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The Pacific Islands carry a perception of having clean air, yet emissions from transport and burning activities are of concern in regard to air quality and health. Ultrafine particle number concentrations (PNCs), one of the best metrics to demonstrate combustion emissions, have not been measured either in Suva or elsewhere in the Islands. This work provides insight into PNC variation across Suva and its relationship with particle mass (PM) concentration and composition. Measurements over a short monitoring campaign provide a vignette of conditions in Suva. Ambient PNCs were monitored for 8 day at a fixed location, and mobile PNC sampling for two days. These were compared with PM concentration (TSP, PM 10 , PM 2.5 , PM 1 ) and are discussed in relation to black carbon (BC) content and PM 2.5 sources, determined from elemental concentrations; for the October 2015 period and longer-term data. Whilst Suva City PM levels remained fairly low, PM 2.5 = 10–12 μg m −3 , mean PNC (1.64 ± 0.02 × 10 4 cm −3 ) was high compared to global data. PNCs were greater during mobile sampling, with means of 10.3 ± 1.4 × 10 4 cm −3 and 3.51 ± 0.07 × 10 4 cm −3 when travelling by bus and taxi, respectively. Emissions from road vehicles, shipping, diesel and open burning were identified as PM sources for the October 2015 period. Transport related ultrafine particle emissions had a significant impact on microscale ambient concentrations, with PNCs near roads being 1.5 to 2 times higher than nearby outdoor locations and peak PNCs occurring during peak traffic times. Further data, particularly on transport and wet-season exposures, are required to confirm results. Understanding PNC in Suva will assist in formulating effective air emissions control strategies, potentially reducing population exposure across the Islands and in developing countries with similar emission characteristics. Suva's PNC was high in comparison to global data; high exposures were related to transport and combustion emissions, which were also identified as significant PM 2.5 sources. [ABSTRACT FROM AUTHOR]

The Imperial Smelting Furnace (ISF) for producing lead and zinc simultaneously has operated on four continents and in eleven countries from the 1950's. One of the process changes that the ISF introduced was the production of a finely granulated slag waste. Although this slag contained significant amounts of residual lead (Pb) and zinc (Zn), because of its glassy nature it was considered environmentally benign. From the Cockle Creek smelter near Boolaroo at the northern end of Lake Macquarie, NSW, Australia, it is estimated that around 2.1 million tonnes of the fine slag was distributed into the community and most remains where it was originally utilised. Residual tonnages of slag of this magnitude are common worldwide wherever the ISF operated. Studies of base metal smelting slags have concluded that mineralogical and morphological characteristics of the slag play a critical role in moderating environmental release of toxic elements. Scanning electron microscopy (SEM) and microanalysis of the ISF slags has shown that the Pb and associated elements are present as discrete nodules (∼6–22 μm) in the slag and that they are not associated with Zn which is contained in the glass slag phase. Using an automated SEM and analysis technique (QEMSCAN ® ) to “map” the mineralogical structure of the particles, it was possible to quantitatively determine the degree of access infiltrating fluids might have to the reaction surface of the Pb phases. The level of access decreases with increasing particle size, but in even the largest sized particles (−3350 + 2000 μm) nearly 80% of the Pb-containing phases were totally or partially accessible. These results provide evidence that the toxic elements in the slags are not contained by the glassy phase and will be vulnerable to leaching over time depending on their individual phase reactivity. [ABSTRACT FROM AUTHOR]

This study aimed to examine how stigma impacts on symptomatic and subjective recovery from psychosis, both concurrently and longitudinally. We also aimed to investigate whether self-esteem and hopelessness mediated the observed associations between stigma and outcomes. 80 service-users with psychosis completed symptom (Positive and Negative Syndrome Scale) and subjective recovery measures (Process of Recovery Questionnaire) at baseline and 6-months later, and also completed the King Stigma Scale, the Self-Esteem Rating Scale and the Beck Hopelessness Scale at baseline. In cross sectional regression and multiple mediation analyses of the baseline data, we found that stigma predicted both symptomatic and subjective recovery, and the effects of stigma on these outcomes were mediated by hopelessness and self-esteem. When the follow-up data were examined, stigma at baseline continued to predict recovery judgements and symptoms. However, self-esteem only mediated the effect of stigma on PANSS passive social withdrawal. Self-esteem and hopelessness should be considered in interventions to reduce the effects of stigma. Interventions that address the current and long-term effects of stigma may positively affect outcome for people being treated for psychosis. [ABSTRACT FROM AUTHOR]

