Psychosocial and functional contributors to personal recovery in serious mental illness.

Background: Although recovery-oriented services have been conceptualized to improve personal recovery, related research often focuses on measures of clinical recovery. Identifying the relationships between personal recovery, clinical recovery, and psychosocial variables will inform service components and outcome measurement in recovery-oriented services. Aims: This study sought to determine the connection between personal recovery and two sets of potential contributors: psychosocial variables (i.e., empowerment, resilience, and consumer involvement) and functional indicators of clinical recovery. Method: These relationships were examined by analyzing survey data collected from 266 consumers who are receiving public mental health services in the United States. Results: Empowerment, resilience and psychological involvement were associated with personal recovery. Clinical recovery did not uniquely contribute to personal recovery once psychosocial factors were accounted for. Interactions revealed that the relationship between psychological involvement and personal recovery was stronger for those who had been recently hospitalized, and for those with relatively greater resilience. Conclusions: Results indicate that personal recovery is an essential outcome measure for recovery-oriented services that cannot be replaced by clinical recovery outcome measurement. Additionally, empowerment, resilience, and consumer involvement are key components of recovery, which suggests that services and outcome measures should prioritize incorporation of these constructs.

Do Health Service Use and Return-to-Work Outcomes Differ with GPs' Injured-Worker Caseload?

Purpose To determine whether healthcare use and return-to-work (RTW) outcomes differ with GPs' injured-worker caseload. Methods Retrospective analyses of the Compensation Research Database, which captures approximately 85% of all injured worker claims in Victoria, Australia was conducted. Four injured-worker caseload groups were examined that represented the 25th, 50th, 75th, and 100th percentiles of claimants seen per GP over the 8-year study period (2003-2010): (i) 1-13 claimants; (ii) 14-26 claimants; (iii) 27-48 claimants; and (iv) 49+ claimants (total claims, n = 124,342; total GPs, n = 9748).The characteristics of claimants in each caseload group, as well as the influence of caseload on three outcomes relevant to RTW (weekly compensation paid, work incapacity days, medical-and-like costs), were examined. Results Distinct profiles for high versus low caseload groups emerged. High caseload GPs treated significantly more men in blue collar occupations and issued significantly more 'alternate duties' certificates. Conversely, low caseload GPs treated significantly more women in white collar occupations, predominantly for mental health injuries, and issued significantly more 'unfit-for-work' certificates. Few significant differences were found between the two intermediate GP caseload groups. High caseload was associated with significantly greater medical-and-like costs, however, no caseload group differences were detected for weekly compensation paid or duration of time-off-work. Conclusions Training GPs who have a low injured-worker caseload in workers' compensation processes, utilising high caseload GPs in initiatives involving peer-to-peer support, or system changes where employers are encouraged to provide preventive or rehabilitative support in the workplace may improve RTW outcomes for injured workers.

The relevance and implications of organizational involvement for serious mental illness populations.

Consumer involvement has gained greater prominence in serious mental illness (SMI) because of the harmonious forces of new research findings, psychiatric rehabilitation, and the recovery movement. Previously conceived subdomains of consumer involvement include physical involvement, social involvement, and psychological involvement. We posit a fourth subdomain, organizational involvement. We have operationally defined organizational involvement as the involvement of mental health consumers in activities and organizations that are relevant to the mental health aspect of their identities from an individual to a systemic level across arenas relevant to mental health. This study surveyed adults with SMI regarding their current level of organizational involvement along with their preferences and beliefs about organizational involvement. Additionally, a path model was conducted to understand the relationships between domains of consumer involvement. Although participants reported wanting to be involved in identified organizational involvement activities and believing it was important to be involved in these kinds of activities, organizational involvement was low overall. The path model indicated that psychological involvement among other factors influence organizational involvement, which informed our suggestions to improve organizational involvement among people with SMI. Successful implementation must be a thoroughly consumer-centered approach creating meaningful and accessible involvement opportunities. Our study and prior studies indicate that organizational involvement and other subdomains of consumer involvement are key to the health and wellbeing of consumers, and therefore greater priority should be given to interventions aimed at increasing these essential domains.

