Prenatal Infection Self-Reacting Antibodies and the Development of Autism in Subsequent Offspring - Free Essay Example

Sample details Pages: 3 Words: 847 Downloads: 3 Date added: 2019/02/14 Category Medicine Essay Level High school Tags: Autism Essay Did you like this example? Autism spectrum disorder, or ASD, is characterized by distinct abnormal behavioral changes, such as repetitiveness, communication difficulty, and lack of social skills. This disorder contains a broad spectrum of symptoms and behavioral difficulties which can vary greatly per individual (1). In recent years, autism has been linked to beginning as early as in the womb by initiating the mother’s immune system during pregnancy and/or producing antibodies that recognize fetal brain proteins as antigens and cause an immune response, leading to a loss of fetal brain proteins and inflammation (2). The idea that the immune system can play a role in the development of autism within the womb began with observing hospitalized mothers. Data regarding pregnant mothers who were hospitalized due to a serious infection and the diagnosis of ASD in their offspring were analyzed to determine if correlation existed. The results show that viral infections of mothers in their first trimester and bacterial infections in the second trimester were associated with the development of ASD in their subsequent offspring (3). The results here support other experiments and is beneficial in that it uses human subjects that were exposed to disease by circumstance only, not purposely. Don’t waste time! Our writers will create an original "Prenatal Infection Self-Reacting Antibodies and the Development of Autism in Subsequent Offspring" essay for you Create order Another study tested this idea by immune stimulation in pregnant rats. In a study performed in 2012, rat models that were in gestation were purposely infected to stimulate the immune system. The results show that the offspring displayed altered immune systems and function, with decreased levels of CD4+ TCR?+ Foxp3+ CD25+ T regulatory cells and heightened levels of IL-6 and IL-17 production by CD4+ T cells. These offspring also displayed similar behavioral symptoms to human ASD (4). At this point, the connection between the mother’s immune system and its ability to promote ASD in her offspring had been made, but the pathways of how it worked had yet to be discovered. The presence of autoimmune diseases in the mother also can play a role in ASD development. Mothers who were diagnosed with at least one autoimmune disease, such as rheumatoid arthritis or type 1 diabetes, were more likely to have children diagnosed with ASD. This further links autism with the infection of a mother in gestation (5). Mothers pass their own IgG isotype antibodies to their children within the womb, but they also can produce autism-associated maternal antibodies that specifically attack certain proteins within the brain of their unborn child. The presence of these antibodies has been linked to increased probability of the development of ASD in the child. One of the many studies that tested this pathway to why prenatal infection was correlated to ASD was focused on X. Women were tested for the presence of anti-fetal brain antibodies. Women who had immune systems that produced these antibodies also had decreased expression of the MET receptor tyrosine kinase led to behavioral changes in their offspring. This study also suggests that there is a predetermined genetic aspect to the production of self-reacting cytokines. A specific gene for MET receptor tyrosine kinase has been positively linked to the broken tolerance of the fetus, leading to the production of self-reacting antibodies. Decreased levels o f regulatory cytokines, such as IL-10, also led to reduced MET expression, which could play a role in the development of ASD in the unborn child (6). This suggests that the development of ASD can begin as early as in the womb. Mothers could also be tested for the presence of these self-reacting antibodies and the presence of the gene that decreases expression of the MET receptor tyrosine kinase to determine the likelihood of producing a child with ASD. When an immune response is initiated by a perceived antigen, an inflammatory state is produced in the affected area. Autism has been found to correlate with increased levels of inflammatory cytokines. In a study published in 2011, blood samples were drawn from three groups of children with an average age of 3.4 – children diagnosed with autism (ASD), children with early symptoms of ASD, and children with no onset of ASD as a control. The samples were tested by an ELISA assay to determine the quantitative presence of inflammatory cytokines. The results show that there is a distinct difference between the control group and the children diagnosed with ASD, with the majority of the children diagnosed with ASD having a significant increase in the levels of pro-inflammatory cytokines in serum. Post-mortem studies have also shown an increased level of inflammatory cytokines in the brain specifically, which could possibly be linked to the mother producing antibodies against the fetal brain during pregnancy (7). In conclusion, many bounds have been made in the study of autism, how it is caused, and how it can be prevented. Definite links in the cause of autism has been made between the activation of a pregnant mother’s immune system during the early stages of pregnancy and the production of self-reacting antibodies against the fetal brain. Though there is a definite link between these pathways and the diagnosis of ASD in her subsequent offspring, there are broad arrays of causes to ASD, just as there is a broad array of symptoms within the spectrum of this disorder.