Abstract: Background and objectives: Cognitive behaviour therapy (CBT) for psychosis has been shown to be effective, but there are recent suggestions that it is less efficacious than initially thought. Metacognitive therapy (MCT), which focuses on metacognitive mechanisms, has led to positive results in other disorders, but has yet to be evaluated in people with schizophrenia spectrum diagnoses. This study evaluates the feasibility of MCT for people with psychotic disorders. Methods: Ten participants with schizophrenia spectrum disorders received up to 12 sessions of MCT in an open trial. Outcomes included psychiatric symptoms measured using the PANSS, at baseline, 9 months (end of treatment) and at 12 months (follow-up), as well as dimensions of hallucinations and delusions, emotional dysfunction, self-rated recovery, social functioning and metacognitive beliefs. Results: T-tests and Wilcoxon's signed ranks tests revealed significant beneficial effects on several outcomes at end-of-treatment and follow-up. Cohen's d effect sizes were moderate to large (for PANSS total, d = 1.0 at end of treatment; d = 0.95 at follow-up). A response rate analysis found 50% and 40% of participants achieved at least a 25% reduction in PANSS total scores by end of therapy and follow-up, respectively. Exploratory analyses revealed that metacognitive beliefs significantly changed over treatment and follow-up periods. Limitations: This study had no control group and was not randomised; therefore, it is likely that effect sizes were inflated. Conclusions: This study provides preliminary evidence that MCT is a feasible treatment for people with psychosis. An adequately powered randomised controlled trial is warranted. [Copyright &y& Elsevier]

Abstract: Although several reviews show that cognitive behavioral therapy (CBT) is an effective treatment for patients with chronic psychosis, the effects of CBT on patients with a first-episode psychosis are less clear. Patients undergoing a first-episode psychosis are unique in that not only are they struggling with the symptoms of the disease, but also the realization of the diagnosis. Understanding how the disease will impact their lives with respect to changes in social goals, roles, and status can also lead to depression, anxiety and low self-esteem. The main aim of the present study is to describe two clinical cases in order to demonstrate the application of CBT in first-episode psychosis patients in an early stage of their psychosis. The two cases are individuals who were in an ongoing CBT trial for first-episode psychosis patients with symptoms of social anxiety, depression, and low self-esteem. Individual case formulations based on these symptoms were developed. Psychoeducation, normalizing, evaluation of negative automatic thoughts and dysfunctional schematic beliefs, and focusing on the negative consequences of safety behavior were the main treatment targets in attempting to improve the patients’ symptoms and functioning. Both patients showed improvement in depressive symptoms, self-esteem, and general functioning. The cases described suggest that treatment designed to target depression, anxiety, and self-esteem in patients with first-episode psychosis could have potential beneficial effects; specific studies of this approach are recommended. [Copyright &y& Elsevier]

Abstract: We outline our understanding of collaborative empiricism (CE) as used in cognitive therapy (CT) for psychosis. We discuss how CE can be thought of as a technique for facilitating cognitive change in the service of a client's goals, but also as an expression of respect for client autonomy, recognizing the ethical imperative to empower clients by involving them in decisions about their care. Taking a CE approach is therefore consistent with user-led conceptualizations of recovery, and the related movements of “shared decision-making” and “evidence-based patient choice.” We discuss how CE can aid with engagement, assessment, formulation, and intervention in CT, illustrating this with case material. We focus on how CE can help with distressing intrusive experiences and beliefs, and also consider its role in helping clients achieve wider life goals. Adaptations to CE for working with people with problems with learning, attention, and memory are discussed, as are considerations for working with high conviction and conceptual disorganization. [Copyright &y& Elsevier]

