha spectrometry. The method is simple, robust and can be performed quickly with excellent removal of interferences, high chemical recovery and very good alpha peak resolution. The efficiency and reliability of the procedures were tested by using spiked samples. The effect of several transition metals (Cu 2+ , Pb 2+ , Fe 3+ , Fe 2+ , and Ni 2+ ) on the performance of this method were also assessed to evaluate the potential matrix effects. Studies indicate that presence of up to 25 mg of these cations in the samples had no adverse effect on the recovery or the resolution of polonium alpha peaks. Copyright © 2018 Elsevier Ltd. All rights reserved.

Vertical and horizontal fluxes of plutonium and americium in the western Mediterranean and the Strait of Gibraltar.

PubMed

León Vintró, L; Mitchell, P I; Condren, O M; Downes, A B; Papucci, C; Delfanti, R

1999-09-30

New data on the vertical distributions of plutonium and americium in the waters of the western Mediterranean and the Strait of Gibraltar are examined in terms of the processes governing their delivery to, transport in and removal from the water column within the basin. Residence times for plutonium and americium in surface waters of approximately 15 and approximately 3 years, respectively, are deduced, and it is shown that by the mid 1990s only approximately 35% of the 239,240Pu and approximately 5% of the 241Am deposited as weapons fallout still resided in the water column. Present 239,240Pu inventories in the water column and the underlying sediments are estimated to be approximately 25 TBq and approximately 40 TBq, respectively, which reconcile well with the time-integrated fallout deposition in this zone, taken to be approximately 69 TBq. The data show that there are significant net outward fluxes of plutonium and americium from the basin through the Strait of Gibraltar at the present time. These appear to be compensated by net inward fluxes of similar magnitude through the Strait of Sicily. Thus, the time-integrated fallout deposition in the western basin can be accounted for satisfactorily in terms of present water column and sediment inventories. Enhanced scavenging on the continental shelves, as evidenced by the appreciably higher transuranic concentrations in shelf sediments, supports this contention.

Service area size assessment for evaluating the spatial scale of solid waste recovery chains: A territorial perspective.

PubMed

Tanguy, Audrey; Villot, Jonathan; Glaus, Mathias; Laforest, Valérie; Hausler, Robert

2017-06-01

Waste recovery is an integrated part of municipal solid waste management systems but its strategic planning is still challenging. In particular, the service area size of facilities is a sensitive issue since its calculation depends on various factors related to treatment technologies (output products) and territorial features (sources waste production and location). This work presents a systemic approach for the estimation of a chain's service area size, based on a balance between costs and recovery profits. The model assigns a recovery performance value to each source, which can be positive, neutral or negative. If it is positive, the source should be included in the facility's service area. Applied to the case of Montreal for food waste recovery by anaerobic digestion, the approach showed that at most 23 out of the 30 districts should be included in the service area, depending on the indicator, which represents around 127,000 t of waste recovered/year. Due to the systemic approach, these districts were not necessarily the closest to the facility. Moreover, for the Montreal case, changing the facility's location did not have a great influence on the optimal service area size, showing that the distance to the facility was not a decisive factor at this scale. However, replacing anaerobic digestion by a composting plant reduced the break-even transport distances and, thus, the number of sources worth collecting (around 68,500 t/year). In this way, the methodology, applied to different management strategies, gave a sense of the spatial dynamics involved in the recovery chain's design. The map of optimal supply obtained could be used to further analyse the feasibility of multi-site and/or multi-technology systems for the territory considered. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Peer-Led Electronic Mental Health Recovery App in an Adult Mental Health Service: Study Protocol for a Pilot Trial.

PubMed

Gulliver, Amelia; Banfield, Michelle; Reynolds, Julia; Miller, Sarah; Galati, Connie; Morse, Alyssa R

2017-12-07

There is growing demand for peer workers (people who use their own lived experience to support others in their recovery) to work alongside consumers to improve outcomes and recovery. Augmenting the workforce with peer workers has strong capacity to enhance mental health and recovery outcomes and make a positive contribution to the workforce within mental health systems and to the peer workers themselves. Technology-based applications are highly engaging and desirable methods of service delivery. This project is an exploratory proof-of-concept study, which aims to determine if a peer worker-led electronic mental (e-mental) health recovery program is a feasible, acceptable, and effective adjunct to usual treatment for people with moderate to severe mental illness. The study design comprises a recovery app intervention delivered by a peer worker to individual consumers at an adult mental health service. Evaluation measures will be conducted at post-intervention. To further inform the acceptability and feasibility of the model, consumers will be invited to participate in a focus group to discuss the program. The peer worker, peer supervisor, and key staff at the mental health service will also be individually interviewed to further evaluate the feasibility of the program within the health service and further inform its future development. The program will be delivered over a period of approximately 4 months, commencing June 2017. If the peer worker-led recovery app is found to be feasible, acceptable, and effective, it could be used to improve recovery in mental health service consumers. ©Amelia Gulliver, Michelle Banfield, Julia Reynolds, Sarah Miller, Connie Galati, Alyssa R Morse. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.12.2017.

Contested understandings of recovery in mental health.

PubMed

McCabe, Rhiannah; Whittington, Richard; Cramond, Laura; Perkins, Elizabeth

2018-05-17

The concept of recovery is contested throughout the existing literature and in mental health services. Little research exists that gives voice to service user perspectives of recovery. This paper explores how service users in two recovery oriented services run by the National Health Service in North West England talked about recovery and what it meant to them. 14 service users accessing these services took part in semi-structured qualitative interviews focusing on the concept of recovery. Data were analysed using an interpretive phenomenological analysis approach. Service users talked about recovery as a dynamic, day to day process as well as an outcome; specifically related to being discharged from inpatient settings. A number of factors including relationships and medication were cited to have the potential to make or break recovery. The study highlights the continued dominance of the biomedical model in mental health services. Service users appear to have internalised staff and services' understanding of recovery perhaps unsurprisingly given the power differential in these relationships. Implications for clinical practice are explored.

The right place? Users and professionals' constructions of the place's influence on personal recovery in community mental health services.

PubMed

Femdal, Ingrid

2018-01-01

Current mental health policy emphasizes the importance of community-based service delivery for people with mental health problems to encompass personal recovery. The aim of this study is to explore how users and professionals construct the place's influence on personal recovery in community mental health services. This is a qualitative, interpretive study based on ten individual, semi-structured interviews with users and professionals, respectively. A discourse analysis inspired by the work of Foucault was used to analyze the interviews. The findings show how place can be constructed as a potential for and as a barrier against recovery. Constructions of the aim of the services matter when choosing a place for the services. Further, constructions of user-professional relationships and flexibility are important in the constructions of an appropriate place for the services. The aim of the service, the user-professional relationship, and flexibility in choosing place were essential in the participants' constructions. To find "the right place" for mental health services was constructed as context-sensitive and complex processes of assessment and co-determination. Trial registration The study is approved by the Regional Committee for Medical Research Ethics, Norway (REK-Midt 2011/2057).

In situ characterization of uranium and americium oxide solid solution formation for CRMP process: first combination of in situ XRD and XANES measurements.

PubMed

Caisso, Marie; Picart, Sébastien; Belin, Renaud C; Lebreton, Florent; Martin, Philippe M; Dardenne, Kathy; Rothe, Jörg; Neuville, Daniel R; Delahaye, Thibaud; Ayral, André

2015-04-14

Transmutation of americium in heterogeneous mode through the use of U1-xAmxO2±δ ceramic pellets, also known as Americium Bearing Blankets (AmBB), has become a major research axis. Nevertheless, in order to consider future large-scale deployment, the processes involved in AmBB fabrication have to minimize fine particle dissemination, due to the presence of americium, which considerably increases the risk of contamination. New synthesis routes avoiding the use of pulverulent precursors are thus currently under development, such as the Calcined Resin Microsphere Pelletization (CRMP) process. It is based on the use of weak-acid resin (WAR) microspheres as precursors, loaded with actinide cations. After two specific calcinations under controlled atmospheres, resin microspheres are converted into oxide microspheres composed of a monophasic U1-xAmxO2±δ phase. Understanding the different mechanisms during thermal conversion, that lead to the release of organic matter and the formation of a solid solution, appear essential. By combining in situ techniques such as XRD and XAS, it has become possible to identify the key temperatures for oxide formation, and the corresponding oxidation states taken by uranium and americium during mineralization. This paper thus presents the first results on the mineralization of (U,Am) loaded resin microspheres into a solid solution, through in situ XAS analysis correlated with HT-XRD.

A comparison of two coaching approaches to enhance implementation of a recovery-oriented service model.

PubMed

Deane, Frank P; Andresen, Retta; Crowe, Trevor P; Oades, Lindsay G; Ciarrochi, Joseph; Williams, Virginia

2014-09-01

Moving to recovery-oriented service provision in mental health may entail retraining existing staff, as well as training new staff. This represents a substantial burden on organisations, particularly since transfer of training into practice is often poor. Follow-up supervision and/or coaching have been found to improve the implementation and sustainment of new approaches. We compared the effect of two coaching conditions, skills-based and transformational coaching, on the implementation of a recovery-oriented model following training. Training followed by coaching led to significant sustained improvements in the quality of care planning in accordance with the new model over the 12-month study period. No interaction effect was observed between the two conditions. However, post hoc analyses suggest that transformational coaching warrants further exploration. The results support the provision of supervision in the form of coaching in the implementation of a recovery-oriented service model, and suggest the need to better elucidate the mechanisms within different coaching approaches that might contribute to improved care.

The work and recovery project: changing organizational culture and practice in New York City outpatient services.

PubMed

Pascaris, Alysia; Shields, Leslie Reed; Wolf, Jessica

2008-01-01

Complex and multiple barriers confront out-patient programs in promoting recovery and addressing mental health recipients' work-related goals. This article describes a focused organizational change project utilizing intensive consultation and technical assistance within five New York City outpatient psychiatric services. The project aimed to increase staff exposure to, understanding and use of work-related and recovery-based concepts to promote consumers' recovery and attainment of employment goals. Tailored assessment, curriculum delivery, and identification and implementation of change objectives were useful strategies in promoting change. This change model can serve to assist programs in their efforts to integrate new approaches and to better understand changes among leadership, staff and consumers, and changes in organizational culture and practice required to support a work and recovery-oriented service paradigm. The project experience suggests that adopting and embracing new practices takes time. Varied and incremental steps toward programmatic and operational changes can be significant and can reap authentic sustainable change occurring in the process of learning, experiencing, internalizing and adjusting to new methods of practice.

High Purity Americium-241 for Fuel Cycle R&D Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dr. Paul A. Lessing

2011-07-01

Previously the U.S. Department of Energy released Am-241 for various applications such as smoke detectors and Am-Be neutron sources for oil wells. At this date there is a shortage of usable, higher purity Am-241 in metal and oxide form available in the United States. Recently, the limited source of Am-241 has been from Russia with production being contracted to existing customers. The shortage has resulted in the price per gram rising dramatically over the last few years. DOE-NE currently has need for high purity Am-241 metal and oxide to fabricate fuel pellets for reactor testing in the Fuel Cycle R&Dmore » program. All the available high purity americium has been gathered from within the DOE system of laboratories. However, this is only a fraction of the projected needs of FCRD over the next 10 years. Therefore, FCR&D has proposed extraction and purification concepts to extract Am-241 from a mixed AmO2-PuO2 feedstock stored at the Savannah River Site. The most simple extraction system is based upon high temperature reduction using lanthanum metal with concurrent evaporation and condensation to produce high purity Am metal. Metallic americium has over a four order of magnitude higher vapor pressure than plutonium. Results from small-scale reduction experiments are presented. These results confirm thermodynamic predictions that at 1000 deg C metallic lanthanum reduces both PuO2 and AmO2. Faster kinetics are expected for temperatures up to about 1500 deg C.« less

Thromboelastograms of dogs with acute and subacute lesions due to inhalation of americium 241 and plutonium 239 nitrates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalmykova, Z.I.

1978-01-01

The effects of inhalation of americium 241 and plutonium 231 on the clotting mechanism of dogs were investigated. Thromboelastograms of whole venous blood were used as the method for studying coagulation properties.

An LDA+U study of the photoemission spectra of ground state phase of americium and curium

NASA Astrophysics Data System (ADS)

Islam, Md; Ray, Asok

2009-03-01

We have investigated the photoemission spectra and other ground state properties such as equilibrium volume and bulk modulus of dhcp americium and the density of states and magnetic properties of dhcp curium using LDA+U method. Our calculations show that spin polarized americium is energetically favorable but spin degenerate configuration produces experimental quantities much better than that calculated using spin polarized configuration. The DOS calculated using LDA+U with both non-magnetic and spin polarized configurations is compared and the non-magnetic DOS is shown to be in good agreement with experimental photoemission spectra when U=4.5 eV. In spin polarized case, U is observed to increase the splitting between occupied and unoccupied bands by enhancing Stoner parameter. The results are shown to be in good agreement with that calculated using dynamical mean field theory for these two heavy actinides. For curium, exchange interaction appears to play the dominant role in its magnetic stability.

Plutonium, americium, and uranium in blow-sand mounds of safety-shot sites at the Nevada Test Site and the Tonopah Test Range

DOE Office of Scientific and Technical Information (OSTI.GOV)

Essington, E.H.; Gilbert, R.O.; Wireman, D.L.

Blow-sand mounds or miniature sand dunes and mounds created by burrowing activities of animals were investigated by the Nevada Applied Ecology Group (NAEG) to determine the influence of mounds on plutonium, americium, and uranium distributions and inventories in areas of the Nevada Test Site and Tonopah Test Range. Those radioactive elements were added to the environment as a result of safety experiments of nuclear devices. Two studies were conducted. The first was to estimate the vertical distribution of americium in the blow-sand mounds and in the desert pavement surrounding the mounds. The second was to estimate the amount or concentrationmore » of the radioactive materials accumulated in the mound relative to the desert pavement. Five mound types were identified in which plutonium, americium, and uranium concentrations were measured: grass, shrub, complex, animal, and diffuse. The mount top (that portion above the surrounding land surface datum), the mound bottom (that portion below the mound to a depth of 5 cm below the surrounding land surface datum), and soil from the immediate area surrounding the mound were compared separately to determine if the radioactive elements had concentrated in the mounds. Results of the studies indicate that the mounds exhibit higher concentrations of plutonium, americium, and uranium than the immediate surrounding soil. The type of mound does not appear to have influenced the amount of the radioactive material found in the mound except for the animal mounds where the burrowing activities appear to have obliterated distribution patterns.« less

38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

Code of Federal Regulations, 2010 CFR

2010-07-01

... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or... section covers collection or recovery by VA, under 38 U.S.C. 1729, for medical care or services provided...

Consumer-operated service program members' explanatory models of mental illness and recovery.

PubMed

Hoy, Janet M

2014-10-01

Incorporating individuals' understandings and explanations of mental illness into service delivery offers benefits relating to increased service relevance and meaning. Existing research delineates explanatory models of mental illness held by individuals in home, outpatient, and hospital-based contexts; research on models held by those in peer-support contexts is notably absent. In this article, I describe themes identified within and across explanatory models of mental illness and recovery held by mental health consumers (N = 24) at one peer center, referred to as a consumer-operated service center (COSP). Participants held explanatory models inclusive of both developmental stressors and biomedical causes, consistent with a stress-diathesis model (although no participant explicitly referenced such). Explicit incorporation of stress-diathesis constructs into programming at this COSP offers the potential of increasing service meaning and relevance. Identifying and incorporating shared meanings across individuals' understandings of mental illness likewise can increase relevance and meaning for particular subgroups of service users. © The Author(s) 2014.

South African mental health care service user views on priorities for supporting recovery: implications for policy and service development.

PubMed

Kleintjes, Sharon; Lund, Crick; Swartz, Leslie

2012-01-01

The paper documents the views of South African mental health care service users on policy directions and service developments that are required to support their recovery. Semi-structured interviews were conducted with forty service users and service user advocates. A framework analysis approach was used to analyse the qualitative data. Service user priorities included addressing stigma, discrimination and disempowerment, and the links between mental health and poverty. They suggested that these challenges be addressed through public awareness campaigns, legislative and policy reform for rights protection, development of a national lobby to advocate for changes, and user empowerment. Users suggested that empowerment can be facilitated through opportunities for improved social relatedness and equitable access to social and economic resources. This study suggests three strategies to bridge the gap between mental health care service users rights and needs on one hand, and unsupportive attitudes, policies and practices on the other. These are: giving priority to service user involvement in policy and service reform, creating empathic alliances to promote user priorities, and building enabling partnerships to effect these priorities.

Frontiers of Chemistry for Americium and Curium

DOE R&D Accomplishments Database

Keller, O. L. Jr.

1984-01-01

The discoveries of americium and curium were made only after Seaborg had formulated his actinide concept in order to design the chemistry needed to separate them from irradiated /sup 239/Pu targets. Their discoveries thus furnished the first clear-cut evidence that the series exists and justified Seaborg`s bold assumption that even though Th and Pa appeared to presage a following 6d series, the pattern established by the periodic table after Cs and Ba would be repeated exactly after Fr and Ra. That is to say, a new 5f element rare earth series (the actinides) would follow Ac in the same way the 4f rare earth series (the lanthanides) follows La. The consequences of the resulting half-filled 5f/sup 7/ shell at Cm were originally presented by Seaborg as a test of his hypothesis. Recent research is outlined that substantiates Seaborg`s predictions in new and definitive ways.

Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

PubMed

Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

2017-09-01

Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues

The Mental Health Recovery Movement and Family Therapy, Part I: Consumer-Led Reform of Services to Persons Diagnosed with Severe Mental Illness

ERIC Educational Resources Information Center

Gehart, Diane R.

2012-01-01

In 2004, the U.S. Department of Health and Human Services issued a consensus statement on mental health recovery based on the New Freedom Commission's recommendation that public mental health organizations adopt a "recovery" approach to severe and persistent mental illness, including services to those dually diagnosed with mental health…

10 CFR 32.102 - Schedule C-prototype tests for calibration or reference sources containing americium-241 or...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Schedule C-prototype tests for calibration or reference sources containing americium-241 or radium-226. 32.102 Section 32.102 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES TO MANUFACTURE OR TRANSFER CERTAIN ITEMS CONTAINING BYPRODUCT MATERIAL Generally...

"Speeding up the road to recovery": The Complex Recovery Assessment and Consultation (CRAC) service.

PubMed

Davis Le Brun, Stephanie

2015-01-01

The number of bed closures in mental health is on the rise, creating additional pressure on services, including acute mental health services. An efficient way of working is required in order to streamline the acute care pathway and decrease unnecessary delays to length of stay, ensuring all individuals can be offered an inpatient bed when in crisis. The Complex Recovery Assessment and Consultation (CRAC) service was created in order to support acute mental health inpatient clinicians in streamlining hospital stays for service users who present with complex presentations that require lengthier admissions (over 40 days) by offering assessment, advice, and intervention from a rehabilitation perspective. The team was also created to understand why individuals may require a lengthy hospital stay. Preliminary data showed that requiring a placement on discharge proved to be the most significant factor in increased length of stay and so the team took on a new role of discharge coordinator after around a year of operating. This involved assisting in decreasing any delays out of hospital through improved communication and dedicated time to complete tasks, such as completing paperwork for placement referrals and funding panels. Since taking on this role it was found that the time taken for individuals to be discharged to a rehabilitation or specialist placement decreased; a rehabilitation placement by 13.12 days and a specialist placement by 9.22 days. Discharge to a family address also decreased by 2.9 days and a home address by 2.47 days. Those patients with complex presentations benefit from having one dedicated team to coordinate the discharge process. Their lengthier acute inpatient stay is improved through streamlining care pathways, ultimately decreasing delays in discharge.

Do it right this time: the role of employee service recovery performance in customer-perceived justice and customer loyalty after service failures.

PubMed

Liao, Hui

2007-03-01

Integrating justice and customer service literatures, this research examines the role of customer service employees' behaviors of handling customer complaints, or service recovery performance (SRP), in conveying a just image of service organizations and achieving desirable customer outcomes. Results from a field study and a laboratory study demonstrate that the dimensions of SRP--making an apology, problem solving, being courteous, and prompt handling--positively influenced customer satisfaction and then customer repurchase intent through the mediation of customer-perceived justice. In addition, service failure severity and repeated failures reduced the positive impact of some dimensions of SRP on customer satisfaction, and customer-perceived justice again mediated these moderated effects. (c) 2007 APA, all rights reserved.

BAG PASSOUT SEALER FOR WATER-SHIELDED CAVE FACILITY (Engineering Materials)

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1963-10-31

The water-shielded cave facility is used in processing irradiated slugs for recovery of americium, curium, berkelium, californium, einsteinium, and fermium. The remotely operated, plastic-bag passout sealer is used in removing isotopic fractions for storage in the rear or for removing radioactive waste for placement in the waste storage containers. The unit is accessible by both the primary inclosure master-slaves and the service area master-slaves. (F.L.S.)

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2013 CFR

2013-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2012 CFR

2012-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2010 CFR

2010-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2014 CFR

2014-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2011 CFR

2011-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems

PubMed Central

Slade, Mike; Amering, Michaela; Farkas, Marianne; Hamilton, Bridget; O'Hagan, Mary; Panther, Graham; Perkins, Rachel; Shepherd, Geoff; Tse, Samson; Whitley, Rob

2014-01-01

An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses (“abuses”) of the concept of recovery: recovery is the latest model; recovery does not apply to “my” patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship. PMID:24497237

Covalency in Americium(III) Hexachloride

DOE PAGES

Cross, Justin Neil; Su, Jing; Batista, Enrigue R.; ...

2017-06-14

Developing a better understanding of covalency (or orbital mixing) is of fundamental importance. Covalency occupies a central role in directing chemical and physical properties for almost any given compound or material. Hence, the concept of covalency has potential to generate broad and substantial scientific advances, ranging from biological applications to condensed matter physics. Given the importance orbital mixing combined with the difficultly in measuring covalency, estimating or inferring covalency often leads to fiery debate. Consider the 60-year controversy sparked by SEABORG and COWORKERS (1954) when it was proposed that covalency from 5f-orbitals contributed to the unique behavior of americium inmore » chloride matrixes. Herein, we describe the use of ligand K-edge X-ray absorption spectroscopy (XAS) and electronic structure calculations to quantify the extent of covalent bonding in – arguably – one of the most difficult systems to study, the Am–Cl interaction within AmCl 6 3-. We observed both 5fand 6d-orbital mixing with the Cl-3p orbitals; however, contributions from the 6d-orbitals were more substantial. Comparisons with the isoelectronic EuCl 6 3- indicated similar bonding for the Am III 6d- and Eu III 5d-orbitals. Meanwhile, the results confirmed SEABORG’S 1954 hypothesis that Am III 5f-orbital covalency was more substantial than 4forbital mixing for Eu III.« less

Recovery of minor actinides from spent fuel using TPEN-immobilized gels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koyama, S.; Suto, M.; Ohbayashi, H.

2013-07-01

A series of separation experiments was performed in order to study the recovery process for minor actinides (MAs), such as americium (Am) and curium (Cm), from the actual spent fuel by using an extraction chromatographic technique. N,N,N',N'-tetrakis-(4-propenyloxy-2-pyridylmethyl) ethylenediamine (TPPEN) is an N,N,N',N'-tetrakis (2-pyridylmethyl) ethylenediamine (TPEN) analogue consisting of an incorporated pyridine ring that acts as not only a ligand but also as a site for polymerization and crosslinking of the gel. The TPPEN and N-isopropylacrylamide (NIPA) were dissolved into dimethylformamide (DMF, Wako Co., Ltd.) and a silica beads polymer, and then TTPEN was immobilized chemically in a polymer gel (somore » called TPEN-gel). Mixed oxide (MOX) fuel, which was highly irradiated up to 119 GWD/MTM in the experimental fast reactor Joyo, was used as a reference spent fuel. First, uranium (U) and plutonium (Pu) were separated from the irradiated fuel using an ion-exchange method, and then, the platinum group elements were removed by CMPO to leave a mixed solution of MAs and lanthanides. The 3 mol% TPPEN-gel was packed with as an extraction column (CV: 1 ml) and then rinsed by 0.1 M NaNO{sub 3}(pH 4.0) for pH adjustment. After washing the column by 0.01 M NaNO{sub 3} (pH 4.0), Eu was detected and the recovery rate reached 93%. The MAs were then recovered by changing the eluent to 0.01 M NaNO{sub 3} (pH 2.0), and the recovery rate of Am was 48 %. The 10 mol% TPPEN-gel was used to improve adsorption coefficient of Am and a condition of eluent temperature was changed in order to confirm the temperature swing effect on TPEN-gel for MA. More than 90% Eu was detected in the eluent after washing with 0.01 M NaNO{sub 3} (pH 3.5) at 5 Celsius degrees. Americium was backwardly detected and eluted continuously during the same condition. After removal of Eu, the eluent temperature was changed to 32 Celsius degrees, then Am was detected (pH 3.0). Finally remained Am could be

The 1976 Hanford Americium Accident: Then and Now

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carbaugh, Eugene H.

2013-10-02

The 1976 chemical explosion of an 241Am ion exchange column at a Hanford Site waste management facility resulted in the extreme contamination of a worker with 241Am, nitric acid and debris. The worker underwent medical treatment for acid burns, as well as wound debridement, extensive personal skin decontamination and long-term DTPA chelation therapy for decorporation of americium-241. Because of the contamination levels and prolonged decontamination efforts, care was provided for the first three months at the unique Emergency Decontamination Facility with gradual transition to the patient’s home occurring over another two months. The medical treatment, management, and dosimetry of themore » patient have been well documented in numerous reports and journal articles. The lessons learned with regard to patient treatment and effectiveness of therapy still form the underlying philosophy of treatment for contaminated injuries. Changes in infrastructure and facilities as well as societal expectations make for interesting speculation as to how responses might differ today.« less

Evaluation of americium-241 toxicity influence on the microbial growth of organic wastes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Takehiro Marumo, Julio; Padua Ferreira, Rafael Vicente de; Keiko Isiki, Vera Lucia

2007-07-01

Available in abstract form only. Full text of publication follows: Since the licenses for using radioactive sources in radioactive lightning rods were lifted by the Brazilian national nuclear authority, in 1989, the radioactive devices have been replaced by Franklin type and collected as radioactive waste. However, only 20 percent of the estimated total number of installed rods was delivered to Brazilian Nuclear Commission. This situation causes concern, due to, first, the possibility of the rods being disposed as domestic waste, and second, the americium, the most commonly employed radionuclide, is classified as a high-toxicity element. In the present study, Am-241more » migration experiments were performed by a lysimeter system, in order to evaluate the risk of contamination caused by radioactive lightning rods disposed as a common solid waste. Besides the risk evaluation, it is important to know the mechanism of the Am-241 release or retention in waste as well as its influence in the waste decomposition processes. Many factors are involved, but microorganisms present in the waste play an important role in its degradation, which control the physical and chemical processes. The objective of this work was to evaluate the Am-241 influence on the microbial population by counting number of cells in lysimeters leachate. Preliminary results suggest that americium may influence significantly the bacteria growth in organic waste, evidenced by culture under aerobiosis and an-aerobiosis and the antimicrobial resistance test. (authors)« less

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery

PubMed Central

Wittman, Fried; Jee, Babette; Polcin, Douglas L.; Henderson, Diane

2014-01-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting – building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city – function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research. PMID:25328377

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery.

PubMed

Wittman, Fried; Jee, Babette; Polcin, Douglas L; Henderson, Diane

2014-07-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting - building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city - function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research.

Leading a Recovery-oriented Social Enterprise.

PubMed

Raeburn, Toby; Hungerford, Catherine; Sayers, Jan; Escott, Phil; Lopez, Violeta; Cleary, Michelle

2015-05-01

Recovery-oriented mental health services promote the principles of recovery, such as hope and optimism, and are characterized by a personalized approach to developing consumer self-determination. Nurse leaders are increasingly developing such services as social enterprises, but there is limited research on the leadership of these programs. Leading a recovery-oriented mental health nurse social enterprise requires visionary leadership, collaboration with consumers and local health providers, financial viability, and commitment to recovery-focused practice. This article describes the framework of an Australian mental health nursing social enterprise, including the service attributes and leadership lessons that have been learned from developing program sustainability.

Coteaching Recovery to Mental Health Care Professionals.

PubMed

Larsen, Christine; Lange, Mads; Jørgensen, Kim; Kistrup, Kristen; Petersen, Lone

2018-06-01

In 2010, the Regional Council of the Capital Region of Denmark endorsed a vision of mental health services based on personal recovery, rehabilitation, and the involvement of caregivers. Programs to achieve this vision include hiring peer support workers, a Recovery College, and service user participation at the organizational level. This column describes a cornerstone of these initiatives-an education program in the recovery model for mental health professionals. In 2013-2014, the Capital Region implemented 148 workshops on recovery-oriented services for all practitioner staff in mental health services in the region. The workshops featured a coteaching model, with both a mental health professional and an individual with lived experience serving as trainers. This model showed promise and should be expanded, including more targeted training for specific services. Such an expansion could be included in a national strategy for user involvement and recovery-oriented practice set to launch in 2018.

