We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
A manual for those working with addicted populations (from lay counsellors to psychiatrists) for delivering the evidence-based Recovery Resilience Program (RRP). RRP is a person-centered, strength and resiliency-based relapse prevention and recovery-oriented intervention that works in synergy with other models, especially 12-Step programs. Presenting practices that enhance 'recovery resilience' – an individual's capacity to effectively apply coping and self-regulation skills in dealing with cravings, triggers, stress, and high-risk situations without reverting to substance use. The program helps individuals to enhance and use their recovery capital at any stage of recovery, and ultimately reach recovery and life goals. It effortlessly integrates with other evidence-based relapse programs, from the original cognitive-behavioral approaches to the newer mindfulness-based and metacognitive approaches. Written by clinicians who have worked with addicts and their families for many decades, the program is easy-to-implement and very little preparation is necessary with handouts and PowerPoints included in each session.
Depth-averaged systems of equations describing the motion of fluid–sediment mixtures have been widely adopted by scientists in pursuit of models that can predict the paths of dangerous overland flows of debris. As models have become increasingly sophisticated, many have been developed from a multi-phase perspective in which separate, but mutually coupled sets of equations govern the evolution of different components of the mixture. However, this creates the opportunity for the existence of pathological instabilities stemming from resonant interactions between the phases. With reference to the most popular approaches, analyses of two- and three-phase models are performed, which demonstrate that they are more often than not ill posed as initial-value problems over physically relevant parameter regimes – an issue which renders them unsuitable for scientific applications. Additionally, a general framework for detecting ill posedness in models with any number of phases is developed. This is used to show that small diffusive terms in the equations for momentum transport, which are sometimes neglected, can reliably eliminate this issue. Conditions are derived for the regularisation of models in this way, but they are typically not met by multi-phase models that feature diffusive terms.
Vallisneria × pseudorosulata S. Fujii & M. Maki is an invasive aquatic weed that has recently become a major issue within the U.S. Southeast. Vallisneria × pseudorosulata is a hybrid between two nonnative eelgrass species (Vallisneria spiralis L. and Vallisneria denseserrulata Makino) and has rapidly overtaken water bodies in Tennessee, Alabama, and Florida. This hybrid can reproduce rapidly through offshoot formation and floating propagules capable of drifting large distances before establishing. Vallisneria × pseudorosulata has been previously found in Japan and is thought to have been introduced in the United States by the aquarium trade or through dumping.
There is a strong link between our capacity to cope with negative emotional states and their associated negative thoughts and substance use relapse. When individuals use substances as a coping mechanism this strategy may be effective in the short term and but proves maladaptive in the long run. The use of drugs provides both negative reinforcement (namely, the reduction of painful feelings via self-medication), and positive reinforcement (that is, the pleasant experience of being high via positive outcome expectancies). The self-medication hypothesis applies when the individual is using a substance to cope with negative emotions, conflict, or stress (negative reinforcement). From a positive outcome expectancy perspective, the person is focusing on the positive aspects and euphoria of using a substance (positive reinforcement), while ignoring the negative consequences. Therefore, an essential component of recovery is learning healthy ways to self-soothe and cope with stress and painful emotions, and the negative thoughts and rumination associated with them. Without healthy coping skills, a key component of recovery capital, individuals in recovery will continue to seek dysfunctional ways to self-regulate. In this chapter the reader is introduced to one of the causes behind negative rumination and over-compensatory behaviour that accompanies it, which perpetuates the cycle of addiction.
High-risk situations can be understood as events and situations that, if not effectively managed, pose a potential risk for relapse. What is important to note is that it is chiefly the individual’s subjective perception of “risk” that plays a significant role in whether a situation is high risk or not. A high-risk situation poses a threat to one’s perceived ability (what psychology calls “self-efficacy”) to handle the challenging situation at hand. Therefore, by developing more effective coping skills, thereby increasing perceived self-efficacy, one can learn to manage a high-risk situation without defaulting to substance use. This chapter provides practices that enables the reader to effectively deal with high-risk situations. The focus of this workbook is not to provide an exhaustive set of relapse prevention skills and tools but to help the reader to unlock their innate resilience through developing a Recovery Resilience Practice, so that they can effectively apply them.