Abstract: Research suggests that both psychosocial factors and neuropsychiatric factors are important predictors of outcome, but little research has examined their relative importance to self-rated recovery. We aim to investigate how such factors are associated with subjective judgements of recovery from psychosis. The participants comprised 122 individuals with experience of psychosis who completed measures of perceived recovery, as well as measures of psychological factors (including self-esteem, locus of control, and emotion) and psychiatric factors (including psychotic symptoms, neurocognition and insight). Measurement models developed using confirmatory factor analysis supported a hypothesis of separate recovery and negative emotion factors. Structural equation modelling showed that negative emotion and internal locus of control had a direct influence on self-rated recovery, and that positive symptoms and internal locus of control had an indirect effect on recovery, mediated via negative emotion. There did not appear to be any effect of insight, negative symptoms or neurocognitive functioning on either self-rated recovery or negative emotion. Psychosocial factors are more directly related to perceived recovery than neuropsychiatric factors. The implications of these findings are discussed. [Copyright &y& Elsevier]

Abstract: Background: Cognitive behaviour therapy (CBT) has been shown to be effective in an open trial for people with psychotic disorders who have not been taking antipsychotic medication. There is little known about predictors of outcome in CBT for psychosis and even less about hypothesised mechanisms of change. Method: 20 participants with schizophrenia spectrum disorders received CBT in an exploratory trial. Our primary outcome was psychiatric symptoms measured using the PANSS. Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning, and hypothesised mechanisms of change included appraisals of psychotic experiences, dysfunctional attitudes and cognitive insight. We also measured patient characteristics that may be associated with outcome. Results: T-tests revealed that several of the hypothesised mechanisms did significantly change over the treatment and follow-up periods. Correlational analyses showed that reductions in negative appraisals of psychotic experiences were related to improvements on outcome measures and that shorter duration of psychosis and younger age were associated with greater changes in symptoms. Conclusions: CBT based on a specific cognitive model appears to change the hypothesised cognitive mechanisms, and these changes are associated with good outcomes. CBT may be more effective for those who are younger with shorter histories of psychosis. [Copyright &y& Elsevier]

Trace metal exposure from environmental sources remains a persistent global problem, particularly in communities residing adjacent to metal extraction and processing industries. This study examines front yard soil and house dust from 62 residences throughout the Australian Ag–Pb–Zn mining city of Broken Hill to better understand spatial variability in metal distributions, compositions and exposures across an industrially polluted urban environment. X-ray fluorescence analysis of paired soil/dust samples indicated that geomean concentrations (mg/kg) of Cu (32/113), Zn (996/1852), As (24/34) and Pb (408/587) were higher in house dust while Ti (4239/3660) and Mn (1895/1101) were higher in outdoor soil. Ore associated metals and metalloids (Mn, Zn, As, Pb) in soil and house dust were positively correlated and declined in concentration away from mining areas, the primary source of metalliferous emissions in Broken Hill. The rate of decline was not equivalent between soil and house dust, with the indoor/outdoor concentration ratio increasing with distance from mining areas for Zn/Pb (geomean = 1.25/1.05 (<1 km); 2.14/1.52 (1–2 km); 2.54/2.04 (>2 km)). House dust and Broken Hill ore Pb isotopic compositions (206Pb/207Pb; 208Pb/207Pb) were more similar in homes nearest to mining areas than those further away (geomean apportioned ore Pb = 88% (<1 km); 76% (1–2 km); 66% (>2 km)), reflecting spatial shifts in the balance of sources contributing to indoor contamination. Incorporation of house dust Pb reduced overestimation of IEUBK modelled blood Pb concentrations compared to when only soil Pb was used. These findings demonstrate that even in contexts where the source and environmental burden of metals are relatively apparent, geochemical relationships and exposures between outdoor and indoor environments are not always predictable, nor easily disaggregated. [Display omitted] • Copper, zinc, arsenic and lead concentrations were higher in house dust than in soil. • External dust and soil reservoirs predicted the trace metal content of house dust. • Mine dispersed metals were a primary source of contamination in nearby homes. • High metal concentrations were present indoors even where soil concentrations were low. • Indoor dust lead concentrations improved local scale exposure uptake modelling. [ABSTRACT FROM AUTHOR]