Transportability Class of Americium in K Basin Sludge under Ambient and Hydrothermal Processing Conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Delegard, Calvin H.; Schmitt, Bruce E.; Schmidt, Andrew J.

2006-08-01

This report establishes the technical bases for using a ''slow uptake'' instead of a ''moderate uptake'' transportability class for americium-241 (241Am) for the K Basin Sludge Treatment Project (STP) dose consequence analysis. Slow uptake classes are used for most uranium and plutonium oxides. A moderate uptake class has been used in prior STP analyses for 241Am based on the properties of separated 241Am and its associated oxide. However, when 241Am exists as an ingrown progeny (and as a small mass fraction) within plutonium mixtures, it is appropriate to assign transportability factors of the predominant plutonium mixtures (typically slow) to themore » Am241. It is argued that the transportability factor for 241Am in sludge likewise should be slow because it exists as a small mass fraction as the ingrown progeny within the uranium oxide in sludge. In this report, the transportability class assignment for 241Am is underpinned with radiochemical characterization data on K Basin sludge and with studies conducted with other irradiated fuel exposed to elevated temperatures and conditions similar to the STP. Key findings and conclusions from evaluation of the characterization data and published literature are summarized here. Plutonium and 241Am make up very small fractions of the uranium within the K Basin sludge matrix. Plutonium is present at about 1 atom per 500 atoms of uranium and 241Am at about 1 atom per 19000 of uranium. Plutonium and americium are found to remain with uranium in the solid phase in all of the {approx}60 samples taken and analyzed from various sources of K Basin sludge. The uranium-specific concentrations of plutonium and americium also remain approximately constant over a uranium concentration range (in the dry sludge solids) from 0.2 to 94 wt%, a factor of {approx}460. This invariability demonstrates that 241Am does not partition from the uranium or plutonium fraction for any characterized sludge matrix. Most of the K Basin sludge

Recovery Support for Adolescents with Substance use Disorders: The Impact of Recovery Support Telephone Calls Provided by Pre-Professional Volunteers

PubMed Central

Garner, Bryan R; Godley, Mark D; Passetti, Lora L; Funk, Rodney R; White, William L

2014-01-01

The present quasi-experiment examined the direct and indirect effects of recovery support telephone calls following adolescent substance use disorder treatment. Six-month outcome data from 202 adolescents who had received recovery support calls from primarily pre-professional (i.e., college-level social service students) volunteers was compared to 6-month outcome data from a matched comparison sample of adolescents (n = 404). Results suggested adolescents in the recovery support sample had significantly greater reductions in their recovery environment risk relative to the comparison sample (β = -.17). Path analysis also suggested that the reduction in recovery environment risk produced by recovery support calls had indirect impacts (via recovery environment risk) on reductions in social risk (β = .22), substance use (β = .23), and substance-related problems (β = .16). Finally, moderation analyses suggested the effects of recovery support calls did not differ by gender, but were significantly greater for adolescents with lower levels of treatment readiness. In addition to providing rare empirical support for the effectiveness of recovery support services, an important contribution of this study is that it provides evidence that recovery support services do not necessarily have to be “peer-based,” at least in terms of the recovery support service provider having the experiential credentials of being “in recovery.” If replicated, this latter finding may have particularly important implications for helping increase the recovery support workforce. PMID:25574502

Development of Support Service for Prevention and Recovery from Dementia and Science of Lethe

NASA Astrophysics Data System (ADS)

Otake, Mihoko

Purpose of this study is to explore service design method through the development of support service for prevention and recovery from dementia towards science of lethe. We designed and implemented conversation support service via coimagination method based on multiscale service design method, both were proposed by the author. Multiscale service model consists of tool, event, human, network, style and rule. Service elements at different scales are developed according to the model. Interactive conversation supported by coimagination method activates cognitive functions so as to prevent progress of dementia. This paper proposes theoretical bases for science of lethe. Firstly, relationship among coimagination method and three cognitive functions including division of attention, planning, episodic memory which decline at mild cognitive imparement. Secondly, thought state transition model during conversation which describes cognitive enhancement via interactive communication. Thirdly, Set Theoretical Measure of Interaction is proposed for evaluating effectiveness of conversation to cognitive enhancement. Simulation result suggests that the ideas which cannot be explored by each speaker are explored during interactive conversation. Finally, coimagination method compared with reminiscence therapy and its possibility for collaboration is discussed.

The recovery model and complex health needs: what health psychology can learn from mental health and substance misuse service provision.

PubMed

Webb, Lucy

2012-07-01

This article reviews key arguments around evidence-based practice and outlines the methodological demands for effective adoption of recovery model principles. The recovery model is outlined and demonstrated as compatible with current needs in substance misuse service provision. However, the concepts of evidence-based practice and the recovery model are currently incompatible unless the current value system of evidence-based practice changes to accommodate the methodologies demanded by the recovery model. It is suggested that critical health psychology has an important role to play in widening the scope of evidence-based practice to better accommodate complex social health needs.

Retrofitting the Williams Energy Services Ignacio Plant for higher throughput and recovery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lynch, J.T.; Pitman, R.N.

1999-07-01

The Ignacio Plant located near Durango, Colorado was originally designed to process 346 MMscfd of feed gas and to recover approximately 82% of the contained ethane. Based on increasing volumes of available feed gas, Williams Energy Services (WES) undertook a study to investigate alternatives for increasing plant capacity and ethane recovery. This study led to the selection of Ortloff's Recycle Split-Vapor (RSV) process for retrofitting the existing facility because it offered several very important advantages: maximum utilization of existing equipment, a 30% increase in plant feed handling capacity and an increase in average ethane recovery to 94% without adding residuemore » compressors. This paper presents the comparative case analysis that led to the selection of the RSV design. It also describes the modifications required for the retrofit, all of which can be accomplished with minimum plant down time. The modified Ignacio Plant is scheduled for startup in March 1999.« less

42 CFR 431.1002 - Recoveries.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Recoveries. 431.1002 Section 431.1002 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... Payments in Medicaid and CHIP § 431.1002 Recoveries. (a) Medicaid. States must return to CMS the Federal...

Association between the perspective of adult inpatients with digestive cancer regarding the nursing service and their quality of recovery on postoperative day 3.

PubMed

Sasaki, Kumiko; Tamakoshi, Koji

2018-02-01

Although qualitative research that focuses on inpatients' experience immediately after surgery has continued to elucidate the efficacy of the nursing service for postoperative recovery, there has been little quantitative research. Our aim was to quantitatively clarify the association between inpatients' perception of the nursing service and the quality of postoperative recovery. Seventy-one digestive cancer patients who underwent surgery were recruited. Participants completed two self-administered questionnaires, including the Japanese version of the 40-item postoperative Quality of Recovery scale (QoR-40J) and the Nursing Service Quality Scale for Japan (NURSERV-J) which has 22 items and five dimensions (tangibles, reliability, responsiveness, assurance, and empathy) on postoperative day 3. There were significant positive associations between the global scores of the NURSERV-J and the QoR-40J. The global score of the QoR-40J was compared between patients who gave full marks for each dimension of the NURSERV-J (the entirely satisfied group) and those who did not (the not entirely satisfied group). The entirely satisfied groups regarding tangibles, reliability and responsiveness had a significantly higher global score for the QoR-40J than the respective not entirely satisfied groups. Adjusted for age, gender, operative procedure, and duration of surgery, the entirely satisfied groups regarding tangibles and responsiveness had a significant higher global score for the QoR-40J than the respective not entirely satisfied groups. Patients who perceived that they had received a nursing service of high quality were likely to attain a high quality of postoperative recovery. Nursing services related to tangibles, reliability, and responsiveness especially contributed to postoperative recovery.

Monte Carlo simulation of thermal neutron flux of americium-beryllium source used in neutron activation analysis

NASA Astrophysics Data System (ADS)

Didi, Abdessamad; Dadouch, Ahmed; Bencheikh, Mohamed; Jai, Otman

2017-09-01

The neutron activation analysis is a method of exclusively elemental analysis. Its implementation of irradiates the sample which can be analyzed by a high neutron flux, this method is widely used in developed countries with nuclear reactors or accelerators of particle. The purpose of this study is to develop a prototype to increase the neutron flux such as americium-beryllium and have the opportunity to produce radioisotopes. Americium-beryllium is a mobile source of neutron activity of 20 curie, and gives a thermal neutron flux of (1.8 ± 0.0007) × 106 n/cm2 s when using water as moderator, when using the paraffin, the thermal neutron flux increases to (2.2 ± 0.0008) × 106 n/cm2 s, in the case of adding two solid beryllium barriers, the distance between them is 24 cm, parallel and symmetrical about the source, the thermal flux is increased to (2.5 ± 0.0008) × 106 n/cm2 s and in the case of multi-source (6 sources), with-out barriers, increases to (1.17 ± 0.0008) × 107 n/cm2 s with a rate of increase equal to 4.3 and with the both barriers flux increased to (1.37 ± 0.0008) × 107 n/cm2 s.

Comparative XRPD and XAS study of the impact of the synthesis process on the electronic and structural environments of uranium–americium mixed oxides

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prieur, D., E-mail: dam.prieur@gmail.com; Lebreton, F.; Martin, P.M.

2015-10-15

Uranium–americium mixed oxides are potential compounds to reduce americium inventory in nuclear waste via a partitioning and transmutation strategy. A thorough assessment of the oxygen-to-metal ratio is paramount in such materials as it determines the important underlying electronic structure and phase relations, affecting both thermal conductivity of the material and its interaction with the cladding and coolant. In 2011, various XAS experiments on U{sub 1−x}Am{sub x}O{sub 2±δ} samples prepared by different synthesis methods have reported contradictory results on the charge distribution of U and Am. This work alleviates this discrepancy. The XAS results confirm that, independently of the synthesis process,more » the reductive sintering of U{sub 1−x}Am{sub x}O{sub 2±δ} leads to the formation of similar fluorite solid solution indicating the presence of Am{sup +III} and U{sup +V} in equimolar proportions. - Graphical abstract: Formation of (U{sup IV/V},Am{sup III})O{sup 2} solid solution by sol–gel and by powder metallurgy. - Highlights: • Uranium–americium mixed oxides were synthesized by sol–gel and powder metallurgy. • Fluorite solid solutions with similar local environment have been obtained. • U{sup V} and Am{sup III} are formed in equimolar proportions.« less

Penetration and decontamination of americium-241 ex vivo using fresh and frozen pig skin.

PubMed

Tazrart, A; Bolzinger, M A; Moureau, A; Molina, T; Coudert, S; Angulo, J F; Briancon, S; Griffiths, N M

2017-04-01

Skin contamination is one of the most probable risks following major nuclear or radiological incidents. However, accidents involving skin contamination with radionuclides may occur in the nuclear industry, in research laboratories and in nuclear medicine departments. This work aims to measure the penetration of the radiological contaminant Americium ( 241 Am) in fresh and frozen skin and to evaluate the distribution of the contamination in the skin. Decontamination tests were performed using water, Fuller's earth and diethylene triamine pentaacetic acid (DTPA), which is the recommended treatment in case of skin contamination with actinides such as plutonium or americium. To assess these parameters, we used the Franz cell diffusion system with full-thickness skin obtained from pigs' ears, representative of human skin. Solutions of 241 Am were deposited on the skin samples. The radioactivity content in each compartment and skin layers was measured after 24 h by liquid scintillation counting and alpha spectrophotometry. The Am cutaneous penetration to the receiver compartment is almost negligible in fresh and frozen skin. Multiple washings with water and DTPA recovered about 90% of the initial activity. The rest remains fixed mainly in the stratum corneum. Traces of activity were detected within the epidermis and dermis which is fixed and not accessible to the decontamination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Inspection report of unauthorized possession and use of unsealed americium-241 and subsequent confiscation, J. C. Haynes Company, Newark, Ohio

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1985-11-01

This US Nuclear Regulatory Commission report documents the circumstances surrounding the March 26, 1985, confiscation and subsequent decontamination activities related to the use of unauthorized quantities of americium-241 at the John C. Haynes Company (licensee) of Newark, Ohio. It focuses on the period from early February to July 26, 1985. The incident started when NRC Region III recieved information that John C. Haynes possessed unauthorized quantities of americium-241 and was conducting unauthorized activities (diamond irradiation). By July 26, 1985, the decontamination activities at the licensee's laboratory were concluded. The licensee's actions with diamond irradiation resulted in contamination in restricted andmore » unrestricted areas of the facility. The confiscation and decontamination activities required the combined efforts of NRC, Federal Bureau of Investigation, US Department of Energy, Oak Ridge Associated Universities, the State of Ohio, and the US Environmental Protection Agency. The report describes the factual information and significant findings associated with the confiscation and decontamination activities.« less

The road to recovery: where are we going and how do we get there? Empirically driven conclusions and future directions for service development and research.

PubMed

Laudet, Alexandre B

2008-01-01

The term "recovery" is often used in the addiction field. However, we have thus far failed to define the term, to delineate its dimensions, or to elucidate the prerequisite conditions to this outcome. This has hindered service development and evaluation as well as changes in policy. This paper: 1. Reviews empirical findings about how "recovery" is defined and experienced by individuals engaged in the process; 2. Examines factors associated with recovery initiation, maintenance, and sustained lifestyle, and review obstacles to recovery; and 3. Discusses implications for services and research; implications include the need to adopt a long-term, wellness-centered approach to addressing substance use related problems, the importance for society to address the stigma of former addiction and to offer attractive viable opportunities to promote making significant life changes toward recovery from substance use.

Young People in Recovery: Building a Movement

ERIC Educational Resources Information Center

Kimball, Colette

2012-01-01

The newly formed national group, Young People in Recovery, is comprised of young people, roughly 17-28 years old, who are in long term recovery. Their goal is to increase awareness amongst social service providers about the needs of youth in recovery, increase services, and facilitate partnerships which support young people in finding and…

Developing and Using Vignettes to Explore the Relationship Between Risk Management Practice and Recovery-Oriented Care in Mental Health Services.

PubMed

Holley, Jessica; Gillard, Steven

2018-02-01

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.

Selective separation of americium from europium using 2,9-bis(triazine)-1,10-phenanthrolines in ionic liquids: a new twist on an old story

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, Neil J.; Dehaudt, Jeremy; Bryantsev, Vyacheslav S.

Bis-triazine phenanthrolines have shown great promise for f-block metal separations, attributable to their highly preorganized structure, nitrogen donors, and more enhanced covalent bonding with actinides over lanthanides. However, their limited solubility in traditional solvents remains a technological bottleneck. Here in this paper we report our recent work using a simple 2,9-bis(triazine)-1,10-phenanthroline (Me-BTPhen) dissolved in an ionic liquid (IL), demonstrating the efficacy of IL extraction systems for the selective separation of americium from europium, achieving separation factors in excess of 7500 and selectively removing up to 99% of the americium. Characterization of the coordination environment was performed using a combination ofmore » X-ray absorption fine structure spectroscopy (XAFS) and density functional theory (DFT) calculations.« less

Selective separation of americium from europium using 2,9-bis(triazine)-1,10-phenanthrolines in ionic liquids: a new twist on an old story

DOE PAGES

Williams, Neil J.; Dehaudt, Jeremy; Bryantsev, Vyacheslav S.; ...

2017-02-10

Bis-triazine phenanthrolines have shown great promise for f-block metal separations, attributable to their highly preorganized structure, nitrogen donors, and more enhanced covalent bonding with actinides over lanthanides. However, their limited solubility in traditional solvents remains a technological bottleneck. Here in this paper we report our recent work using a simple 2,9-bis(triazine)-1,10-phenanthroline (Me-BTPhen) dissolved in an ionic liquid (IL), demonstrating the efficacy of IL extraction systems for the selective separation of americium from europium, achieving separation factors in excess of 7500 and selectively removing up to 99% of the americium. Characterization of the coordination environment was performed using a combination ofmore » X-ray absorption fine structure spectroscopy (XAFS) and density functional theory (DFT) calculations.« less

‘Recovery work’ and ‘magic’ among long-term mental health service-users

PubMed Central

Laws, Jennifer

2013-01-01

Based on an extended period of qualitative research with mental health service-users in north-east England, this article considers the various forms of ‘magical work’ and ‘recovery work’ that emerge in the lives of people living with severe mental health problems. Given the now sizeable body of literature which seeks to problematize traditional conceptual boundaries of work, the article asks to what extent these hidden and unusual work-forms might also be considered legitimate members of the category. Rather than argue for the expansion of the construct to accommodate these activities, the paper attempts simply to problematize the extent to which so-called ‘mad’ forms of work are irresolvably different to more conventional forms of occupation. In challenging notions of the psychiatric patient as inevitably inactive, new vocabularies for service-user work are explored. Concluding remarks are also directed to recent policy debates concerning ‘back-to-work’ welfare reform for long-term out of work service-users. PMID:24223439

Pathways to recovery (PTR): impact of peer-led group participation on mental health recovery outcomes.

PubMed

Fukui, Sadaaki; Davidson, Lori J; Holter, Mark C; Rapp, Charles A

2010-01-01

This study examined the positive effects on recovery outcomes for people with severe and persistent mental illness using peer-led groups based on Pathways to Recovery: A Strengths Recovery Self-Help Workbook (PTR). PTR translates the evidence-supported practice of the Strengths Model into a self-help approach, allowing users to identify and pursue life goals based on personal and environmental strengths. A single-group pretest-posttest research design was applied. Forty-seven members in 6 consumer-run organizations in one Midwestern state participated in a PTR peer-led group, completing a baseline survey before the group and again at the completion of the 12-week sessions. The Rosenberg Self-Esteem Scale, the General Self-Efficacy Scale, Multidimensional Scale of Perceived Social Support, the Spirituality Index of Well-Being, and the Modified Colorado Symptom Index were employed as recovery outcomes. Paired Hotelling's T-square test was conducted to examine the mean differences of recovery outcomes between the baseline and the completion of the group. Findings revealed statistically significant improvements for PTR participants in self-esteem, self-efficacy, social support, spiritual well-being, and psychiatric symptoms. This initial research is promising for establishing PTR as an important tool for facilitating recovery using a peer-led group format. The provision of peer-led service has been emphasized as critical to integrating consumers' perspectives in recovery-based mental health services. Given the current federal funding stream for peer services, continued research into PTR and other peer-led services becomes more important.

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study

PubMed Central

Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-01-01

Background Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. Objective The aim was to illustrate uses and experiences with the secure e-recovery portal “ReConnect” as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. Methods ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Results Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different

Recovery practice in community mental health teams: national survey

PubMed Central

Leamy, M.; Clarke, E.; Le Boutillier, C.; Bird, V.; Choudhury, R.; MacPherson, R.; Pesola, F.; Sabas, K.; Williams, J.; Williams, P.; Slade, M.

2016-01-01

Background There is consensus about the importance of ‘recovery’ in mental health services, but the link between recovery orientation of mental health teams and personal recovery of individuals has been underresearched. Aims To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. Method In six English mental health National Health Service (NHS) trusts, randomly chosen community adult mental health teams were surveyed. A random sample of ten patients, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using the Questionnaire about Processes of Recovery (QPR). Results Team leaders (n = 22) rated recovery orientation higher than clinicians (n = 109) or patients (n = 120) (Wald(2) = 7.0, P = 0.03), and both NHS trust and team type influenced RSA ratings. Patient-rated recovery orientation was a predictor of personal recovery (b = 0.58, 95% CI 0.31–0.85, P<0.001). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. Conclusions Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery. PMID:27340113

Addiction recovery: its definition and conceptual boundaries.

PubMed

White, William L

2007-10-01

The addiction field's failure to achieve consensus on a definition of "recovery" from severe and persistent alcohol and other drug problems undermines clinical research, compromises clinical practice, and muddles the field's communications to service constituents, allied service professionals, the public, and policymakers. This essay discusses 10 questions critical to the achievement of such a definition and offers a working definition of recovery that attempts to meet the criteria of precision, inclusiveness, exclusiveness, measurability, acceptability, and simplicity. The key questions explore who has professional and cultural authority to define recovery, the defining ingredients of recovery, the boundaries (scope and depth) of recovery, and temporal benchmarks of recovery (when recovery begins and ends). The process of defining recovery touches on some of the most controversial issues within the addictions field.

A descriptive analysis of change in eligibility status for the USDA Forest Service Economic Recovery Program

Treesearch

Krista M. Gebert; Susan L. Odell

2007-01-01

This report summarizes the results of a 2004 analysis of county-level eligibility for financial and technical assistance through the USDA Forest Service Economic Recovery program and contrasts those results to the initial eligibility analysis performed in 1993. County-level eligibility was based on three criteria: (1) proximity to a National Forest or National...

Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study.

PubMed

Gammon, Deede; Strand, Monica; Eng, Lillian Sofie; Børøsund, Elin; Varsi, Cecilie; Ruland, Cornelia

2017-05-02

Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. The aim was to illustrate uses and experiences with the secure e-recovery portal "ReConnect" as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was

Toward Understanding Music Therapy as a Recovery-Oriented Practice within Mental Health Care: A Meta-Synthesis of Service Users' Experiences.

PubMed

Solli, Hans Petter; Rolvsjord, Randi; Borg, Marit

2013-01-01

The perspective of mental health recovery is increasingly shaping mental health care policies. Current texts in music therapy identify the importance of this critical and user-oriented perspective, but the relevance and implications for music therapy need to be outlined. This study explores service users' experiences of music therapy in mental health care, and the potential role of music therapy in the development of recovery-oriented service provision. We conducted a qualitative meta-synthesis of studies examining service users' experiences in music therapy; included were 14 studies with a total of 113 participants. Both first-hand account of participants and the researchers' representations of such statements were taken into account in the analysis. A taxonomy of four areas of users' experiences was identified: "having a good time;" "being together;" "feeling;" and "being someone." These core categories point towards music therapy as an arena that can be used by persons with mental health problems in their personal and social recovery process. Music therapy can contribute to the quality of mental health care by providing an arena for stimulation and development of strengths and resources that may contribute to growth of positive identity and hope for people with mental illness. The findings from this meta-synthesis indicate that the provision of music therapy closely resembles recognized benefits of a recovery-oriented practice. Awareness of users' self-determination and the development of a strength-based and contextual approach to music therapy that fosters mutual empowering relationships are recommended. © 2013 by the American Music Therapy Association.

Development of Support Service for Prevention and Recovery from Dementia and Science of Lethe

NASA Astrophysics Data System (ADS)

Otake, Mihoko

This paper proposes multiscale service design method through the development of support service for prevention and recovery from dementia towards science of lethe. Proposed multiscale service model consists of tool, event, human, network, style and rule. Service elements at different scales are developed according to the model. Firstly, the author proposes and practices coimagination method as an ``event'', which is expected to prevent the progress of cognitive impairment. Coimagination support system was developed as a ``tool''. Experimental results suggest the effective activation of episodic memory, division of attention, and planning function of participants by the measurement of cognitive activities during the coimagination. Then, Fonobono Research Institute was established as a ''network'' for ``human'' who studies coimagination, which is a multisector research organization including elderly people living around Kashiwa city, companies including instrument and welfare companies, Kashiwa city and Chiba prefecture, researchers of the University of Tokyo. The institute proposes and realizes lifelong research as a novel life ``style'' for elderly people, and discusses life with two rounds as an innovative ``rule'' for social system of aged society.

76 FR 52317 - Endangered and Threatened Species; Recovery Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... authority. Recovery of Upper Willamette salmon and steelhead will require a long-term effort in cooperation... and Threatened Species; Recovery Plans AGENCY: National Marine Fisheries Service, National Oceanic and... Service (NMFS) announces the adoption of an Endangered Species Act (ESA) recovery plan for the Upper...

Predictors of personal recovery for persons with psychiatric disabilities: An examination of the Unity Model of Recovery.

PubMed

Song, Li-Yu

2017-04-01

This study examined a comprehensive set of potential correlates of recovery based on the Unity Model of Recovery. Thirty-two community psychiatric rehabilitation centers in Taiwan agreed to participate in this study. A sample of 592 participants were administered the questionnaires. Five groups of independent variables were included in the model: socio-demographic variables, illness variables, resilience, informal support, and formal support. The results of regression analysis provided support for the validity of the Unity Model of Recovery. The independent variables explained 53.5% of the variance in recovery for the full sample, and 55.5% for the subsample of the consumers who have been ever employed. The significance of the three cornerstones (resilience, family support, and symptoms) for recovery was confirmed. Other critical support variables, including the extent of rehabilitation service use, professional relationship, and professional support were also found to be significant factors. Among all the significant correlates, resilience, family support, and extent of rehabilitation service use ranked in the top three. The findings could shed light on paths to recovery. Implications for psychiatric services were discussed and suggested. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Partnering to enhance interprofessional service-learning innovations and addictions recovery.

PubMed

Mihalynuk, T V; Soule Odegard, P; Kang, R; Kedzierski, M; Johnson Crowley, N

2007-11-01

Service-learning programs are reported to benefit students, faculty, higher education institutions, community agencies and the relationships among these groups. An interprofessional service-learning paradigm may strengthen these benefits. Community settings can expose students to social and cultural determinants of health, in addition to those biomedical determinants more commonly addressed in health sciences curricula. These experiences can also enhance student understanding of the complexities underlying treatment and prevention of modern health problems, particularly chronic diseases. The purpose of this initiative was to create and deliver interprofessional service-learning innovations that would enhance student learning and addictions recovery. To address this initiative, the University of Washington's Health Science Partnerships in Interdisciplinary Clinical Education (HSPICE) and the Salvation Army Adult Rehabilitation Center (ARC) began a community-campus partnership in 1997. Innovations took into account student educational objectives established by HSPICE which included: participation in interdisciplinary teams, in conjunction with community partners to identify and reduce population-based health issues, realization and articulation of biases regarding issues faced by the participating community, acquiring an understanding of the broader determinants of health and developing an understanding of why the complexity of population health requires interdisciplinary strategies for cost effectiveness. Findings are reported from evaluations, needs assessments and ongoing feedback of men recovering from addictions, as applied to health education materials and presentations developed for the ARC. Future directions are highlighted, including the need for further research and evaluation efforts aimed at rigorously assessing cost savings and student knowledge, skills and cultural sensitivity, among others.

TRANSURANIC STUDIES STATUS AND PROBLEM STATEMENT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leuze, R E

1959-04-29

The purpose of the Transuranics Program is to develop separation processes for the transuranic elements, primarily those produced by long-term neutron irradiation of Pu/sup 239/. The program includes laboratory process development, pilot-plant process testing, processing of 10 kg of Pu/sup 239/ irradiated to greater than 99% burn-up for plutonium and americium-curium recovery, and processing the reirradiated plutonium and americium-curium fractions. The proposed method for processing highly irradiated plutonium is: (1) plutonium-aluminum alloy dissolution in HNO/sub 3/; (2) plutonium recovery by TBP extraction; (3) americium, curium, and rare-earth extraction by TBP from neutral nitrate solution; (4) partial rare-earth removal (primarily lanthanum)more » by americium-curium extraction into 100% TBP from 15M HNO/sub 3/; (5) additional rare-earth removal by extraction in 0.48M mono-2-ethylhexylphosphoric acid from 12M HCl; and (6) americium-curium purification by chloride anion exchange. Processing through the 100% TBP, 15M HNO/sub 3/ cycle can be carried out in the Power Reactor Fuel Reprocessing Pilot Plant. New facilities are proposed 15M HNO/ sub 3/ cycle can be carried out in the Power Reactor Fuel Reprocessing Pilot Plant. New facilities are proposed for laboratory process development studies and the final processing of the transplutonic elements. (auth)« less

Preserving the person: The ethical imperative of recovery-oriented practices.

PubMed

Atterbury, Kendall

2014-03-01

For more than a decade the principles of mental health recovery have been promoted as an alternative to traditional models of care. Recovery-oriented practices are those that recognize the strengths of service users and empower them within the mental health system. In contrast to a more hierarchical model of care in which service providers make decisions with a pronounced absence of input from service users, recovery-oriented practices emphasize shared decision-making, respect for service user goals, and the recognition of the full humanity of all persons in care relationships. Recovery-oriented care has yet to be embraced by the majority of service providers, however. There are several reasons for this failure but among them is the lack of attention given to the ethical ground of recovery. This article seeks to bring recovery into conversation with moral philosophy by arguing that recovery-oriented care is essentially linked to fundamental rights and values of personhood within a liberal democracy. By joining together a conception of personhood rooted in essential vulnerability and a Rawlsian perspective on justice, this article argues that recovery is not only a desirable approach to mental health practice but that it is ethically necessary. It argues that recovery practices are not exceptional interventions to be reserved for a few but that a recovery-orientation entails fundamental elements of justice and respect to which all persons are entitled.

