Radical surgery for mesothelioma.
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Asbestos↗
Biomedical subjects
David Waller
Publications and source records attributed to David Waller.
Body-based senses enhance knowledge of directions in large-scale environments.
Previous research has shown that inertial cues resulting from passive transport through a large environment do not necessarily facilitate acquiring knowledge about its layout. Here we examine whether the additional body-based cues that result from active movement facilitate the acquisition of spatial knowledge. Three groups of participants learned locations along an 840-m route. One group walked the route during learning, allowing access to body-based cues (i.e., vestibular, proprioceptive, and efferent information). Another group learned by sitting in the laboratory, watching videos made from the first group. A third group watched a specially made video that minimized potentially confusing head-on-trunk rotations of the viewpoint. All groups were tested on their knowledge of directions in the environment as well as on its configural properties. Having access to body-based information reduced pointing error by a small but significant amount. Regardless of the sensory information available during learning, participants exhibited strikingly common biases.
Cues↗
Is there a role for pre-operative contrast-enhanced magnetic resonance imaging for radical surgery in malignant pleural mesothelioma?
OBJECTIVE: To assess the use of contrast-enhanced magnetic resonance imaging (CEMRI) in addition to computed tomography in the pre-operative assessment of patients for radical surgery in malignant pleural mesothelioma. METHODS: Over a 45-month period, 51 of 76 patients assessed (69 men and seven women), underwent extra-pleural pneumonectomy or radical pleurectomy/decortication. Post-operative pathological stage was correlated with radiological staging, with particular emphasis on tumour resectability. RESULTS: Seventeen (22%) patients were found on CEMRI to have unresectable, but histologically unconfirmed disease, not previously seen on CT. Fifty-one (67%) patients proceeded to radical surgery, but pathological nodal data were incomplete in three, so excluding these patients from further analyses. The median pre-operative interval after CEMRI was 17 days. Two patients were found to have unexpectedly extensive disease at thoracotomy, thus the sensitivity of CEMRI for prediction of resectability was 97%. Using the International Mesothelioma Interest Group system, tumour stage was correctly predicted by CEMRI in 48% of patients, but understaged in 50% of cases, largely due to the underestimation of pericardial involvement, but this did not affect resectability and had no significant effect on prognosis. Nodal stage was correctly identified in 60% of patients. CEMRI was successful in predicting pathological tumour stage T3 or less (sensitivity of 85%; specificity of 100%), but less so in identifying tumour stage T2 or less (sensitivity of 23%; specificity of 96%) or N2 nodal disease (sensitivity 66%; specificity 73%). CONCLUSIONS: CEMRI is most useful in the differentiation of T3 and T4 disease and may be unnecessary at earlier stages. Its multiplanar tumour localisation abilities are of value in the assessment of resectability. It is unlikely to contribute significantly to nodal staging, but it remains a valuable adjunct in the selection of patients for radical surgery.
Adult↗
Inertial cues do not enhance knowledge of environmental layout.
Several sensory modalities besides vision are available to people as they move through an environment, learning where things are. For example, sensory information about linear and angular acceleration (i.e., inertial information) has been shown to be useful for maintaining orientation in a room-sized space. Because noise in inertial systems can compound over time and over extended travel, it is an open question whether inertial information is important for acquiring knowledge about large-scale environments. We addressed this issue in an experiment in which people learned the spatial layout of a large environment under conditions that varied in the degree to which valid inertial cues were available. The presence of valid inertial cues did not facilitate the acquisition of an accurate memory of the environment. Moreover, the presence of invalid inertial cues did not interfere with such acquisition. We conclude that the effect of inertial information on the acquisition of environmental knowledge is minimal.
Acceleration↗
Scaling techniques for modeling directional knowledge.
A common way for researchers to model or graphically portray spatial knowledge of a large environment is by applying multidimensional scaling (MDS) to a set of pairwise distance estimations. We introduce two MDS-like techniques that incorporate people's knowledge of directions instead of (or in addition to) their knowledge of distances. Maps of a familiar environment derived from these procedures were more accurate and were rated by participants as being more accurate than those derived from nonmetric MDS. By incorporating people's relatively accurate knowledge of directions, these methods offer spatial cognition researchers and behavioral geographers a sharper analytical tool than MDS for studying cognitive maps.
Adult↗
Orientation specificity and spatial updating of memories for layouts.
This article examines the degree to which knowledge about the body's orientation affects transformations in spatial memory and whether memories are accessed with a preferred orientation. Participants learned large paths from a single viewpoint and were later asked to make judgments of relative directions from imagined positions on the path. Experiments 1 and 2 contribute to the emerging consensus that memories for large layouts are orientation specific, suggesting that prior findings to the contrary may not have fully accounted for latencies. Experiments 2 and 3 show that knowledge of one's orientation can create a preferred direction in spatial memory that is different from the learned orientation. Results further suggest that spatial updating may not be as automatic as previously thought.
Adult↗
A follow-up study of adherence and glycemic control among Hong Kong youths with diabetes.
OBJECTIVE: To extend longitudinally an earlier study of the pathway from symptoms of emotional distress (ED) through self-efficacy (SE) and adherence to glycemic control (GC) in youths with diabetes, and to examine the contribution of different specific adherence behaviors to changes in GC. METHODS: Fifty-six Hong Kong youths with diabetes received a follow-up evaluation 12-24 months after initial participation. ED, SE, self-reported adherence to medical regimen (SRA), and GC were assessed at both evaluations. RESULTS: The pathway from ED to SE to SRA to GC was replicated. Participants' SRA to regular checks on blood glucose levels, and taking steps to maintain levels in the recommended range, explained significant variance in changes in GC. CONCLUSIONS: The model offers strategies to enhance health care in youths with diabetes. Findings support the importance of adherence to the medical regimen but emphasize the complexity of the relationship between adherence behaviors and GC. Self-regulatory behaviors, rather than compliance with fixed instructions, appear to have the most impact on GC.
Adaptation, Psychological↗