On the very idea of a recovery model for mental health

Both in the UK and internationally, the ‘recovery model’ has been promoted to guide mental healthcare in reaction against what is perceived to be an overly narrow traditional bio-medical model. It has also begun to have an influence in thinking more broadly about mental health both for individuals and for communities and in the latter case has been linked to policies to promote social inclusion. In this widening application, however, there is a risk that the model becomes too broad to count as a model and thus to compete with other models such as a bio-medical model of health or illness. In this short paper we sketch some of the competing views of illness and health in order to locate and articulate a possible recovery model for mental health. We suggest that a distinct recovery model could be based on a view that places values at the centre of an analysis of mental health. Our aim, however, is to clarify the options rather than defend the model that emerges. We do, however, caution against one possible version of a recovery model. Thus if a recovery model were to be defended along the line we sketch we think that it would be better to construe the values involved on eudaimonic rather than hedonic lines

Are Delayed Issues Harder to Resolve? Revisiting Cost-to-Fix of Defects throughout the Lifecycle

Many practitioners and academics believe in a delayed issue effect (DIE); i.e. the longer an issue lingers in the system, the more effort it requires to resolve. This belief is often used to justify major investments in new development processes that promise to retire more issues sooner. This paper tests for the delayed issue effect in 171 software projects conducted around the world in the period from 2006--2014. To the best of our knowledge, this is the largest study yet published on this effect. We found no evidence for the delayed issue effect; i.e. the effort to resolve issues in a later phase was not consistently or substantially greater than when issues were resolved soon after their introduction. This paper documents the above study and explores reasons for this mismatch between this common rule of thumb and empirical data. In summary, DIE is not some constant across all projects. Rather, DIE might be an historical relic that occurs intermittently only in certain kinds of projects. This is a significant result since it predicts that new development processes that promise to faster retire more issues will not have a guaranteed return on investment (depending on the context where applied), and that a long-held truth in software engineering should not be considered a global truism.Comment: 31 pages. Accepted with minor revisions to Journal of Empirical Software Engineering. Keywords: software economics, phase delay, cost to fi

Promotion of faster weight gain in infants born small for gestational age - Is there an adverse effect on later blood pressure?

Background - Being born small for gestational age is associated with later risk factors for cardiovascular disease, such as high blood pressure. Promotion of postnatal growth has been proposed to ameliorate these effects. There is evidence in animals and infants born prematurely, however, that promotion of growth by increased postnatal nutrition increases rather than decreases later cardiovascular risk. We report the long-term impact of growth promotion in term infants born small for gestational age ( birth weight < 10th percentile).Methods and Results - Blood pressure was measured at 6 to 8 years in 153 of 299 ( 51%) of a cohort of children born small for gestational age and randomly assigned at birth to receive either a standard or a nutrient-enriched formula. The enriched formula contained 28% more protein than standard formula and promoted weight gain. Diastolic and mean ( but not systolic) blood pressure was significantly lower in children assigned to standard compared with nutrient-enriched formula ( unadjusted mean difference for diastolic blood pressure, - 3.2 mm Hg; 95% CI, - 5.8 to - 0.5; P = 0.02) independent of potential confounding factors ( adjusted difference, - 3.5 mm Hg; P = 0.01). In observational analyses, faster weight gain in infancy was associated with higher later blood pressure.Conclusions - In the present randomized study targeted to investigate the effect of early nutrition on long-term cardiovascular health, we found that a nutrient-enriched diet increased later blood pressure. These findings support an adverse effect of relative "overnutrition" in infancy on long-term cardiovascular disease risk, have implications for the early origins of cardiovascular disease hypothesis, and do not support the promotion of faster weight gain in infants born small for gestational age

Large Animal Clinical Quiz

This article contains a quiz pertinent to knowledge about Large Animal medicine for the benefit of students

Motives, perceptions and experiences of electric bicycle owners and implications for health, wellbeing and mobility

This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.jtrangeo.2016.04.006The sale of electrically assisted bicycles (‘e-bikes’) is growing at a rapid rate across Europe. Whereas market data is available describing sales trends, there is limited understanding of the experience of early adopters of e-bike technology. This paper investigates the motives for e-bike purchase, rider experience and perceived impact on mobility, health and wellbeing through in-depth interviews with e-bike owners in the Netherlands and the UK. Findings revealed that the motive for purchasing e-bikes was often to allow maintenance of cycling against a backdrop of changing individual or household circumstances. E-bikes also provided new opportunities for people who would not otherwise consider conventional cycling. Perceptions of travel behaviour change revealed that e-biking was replacing conventional cycling but was also replacing journeys that would have been made by car. There was also a perception that e-biking has increased, or at least allowed participants to maintain, some form of physical activity and had benefitted personal wellbeing. Technological, social and environmental barriers to e-biking were identified. These included weight of bicycle, battery life, purchase price, social stigma and limitations of cycle infrastructure provision. Additional research is necessary to quantify actual levels of mode substitution and new journey generation among new e-bike owners and the impact of e-biking on promoting physical health and mental wellbeing.This work was supported by The NetherlandsOrganization for Scientific Research (NWO) (434-11-010) as part of the Sustainable Accessibility of the Randstad programme. Lucas Harms undertook conceptualisation, fieldwork, analysis and writing whilst working at the Urban Cycling Institute of the University of Amsterdam. Eva Heinen undertook conceptualisation and fieldwork whilst at the Faculty of Spatial Sciences, University of Groningen (NL), and subsequent analysis and writing under the auspices of the Centre for Diet and Activity Research (CEDAR), a UK Public Health Research Centre of Excellence funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust. She is now based at the Institute of Transport Studies at the University of Leeds. We would like to thank NWO, colleagues at the University of Amsterdam, University of Groningen and Oxford Brookes University - particularly Nick Beale for proof reading. Also, to all of our participants who willingly gave up their time to provide a rich insight into their ebiking