EPA Method: Rapid Radiochemical Method for Americium-241, Radium-226, Plutonium-238/-239, Radiostronium, and Isotopic Uranium in Water for Environmental Restoration Following Homeland Security Events

EPA Pesticide Factsheets

SAM lists this method for the qualitative determination of Americium-241, Radium-226, Plutonium-238, Plutonium-239 and isotopic uranium in drinking water samples using alpha spectrometry and radiostrontium using beta counting.

Actinide Oxidation State and O/M Ratio in Hypostoichiometric Uranium-Plutonium-Americium U0.750Pu0.246Am0.004O2-x Mixed Oxides.

PubMed

Vauchy, Romain; Belin, Renaud C; Robisson, Anne-Charlotte; Lebreton, Florent; Aufore, Laurence; Scheinost, Andreas C; Martin, Philippe M

2016-03-07

Innovative americium-bearing uranium-plutonium mixed oxides U1-yPuyO2-x are envisioned as nuclear fuel for sodium-cooled fast neutron reactors (SFRs). The oxygen-to-metal (O/M) ratio, directly related to the oxidation state of cations, affects many of the fuel properties. Thus, a thorough knowledge of its variation with the sintering conditions is essential. The aim of this work is to follow the oxidation state of uranium, plutonium, and americium, and so the O/M ratio, in U0.750Pu0.246Am0.004O2-x samples sintered for 4 h at 2023 K in various Ar + 5% H2 + z vpm H2O (z = ∼ 15, ∼ 90, and ∼ 200) gas mixtures. The O/M ratios were determined by gravimetry, XAS, and XRD and evidenced a partial oxidation of the samples at room temperature. Finally, by comparing XANES and EXAFS results to that of a previous study, we demonstrate that the presence of uranium does not influence the interactions between americium and plutonium and that the differences in the O/M ratio between the investigated conditions is controlled by the reduction of plutonium. We also discuss the role of the homogeneity of cation distribution, as determined by EPMA, on the mechanisms involved in the reduction process.

What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance.

PubMed

Le Boutillier, Clair; Leamy, Mary; Bird, Victoria J; Davidson, Larry; Williams, Julie; Slade, Mike

2011-12-01

Recovery is a multifaceted concept, and the need for operationalization in practice has been identified. Although guidance on recovery-oriented practice exists, it is from disparate sources and is difficult to apply. The aims of the study were to identify the key characteristics of recovery-oriented practice guidance on the basis of current international perspectives and to develop an overarching conceptual framework to aid the translation of recovery guidance into practice. A qualitative analysis of 30 international documents offering recovery-oriented practice guidance was conducted. Inductive, semantic-level, thematic analysis was used to identify dominant themes. Interpretive analysis was then undertaken to group the themes into practice domains. The guidance documents were diverse; from six countries-the United States, England, Scotland, Republic of Ireland, Denmark, and New Zealand-and varied in document type, categories of guidance, and level of service user involvement in guidance development. The emerging conceptual framework consists of 16 dominant themes, grouped into four practice domains: promoting citizenship, organizational commitment, supporting personally defined recovery, and working relationship. A key challenge for mental health services is the lack of clarity about what constitutes recovery-oriented practice. The conceptual framework contributes to this knowledge gap and provides a synthesis of recovery-oriented practice guidance.

Experimental findings on actinide recovery utilizing oxidation by peroxydisulfate followed by ion exchange: Fuel cycle research & development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hobbs, D. T.; Shehee, T. C.

2015-08-31

Our research seeks to determine if inorganic ion-exchange materials can be exploited to provide effective minor actinide (Am, Cm) separation from lanthanides. Previous work has established that a number of inorganic and UMOF ion-exchange materials exhibit varying affinities for actinides and lanthanides, which may be exploited for effective separations. During FY15, experimental work focused on investigating methods to oxidize americium in dilute nitric and perchloric acid with subsequent ion-exchange performance measurements of ion exchangers with the oxidized americium in dilute nitric acid. Ion-exchange materials tested included a variety of alkali titanates. Americium oxidation testing sought to determine the influence thatmore » other redox active components may have on the oxidation of Am III. Experimental findings indicated that Ce III, Np V, and Ru II are oxidized by peroxydisulfate, but there are no indications that the presence of Ce III, Np V, and Ru II affected the rate or extent of americium oxidation at the concentrations of peroxydisulfate being used.« less

Adsorption and Dissociation of Water on the (0001) Surface of DHCP Americium

NASA Astrophysics Data System (ADS)

Dholabhai, Pratik; Ray, Asok

2009-03-01

Ab initio total energy calculations within the framework of density functional theory have been performed for water molecule adsorption on the (0001) surface of double hexagonal closed packed americium. Subsequent partial dissociation (OH+H) and complete dissociation (H+O+H) of the water molecule have been examined. The completely dissociated configuration exhibits the strongest binding with the surface followed by partially dissociated species, with all molecular H2O configurations showing weak physisorption. The change in work functions and net magnetic moments before and after adsorption will be presented for all the cases studied. The adsorbate-substrate interactions will be elaborated using the difference charge density distributions and the local density of states. The effects of adsorption on Am 5f electron localization-delocalization in the vicinity of the Fermi level will be discussed.

47 CFR 51.915 - Recovery mechanism for price cap carriers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Recovery mechanism for price cap carriers. 51... SERVICES (CONTINUED) INTERCONNECTION Transitional Access Service Pricing § 51.915 Recovery mechanism for... recover certain revenues, through the recovery mechanism outlined below, to implement reforms adopted in...

47 CFR 51.915 - Recovery mechanism for price cap carriers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Recovery mechanism for price cap carriers. 51... SERVICES (CONTINUED) INTERCONNECTION Transitional Access Service Pricing § 51.915 Recovery mechanism for... recover certain revenues, through the recovery mechanism outlined below, to implement reforms adopted in...

47 CFR 51.915 - Recovery mechanism for price cap carriers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Recovery mechanism for price cap carriers. 51... SERVICES (CONTINUED) INTERCONNECTION Transitional Access Service Pricing § 51.915 Recovery mechanism for... recover certain revenues, through the recovery mechanism outlined below, to implement reforms adopted in...

A recovery-based outreach program in rural Victoria.

PubMed

Prabhu, Radha; Browne, Mark Oakley

2007-04-01

A recovery-based outreach program for people with severe mental illness in regional Victoria is described. The paper covers a description of the program, the services provided and outcomes achieved. The program emphasized active collaboration between patients and clinicians as outlined in the collaborative recovery model and recognized that recovery from mental illness is an individual, personal process. The program provided service to 108 people over 3 years and had a positive impact on clinicians, patients and carers. The benefits of recovery orientation, multidisciplinary teams, collaborative relationships and carer involvement are discussed. The paper highlights the need for a focus on recovery and comprehensive care for people with severe mental illness.

Recovery High Schools: Students and Responsive Academic and Therapeutic Services

ERIC Educational Resources Information Center

Moberg, D. Paul; Finch, Andrew J.; Lindsley, Stephanie M.

2014-01-01

This article reviews findings from the authors' studies of recovery high schools (RHS), including a 1995 program evaluation of a school in New Mexico (Moberg & Thaler, 1995), a 2006-09 descriptive study of 17 recovery high schools (Moberg & Finch, 2008), and presents early findings from a current study of the effectiveness of recovery high…

Recovery from schizophrenia and the recovery model.

PubMed

Warner, Richard

2009-07-01

The recovery model refers to subjective experiences of optimism, empowerment and interpersonal support, and to a focus on collaborative treatment approaches, finding productive roles for user/consumers, peer support and reducing stigma. The model is influencing service development around the world. This review will assess whether optimism about outcome from serious mental illness and other tenets of the recovery model are borne out by recent research. Remission of symptoms has been precisely defined, but the definition of 'recovery' is a more diffuse concept that includes such factors as being productive and functioning independently. Recent research and a large, earlier body of data suggest that optimism about outcome from schizophrenia is justified. A substantial proportion of people with the illness will recover completely and many more will regain good social functioning. Outcome is better for people in the developing world. Mortality for people with schizophrenia is increasing but is lower in the developing world. Working appears to help people recover from schizophrenia, and recent advances in vocational rehabilitation have been shown to be effective in countries with differing economies and labor markets. A growing body of research supports the concept that empowerment is an important component of the recovery process. Key tenets of the recovery model - optimism about recovery from schizophrenia, the importance of access to employment and the value of empowerment of user/consumers in the recovery process - are supported by the scientific research. Attempts to reduce the internalized stigma of mental illness should enhance the recovery process.

Implementing recovery: an analysis of the key technologies in Scotland

PubMed Central

2011-01-01

Background Over the past ten years the promotion of recovery has become a stated aim of mental health policies within a number of English speaking countries, including Scotland. Implementation of a recovery approach involves a significant reorientation of mental health services and practices, which often poses significant challenges for reformers. This article examines how four key technologies of recovery have assisted in the move towards the creation of a recovery-oriented mental health system in Scotland. Methods Drawing on documentary analysis and a series of interviews we examine the construction and implementation of four key recovery 'technologies' as they have been put to use in Scotland: recovery narratives, the Scottish Recovery Indicator (SRI), Wellness Recovery Action Planning (WRAP) and peer support. Results Our findings illuminate how each of these technologies works to instantiate, exemplify and disseminate a 'recovery orientation' at different sites within the mental health system in order to bring about a 'recovery oriented' mental health system. They also enable us to identify some of the factors that facilitate or hinder the effectiveness of those technologies in bringing about a change in how mental health services are delivered in Scotland. These finding provide a basis for some general reflections on the utility of 'recovery technologies' to implement a shift towards recovery in mental health services in Scotland and elsewhere. Conclusions Our analysis of this process within the Scottish context will be valuable for policy makers and service coordinators wishing to implement recovery values within their own national mental health systems. PMID:21569633

42 CFR 53.154 - Waiver of right of recovery.

Code of Federal Regulations, 2010 CFR

2010-10-01

... purposes; and (c) Such recovery would seriously curtail the provision of medical services to persons in... 42 Public Health 1 2010-10-01 2010-10-01 false Waiver of right of recovery. 53.154 Section 53.154 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS, LOANS AND...

Instruments for measuring mental health recovery: a systematic review.

PubMed

Sklar, Marisa; Groessl, Erik J; O'Connell, Maria; Davidson, Larry; Aarons, Gregory A

2013-12-01

Persons in recovery, providers, and policymakers alike are advocating for recovery-oriented mental health care, with the promotion of recovery becoming a prominent feature of mental health policy in the United States and internationally. One step toward creating a recovery-oriented system of care is to use recovery-oriented outcome measures. Numerous instruments have been developed to assess progress towards mental health recovery. This review identifies instruments of mental health recovery and evaluates the appropriateness of their use including their psychometric properties, ease of administration, and service-user involvement in their development. A literature search using the Medline and Psych-INFO databases was conducted, identifying 21 instruments for potential inclusion in this review, of which thirteen met inclusion criteria. Results suggest only three instruments (25%) have had their psychometric properties assessed in three or more unique samples of participants. Ease of administration varied between instruments, and for the majority of instruments, development included service user involvement. This review updates and expands previous reviews of instruments to assess mental health recovery. As mental health care continues to transform to a recovery-oriented model of service delivery, this review may facilitate selection of appropriate assessments of mental health recovery for systems to use in evaluating and improving the care they provide. © 2013.

Hope for recovery - how clinicians may facilitate this in their work.

PubMed

Hobbs, Mia; Baker, Martyn

2012-04-01

The importance of having hope for recovery has been highlighted in numerous qualitative studies of recovery. It is identified as a vital part of this process, and guidelines suggest that service providers should therefore facilitate hope in their clinical work; however, they do not indicate how this guidance can be operationalised. To identify the sources of hope for recovery based on the accounts of people with experience of recovery; to ascertain how these accounts show service providers can facilitate such hope in their therapeutic work. Semi-structured interviews were conducted with eight people with experience of recovering from mental health problems. A grounded theory analysis was undertaken. A model conceptualising the role of hope in recovery was developed with three categories: "influence of others on hope", "personal hope" and "doing recovery". The model indicates a complex interaction between hope and recovery with an important role for social context and interpersonal relationships, including those with clinicians. Mental health service providers occupy a powerful position in relation to service users' hope, and must carefully consider how they communicate their own hopefulness about clients' recovery. Suggestions are made about facilitating hope for recovery.

Mental health recovery: A review of the peer-reviewed published literature.

PubMed

Jacob, Sini; Munro, Ian; Taylor, Beverley Joan; Griffiths, Debra

The concept of mental health recovery promotes collaborative partnership among consumers, carers and service providers. However views on mental health recovery are less explored among carers and service providers. The aim of this review was to analyse contemporary literature exploring views of mental health consumers, carers and service providers in relation to their understanding of the meaning of mental health recovery and factors influencing mental health recovery. The literature review questions were: How is mental health recovery and factors influencing mental health recovery viewed by consumers, carers and service providers? What are the differences and similarities in those perceptions? How can the outcomes and recommendations inform the Australian mental health practices? A review of the literature used selected electronic databases and specific search terms and supplemented with manual searching. Twenty-six studies were selected for review which included qualitative, mixed method, and quantitative approaches and a Delphi study. The findings indicated that the concept of mental health recovery is more explored among consumers and is seldom explored among carers and service providers. The studies suggested that recovery from mental illness is a multidimensional process and the concept cannot be defined in rigid terms. In order to achieve the best possible care, the stakeholders require flexible attitudes and openness to embrace the philosophy.

Space Debris Mitigation Efforts through the Disposition of the Service Module of the Unmanned Space Experiment Recovery System (USERS)

NASA Astrophysics Data System (ADS)

Ijichi, Koichi; Ushikoshi, Atsuo; Nakamura, Shuji; Kanai, Hiroshi

The Unmanned Space Experiment Recovery System (USERS) Project has been completed with full success, and the Service Module (SEM) of the USERS Spacecraft, which supported the recovery portion of the spacecraft which was left on the orbit, was properly disposed to the maximum extent as possible according to the IADC debris mitigation guideline and re-entered the atmosphere on June 15, 2007 (JST). USERS spacecraft disposition by possible means available at the mission completion showed good example of realizing debris mitigation purpose in spite of originally different design baseline, and obtained actual data and experiences to be reflected for future space programs.

Adolescents with anxiety and depression: is social recovery relevant?

PubMed

Simonds, Laura M; Pons, Rebecca A; Stone, Nicola J; Warren, Fiona; John, Mary

2014-01-01

Social recovery has become a prominent aspect of mental health service design and delivery in the past decade. Much of the literature on social recovery is derived from first-person accounts or primary research with adult service users experiencing severe mental illness. There is a lack of both theoretical and empirical work that could inform consideration of how the concept of social recovery might apply to adolescents experiencing common (non-psychotic) mental health problems such as anxiety and depression. The current study was conducted to understand the process of experiencing anxiety and depression in young people. Semi-structured interviews were conducted with nine adolescents with anxiety and depression (seven girls and two boys aged 14-16 years) and 12 mothers who were recruited from a specialist Child and Adolescent Mental Health Service in the South of England. Thematic analysis indicated that young people do experience a process of 'recovery'; the processes participants described have some congruence with the earlier stages of adult recovery models involving biographical disruption and the development of new meanings, in this case of anxiety or depression, and changes in sense of identity. The accounts diverge with regard to later stages of adult models involving the development of hope and responsibility. The findings suggest that services should attend to social isolation and emphasise support for positive aspirations for future selves whilst also attending to young people's and parents' expectations about change. Methodological challenges face enquiry about 'recovery' given its connotations with cure in everyday language. Theoretical and empirical work on social recovery in young people and families is lacking. Using interviews, this study sought to understand the relevance of social recovery for adolescents with anxiety and depression and their mothers. Findings suggest some congruence with the earlier stages of adult recovery models involving

Effect of americium-241 on luminous bacteria. Role of peroxides.

PubMed

Alexandrova, M; Rozhko, T; Vydryakova, G; Kudryasheva, N

2011-04-01

The effect of americium-241 ((241)Am), an alpha-emitting radionuclide of high specific activity, on luminous bacteria Photobacterium phosphoreum was studied. Traces of (241)Am in nutrient media (0.16-6.67 kBq/L) suppressed the growth of bacteria, but enhanced luminescence intensity and quantum yield at room temperature. Lower temperature (4 °C) increased the time of bacterial luminescence and revealed a stage of bioluminescence inhibition after 150 h of bioluminescence registration start. The role of conditions of exposure the bacterial cells to the (241)Am is discussed. The effect of (241)Am on luminous bacteria was attributed to peroxide compounds generated in water solutions as secondary products of radioactive decay. Increase of peroxide concentration in (241)Am solutions was demonstrated; and the similarity of (241)Am and hydrogen peroxide effects on bacterial luminescence was revealed. The study provides a scientific basis for elaboration of bioluminescence-based assay to monitor radiotoxicity of alpha-emitting radionuclides in aquatic solutions. Copyright © 2011 Elsevier Ltd. All rights reserved.

47 CFR 51.917 - Revenue recovery for Rate-of-Return Carriers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Revenue recovery for Rate-of-Return Carriers... SERVICES (CONTINUED) INTERCONNECTION Transitional Access Service Pricing § 51.917 Revenue recovery for Rate... may recover, through the recovery mechanism outlined in paragraphs (d) through (f) of this section, a...

47 CFR 51.917 - Revenue recovery for Rate-of-Return Carriers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Revenue recovery for Rate-of-Return Carriers... SERVICES (CONTINUED) INTERCONNECTION Transitional Access Service Pricing § 51.917 Revenue recovery for Rate... may recover, through the recovery mechanism outlined in paragraphs (d) through (f) of this section, a...

47 CFR 51.917 - Revenue recovery for Rate-of-Return Carriers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Revenue recovery for Rate-of-Return Carriers... SERVICES (CONTINUED) INTERCONNECTION Transitional Access Service Pricing § 51.917 Revenue recovery for Rate... may recover, through the recovery mechanism outlined in paragraphs (d) through (f) of this section, a...

Recovery in Psychosis: A Delphi Study With Experts by Experience

PubMed Central

Law, Heather; Morrison, Anthony P.

2014-01-01

This study aimed to establish consensus about the meaning of recovery among individuals with experience of psychosis. A Delphi approach was utilized to allow a large sample of service users to be anonymously consulted about their views on recovery. Service users were invited to take part in a 3-stage consultation process. A total of 381 participants gave their views on recovery in the main stage of this study, with 100 of these taking part in the final review stage. The final list of statements about recovery included 94 items, which were rated as essential or important by >80% of respondents. These statements covered items which define recovery, factors which help recovery, factors which hinder recovery, and factors which show that someone is recovering. As far as we are aware, it is the first study to identify areas of consensus in relation to definitions of recovery from a service user perspective, which are typically reported to be an idiosyncratic process. Implications and recommendations for clinical practice and future research are discussed. PMID:24727194

Identifying profiles of service users in housing services and exploring their quality of life and care needs.

PubMed

Bitter, Neis A; Roeg, Diana P K; van Nieuwenhuizen, Chijs; van Weeghel, Jaap

2016-11-23

Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be

42 CFR 57.1516 - Right of recovery-subordination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Right of recovery-subordination. 57.1516 Section 57.1516 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR... Personnel § 57.1516 Right of recovery-subordination. (a) The United States shall be entitled to recover from...

Adsorption and Dissociation of Molecular Hydrogen on the (0001) Surface of DHCP Americium

NASA Astrophysics Data System (ADS)

Dholabhai, Pratik; Ray, Asok

2009-03-01

Hydrogen molecule adsorption on the (0001) surface of double hexagonal closed packed americium has been studied in detail within the framework of density functional theory. Weak molecular hydrogen adsorptions were observed. The most stable configuration corresponded to a Hor2 approach molecular adsorption at the one-fold top site where the molecule's approach is perpendicular to a lattice vector. Adsorption energies and adsorption geometries for different adsorption sites will be discussed. The change in work functions, magnetic moments, partial charges inside muffin-tins, difference charge density distributions and density of states for the bare Am slab and the Am slab after adsorption of the hydrogen molecule will be discussed. Reaction barrier for the dissociation of hydrogen molecule will be presented. The implications of adsorption on Am 5f electron localization-delocalization will be summarized.

Youth Homelessness: The Impact of Supportive Relationships on Recovery.

PubMed

Gasior, Sara; Forchuk, Cheryl; Regan, Sandra

2018-03-01

Background Homeless youth are the fastest growing sub-group within the homeless population. They face impaired access to health services and are often left unsupported. They lack social and family support or relationships with service providers. Unsupported homeless youth often become homeless adults. Purpose To test a model based on Peplau's Theory of Interpersonal Relations, examining the influence of a network of service providers, perceptions of social supports, and family relations on a homeless youth's perceptions of recovery. Methods This study is a secondary analysis and used a sample (n = 187) of data collected as part of the original Youth Matters in London study. A cross-sectional design was used to analyze the relationship between variables. Participants were interviewed at 6-month intervals over a 2.5-year period. Hierarchical multiple regression analysis was used. Results Network of service providers, perceived social supports, and perceived family relations explained 21.8% of the variance in homeless youth perceptions of recovery. Perceived social support and family relations were significantly, positively correlated to perceptions of recovery. Network of service providers was not significantly correlated to perceptions of recovery. Conclusions The findings suggest that stronger social supports and family relations may contribute to increased perceptions of recovery among homeless youth.

Exploring Working Relationships in Mental Health Care via an E-Recovery Portal: Qualitative Study on the Experiences of Service Users and Health Providers

PubMed Central

Strand, Monica; Eng, Lillian Sofie; Ruland, Cornelia

2017-01-01

Background The quality of working relationships between service users and health providers is fundamental in the processes of recovery in mental health. How Internet-based interventions will influence these relationships for persons with long-term care needs, and the measures that can be taken to maintain and enhance working relationships through Internet, is still not well understood. Objective The aim of this study was to gain insights into how service users and health providers experience their working relationships when they are offered the option of supplementing ongoing collaboration with an e-recovery portal. Methods In this exploratory and descriptive study, an e-recovery portal was used by service users and their health providers in 2 mental health communities in Norway for at least 6 months and at most 12 months (2015-2016). The portal consists of secure messaging, a peer support forum, and a toolbox of resources for working with life domains including status, goals and activities, network map, crisis plan, and exercises. The portal was owned and managed by the service user while health providers could remotely access parts of the service user–generated content. The participants could use the portal in whatever way they wished, to suit their collaboration. Data from 6 focus groups, 17 individual interviews, and an interview with 1 dyad about their experiences of use of the portal over the study period were inductively coded and thematically analyzed. Results The thematic analysis resulted in 2 main themes: (1) new relational avenues and (2) out of alignment, illustrated by 8 subthemes. The first main theme is about dyads who reported new and enriching ways of working together through the portal, particularly related to written communication and use of the goal module. Illustrative subthemes are ownership, common ground, goals and direction, and sense of presence and availability. The second main theme illuminates the difficulties that arose when service

Exploring Working Relationships in Mental Health Care via an E-Recovery Portal: Qualitative Study on the Experiences of Service Users and Health Providers.

PubMed

Strand, Monica; Gammon, Deede; Eng, Lillian Sofie; Ruland, Cornelia

2017-11-14

The quality of working relationships between service users and health providers is fundamental in the processes of recovery in mental health. How Internet-based interventions will influence these relationships for persons with long-term care needs, and the measures that can be taken to maintain and enhance working relationships through Internet, is still not well understood. The aim of this study was to gain insights into how service users and health providers experience their working relationships when they are offered the option of supplementing ongoing collaboration with an e-recovery portal. In this exploratory and descriptive study, an e-recovery portal was used by service users and their health providers in 2 mental health communities in Norway for at least 6 months and at most 12 months (2015-2016). The portal consists of secure messaging, a peer support forum, and a toolbox of resources for working with life domains including status, goals and activities, network map, crisis plan, and exercises. The portal was owned and managed by the service user while health providers could remotely access parts of the service user-generated content. The participants could use the portal in whatever way they wished, to suit their collaboration. Data from 6 focus groups, 17 individual interviews, and an interview with 1 dyad about their experiences of use of the portal over the study period were inductively coded and thematically analyzed. The thematic analysis resulted in 2 main themes: (1) new relational avenues and (2) out of alignment, illustrated by 8 subthemes. The first main theme is about dyads who reported new and enriching ways of working together through the portal, particularly related to written communication and use of the goal module. Illustrative subthemes are ownership, common ground, goals and direction, and sense of presence and availability. The second main theme illuminates the difficulties that arose when service users' and health providers

People living with psychosocial disability: Rehabilitation and recovery-informed service provision within the second Australian national survey of psychosis.

PubMed

Harvey, Carol; Brophy, Lisa; Parsons, Samuel; Moeller-Saxone, Kristen; Grigg, Margaret; Siskind, Dan

2016-06-01

People with psychosocial disability are an important, although often neglected, subgroup of those living with severe and persistent mental illness. Rehabilitation, provided through clinical and non-government organisations in Australia, may contribute to their personal recovery goals. We hypothesised that people with psychoses with the greatest disability and complex needs would receive services from both sectors, reflecting treatment and rehabilitation needs. Participants in the 2010 Australian national survey of psychosis (n = 1825) were interviewed to assess demographic, functional, mental and physical health characteristics and service use in the previous year. Two subgroups were created and compared: those using services from community mental health with, and without, non-governmental organisation involvement. Group membership was predicted by hierarchical logistic regression using variables selected on a priori grounds. Usefulness of the final model was examined by calculating improvement over the rate of accuracy achievable by chance alone. The model was statistically significant but fell just short of useful (criterion 71.6%, model achieved 70.6%). Four independent variables contributed uniquely to predicting whether participants received both services (never married, childhood trauma, group accommodation, poor global functioning) consistent with the hypothesis. However, severe dysfunction in socialising was less likely to predict membership of the combined services group when compared with no dysfunction (p = 0.001, odds ratio = 0.384, confidence interval = [0.218, 0.677]), as was current smoking compared with none (p = 0.001, odds ratio = 0.606, confidence interval = [0.445, 0.824]). Findings suggest services provided by non-governmental organisations are targeted to those with the greatest disability although targeting could be improved. A subgroup of people with psychosis and severe disability in community mental health

A home for body and soul: Substance using women in recovery

PubMed Central

2013-01-01

Background We report on an in-depth qualitative study of 28 active and former substance addicted women of low or marginal income on the core components of a harm reduction-based addiction recovery program. These women volunteered to be interviewed about their perceptions of their therapeutic needs in their transition from substance addiction to recovery. Method Data were gathered about women’s experiences and essential needs in addiction recovery, what helped and what hindered their past efforts in recovery, and their views of what would constitute an effective woman-centred recovery program. The research was based upon the experience and knowledge of the women in interaction with their communities and with recovery programs. The study was informed by harm reduction practice principles that emphasize the importance of individual experience in knowledge construction, reduction of harm, low threshold access, and the development of a hierarchy of needs in regard to addiction recovery. Results Three core needs were identified by study participants: normalization and structure, biopsychosocial-spiritual safety, and social connection. What hindered recovery efforts as identified by participants was an inner urban location, prescriptive recovery, invidious treatment, lack of safety, distress-derived distraction, problem-focused treatment, coercive elements of mutual support groups, and social marginalization. What helped included connection in counselling and therapy, multidisciplinary service provision, spirituality focus, opportunities for learning and work, and a safe and flexible structure. Core components of an effective recovery program identified by women themselves stand in contrast to the views of service providers and policymakers, particularly in regard to the need for a rural location for residential programs, low threshold access, multidisciplinary service provision of conventional and complementary modalities and therapies for integrated healing, long

A home for body and soul: substance using women in recovery.

PubMed

Kruk, Edward; Sandberg, Kathryn

2013-12-20

We report on an in-depth qualitative study of 28 active and former substance addicted women of low or marginal income on the core components of a harm reduction-based addiction recovery program. These women volunteered to be interviewed about their perceptions of their therapeutic needs in their transition from substance addiction to recovery. Data were gathered about women's experiences and essential needs in addiction recovery, what helped and what hindered their past efforts in recovery, and their views of what would constitute an effective woman-centred recovery program. The research was based upon the experience and knowledge of the women in interaction with their communities and with recovery programs. The study was informed by harm reduction practice principles that emphasize the importance of individual experience in knowledge construction, reduction of harm, low threshold access, and the development of a hierarchy of needs in regard to addiction recovery. Three core needs were identified by study participants: normalization and structure, biopsychosocial-spiritual safety, and social connection. What hindered recovery efforts as identified by participants was an inner urban location, prescriptive recovery, invidious treatment, lack of safety, distress-derived distraction, problem-focused treatment, coercive elements of mutual support groups, and social marginalization. What helped included connection in counselling and therapy, multidisciplinary service provision, spirituality focus, opportunities for learning and work, and a safe and flexible structure. Core components of an effective recovery program identified by women themselves stand in contrast to the views of service providers and policymakers, particularly in regard to the need for a rural location for residential programs, low threshold access, multidisciplinary service provision of conventional and complementary modalities and therapies for integrated healing, long-term multi-phase recovery, and

Oxford House: Deaf-Affirmative Support for Substance Abuse Recovery

ERIC Educational Resources Information Center

Alvarez, Josefina; Adebanjo, Aderonke M.; Davidson, Michelle K.; Jason, Leonard A.; Davis, Margaret I.