Abstract: Background: Recent models of emotional disorders and psychosis implicate metacognitive beliefs in the development and maintenance of psychological distress. We predicted that patients with established psychotic disorders and those meeting at risk mental state (ARMS) criteria (and, thus, at increased risk of developing psychosis) would show higher levels of metacognitive beliefs than non-patient controls. Furthermore, we predicted that patients with psychosis would show higher levels of such beliefs than the at risk group. Method: The Metacognitions Questionnaire was administered to 73 patients with psychotic disorders, 43 ARMS patients and 188 non-patients. Results: As predicted, patients with psychotic diagnoses and those at risk scored higher on metacognitive belief dimensions than non-patients. Patients with psychosis showed higher positive metacognitive beliefs than the at risk patients, indicating a greater range of unhelpful metacognitions overall, when compared to non-patients. Conclusions: These findings are consistent with metacognitive conceptualisations of psychological disorders. The implications of these findings for clinical practice are discussed. [Copyright &y& Elsevier]

Abstract: Background: This study tests the hypothesis that worry is associated with psychotic experiences and examines whether worry would contribute significantly to emotional response independently of the intensity of psychotic experiences. This study also explores differences in worry between patients with a diagnosis of a schizophrenia spectrum disorder, patients with anxiety disorders and non-patients. Method: Fifty-one patients with psychotic diagnoses, 40 patients with anxiety disorders and 60 non-patients were assessed on measures of psychotic experiences, cognitive components of anxiety and depression. Results: Dimensions of worry were associated with dimensions of delusional ideation and with psychotic experiences and social worry predicted emotional responses over and above the intensity of psychotic experiences. Both clinical groups had significantly higher levels of worry in comparison with non-patients. Conclusions: These findings suggest that worry may be implicated in psychotic experiences and that people with psychotic diagnoses experience high levels of worry. The clinical implications of the findings are also discussed. [Copyright &y& Elsevier]

Abstract: The psychological consequences of bullying have been the focus of much research over the last 25 years. However, the relationship between bullying and psychotic experiences has been relatively ignored despite the weight of evidence which suggests that traumatic events in childhood are significantly related to psychotic disorders. 373 pupils aged between 14 and 16 years took part in the study. They were asked to complete a number of self-report measures which examined their experience of bullying, predisposition to auditory hallucinations, paranoia and dissociation, and beliefs about both the self and the world and about paranoia. It was found that bullying was significantly associated with predisposition to psychotic experiences. Negative post-trauma cognitions were also associated with predisposition to psychotic phenomena as were positive beliefs about paranoia. Being bullied at school and beliefs about trauma and psychotic symptoms may contribute to the development of psychosis. However, it is also possible that these results indicate that experiencing psychotic-like phenomena increases the likelihood that a pupil''s interpersonal context is characterised by peer hostility and rejection. The implications of these results are discussed. [Copyright &y& Elsevier]

The case of Sam is conceptualized using a normalizing cognitive approach, which assumes that the cultural acceptability of his appraisals distinguishes them as psychotic. The treatment approach that is based upon such a case formulation involves the evaluation of such distressing appraisals and the generation of alternative explanations. Intervention also involves the identification and manipulation of maintenance factors such as selective attention, thought-control strategies and safety behaviors, as well as beliefs about self, world, and others and metacognitive beliefs. The desired goals that may be collaboratively generated are considered, and potential problems in therapy are discussed. [Copyright &y& Elsevier]

Background: This study tested the hypotheses that interpretations of voices will be associated with distress linked to auditory hallucinations, and that patients experiencing hallucinations will exhibit higher levels of negative interpretations in comparison with non-patients.Method: The Interpretation of Voices Inventory (British Journal of Clinical Psychology 41 (2002) 259) was administered to patients who met DSM-IV criteria for schizophrenia spectrum disorders with auditory hallucinations and non-patients. Patients were also assessed using a semi-structured interview to asses clinical dimensions of their voices.Results: The results showed that people with psychosis who experience auditory hallucinations did exhibit higher levels of positive and negative interpretations of voices, in comparison to non-patients. Correlational analyses revealed that interpretations of voices were significantly associated with emotional, physical and cognitive characteristics of voices. Regression analyses demonstrated that physical characteristics of voices and metaphysical beliefs were significant predictors of emotional characteristics of voices.Conclusions: The theoretical and clinical implications of these findings are discussed. [Copyright &y& Elsevier]

