Fear Conditioning and Clinical Implications: What Can We Learn From the Past?

Author(s):  
Paul Eelen ◽  
Bram Vervliet
2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Author(s):  
Jenny L. Pierce

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.


2014 ◽  
Vol 38 (6) ◽  
pp. 260-264 ◽  
Author(s):  
Alan Meaden ◽  
Martin Commander ◽  
Colin Cowan ◽  
Tom Edwards

Aims and methodTo build on previous research findings by examining engagement and problematic behaviours of patients in 10 residential rehabilitation units. Two measures were completed on patients in community rehabilitation, longer-term complex care and high-dependency units (109 patients in total). Data were analysed and categorised into higher-engagement ratings across the domains of engagement and behaviour over the past 6 months and lifetime in terms of presence of the behaviour and likelihood of resulting harm.ResultsData were available for 73% of patients. All aspects of engagement were consistently low for all units, with highest levels in community rehabilitation units. Levels of problematic behaviours were similar across all units. Socially inappropriate behaviours and failure to complete everyday activities were evident for over half of all patients and higher for lifetime prevalence. Verbal aggression was at significantly lower levels in community units. Lifetime behaviours likely to lead to harm were much more evident in high-dependency units.Clinical implicationsDespite some benefits of this type of care, patients continue to present challenges in engagement and problematic behaviours that require new approaches and a change in focus.


2017 ◽  
Vol 23 (9-10) ◽  
pp. 768-777 ◽  
Author(s):  
Kathleen Y. Haaland ◽  
Richard P. Dum ◽  
Pratik K. Mutha ◽  
Peter L. Strick ◽  
Alexander I. Tröster

AbstractThis paper highlights major developments over the past two to three decades in the neuropsychology of movement and its disorders. We focus on studies in healthy individuals and patients, which have identified cognitive contributions to movement control and animal work that has delineated the neural circuitry that makes these interactions possible. We cover advances in three major areas: (1) the neuroanatomical aspects of the “motor” system with an emphasis on multiple parallel circuits that include cortical, corticostriate, and corticocerebellar connections; (2) behavioral paradigms that have enabled an appreciation of the cognitive influences on the preparation and execution of movement; and (3) hemispheric differences (exemplified by limb praxis, motor sequencing, and motor learning). Finally, we discuss the clinical implications of this work, and make suggestions for future research in this area. (JINS, 2017, 23, 768–777)


Author(s):  
Siba El Hussein ◽  
Sa A. Wang ◽  
Naveen Pemmaraju ◽  
Joseph D. Khoury ◽  
Sanam Loghavi

ABSTRACT Our understanding of chronic myelomonocytic leukemia (CMML) has evolved tremendously over the past decade. Large-scale sequencing studies have led to increased insight into the genomic landscape of CMML and clinical implications of these changes. This in turn has resulted in refined and improved risk stratification models, which to date remain versatile and subject to remodeling, as new and evolving studies continue to refine our understanding of this disease. In this article, we present an up-to-date review of CMML from a hematopathology perspective, while providing a clinically practical summary that sheds light on the constant evolution of our understanding of this disease.


2006 ◽  
Vol 30 (9) ◽  
pp. 337-339
Author(s):  
John Dunn ◽  
David Robertson ◽  
Paul Davis ◽  
Babak Khosrawan ◽  
Suneel Christian

Aims and MethodA satellite methadone prescribing service was set up in a hostel in London's West End. The aim was to investigate if it were feasible to engage and retain these hard-to-reach, chaotic, polydrug users in treatment. A basic needs assessment was undertaken with staff and clients at the hostel. Treatment outcomes were assessed at 16 weeks using the Maudsley Addiction Profile.ResultsAt 16 weeks 87% of the original cohort (26 out of 30) were still in treatment. There were also significant reductions in mean heroin use (from 29.7 to 14.5 out of the past 30 days, P<0.001) and in the frequency of injecting (from 25.9 to 15.9 days, P<0.001).Clinical ImplicationsThis outreach clinic offers a model for developing services to homeless people with substance misuse problems.


