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PubMed1984

The relatives of the mentally ill. A comparative trial of community-oriented and hospital-oriented psychiatric care.

One hundred and twenty patients presenting for admission were randomly allocated into two groups. Control patients received standard psychiatric hospital care and aftercare. Experimental patients were not admitted, if possible; they and their relatives were provided with comprehensive community treatment, including a 24-hour crisis service. Patients with a diagnosis of alcohol or drug dependence, organic brain disorder, or mental retardation were excluded. The great majority of patients were diagnosed as suffering from one of the functional psychoses--mainly schizophrenia. During the study year, control patients spent an average of 53.5 days in psychiatric hospitals, experimental patients spent an average of 8.4 days. Psychiatric patients were treated more effectively and economically in the community, without shifting the burden onto the relatives. Nearly all the relatives of experimental patients preferred community treatment; they considered it to be significantly more helpful to the patients and themselves than standard psychiatric hospital care and aftercare.

Adaptation, Psychological↗
PubMed1998

[Incidence of psychiatric symptoms and somatic complaints in 4- to 10-year-old children in Germany as judged by parents--a comparison of norm-oriented and criteria-oriented models].

OBJECTIVES: To analyze the frequency of behavioral/emotional problems and somatic complaints of children aged four to ten as rated by their parents. METHOD: The analysis is based on the PAK-KID study on behavioural and emotional problems and psychosocial competencies of children and adolescents in Germany. In a nationally representative sample of N = 1030 children aged four to ten years the parents rated their child using the Child Behavior Checklist. RESULTS: The prevalence rates of the symptoms are presented. Additionally global prevalence rates based on three different models were calculated and compared. They range from 13.1% to 28.3%. The issues of defining cutoffs necessary for the calculation of prevalence rates are discussed.

Affective Symptoms↗
PubMedDate not supplied

GABA-induced inactivation of functionally characterized sites in cat striate cortex: effects on orientation tuning and direction selectivity.

Microiontophoresis of gamma-aminobutyric acid (GABA) was used to reversibly inactivate small sites of defined orientation/direction specificity in layers II-IV of cat area 17 while single cells were recorded in the same area at a horizontal distance of approximately 350-700 microns. We compared the effect of inactivating iso-orientation sites (where orientation preference was within 22.5 deg) and cross-orientation sites (where it differed by 45-90 deg) on orientation tuning and directionality. The influence of iso-orientation inactivation was tested in 33 cells, seven of which were subjected to alternate inactivation of two iso-orientation sites with opposite direction preference. Of the resulting 40 inactivations, only two (5%) caused significant changes in orientation tuning, whereas 26 (65%) elicited effects on directionality: namely, an increase or a decrease in response to a cell's preferred direction when its direction preference was the same as that at an inactivation site, and an increase in response to a cell's nonpreferred direction when its direction preference was opposite that at an inactivation site. It is argued that the decreases in response to the preferred direction reflected a reduction in the strength of intracortical iso-orientation excitatory connections, while the increases in response were due to the loss of iso-orientation inhibition. Of 35 cells subjected to cross-orientation inactivation, only six (17%) showed an effect on directionality, whereas 21 (60%) showed significant broadening of orientation tuning, with an increase in mean tuning width at half-height of 126%. The effects on orientation tuning were due to increases in response to nonoptimal orientations. Changes in directionality also resulted from increased responses (to preferred or nonpreferred directions) and were always accompanied by broadening of tuning. Thus, the effects of cross-orientation inactivation were presumably due to the loss of a cross-orientation inhibitory input that contributes mainly to orientation tuning by suppressing responses to nonoptimal orientations. Differential effects of iso-orientation and cross-orientation inactivation could be elicited in the same cell or in different cells from the same inactivation site. The results suggest the involvement of three different intracortical processes in the generation of orientation tuning and direction selectivity in area 17: (1) suppression of responses to nonoptimal orientations and directions as a result of cross-orientation inhibition and iso-orientation inhibition between cells with opposite direction preferences; (2) amplification of responses to optimal stimuli via iso-orientation excitatory connections; and (3) regulation of cortical amplification via iso-orientation inhibition.