Local control rates with five-fraction stereotactic body radiotherapy for oligometastatic cancer to the lung.

OBJECTIVE: To report our institutional experience with five fractions of daily 8-12 Gy stereotactic body radiotherapy (SBRT) for the treatment of oligometastatic cancer to the lung. METHODS: Thirty-four consecutive patients with oligometastatic cancers to the lung were treated with image-guided SBRT between 2008 and 2011. Patient age ranged from 38 to 81 years. There were 17 males and 17 females. Lung metastases were from the following primary cancer types: colon cancer (n=13 patients), head and neck cancer (n=6), breast cancer (n=4), melanoma (n=4), sarcoma (n=4) and renal cell carcinoma (n=3). The median prescription dose was 50 Gy in five fractions (range, 40-60 Gy) to the isocenter, with the 80% isodose line encompassing the planning target volume (PTV) [defined as gross tumor volume (GTV) + 7-11 mm volumetric expansion]. The follow-up interval ranged from 2.4-54 months, with a median of 16.7 months. RESULTS: The 1-, 2-, and 3-year patient local control (LC) rates for all patients were 93%, 88%, and 80% respectively. The 1-, 2-, and 3-year overall survival (OS) rates were 62%, 44%, and 23% respectively. The 1- and 2-year patient LC rates were 95% and 88% for tumor size 1-2 cm (n=25), and 86% for tumor size 2-3 cm (n=7). The majority (n=4) of local failures occurred within 12 months. No patient experienced local failure after 12 months except for one patient with colon cancer whose tumors progressed locally at 26 months. All five patients with local recurrences had colorectal cancer. Statistical analyses showed that age, gender, previous chemotherapy, previous surgery or radiation had no significant effect on LC rates. No patient was reported to have any symptomatic pneumonitis at any time point. CONCLUSIONS: SBRT for oligometastatic disease to the lung using 8-12 Gy daily fractions over five treatments resulted in excellent 1- and 2-year LC rates. Most local failures occurred within the first 12 months, with five local failures associated with colorectal cancer. The treatment is safe using this radiation fractionation schedule with no therapy-related pneumonitis.

MEMORY FOR POETRY: MORE THAN MEANING?

The assumption has become that memory for words' sound patterns, or form, is rapidly lost in comparison to content. Memory for form is also assumed to be verbatim rather than schematic. Oral story-telling traditions suggest otherwise. The present experiment investigated if form can be remembered schematically in spoken poetry, a context in which form is important. We also explored if sleep could help preserve memory for form. We tested whether alliterative sound patterns could cue memory for poetry lines both immediately and after a delay of 12 hours that did or did not include sleep. Twelve alliterative poetry lines were modified into same alliteration, different alliteration, and no alliteration paraphrases. We predicted that memory for original poetry lines would be less accurate after 12 hours, same alliteration paraphrases would be falsely recognized as originals more often after 12 hours, and that the no-sleep group would make more errors. Different alliteration and no alliteration paraphrases were not expected to share this effect due to schematically different sound patterns. Our data support these hypotheses and provide evidence that memory for form is schematic in nature, retained in contexts in which form matters, and that sleep may help preserve memory for sound patterns.

Generalized event knowledge activation during online sentence comprehension.

Recent research has demonstrated that knowledge of real-world eventsplays an important role inguiding online language comprehension. The present study addresses the scope of event knowledge activation during the course of comprehension, specifically investigating whether activation is limited to those knowledge elements that align with the local linguistic context.The present study addresses this issue by analyzing event-related brain potentials (ERPs) recorded as participants read brief scenariosdescribing typical real-world events. Experiment 1 demonstratesthat a contextually anomalous word elicits a reduced N400 if it is generally related to the described event, even when controlling for the degree of association of this word with individual words in the preceding context and with the expected continuation. Experiment 2 shows that this effect disappears when the discourse context is removed.These findings demonstrate that during the course of incremental comprehension, comprehenders activate general knowledge about the described event, even at points at which this knowledge would constitute an anomalous continuation of the linguistic stream. Generalized event knowledge activationcontributes to mental representations of described events, is immediately available to influence language processing, and likely drives linguistic expectancy generation.

