The resonance-dissonance framework of environmental perception : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

Theorising and research in the field of environmental psychology has been dominated by two different schools of thought. The cognitive approach emphasises the primacy of cognitive processes on preference judgements between various types of environments and on the restorative effect of nature on humans. The competing psycho-evolutionary approach emphasises the primacy of affect. This theoretical fragmentation has contributed to environmental psychology's conceptual isolation in respect to its potential significance for other psychological sub-disciplines. This thesis proposes a new theoretical account, the "Resonance-Dissonance" (RD) framework of environmental perception, which provides a unifying framework for hitherto competing approaches in environmental psychology. It also seeks to contribute towards building and strengthening the tenuous or missing conceptual links between environmental psychology and other psychological sub-fields. A series of interlocking concepts, which bind together aspects of the relationship between perceivers and their immediate physical surroundings, is proposed to achieve this theoretical integration. Innate and culturally shaped needs and wants, in the form of mental structures providing reference patterns, are conceptualised as a fundamental aspect of the relationship between individual and environment. If the environment is appraised as having the agency to meet these needs, a state of resonance in the form of positive affect and cognitions ensues. Conversely, if the environment is appraised as not having this agency, a state of dissonance in the form of negative affect and cognitions emerges. These perceptually based cognitive-affective states are conceptualised to influence cognitions, emotions, behaviour, and physiology of the individual. Preference judgements and psycho-physiological restorative effects, as the main areas of theorising and research in environmental psychology, will be addressed. Possible theoretical implications, as well as practical applications, of the proposed RD framework on other psychological sub-fields are outlined and a tentative research programme is suggested

Transarticular screw fixation for osteoarthritis of the atlanto axial segment

Atlantoaxial (C1-C2) facet joint osteoarthitis is a distinct clinical syndrome that often goes unrecognized. Severe pain resistant to conservative treatment that is corroborated by the radiographic findings represents the indication for surgery. The aim of this study was to retrospectively examine the long-term outcome [after an average 6.5years (SD 4.0)] of C1-2 fusion for osteoarthritis of the atlantoaxial segment in 35 consecutive patients [25 male, 10 female; aged 62 (SD 15)years]. At follow-up, clinical outcome and radiological status was examined in 27/35 (77%) patients, and self-rated pain and disability (Neck Pain and Disability Scale; NPDS) in 29/35 (83%) patients. In 27/35 patients (77%), 2 screws were inserted; in 7 patients (20%), only 1 screw; and in 1 patient (3%), no screws. 11% of the patients had late complications requiring revision surgery. All patients showed solid fusion at the long-term follow-up. 26% patients showed an improvement in sensory disturbances, 63% no change, and 11% a worsening. 89% were pain-free or had markedly reduced pain. The average score on the NPDS (0-100) was 34 (SD 27), representing ‘mild' neck problems, and the average pain intensity (0-5 VAS) was 1.5 (SD 1.5). Eighty-five percent of the patients declared that they would make the same decision again to undergo surgery. In conclusion, in a group of patients with a painful and debilitating degenerative disorder of C1-2, posterior transarticular atlantoaxial fusion proved to be an effective treatment with a low rate of serious complication

Multimodal intraoperative monitoring (MIOM) during surgical decompression of thoracic spinal stenosis in 36 patients

A prospective study of 36 patients who received multimodal intraoperative monitoring (MIOM) during decompression of thoracic spinal stenosis between March 2000 and December 2005 was chosen as the study design. The objective was to determine the sensitivity and specificity of MIOM techniques used for monitoring spinal cord during surgical thoracic decompression. The background data revealed that the surgical decompression for thoracic spinal stenosis is less frequent than in other regions of the spine. However, due to the relative narrow spinal canal, neurological complications could be severe. The combination of monitoring ascending and descending pathways may provide an early alert to the surgeon in order to alter the surgical procedure, and avoid neurological complications. The methods involved evaluation of intraoperative somatosensory spinal and cerebral evoked potentials and motor evoked potentials of the spinal cord and muscles that were compared with post operative clinical neurological changes. 36 consecutive patients with thoracic spinal stenosis of different aetiologies were monitored by the means of MIOM during the surgical procedure. 31 patients had true negative while one patient had false positive findings. Three patients had true positive and one patient had false negative findings. This indicates a sensitivity of 75% and a specificity of 97%. The one case of false negative findings recovered completely within 3 months. In conclusion, the MIOM is an effective method of monitoring the spinal cord during surgical decompression of the thoracic spine

The diagnostic value of multimodal intraoperative monitoring (MIOM) during spine surgery: a prospective study of 1,017 patients

A prospective study of 1,017 patients who received MIOM during spine surgery procedures between March 2000 and December 2005. To determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve roots function during spine surgery. MIOM has become a widely used method of monitoring neural function during spine surgery. Several techniques only monitor either ascending or descending pathways and thus may not provide sensitive or specific results. MIOM aims to monitor both ascending and descending pathways therefore giving immediate feedback information regarding any neurological deficits during the operation. Intraoperative sensory spinal and cortical evoked potentials, combined with monitoring of EMG and motor evoked potentials recorded from the spinal cord and muscles elicited by electrical motor cortex, spinal cord, cauda equina and nerve root stimulation, was evaluated and compared with post-operative clinical neurological changes. One thousand and seventeen consecutive patients underwent a total of 4,731 h of MIOM to evaluate any neural deficits that may have occurred during spine surgery. Of these, 935 were true negative cases, 8 were false negative cases, 66 were true positive cases and 8 were false positive cases, resulting in a sensitivity of 89% and a specificity of 99%. Based on the results of this study, MIOM is an effective method of monitoring the spinal cord functional integrity during spine surgery and therefore can lead to reduction of neurological deficit and consequently improve postoperative results