Animals↗
PubMed2006

Reality orientation: its use and effectiveness within older person mental health care.

AIM: The aim of this study was to find out how psychiatric nurses use reality orientation and perceive its effectiveness in older person mental health care. BACKGROUND: The study described in this article relates to how effective reality orientation is and how it is used, within older person mental health care. As a technique, reality orientation originated in North America in the 1950s. It has been defined as an approach which may decrease confusion and dysfunctional behaviour patterns in people with dementia. Although there exists some confusion as to how reality orientation should be delivered, it is generally agreed that reality orientation may be delivered in two ways. Firstly, through constantly orientating patients to time, place and person (24-hour reality orientation) and, secondly, orientating patients to reality within a group setting. METHODS: Six psychiatric nurses practicing in an older person mental health care inpatient unit took part in in-depth semi-structured interviews. These six nurses all practiced upon the same older person care unit, which was part of a larger psychiatric hospital randomly selected from psychiatric hospitals in Dublin, Ireland, to take part in the study. The six nurses were also part of a larger cohort of nurses who helped the author explore how psychiatric nurses use and perceive reality orientation as used in older person and acute inpatient mental health care. This was a descriptive qualitative study, using the technique of constant comparative analysis as outlined by Strauss and Corbin as a way to code interview data and arrange themes that represented what participants had talked about in the interviews. More particularly, this form of analysis closely resembled the type of open coding as outlined by Strauss and Corbin. The analysis of interview data was presented to interview participants prior to the formal acceptance of these themes as a valid representation of what interviewees talked about. FINDINGS: Upon analysis, interview data yielded five themes. Firstly, reality orientation means interacting with patients about the patient's current environment and issues in their predicament. Secondly, the sampled nurses use reality orientation frequently in their nursing work, with reality orientation being most often used in the mornings and evenings. Thirdly, reality orientation is implemented through interacting with the patient. It may also be implemented as part of other approaches, such as occupational therapy. Fourthly, improvements in the areas of orientation and behaviour functioning may be possible through the use of reality orientation, although more contemporary research is required to validate this. Finally, participants talked of the need for psychiatric nurses practicing in older person settings to become more aware of what reality orientation entails as an approach, such awareness may be increased through more reality orientation-based research. CONCLUSIONS: Interview data point to reality orientation being used frequently through nurse-patient interaction. Participants talked about how using reality orientation may hold benefits for patients; however, on a more cautionary note, participants also raised the need for a greater clinical awareness of reality orientation as an approach for use in caring for older persons with mental health problems. RELEVANCE TO CLINICAL PRACTICE: Psychiatric nurses practicing in older person care environments often have to provide care to persons having difficulty comprehending reality. For example, a person who is confused through suffering from an organic brain disorder such as Alzheimer's disease, or who is expressing a delusion through suffering from a functional mental illness such as depression. Taking this into consideration, there is an onus on psychiatric nurses to be able to care for older persons having difficulties comprehending the reality they are living in. Participants in this study identified reality orientation as an approach which can be used by psychiatric nurses in attempting to help older persons experiencing mental health problems cope with not being able to comprehend and recognize their surroundings. Participants also suggested that reality orientation may hold some benefits for older disorientated person, such as facilitating a greater level of orientation. On a more cautionary note, participants talked of the need for psychiatric nurses caring for older persons with mental health problems to become more aware of the use of reality orientation in clinical practice.

Aged↗
PubMed1975

A quantitative study of the projection area of the central and the paracentral visual field in area 17 of the cat. II. The spatial organization of the orientation domain.