Event-based plausibility immediately influences on-line language comprehension.

In some theories of sentence comprehension, linguistically relevant lexical knowledge, such as selectional restrictions, is privileged in terms of the time-course of its access and influence. We examined whether event knowledge computed by combining multiple concepts can rapidly influence language understanding even in the absence of selectional restriction violations. Specifically, we investigated whether instruments can combine with actions to influence comprehension of ensuing patients of (as in Rayner, Warren, Juhuasz, & Liversedge, 2004; Warren & McConnell, 2007). Instrument-verb-patient triplets were created in a norming study designed to tap directly into event knowledge. In self-paced reading (Experiment 1), participants were faster to read patient nouns, such as hair, when they were typical of the instrument-action pair (Donna used the shampoo to wash vs. the hose to wash). Experiment 2 showed that these results were not due to direct instrument-patient relations. Experiment 3 replicated Experiment 1 using eyetracking, with effects of event typicality observed in first fixation and gaze durations on the patient noun. This research demonstrates that conceptual event-based expectations are computed and used rapidly and dynamically during on-line language comprehension. We discuss relationships among plausibility and predictability, as well as their implications. We conclude that selectional restrictions may be best considered as event-based conceptual knowledge rather than lexical-grammatical knowledge.

Effects of event knowledge in processing verbal arguments.

This research tests whether comprehenders use their knowledge of typical events in real time to process verbal arguments. In self-paced reading and event-related brain potential (ERP) experiments, we used materials in which the likelihood of a specific patient noun (brakes or spelling) depended on the combination of an agent and verb (mechanic checked vs. journalist checked). Reading times were shorter at the word directly following the patient for the congruent than the incongruent items. Differential N400s were found earlier, immediately at the patient. Norming studies ruled out any account of these results based on direct relations between the agent and patient. Thus, comprehenders dynamically combine information about real-world events based on intrasentential agents and verbs, and this combination then rapidly influences online sentence interpretation.

The wind chilled the spectators, but the wine just chilled: Sense, structure, and sentence comprehension.

Anticipation plays a role in language comprehension. In this article, we explore the extent to which verb sense influences expectations about upcoming structure. We focus on change of state verbs like shatter, which have different senses that are expressed in either transitive or intransitive structures, depending on the sense that is used. In two experiments we influence the interpretation of verb sense by manipulating the thematic fit of the grammatical subject as cause or affected entity for the verb, and test whether readers' expectations for a transitive or intransitive structure change as a result. This sense-biasing context influenced reading times in the post-verbal regions. Reading times for transitive sentences were faster following good-cause than good theme subjects, but the opposite pattern was found for intransitive sentences. We conclude that readers use sense-contingent subcategorization preferences during on-line comprehension.

Activating event knowledge.

An increasing number of results in sentence and discourse processing demonstrate that comprehension relies on rich pragmatic knowledge about real-world events, and that incoming words incrementally activate such knowledge. If so, then even outside of any larger context, nouns should activate knowledge of the generalized events that they denote or typically play a role in. We used short stimulus onset asynchrony priming to demonstrate that (1) event nouns prime people (sale-shopper) and objects (trip-luggage) commonly found at those events; (2) location nouns prime people/animals (hospital-doctor) and objects (barn-hay) commonly found at those locations; and (3) instrument nouns prime things on which those instruments are commonly used (key-door), but not the types of people who tend to use them (hose-gardener). The priming effects are not due to normative word association. On our account, facilitation results from event knowledge relating primes and targets. This has much in common with computational models like LSA or BEAGLE in which one word primes another if they frequently occur in similar contexts. LSA predicts priming for all six experiments, whereas BEAGLE correctly predicted that priming should not occur for the instrument-people relation but should occur for the other five. We conclude that event-based relations are encoded in semantic memory and computed as part of word meaning, and have a strong influence on language comprehension.

Phonological typicality and sentence processing.

In studies of language, it is widely accepted that the form of a word is independent of its meaning and syntactic category. Thus, the relationship between phonological form and grammatical class would not be expected to affect reading time. However, Farmer et al. have now shown that the phonological typicality of a noun or verb influences how rapidly it is read. This finding has implications for both sentence processing and the interpretation of fixation patterns in reading.