Controversial Issues Regarding Juvenile Death Penalty

One of the most controversial issues in the rights of juveniles today is addressed in the question, Should the death penalty be applied to juveniles? For nearly a century the juvenile courts have existed to shield the majority of juvenile offenders from the full weight of criminal law and to protect their entitled special rights and immunities. In the case of kent vs. United states in 1996, Justice Fortas stated some of these special rights which include; Protection from publicity, confinement only to twenty-one years of age, no confinement with adults, and protection against the consequences of adult conviction such as the loss of civil rights, the use of adjudication against him in subsequent proceedings and disqualification of public†¦show more content†¦Before the minimum age of 16 statutes, English Common law from the 16th Century had a direct influence on the Constitution. This common law carried over to American statutes and established the presumption that no one und er the age of seven had the mental capacity to commit crimes, therefore, they had no concept of mens rea or evil intent (Hale 23). In English Common L, Criminal intent had to be proven in cases concerning offenders of ages seven to fourteen. This carried over to become an American standard (hale 23). Only in cases of youth ages fourteen and over was it possible to concede that they had the mental capacity to perform a crime with mens rea (Samaha 1993:295). After adopting these common laws, individual states made specific changes within the law. For example, some states excluded juvenile court from the proceedings when crimes were severe (hale 23). These exclusions lead to my next subject on the methods of transferring juvenile cases to criminal courts and in turn, makes it possible to sentence violent juvenile offenders the death penalty. The idea of whether or not the death penalty should apply to juvenile violent offenders is only possible through the transfer of juveniles out of the juvenile court and into the adult criminal court. Only then can a guilty violent youth be punished to the full extent. As the number of certified or transferred cases increases, the public recognition that juveniles can and doShow MoreRelatedJuveniles and The Death Penalty Essay1604 Words   |  7 PagesJuveniles and The Death Penalty *No Works Cited One of the most controversial issues in the rights of juveniles today is addressed in the question, Should the death penalty be applied to juveniles? For nearly a century the juvenile courts have existed to shield the majority of juvenile offenders from the full weight of criminal law and to protect their entitled special rights and immunities. 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British Journal of Neuroscience Nursing

Question: Describe about the British Journal of Neuroscience Nursing? Answer: This assignment will explore the case study of Jeremy and it will be divided into different sections. Firstly, it will consider defining dignity and then, will identify one nursing problem on the Nursing care theme. Then, it will go on and explain why that problem poses a risk to the dignity of the patient. Secondly, will choose one nursing care intervention and then discuss why the intervention would promote the dignity of the patient. On section two, I will first choose another nursing problem on Nursing care theme and then on Empowerment scenario, I will first define empowerment and then use the collaborative care scenario to identify a situation where the patient needs to be empowered and then one collaborative initiative, intervention, resource or organization that could be used to increase the empowerment. Then I will also identify possible barriers to implementation and how they can possible be overcome. On section three, for the law and ethics, I will identify a situation tha t has legal and ethical implications using the End of life scenario, and one ethical principle including the Human Rights Act, then will critically analyze the rights of the patient within the situation I have chosen. Challenging behavior and the intervention According to (RCN,2008) dignity is described as a basic human right which is associated with individuals feeling and behavior relating to the value or importance of themselves and others. Treating someone with dignity clearly indicates that to treat them as an important person by respecting them as a valued individual (Parse, 2010). On the other hand, Lin et al. (2011) also highlights that in absence of dignity people feel devalued and uncomfortable. Lack of confidence and control make them indecisive in this situation and individuals feel embarrassed and ashamed. The challenging behavior of Jeremy includes the alteration in sleeping habits. From the case study it is known that he often slept during the day and would awake during the early hours of the morning. He has been found adjusting the rate of flow of his neighbors drip. During the morning Jeremy can usually understand that he is a patient and is ill and hence is admitted in the hospital. But