Cells in cat's area 17 respond optimally if elongated contrasts are presented at a certain angle or orientation with respect to the retina, or to the visual field, respectively (Hubel and Wiesel, 1962). The preferred orientation and the range of orientation sensitivity of cells in close proximity to one another have been determined in order to investigate the spatial arrangement of the orientation domain in area 17. 1. A slight overrepresentation of vertical and horizontal orientations is seen in cells with complex receptive fields, whereas in cells with simple fields all orientations are represented to an equal degree. The orientation selectivity, defined as the halfwidth of tuning curves constructed from the cells response to a moving stimulus, is less than 60 degrees in more than 80% of all cells investigated, and is on the average 20-30 degrees smaller in cells with simple than in cells with complex receptive fields. 2. In 80% of all cases considered the difference in the preferred orientation between two cells less than 200 mum horizontally distant in area 17 is less than 30 degrees, which is of the order of an individual cells orientation selectivity. Each cell, therefore, will respond to some extent to that orientation which is preferred by the cells in the immediate surroundings. 3. Sequential changes in the preferred orientation between cells successively recorded are observed as the postlateral gyrus is explored from anterior to posterior and from medial to lateral. On these general trends a random variation in the preferred orientation between neighbouring cells of the order of 5-10 degrees is superimposed. One orientation sequence (180 degrees) occupies 700-1200 mum, so that on the average a change in the preferred orientation of the order of 10 degrees is complete after 50 mum distance in the cortex measured parallel to the pial surface. Assuming that 18 different orientations (+/- 5 degrees) functionally represent one complete orientation sequence it is found that 'all' orientations are functionally represented by the cells contained in a cortical cylinder of 300-700 mum in diameter. 4. Cells having the same preferred orientation are grouped together in cortical regions which appear in crossection as a band or a spot. These regions have been termed iso-orientation bands or spots. The diameter of the spots and the small diameter of the bands do not exceed 100 mum. Taking an average orientation selectivity of 40 degrees for cells vertically aligned in area 17 it is calculated that cells situated 100 mum to either side of an iso-orientation band or around an iso-orientation spot still respond with 50% of the discharge to their own optimal orientation ...

Evoked Potentials↗
PubMed2002

Spatial organization and magnitude of orientation contrast interactions in primate V1.

We have explored the spatial organization of orientation contrast effects in primate V1. Our stimuli were either concentric patches of drifting grating of varying orientation and diameter or grating patches displaced in x-y coordinates around a central patch overlying the classical receptive field (CRF). All cells in the sample exhibited response suppression to iso-oriented stimuli exceeding the CRF. Changing the outer stimulus orientation revealed five response patterns: 1) orientation alignment suppression (17% of cells)-a suppressive component tuned to the same orientation as the cell's optimal, 2) orientation contrast facilitation (63%)-responses to orientation contrast stimuli exceeded those to the center stimulus alone, 3) nonorientation specific suppression (3%), 4) mixed general suppression and alignment suppression (14%), and 5) orientation contrast suppression (14%)-cross-oriented stimuli evoked stronger suppression than iso-oriented stimuli. Thus most cells (94%) showed larger responses to orientation contrast stimuli than to iso-oriented stimuli, and over one-half showed orientation contrast facilitation. There appeared to be a spatially structured organization of the zones driving the different response patterns with respect to the CRF. Nonorientation-specific suppression and orientation contrast suppression were predominantly evoked by orientation contrast borders located within the CRF, and orientation contrast facilitation was mainly driven by surround stimuli lying outside the CRF. This led to different response patterns according to border location. Zones driving orientation contrast facilitation were not necessarily contiguous to, nor uniformly distributed around, the CRF. Our data support two processes underlying orientation contrast enhancement effects: a simple variation in the strength of surround suppression drawing on the fact that surround suppression is tuned to the same orientation as the CRF and a second process driven by orientation contrast that enhanced cells' responses to CRF stimulation by either dis-inhibition or orientation contrast facilitation. We suggest these processes may serve to enhance response levels to salient image features such as junctions and corners and may contribute to orientation pop-out.

Algorithms↗