2006-01-01

Deaf individuals seeking substance abuse recovery are less likely to have access to treatment and aftercare services because of a lack of culturally and linguistically specific programs and insufficient information about existing services. Previous research indicates that Oxford House, a network of resident-run recovery homes, serves a diverse…

Recovery in psychosis: a Delphi study with experts by experience.

PubMed

Law, Heather; Morrison, Anthony P

2014-11-01

This study aimed to establish consensus about the meaning of recovery among individuals with experience of psychosis. A Delphi approach was utilized to allow a large sample of service users to be anonymously consulted about their views on recovery. Service users were invited to take part in a 3-stage consultation process. A total of 381 participants gave their views on recovery in the main stage of this study, with 100 of these taking part in the final review stage. The final list of statements about recovery included 94 items, which were rated as essential or important by >80% of respondents. These statements covered items which define recovery, factors which help recovery, factors which hinder recovery, and factors which show that someone is recovering. As far as we are aware, it is the first study to identify areas of consensus in relation to definitions of recovery from a service user perspective, which are typically reported to be an idiosyncratic process. Implications and recommendations for clinical practice and future research are discussed. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

76 FR 57807 - Medicaid Program; Recovery Audit Contractors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... for Medicare & Medicaid Services 42 CFR Part 455 Medicaid Program; Recovery Audit Contractors; Final... 42 CFR Part 455 [CMS-6034-F] RIN 0938-AQ19 Medicaid Program; Recovery Audit Contractors AGENCY... costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State...

Access to Recovery and Recidivism among Former Prison Inmates

PubMed Central

Ray, Bradley; Grommon, Eric; Buchanan, Victoria; Brown, Brittany

2015-01-01

Access to Recovery (ATR) is a SAMHSA-funded initiative that offers a mix of clinical and supportive services for substance abuse. ATR clients choose which services will help to overcome barriers in their road to recovery, and a recovery consultant provides vouchers and helps link the client to these community resources. One of ATR's goals was to provide services to those involved in the criminal justice system in the hopes that addressing substance abuse issues could reduce subsequent criminal behaviors. This study examines this goal by looking at recidivism among a sample of clients in one state's ATR program who returned to the community after incarceration. Results suggest there were few differential effects of service selections on subsequent recidivism. However, there are significant differences in recidivism rates among the agencies that provided ATR services. Agencies with more resources and a focus on prisoner reentry had better recidivism outcomes than those that focus only on substance abuse services. PMID:26385191

A recovery journey for people with personality disorder.

PubMed

Castillo, Heather; Ramon, Shulamit; Morant, Nicola

2013-05-01

The study investigates the process of recovery for people diagnosed with personality disorder, a client group that suffers significant social exclusion known to impact on demand for health and other public services. It aims to examine efforts that attempt to reverse this social exclusion as an aspect of the recovery process. and The following study aims to (1) explore what recovery means to people with personality disorder; (2) develop a conceptual model of recovery in personality disorder; and (3) evaluate the contribution of the setting (The Haven) to recovery practice. The study uses a Participatory Action Research (PAR) design. Data was collected from 66 participants by focus groups and individual interviews. A map based on thematic analysis of data collected during the study is proposed of the recovery journey for people with this diagnosis, shown as a pyramid that represents a hierarchy of progress, from building trust through stages of recovery to social inclusion. The findings offer contributions to knowledge in terms of the service design and propose a new model of recovery in personality disorder. This is defined as a journey of small steps highlighting recovery as a process rather than a goal, leading to the emergence of the new concept of transitional recovery.

Americium-241 in surface soil associated with the Hanford site and vicinity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Price, K.R.; Gilbert, R.O.; Gano, K.A.

1981-05-01

Various kinds of surface soil samples were collected and analyzed for Americium-241 (/sup 241/Am) to examine the feasibility of improving soil sample data for the Hanford Surface Environmental Surveillance Program. Results do not indicate that a major improvement would occur if procedures were changed from the current practices. Conclusions from this study are somewhat tempered by the very low levels of /sup 241/Am (< 0.10 pCi/g dry weight) detected in surface soil samples and by the fact that statistical significance depended on the type of statistical tests used. In general, the average concentration of /sup 241/Am in soil crust (0more » to 1.0 cm deep) was greater than the corresponding subsurface layer (1.0 to 2.5 cm deep), and the average concentration of /sup 241/Am in some onsite samples collected near the PUREX facility was greater than comparable samples collected 60 km upwind at an offsite location.« less

Effect of a package of health and nutrition services on sustained recovery in children after moderate acute malnutrition and factors related to sustaining recovery: a cluster-randomized trial.

PubMed

Stobaugh, Heather C; Bollinger, Lucy B; Adams, Sara E; Crocker, Audrey H; Grise, Jennifer B; Kennedy, Julie A; Thakwalakwa, Chrissie; Maleta, Kenneth M; Dietzen, Dennis J; Manary, Mark J; Trehan, Indi

2017-08-01

Background: Children who recover from moderate acute malnutrition (MAM) have high rates of relapse in the year after nutritional recovery. Interventions to decrease these adverse outcomes are needed to maximize the overall effectiveness of supplemental feeding programs (SFPs). Objective: We evaluated the effectiveness of a package of health and nutrition interventions on improving the proportion of children who sustained recovery for 1 y after MAM treatment. We further explored factors related to sustained recovery. Design: We conducted a cluster-randomized clinical effectiveness trial involving rural Malawian children aged 6-62 mo who were enrolled on discharge from an SFP for MAM. We enrolled 718 children at 10 control sites and 769 children at 11 intervention sites. In addition to routine health and nutrition counseling, the intervention group received a package of health and nutrition interventions that consisted of a lipid nutrient supplement, deworming medication, zinc supplementation, a bed net, and malaria chemoprophylaxis. A survival analysis was used to determine the effectiveness of the intervention as well as to identify factors associated with sustained recovery. Results: Of 1383 children who returned for the full 12-mo follow-up period, 407 children (56%) and 347 children (53%) sustained recovery in the intervention and control groups, respectively. There was no significant difference in relapse-free survival curves between the treatment and control groups ( P = 0.380; log-rank test). The risk factors for relapse or death after initial recovery were a smaller midupper arm circumference on SFP admission ( P = 0.01) and discharge ( P < 0.001), a lower weight-for-height z score on discharge ( P < 0.01), and the receipt of ready-to-use supplementary food as opposed to ready-to-use therapeutic food during treatment ( P < 0.05). Conclusion: The provision of a package of health and nutrition services in addition to traditional SFP treatment has no

The property of the Japanese version of the Recovery Knowledge Inventory (RKI) among mental health service providers: a cross sectional study.

PubMed

Chiba, Rie; Umeda, Maki; Goto, Kyohei; Miyamoto, Yuki; Yamaguchi, Sosei; Kawakami, Norito

2017-01-01

The Recovery Knowledge Inventory (RKI) is one of the influential scales to assess knowledge and attitude toward recovery-oriented practices among mental health service providers. In the present study, we aimed to develop a Japanese version of RKI and examine the validity and reliability. We translated RKI into Japanese by reference to the guidelines for translating and adapting psychometric scales. A cross-sectional questionnaire survey was conducted with mental health service providers. Of a total of 475 eligible professionals, we used data from the 299 participants without missing value for the analyses (valid response rate = 62.9%). The questionnaire included Japanese RKI, Recovery Attitudes Questionnaire, The positive attitudes scale, and Japanese-language version of the Social Distance Scale. To examine the factorial validity of RKI, explanatory factor analysis and confirmatory factor analysis was employed. Convergent validity was assessed by calculating Pearson's correlation coefficients between the total RKI score and the scores for the other three scales. We also calculated Cronbach's α coefficients for the total score and for each domain of RKI to assess internal consistency reliability. The participants' mean age was 40.4 years and 30.4% were men. 20-item RKI did not provide any adequate or interpretable factor solutions at any number of factors by EFAs. Thus four items (#1, 4, 5, and 13) were subsequently eliminated in stages, then 16-item RKI was employed as a consequence for further analyses. EFA with four factor structures yielded marginally interpretable constitution. Each factor represented the knowledge regarding psychiatric symptoms and recovery; knowledge about the recovery process; the understanding of what is important for recovery; and the understanding of the challenges and responsibility in recovery, respectively. Subsequent CFA suggested good fit to the data. Good convergent validity and understandable internal consistency reliability

7 CFR 3555.356 - Future recovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... recovery. The lender must notify the Agency upon sale of an REO property. If the lender recovers additional... 7 Agriculture 15 2014-01-01 2014-01-01 false Future recovery. 3555.356 Section 3555.356 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF...

Recovery-oriented care in a secure mental health setting: "striving for a good life".

PubMed

McKenna, Brian; Furness, Trentham; Dhital, Deepa; Park, Malcolm; Connally, Fiona

2014-01-01

Recovery-oriented care acknowledges the unique journey of the consumer to regain control of his or her life in order to live a good life. Recovery has become a dominant policy-directed model of mental health service delivery. Even services that have traditionally been institutional and custodial have been challenged to embrace a recovery-oriented model. The aim of this qualitative study was to provide a description of service delivery in a secure in-patient mental health service, which has developed a self-professed recovery-oriented model of service delivery. An in-depth case study of the secure in-patient service using an exploratory research design was undertaken to meet the aim of this study. Qualitative data was gathered from interviews with consumers and staff (n = 15) and a focus group with carers (n = 5). Data were analyzed using a content analysis approach. Ethical approval for the study was obtained. The stakeholders readily described the secure service within recovery domains. They described a common vision; ways to promote hope and autonomy; examples of collaborative partnership which enhanced the goal of community integration; a focus on strength-based, holistic care; and the management of risk by taking calculated risks. Discrepancies in the perceptions of stakeholders were determined. This case study research provides a demonstrable example of recovery-in-action in one secure mental health service in Australia. It is intended to assist mental health services and clinicians seeking guidance in developing strategies for building and maintaining partnerships with consumers and carers in order for secure services to become truly recovery-oriented.

Looking back, looking forward: Recovery journeys in a high secure hospital.

PubMed

McKeown, Mick; Jones, Fiona; Foy, Paul; Wright, Karen; Paxton, Tracey; Blackmon, Mike

2016-06-01

A qualitative study of staff and service users' views of recovery was undertaken in a UK high secure hospital working to implement recovery practices. 30 staff and 25 service users participated in semi-structured interviews or focus groups. Thematic analysis identified four broad accounts of how recovery was made sense of in the high secure environment: the importance of meaningful occupation; valuing relationships; recovery journeys and dialogue with the past; and recovery as personal responsibility. These themes are discussed with an emphasis on service user strategies of cooperation or resistance, respectively advancing or impeding progress through the system. In this context the notion of cooperation is, for many, commensurate with compliance with a dominant medical model. The policy framing of recovery opens up contemplation of treatment alternatives, more participatory approaches to risk management, and emphasise the value of relational skills, but may not elude the overarching bio-psychiatric episteme. © 2016 Australian College of Mental Health Nurses Inc.

77 FR 54565 - Endangered and Threatened Species; Recovery Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... and authority. Recovery of Central California Coast coho salmon will require a long-term effort in... and Threatened Species; Recovery Plans AGENCY: National Marine Fisheries Service (NMFS), National... public meetings. SUMMARY: NMFS announces the adoption of a Final Endangered Species Act (ESA) recovery...

Developing an Australian-first recovery model for parents in Victorian mental health and family services: a study protocol for a randomised controlled trial.

PubMed

Maybery, Darryl; Goodyear, Melinda; Reupert, Andrea; Sheen, Jade; Cann, Warren; Dalziel, Kim; Tchernagovski, Phillip; O'Hanlon, Brendan; von Doussa, Henry

2017-05-26

A considerable number of people with a mental illness are parents caring for dependent children. For those with a mental illness, parenting can provide a sense of competence, belonging, identity and hope and hence is well aligned to the concept of personal recovery. However, little research has focused on the recovery journey of those who are parents and have a mental illness. This randomised controlled trial aims to (i) evaluate the effectiveness of an intervention model of recovery for parents (Let's Talk about Children) in three different mental health service sectors and (ii) examine the economic value of a larger roll out (longer term) of the parent recovery model. A two arm parallel randomised controlled trial will be used with participants, who are being treated for their mental illness in adult mental health, non-government community mental health or family welfare services. The study will involve 192 parents, who are considered by their treating practitioner to be sufficiently well to provide informed consent and participate in an intervention (Let's Talk about Children) or control group (treatment as usual). Participant randomisation will occur at the level of the treating practitioner and will be based on whether the randomised practitioner is trained in the intervention. Outcomes are compared at pre, post intervention and six-month follow-up. Recovery, parenting and family functioning, and quality of life questionnaires will be used to measure parent wellbeing and the economic benefits of the intervention. This is the first randomised controlled trial to investigate the efficacy of a parenting intervention on recovery outcomes and the first to provide an economic evaluation of an intervention for parents with a mental illness. An implementation model is required to embed the intervention in different sectors. The trial was retrospectively registered: ACTRN12616000460404 on the 8/4/2016.

Promoting recovery through peer support: possibilities for social work practice.

PubMed

Loumpa, Vasiliki

2012-01-01

The Recovery Approach has been adopted by mental health services worldwide and peer support constitutes one of the main elements of recovery-based services. This article discusses the relevancy of recovery and peer support to mental health social work practice through an exploration of social work ethics and values. Furthermore, it provides an exploration of how peer support can be maximized in groupwork to assist the social work clinician to promote recovery and well-being. More specifically, this article discusses how the narrative therapy concepts of "retelling" and "witnessing" can be used in the context of peer support to promote recovery, and also how social constructionist, dialogical, and systemic therapy approaches can assist the social work practitioner to enhance peer support in recovery oriented groupwork. Copyright © Taylor & Francis Group, LLC

Recovery as a model of care? Insights from an Australian case study.

PubMed

Hungerford, Catherine

2014-03-01

The terms "model of health care," "service model." and "nursing model of practice" are often used interchangeably in practice, policy, and research, despite differences in definitions. This article considers these terms in the context of consumer-centred recovery and its implementation into a publicly-funded health service organization in Australia. Findings of a case study analysis are used to inform the discussion, which considers the diverse models of health care employed by health professionals; together with the implications for organizations worldwide that are responsible for operationalizing recovery approaches to health care. As part of the discussion, it is suggested that the advent of recovery-oriented services, rather than recovery models of health care, presents challenges for the evaluation of the outcomes of these services. At the same time, this situation provides opportunities for mental health nurses to lead the way, by developing rigorous models of practice that support consumers who have acute, chronic, or severe mental illness on their recovery journey; and generate positive, measureable outcomes.

38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Terminology code, a five-digit identifier defined by the American Medical Association for a specified... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or...

38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Terminology code, a five-digit identifier defined by the American Medical Association for a specified... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or...

38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Terminology code, a five-digit identifier defined by the American Medical Association for a specified... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or...

38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Terminology code, a five-digit identifier defined by the American Medical Association for a specified... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or...

The uptake of plutonium-238, 239, 240, americium-241, strontium-90 and caesium-137 into potatoes.

PubMed

Popplewell, D S; Ham, G J; Johnson, T E; Stather, J W; Sumner, S A

1984-09-01

Transfer factors have been measured for 239 Pu + 240 Pu, 241 Am, 90 Sr and 137 Cs into potatoes grown in a blend of soil which included silt polluted with radioactive waste discharged into the Irish Sea. The experiment has been carried out over four seasons and attempts to assess the radiological consequences to the consumer which would arise if potatoes were to be grown in land heavily contaminated with the silt. During the course of the experiment plutonium and americium became less available for uptake, 90 Sr became slightly more available and 137 Cs remained nearly constant in its availability. The values of the transfer factors are among the lowest reported for these radionuclides into potatoes.

Recovery Housing: Evolving Models to Address Resident Needs.

PubMed

Mericle, Amy A; Polcin, Douglas L; Hemberg, Jordana; Miles, Jennifer

2017-01-01

Recovery housing is a service delivery modality that simultaneously addresses the social support and housing needs of those in recovery from substance use disorders. This article describes a group of recovery homes in Texas (N = 10) representing a lesser-studied type of recovery housing, one which explicitly bridges treatment and peer support by providing a variety of recovery support services. All residents meet with a recovery coach, undergo regular drug screening, and have access to intensive outpatient treatment-a program that was developed specifically to support the needs of residents in the homes. Unlike the Oxford House TM model and California sober living houses, which are primarily financed through resident fees, these homes are supported through a mix of resident fees as well as private and public insurance. While adhering to some aspects of the social model of recovery, none of these homes would meet criteria to be considered a true social model program, largely because residents have a limited role in the governance of the homes. Residences like the ones in this study are not well-represented in the literature and more research is needed.

5 CFR 844.401 - Recovery from disability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Recovery from disability. 844.401 Section 844.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... Disability Annuity § 844.401 Recovery from disability. (a) Each annuitant receiving disability annuity from...

7 CFR 1580.503 - Recovery of overpayments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Recovery of overpayments. 1580.503 Section 1580.503 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.503 Recovery of overpayments. (a) If...

Enhancing recovery rates: lessons from year one of IAPT.

PubMed

Gyani, Alex; Shafran, Roz; Layard, Richard; Clark, David M

2013-09-01

The English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines. Data from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7). Data completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff. Compliance with the IAPT clinical model is associated with enhanced rates of reliable recovery. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Barriers to the long-term recovery of individuals with disabilities following a disaster.

PubMed

Stough, Laura M; Sharp, Amy N; Resch, J Aaron; Decker, Curt; Wilker, Nachama

2016-07-01

This study examines how pre-existing disabling conditions influenced the recovery process of survivors of Hurricane Katrina. It focuses specifically on the barriers that hindered the recovery process in these individuals. Focus groups were convened in four Gulf Coast states with 31 individuals with disabilities who lived in or around New Orleans, Louisiana, prior to Hurricane Katrina in August 2005. Qualitative data were analysed using grounded theory methodology. Five themes emerged as the most significant barriers to recovery: housing; transportation; employment; physical and mental health; and accessing recovery services. While these barriers to recovery were probably common to most survivors of the disaster, the research results suggest that disability status enhanced the challenges that participants experienced in negotiating the recovery process and in acquiring resources that accommodated their disabilities. The findings indicate that, when disaster recovery services and resources did not accommodate the needs of individuals with disabilities, recovery was hindered. Recovery efforts should include building accessible infrastructure and services that will allow for participation by all. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Opening Doors to Recovery: Recidivism and Recovery Among Persons With Serious Mental Illnesses and Repeated Hospitalizations.

PubMed

Compton, Michael T; Kelley, Mary E; Pope, Alicia; Smith, Kelly; Broussard, Beth; Reed, Thomas A; DiPolito, June A; Druss, Benjamin G; Li, Charles; Lott Haynes, Nora

2016-02-01

Repeated hospitalizations and arrests or incarcerations diminish the ability of individuals with serious mental illnesses to pursue recovery. Community mental health systems need new models to address recidivism as well as service fragmentation, lack of engagement by local stakeholders, and poor communication between mental health providers and the police. This study examined the initial effects on institutional recidivism and measures of recovery among persons enrolled in Opening Doors to Recovery, an intensive, team-based community support program for persons with mental illness and a history of inpatient psychiatric recidivism. A randomized controlled trial of the model is underway. The number of hospitalizations, days hospitalized, and arrests (all from state administrative sources) in the year before enrollment and during the first 12 months of enrollment in the program were compared. Longitudinal trajectories of recovery-using three self-report and five clinician-rated measures-were examined. Analyses accounted for baseline symptom severity and intensity of involvement in the program. One hundred participants were enrolled, and 72 were included in the analyses. Hospitalizations decreased, from 1.9±1.6 to .6±.9 (p<.001), as did hospital days, from 27.6±36.4 to 14.9±41.3 (p<.001), although number of arrests (which are rare events) did not. Significant linear trends were observed for recovery measures, and trajectories of improvement were apparent across the entire follow-up period. Opening Doors to Recovery holds promise as a new service approach for reducing hospital recidivism and promoting recovery in community mental health systems and is deserving of further controlled testing.

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 4 2013-01-01 2013-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 4 2012-01-01 2012-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 4 2014-01-01 2014-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

Unintended Consequences of Cost Recovery

ERIC Educational Resources Information Center

Piercey, David

2010-01-01

An Alberta school district that used a cost-recovery model to finance school services for 20 years is finding that the model produces unintended negative results. Some schools didn't spend this money on services but used it for other school operations. Some spent the money on external consultants. Professional relationships were damaged, and…

Design of Alpha Voltaic Power Source Using Americium 241 (241Am) and Diamond with a Power Density of 10 mW/cm3

DTIC Science & Technology

2017-10-19

GaN) was calculated and compared . Alpha-voltaic energy converters were designed in diamond and GaN based on the energy deposition calculations...Example Power Source Two example device designs are calculated and compared . A diamond device containing 2 charge collection regions (Schottky and p...ARL-TR-8189 ● OCT 2017 US Army Research Laboratory Design of Alpha-Voltaic Power Source Using Americium-241 (241Am) and Diamond

"Fee Contracting": Marketing Adult Education Program Offerings on a Cost-Recovery Basis. Cost-Recovery Basis.

ERIC Educational Resources Information Center

Creighton, John P.

This workshop presents a Maryland model of delivering public adult education services to business, industry, and public agencies on a cost-recovery basis. A rationale is discussed for the role of public adult education in provision of services on this basis. Ten ways to get started without a marketing specialist are listed. Good leads to…

Recovery Ship Freedom Star

NASA Technical Reports Server (NTRS)

1998-01-01

Freedom Star, one of NASA's two solid rocket booster recovery ships, is towing a barge containing the third Space Shuttle Super Lightweight External Tank (SLWT) into Port Canaveral. This SLWT was slated for use to launch the orbiter Discovery on mission STS-95 in October 1998. This first time towing arrangement, part of a cost saving plan by NASA to prudently manage existing resources, began June 12 from the Michoud Assembly Facility in New Orleans where the Shuttle's external tanks were manufactured. The barge was transported up Banana River to the LC-39 turn basin using a conventional tug boat. Previously, NASA relied on an outside contractor to provide external tank towing services at a cost of about $120,000 per trip. The new plan allowed NASA's Space Flight Operations contractor, United Space Alliance (USA), to provide the same service to NASA using the recovery ships during their downtime between Shuttle launches. Studies showed a potential savings of about $50,000 per trip. The cost of the necessary ship modifications would be paid back by the fourteenth tank delivery. The other recovery ship, Liberty Star, also underwent deck strengthening enhancements and had the necessary towing wench installed.

Contractors on road to recovery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stremel, K.

1984-06-01

Ravaged by two years of spotty markets and minimal profits, the well service industry is on the road to recovery. A discussion of the increase and decrease of drilling rigs and drilling activity in the Rocky Mountain region is given. It also discusses the current trend of well service costs and the direction it should take in the future.

Osteosarcoma development following single inhalation exposure to americium-241 in beagle dogs.

PubMed

Gillett, N A; Hahn, F F; Mewhinney, J A; Muggenberg, B A

1985-10-01

Young, mature Beagle dogs underwent single inhalation exposure to respirable aerosols of 241AmO2 to determine the radiation dose distribution to tissues. The dogs were serially sacrificed to assess the clearance of 241Am from the lung, the rate of translocation to internal organs, the pattern of retention in the organs, and the rates and modes of excretion. Americium dioxide was relatively soluble in the lung, leading to the translocation of significant quantities of 241Am to bone and liver, thus delivering radiation doses to these tissues nearly equal to that received by the lung. Osteoblastic osteosarcomas developed in four dogs surviving more than 1000 days after exposure. Histologically, all of the osteosarcomas were associated with areas of radiation osteodystrophy characterized by bone infarction, peritrabecular new bone formation, marrow fibrosis, and microresorptive cavities. The retention and translocation of inhaled 241Am in dogs is similar to that of man, indicating that 241Am inhaled by humans may potentially result in significant risk of bone tumor development.

Assessment of radiation doses from residential smoke detectors that contain americium-241

NASA Astrophysics Data System (ADS)

Odonnell, F. R.; Etnier, E. L.; Holton, G. A.; Travis, C. C.

1981-10-01

External dose equivalents and internal dose commitments were estimated for individuals and populations from annual distribution, use, and disposal of 10 million ionization chamber smoke detectors that contain 110 kBq americium-241 each. Under exposure scenarios developed for normal distribution, use, and disposal using the best available information, annual external dose equivalents to average individuals were estimated to range from 4 fSv to 20 nSv for total body and from 7 fSv to 40 nSv for bone. Internal dose commitments to individuals under post disposal scenarios were estimated to range from 0.006 to 80 micro-Sv (0.0006 to 8 mrem) to total body and from 0.06 to 800 micro-Sv to bone. The total collective dose (the sum of external dose equivalents and 50-year internal dose commitments) for all individuals involved with distribution, use, or disposal of 10 million smoke detectors was estimated to be about 0.38 person-Sv (38 person-rem) to total body and 00 ft squared.

Knowledge and Attitude regarding Recovery among Mental Health Practitioners in Sweden

ERIC Educational Resources Information Center

Klockmo, Carolina; Marnetoft, Sven-Uno; Nordenmark, Mikael; Dalin, Rolf

2012-01-01

The aim was to investigate the knowledge and the attitude regarding recovery among practitioners working in the Swedish mental health system, Personligt Ombud (PO), Supported Housing Team (SHT) and Psychiatric Out Patient Service (POPS), to determine whether and how knowledge and attitude regarding recovery differ between the three services. A…

I have my own lease-So why the service plan again? Perspectives on service planning in supportive housing.

PubMed

Choy-Brown, Mimi; Hamovitch, Emily K; Cuervo, Carolina; Stanhope, Victoria

2016-12-01

This study aimed to understand multiple stakeholder perspectives implementing a recovery-oriented approach to service planning in supportive housing programs serving people with lived experience of mental illnesses. Multiple stakeholders (N = 57) were recruited to participate in focus groups (N = 8), including 4 with tenants, 2 with service coordinators, 1 with supervisors, and 1 with leadership. Supportive housing programs were purposively sampled from a recovery-oriented organization serving 1,500 people annually. Stakeholders' experiences with service planning and implementing a recovery-oriented approach to service planning were explored. The authors conducted inductive thematic analyses combined with a conceptual matrix, which yielded themes across and within multiple stakeholder focus groups. Three themes emerged: (a) an institutional reminder-service planning experiences elicited negative emotions and served to remind people of experiences in institutional settings, (b) one-size-fits-all service planning-stakeholders perceived the use of quality assurance tools within the planning process as rigid to others' interests beyond their own, and (c) rules and regulations-reconciling funder requirements (e.g., completion dates) while also tailoring services to tenants' particular situations challenged providers. Even in a recovery-oriented organization, findings suggest that service planning in supportive housing has limitations in responding to each tenant's iterative recovery process. Further, in this context where people can make their home, stakeholders questioned whether the very presence of ongoing service planning activities is problematic. However, tenant-service coordinator relationships predicated on mutual respect and esteem overcame some service planning limitations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Resident and proprietor perspectives on a recovery orientation in community-based housing.