during the afternoon he becomes very anxious, he repeats words, usually Shirley and Mama frequently and tried to leave via the fire escape. He has urinated in the waste paper box and tried to get into the bed with a female patient. Such changes in Jeremys behavior scared the other patients within the ward and few of the patient relatives have also lodged complaints against Jeremy. In addition, Jeremy feels reluctant to take his medication and his medicines are found under his pillow. It is also seen that when nurses enquire him about his certain changes in behavior, Jeremy feels angry with them and many of the nursing staff believe that Jeremy can hurt any of them and any patient at any point of time. Intervention and management of such behavioral changes are vital skills for all the nursing staffs. Jeremys safety along with the safety of the engaged nursing staffs and other patients should be considered with the highest priority. The nurses should open the doors from outside and should make sure that Jeremy cannot lock him from inside. Nurses should take care of the fact that Jeremy has less accessibility to movable objects, jewellery or any sharp instruments that might increase the risk of harm at any point of time. Nurses who are taking care of Jeremy may prefer to present few important observations in a firm and calm but respectful way (Braine, 2005). They should maintain proper space between Jeremy and them. This is because few patients appreciate the matter of maintaining less distance between care provider and them. Patients feel comfortable with their healing touch (L ettice and Thomond, 2008). But in this case it is seen that Jeremy is mentally disturbed and it is quite difficult of the health care professionals to understand him and his sudden way of behaving in an awkward manner. There is also a chance that Jeremy can hurt the care providers, so to ensure proper safety the care providers should maintain proper space between self and Jeremy. According to Valle (2014), nurses should avoid verbal and physical threats, restraining patients, false promises and they should build rapport with Jeremy (Valle, 2014). In case of physical threats or application of restraints, Jeremy might act more aggressively and there might be a chance to develop a sense of revenge inside him. This in turn can disturb a safety environment within the ward. Building up a good rapport with Jeremy might help the nurses to properly communicate with Jeremy and this could build a trusting relationship between Jeremy and his care providers (McGill, 2005). This kind of approach helps the nurses to serve the patient with a quality care. Jeremys Mini Mental State Examination result has demonstrated that Jeremy has developed mixed dementia, that means both Alzheimers disease and vascular dementia. Nursing interventions for Alzheimers disease include maintenance of safe environment, promotion of function and mobility, teaching care givers and patients with efficient coping patterns, promoting sufficient sleep, hygiene, provide medication understanding and support to the care providers (Morris, 2008). Nazarko (2011) highlights that challenging behavior can be challenging to nursing staff or other patients, but behavior that mainly affects the quality of life of the patient has been estimated that between 20% and 92% of people living with dementia will experience at least one behavioral disturbances during the illness (Nazarko, 2011). However, (Osborne et al, 2010) argues that such figures indicates that not all people with dementia display challenging behavior and that the determinants of whether a behavior thought of a challenging is likely to depend on the context within which the behavior occurs and the meaning that towards others (Osborne, Simpson and Stokes, 2010). The nursing care intervention for reducing risk to dignity is that nurses must focus on promoting patient centered care practices for reducing the threat associated with dignity (Dignity Therapy Shown to Improve End of Life for Dying patients as Well as Families, 2011). A person-centered approach to understanding each individual and planning their care is most important to negating the need for challenging behavior (Butterworth 2012). The input of family and friends to help identify a persons likes and dislikes can help care homes to put meaningful activities in place (Frankova, 2015).The nurses must explain to Jeremy what actually happened and its impact. As it is stated on the scenario that, in the morning, Jeremy behaves normally and this time can be capitalized for discussing with him. Empower a person who has a problem of wandering around Jeremy would wander around the house and try the doors to check if they were open. This made his sister worried that Jeremy would get out of the house at any point of time. Unfortunately, Jeremy went out at late night unnoticed by his sister. Jeremys social care group includes his sister, daughter-in-law and associated health care providers. His care might also be assisted by the NHS. Jeremys condition starts improving and according to her sister, she will be able to cope