In this chapter there is a focus on the expectations or Requirements that sustain an addictive lifestyle. It highlights that in addition to fueling resentments, Requirements also affect how one relates to potential high-risk situations, triggers, and stressful events in general. Chapter 1 of this workbook highlighted that oftentimes it is not the situation or event itself that creates emotional distress, but the Requirements individuals have (often automatically and out of awareness) for the situation or event that activate their I-Systems. Thus, a Recovery Resilience Practice does not focus on changing any given situation (crucial insofar as many distressful situations or triggers may be unavoidable) but focuses instead on changing the “who” one brings to that situation – the Natural Functioning self or I-System Functioning self.
Research points out that one reason that many individuals fail to achieve and/or maintain sobriety is that they have inadequate coping skills for dealing with stressful situations and painful feelings. Therefore, the key to preventing relapse is to gain and practice new skills for coping with both anticipated and potentially unforeseen challenges. Yet, simply acquiring these coping skills does not guarantee sustained recovery. One also needs to effectively practice these skills and work a sustainable recovery program. This is evidenced by the fact that addiction treatment and relapse prevention programs have high rates of relapse, despite individuals having a plethora of skills available to them and often being highly motivated for recovery. What the authors highlight in the workbook is that there is a mind-body system, called the I-System, that hinders individuals in recovery from effectively applying these skills and recovery practices, saps their motivation, and causes them to veer off their chosen recovery pathways. From a psychological standpoint, the I-System serves as a regulatory mechanism that maintains psychic balance and prevents psychic disintegration. The approach outlined in the workbook teaches the reader how to recognize and “befriend” this hindrance – so that instead of it being an impediment, it can serve as a compass that guides them through their activities of daily living to stay true to their chosen recovery pathways. The practices in the workbook centers on discerning mind-body practices that support regulation of both mental and physical health, preserving the inherent resilience of our true self. The introduction provides an overview of the workbook and brief introduction to the theory that informs the workbook. The workbook is structured progressively, with each section building on information provided previously. The exercise questions are easy to understand and apply, aiming to heighten the reader’s self-awareness of the dynamics that underlie their addictive behaviour in several key areas of life. The workbook is divided into six sections, each detailing an aspect of a Recovery Resilience Practice and outlining various exercises to help foster their recovery resilience and well-being. Initial exercises aim to unearth what might be hindering their resilience, ultimately resulting in diminished mental and physical functioning. The authors equip readers with a baseline measurement to monitor progress as they gradually introduce various practices and exercises in a systematic way.
In this chapter the workbook’s previous chapters are integrated into an explanation of the dynamics that underlie the cycle of addiction. It highlights that when the I-System becomes hyperactive, individuals forfeit their innate capabilities for creative thought, open-mindedness, and resilience, exhibiting instead overly stringent expectations or assumptions about themselves, others, and circumstances. By presenting examples of thought patterns that obstruct resilience, the authors demystify the nature of problematic and unrealistic “I-System Requirements” or “the shoulds” in life that often breed frustration, physical tension, shame, or withdrawal. The reader is then guided on how to neutralize these negative thoughts or what the authors term the Depressor Storyline. They describe a self-perpetuating cycle often created between a Depressor Storyline and the Fixer Storyline, which involves the Depressor generating negative thoughts that snowball into a Storyline, while the Fixer incessantly devises stories on how to rectify self, others, or circumstances. The objective is to find means to deactivate the hyperactive I-System Requirements, which is crucial to freeing individuals from restrictive and repetitive patterns to attain a state of Natural Functioning.