PubMed

Piat, Myra; Boyer, Richard; Fleury, Marie-Josée; Lesage, Alain; O'Connell, Maria; Sabetti, Judith

2015-03-01

Stable housing is a fundamental human right, and an important element for both mental health recovery and social inclusion among people with serious mental illness. This article reports findings from a study on the recovery orientation of structured congregate community housing services using the Recovery Self-Assessment Questionnaire (RSA) adapted for housing (O'Connell, Tondora, Croog, Evans, & Davidson, 2005). The RSA questionnaires were administered to 118 residents and housing providers from 112 congregate housing units located in Montreal, Canada. Residents rated their homes as significantly less recovery-oriented than did proprietors, which is contrary to previous studies of clinical services or Assertive Community Treatment where RSA scores for service users were significantly higher than service provider scores. Findings for both groups suggest the need for improvement on 5 of 6 RSA factors. While proprietors favored recovery training and education, and valued resident opinion and experience, vestiges of a traditional medical model governing this housing emerged in other findings, as in agreement between the 2 groups that residents have little choice in case management, or in the belief among proprietors that residents are unable to manage their symptoms. This study demonstrates that the RSA adapted for housing is a useful tool for creating recovery profiles of housing services. The findings provide practical guidance on how to promote a recovery orientation in structured community housing, as well as a novel approach for reaching a common understanding of what this entails among stakeholders. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Resident and Proprietor Perspectives of a Recovery Orientation in Community-Based Housing

PubMed Central

Piat, Myra; Boyer, Richard; Fleury, Marie-Josée; Lesage, Alain; O’Connell, Maria; Sabetti, Judith

2016-01-01

Objective Stable housing is a fundamental human right, and an important element for both mental health recovery and social inclusion among people with serious mental illness. This article reports findings from a study on the recovery orientation of structured congregate community housing services using the Recovery Self-Assessment Questionnaire (RSA) adapted for housing (O’Connell, Tondora, Croog, Evans, & Davidson, 2005). Methods The RSA questionnaires were administered to 118 residents and housing providers from 112 congregate housing units located in Montreal, Canada. Results Residents rated their homes as significantly less recovery-oriented than did proprietors, which is contrary to previous studies of clinical services or Assertive Community Treatment where RSA scores for service users were significantly higher than service provider scores. Findings for both groups suggest the need for improvement on 5 of 6 RSA factors. While proprietors favored recovery training and education, and valued resident opinion and experience, vestiges of a traditional medical model governing this housing emerged in other findings, as in agreement between the 2 groups that residents have little choice in case management, or in the belief among proprietors that residents are unable to manage their symptoms. Conclusions and Implications for Practice This study demonstrates that the RSA adapted for housing is a useful tool for creating recovery profiles of housing services. The findings provide practical guidance on how to promote a recovery orientation in structured community housing, as well as a novel approach for reaching a common understanding of what this entails among stakeholders. PMID:25559078

Study protocol: a mixed methods study to assess mental health recovery, shared decision-making and quality of life (Plan4Recovery).

PubMed

Coffey, Michael; Hannigan, Ben; Meudell, Alan; Hunt, Julian; Fitzsimmons, Deb

2016-08-17

Recovery in mental health care is complex, highly individual and can be facilitated by a range of professional and non-professional support. In this study we will examine how recovery from mental health problems is promoted in non-medical settings. We hypothesise a relationship between involvement in decisions about care, social support and recovery and quality of life outcomes. We will use standardised validated instruments of involvement in decision-making, social contacts, recovery and quality of life with a random sample of people accessing non-statutory mental health social care services in Wales. We will add to this important information with detailed one to one case study interviews with people, their family members and their support workers. We will use a series of these interviews to examine how people build recovery over time to help us understand more about their involvement in decisions and the social links they build. We want to see how being involved in decisions about care and the social links people have are related to recovery and quality of life for people with experience of using mental health support services. We want to understand the different perspectives of the people involved in making recovery possible. We will use this information to guide further studies of particular types of social interventions and their use in helping recovery from mental health problems.

Community mental health nurses' perspectives of recovery-oriented practice.

PubMed

Gale, J; Marshall-Lucette, S

2012-05-01

Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery. © 2011 Blackwell Publishing.

Longitudinal predictors of subjective recovery in psychosis.

PubMed

Law, Heather; Shryane, Nick; Bentall, Richard P; Morrison, Anthony P

2016-07-01

Research has highlighted the importance of recovery as defined by the service user, and suggests a link to negative emotion, although little is known about the role of negative emotion in predicting subjective recovery. To investigate longitudinal predictors of variability in recovery scores with a focus on the role of negative emotion. Participants (n = 110) with experience of psychosis completed measures of psychiatric symptoms, social functioning, subjective recovery, depression, hopelessness and self-esteem at baseline and 6 months later. Path analysis was used to examine predictive factors for recovery and negative emotion. Subjective recovery scores were predicted by negative emotion, positive self-esteem and hopelessness, and to a lesser extent by symptoms and functioning. Current recovery score was not predicted by past recovery score after accounting for past symptoms, current hopelessness and current positive self-esteem. Psychosocial factors and negative emotion appear to be the strongest longitudinal predictors of variation in subjective recovery, rather than psychiatric symptoms. © The Royal College of Psychiatrists 2016.

Impact of the cation distribution homogeneity on the americium oxidation state in the U0.54Pu0.45Am0.01O2-x mixed oxide

NASA Astrophysics Data System (ADS)

Vauchy, Romain; Robisson, Anne-Charlotte; Martin, Philippe M.; Belin, Renaud C.; Aufore, Laurence; Scheinost, Andreas C.; Hodaj, Fiqiri

2015-01-01

The impact of the cation distribution homogeneity of the U0.54Pu0.45Am0.01O2-x mixed oxide on the americium oxidation state was studied by coupling X-ray diffraction (XRD), electron probe micro analysis (EPMA) and X-ray absorption spectroscopy (XAS). Oxygen-hypostoichiometric Am-bearing uranium-plutonium mixed oxide pellets were fabricated by two different co-milling based processes in order to obtain different cation distribution homogeneities. The americium was generated from β- decay of 241Pu. The XRD analysis of the obtained compounds did not reveal any structural difference between the samples. EPMA, however, revealed a high homogeneity in the cation distribution for one sample, and substantial heterogeneity of the U-Pu (so Am) distribution for the other. The difference in cation distribution was linked to a difference in Am chemistry as investigated by XAS, with Am being present at mixed +III/+IV oxidation state in the heterogeneous compound, whereas only Am(IV) was observed in the homogeneous compound. Previously reported discrepancies on Am oxidation states can hence be explained by cation distribution homogeneity effects.

Telecommunications Policy Research Conference. Capital Recovery Section. Papers.

ERIC Educational Resources Information Center

Telecommunications Policy Research Conference, Inc., Washington, DC.

Two papers consider the capital recovery difficulties of telephone companies in the current deregulatory environment. The first, "Capital Recovery in the Transition Period" (Gail Garfield Schwartz, New York State Public Service Commission) describes the process determining depreciation in both regulated and deregulated environments, and…

The transformation from custodial to recovery-oriented care: a paradigm shift that needed to happen.

PubMed

McKenna, Brian; Furness, Trentham; Dhital, Deepa; Park, Malcolm; Connally, Fiona

2014-01-01

As custodial mental health services are beginning to adopt a recovery-oriented model of care, it is imperative that successes in the transformation to recovery are captured. The aim of this illustrative case study was to describe the organizational procedure that enabled the systematic transformation of a custodial mental health service to a service with a self-professed recovery orientation as its model of service delivery. One-to-one interviews with key stakeholders and a document analysis were completed to thoroughly describe the transformation of the service. Four major themes arose from the data: (a) "We had this whole paradigm shift that needed to happen;" (b) "Think recovery," the development of a manualized guide; (c) "Stepping out my recovery;" adaptation of the service guide to the secure care context; and (d) developing the culture. The "developing the culture" major theme was subcategorized to consist of (a) the right people, (b) education, (c) reflective learning, and (d) leadership. The themes provided insights to assist mental health nurses to understand the processes involved in systems transformation. However, the major successes of the service, although only recently evaluated, commenced over a decade ago and yet continue to evolve.

The Alternative Peer Group: A Developmentally Appropriate Recovery Support Model for Adolescents.

PubMed

Nash, Angela; Collier, Crystal

2016-01-01

Recovery as the goal for substance use disorder treatment has been a key component of the Substance Abuse and Mental Health Services Administration's mission for the past decade. Consistent with their mission, there is a call for research and development of recovery-oriented systems of care to support affected individuals through all stages of the recovery process. Evidence is emerging to support recovery practice and research for adults, but recovery-oriented models for adolescents are scant. The Alternative Peer Group (APG) is a comprehensive adolescent recovery support model that integrates recovering peers and prosocial activities into evidence-based clinical practice. Employing APG participants' own words, this article will describe the essential elements and three theoretical frameworks underlying the APG model to illustrate how the APG serves as a developmentally appropriate recovery support service for adolescents with substance use disorder.

Course of Recovery from Alcoholism

PubMed Central

Venner, Kamilla L.; Matzger, Helen; Forcehimes, Alyssa A.; Moos, Rudolf H.; Feldstein, Sarah W.; Willenbring, Mark L.; Weisner, Constance

2010-01-01

This article represents the proceedings of a symposium at the 2005 Research Society on Alcoholism meeting in Santa Barbara, California, organized and chaired by Kamilla L. Venner. This symposium integrated current empirical research on the course of recovery from alcoholism from multiple perspectives, an aim that is consistent with NIAAA's new focus on the process of recovery. The presentations and presenters were as follows: (1) The Role of Community Services and Informal Support on 7-Year Drinking Outcomes in Treated and Untreated Drinkers, by Helen Matzger; (2) The Sequence of Recovery Events in a Native American Sample, by Kamilla L. Venner; (3) Transformational Change in Recovery, by Alyssa A. Forcehimes; (4) Social Settings and Substance Use: Contextual Factors in Recovery, by Rudolf H. Moos; and (5) A Broader View of Change in Drinking Behavior, by discussant Mark L. Willenbring. A theme connecting the presentations was that treatment is but one discrete aspect to recovery and that sustained recovery is often influenced by an individual interaction with others within a social context. Collectively, presentations underscored the need to think more broadly about factors contributing to the remission of alcohol dependence. PMID:16737468

Making the Most of the American Recovery and Reinvestment Act of 2009: A Guide for Full-Service School Leaders and Community Partners

ERIC Educational Resources Information Center

Gaughen, Katherine; Stewart, Nichole H.; LaVallee, Robert; Zvara, Alexandra

2009-01-01

To address the economic crisis facing the country, the President signed the American Recovery and Reinvestment Act (ARRA) into law on February 17, 2009. The ARRA offers numerous opportunities for full-service school leaders and may provide the necessary funding to prevent significant decreases in operating budgets. One of the largest investments…

Recovery definitions: Do they change?

PubMed Central

Kaskutas, Lee Ann; Witbrodt, Jane; Grella, Christine E.

2015-01-01

Background The term “recovery” is widely used in the substance abuse literature and clinical settings, but data have not been available to empirically validate how recovery is defined by individuals who are themselves in recovery. The “What Is Recovery?” project developed a 39-item definition of recovery based on a large nationwide online survey of individuals in recovery. The objective of this paper is to report on the stability of those definitions one to two years later. Methods To obtain a sample for studying recovery definitions that reflected the different pathways to recovery, the parent study involved intensive outreach. Follow-up interviews (n = 1237) were conducted online and by telephone among respondents who consented to participate in follow-up studies. Descriptive analyses considered endorsement of individual recovery items at both surveys, and t-tests of summary scores studied significant change in the sample overall and among key subgroups. To assess item reliability, Cronbach’s alpha was estimated. Results Rates of endorsement of individual items at both interviews was above 90% for a majority of the recovery elements, and there was about as much transition into endorsement as out of endorsement. Statistically significant t-test scores were of modest magnitude, and reliability statistics were high (ranging from .782 to .899). Conclusions Longitudinal analyses found little evidence of meaningful change in recovery definitions at follow-up. Results thus suggest that the recovery definitions developed in the parent “What Is Recovery?” survey represent stable definitions of recovery that can be used to guide service provision in Recovery-Oriented Systems of Care. PMID:26166666

47 CFR 64.1515 - Recovery of costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Recovery of costs. 64.1515 Section 64.1515 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other Information Services § 64.1515...

Exploring the effect of organizational culture on consumer perceptions of agency support for mental health recovery.

PubMed

Clossey, Laurene; Rheinheimer, David

2014-05-01

This research explores the impact of mental health agency culture on consumers' perceptions of agency support for their recovery. This study hypothesized that a constructive organizational culture must be present for consumers to perceive agency support for recovery. A sample of 12 mental health agencies in rural Pennsylvania participated in the research. Agency administrators completed an instrument called the recovery oriented service environment, which measured the number of recovery model program components offered by the agency. Consumers completed the recovery oriented services indicators, which taps into their perception of agency support for recovery. Direct service staff completed the organizational social context, which measured their agency's culture. Results showed that in this sample stronger consumer perceptions of agency support for recovery were correlated with higher ratings of agency constructive culture. The results suggest that agency culture is an important variable to target when implementing recovery model programming.

Evaluating an early intervention in psychosis service for 'high-risk' adolescents: symptomatic and social recovery outcomes.

PubMed

Lower, Rebecca; Wilson, Jonathan; Medin, Evelina; Corlett, Emma; Turner, Ruth; Wheeler, Karen; Fowler, David

2015-06-01

This study presents client characteristics and treatment outcomes for a group of young people seen by Central Norfolk Early Intervention Team (CNEIT). The team offers an intensive outreach model of treatment to young people with complex co-morbid emotional, behavioural and social problems, as well as the presence of psychotic symptoms. Outcomes include both client self-report and clinician-rated measures. Data are routinely collected at acceptance into service, after 12 months of service and at point of discharge. Data show that clients seen by the CNEIT youth team are a group of young people at high risk of developing long-term mental illness and social disability. Outcomes show significant reductions in not only psychotic symptomatology, but also co-morbid anxiety and depression, as well as improvements in social recovery. At the end of their time with the service, the majority of clients are discharged back to the care of their general practitioner, which indicates that the team successfully managed to reduce the complexity of needs and difficulties associated with this client group. Outcomes support the use of an intensive outreach approach for young people at high risk of developing psychotic disorders. It has been suggested that this model may be successfully broadened to young people with other emerging, potentially severe or complex mental disorders. Norfolk and Suffolk NHS Foundation Trust has built on the success of its youth early intervention team and innovatively redesigned its services in line with this model by developing a specific youth mental health service. © 2014 Wiley Publishing Asia Pty Ltd.

From recovery programs to recovery-oriented practice? A qualitative study of mental health professionals' experiences when facilitating a recovery-oriented rehabilitation program.

PubMed

Dalum, Helle Stentoft; Pedersen, Inge Kryger; Cunningham, Harry; Eplov, Lene Falgaard

2015-12-01

The recovery model has influenced mental health services and fostered new standards for best practice. However, knowledge about how mental health care professionals (HCPs) experience recovery-oriented programs is sparse. This paper explores HCPs' experiences when facilitating a recovery-oriented rehabilitation program. The research question is how do HCPs experience a change in their attitude and practice when applying recovery-oriented programs? This paper draws on semi-structured in-depth qualitative interviews conducted with 16 HCPs experienced in facilitating a recovery-oriented rehabilitation program in either the USA or Denmark. Three themes emerged from the HCPs' reflections on changes in attitudes and practices: "Hopeful Attitude" captures a change in the HCPs' attitude toward a more positive view on the future for clients' living with mental illness; "A New Focus in the Dialogue With Clients" thematizes how the HCPs focus more on the individual's own goal for recovery rather than disease-induced goals in the dialog with clients; "A Person-Centered Role" comprises a shift in the professional role whereby the HCPs value the client's own ideas in addition to the professional's standards. This study supports the theory of the recovery model by its empirical findings and indications that when facilitating a recovery-oriented program, HCPs experience recovery-oriented changes in their attitude toward life with mental illness, and it alters their professional practice toward a stronger focus on client's own goals during treatment. More studies are needed to further clarify how changes in HCPs' attitudes translate into changes in mental health practices. Copyright © 2015 Elsevier Inc. All rights reserved.

Initial Development and Psychometric Properties of a New Measure of Substance Use Disorder "Recovery Progression": The Recovery Progression Measure (RPM).

PubMed

Elison, Sarah; Davies, Glyn; Ward, Jonathan

2016-07-28

There is a growing literature around substance use disorder treatment outcomes measures. Various constructs have been suggested as being appropriate for measuring recovery outcomes, including "recovery capital" and "treatment progression." However, these previously proposed constructs do not measure changes in psychosocial functioning during the recovery process. Therefore, a new psychometric assessment, the "Recovery Progression Measure" (RPM), has been developed to measure this recovery oriented psychosocial change. The aims of this study were to evaluate the reliability and factor structure of the RPM via data collected from 2218 service users being treated for their substance dependence. Data were collected from service users accessing the Breaking Free Online (BFO) substance use disorder treatment and recovery program, which has within its baseline assessment a 36-item psychometric measure previously developed by the authors to assess the six areas of functioning described in the RPM. Reliability analyses and exploratory factor analyses (EFA) were conducted to examine the underlying factor structure of the RPM measure. Internal reliability of the RPM measure was found to be excellent (α > .70) with the overall assessment to have reliability α = .89, with item-total correlations revealing moderate-excellent reliability of individual items. EFA revealed the RPM to contain an underlying factor structure of eight components. This study provides initial data to support the reliability of the RPM as a recovery measure. Further work is now underway to extend these findings, including convergent and predictive validity analyses.

Recovery and Borderline Personality Disorder: A Description of the Innovative Open Borders Program.

PubMed

Mortimer-Jones, Sheila; Morrison, Paul; Munib, Ahmed; Paolucci, Francesco; Neale, Sonia; Bostwick, Amanda; Hungerford, Catherine

2016-09-01

Although Recovery-oriented approaches to delivering mental health services are now promoted in health services across the globe, there is an ongoing need to adapt these approaches to meet the unique needs of consumers with a diagnosis of borderline personality disorder. The lived experience of borderline personality disorder includes emotional dysregulation, intense and unstable relationships, self-harming behaviours, fear of abandonment, and a limited capacity to cope with stress. These experiences present a range of challenges for those who deliver Recovery-oriented services and advocate the principles of empowerment and self-determination. This paper describes a novel crisis intervention program, "Open Borders," which has been established to meet the unique needs of people with a borderline personality disorder diagnosis. Open Borders is a Recovery-oriented model that is run at a public, state-wide residential facility for mental health consumers in Western Australia, and offers alternative pathways to achieving mental health Recovery, including self-referral and short-term admission to a residential facility. The aims of the program are to break the cycle of hospital admission, reduce rates of self-harm, and support the complex Recovery journey of consumers with a diagnosis of borderline personality disorder. Open Borders provides an exemplar for other health service organisations seeking to establish Recovery-oriented crisis intervention alternatives.

Recovery post treatment: plans, barriers and motivators

PubMed Central

2013-01-01

Background The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital) that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital) or facilitators of (presence of capital) sustained recovery post treatment. Methods A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Results Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular) was a key motivator post treatment. Conclusions Addressing internal factors and underlying issues i.e. ‘human capital’, provided confidence for continued recovery whilst motivators focused on external factors such as family and maintaining aspects of a �

Recovery post treatment: plans, barriers and motivators.

PubMed

Duffy, Paul; Baldwin, Helen

2013-01-30

The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital) that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital) or facilitators of (presence of capital) sustained recovery post treatment. A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular) was a key motivator post treatment. Addressing internal factors and underlying issues i.e. 'human capital', provided confidence for continued recovery whilst motivators focused on external factors such as family and maintaining aspects of a 'normal' life i.e. 'social and physical

Community perspectives on post-Katrina mental health recovery in New Orleans.

PubMed

Meyers, Diana; Allien, Charles E; Dunn, Donisha; Wennerstrom, Ashley; Springgate, Benjamin F

2011-01-01

Disaster-affected communities may face prolonged challenges to community-wide mental health recovery due to limitations in local resources, infrastructure, and leadership. REACH NOLA, an umbrella non-profit organization comprising academic institutions and community-based agencies, sought to promote community recovery, increase mental health service delivery capacity, and develop local leadership in post-Katrina New Orleans through its Mental Health infrastructure and Training Project (MHIT). The project offered local health service providers training and follow-up support for implementing evidence-based and new approaches to mental health service delivery. This commentary shares the perspectives of three community leaders who co-directed MHIT. They describe the genesis of MHIT, the experience of each agency in adopting leadership roles in addressing post-disaster needs, challenges and growth opportunities, and then overarching lessons learned concerning leadership in a prolonged crisis. These lessons may be relevant to community agencies addressing hurricane recovery in other areas of the Gulf States as well as to inform long-term disaster recovery efforts elsewhere.

77 FR 55191 - Endangered and Threatened Species; Recovery Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... and Threatened Species; Recovery Plans AGENCY: National Marine Fisheries Service (NMFS), National... Species Act (ESA) Recovery Plan for Lower Columbia River Chinook Salmon, Lower Columbia River Coho Salmon, Columbia River Chum Salmon, and Lower Columbia River Steelhead (Proposed Plan) was available for public...

A Mixed-Methods Study of the Recovery Concept, "A Meaningful Day," in Community Mental Health Services for Individuals with Serious Mental Illnesses.

PubMed

Myers, Neely A L; Smith, Kelly; Pope, Alicia; Alolayan, Yazeed; Broussard, Beth; Haynes, Nora; Compton, Michael T

2016-10-01

The recovery concept encompasses overcoming or managing one's illness, being physically and emotionally healthy, and finding meaningful purpose through work, school, or volunteering, which connects one to others in mutually fulfilling ways. Using a mixed-methods approach, we studied the emphasis on "a meaningful day" in the new Opening Doors to Recovery (ODR) program in southeast Georgia. Among 100 participants, we measured the meaningful day construct using three quantitative items at baseline (hospital discharge) and at 4-, 8-, and 12-month follow-up, finding statistically significant linear trends over time for all three measures. Complementary qualitative interviews with 30 individuals (ODR participants, family members, and ODR's Community Navigation Specialists and program leaders) revealed themes pertaining to companionship, productivity, achieving stability, and autonomy, as well as the concern about insufficient resources. The concept of "a meaningful day" can be a focus of clinical attention and measured as a person-centered outcome for clients served by recovery-oriented community mental health services.

A Cross-Diagnostic Investigation of the Differential Impact of Discrimination on Clinical and Personal Recovery.

PubMed

Mak, Winnie W S; Chan, Randolph C H; Wong, Samuel Y S; Lau, Joseph T F; Tang, Wai Kwong; Tang, Alan K L; Chiang, Tin Po; Cheng, Sammy K W; Chan, Fu; Cheung, Fanny M; Woo, Jean; Lee, Diana T F

2017-02-01

Although the negative association between discrimination and recovery has been established, only a few studies have attempted to investigate the underlying mechanism of how perceived discrimination dampens both clinical and personal recovery among people with psychiatric disorders. This study aimed to examine the mediating roles of self-stigma and mental health service engagement in the relationship between perceived discrimination and recovery. A total of 374 people (half men and half women; mean±SD age=43.47±12.76) living in Hong Kong and in recovery with a primary diagnosis of a psychotic disorder, mood disorder, or substance use disorder responded to a cross-sectional questionnaire on discrimination, self-stigma, mental health service adherence, recovery orientation of services, clinical recovery, and personal recovery. Multisample structural equation modeling was conducted to examine whether the hypothesized model for perceived discrimination and recovery produced results that could be generalized across people with various psychiatric diagnoses. Findings indicated that respondents perceived discrimination from the general public and from health care professionals, which was positively associated with self-stigmatization and service disengagement and was negatively associated with clinical and personal recovery across three different types of psychiatric disorder. This study showed that the influence of perceived discrimination on recovery was universal and could be generalized across people with different psychiatric diagnoses. Multipronged stigma reduction interventions targeting the general public, health care professionals, and people in recovery, along with policies that avert discrimination and uphold human rights in health care settings and beyond, should be implemented.

Assessment of radiation doses from residential smoke detectors that contain americium-241

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Donnell, F.R.; Etnier, E.L.; Holton, G.A.

1981-10-01

External dose equivalents and internal dose commitments were estimated for individuals and populations from annual distribution, use, and disposal of 10 million ionization chamber smoke detectors that contain 110 kBq (3 ..mu..Ci) americium-241 each. Under exposure scenarios developed for normal distribution, use, and disposal using the best available information, annual external dose equivalents to average individuals were estimated to range from 4 fSv (0.4 prem) to 20 nSv (2 ..mu..rem) for total body and from 7 fSv to 40 nSv for bone. Internal dose commitments to individuals under post disposal scenarios were estimated to range from 0.006 to 80 ..mu..Svmore » (0.0006 to 8 mrem) to total body and from 0.06 to 800 ..mu..Sv to bone. The total collective dose (the sum of external dose equivalents and 50-year internal dose commitments) for all individuals involved with distribution, use, or disposal of 10 million smoke detectors was estimated to be about 0.38 person-Sv (38 person-rem) to total body and 00 ft/sup 2/).« less

Recovery and rehabilitation after stroke.

PubMed

Brown, Allen W; Schultz, Billie A

2010-11-01

Most individuals survive stroke and age with its consequences. Rehabilitation becomes the dominant medical need soon after onset, and coordinated rehabilitation services using evidence-based interventions determined by patient need are of primary importance in affecting outcome and quality of life. This discussion will focus on the natural history of recovery after stroke and the changes in brain organization that support behavioral improvement during recovery, then review established and emerging therapeutic approaches directed at improving independent functional performance and quality of life. © Thieme Medical Publishers.

Medication-assisted recovery from opioid addiction: historical and contemporary perspectives.

PubMed

White, William L

2012-01-01

Recovery is being used as a conceptual fulcrum for the redesign of addiction treatment and related support services in the United States. Efforts by policy, research, and clinical leaders to define recovery and calls for assertive models of long-term recovery management raise critical questions about how transformation efforts of recovery-focused systems will affect the pharmacotherapeutic treatment of opioid addiction and the status of patients participating in such treatment. This article highlights recent work advocating a recovery-oriented approach to medication-assisted treatment.

An empirical evaluation of recovery transformation at a large community psychiatric rehabilitation organization.

PubMed

Malinovsky, Igor; Lehrer, Paul; Silverstein, Steven M; Shankman, Stewart A; O'Brien, William; Samuelson, Tracy; van Nostrand, Gary

2013-11-01

In recent decades, the concept of "recovery" from Severe Mental Illness (SMI) has gained increased prominence among organizations providing behavioral health services. Many states and organizations are currently developing plans to transform their mental health systems in accordance with recovery-oriented care. Even though efforts to bring the principles of recovery to mental health agencies have been well documented in the United States and abroad, there is little empirical evidence to suggest that recovery-oriented services are advantageous. The purpose of this longitudinal study was to evaluate the effectiveness of a recovery-oriented transformation carried out by a large, private, not-for-profit psychiatric rehabilitation organization serving individuals with SMI. This transformation targeted the philosophy and specific procedures involved in the provision of care to residents within the organization. The outcome variables selected to evaluate the impact of the transformation were grouped into the following categories: (a) objective indicators of recovery, (b) self-report indicators of recovery, (c) indicators of staff competency, and (d) processes that promote recovery. Six-hundred and 27 residents and 490 staff participated in the evaluation. The findings suggest that recovery-oriented services had a positive impact on rates of overnight hospitalization, residents' ability to function in the community, some professional skills of employees, and working alliance between direct care providers and residents. This indicates that comprehensive and well-structured recovery-oriented care may offer a cost-efficient and effective alternative to the deficit approach to mental health care.

7 CFR 1580.504 - Fraud and recovery of overpayments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Fraud and recovery of overpayments. 1580.504 Section 1580.504 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.504 Fraud and recovery...

Recovery-based services in a psychiatric intensive care unit - the consumer perspective.

PubMed

Ash, David; Suetani, Shuichi; Nair, Jayakrishnan; Halpin, Matthew

2015-10-01

To describe the implementation of recovery-based practice into a psychiatric intensive care unit, and report change in seclusion rates over the period when these changes were introduced (2011-2013). Recovery-based practices including collaborative care, safety care plans, a comfort room, and debriefing after coercive interventions were introduced. A carer consultant was employed. A restraint and seclusion review committee, chaired by a peer worker, was established. A consumer exit interview was introduced and these data were collected, reviewed by staff and the peer worker and used to improve the ward environment. Rates of seclusion were measured during the period when recovery-based practices were introduced. Consumer feedback indicated that positive aspects of the psychiatric intensive care unit included approachable, helpful staff and completion of a safety care plan. Negative aspects included lack of involvement in decisions about admission and about medications, the non-smoking policy, and being placed in seclusion or restraint. There was a significant reduction in the number of consumers secluded and the total number of seclusions. Recovery principles can be successfully introduced in a psychiatric intensive care unit environment. Introduction of recovery based practice was associated with a reduction in seclusion. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Recovery Competencies for New Zealand Mental Health Workers.

ERIC Educational Resources Information Center

O'Hagan, Mary

This book contains a detailed report of the recovery principles set out in the Mental Health Commission's Blueprint for Mental Health Services in New Zealand. The competencies, endorsed by the New Zealand government, describe what mental health workers need to know about using the recovery approach in their work with people with mental illness.…

Podoconiosis patients' willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery.

PubMed

Tamiru, Abreham; Tsegay, Girmay; Wubie, Moges; Gedefaw, Molla; Tomczyk, Sara; Tekola-Ayele, Fasil

2014-03-19

Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient's willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n=393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government's primary health care system.

A Case Study Comparison of Charter and Traditional Schools in New Orleans Recovery School District: Selection Criteria and Service Provision for Students with Disabilities

ERIC Educational Resources Information Center

Wolf, Nikki L.

