[Expectations of patients and relatives for modern hospital care in geriatric psychiatry]

OBJECTIVE

In order to improve health care in geriatric psychiatry, users must be granted a larger role in shaping their treatment. To this aim we identify factors that are essential to psychiatric care from users' perspectives.

METHODS

Focus groups and interviews (n = 12) were conducted to identify the health care factors that were most essential to its users. In addition, patients (n = 72) and relatives (n = 62) evaluated the current health care in a questionnaire.

RESULTS

The most essential factors were longer consultations with doctors and treatment providers, comprehensive and comprehensible information, individualized procedures and therapies, having clearly defined scopes for each professional group, environmental factors and the integration of relatives into the therapy process.

CONCLUSION

The reported factors could help improve health services in geriatric psychiatry by pointing towards potential changes and room for optimization in health care on both structural and process levels.

Classical swine fever virus: a second ring test to evaluate RT-PCR detection methods

Six laboratories participated in a study to compare the sensitivity and specificity of RT-PCR tests for the detection of classical swine fever virus (CSFV). Sets of coded samples were prepared by serial dilution of positive samples and then distributed to each of the laboratories. One set comprised 25 samples of random primed cDNA, synthesised from viral RNA representative of different pestiviruses. The other set comprised samples of blood and serum obtained from virus-free or CSFV-infected pigs. Each laboratory tested the samples using PCR/RT-PCR according to a set of standardised protocols that specified the exact conditions and requirements for inclusion of control samples. Two types of test were evaluated. One amplified a part of the 5'-non coding region of the pestivirus genome by means of a closed, one-tube RT-nested PCR. The other amplified a part of the NS5B gene using non-nested RT-PCR. The results of the laboratories were compared with one another, and with those obtained earlier when similar samples were tested by the same laboratories using non-standardised methods [Paton et al., Classical swine fever virus: a ring test to evaluate RT-PCR detection methods, Vet. Microbiol., in press]. Standardisation of the protocols resulted in a more consistent test sensitivity. Three laboratories avoided significant false positive results. Others that did not, could nevertheless recognise that test specificity was inadequate from the results obtained with the control samples. Minimum requirements for the inclusion of adequate controls and periodic proficiency testing are proposed.

[Detection of the genome of bovine viral diarrhea virus (BVDV) using the polymerase chain reaction after reverse transcription (RT-PCR): comparison of methods for the isolation of ribonucleic acid (RNA) from clinical samples]

The RT-PCR is an in vitro technique that is increasingly being used for diagnosis of viral animal pathogens. Due to its high sensitivity it is considered as an alternative to current standard methods for detecting BVDV especially in pooled samples, e.g. from bulk tank milk. A prerequisite for the performance of RT-PCR is an efficient and simple method for sample preparation. The aim of this work was to compare the efficiency of three commercially available kits for RNA extraction, and their suitability for sample preparation for the detection of the BVDV genome by RT-PCR in blood, milk and tissue samples. The kits were based on different methods for extraction of RNA and differed in costs, labour and time consumption. The most sensitive RT-PCRs (exception: heparinised blood) were obtained when sample preparation was performed by acidic guanidinium-isothiocyanate-phenol-chloroform extraction with the Trizol (Gibco) reagent. Using a kit based on the binding of RNA to silica membrane in a spin column, positive results in RT-PCR were obtained from all samples, but with lower sensitivity. The advantage of the column-based kits is that they are less time-consuming, easier to handle and suitable for automatisation of sample preparation. A kit using salt precipitation of the desoxribose nucleic acid (DNA) and proteins was unsuitable for the isolation of viral RNA from the samples.

Dichromacy characterized by chrominance planes

Dichromacy is described in terms of dichromatic opponent colour spaces. By means of the perceptual criteria 'equally bright', 'neither blue nor yellow' and 'neither red nor green' and embedding in a three-dimensional colour space, it is possible for each type of dichromat to quantify a null-chrominance plane and a null-luminance plane, both of which intersect in the missing colour. These two null planes (or the trace of their intersection with the chromaticity chart) are the chromaticities of the dichromatic opponent primaries. Since a null-luminance plane contains only colour ('chrominance'), it is simply a chrominance plane. Under the assumption that the retinal short-wavelength cones do not contribute to luminance, the chrominance planes of the three types of dichromats intersect in a common straight line, the 'blue' fundamental primary vector. This constellation may serve as a general characterisation of dichromacy.

[Foveal deuteranoptic opposing color vision]

By means of a visual tristimulus colorimeter according to Guild-Bechstein, the following items were determined for a male deuteranopic observer on a foveal, i.e. 2 degrees diameter visual field: (1) the deuteranopic missing color, by means of the perceptual criterion "indistinguishably equal", (2) the neutral zone, by means of the perceptual criterion "neither blue nor yellow," (3) the alychne trace, by means of the perceptual criterion "heterochromatically equally bright." The evaluation in the chromaticity chart resulted in two straight lines forming a dichromatic pencil, the deuteranopic missing color providing the carrier point (vertex). These two straight lines represent the referential chromaticities of a deuteranopic opponent color system.

Deuteranomaly studied with four perceptual criteria

In the theoretical section of the present paper, we develop our view of the roles played by the perceptual criteria: indistinguishably equal, neither blue nor yellow, neither green nor red, and heterochromatically equally bright. These criteria constitute a vectorial opponent-colour space, a concept used throughout the paper. Within this framework, two new theorems on psychophysical opponent-colour channels are stated. In the experimental section, the perceptual criteria are applied to the colour vision of an (extreme) deuteranomalous male. A quantitative perceptual description of his deuteranomaly is developed, the main constituents of which are measured deuteranomalous colour matching functions, the deuteranomalous opponent-colour functions derived from them and taking quantitative account of the Abney effect.

[Reference to the Abney effect within the scope of linear opponent-color theory]

The Abney effect states that desaturation of spectral colours does not only change their chromatic saturation but also their hue. By means of Hering's perceptual criteria "neither blue nor yellow" and "neither green nor red" and heterochromatic brightness matching, chromaticity loci were measured in a visual tri-stimulus colorimeter; the loci served for construction of an opponent-colour triangle and the associated opponent-colour space. The chromaticity line resulting from the perceptual criterion "neither green nor red" deviated markedly--as an expression of the Abney effect--from a straight line. This phenomenon was captured by piecewise linearizing. The transformation of the (known) fundamental colour space, which may be interpreted as a cone excitation space, onto the opponent colour space thus gained yielded an explicit opponent-colour theory that reproduces some aspects of the Abney effect.