Objective: To assess psychosocial distress in patients with early (localised) and advanced (metastatic) prostate cancer (PCA) at diagnosis (Time 1) and 12 months later (Time 2), and identify psychosocial factors predictive of later distress. Design, participants and setting: Observational, prospective study of 367 men with early (211) or advanced (156) PCA recruited as consecutive attendees at clinics at seven public hospitals and practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Both groups completed questionnaires at Time 1 and Time 2. Main outcome measures: Health‐related quality of life as assessed by the Short Form 36‐item Health Survey; psychological distress, including depression and anxiety as assessed by the Brief Symptom Inventory; and coping patterns as assessed by the Mini‐Mental Adjustment to Cancer scale. Results: Over the 12 months, both the early and advanced PCA group showed reduced vitality and increased depression and anxiety; this effect was greater in the advanced PCA group. Mental health, social functioning and role‐emotional functioning also deteriorated in the advanced group. Predictors of depression at Time 2 for the early PCA group were depression, vitality and a fatalistic coping pattern at Time 1; anxiety at Time 2 was predicted by anxiety and vitality at Time 1. In the advanced PCA group, depression at Time 2 was predicted by depression and mental health at Time 1; anxiety at Time 2 was predicted by anxiety, mental health, cognitive avoidance and lower anxious preoccupation at Time 1. Conclusions: Men with early PCA experience decreasing vitality and increasing psychological distress over the 12 months following diagnosis; this trend is accelerated after diagnosis with advanced PCA. A fatalistic coping pattern at diagnosis of early PCA predicts later depression while cognitive avoidance and lower anxious preoccupation at diagnosis of advanced PCA predict later anxiety.

Pharyngeal dilator muscles are clearly important in the pathophysiology of obstructive sleep apnoea syndrome (OSA). We have previously shown that the activity of both the genioglossus (GGEMG) and tensor palatini (TPEMG) are decreased at sleep onset, and that this decrement in muscle activity is greater in the apnoea patient than in healthy controls. We have also previously shown this decrement to be greater in older men when compared with younger ones. In order to explore the mechanisms responsible for this decrement in muscle activity nasal continuous positive airway pressure (CPAP) was applied to reduce negative pressure mediated muscle activation. We then investigated the effect of sleep onset (transition from predominantly a to predominantly u EEG activity) on ventilation, upper airway muscle activation and upper airway resistance (UAR) in middle-aged and younger healthy men. We found that both GGEMG and TPEMG were reduced by the application of nasal CPAP during wakefulness, but that CPAP did not alter the decrement in activity in either muscle seen in the first two breaths following an a to u transition. However, CPAP prevented both the rise in UAR at sleep onset that occurred on the control night, and the recruitment in GGEMG seen in the third to fifth breaths following the a to u transition. Further, GGEMG was higher in the middle-aged men than in the younger men during wakefulness and was decreased more in the middle-aged men with the application of nasal CPAP. No differences were seen in TPEMG between the two age groups. These data suggest that the initial sleep onset reduction in upper airway muscle activity is due to loss of a 'wakefulness' stimulus, rather than to loss of responsiveness to negative pressure. In addition, it suggests that in older men, higher wakeful muscle activity is due to an anatomically more collapsible upper airway with more negative pressure driven muscle activation. Sleep onset per se does not appear to have a greater effect on upper airway muscle activity as one ages.

Previous research suggests that a couple-focused psychological intervention is desirable in the context of early stage PCa. This pilot study has established that CECT is acceptable, feasible and valued by couples facing a recent PCa diagnosis and demonstrates a potential for reduced psychological distress following CECT. A randomised controlled trial is currently being undertaken to validate the efficacy of this novel approach.

Descriptions of interference effects from non-relevant stimuli are extensive in visual target detection and identification paradigms. To explore the influence of features of non-relevant objects on reach-to-grasp movements, we instructed healthy normal controls to reach for and pick up a cylinder (target) placed midsagittally 30 cm from the starting position of the hand. In Experiment 1, the target was presented alone, or accompanied by a narrower, wider, or same-size distractor positioned to the left or right of the target. In Experiment 2, the target was presented alone or accompanied by a distractor, which was slanted at a different orientation to the target. Reflective markers were placed on the wrist, thumb, and index finger of the right hand, and infra-red light-detecting cameras recorded their displacement through a calibrated 3-dimensional working space. Kinematic parameters were derived and analysed. Consistent changes in the expression of peak velocity, acceleration, and deceleration were evident when the distractor was narrower or wider than the target. The impact of the orientation of the distractor, conversely, was not marked. We discuss the results in the context of physiological findings and models of selective attention.

Body Dysmorphic Disorder (BDD) is characterised by overvalued or delusional beliefs of 'imagined ugliness'. Delusional beliefs have been explained by a number of cognitive theories, including faulty perceptions, biases in attention, and corruption of semantic memory. Atypical aesthetics may also influence beliefs in BDD. In fourteen BDD patients, compared to controls (n=14), we examined these theories of beliefs in a cognitive test battery consisting of perceptual organisation and visual affect perception tasks, a Stroop task using body words, a sentence verification task, a fluency task, and an attractiveness task. BDD patients performed similar to controls on tasks measuring information (bias) processing and aesthetics. However, BDD showed abnormal abilities on semantic processing involving sentence verification and category fluency. There was only a trend finding of impaired performance on perceptual processing tasks in BDD. The findings suggest that the delusional beliefs in BDD may be explained by impaired semantic processing.