with him at home. Jeremys son is bit reluctant to take care of his father, so Shirley needs to play the key role in terms of her brothers care. She meets all the members of the hospital social care team; however, she refuses offer of help at home by a nurse aide, as according to her, Jeremy would not like strangers in his home. She also does not want to take help from the NHS, as recently it is facing cuts. Ultimately, Shirley accepts the fact that she is unable to cope at home, as Jeremy is still wandering and is s ometimes aggressive although improved than prior condition. It terms of social support, rather family support, it is very clear from the case study that Jeremy has received no help from James. According to Shirley, if no options are available then the ultimate option would be selling the house, which is 500,000, her state pension and also Jeremy has 40,000 in savings along with a good NHS pension. Shirley is taking care of her brothers legal affairs. Jeremys recent hospital admission does not work well and after returning home he finds it difficult to settle even though Jeremy is familiar with his surroundings. To support Jeremy, Shirley asks for help to adapt the house so that the surroundings will be safer and more befitting to his needs. This would otherwise empower Shirley to continue caring for Jeremy at his own residence. So, with the help of this case study it can be said that with these supports one can empower a person who has a problem of wandering around. Mabbott (2006) d efined empowerment a process designed to facilitate self-directed behavior change (Mabbott, 2006); whereas Hathaway (2009) states that it is a process of enabling people to choose to take control and make decisions about their lives. It is also a process which values all those involved (Hathaway, 2009). As empowerment promotes independency, it would be more help full for Jeremy to manage to do things on his own (Husain et al., 2009). Looking at the scenario, Jeremy needs to be empowered in managing to do more for him, therefore, putting pictures and signs on the toilet will help Jeremy to recognize where the toilet is and to be able to use it independently. The idea of patient centered model has developed from patient empowerment. It stresses upon authorizing patient to find their own answers. As health care staff people feel most obliging while they have given advice. Nevertheless, the fact is that the professionals do not exactly assist patient to solve their complications or build up enduring alterations in their lives by advising them what they should achieve. Finally, the patients should find their own ways out and motivation and should take accountability for their health and here comes the great role of the health care professionals; they should empower them to perform just that. It can be said that for Jeremys condition achieving this is quite hectic and therefore, the care professionals might set some changes in Jeremys surroundings. For example: improved lightening, removal of rugs to assist fall prevention; installation of hand rails so that Jeremy can climb the stairs more safety; use of a nightlight to assist with disorient ation in the dark; placing pictures and signs on the washroom door so that Jeremy knew where the toilet was which assisted to prevent some of the accidents he was having and labeled cupboards with pictures, which help Jeremy to identify where things were kept. Law and Ethics Jeremy went out at late night unnoticed by his sister. He already has cold and he got lost on a rainy night. He fell and was unable to get up and get home, which augments his complications. Jeremy had a stroke and readmitted to the hospital. Jeremy stated 10years prior that he does not want any unnecessary procedures or interventions if he has ever lost his mental or physical capacity by illness or injury. But the speech and language therapists have evaluated that it is unsafe for Jeremy to take diet and fluids orally because of the risk of inhalation, as a result he has had an insertion of naso-gastric tube. This initiates an ethical issue. His son would be happy in this matter as he wanted his father to be at hospital itself. From the case study it is clear that Shirley is the legal executor of Jeremys affairs. Therefore, when such ethical concerns take place within the health care set up, the doctor should communicate the issue to Jeremy. It is true that 10years prior Jeremy stated that he does not want any unnecessary procedures or interventions if he has ever lost his mental or physical capacity by illness or injury (Guido, 2006). But if the present condition is considered, it would be vital to mention that without the naso-gastric tube insertion Jeremy will receive no nutrition and it is illegal to restrict a patient from getting his terminal life support (Tschudin, 2012). So, a proper way would be communicating first with Jeremys sister and then if the doctor has some other alternatives rather than the insertion of naso-gastric tube, they must opt for that or else, they should support the idea of insertion of naso-gastric tube. As a healthcare