Current writing and research on addiction recovery is inconclusive about what is effective in promoting recovery from alcoholism and drug addiction. This thesis focuses on the narrative commentaries of people currently in recovery in an effort to determine what elements may be common among them that promote and sustain their recovery conditions. In depth interviews were conducted with eight individuals who offered personal details about their addictions and their recovery. Analysis of their narratives reveals a variety of thematic conditions related to the maintenance of sobriety and other personal goals.

Outcome measures have been developed in an acute hospital for specific patient groups (primarily cholecystectomy, diabetes, coronary angioplasty and knee replacements). For each condition a set of indicators was derived which ranged from clinical and laboratory measures to measures of general health status. All indicators attempt to show changes in patient health over time. It has been shown possible to collect the necessary data for such outcomes measures. The costs and methods of data collection varied between conditions. Patient completed questionnaires were found to be particularly useful and in inpatient studies have given high response rates (over 95%) for postal follow-ups and have been validated by interviews. The differing ability of the various indicators to show clinical changes has been demonstrated. In all specialties there was found to be generally high levels of association between different indicators. The information collected on patient outcomes was presented at meetings of the various clinical teams and the value of the information in promoting practical change was examined. It was concluded that different indicators have different value in such reviews and that three key characteristics are identified. The first concerns whether the measures reflect clinical or patient's perceptions of health. The second concerns the extent to which an indicator is a direct measure of health or a proxy (or process) measure. The third concerns the extent to which an observed outcome indicator can be linked to particular processes of care. The study has generated support from the clinicians and it is suggested has changed their views on how they judge their own performance. In some instances practical changes have resulted form the presence of the outcome information. The potential future roles for outcome measurement in the health service is discussed.

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This study uses a phenomenological methodology to understand Japanese women, living in Tohoku region, Japan, who have the experience of alcohol dependency and recovery. Moreover, the purpose of the study was to understand what would be the most effective ways if supporting women in rural communities. Six women were interviewed to obtain the meanings they attach to recovery. Nine themes emerged. It was found that the women had common turning points prior to beginning their recovery, and had adopted various changes in their process of recovery. For all women in the study, the essential meaning of recovery was to live and to live fully. Recommendations are presented regarding the advocacy required to create the conditions necessary for women to live fully. This involves greater education of the community at large about alcohol dependency and the creation of supportive environments for individuals in recovery and their families.

Current writing and research on addiction recovery is inconclusive about what is effective in promoting recovery from alcoholism and drug addiction. This thesis focuses on the narrative commentaries of people currently in recovery in an effort to determine what elements may be common among them that promote and sustain their recovery conditions. In depth interviews were conducted with eight individuals who offered personal details about their addictions and their recovery. Analysis of their narratives reveals a variety of thematic conditions related to the maintenance of sobriety and other personal goals.

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Reservoir wettability is controlled by crude oil/brine/rock interactions that have not been well understood. Studies using either model compounds or crude oil fractions have had only limited success in reproducing the wetting alteration that can occur in nature. In this study, the approach is first to identify the key features of interfacial activity unique to crude oils, then to design and conduct wetting alteration experiments—using both flat solids and porous media—that demonstrate the mechanisms by which alteration can occur. Components of crude oils that are interfacially active are found in the highest molecular weight, most polar fractions of the oil, the resins and asphaltenes. How these components affect wetting depends on the compositions of not only the oil, but also the mineral surfaces and the aqueous phase that is always present in oil reservoirs. Wettability altering interactions can occur by several mechanisms. In the absence of water, adsorption of polar species can create intermediately-wet surfaces. If the oil is a poor solvent for its asphaltene fraction, adsorption of large asphaltene aggregates can make surfaces fairly oil-wet. Adsorption can also occur because of ionic interactions between oppositely charged acidic and basic sites at the oil/water and solid/water interfaces. There may also be interactions between similarly charged sites, if ion binding can occur. All of these mechanisms have been documented for a range of crude oils with varying asphaltene fraction, solvency, acid number, and base number.

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