2011-01-01

In post-Katrina New Orleans, Louisiana, there is a growing concentration of charter schools. The Recovery School District (RSD) has oversight of the majority of these schools. To explore charges from community advocates that RSD charter schools restricted admission and provided inadequate services for students with disabilities, the following…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marshall, R.S.

A simple in-line americium assay instrument (AAI) was installed at an americium recovery process area at LASL for use in process development and for providing process control information. The AAI counts 59.5-keV /sup 241/Am gamma rays, using a NaI(T1) detector and Eberline SAM II electronics. It has a useful range of 3 x 10/sup -5/ to 10 g Am/l and does not suffer from plutonium interference. Comparative analyses of samples assayed in the AAI and samples assayed by the LASL Analytical Laboratory show a combined relative standard deviation of 14%.

Mental Health Recovery in the Patient-Centered Medical Home

PubMed Central

Aarons, Gregory A.; O’Connell, Maria; Davidson, Larry; Groessl, Erik J.

2015-01-01

Objectives. We examined the impact of transitioning clients from a mental health clinic to a patient-centered medical home (PCMH) on mental health recovery. Methods. We drew data from a large US County Behavioral Health Services administrative data set. We used propensity score analysis and multilevel modeling to assess the impact of the PCMH on mental health recovery by comparing PCMH participants (n = 215) to clients receiving service as usual (SAU; n = 22 394) from 2011 to 2013 in San Diego County, California. We repeatedly assessed mental health recovery over time (days since baseline assessment range = 0–1639; mean = 186) with the Illness Management and Recovery (IMR) scale and Recovery Markers Questionnaire. Results. For total IMR (log-likelihood ratio χ2[1] = 4696.97; P < .001) and IMR Factor 2 Management scores (log-likelihood ratio χ2[1] = 7.9; P = .005), increases in mental health recovery over time were greater for PCMH than SAU participants. Increases on all other measures over time were similar for PCMH and SAU participants. Conclusions. Greater increases in mental health recovery over time can be expected when patients with severe mental illness are provided treatment through the PCMH. Evaluative efforts should be taken to inform more widespread adoption of the PCMH. PMID:26180945

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zalupski, Peter R.; Klaehn, John R.; Peterman, Dean R.

The feasibility of simultaneous separation of uranium, neptunium, plutonium, americium, and curium from a simulated dissolved used fuel simulant adjusted to 1.0 M nitric acid is investigated using a mixture of the soft donor bis(bis-3,5-trifluoromethyl)phenyl) dithiophosphinic acid (“0”) and the hard donor synergist trioctylphosphine oxide (TOPO) dissolved in toluene. The results reported in this work are compared to our recent demonstration of a complete actinide recovery from a simulated dissolved fuel solution using a synergistic combination of bis(o-trifluoromethylphenyl)dithiophosphinic acid (“1”) and TOPO dissolved in either toluene or trifluoromethylphenyl sulfone. While the extraction efficiency of americium was enhanced for the liquid-liquidmore » system containing “0”, enabling to accomplish a trivalent An/Ln separation at 1.0 M HNO3, the extraction of neptunium was drastically diminished, relative to “1”. The partitioning behavior of curium was also negatively impacted, introducing an effective opportunity for americium/curium separation. Radiometric and spectrophotometric studies demonstrate that the complete actinide recovery using the solvent based upon “0” and TOPO is not feasible. Additionally, the importance of radiolytic degradation processes is discussed through the comparisons of extraction properties of liquid-liquid systems based on both soft donor reagents.« less

A study protocol for tracking quality of life among U.S. service members wounded in Iraq and Afghanistan: the Wounded Warrior Recovery Project.

PubMed

Woodruff, Susan I; Galarneau, Michael R; Luu, Bethi N; Sack, Daniel; Han, Peggy

2014-03-01

There is a need for more work to understand the quality of life (QOL) outcomes of survivors of Operations Enduring Freedom and Iraqi Freedom combat injury to improve care and treatment, and prevent poor physical, psychological, and social outcomes. We describe the study design and methods of the Wounded Warrior Recovery Project, a study supported by the Department of Defense that will track close to 10,000 military personnel wounded in Operations Enduring Freedom and Iraqi Freedom. The overall objective of the 6-year longitudinal study is to track changes in QOL and describe variations in those changes as they relate to sociodemographic factors, injury characteristics, service-related factors, clinical/diagnostic measures including traumatic brain injury and posttraumatic stress disorder, and medical procedures and services. The Wounded Warrior Recovery Project study will be among the first longitudinal population-based investigations of QOL outcomes after combat injury and will provide a basis upon which large-scale epidemiological studies can be conducted. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Adsorption and Dissociation of Molecular Oxygen on the (0001) Surface of Double Hexagonal Close Packed Americium

NASA Astrophysics Data System (ADS)

Dholabhai, Pratik; Atta-Fynn, Raymond; Ray, Asok

2008-03-01

Oxygen molecule adsorption on (0001) surface of double hexagonal packed americium has been studied in detail within the framework of density functional theory using a full-potential all-electron linearized augmented plane wave plus local orbitals method. The most stable configuration corresponded to molecular dissociation with the oxygen atoms occupying neighboring three-fold hollow h3 sites. Chemisorption energies and adsorption geometries for the adsorbed species, and change in work functions, magnetic moments, partial charges inside muffin-tins, difference charge density distributions and density of states for the bare Am slab and the Am slab after adsorption of the oxygen molecule will be discussed. The effects of chemisorption on Am 5f electron localization-delocalization in the vicinity of the Fermi level and the reaction barrier calculation for the dissociation of oxygen molecule to the most stable h3 sites will be discussed.

Cross-Validating Chinese Language Mental Health Recovery Measures in Hong Kong

ERIC Educational Resources Information Center

Bola, John; Chan, Tiffany Hill Ching; Chen, Eric HY; Ng, Roger

2016-01-01

Objectives: Promoting recovery in mental health services is hampered by a shortage of reliable and valid measures, particularly in Hong Kong. We seek to cross validate two Chinese language measures of recovery and one of recovery-promoting environments. Method: A cross-sectional survey of people recovering from early episode psychosis (n = 121)…

Biodynamic study of americium-241 accumulation in the cytosol of the hepatopancreas of the lobster Homarus gammarus.

PubMed

Goudard, F; Paquet, F; Durand, J P; Milcent, M C; Germain, P; Pieri, J

1994-08-01

In the lobster, most of the radionuclides ingested with contaminated food are concentrated in the digestive gland. Americium-241 accumulation in the hepatopancreas of the lobster was studied during the digestive cycle. Fractionations of cytosols at different times after ingestion of radioactive preys were performed by gel permeation chromatography to determine the distribution of 241Am in the different macromolecular components. 241Am was associated with ferritin during the whole digestive cycle. This observation suggests a correlation between 241Am distribution pathways and iron metabolism. The distribution of 241Am present in the other cytosolic proteins followed two major steps of accumulation which may be correlated to the evolution of the two main cellular types playing an important role in the digestive cycle (B and R type cells).

Participants' Assessment of the Impact of Behavioral Health Self-Direction on Recovery.

PubMed

Croft, Bevin; Parish, Susan

2016-10-01

Self-direction involves managing a flexible budget, selecting and purchasing services and supports to meet individual needs and preferences. An emerging practice in the behavioral health field, self-direction is part of a systemic shift toward person-centered approaches to service provision. To understand the relationship between recovery and self-direction, the authors conducted a content analysis of 30 in-depth interviews with individuals from two self-direction programs in one state. A positive relationship between self-direction and recovery was established. Meeting basic needs for food, clothing, and shelter are important first steps in the recovery process for self-directing participants. Recovery domains were dynamic and interrelated, with gains in independence, self-esteem, and self-confidence facilitating achievement of goals in other domains. To maximize the benefits of self-direction, program administrators may need to develop clearer program implementation standards and address poverty and limited access to appropriate behavioral health services and supports.

45 CFR 1630.8 - Recovery of disallowed costs and other corrective action.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Recovery of disallowed costs and other corrective... SERVICES CORPORATION COST STANDARDS AND PROCEDURES § 1630.8 Recovery of disallowed costs and other... limits and conditions set forth in the Corporation's management decision. Recovery of the disallowed...

45 CFR 1630.8 - Recovery of disallowed costs and other corrective action.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Recovery of disallowed costs and other corrective... SERVICES CORPORATION COST STANDARDS AND PROCEDURES § 1630.8 Recovery of disallowed costs and other... limits and conditions set forth in the Corporation's management decision. Recovery of the disallowed...

45 CFR 1630.8 - Recovery of disallowed costs and other corrective action.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Recovery of disallowed costs and other corrective... SERVICES CORPORATION COST STANDARDS AND PROCEDURES § 1630.8 Recovery of disallowed costs and other... limits and conditions set forth in the Corporation's management decision. Recovery of the disallowed...

Concept analysis of recovery in mental illness in young adulthood.

PubMed

McCauley, C O; McKenna, H P; Keeney, S; McLaughlin, D F

2015-10-01

Recovery, as a concept, emerged as a core philosophy of the service user movement that began in the late 1960s and 1970s. Previous reviews on recovery in mental health have presented definitions or a conceptual framework; however, over time it has been open to disparate interpretations. The aim of this paper was to conduct the first concept analysis of mental health recovery in young adulthood within various multidisciplinary contexts. Rodgers's (2000) six-stepped evolutionary method enabled the analysis of recovery's conceptual characteristics, the identification of an exemplar and the proposition of a hypothesis with implications for practice. This analysis has revealed the derivation of the term recovery does not convey its identified conceptual characteristics. Identified attributes include the reawakening of hope, reclaiming a positive self and meaning through personal growth. Antecedents include the disruption of illness, stigmatization, internal inventory and contemplative recovery. Identified consequences include the return to normality, reconstruction of self and active social connection. The new conceptual definition is the reawakening of hope and rediscovery of a positive sense of self through finding meaning and purpose within personal growth and connection using creative self-care coping strategies. This paper reveals an apparent disparity between professional and personal interpretations of recovery. Therefore, the implication for mental health nursing is the congruence of recovery-orientated practice with the process of recovery experienced by young adult service users. © 2015 John Wiley & Sons Ltd.

31 CFR 210.12 - RDFI's rights of recovery.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false RDFI's rights of recovery. 210.12 Section 210.12 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE FEDERAL GOVERNMENT PARTICIPATION IN THE...

36 CFR 72.52 - Recovery Action Program grant applications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Recovery Action Program grant applications. 72.52 Section 72.52 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR URBAN PARK AND RECREATION RECOVERY ACT OF 1978 Grant Selection, Approval and Administration § 72...

Untangling the nonrecyclable citizen: a critical reconceptualization of responsibility in recovery.

PubMed

Vandekinderen, Caroline; Roets, Griet; Van Hove, Geert

2014-10-01

Over the last decades, international research, policy, and practice in the field of mental health care and a complementary variety of social work and social service delivery methods have been focused on recovery as a dominant concept. Emphasizing the service user's responsibility appears to be a central component in the empowering process of recovery. Using a critical disability studies perspective, we aimed to untangle the relationship between the individual citizen with mental health problems and the society in which the recovery discourse operates in Belgium. In this article we explore the social dynamics in the unique life story of Jimmy Sax and analyze a diversity of discourses and practices that turned him into a nonrecyclable citizen. While exploring the different modes through which Jimmy's subjectivity was transformed throughout the course of his life, we expose the convoluted nature of the recovery paradigm, which leads to a reconceptualization of the notion of responsibility in recovery. © The Author(s) 2014.

15. VIEW OF LABORATORY EQUIPMENT IN THE BUILDING 771 ANALYTICAL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. VIEW OF LABORATORY EQUIPMENT IN THE BUILDING 771 ANALYTICAL LABORATORY. THE LAB ANALYZED SAMPLES FOR PLUTONIUM, AMERICIUM, URANIUM, NEPTUNIUM, AND OTHER RADIOACTIVE ISOTOPES. (9/25/62) - Rocky Flats Plant, Plutonium Recovery & Fabrication Facility, North-central section of plant, Golden, Jefferson County, CO

Claus sulfur recovery unit startups

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parnell, D.C.

1973-08-01

Because of the recent emphasis on reducing sulfur emissions to the atmosphere, Claus-type sulfur recovery units are becoming more prevalent throughout the industry. Many plants, including refinery, chemical, and natural gasoline units, are being required to install Claus sulfur recovery facilities to meet pollution requirements. Although Claus units in some cases cannot alone meet the most rigid air pollution codes currently being enforced, they are still the most economical and practical method for recovering about 94 to 97% of the sulfur from hydrogen sulfide rich gases. For best operation and longer service life, proper startup and shutdown procedures for thesemore » sulfur recovery units should be followed. On all startups and shutdowns, these units require considerable operator attention; improper operation during these critical phases can affect overall plant efficiency.« less

Evaluation of the United States public health service guidelines for discontinuation of anticytomegalovirus therapy after immune recovery in patients with cytomegalovirus retinitis.

PubMed

Holbrook, Janet T; Colvin, Ryan; van Natta, Mark L; Thorne, Jennifer E; Bardsley, Mark; Jabs, Douglas A

2011-10-01

To evaluate United States Public Health Service (USPHS) guidelines for discontinuing anticytomegalovirus (CMV) therapy in patients with AIDS who have immune recovery and quiescent retinitis after initiating highly active antiretroviral therapy. Cohort study of patients with CMV retinitis (Longitudinal Study of Ocular Complications of AIDS). Participants had CMV retinitis and CD4+ T-cell counts of 50 cells/μL or fewer enrolled from 1998 through 2009 who demonstrated sustained immune recovery (2 consecutive CD4+ T-cell counts of 100 cells/μL or more at least 6 months apart) and inactive retinitis. Participants were classified into 2 groups according to anti-CMV treatment after immune recover: (1) continued anti-CMV therapy and (2) discontinued therapy. We evaluated survival, visual acuity, and CMV retinitis activity; we used propensity scores to adjust for confounding factors for these analyses. Of 152 participants reviewed, 71 demonstrated immune recovery, 37 of whom discontinued therapy and 34 of whom continued therapy. At immune recovery, participants continuing therapy tended to be older (44 vs 40 years; P = .09), have bilateral retinitis (53% vs 32%; P = .10), and have lower CD4+ T-cell counts (148 vs 207 cells/μL; P < .001). There were no statistical differences in any of the clinical outcomes (death, retinitis progress, visual acuity, or incidence of bilateral retinitis). Both groups lost visual acuity during follow-up, on average 1.2 letters per year (P < .01). Discontinuation of anti-CMV therapy after immune recovery did not increase the risk of poor outcomes. These results support the current guidelines for discontinuation of anti-CMV therapy after achievement of sustained immune recovery. Copyright © 2011 Elsevier Inc. All rights reserved.

Disposition of americium-241 oxide following inhalation by beagles

DOE Office of Scientific and Technical Information (OSTI.GOV)

Craig, D.K.; Park, J.F.; Powers, G.J.

1979-06-01

The disposition of americium-241 in beagles was followed for up to 810 days after a single inhalation exposure to /sup 241/AmO/sub 2/ aerosols having an activity median aerodynamic diameter (AMAD) of 1.3 ..mu..m and a geometric standard deviation 8GSD) of 1.8 for medium (approx. 40 nCi/liter) and high (approx. 340 nCi/liter) concentrations. At low concentrations (< 1 nCi/liter), the aerosols were smaller (AMAD approx. 0.6 ..mu..m) and the distribution broader (GSD approx. 2.6). Excreta were analyzed for up to 30 days postexposure and where appropriate, during the last week before sacrifice. Tissue analyses for /sup 241/Am were conducted on groupsmore » of three dogs sacrificed 10, 30, 90, 270, and 810 days postexposure. Forty percent of the final body burden of /sup 241/Am was located in tissues other than the lung parenchyma by 10 days postexposure and only 6% remained in the lung by 810 days postexposure. Translocation was primarilly to the liver and skeleton, with roughly equal fractions of the final body burden in each at all postexposure sacrifice times. There in the gonads was negligible (< 0.05%) for these dogs. Both the rate of translocation and the organ distribution as a function of time are different from those found in dogs that inhaled /sup 238/PuO/sub 2/ or /sup 239/PuO/sub 2/. Therefore it is not appropriate to use data derived from /sup 239/PuO/sub 2/ experiments or observations to predict the behavior of other transuranic isotopes and elements.« less

Factors affecting the availability of americium-241 to the rice plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Adriano, D.C.

1979-11-01

Since there has been no published transuranic uptake data on the rice plant (Oryza sativa L.), greenhouse experiments were conducted to determine the effects of some factors on the uptake of /sup 241/Am by this crop. Results indicate that chelated /sup 241/Am (in the form of americium-241-diethylenetriaminepentaacetic acid) applied to the flood water was markedly taken up by the rice plant, compared to the nonchelated form. However, most of the accumulation of /sup 241/Am occurred in the vegetative parts and only trace amounts, if any, were translocated to the grain. Soil application of /sup 241/Am resulted in much lower uptake.more » Soil amendment with either diethylenetriaminepentaacetic acid (DTPA) or organic matter did not produce a discernible uptake pattern. A synthesis of published data on plant uptake of /sup 241/Am indicates that the concentration ratio (CR, a measure of availability of /sup 241/Am to the plants) values for /sup 241/Am for agricultural crops ranged from 10-/sup 6/ to 10/sup 1/ (from lowest to highest availability). Some factors that appear to influence /sup 241/Am uptake are as follows: plant parts (grain usually having lower CR), chelating agents (DTPA usually increasing the CR), organic matter (inconsistent effects although generally decreasing the CR), and lime (usually decreasing the CR).« less

Podoconiosis patients’ willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery

PubMed Central

2014-01-01

Background Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient’s willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. Methods A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n = 393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. Results The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. Conclusions The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government’s primary health care system. PMID:24642085

Introducing an enhanced recovery programme to an established totally intracorporeal robot-assisted radical cystectomy service.

PubMed

Collins, Justin W; Adding, Christofer; Hosseini, Abolfazl; Nyberg, Tommy; Pini, Giovannalberto; Dey, Linda; Wiklund, Peter N

2016-01-01

The aim of this study was to assess the effect of introducing an enhanced recovery programme (ERP) to an established robot-assisted radical cystectomy (RARC) service. Data were prospectively collected on 221 consecutive patients undergoing totally intracorporeal RARC between December 2003 and May 2014. The ERP was specifically designed to support an evolving RARC service, where increasing proportions of patients requiring radical cystectomy underwent RARC. Patient demographics and outcomes before and after implementation of the ERP were compared. The primary endpoint was length of stay (LOS). Secondary outcomes included age, American Society of Anesthesiologists (ASA) score, preoperative staging, operative time, complications and readmissions. Differences in outcomes between patients before and after implementation of ERP were tested with the Jonckheere-Terpstra trend test and quantile regression with backward selection. Following implementation of the ERP, the demographics of the patients (n = 135) changed, with median age increasing from 66 to 70 years (p < 0.01), higher ASA grade (p < 0.001), higher preoperative stage cancer (pT ≥ 2, p < 0.05) and increased likelihood of undergoing an ileal conduit diversion (p < 0.001). Median LOS before ERP was 9 days [interquartile range (IQR) 8-13 days] and after ERP was 8 days (IQR 6-10 days) (p < 0.001). ASA grade and neoadjuvant chemotherapy also affected LOS (p < 0.05 and p < 0.01, respectively). There was no significant difference in 30 day complication rates, readmission rates or 90 day mortality, with 59% experiencing complications before ERP implementation and 57% after implementation. The majority of complications were low grade. Patient demographics changed as the RARC service evolved from selected patients to a general service. Despite worsening demographics, LOS decreased following ERP implementation. This evidence-based ERP safely standardized perioperative care, resulting in decreased LOS and decreased

Use of DTPA for increasing the rate of elimination of plutonium-238 and americium-241 from rodents after their inhalation as the nitrates.

PubMed

Stather, J W; Stradling, G N; Gray, S A; Moody, J; Hodgson, A

1985-11-01

This study has shown that: both inhaled (2 mumol/kg) and injected (30 mumol/kg) diethylenetriaminepenta-acetic acid (DTPA) can reduce the lung deposit of 238 Pu and 241 Am inhaled as nitrate to about 1% of that in untreated controls; injection of DTPA is more effective than aerosolized DTPA for reducing deposits of 238Pu and 241Am in the liver and skeleton; combined treatment involving early inhalation of DTPA followed by repeated intravenous injections is likely to be the most effective treatment for workers who have accidentally inhaled plutonium and americium nitrates.

Elements That Define Recovery: The Experiential Perspective

PubMed Central

Kaskutas, Lee Ann; Borkman, Thomasina J; Laudet, Alexandre; Ritter, Lois A; Witbrodt, Jane; Subbaraman, Meenakshi Sabina; Stunz, Aina; Bond, Jason

2014-01-01

Objective: Although recovery increasingly guides substance use disorder services and policy, definitions of recovery continue to lack specificity, thereby hindering measure development and research. The goal of this study was to move the substance use disorders field beyond broad definitions by empirically identifying the domains and specific elements of recovery as experienced by persons in recovery from diverse pathways. Method: An Internet-based survey was completed by 9,341 individuals (54% female) who self-identified as being in recovery, recovered, in medication-assisted recovery, or as having had a problem with alcohol or drugs (but no longer do). Respondents were recruited via extensive outreach with treatment and recovery organizations, electronic media, and self-help groups. The survey included 47 recovery elements developed through qualitative work followed by an iterative reduction process. Exploratory and confirmatory factor analyses were conducted using split-half samples, followed by sensitivity analyses for key sample groupings. Results: Four recovery domains with 35 recovery elements emerged: abstinence in recovery, essentials of recovery, enriched recovery, and spirituality of recovery. The four-factor structure was robust regardless of length of recovery, 12-step or treatment exposure, and current substance use status. Four uncommon elements did not load on any factor but are presented to indicate the diversity of definitions. Conclusions: Our empirical findings offer specific items that can be used in evaluating recovery-oriented systems of care. Researchers studying recovery should include measures that extend beyond substance use and encompass elements such as those examined here—e.g., self-care, concern for others, personal growth, and developing ways of being that sustain change in substance use. PMID:25343658

Solution speciation of plutonium and Americium at an Australian legacy radioactive waste disposal site.

PubMed

Ikeda-Ohno, Atsushi; Harrison, Jennifer J; Thiruvoth, Sangeeth; Wilsher, Kerry; Wong, Henri K Y; Johansen, Mathew P; Waite, T David; Payne, Timothy E

2014-09-02

During the 1960s, radioactive waste containing small amounts of plutonium (Pu) and americium (Am) was disposed in shallow trenches at the Little Forest Burial Ground (LFBG), located near the southern suburbs of Sydney, Australia. Because of periodic saturation and overflowing of the former disposal trenches, Pu and Am have been transferred from the buried wastes into the surrounding surface soils. The presence of readily detected amounts of Pu and Am in the trench waters provides a unique opportunity to study their aqueous speciation under environmentally relevant conditions. This study aims to comprehensively investigate the chemical speciation of Pu and Am in the trench water by combining fluoride coprecipitation, solvent extraction, particle size fractionation, and thermochemical modeling. The predominant oxidation states of dissolved Pu and Am species were found to be Pu(IV) and Am(III), and large proportions of both actinides (Pu, 97.7%; Am, 86.8%) were associated with mobile colloids in the submicron size range. On the basis of this information, possible management options are assessed.

Americium characterization by X-ray fluorescence and absorption spectroscopy in plutonium uranium mixed oxide

NASA Astrophysics Data System (ADS)

Degueldre, Claude; Cozzo, Cedric; Martin, Matthias; Grolimund, Daniel; Mieszczynski, Cyprian

2013-06-01

Plutonium uranium mixed oxide (MOX) fuels are currently used in nuclear reactors. The actinides in these fuels need to be analyzed after irradiation for assessing their behaviour with regard to their environment and the coolant. In this work the study of the atomic structure and next-neighbour environment of Am in the (Pu,U)O2 lattice in an irradiated (60 MW d kg-1) MOX sample was performed employing micro-X-ray fluorescence (µ-XRF) and micro-X-ray absorption fine structure (µ-XAFS) spectroscopy. The chemical bonds, valences and stoichiometry of Am (˜0.66 wt%) are determined from the experimental data gained for the irradiated fuel material examined in its peripheral zone (rim) of the fuel. In the irradiated sample Am builds up as Am3+ species within an [AmO8]13- coordination environment (e.g. >90%) and no (<10%) Am(IV) or (V) can be detected in the rim zone. The occurrence of americium dioxide is avoided by the redox buffering activity of the uranium dioxide matrix.

Ride 2 Recovery's Project HERO: using cycling as part of rehabilitation.

PubMed

Springer, Barbara A

2013-05-01

Ride 2 Recovery was founded in 2008 by a former world-class cycling competitor and coach to enhance the physical and psychological recovery of our nation's wounded, ill and injured service members and veterans through the sport of cycling. Ride 2 Recovery's most notable endeavor is Project HERO (Healing Exercise Rehabilitation Opportunity) which uses staff members and volunteers to promote cycling as an integral part of rehabilitation at select military facilities to enhance physical, psychological, spiritual and social recovery. Project HERO is directed by a retired military physical therapist that spent the last decade caring for service men and women wounded in Iraq and Afghanistan. This article describes all facets of the Project HERO initiative and highlights the profound impact it has had in the lives of US military members and veterans. Copyright © 2012 Elsevier Ltd. All rights reserved.

Recovery in Canada: Toward social equality

PubMed Central

PIAT, MYRA; SABETTI, JUDITH

2016-01-01

This article reviews evolution of the recovery paradigm in Canadian mental health. We first trace the origins and development of the recovery concept through the literature, followed by an examination of how the recovery concept has been implemented in national and provincial mental health policy since publication of the 2006 Kirby Commission Report. Based on consultations with Canadian policymakers, and an examination of available policy documents, we explore how the dual theme of ‘recovery’ and ‘well-being’, adopted by the Mental Health Commission of Canada in its 2009 strategy: Toward Recovery and Well-being - A Framework For a Mental Health Strategy has subsequently played out in mental health policymaking at the provincial level. Findings reveal mixed support for recovery as a guiding principle for mental health reform in Canada. While policies in some provinces reflect widespread support for recovery, and strong identification with the aspirations of the consumer movement; other provinces have shifted to population-based, wellness paradigms that privilege evidence-based services and professional expertise. The recognition of social equality for people who experience mental illness emerges as an important value in Canadian mental health policy, cutting across the conceptual divide between recovery and well-being. PMID:22385423

Perspectives of people who are deaf and hard of hearing on mental health, recovery, and peer support.

PubMed

Cabral, Linda; Muhr, Kathy; Savageau, Judith

2013-12-01

This qualitative study sought to better understand the experiences of deaf and hard of hearing individuals with accessing recovery-oriented mental health services and peer support via a focus group and interviews. Cultural brokers were used to facilitate culturally-sensitive communication with study participants. Findings indicate that access to adequate mental health services, not just recovery-oriented and peer support services, is not widely available for this population, largely due to communication barriers. Feelings of isolation and stigma are high among this population. Public mental health systems need to adapt and expand services for various cultural groups to insure recovery.

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

15 CFR 971.203 - Commercial recovery plan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Applications Contents... requirements for resource assessment and logical mining unit (§ 971.501); (6) A description of the methods and...

15 CFR 971.203 - Commercial recovery plan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Applications Contents... requirements for resource assessment and logical mining unit (§ 971.501); (6) A description of the methods and...

Mental health care reforms in Asia: the urgency of now: building a recovery-oriented, community mental health service in china.

PubMed

Tse, Samson; Ran, Mao-Sheng; Huang, Yueqin; Zhu, Shimin

2013-07-01

For the first time in history, China has a mental health legal framework. People in China can now expect a better life and more accessible, better-quality health care services for their loved ones. Development of a community mental health service (CMHS) is at a crossroads. In this new column on mental health reforms in Asia, the authors review the current state of the CMHS in China and propose four strategic directions for future development: building on the strengths of the "686 Project," the 2004 initiative that launched China's mental health reform; improving professional skills of the mental health workforce, especially for a recovery approach; empowering families and caregivers to support individuals with severe mental illness; and using information and communications technology to promote self-help and reduce the stigma associated with psychiatric disorders.

42 CFR 412.76 - Recovery of excess transition period payment amounts resulting from unlawful claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... 42 Public Health 2 2010-10-01 2010-10-01 false Recovery of excess transition period payment... System for Inpatient Operating Costs § 412.76 Recovery of excess transition period payment amounts...

5 CFR 831.1208 - Termination of disability annuity because of recovery.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of recovery. 831.1208 Section 831.1208 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Disability Retirement § 831.1208 Termination of disability annuity because of recovery. (a) Each annuitant receiving disability annuity from the Fund shall...

The lived experience of art making as a companion to the mental health recovery process.