professional one should be responsible for his/her action s (Momoh, 2006). Nurses have legal, ethical, contractual and social accountabilities and are liable for the actions they undertake (Tingle and Cribb, 2007). Therefore, this can be achieved by nurses ensuring that patients are able to decide what happens to them and then to respect those choices (Bailey, 2006).In addition, (Mental Capacity Act, 2005) make it clear that peoples advanced decisions should be taken into account in decision making, in particular, peoples advanced refusal of treatment should be respected. Therefore, Jeremys refusal to have a peg feed should be taken into account. With reference to Human Rights Act Article 2, with Jeremys decision of not having a peg feed, the act states that the concept of everyones life shall be protected by law requires the states not only to refrain from taking life intentionally, but they must also take appropriate steps to safeguard life. Therefore, the right to life covers both the intentional deprivation and careless endangering life (Griffith et al, 2009). Whereas, (Wheat,2009) emphasises that on Article 8, which is the right to respect for privacy and family life, for Jeremy decision, healthcare professionals have to be aware that the law relating to privacy and confidentiality means that the patient information must not be disclosed to others without a very good reason for breaching the obligation of confidence. However, the obligation is an obligation that is based upon the respect for autonomy and privacy and upon utilitarian principle that people are more likely to seek medical advice if they know that the inform ation will remain confidential (Wheat, 2009). Legal and ethical implications were brought in to the assignment and one ethical principle as well as Human Rights Act was critically analyzed on the rights of the patient in having a peg feed inserted. Lastly, this assignment demonstrated awareness of how to recognize a nursing problem and to knowledge on how to deal with the nursing problems in order to promote the quality of life of the patient. It would also influence my future practice by having understanding and awareness of Human Rights Act and ethical principles when dealing with decision making processes. According to the ANA Code of Ethics (2001), delegation is depend upon the nurses judgment regarding a patients status, the capability of all the health care professionals of a nursing team and the required level of supervision (Rcn.org.uk, 2015). Hence, the accurate delegation includes right task, right person, right circumstance, right communication and right supervision. This is very much needed in Jeremys case as the case study reveals that Jeremys condition is critical and engages various legal, ethical and professional accountabilities. References Braine, M. (2005). The management of challenging behaviour and cognitive impairment.British Journal of Neuroscience Nursing, 1(2), pp.67-74. Guido, G. (2006).Legal and ethical issues in nursing. Upper Saddle River, N.J.: Pearson/Prentice Hall. Hathaway, L. (2009). Got empowerment?.Nursing Made Incredibly Easy!, 7(1), p.4. Husain, M., Cross, E., Nicholas, H., Bryant, S. and Boothby, H. (2009). The Association Between Pre-morbid Personality Disorder And Alzheimer'S Disease.Alzheimer's Dementia, 5(4), p.e29. Lettice, F. and Thomond, P. (2008). Allocating resources to disruptive innovation projects: challenging mental models and overcoming management resistance.International Journal of Technology Management, 44(1/2), p.140. Mabbott, I. (2006). Public Health - Power, Empowerment and Professional PracticePublic Health - Power, Empowerment and Professional Practice.Nursing Standard, 20(32), pp.36-36. McGill, P. (2005). Staff Reports of Setting Events Associated With Challenging Behavior.Behavior Modification, 29(4), pp.599-615. Momoh, P. (2006). Book Review: Medical ethics and law: an introduction.Nursing Ethics, 13(2), pp.211-212. Morris, J. (2008). Challenging Behaviour: A Unified Approach.Adv Mental Hlth Learn Disabil, 2(2), pp.55-57. Nazarko, L. (2011). A practical approach to issues of challenging behaviour.Br J Healthcare Assistants, 5(10), pp.487-490. Osborne, H., Simpson, J. and Stokes, G. (2010). The relationship between pre-morbid personality and challenging behaviour in people with dementia: A systematic review.Aging Mental Health, 14(5), pp.503-515. Parse, R. (2010). Human Dignity: A Humanbecoming Ethical Phenomenon.Nursing Science Quarterly, 23(3), pp.257-262. Rcn.org.uk, (2015).Accountability and delegation - RCN. [online] Available at: https://www.rcn.org.uk/development/health_care_support_workers/professional_issues/accountability_and_delegation_film [Accessed 13 Apr. 2015]. Tingle, J. and Cribb, A. (2007).Nursing law and ethics. Oxford: Blackwell Pub. Tschudin, V. (2012). Book review: End-of-life care: ethics and law.Nursing Ethics, 19(3), pp.443-443. Valle, J. (2014). Being a nurse leader is a tough role.Nursing Management, 21(3), pp.9-9. Westrick, S. and Dempski, K. (2009).Essentials of nursing law and ethics. Sudbury, Mass.: Jones and Bartlett Publishers.

