The moral appropriateness of shame

In this article I explore the much neglected moral emotion of shame and consider the senses in which it may be regarded as morally appropriate. I argue that there is a connection between coming to terms with shame for those who feel ashamed, and judgments concerning its moral appropriateness. The elucidation of normative connections between shame, self-respect and autonomy implies the need to accept certain aspects of shame as regrettable yet, sometimes, as valuable

Role of Neuronal Nitric Oxide Synthase on Cardiovascular Functions in Physiological and Pathophysiological States

This review describes and summarizes the role of neuronal nitric oxide synthase (nNOS) on the central nervous system, particularly on brain regions such as the ventrolateral medulla (VLM) and the periaqueductal gray matter (PAG), and on blood vessels and the heart that are involved in the regulation and control of the cardiovascular system (CVS). Furthermore, we shall also review the functional aspects of nNOS during several physiological, pathophysiological, and clinical conditions such as exercise, pain, cerebral vascular accidents or stroke and hypertension. For example, during stroke, a cascade of molecular, neurochemical, and cellular changes occur that affect the nervous system as elicited by generation of free radicals and nitric oxide (NO) from vulnerable neurons, peroxide formation, superoxides, apoptosis, and the differential activation of three isoforms of nitric oxide synthases (NOSs), and can exert profound effects on the CVS. Neuronal NOS is one of the three isoforms of NOSs, the others being endothelial (eNOS) and inducible (iNOS) enzymes. Neuronal NOS is a critical homeostatic component of the CVS and plays an important role in regulation of different systems and disease process including nociception. The functional and physiological roles of NO and nNOS are described at the beginning of this review. We also elaborate the structure, gene, domain, and regulation of the nNOS protein. Both inhibitory and excitatory role of nNOS on the sympathetic autonomic nervous system (SANS) and parasympathetic autonomic nervous system (PANS) as mediated via different neurotransmitters/signal transduction processes will be explored, particularly its effects on the CVS. Because the VLM plays a crucial function in cardiovascular homeostatic mechanisms, the neuroanatomy and cardiovascular regulation of the VLM will be discussed in conjunction with the actions of nNOS. Thereafter, we shall discuss the up-to-date developments that are related to the interaction between nNOS and cardiovascular diseases such as hypertension and stroke. Finally, we shall focus on the role of nNOS, particularly within the PAG in cardiovascular regulation and neurotransmission during different types of pain stimulus. Overall, this review focuses on our current understanding of the nNOS protein, and provides further insights on how nNOS modulates, regulates, and controls cardiovascular function during both physiological activity such as exercise, and pathophysiological conditions such as stroke and hypertension

Rheumatoid arthritis

Immune-mediated inflammatory disorders include a clinically diverse group of conditions that share similar pathogenic mechanisms. Conditions such as rheumatoid arthritis (RA), psoriasis, spondyloarthropathy, inflammatory bowel disease and connective-tissue disease are characterised by immune dysregulation and chronic inflammation. This review will focus on immunopathogenic mechanisms, aspects of early disease, co-morbidity and therapy in RA.Keywords: immune, inflammatory, rheumatoid arthritis, therap

Occupational Therapy for People With Dementia who Have Occupational Performance Challenges due to Depression

Individuals with dementia experience a multitude of barriers and challenges that impact their daily engagement throughout the environment. In addition, although the pandemic has concluded, noxious effects are still influencing people\u27s lives. Residential care facilities have noticed continual acts of isolation that are presenting as barriers in mental health. Depression has known to be a common comorbidity in the ailment of dementia. Occupational therapy (OT) practitioners have the unique and valuable role in working with this population to target beyond the biomechanical aspects of a resident. Identifying barriers for mastery in leisure pursuits throughout someone’s day is crucial. When residents do not have successful experiences throughout their day they are not living through an encouraging environment to allow for the opportunity of prolonging cognition. Based on the literature review and the capstone experience site OT practitioners show the need for a program consisting of therapeutic activities that target depression in those with dementia. The purpose of the project is to develop an occupation-based OT program to treat people with dementia who had occupational performance challenges due to depression. This program is structured around the Model of Human Occupation (MOHO), Behavioral Activation (BA), and the Allen Cognitive Level Screen (ACLS). The program consists of eight therapeutic activities that are broken down into three different ways of executing, based off the ACLS levels of three through five. The development of this capstone project will be an influential piece for occupational therapists to reference throughout their plan of care for a resident.https://soar.usa.edu/otdcapstonesspring2024/1026/thumbnail.jp