2016 ◽  
Vol 73 (4) ◽  
pp. 308-325 ◽  
Author(s):  
Marie-Claude Proulx ◽  
Anne-Marie Martinez ◽  
Franco Carnevale ◽  
Alain Legault

The death of a child is traumatic for parents. The grief of bereaved fathers is inadequately understood since most studies on this subject have focused primarily on mothers. The goal of this phenomenological study was to understand fathers’ experiences following the death of their child. Interviews were conducted with 13 fathers whose child (aged 1–17 years) had died at least 1 and up to 6 years earlier, either from a life-limiting illness or unexpectedly in an intensive care unit in a pediatric hospital in Eastern Canada. The analysis indicates that fathers’ experience deep suffering after the death of their child and feel torn between the past and the future. Three major themes were identified: needing to push forward in order to avoid breakdown, keeping the child present in everyday life, and finding meaning in their experience of grief. Clinical implications for professionals working with this population are discussed.


2011 ◽  
Vol 35 (4) ◽  
pp. 130-134 ◽  
Author(s):  
Shanaya Rathod ◽  
Minal Mistry ◽  
Ben Ibbotson ◽  
David Kingdon

Aims and methodThe study explored the impact of National Health Service changes on the working and personal lives of psychiatrists. A questionnaire survey was carried out with psychiatrists working in the South Eastern Division of the Royal College of Psychiatrists.ResultsThe response rate was 44.9%. Changes to services have reduced stress in some areas, but increased stress in others. Over the past decade early retirement has become less popular, but psychiatrists have been more likely to self-prescribe and have suicidal thoughts.Clinical implicationsThe increasing involvement of psychiatrists in leadership may be a way to reduce adverse impacts of future changes on their working lives.


2014 ◽  
Vol 38 (5) ◽  
pp. 216-219 ◽  
Author(s):  
Kathryn Walsh ◽  
Alex Copello

Aims and methodThe study reports findings of an investigation into the presence of severe and enduring mental health problems within the four statutory and non-statutory teams of an established substance misuse treatment partnership.ResultsOf a total of 772 clients in the four teams surveyed, 69 (8.9%) were identified as having severe and enduring mental health problems and problem substance use in the past 12 months. Alcohol was the most prevalent substance used by this predominantly male group. Different rates were found across the four teams, with higher numbers in the non-statutory teams. The clients displayed significant levels of self-harm and suicide risk and were responsible for 131 acute service contacts over the past 12 months.Clinical implicationsClients with severe and enduring mental health problems engaged with substance misuse services display high levels of complex need. It is important to identify the best and most effective service response to this group.


2010 ◽  
Vol 23 (1) ◽  
pp. 99-139 ◽  
Author(s):  
Benjamin P. Howden ◽  
John K. Davies ◽  
Paul D. R. Johnson ◽  
Timothy P. Stinear ◽  
M. Lindsay Grayson

SUMMARY The emergence of vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) over the past decade has provided a challenge to diagnostic microbiologists to detect these strains, clinicians treating patients with infections due to these strains, and researchers attempting to understand the resistance mechanisms. Recent data show that these strains have been detected globally and in many cases are associated with glycopeptide treatment failure; however, more rigorous clinical studies are required to clearly define the contribution of hVISA to glycopeptide treatment outcomes. It is now becoming clear that sequential point mutations in key global regulatory genes contribute to the hVISA and VISA phenotypes, which are associated predominately with cell wall thickening and restricted vancomycin access to its site of activity in the division septum; however, the phenotypic features of these strains can vary because the mutations leading to resistance can vary. Interestingly, changes in the staphylococcal surface and expression of agr are likely to impact host-pathogen interactions in hVISA and VISA infections. Given the subtleties of vancomycin susceptibility testing against S. aureus, it is imperative that diagnostic laboratories use well-standardized methods and have a framework for detecting reduced vancomycin susceptibility in S. aureus.


2015 ◽  
Vol 39 (3) ◽  
pp. 124-128
Author(s):  
Victoria Osman-Hicks ◽  
Hannah Graham ◽  
Peter Leadbetter ◽  
Andrew Brittlebank

Aims and methodThis paper intends to analyse the number of applications, trainee demographic and approval rate of those applying for out of programme training (OOPT) or out of programme research (OOPR) between January 2008 and April 2013 using the committee's anonymised database. We also describe the process of application and approval by the Quality Assurance Committee.ResultsThere were 90 applications, including 10 resubmissions during the 64-month period. Most applicants (77%) were higher trainees; 53% of applicants were from the London deanery; 60% of applications were for research posts and higher degrees (OOPR). Overall, 64% were approved by the committee: 70% for OOPRs and 53% for OOPTs.Clinical implicationsThis paper shows with transparency the breakdown of applications to the Quality Assurance Committee. Around two-thirds of applications to the committee are supported (64%). Relatively few psychiatry trainees (2.5%) have applied for an OOPT or an OOPR over the past 5 years.


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