This study reports the development of a self-report measure to assess beliefs about and frequency of anti-depressive behaviour. This study tests the hypothesis that people predisposed to depression and mania will be associated with higher levels of unhelpful beliefs about anti-depressive behaviour, sociotropy and autonomy, and higher levels of dysfunctional antidepressive behaviour. Non-clinical participants (112) were asked to complete questionnaires assessing beliefs about and frequency of anti-depressive behaviour, predisposition to mania, depression, sociotropy and autonomy. The results showed that three empirically distinct subscales measuring the beliefs people hold about how to avoid depression can be identified reliably. The questionnaire assessing frequency of antidepressive behaviour also had three subscales. The scales possessed acceptable internal consistency and were moderately stable over a 4–6 week period. Consistent with predictions, it was found that sociotropy, autonomy and beliefs about antidepressive behaviour were significantly associated with depression. Autonomy was found to predict predisposition to mania, and those with high vulnerability to mania scored significantly higher on measures of autonomy, sociotropy and frequency of active coping than those of lowest vulnerability. The theoretical and clinical implications of the findings are discussed. [Copyright &y& Elsevier]

Cognitive models suggest that auditory hallucinations occur as the result of internal events attributed to an external source. The present study represents an attempt to evaluate the source monitoring performance of people who experience auditory hallucinations, specifically in terms of the suggested links between source monitoring, emotionality of stimuli and self-focused attention. The source monitoring performance of a group of 30 patients with a diagnosis of a schizophrenia spectrum disorder who experience auditory hallucinations was compared following successful experimental manipulation of their attention, designed to increase and decrease their levels of self-focused attention. The inclusion of words previously rated as emotionally salient by schizophrenic patients assessed the effect of emotionality on source monitoring performance. This study demonstrated that participants’ ratings of both internality and control of their responses to the word association task were lower in the external focus condition than the internal focus condition. Furthermore, it was found that ratings of internality and control were lower for responses to both positive and negative stimuli compared to responses to neutral stimuli, and the magnitude of these differences was amplified in the internal focus condition relative to the external focus condition. Focus of attention has a significant effect on source monitoring performance in people experiencing auditory hallucinations. The theoretical and clinical implications of these findings are discussed. [Copyright &y& Elsevier]

This study tested the hypothesis that metacognitions are a general vulnerability factor for psychological disorder. It was predicted that patients with psychosis (hallucinations or delusions), and patients with panic disorder would score higher than non-patients on measures of metacognition. Moreover, it was hypothesised that patients showing most dysregulation of thinking (voice-hearers) would endorse significantly higher metacognition scores than individuals in the other groups. The Meta-Cognitions Questionnaire (MCQ: ) was administered to patients who met DSM-IV criteria for schizophrenia spectrum disorders with auditory hallucinations, patients who met DSM-IV criteria for schizophrenia spectrum disorders with persecutory delusions, patients who met DSM-IV criteria for panic disorder and non-patients. The results showed that psychotic patients who experience auditory hallucinations tended to exhibit higher levels of dysfunctional metacognitive beliefs than other patient groups, scoring significantly higher than at least two of the three control groups on positive beliefs about worry, negative beliefs about uncontrollability and danger, cognitive confidence and negative beliefs including superstition, punishment and responsibility. It was also found that the metacognitive beliefs of patients with persecutory delusions and panic patients were often similar to each other, and elevated in comparison to non-patients, suggesting that such beliefs are generic vulnerability factors. The theoretical and clinical implications of these findings are discussed. [Copyright &y& Elsevier]

Focuses on a study which tested whether patients with a diagnosis of schizophrenia would report the use of different thought control strategies in comparison with normal subjects. Account of related studies; Methods; Results; Discussion.

Presents information on a study which tested the hypothesis that patients who experience auditory hallucinations experience more intrusive thoughts. Factors leading to auditory hallucinations; Association of hallucinations with distress; Interpretation of hallucinations.

Abstract: The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI; ) was developed as a theory-driven cognitive measure of extreme, personalised appraisals of internal state. According to an integrative cognitive model of mood swings and bipolar disorder (), these positive and negative appraisals are a key factor in the development of mania and depression. Factor analysis was performed on an extended version of the HAPPI () in a student sample (N= 293). A six-factor solution emerged, representing separate categories of beliefs about internal states labelled Social Self-Criticism, Increasing Activation to Avoid Failure, Success Activation and Triumph Over Fear, Loss of Control, Grandiose Appraisals of Ideation, and Regaining Autonomy. Aspects of the cognitive model were supported by the finding of independent and unique associations between HAPPI factors and analogue bipolar symptoms. [ABSTRACT FROM AUTHOR]