It is often stated that cravings are a formidable adversary to those on a recovery pathway and that cravings are one of the major factors related to relapse. Individuals who lack effective coping responses and/or the confidence (self-efficacy) to deal with cravings and the situations that trigger them are at high risk for relapse. In this chapter the authors assist the reader to enhance their ability to manage cravings and highlight that it is a pivotal coping skill needed for their sustained recovery from addiction. In this chapter it is highlighted that a Recovery Resilience Practice supports regulation of both mental and physical health, preserving the inherent resilience of our true self. The theoretical underpinning of the practices is based on the notion that the true self, or our genuine essence, can be reclaimed or further nurtured once deeply entrenched defensive patterns, developed to offset feelings of shame and inadequacy, are consciously recognized, understood, and neutralized. It highlights how these patterns are malleable and can be effectively deconstructed through various means to encourage authentic functioning, characterized by creativity, optimism, spontaneity, and resilience.
In the last chapter the authors provide an overview of all aspects of a Recovery Resilience Practice that will contribute towards a sustainable recovery-oriented lifestyle. In this chapter the reader will consolidate their Recovery Resilience Practice and see how to use it to support any recovery program or pathway. As highlighted throughout the workbook, the central aim of a Recovery Resilience Practice is to remove the hindrance that obstructs one’s capacity to access Recovery Capital and apply recovery skills as well as provide a practice that can help one deal moment by moment with stress, high-risk situation, triggers, or any troubling situations. In short, a Recovery Resilience Practice removes the hindrance to one’s innate resilience and capacity for flourishing and assists in achieving recovery and life goals. The last chapter provides an overview of how the workbook assists individuals in recovery to have greater self-awareness of their unhealthy and healthy coping styles and prompts them to evolve to a place of greater self-awareness so that they can make more informed decisions about their lives and efficaciously deal with life’s challenges.
The first workbook written for individuals progressing through the Recovery Resilience Program, a person-centered, strength and resiliency-based relapse prevention and recovery-oriented intervention designed for individuals in addiction recovery. The book presents practices derived from the I-System Model and the evidence-based intervention Mind-Body Bridging that enhance 'recovery resilience' – a term we use to refer to an individual's capacity to effectively apply coping and self-regulation skills in dealing with cravings, triggers, stress, and high-risk situations without reverting to substance use. Each chapter introduces various Recovery Resilience Practices and explains how they can positively augment any recovery pathway. Readers can learn to use these practices through various exercises, which they can complete before moving on to the next chapter. The program helps individuals to draw upon and use their recovery capital (for example, skills, tools, knowledge, etc.), remove barriers along the way, and strengthen their internal resources, and ultimately reach recovery and life goals.
In 2020, an outbreak of Salmonella Hadar illnesses was linked to contact with non-commercial, privately owned (backyard) poultry including live chickens, turkeys, and ducks, resulting in 848 illnesses. From late 2020 to 2021, this Salmonella Hadar strain caused an outbreak that was linked to ground turkey consumption. Core genome multilocus sequence typing (cgMLST) analysis determined that the Salmonella Hadar isolates detected during the outbreak linked to backyard poultry and the outbreak linked to ground turkey were closely related genetically (within 0–16 alleles). Epidemiological and traceback investigations were unable to determine how Salmonella Hadar detected in backyard poultry and ground turkey were linked, despite this genetic relatedness. Enhanced molecular characterization methods, such as analysis of the pangenome of Salmonella isolates, might be necessary to understand the relationship between these two outbreaks. Similarly, enhanced data collection during outbreak investigations and further research could potentially aid in determining whether these transmission vehicles are truly linked by a common source and what reservoirs exist across the poultry industries that allow Salmonella Hadar to persist. Further work combining epidemiological data collection, more detailed traceback information, and genomic analysis tools will be important for monitoring and investigating future enteric disease outbreaks.