Rheumatoid arthritis

Immune-mediated inflammatory disorders include a clinically diverse group of conditions sharing similar pathogenic mechanisms. Conditions such as rheumatoid arthritis, psoriasis, spondyloarthropathy, inflammatory bowel disease and connective tissue diseases are characterised by immune dysregulation and chronic inflammation. This review will focus immuno-pathogenic mechanisms, aspects of early disease, co-morbidity and therapy in rheumatoid arthritis

Nurses’ experiences regarding adverse events in a public hospital in Gauteng

Abstract: Background: Nurse related adverse events refer to any event leading to the injury of a patient. Adverse events have been a significant and worrying challenge within nursing practice both nationally and internationally. Involvement of nurses in adverse events who in most cases are rarely to blame, results in feelings of exhaustion, being emotionally drained, hospitals experiencing high nurse turnover and subsequent negative effects on the nursing care rendered. Most of the involved nurses struggle in isolation personally and professionally with a negative impact on colleagues, patients and the organizations. Existing literature has indicated that no current research demonstrating the nurse’s experiences regarding adverse events exists in this specific public hospital. Purpose: The purpose of this study was to explore and describe the experiences of the nurses regarding adverse events in this public hospital in Gauteng in order to develop recommendations to improve these experiences. Methodology: A qualitative, explorative, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews, focus group interviews and the documentation of naïve sketches from a purposive sample of professional nurses, enrolled nurses and enrolled nursing assistants . Data was analyzed using Tesch’s open coding protocol of qualitative data analysis. Lincoln and Guba’s four principles were applied to ensure trustworthiness. Results: The findings of the study revealed one central theme reflecting that the participants experienced their involvement in nurse related adverse events negatively. Three main themes emerged namely negative emotional experiences, negative social experiences and inappropriate management experiences..

Interactions among Endothelial Nitric Oxide Synthase, Cardiovascular System, and Nociception during Physiological and Pathophysiological States

Nitric oxide synthase (NOS) plays important roles within the cardiovascular system in physiological states as well as in pathophysiologic and specific cardiovascular (CV) disease states, such as hypertension (HTN), arteriosclerosis, and cerebrovascular accidents. This review discusses the roles of the endothelial NOS (eNOS) and its effect on cardiovascular responses that are induced by nociceptive stimuli. The roles of eNOS enzyme in modulating CV functions while experiencing pain will be discussed. Nociception, otherwise known as the subjective experience of pain through sensory receptors, termed “nociceptors”, can be stimulated by various external or internal stimuli. In turn, events of various cascade pathways implicating eNOS contribute to a plethora of pathophysiological responses to the noxious pain stimuli. Nociception pathways involve various regions of the brain and spinal cord, including the dorsolateral periaqueductal gray matter (PAG), rostral ventrolateral medulla (RVLM), caudal ventrolateral medulla, and intermediolateral column of the spinal cord. These pathways can interrelate in nociceptive responses to pain stimuli. The alterations in CV responses that affect GABAergic and glutamatergic pathways will be discussed in relation to mechanical and thermal (heat and cold) stimuli. Overall, this paper will discuss the aggregate recent and past data regarding pain pathways and the CV system

A Brief Synopsis of Monoclonal Antibody for the Treatment of Various Groups of Diseases

Monoclonal antibodies (mAbs) are increasingly being prescribed to patients and investigated in the field of medicine and research. This class of medication is unique due to its ability to be engineered into targeting a specific receptor. Numerous studies and reviews have reported the efficacy, potency, and clinical usage of mAbs in the treatment of a variety of diseases ranging from autoimmune disorders to malignant cancers. However, very few publications classify and provide a brief synopsis of mAbs that includes their pharmacological profiles, mechanisms of action, uses, and side effects in a concise manner. Therefore, this review aims to classify the current mAbs drugs used in clinical practice according to system diseases by providing a brief summary for each of them. For example, regarding cardiovascular disorders, mAbs such as Abciximab, Bevacizumab, and Digoxin Immune Fab will be reviewed. Denosumab, used to treat musculoskeletal disorders, will be also discussed. In addition, mAbs such as Adalimumab, Eculizumab, Natalizumab used in autoimmune disorders and Alemtuzumab, Trastuzumab, Cetuximab, and Rituximab that are prescribed for tumors will be reviewed. Finally, we shall discuss two mAbs that are IL-6 antagonists, Tocilizumab and Siltuximab, which are in ongoing clinical trials as potential treatments of COVID-19. The mAbs have profound benefits against chronic and malignant conditions, and the overall purpose of this review is to illustrate the basic pharmacological profiles of mAbs that physicians may find useful in establishing their management protocols