Objective: This article reviews the available scientific literature concerning the neurobiological substrates of Tourette's disorder (TD). Methods: The electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies using relevant search terms. Results: Neuropathological as well as structural and functional neuroimaging studies of TD implicate not only the sensorimotor corticostriatal circuit, but also the limbic and associative circuits as well. Preliminary evidence also points to abnormalities in the frontoparietal network that is thought to maintain adaptive online control. Evidence supporting abnormalities in dopaminergic and noradrenergic neurotransmission remains strong, although the precise mechanisms remain the subject of speculation. Conclusion: Structural and functional abnormalities in multiple parallel corticostriatal circuits may underlie the behavioral manifestations of TD and related neuropsychiatric disorders over the course of development. Further longitudinal research is needed to elucidate these neurobiological substrates.
Goal-setting is a very satisfactory activity for the team but to be as successful for the patient their needs must be acknowledged. People with mild disability and a short inpatient stay have different needs to those with acute onset severe permanent disability and those with chronic or progressive disability admitted from the community. Comparison of both process and outcome effects of different types of goal-setting is an area for future study.
Clinical supervision is presented as a complex set of skills that may broadly apply to any and all allied health professions. However, it is also noted that a clear understanding of clinical supervision and how to implement it in allied health is currently lacking. It is argued that there is a need to reflect upon current approaches to clinical supervision amongst allied health professionals and to gain a shared understanding about what supervision involves, what effective supervision is, and what effective implementation of clinical supervision might look like. By gaining an understanding of what high quality clinical supervision is and how it is best put into practice, it is anticipated that this will form the first step in developing an understandable and useful universal supervision policy for all allied health professionals.
Optimising the quality of decision making in the context of health care today requires an awareness and consideration of a range of factors influencing decision making.
This study contributes to the body of literature on physiotherapy reasoning and decision making by revealing details about the characteristics and processes of cardiorespiratory physiotherapy decision making. This research can be used to shape the education of beginning practitioners and provide practicing physiotherapists with a basis for critical appraisal of their decision making.
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