PubMed

Van Lith, Theresa; Fenner, Patricia; Schofield, Margot

2011-01-01

Art making is a common activity provided for consumers in mental health psychosocial rehabilitation services, yet there is little evidence available which examines its role in the recovery process. The current study inquires into mental health consumers' lived experiences of art making within psychosocial rehabilitation services and their views on how art making supports mental health recovery. This research used qualitative in-depth interviews to explore the role of art making in the mental health recovery journey. The sample comprised 18 consumer participants who attended art-based programs in two psychosocial services in Victoria, Australia. The 60-90 min interviews were analysed using interpretative phenomenological analysis. A total of 11 major themes were identified and organised into three areas: qualities conducive to the art making context, how the art making process benefits mental health recovery, and how the image or art product benefits mental health recovery. The 11 themes are described and illustrated from participant interviews. Consumers described art making as a transformative activity which enabled them to take greater control of their lives, resulting in feeling stronger, more confident, and more capable of driving their journey of recovery. The art product also served valuable roles in supporting their recovery. Art making is a highly valued activity by consumers, who suggest that innovative and strengths-based methods, such as art making, can facilitate recovery and self-expression. A key challenge for the field is to determine how such methods can be better integrated into mental health service delivery.

77 FR 22760 - Endangered and Threatened Species; Notice of Intent To Update a Recovery Plan for the Blue Whale...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-17

... Recovery Plan for the North Pacific Right Whale AGENCY: National Marine Fisheries Service (NMFS), National... recovery plans; request for information. SUMMARY: The National Marine Fisheries Service (NMFS) is... ESA. The recovery planning process is guided by the statutory language of Section 4(f) of the ESA and...

Interdependent recovery of adults with schizophrenia: Asian American consumer perspectives of family involvement and influence.

PubMed

Lee, Karen Kyeunghae; Yamada, Ann-Marie; Kim, Min Ah; Dinh, Tam Q

2015-09-01

Family involvement is important in the recovery experience of culturally diverse adults with schizophrenia. However, little is known about the influence of family among consumers purported to have close family ties without regular contact. This study explored Asian American consumers' views about family relationships and participation in their recovery. Secondary analysis of qualitative data from a larger project was conducted to explore family related themes of 8 Asian Americans receiving services from recovery-focused programs in urban Southern California. Most consumers described their family support as adequate while simultaneously reporting limited family involvement. Asia-born and U.S.-born Asian consumers varied in describing family support, suggesting providers consider nativity in culturally responsive service delivery. Families need not be present to affect the perspectives of Asian Americans receiving recovery-oriented services. The extent of family influences on recovery, beyond the initial determination of current family contact, requires further exploration. (c) 2015 APA, all rights reserved).

26 CFR 1.43-2 - Qualified enhanced oil recovery project.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Qualified enhanced oil recovery project. 1.43-2 Section 1.43-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME... the tertiary recovery method; or (ii) Test or experimental injections. (2) Example. The following...

26 CFR 1.43-2 - Qualified enhanced oil recovery project.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Qualified enhanced oil recovery project. 1.43-2 Section 1.43-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME... the tertiary recovery method; or (ii) Test or experimental injections. (2) Example. The following...

Total Value of Phosphorus Recovery.

PubMed

Mayer, Brooke K; Baker, Lawrence A; Boyer, Treavor H; Drechsel, Pay; Gifford, Mac; Hanjra, Munir A; Parameswaran, Prathap; Stoltzfus, Jared; Westerhoff, Paul; Rittmann, Bruce E

2016-07-05

Phosphorus (P) is a critical, geographically concentrated, nonrenewable resource necessary to support global food production. In excess (e.g., due to runoff or wastewater discharges), P is also a primary cause of eutrophication. To reconcile the simultaneous shortage and overabundance of P, lost P flows must be recovered and reused, alongside improvements in P-use efficiency. While this motivation is increasingly being recognized, little P recovery is practiced today, as recovered P generally cannot compete with the relatively low cost of mined P. Therefore, P is often captured to prevent its release into the environment without beneficial recovery and reuse. However, additional incentives for P recovery emerge when accounting for the total value of P recovery. This article provides a comprehensive overview of the range of benefits of recovering P from waste streams, i.e., the total value of recovering P. This approach accounts for P products, as well as other assets that are associated with P and can be recovered in parallel, such as energy, nitrogen, metals and minerals, and water. Additionally, P recovery provides valuable services to society and the environment by protecting and improving environmental quality, enhancing efficiency of waste treatment facilities, and improving food security and social equity. The needs to make P recovery a reality are also discussed, including business models, bottlenecks, and policy and education strategies.

CMPO purity tests in the TRUEX solvent using americium-241

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brewer, K.N.; Herbst, R.S.; Tranter, T.J.

1993-12-01

The Transuranic Extraction (TRUEX) Process was developed by E.P. Horwitz and coworkers at Argonne National Laboratory (ANL) to separate the +4, +6, and +3 actinides from acidic aqueous solutions of nuclear wastes. Octyl (phenyl)-N-N-diisobutyl-carbamoylmethylphosphine oxide (CMPO) is the active actinide complexant used in the TRUEX solvent. CMPO is combined with tributyl phosphate (TBP) in an organic diluent, typically n-dodecane, to form the TRUEX solvent. Small quantities of impurities in the CMPO resulting from: (1) synthesis, (2) acid hydrolysis, or (3) radiolysis can result in actinide stripping problems from the solvent. The impurity, octylphenylphosphinic acid (POPPA), ia a powerful extractant atmore » low acid concentrations which may be formed during CMPO synthesis. Consequently, commercial CMPO may contain sufficient quantities of POPPA to significantly impact the stripping of actinides from the TRUEX solvent. The purpose of these tests was to (1) determine if commercially available CMPO is sufficiently pure to alleviate actinide stripping problems from the TRUEX process and (2) to determine if solvent cleanup methods are sufficient to purify the commercially purchased CMPO. Extraction and solvent cleanup methodologies used by Horwitz and coworkers at ANL were used to determine CMPO purity with {sup 241}Am. The improvement of the americium distribution coefficient in dilute nitric acid resulting from further purifying this CMPO is not significant enough to warrant additional CMPO purifying steps. The commercially purchased CMPO is found to be acceptable to use, as received, in a full-scale TRUEX process.« less

Impact of Illness Management and Recovery Programs on Hospital and Emergency Room Use by Medicaid Enrollees

PubMed Central

Salyers, Michelle P.; Rollins, Angela L.; Clendenning, Daniel; McGuire, Alan B.; Kim, Edward

2011-01-01

Objective Illness management and recovery is a structured program that helps consumers with severe mental illness learn effective ways to manage illness and pursue recovery goals. This study examined the impact of the program on health service utilization. Methods This was a retrospective cohort study of five assertive community treatment (ACT) teams in Indiana that implemented illness management and recovery. With Medicaid claims data from July 1, 2003, to June 30, 2008, panel data were created with person-months as the level of analysis, resulting in 14,261 observations, for a total of 498 unique individuals. Zero-inflated negative binomial regression models were used to predict hospitalization days and emergency room visits, including covariates of demographic characteristics, employment status, psychiatric diagnosis, and concurrent substance use disorder. The main predictor variables of interest were receipt of illness management and recovery services, dropout from the program, and program graduation status. Results Consumers who received some illness management and recovery services had fewer hospitalization days than those receiving only ACT. Graduates had fewer emergency room visits than did ACT-only consumers. Conclusions This is the first study to examine the impact of illness management and recovery on service utilization. Controlling for a number of background variables, the study showed that illness management and recovery programs were associated with reduced inpatient hospitalization and emergency room use over and above ACT. PMID:21532077

General Services Administration Semiannual Regulatory Agenda

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-20

... products and services to be used to facilitate recovery from a major disaster declared by the President or... Services Administration Semiannual Regulatory Agenda] Part XVI General Services Administration Semiannual Regulatory Agenda [[Page 79860

The Stigma of Mental Illness and Recovery.

PubMed

Avdibegović, Esmina; Hasanović, Mevludin

2017-12-01

Stigma and recovery "from" and "in" mental illness are associated in many various ways. While recovery gives opportunities, makes person stronger, gives purpose and meaning to their lives and leads to social inclusion, in the same time stigma reduces opportunities, reduces self-esteem and self-efficacy, reduces the belief in own abilities and contributes to social exclusion through discrimination. The recovery of a person with mental illness means to get and keep hope, to understand their own possibilities and impossibilities, active living, to be autonomous, to have a social identity and to give meaning and purpose of our own lives. The care system, recovery-oriented, provides help and support to people with mental disorders in his/her recovery, which contributes to reduction of self-stigma, to the elimination of stigmatizing attitudes and beliefs in mental health services which consequently may have a positive reflection in reducing the stigma of mental illness in the community. It is important to look at the stigma and recovery from the perspective of individual experience of each person with a mental illness in the process of recovery. A support to the recovery concept and the development of a recovery-oriented system of care should be one of the key segments of any strategy to combat the stigma of mental illness. Also, the cultural and the social stigma aspects of stigma would be taken into account in the developing of the recovery concept and on the recovery-oriented care system.

75 FR 39916 - Endangered and Threatened Species; Notice of Intent to Prepare a Recovery Plan for the Sei Whale

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... Fisheries Service (NMFS) is announcing its intent to prepare a recovery plan for the Sei Whale (Balaenoptera... the fax comments as ``Sei Whale Recovery Plan Information'' 3. Mail: National Marine Fisheries Service... and Threatened Species; Notice of Intent to Prepare a Recovery Plan for the Sei Whale AGENCY: National...

Understanding recovery in the context of lived experience of personality disorders: a collaborative, qualitative research study.

PubMed

Gillard, Steve; Turner, Kati; Neffgen, Marion

2015-07-31

Concepts of recovery increasingly inform the development and delivery of mental health services internationally. In the UK recent policy advocates the application of recovery concepts to the treatment of personality disorders. However diagnosis and understanding of personality disorders remains contested, challenging any assumption that mainstream recovery thinking can be directly translated into personality disorders services. In a qualitative interview-based study understandings of recovery were explored in extended, in-depth interviews with six people purposively sampled from a specialist personality disorders' service in the UK. An interpretive, collaborative approach to research was adopted in which university-, clinical- and service user (consumer) researchers were jointly involved in carrying out interviews and analysing interview data. Findings suggested that recovery cannot be conceptualised separately from an understanding of the lived experience of personality disorders. This experience was characterised by a complexity of ambiguous, interrelating and conflicting feelings, thoughts and actions as individuals tried to cope with tensions between internally and externally experienced worlds. Our analysis was suggestive of a process of recovering or, for some, discovering a sense of self that can safely coexist in both worlds. We conclude that key facilitators of recovery - positive personal relationships and wider social interaction - are also where the core vulnerabilities of individuals with lived experience of personaility disorders can lie. There is a role for personality disorders services in providing a safe space in which to develop positive relationships. Through discursive practice within the research team understandings of recovery were co-produced that responded to the lived experience of personality disorders and were of applied relevance to practitioners.

Part 2: Screening, Brief Intervention and Referral to Treatment Plus Recovery Management: A Proposed Model for Recovery-Oriented Primary Care.

PubMed

Fornili, Katherine S

2016-01-01

Part 1 of this two-part series (The Theoretical Basis for Recovery-Oriented Management of Substance Use Disorders in the Primary Care) explored the theoretical foundations for evidence-based substance Screening, Brief Intervention and Referral to Treatment (SBIRT) services. The aim was to produce possible explanations for why traditional SBIRT works well for individuals with unhealthy alcohol use but not as well for individuals who have more serious substance use disorders, including drug use and alcohol/drug dependence. Building on that analysis, through meaningful application of recovery management (RM) concepts within an integrated primary care/behavioral health context, a new, theory-based, recovery-oriented framework for primary care SBIRT is now introduced in Part 2. The proposed SBIRT Plus Recovery Management (SBIRT + RM) model moves traditional SBIRT from its original, limited, and narrow focus only on substance detection, brief intervention, and referral to its rightful, structured placement within a comprehensive, multidimensional, recovery-oriented system of care clinical practice environment. SBIRT+RM describes relevant strategies for improving recovery outcomes for individuals identified through primary care substance screening and defines primary care provider roles and responsibilities for sustained recovery support and long-term recovery maintenance.

The twelve-step recovery model of AA: a voluntary mutual help association.

PubMed

Borkman, Thomasina

2008-01-01

Alcoholism treatment has evolved to mean professionalized, scientifically based rehabilitation. Alcoholics Anonymous (AA) is not a treatment method; it is far better understood as a Twelve-Step Recovery Program within a voluntary self-help/mutual aid organization of self-defined alcoholics. The Twelve-Step Recovery Model is elaborated in three sections, patterned on the AA logo (a triangle within a circle): The triangle's legs represent recovery, service, and unity; the circle represents the reinforcing effect of the three legs upon each other as well as the "technology" of the sharing circle and the fellowship. The first leg of the triangle, recovery, refers to the journey of individuals to abstinence and a new "way of living." The second leg, service, refers to helping other alcoholics which also connects the participants into a fellowship. The third leg, unity, refers to the fellowship of recovering alcoholics, their groups, and organizations. The distinctive AA organizational structure of an inverted pyramid is one in which the members in autonomous local groups direct input to the national service bodies creating a democratic, egalitarian organization maximizing recovery. Analysts describe the AA recovery program as complex, implicitly grounded in sound psychological principles, and more sophisticated than is typically understood. AA provides a nonmedicalized and anonymous "way of living" in the community and should probably be referred to as the Twelve-Step/Twelve Tradition Recovery Model in order to clearly differentiate it from professionally based twelve-step treatments. There are additional self-help/mutual aid groups for alcoholics who prefer philosophies other than AA.

21 CFR 1271.215 - Recovery.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Recovery. 1271.215 Section 1271.215 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND CELLULAR AND...

31 CFR 361.10 - Recoveries.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Recoveries. 361.10 Section 361.10 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT CLAIMS PURSUANT TO THE GOVERNMENT LOSSES IN SHIPMENT ACT...

Success in Online Credit Recovery: Factors Influencing Student Academic Performance

ERIC Educational Resources Information Center

Nourse, David

2017-01-01

Recent estimates show nearly 90% of school districts nationwide offer some form of online credit recovery. Additionally, credit recovery services have become one of the fastest growing areas of educational software. Despite the widespread adoption of these programs, there is a lack of scholarly research on the effectiveness, rigor, and suitability…

42 CFR 405.355 - Waiver of adjustment or recovery.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Waiver of adjustment or recovery. 405.355 Section 405.355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

42 CFR 405.355 - Waiver of adjustment or recovery.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Waiver of adjustment or recovery. 405.355 Section 405.355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

75 FR 17758 - Approved Recovery Plan for the Scaleshell Mussel

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R3-ES-2010-N058; 30120-1113-0000 D2] Approved Recovery Plan for the Scaleshell Mussel AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of document availability. [[Page 17759

Implementing program-wide awareness about recovery in a large mental health and addictions program.

PubMed

McVanel-Viney, Sarah; Younger, Jodi; Doyle, Winnie; Kirkpatrick, Helen

2006-01-01

St. Joseph's Healthcare Hamilton conceptualized a multi-step plan for implementing a recovery oriented service delivery approach within their Mental Health and Addictions Program. This brief report discusses the first phase of this plan which included building awareness of recovery utilizing Anthony's (2000) system standards to develop a needs assessment for managers and senior team members. The survey had three purposes: to increase managers' awareness about recovery; to allow managers to express concerns that they had with this paradigm; and to afford managers an opportunity to explore the ways in which their service was and was not operating in a recovery oriented way. Initiatives designed to build awareness throughout the program are discussed.

42 CFR 411.24 - Recovery of conditional payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Medicare claims processing and for coordination of benefits purposes. (b) Right to initiate recovery. CMS... items and services furnished before October 31, 1994, CMS charges interest, exercising common law...

Cross-Validation of Mental Health Recovery Measures in a Hong Kong Chinese Sample

ERIC Educational Resources Information Center

Ye, Shengquan; Pan, Jia-Yan; Wong, Daniel Fu Keung; Bola, John Robert

2013-01-01

Objectives: The concept of recovery has begun shifting mental health service delivery from a medical perspective toward a client-centered recovery orientation. This shift is also beginning in Hong Kong, but its development is hampered by a dearth of available measures in Chinese. Method: This article translates two measures of recovery (mental…

75 FR 34279 - Federal Acquisition Regulation; FAR Case 2009-011, American Recovery and Reinvestment Act of 2009...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

..., Sequence 1] RIN 9000-AL20 Federal Acquisition Regulation; FAR Case 2009-011, American Recovery and Reinvestment Act of 2009 (Recovery Act)--GAO/IG Access AGENCIES: Department of Defense (DoD), General Services... DEPARTMENT OF DEFENSE GENERAL SERVICES ADMINISTRATION NATIONAL AERONAUTICS AND SPACE...

Written plans: an overlooked mechanism to develop recovery-oriented primary care for depression?

PubMed

Palmer, Victoria J; Johnson, Caroline L; Furler, John S; Densley, Konstancja; Potiriadis, Maria; Gunn, Jane M

2014-01-01

There is a global shift to foster patient-centred and recovery-oriented mental health services. This has resulted from the expansion of how the concept of recovery is understood in mental health literature and practice. Recovery is now more than a return to function or reduction in symptoms; it is a subjective, individualised and multi-faceted experience. To date there has not been investigation of how recovery-oriented services can be translated and implemented into the primary mental health care system. This paper presents the results of a survey from a prospective cohort of primary care patients with probable depression about the importance of written plans to recover. The benefits of having a written plan to recover from depression, as outlined by the participants, were analysed using Leximancer software. The findings provide insights into how written plans may be an important mechanism for implementing a recovery-oriented primary mental health care system. We conclude that the benefits of a written plan provide insight into how patients conceptualise recovery.

Evaluation of the United States Public Health Service guidelines for discontinuation of anti-CMV therapy after immune recovery in patients with CMV retinitis

PubMed Central

Holbrook, Janet T.; Colvin, Ryan; Van Natta, Mark L.; Thorne, Jennifer E.; Bardsley, Mark; Jabs, Douglas A.

2011-01-01

Purpose To evaluate US Public Health Service (USPHS) guidelines for discontinuing anti-CMV therapy in patients with AIDS who have immune recovery and quiescent retinitis after initiating highly active anti-retroviral therapy (HAART). Design Cohort study of patients with CMV retinitis (Longitudinal Study of Ocular Complications of AIDS). Methods Participants had CMV retinitis and CD4+ T-cell counts of 50 cells/uL or fewer enrolled from 1998 to 2009 who demonstrated sustained immune recovery (two consecutive CD4+ T-cell counts of 100 cells/uL or more at least 6 months apart) and inactive retinitis. Participants were classified into 2 groups according to anti-CMV treatment after immune recover: (1) continued anti-CMV therapy and (2) discontinued therapy. We evaluated survival, visual acuity, and CMV retinitis activity; we employed propensity scores to adjust for confounding factors for these analyses. Results Of 152 participants reviewed, 71 demonstrated immune recovery; 37 of whom discontinued therapy and 34 who continued therapy. At immune recovery, participants continuing therapy tended to be older (44 vs 40 years, P=0.09), have bilateral retinitis (53% vs 32%, P=0.10), and have lower CD4+ T-cell counts (148 vs 207 cells/μL, P<0.001). There were no statistical differences in any of the clinical outcomes (death, retinitis progress, visual acuity or incidence of bilateral retinitis). Both groups lost visual acuity during follow-up, on average 1.2 letters per year (P<0.01). Conclusion Discontinuation of anti-CMV therapy after immune recovery did not increase the risk of poor outcomes. These results support the current guidelines for discontinuation of anti-CMV therapy after achievement of sustained immune recovery. PMID:21742304

Social Stressors at Work, Sleep, and Recovery.

PubMed

Pereira, Diana; Gross, Sven; Elfering, Achim

2016-03-01

Many employees in service work are required to work on Saturdays, recovering during work-free Sundays and working again Mondays. We examined the effects of social stressors at work on recovery status at Sunday noon and Monday noon, and investigated if sleep quality mediates the negative effects of social stressors at work on recovery. From Saturday until Monday morning, 41 participants wore actigraphs to measure sleep duration and sleep fragmentation. Social stressors at work were assessed by self-reported questionnaires administered on Saturday. Recovery status was reported Sunday noon and Monday noon. Hierarchical regression analysis revealed that social stressors at work were negatively related to recovery status on Sunday and on Monday. Supporting our assumptions, more social stressors at work predicted higher sleep fragmentation in the night to Monday. A mediation effect of sleep quality, however, was not found. Theoretical and practical implications of these results are discussed.

Love and Service in Adolescent Addiction Recovery

PubMed Central

Lee, Matthew T.; Pagano, Maria E.; Johnson, Byron R.; Post, Stephen G.

2016-01-01

This article is one of the first to examine the relationships among a specific combination of “spiritual virtues” (helping others and the experience of divine love) and outcomes related to criminal involvement, sobriety, and character development among adolescents. One-hundred ninety five adolescents with substance dependency court-referred to residential treatment were assessed at intake, discharge, and 6 months post-treatment. Higher service to others predicted reduced recidivism, reduced relapse, and greater character development. Experiencing divine love enhanced the effect of service on recidivism. Greater attention to spiritual virtues might improve treatment for youth involved with alcohol, drugs, and certain forms of crime. PMID:27482142

On-Campus Programs to Support College Students in Recovery

ERIC Educational Resources Information Center

Misch, Donald A.

2009-01-01

The author argues that referral of alcohol-abusing college students to off-campus treatment services, although necessary for some, is not optimal for many. He advocates the implementation of comprehensive on-campus services for students committed to recovery in order to optimize their treatment while allowing them to remain in school and work…

Evaluating the INSPIRE measure of staff support for personal recovery in a Swedish psychiatric context.

PubMed

Schön, Ulla-Karin; Svedberg, Petra; Rosenberg, David

2015-05-01

Recovery is understood to be an individual process that cannot be controlled, but can be supported and facilitated at the individual, organizational and system levels. Standardized measures of recovery may play a critical role in contributing to the development of a recovery-oriented system. The INSPIRE measure is a 28-item service user-rated measure of recovery support. INSPIRE assesses both the individual preferences of the user in the recovery process and their experience of support from staff. The aim of this study was to evaluate the psychometric properties of the Swedish version of the INSPIRE measure, for potential use in Swedish mental health services and in order to promote recovery in mental illness. The sample consisted of 85 participants from six community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. For the test-retest evaluation, 78 participants completed the questionnaire 2 weeks later. The results in the present study indicate that the Swedish version of the INSPIRE measure had good face and content validity, satisfactory internal consistency and some level of instability in test-retest reliability. While further studies that test the instrument in a larger and more diverse clinical context are needed, INSPIRE can be considered a relevant and feasible instrument to utilize in supporting the development of a recovery-oriented system in Sweden.

26 CFR 1.168(a)-1 - Modified accelerated cost recovery system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Modified accelerated cost recovery system. 1.168(a)-1 Section 1.168(a)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY... Corporations § 1.168(a)-1 Modified accelerated cost recovery system. (a) Section 168 determines the...

26 CFR 1.168(a)-1 - Modified accelerated cost recovery system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Modified accelerated cost recovery system. 1.168(a)-1 Section 1.168(a)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY... Corporations § 1.168(a)-1 Modified accelerated cost recovery system. (a) Section 168 determines the...

26 CFR 1.168(a)-1 - Modified accelerated cost recovery system.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 2 2013-04-01 2013-04-01 false Modified accelerated cost recovery system. 1.168(a)-1 Section 1.168(a)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY... Corporations § 1.168(a)-1 Modified accelerated cost recovery system. (a) Section 168 determines the...

26 CFR 1.168(a)-1 - Modified accelerated cost recovery system.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 2 2012-04-01 2012-04-01 false Modified accelerated cost recovery system. 1.168(a)-1 Section 1.168(a)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY... Corporations § 1.168(a)-1 Modified accelerated cost recovery system. (a) Section 168 determines the...

26 CFR 1.168(a)-1 - Modified accelerated cost recovery system.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 2 2014-04-01 2014-04-01 false Modified accelerated cost recovery system. 1.168(a)-1 Section 1.168(a)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY... Corporations § 1.168(a)-1 Modified accelerated cost recovery system. (a) Section 168 determines the...

Supporting recovery by improving patient engagement in a forensic mental health hospital: results from a demonstration project.

PubMed

Livingston, James D; Nijdam-Jones, Alicia; Lapsley, Sara; Calderwood, Colleen; Brink, Johann

2013-01-01

Mental health services are shifting toward approaches that promote patients' choices and acknowledge the value of their lived experiences. To support patients' recovery and improve their experiences of care in a Canadian forensic mental health hospital, an intervention was launched to increase patient engagement by establishing a peer support program, strengthening a patient advisory committee, and creating a patient-led research team. The effect of the intervention on patient- and system-level outcomes was studied using a naturalistic, prospective, longitudinal approach. Quantitative and qualitative data were gathered from inpatients and service providers twice during the 19-month intervention. Despite succeeding in supporting patients' participation, the intervention had minimal impacts on internalized stigma, personal recovery, personal empowerment, service engagement, therapeutic milieu, and the recovery orientation of services. Peer support demonstrated positive effects on internalized stigma and personal recovery. Strengthening patient engagement contributes toward improving experiences of care in a forensic hospital, but it may have limited effects on outcomes.

Effective organizational transformation in psychiatric rehabilitation and recovery.

PubMed

Clossey, Laurene; Rowlett, Al

2008-01-01

The recovery model represents a new paradigm in the treatment of psychiatric disability. Many states have mandated the model's adoption by their public mental health agencies. As organizational transformation toward this new approach is rapidly occurring, guidance to make successful change is necessary. The recovery model is readily misunderstood and may be resisted by professional occupational cultures that perceive it as a threat to their expertise. Successful change agents need to understand likely sources of resistance to agency transformation, and be knowledgeable and skilled in organizational development to facilitate service conversion to the recovery model. Change agents need to carefully consider how to transform agency structure and culture and how to develop committed leadership that empowers staff. Recovery values and principles must infuse the entire organization. Guidelines to assist change agents are discussed and distilled through the example of a successful northern California recovery model mental health agency called Turning Point Community Programs. The guidance provided seeks to help make the recovery model portable across many types of mental health settings.

5 CFR 950.106 - PCFO expense recovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... VOLUNTARY ORGANIZATIONS General Provisions § 950.106 PCFO expense recovery. (a) The PCFO shall recover from... 950.106 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... shared proportionately by all the recipient organizations reflecting their percentage share of gross...

5 CFR 950.106 - PCFO expense recovery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... VOLUNTARY ORGANIZATIONS General Provisions § 950.106 PCFO expense recovery. (a) The PCFO shall recover from... 950.106 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... shared proportionately by all the recipient organizations reflecting their percentage share of gross...

5 CFR 950.106 - PCFO expense recovery.

Code of Federal Regulations, 2010 CFR

2010-01-01

... VOLUNTARY ORGANIZATIONS General Provisions § 950.106 PCFO expense recovery. (a) The PCFO shall recover from... 950.106 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... shared proportionately by all the recipient organizations reflecting their percentage share of gross...

5 CFR 950.106 - PCFO expense recovery.

Code of Federal Regulations, 2011 CFR

2011-01-01

... VOLUNTARY ORGANIZATIONS General Provisions § 950.106 PCFO expense recovery. (a) The PCFO shall recover from... 950.106 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... shared proportionately by all the recipient organizations reflecting their percentage share of gross...

5 CFR 950.106 - PCFO expense recovery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... VOLUNTARY ORGANIZATIONS General Provisions § 950.106 PCFO expense recovery. (a) The PCFO shall recover from... 950.106 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... shared proportionately by all the recipient organizations reflecting their percentage share of gross...

7 CFR 247.24 - Recovery and redistribution of caseload and administrative funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Recovery and redistribution of caseload and...) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS COMMODITY SUPPLEMENTAL FOOD PROGRAM § 247.24 Recovery and redistribution of caseload and administrative funds. (a) May FNS...

17 CFR 229.1108 - (Item 1108) Servicers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... charged for such advances and terms of recovery by the servicer of such advances. To the extent material...) State how long the servicer has been servicing assets. Provide, to the extent material, a general... material terms of the servicing agreement and the servicer's duties regarding the asset-backed securities...

17 CFR 229.1108 - (Item 1108) Servicers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... charged for such advances and terms of recovery by the servicer of such advances. To the extent material...) State how long the servicer has been servicing assets. Provide, to the extent material, a general... material terms of the servicing agreement and the servicer's duties regarding the asset-backed securities...

17 CFR 229.1108 - (Item 1108) Servicers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... charged for such advances and terms of recovery by the servicer of such advances. To the extent material...) State how long the servicer has been servicing assets. Provide, to the extent material, a general... material terms of the servicing agreement and the servicer's duties regarding the asset-backed securities...

17 CFR 229.1108 - (Item 1108) Servicers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... charged for such advances and terms of recovery by the servicer of such advances. To the extent material...) State how long the servicer has been servicing assets. Provide, to the extent material, a general... material terms of the servicing agreement and the servicer's duties regarding the asset-backed securities...