Understanding and producing the reduced relative construction: Evidence from ratings, editing and corpora.

Tworating studies demonstrate that English speakers willingly produce reduced relatives with internal cause verbs (e.g., Whisky fermented in oak barrels can have a woody taste), and judge their acceptability based on factors known to influence ambiguity resolution, rather than on the internal/external cause distinction. Regression analyses demonstrate that frequency of passive usage predicts reduced relative frequency in corpora, but internal/external cause status does not. The authors conclude that reduced relatives with internal cause verbs are rare because few of these verbs occur in the passive. This contrasts with the claim in McKoon and Ratcliff (McKoon, G., & Ratcliff, R. (2003). Meaning through syntax: Language comprehension and the reduced relative clause construction. Psychological Review, 110, 490-525) that reduced relatives like The horse raced past the barn fell are rare and, when they occur, incomprehensible, because the meaning of the reduced relative construction prohibits the use of a verb with an internal cause event template.

Motorcycle deployment and rider characteristics on Victorian farms.

OBJECTIVE: To describe the motorcycle fleet and rider characteristics on Victorian farms. DESIGN: Cross-sectional postal survey. SETTING: Victorian agricultural industries. PARTICIPANTS: A total of 1382 randomly selected farmers in 2001. MAIN OUTCOME MEASURES: Farm motorcycle characteristics, use and maintenance schedule; motorcycle rider characteristics, respondent demographics and property characteristics. RESULTS: A total of 70% of farms had motorcycles, with an average of 1.7 per property. A total of 49% were four-wheel, and 44% were two-wheel. The average engine size and age were 255 cc and 8.8 years, respectively. The milk cattle sector owned the largest share of the motorcycle fleet and cereal/grain farms the smallest share. Four-wheel motorcycles were often used across the entire spectrum of agricultural tasks. Two-wheel motorcycle use was concentrated more on mustering and transport. A total of 61% of farms performed motorcycle maintenance every 1-6 months. Fifteen per cent of riders were under 15 years of age, and the majority (71%) rode four-wheel motorcycles. A total of 29% of all riders had received some form of motorcycle training. CONCLUSIONS: This study provides useful information on state-level patterns of farm motorcycle use, as well as the key safety behaviours of rider training and motorcycle maintenance. This information might serve as baseline data for future monitoring and surveillance, and might assist with planning of prevention programs.

Meaning through syntax is insufficient to explain comprehension of sentences with reduced relative clauses: comment on McKoon and Ratcliff (2003).

The authors argue that the meaning through syntax (MTS) model proposed by G. McKoon and R. Ratcliff fails to account for the comprehension of sentences with reduced relative clauses. First, the theory's core assumptions regarding verb-based event representations and how they link to constructions are incompatible with well-established analyses from the lexical semantics literature. Second, the MTS theory provides neither a principled nor a consistent account for why some reduced relatives are hard whereas others are easy. Finally, McKoon and Ratcliff's critique of constraint-based models is flawed in that sometimes they tested a nonexistent theory and sometimes they provided evidence for the constraint-based models against which they were arguing.

A basis for generating expectancies for verbs from nouns.

We explore the implications of an event-based expectancy generation approach to language understanding, suggesting that one useful strategy employed by comprehenders is to generate expectations about upcoming words. We focus on two questions: (1) What role is played by elements other than verbs in generating expectancies? (2) What connection exists between expectancy generation and event-based knowledge? Because verbs follow their arguments in many constructions (particularly in verb-final languages), deferring expectations until the verb seems inefficient. Both human data and computational modeling suggest that other sentential elements may also play a role in predictive processing and that these constraints often reflect knowledge regarding typical events. We investigated these predictions, using both short and long stimulus onset asynchrony priming. Robust priming obtained when verbs were named aloud following typical agents, patients, instruments, and locations, suggesting that event memory is organized so that nouns denoting entities and objects activate the classes of events in which they typically play a role. These computations are assumed to be an important component of expectancy generation in sentence processing.