Six well-characterized soil kaolins from widely separated sites in south-western Australia and four reference kaolins were studied by 57Fe Mössbauer spectroscopy at room temperature after removal of non-structurally-bound iron with dithionite-citrate-bicarbonate solution. The soil kaolins and one of the reference kaolins were also studied at temperatures near 16 K. The soil kaolins were remarkably similar in crystal size, crystallinity, dehydroxylation temperature, cation exchange capacity, surface area and iron content. Müssbauer spectra of the soil kaolins at room temperature were also essentially identical consisting of a quadrupole-split doublet superimposed on a broad component which indicated that all of the iron was present as Fe(III) and that slow paramagnetic relaxation effects were present. Mean values for the chemical isomer shift and quadrupole splitting of the doublet for the soil kaolins were 0.33 and 0.55 mm/s respectively which indicates that the iron is in the octahedral sites of the kaolin lattice. The spectra of the soil kaolin samples at temperatures near 16 K showed a further slowing down of the paramagnetic relaxation and confirmed that no discrete iron oxide minerals were present.
Mössbauer spectra of the four reference kaolins at room temperature showed a doublet component similar to those for the soil kaolins. Three of them showed evidence for other spectral components including, in two cases, a component due to the presence of Fe(II).
Hoarding disorder is a surprisingly common problem which impacts on most areas of life. People who hoard typically have multiple agencies involved in their care due to the complex health and safety impact and risks associated with hoarding. ‘Treatment’ involves finding ways of supporting discarding large amounts, typically underpinned by CBT principles. We evaluated the impact and outcomes of a conference designed to boost professionals’ confidence and understanding in working with hoarding problems, both individually and with other agencies with a view to improving inter-agency service provision. Changes in professionals’ confidence and understanding were evaluated immediately before and after the conference. Conference participants’ qualitative responses related to service improvements were analysed using content analysis. People with personal experience of hoarding issues subsequently participated in a focus group where the results of the conference were presented. These data were analysed using thematic analysis. Confidence and understanding in working with hoarding problems substantially increased from pre- to post-conference. Professionals identified a range of possible improvements, most commonly working more closely and improving communication with other agencies. People with personal experience suggested improvements across three over-arching themes: developing an improved understanding of hoarding, the need for improved resources, and improved multi-agency working. A multi-agency conference increased confidence and understanding in professionals working with hoarding problems, and improvements specified by both people with personal experience and professionals provide a useful guide to service improvement. Results provide a framework in which CBT approaches should be embedded.
Key learning aims
(1) To assess the effectiveness of a multi-agency hoarding conference at improving understanding and confidence in working with hoarding problems.
(2) To explore professionals’ perceptions of improvements to multi-agency service provision.
(3) To explore perceptions of improvements that could be made to multi-agency service provision from people with personal experience of hoarding problems.
Observational studies suggest that 25-hydroxy vitamin D (25(OH)D) concentration is inversely associated with pain. However, findings from intervention trials are inconsistent. We assessed the effect of vitamin D supplementation on pain using data from a large, double-blind, population-based, placebo-controlled trial (the D-Health Trial). 21 315 participants (aged 60–84 years) were randomly assigned to a monthly dose of 60 000 IU vitamin D3 or matching placebo. Pain was measured using the six-item Pain Impact Questionnaire (PIQ-6), administered 1, 2 and 5 years after enrolment. We used regression models (linear for continuous PIQ-6 score and log-binomial for binary categorisations of the score, namely ‘some or more pain impact’ and ‘presence of any bodily pain’) to estimate the effect of vitamin D on pain. We included 20 423 participants who completed ≥1 PIQ-6. In blood samples collected from 3943 randomly selected participants (∼800 per year), the mean (sd) 25(OH)D concentrations were 77 (sd 25) and 115 (sd 30) nmol/l in the placebo and vitamin D groups, respectively. Most (76 %) participants were predicted to have 25(OH)D concentration >50 nmol/l at baseline. The mean PIQ-6 was similar in all surveys (∼50·4). The adjusted mean difference in PIQ-6 score (vitamin D cf placebo) was 0·02 (95 % CI (−0·20, 0·25)). The proportion of participants with some or more pain impact and with the presence of bodily pain was also similar between groups (both prevalence ratios 1·01, 95 % CI (0·99, 1·03)). In conclusion, supplementation with 60 000 IU of vitamin D3/month had negligible effect on bodily pain.