Logistic regression analysis of psychosocial correlates associated with recovery from schizophrenia in a Chinese community.

PubMed

Tse, Samson; Davidson, Larry; Chung, Ka-Fai; Yu, Chong Ho; Ng, King Lam; Tsoi, Emily

2015-02-01

More mental health services are adopting the recovery paradigm. This study adds to prior research by (a) using measures of stages of recovery and elements of recovery that were designed and validated in a non-Western, Chinese culture and (b) testing which demographic factors predict advanced recovery and whether placing importance on certain elements predicts advanced recovery. We examined recovery and factors associated with recovery among 75 Hong Kong adults who were diagnosed with schizophrenia and assessed to be in clinical remission. Data were collected on socio-demographic factors, recovery stages and elements associated with recovery. Logistic regression analysis was used to identify variables that could best predict stages of recovery. Receiver operating characteristic curves were used to detect the classification accuracy of the model (i.e. rates of correct classification of stages of recovery). Logistic regression results indicated that stages of recovery could be distinguished with reasonable accuracy for Stage 3 ('living with disability', classification accuracy = 75.45%) and Stage 4 ('living beyond disability', classification accuracy = 75.50%). However, there was no sufficient information to predict Combined Stages 1 and 2 ('overwhelmed by disability' and 'struggling with disability'). It was found that having a meaningful role and age were the most important differentiators of recovery stage. Preliminary findings suggest that adopting salient life roles personally is important to recovery and that this component should be incorporated into mental health services. © The Author(s) 2014.

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy.

PubMed

Egeland, Karina Myhren; Ruud, Torleif; Ogden, Terje; Färdig, Rickard; Lindstrøm, Jonas Christoffer; Heiervang, Kristin Sverdvik

2017-01-01

The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014.

An autonomous recovery mechanism against optical distribution network failures in EPON

NASA Astrophysics Data System (ADS)

Liem, Andrew Tanny; Hwang, I.-Shyan; Nikoukar, AliAkbar

2014-10-01

Ethernet Passive Optical Network (EPON) is chosen for servicing diverse applications with higher bandwidth and Quality-of-Service (QoS), starting from Fiber-To-The-Home (FTTH), FTTB (business/building) and FTTO (office). Typically, a single OLT can provide services to both residential and business customers on the same Optical Line Terminal (OLT) port; thus, any failures in the system will cause a great loss for both network operators and customers. Network operators are looking for low-cost and high service availability mechanisms that focus on the failures that occur within the drop fiber section because the majority of faults are in this particular section. Therefore, in this paper, we propose an autonomous recovery mechanism that provides protection and recovery against Drop Distribution Fiber (DDF) link faults or transceiver failure at the ONU(s) in EPON systems. In the proposed mechanism, the ONU can automatically detect any signal anomalies in the physical layer or transceiver failure, switching the working line to the protection line and sending the critical event alarm to OLT via its neighbor. Each ONU has a protection line, which is connected to the nearest neighbor ONU, and therefore, when failure occurs, the ONU can still transmit and receive data via the neighbor ONU. Lastly, the Fault Dynamic Bandwidth Allocation for recovery mechanism is presented. Simulation results show that our proposed autonomous recovery mechanism is able to maintain the overall QoS performance in terms of mean packet delay, system throughput, packet loss and EF jitter.

Processes of recovery through routine or specialist treatment for borderline personality disorder (BPD): a qualitative study.

PubMed

Katsakou, Christina; Pistrang, Nancy; Barnicot, Kirsten; White, Hayley; Priebe, Stefan

2017-07-04

Recovery processes in borderline personality disorder (BPD) are poorly understood. This study explored how recovery in BPD occurs through routine or specialist treatment, as perceived by service users (SUs) and therapists. SUs were recruited from two specialist BPD services, three community mental health teams, and one psychological therapies service. Semi-structured interviews were conducted with 48 SUs and 15 therapists. The "framework" approach was used to analyse the data. The findings were organized into two domains of themes. The first domain described three parallel processes that constituted SUs' recovery journey: fighting ambivalence and committing to taking action; moving from shame to self-acceptance and compassion; and moving from distrust and defensiveness to opening up to others. The second domain described four therapeutic challenges that needed to be addressed to support this journey: balancing self-exploration and finding solutions; balancing structure and flexibility; confronting interpersonal difficulties and practicing new ways of relating; and balancing support and independence. Therapies facilitating the identified processes may promote recovery. The recovery processes and therapeutic challenges identified in this study could provide a framework to guide future research.

Using appreciative inquiry to facilitate implementation of the recovery model in mental health agencies.

PubMed

Clossey, Laurene; Mehnert, Kevin; Silva, Sara

2011-11-01

This article describes an organizational development tool called appreciative inquiry (AI) and its use in mental health to aid agencies implementing recovery model services. AI is a discursive tool with the power to shift dominant organizational cultures. Its philosophical underpinnings emphasize values consistent with recovery: community, empowerment, and positive focus. Recent research in the field of mental health demonstrates the salience of organizational cultural context in affecting new service adoption. This article explores how AI could be helpful in shifting an organization's culture to render it compatible with recovery through descriptions of two mental health centers' use of the tool. The experiences described indicate that AI, if used consistently, empowers staff. The article concludes with consideration of the implications of this empowerment for recovery model implementation and directions for future research.

Development of the REFOCUS intervention to increase mental health team support for personal recovery.

PubMed

Slade, Mike; Bird, Victoria; Le Boutillier, Clair; Farkas, Marianne; Grey, Barbara; Larsen, John; Leamy, Mary; Oades, Lindsay; Williams, Julie

2015-12-01

There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking. To develop a theoretically based and empirically defensible new pro-recovery manualised intervention--called the REFOCUS intervention. Seven systematic and two narrative reviews were undertaken. Identified evidence gaps were addressed in three qualitative studies. The findings were synthesised to produce the REFOCUS intervention, manual and model. The REFOCUS intervention comprises two components: recovery-promoting relationships and working practices. Approaches to supporting relationships comprise coaching skills training for staff, developing a shared team understanding of recovery, exploring staff values, a Partnership Project with people who use the service and raising patient expectations. Working practices comprise the following: understanding values and treatment preferences; assessing strengths; and supporting goal-striving. The REFOCUS model describes the causal pathway from the REFOCUS intervention to improved recovery. The REFOCUS intervention is an empirically supported pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940). © The Royal College of Psychiatrists 2015.

Integrated risk and recovery monitoring of ecosystem restorations on contaminated sites

USGS Publications Warehouse

Hooper, Michael J.; Glomb, Stephen J.; Harper, David; Hoelzle, Timothy B.; McIntosh, Lisa M.; Mulligan, David R.

2016-01-01

Ecological restorations of contaminated sites balance the human and ecological risks of residual contamination with the benefits of ecological recovery and the return of lost ecological function and ecosystem services. Risk and recovery are interrelated dynamic conditions, changing as remediation and restoration activities progress through implementation into long-term management and ecosystem maturation. Monitoring restoration progress provides data critical to minimizing residual contaminant risk and uncertainty, while measuring ecological advancement toward recovery goals. Effective monitoring plans are designed concurrently with restoration plan development and implementation and are focused on assessing the effectiveness of activities performed in support of restoration goals for the site. Physical, chemical, and biotic measures characterize progress toward desired structural and functional ecosystem components of the goals. Structural metrics, linked to ecosystem functions and services, inform restoration practitioners of work plan modifications or more substantial adaptive management actions necessary to maintain desired recovery. Monitoring frequency, duration, and scale depend on specific attributes and goals of the restoration project. Often tied to restoration milestones, critical assessment of monitoring metrics ensures attainment of risk minimization and ecosystem recovery. Finally, interpretation and communication of monitoring findings inform and engage regulators, other stakeholders, the scientific community, and the public. Because restoration activities will likely cease before full ecosystem recovery, monitoring endpoints should demonstrate risk reduction and a successional trajectory toward the condition established in the restoration goals. A detailed assessment of the completed project's achievements, as well as unrealized objectives, attained through project monitoring, will determine if contaminant risk has been minimized, if injured

Can targeted early intervention improve functional recovery in psychosis? A historical control evaluation of the effectiveness of different models of early intervention service provision in Norfolk 1998-2007.

PubMed

Fowler, David; Hodgekins, Jo; Howells, Lawrence; Millward, Melanie; Ivins, Annabel; Taylor, Gavin; Hackmann, Corinna; Hill, Katherine; Bishop, Nick; Macmillan, Iain

2009-11-01

This paper assesses the impact of different models of early intervention (EI) service provision on functional recovery and inpatient hospital admission. The study compares the outcome of a comprehensive EI team with a partial model (community mental health team (CMHT) plus specialist support) and traditional care (generic CMHT) over a 10-year period. The design is in comparison with historical control. The study compares the functional recovery outcomes of three cohorts from the same geographical area over the period 1998-2007. The primary outcomes were partial and full functional recovery defined with respect to readily identifiable UK benefit system thresholds and psychiatric inpatient admission days at 1 and 2 years post-referral. Only 15% of individuals made a full or partial functional recovery at 2 years under the care of a traditional generic CMHT in 1998. In 2007, 52% of the cases were making a full or partial functional recovery under the care of the comprehensive EI team. A large reduction in inpatient admissions was associated with the EI strategy. The implementation of comprehensive EI teams can have a major impact in improving functional recovery outcomes in psychosis and reducing inpatient admissions. Partial implementation using limited funding of specialist workers in collaboration with traditional care appeared to have a more limited effect on these recovery dimensions. The implementation of targeted EI in psychosis strategies can result in substantive functional benefits. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders.

PubMed

Roux, Paul; Passerieux, Christine; Fleury, Marie-Josée

2016-12-01

Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life. © The Royal College of Psychiatrists 2016.

17 CFR 229.1108 - (Item 1108) Servicers.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., provide statistical information regarding servicer advances on the pool assets and the servicer's overall... handling delinquencies, losses, bankruptcies and recoveries, such as through liquidation of the underlying...

Enhanced recovery from surgery in the UK: an audit of the enhanced recovery partnership programme 2009-2012.

PubMed

Simpson, J C; Moonesinghe, S R; Grocott, M P W; Kuper, M; McMeeking, A; Oliver, C M; Galsworthy, M J; Mythen, M G

2015-10-01

The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data. The data regarding length of stay and compliance with each element of Enhanced Recovery protocols for colorectal, orthopaedic, urological and gynaecological surgery patients were analysed. The relationship between Enhanced Recovery protocol compliance and length of stay was measured. From 16 267 patients from 61 hospital trusts, three out of four surgical specialties showed Enhanced Recovery, compliance being weakly associated with shorter length of stay (correlation coefficients -0.18, -0.14, -0.25 in colorectal, orthopaedics and gynaecology respectively). At a cut-off of 80% compliance, good compliance was associated with two, one and three day reductions in median length of stay respectively in colorectal, orthopaedic and urological surgeries, with no saving in gynaecology. This study is the largest assessment of the relationship between Enhanced Recovery protocol compliance and outcome in four surgical specialties. The data suggest that higher compliance with an Enhanced Recovery protocol has a weak association with shorter length of stay. This suggests that changes in process, resulting from highly protocolised pathways, may be as important in reducing perioperative length of stay as any individual element of Enhanced Recovery protocols in isolation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Measuring personal recovery - psychometric properties of the Swedish Questionnaire about the Process of Recovery (QPR-Swe).

PubMed

Argentzell, Elisabeth; Hultqvist, Jenny; Neil, Sandra; Eklund, Mona

2017-10-01

Personal recovery, defined as an individual process towards meaning, is an important target within mental health services. Measuring recovery hence requires reliable and valid measures. The Process of Recovery Questionnaire (QPR) was developed for that purpose. The aim was to develop a Swedish version of the QPR (QPR-Swe) and explore its psychometric properties in terms of factor structure, internal consistency, construct validity and sensitivity to change. A total of 226 participants entered the study. The factor structure was investigated by Principal Component Analysis and Scree plot. Construct validity was addressed in terms of convergent validity against indicators of self-mastery, self-esteem, quality of life and self-rated health. A one-factor solution of QPR-Swe received better support than a two-factor solution. Good internal consistency was indicated, α = 0.92, and construct validity was satisfactory. The QPR-Swe showed preliminary sensitivity to change. The QPR-Swe showed promising initial psychometric properties in terms of internal consistency, convergent validity and sensitivity to change. The QPR-Swe is recommended for use in research and clinical contexts to assess personal recovery among people with mental illness.

26 CFR 301.7430-2 - Requirements and procedures for recovery of reasonable administrative costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... recovery—(1) Determination by the Internal Revenue Service. The Internal Revenue Service will grant a... such request is filed, the Internal Revenue Service's failure to respond may be considered by the..., the Internal Revenue Service will not grant a request for recovery of the reasonable administrative...

Comparative biokinetics of trivalent radionuclides with similar ionic dimensions: promethium-147, curium-242 and americium-241.

PubMed

Priest, N D

2007-09-01

Data on the distribution and redistribution patterns in the laboratory rat of three trivalent elements with a similar ionic radius have been compared. This showed that these distributions for the two ions with the same ionic radius (111 pm), i.e., those of promethium (a lanthanoid) and curium (an actinoid), were indistinguishable and that americium, with a slightly larger ion size (111.5 pm), behaved similarly. The results are consistent with the suggestion that ion size is the only important factor controlling the deposition and redistribution patterns of trivalent lanthanoids and actinoids in rats. The result is important because it suggests that the same radiological protection dosimetry models should be used for trivalent actinoids and lanthanoids, that human volunteer data generated for lanthanoid isotopes can be used to predict the behavior of actinoids with the same ion size, and that appropriate pairs of beta-particle-emitting lanthanoid and alpha-particle-emitting actinoids could be used to study the relative toxicity of alpha and beta particles in experimental animals.

Exploring the effectiveness of the output-based aid voucher program to increase uptake of gender-based violence recovery services in Kenya: A qualitative evaluation

PubMed Central

2012-01-01

Background Few studies in Africa have explored in detail the ability of output-based aid (OBA) voucher programs to increase access to gender-based violence recovery (GBVR) services. Methods A qualitative study was conducted in 2010 and involved: (i) in-depth interviews (IDIs) with health managers, service providers, voucher management agency (VMA) managers and (ii) focus group discussions (FGDs) with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya. Results The findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services. Conclusions The above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers. PMID:22691436

Hurricane preparedness and recovery by a transportation agency.

DOT National Transportation Integrated Search

2002-01-01

A hurricane can be crippling to a regional transportation system such as the Hampton Roads District of Virginia. Preparedness and recovery by the highway agency, in coordination with localities and emergency services, is critical to minimizing the sh...

The professional psychiatric/mental health nurse: skills, competencies and supports required to adopt recovery-orientated policy in practice.

PubMed

Cusack, E; Killoury, F; Nugent, L E

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland. In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment. Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally. Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical

Quantum size effects on the (0001) surface of double hexagonal close packed americium

NASA Astrophysics Data System (ADS)

Gao, D.; Ray, A. K.

2007-01-01

Electronic structures of double hexagonal close-packed americium and the (0001) surface have been studied via full-potential all-electron density-functional calculations with a mixed APW+lo/LAPW basis. The electronic and geometric properties of bulk dhcp Am as well as quantum size effects in the surface energies and the work functions of the dhcp Am (0001) ultra thin films up to seven layers have been examined at nonmagnetic, ferromagnetic, and antiferromagnetic configurations with and without spin orbit coupling. The anti-ferromagnetic state including spin-orbit coupling is found to be the ground state of dhcp Am with the 5f electrons primarily localized. Our results show that both magnetic configurations and spin-orbit coupling play important roles in determining the equilibrium lattice constant, the bulk modulus as well as the localized feature of 5f electrons for dhcp Am. Our calculated equilibrium lattice constant and bulk modulus at the ground state are in good agreement with the experimental values respectively. The work function of dhcp Am (0001) 7-layer surface at the ground state is predicted to be 2.90 eV. The surface energy for dhcp Am (0001) semi-infinite surface energy at the ground state is predicted to be 0.84 J/m2. Quantum size effects are found to be more pronounced in work functions than in surface energies.

Peer Support in Full-Service Partnerships: A Multiple Case Study Analysis.

PubMed

Siantz, Elizabeth; Henwood, Benjamin; Gilmer, Todd

2017-07-01

Peer providers are integral to Full Service Partnerships (FSPs), which are team-based mental health service models. Peer providers use principles of recovery to engage clients, but FSPs can vary in their recovery orientation. Whether and how peer recovery orientation reflects the organizational environments of FSPs is unclear. This qualitative study explored peer provider attitudes towards recovery within the organizational contexts of FSPs where they are employed. Case study analysis was conducted on eight purposively sampled FSPs using qualitative interviews with peer providers and program directors. In two cases, peer recovery attitudes diverged from those of their organizational context. In these cases, peer providers were champions for recovery, and used practice-based strategies to promote client autonomy despite working in settings with lower recovery orientation. Peer providers could be uniquely positioned to promote client autonomy in settings where organizational factors limit consumer choice.

REFOCUS Trial: protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams.

PubMed

Slade, Mike; Bird, Victoria; Le Boutillier, Clair; Williams, Julie; McCrone, Paul; Leamy, Mary

2011-11-23

There is a consensus about the importance of 'recovery' in mental health services, but the evidence base is limited. A two centre, cluster randomised controlled trial. Participants are community-based mental health teams, and service users aged 18-65 years with a primary clinical diagnosis of psychosis. In relation to the REFOCUS Manual researchintorecovery.com/refocus, which describes a 12-month, pro-recovery intervention based on the REFOCUS Model, the objectives are: (1) To establish the effectiveness of the intervention described in the REFOCUS Manual; (2) To validate the REFOCUS Model; (3) To establish and optimise trial parameters for the REFOCUS Manual; and (4) To understand the relationship between clinical outcomes and recovery outcomes. The hypothesis for the main study is that service users in the intervention arm will experience significantly greater increases in measures of personal recovery (as measured by the QPR) compared to service users receiving care from control teams. The hypothesis for the secondary study is that black service users in the intervention arm will experience significantly greater increases in measures of personal recovery (as measured by the QPR) and client satisfaction (as measured by the CSQ) compared to Black service users receiving care from control teams. The intervention comprises treatment as usual plus two components: recovery-promoting relationships and working practices. The control condition is treatment as usual. The primary outcme is the Process of Recovery Questionnaire (QPR). Secondary outcomes are satisfaction, Goal setting - Personal Primary Outcome, hope, well-being, empowerment, and quality of life. Primary outcomes for the secondary study will be QPR and satisfaction. Cost data will be estimated, and clinical outcomes will also be reported (symptomatology, need, social disability, functioning). 29 teams (15 intervention and 14 control) will be randomised. Within each team, 15 services users will be randomly

Quantitative NDA measurements of advanced reprocessing product materials containing uranium, neptunium, plutonium, and americium

NASA Astrophysics Data System (ADS)

Goddard, Braden

The ability of inspection agencies and facility operators to measure powders containing several actinides is increasingly necessary as new reprocessing techniques and fuel forms are being developed. These powders are difficult to measure with nondestructive assay (NDA) techniques because neutrons emitted from induced and spontaneous fission of different nuclides are very similar. A neutron multiplicity technique based on first principle methods was developed to measure these powders by exploiting isotope-specific nuclear properties, such as the energy-dependent fission cross sections and the neutron induced fission neutron multiplicity. This technique was tested through extensive simulations using the Monte Carlo N-Particle eXtended (MCNPX) code and by one measurement campaign using the Active Well Coincidence Counter (AWCC) and two measurement campaigns using the Epithermal Neutron Multiplicity Counter (ENMC) with various (alpha,n) sources and actinide materials. Four potential applications of this first principle technique have been identified: (1) quantitative measurement of uranium, neptunium, plutonium, and americium materials; (2) quantitative measurement of mixed oxide (MOX) materials; (3) quantitative measurement of uranium materials; and (4) weapons verification in arms control agreements. This technique still has several challenges which need to be overcome, the largest of these being the challenge of having high-precision active and passive measurements to produce results with acceptably small uncertainties.

Experiences of support in working toward personal recovery goals: a collaborative, qualitative study.

PubMed

Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

2016-11-25

Recovery can be understood as a subjective process guided by personal expectations, goals and hopes. The aim of the study was to explore how persons using a Community Mental Health Centre (CMHC) experienced that their expectations for treatment, and goals and hopes for recovery were supported by the health professionals during treatment. Employing a hermeneutic-phenomenological approach, eight service users were interviewed about their expectations for treatment and their goals and hopes for recovery at the start of their contact with health professionals at a CMHC. Two years later, they were re-interviewed about their experiences of treatment and support from the health professionals in their work towards these goals and hopes. A collaborative approach was adopted. A co-researcher with lived experience took part in all stages of the study. Data were analysed by means of a data-driven stepwise approach in line with thematic analysis. Five themes reflecting how participants experienced support from health professionals at the CMHC in their work towards their recovery goals were elicited, as follows: developing an understanding of oneself and one's mental health problems; learning how to change feelings and behaviours; being 'pushed' into social arenas; finding helpful medication; and counselling in family, practical and financial issues. The participants' expectations about counselling with regard to longer-term family, practical, and financial challenges were insufficiently met by the CMHC. In the experience of the service users, recovery occurred within the context of their everyday life with or without the support of their professional helpers. To facilitate recovery, health professionals should acknowledge the service user's personal goals and hopes and take a more comprehensive and longer-term approach to his or her needs and desires. Acknowledging and facilitating recovery goals by offering counselling with regard to family, practical and financial issues

Exploring identity within the recovery process of people with serious mental illnesses.

PubMed

Buckley-Walker, Kellie; Crowe, Trevor; Caputi, Peter

2010-01-01

To examine self-identity within the recovery processes of people with serious mental illnesses using a repertory grid methodology. Cross-sectional study involving 40 mental health service consumers. Participants rated different "self" and "other" elements on the repertory grid against constructs related to recovery, as well as other recovery focused measures. Perceptions of one's "ideal self" represented more advanced recovery in contrast to perceptions of "a person mentally unwell." Current perceptions of self were most similar to perceptions of "usual self" and least similar to "a person who is mentally unwell." Increased identification with one's "ideal self" reflected increased hopefulness in terms of recovery. The recovery repertory grid shows promise in clinical practice, in terms of exploring identity as a key variable within mental health recovery processes. Distance measures of similarity between various self-elements, including perceptions of others, maps logically against the recovery process of hope.

System Transformation Under the California Mental Health Services Act: Implementation of Full-Service Partnerships in L.A. County.

PubMed

Starks, Sarah L; Arns, Paul G; Padwa, Howard; Friedman, Jack R; Marrow, Jocelyn; Meldrum, Marcia L; Bromley, Elizabeth; Kelly, Erin L; Brekke, John S; Braslow, Joel T

2017-06-01

The study evaluated the effect of California's Mental Health Services Act (MHSA) on the structure, volume, location, and patient centeredness of Los Angeles County public mental health services. This prospective mixed-methods study (2006-2013) was based in five Los Angeles County public mental health clinics, all with usual care and three with full-service partnerships (FSPs). FSPs are MHSA-funded programs designed to "do whatever it takes" to provide intensive, recovery-oriented, team-based, integrated services for clients with severe mental illness. FSPs were compared with usual care on outpatient services received (claims data) and on organizational climate, recovery orientation, and provider-client working alliance (surveys and semistructured interviews), with regression adjustment for client and provider characteristics. In the first year after admission, FSP clients (N=174) received significantly more outpatient services than did usual care clients (N=298) (5,238 versus 1,643 minutes, p<.001), and a larger proportion of these services were field based (22% versus 2%, p<.001). Compared with usual care clients, FSP clients reported more recovery-oriented services (p<.001) and a better provider-client working alliance (p=.01). Compared with usual care providers (N=130), FSP providers (N=42) reported more stress (p<.001) and lower morale (p<.001). Los Angeles County's public mental health system was able to transform service delivery in response to well-funded policy mandates. For providers, a structure emphasizing accountability and patient centeredness was associated with greater stress, despite smaller caseloads. For clients, service structure and volume created opportunities to build stronger provider-client relationships and address their needs and goals.

Recovery orientation in mental health inpatient settings: Inpatient experiences?

PubMed

Waldemar, Anna Kristine; Esbensen, Bente Appel; Korsbek, Lisa; Petersen, Lone; Arnfred, Sidse

2018-06-01

Offering mental health treatment in line with a recovery-oriented practice has become an objective in the mental health services in many countries. However, applying recovery-oriented practice in inpatient settings seems challenged by unclear and diverging definitions of the concept in and the organization of these settings. In Denmark, educational and organizational efforts have been made to organize inpatient services with a recovery-oriented approach. Hence, we aimed to explore whether and how these efforts are reflected in the inpatients' experiences of their care and treatment. Semi-structured interviews were conducted with 14 inpatients from two mental health inpatient wards using an interview guide based on factors from the Recovery Self-Assessment. Qualitative content analysis was applied in the analysis. Six themes covering the participants' experiences were identified. The participants felt accepted and protected in the ward and found comfort in being around other people but missed talking and engaging with health professionals. They described limited choice and influence on the course of their treatment, and low information levels regarding their treatment, which they considered to consist predominantly of medication. Furthermore, they described feeling continuously observed and assessed from a distance by health professionals. Like the sparse previous research among inpatients, the results highlight ambivalent experiences of health professionals' support and ward structure as well as the medical treatment hegemony. As such, the educational and organizational efforts of introducing recovery-oriented practices in the wards seemed not very well reflected in the participants' experiences of their stay. © 2018 Australian College of Mental Health Nurses Inc.

Using the tidal model of mental health recovery to plan primary health care for women in residential substance abuse recovery.

PubMed

Young, Brenda B

2010-09-01

Women currently are 30% of the substance abuse recovery population in North America and have gender specific treatment needs as they enter the difficult work of recovery. Important among women's specific needs as they enter recovery is the need for a focus on primary health care. Few models designed to guide the provision of health care for this population are available in the literature. The Tidal Model of Mental Health Recovery and Reclamation is based on the concept of nursing as "caring with" persons in the experience of distress. Given the emphasis in this model on developing a partnership between caregiver and client, it is especially appropriate for women in recovery for substance abuse. The Tidal Model, integrated with the United States Substance Abuse and Mental Health Services' CSAT model for comprehensive alcohol and other drug (AOD) abuse treatment, is used to guide planning for delivery of primary health care in a residential women's substance abuse recovery center in the Midwest. This article describes the Tidal Model, and identifies how the model can improve the delivery of primary care to women in residential substance abuse treatment. Strategies for implementation of the model are proposed. Evaluation and outcome criteria are identified.

A Multicultural Service Sensitivity Exercise for Marketing Students

ERIC Educational Resources Information Center

Rosenbaum, Mark S.; Moraru, Ioana; Labrecque, Lauren I.

2013-01-01

Services marketing and retailing courses place service quality at the heart of the curriculum, painting service providers as defenders of their customers' welfare and thwarters of service failures by ushering in recovery solutions. Yet academic literature and the popular press provide evidence that in some cases, service providers act as…

Peer Education: Productive Engagement for Older African Americans in Recovery From Depression.

PubMed

Conner, Kyaien O; Gum, Amber; Johnson, Angela; Cadet, Tamara; Brown, Charlotte

2017-06-17

Older adults who have personal experience with the mental health service delivery system gain unique and potentially valuable insight from their treatment experiences. Research suggests that incorporating trained individuals in recovery from a mental illness (i.e., peer educators) into mental health service delivery roles results in substantial benefits for current mental health consumers, particularly for older adults and racial and ethnic minorities who may feel disenfranchised from the traditional mental health service delivery system. However, little research has examined the impact of participating in these activities on the peer educators themselves. This mixed methods study examines the experiences of 10 African American older adults in recovery from depression currently working as trained peer educators. Peer educators reported feeling more positive, feeling their lives had significantly improved, and feeling better in general due to their peer educator roles. This qualitative investigation highlights four unique themes that can explain the benefit of serving in this capacity (i.e., Community Engagement, Life Long Learning and Education, Mental Health Recovery and Productive Aging). This study suggests that serving has a peer educator has a number of beneficial outcomes for African American older adults in recovery from depression. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Steelhead of the south-central/southern California coast: Population characterization for recovery planning

USGS Publications Warehouse

Boughton, David A.; Adams, P.B.; Anderson, E.; Fusaro, Craig; Keller, E.; Kelley, Elsie; Lentsch, Leo; Nielsen, J. L.; Perry, Katie; Regan, Helen; Swift, C.; Watson, Fred

2006-01-01

This report by the National Marine Fisheries Service applies a formal evaluation framework to the problem of delineating Oncorhynchus mykiss populations in the South-Central/Southern California Coast recovery domain, in support of recovery planning under the Endangered Species Act.