The Crucible- Injustice Essays - Creativity, Film, Arts,

The Crucible- Injustice In The Crucible, by Arthur Miller, justice and injustice is portrayed through the characters of John Proctor, Elizabeth Proctor and Abigail Williams. It is also shown through the minor characters of Mary Warren and Mercy Lewis, followers of Abigail Williams, and through Danforth and various townspeople. After Abigail Williams and the girls are discovered dancing in the forest by Reverend Parris, there are rumours of witchcraft among them, when Betty Parris and Ruth Putnam are found witched. Once the girls discover this, they become more and more frightened of being accused of witchcraft. Abigail is the first to admit to seeing the devil, and all the other girls join in, so the blame will not be placed on them. I saw Sarah Good with the Devil. I saw Goody Osburn with the Devil. I saw Bridget Bishop with the Devil. Once the accusations began, many innocent people in the community were taken away. They were then either forced to admit that they were witches, to free themselves from a public hanging, or deny that they were witches, saving their integrity, but subjecting themselves to an unjust public hanging. One of the first people to be charged, was Rebecca Nurse, wife of Francis Nurse, a well-respected man of the community. This disturbance caused great anxiety amongst the people in Salem, as they would have least suspected Rebecca Nurse to be one to deal with the Devil. If Rebecca Nurse be tainted, then nothings left to stop the whole green world from burning. Goody Putnam was the one to accuse her of witchcraft, for the death of her seven babies, but even with no just proof, Rebecca Nurse is hanged for sending her spirit out on them. Wild accusations are flying between people in Salem. In the case of Martha Corey, Walcott accused Corey of witchcraft, to settle a score that had happened four or five years ago. Walcott claimed that after buying a pig from Corey, it died soon after that and from that day to this he cannot keep a pig alive for more than four weeks. Giles Corey, Martha Coreys husband, was later killed for a different reason. He refused to give the name of a man who heard Putnam say he was killing his neighbours for their land. Giles Corey died an unjust death, great stones placed on his chest, pressing him slowly to death. Any outrageous claims were taken in by the courts, and everyone had a reason to accuse another, resulting in many innocent deaths. The main accuser, Abigail Williams, had an ulterior motive to destroy Elizabeth Proctor. Beforehand, Abigail had an affair with Elizabeths husband, John Proctor, and Abigail believed if she removed Elizabeth, she would have John to herself. Most of Abigails allegations were based on false claims, believing the relationship between her and John Proctor to be true love. Because of Abigails twisted plot of sticking a needle in herself to signify Elizabeths familiar spirit pushing it in, and Cheever finding a poppet in the Proctors house, Elizabeth is charged with murder. Proctor realises what Abigail is trying to do, and feels remorse, as he is partly at fault for his relationship with Abigail. Ill not give my wife to vengeance. At the trial, Proctor no longer tried to protect himself and admits to having an affair with Abigail, explains Abigails plan to destroy Elizabeth for revenge. Elizabeth is called in to secure these claims, but does not admit to John being an adulterer, to save his reputation and to protect him. Elizabeth, I have confessed it. Mary Warren, a follower of Abigail Williams and John Proctors servant, wanted to confess to the court, the falseness and injustice of the whole incident, the girls' imagination running wild, just to save themselves from being convicted of witchcraft, themselves. John Proctor learns this truth, and forces Mary to confess, to give justice to the rest of the community. The girls are given a chance to defend themselves against the claim that they were only acting. To prove their innocence, Abigail leads them to act as if Mary Warren had send her spirit in the form of a yellow bird up on the rafters. The girls hysterics, causes Mary Warren to