Sonny s Blues By James Baldwin - 827 Words

Sonny’s Blues In James Baldwin’s â€Å"Sonny’s Blues† it is only when a brother loses his child that he realizes how easy it can be to lose his brother. The narrator’s little brother, Sonny, was left in his charge when their parents passed away. He neglects Sonny and leaves him to work through hard decisions on his own which leads to Sonny being picked up by the police for using and selling drugs. When the narrator’s daughter, Grace, passes he sees how suffering can affect people and reaches out to Sonny, who is fighting to make his way in the world through music. Baldwin shows us that you don’t have to see eye to eye on everything to accept that person. The narrator doesn’t agree with his brother’s use of drugs and the comfort he finds in music. When the news of his Sonny’s arrest arrives he brushes it aside, not seeing a need to reach out to his brother. â€Å"I couldn’t find any room for it anywhere inside me.† He rese nts his brother because he believes Sonny is intentionally suffering. When he reaching out to Sonny he sees that music is helping him and the narrator begins to accept his different path. â€Å"Filling the air with the immense suggestion that Sonny speak for himself.† He doesn’t try to persuade him to follow a path that guarantees success but embraces his way of overcoming his suffering. The narrator’s internal conflict displays that is having a hard time reaching out and accepting Sonny because of the decisions he made. In the beginning of the story,Show MoreRelatedSonny s Blues By James Baldwin1252 Words   |  6 PagesThe story â€Å"Sonny’s Blues† by James Baldwin centers on the conflicting relationship between two brothers that is explored throughout various stages of their lives. Through the structured, melodic style used by Baldwin there are reoccurring themes of suffering, family, and home that are used to further convey the idea of two br others who love each other, but don’t understand each other. Ultimately, the relationship between the two brothers is greatly strained due them being polar opposites, their lackRead MoreJames Baldwin s Sonny s Blues956 Words   |  4 PagesJames Baldwin brings you on an emotional ride through Harlem in the 1950’s with his short story, â€Å"Sonny’s Blues.† From the beginning, we are in media res when the unnamed narrator is informed of bad news concerning his younger, troubled brother, Sonny. Throughout the story we witness the ocean of emotions between these two brothers battling hardships from their past, through flashbacks, and present time. The setting plays an important role in â€Å"Sonny’s Blues† to an extent where it is practically aRead MoreSonny s Blues By James Baldwin2300 Words   |  10 PagesIn the short story â€Å"Sonny’s Blues†, by James Baldwin there is the notion or a reoccurring theme of a conflict between light and dark between the characters. The notion is carried throughout the story of two brothers finding their own lights and trying to work towards a greater life. In the late 50’s, after the Harlem Renaissance, adolescents are faced with drug sales everywhere and crime sprees around every corner, this is one example of the darkness in the story. Kids began to form bad habits thatRead MoreJames Baldwin s Sonny s Blues2994 Words   |  12 PagesINTRODUCTION Sonny, from James Baldwin’s â€Å"Sonny’s Blues,† is portrayed as a sufferer. He struggles with his stagnation in Harlem, his unfulfilled dreams and the disconnect between himself and his only family, his brother. However, not all hope is lost. He serves as a teacher for others, full of knowledge of how one can truly suffer and still triumph (Norton 47). Only when he is finally able to connect with his brother through music, are his â€Å"blues† finally heard and he affirms his individualityRead MoreSonny s Blues By James Baldwin1028 Words   |  5 Pagesand influence the subject’s ideas. Consciously and unconsciously, the individual reflects the confluence of his or her history and culture. In â€Å"Sonny’s Blues†, a short story by James Baldwin, the dominant culture constricts the black individual. Subject to the explicit and latent biases of a racist society, the black population of â€Å"Sonny’s Blues† attempt to en dure oppression and suffering and survive in an unforgiving land. However, they can thrive here with the hope and salvation provided by theRead MoreSonny s Blues By James Baldwin Essay1745 Words   |  7 Pagesâ€Å"Sonny’s Blues† is a narration about two siblings – brothers - who choose very different routes in life in order to accomplish the zenith of individualism, expressionism and recognition. In doing so, they take a glimpse into one another’s spheres and learn to assent and appreciate each other for who they are. In 1951, Baldwin wrote Sonny’s Blues, a story of the ills that Harlem provided its youth. In Baldwin’s telling of the narration, it forms a nous of liberation, an atmosphere of therapeutic acceptanceRead MoreAnalysis Of James Baldwin s Sonny s Blues Essay1154 Words   |  5 Pagesntroduction: James Baldwin, author of Sonny s Blues, once said, I grew up with music...much more than with any other language. In a way, the mus ic I grew up with saved my life (Session 3 Inquiry: Rudolfo Anaya and James Baldwin, 2015).   Blues becomes Sonny s drug and his addiction to it his salvation.       Even though the adults refrain from lamenting their sufferings directly to the children and telling them about the darkness, the child-narrator still intimates its marks in their facesRead MoreAnalysis Of James Baldwin s Sonny s Blues 995 Words   |  4 PagesJames Baldwin presents an emotional journey through Harlem in the 1950’s with his short story, â€Å"Sonny’s Blues.† From the beginning, the story is in medias res when the unnamed narrator is informed of bad news concerning his younger, troubled brother, Sonny. Throughout the story there is an ocean of emotions witnessed between these two brothers as they battle hardships from their past and present time. The setting plays an important role in â€Å"Sonny’s Blues† to an extent where it is practically a characterRead MoreAnalysis Of James Baldwin s Sonny s Blues Essay2104 Words   |  9 PagesSeveral dialectics are at play in James Baldwin’s short story â€Å"Sonnyâ€℠¢s Blues† including a dialectic between the narrator and his beloved brother Sonny involving their opposing responses to the sense of oppression and limitation that arises from living in Harlem. This dialectic and its resolution closely parallel Baldwin’s masterful use of Blues, Jazz, and Gospel music. We follow the narrator and his brother Sonny as they traverse the complexities of their individual and interconnected Harlem livesRead MoreAnalysis Of `` Sonny s Blue `` By James Baldwin1474 Words   |  6 Pages Music can be the lead to freedom from darkness. The story â€Å"Sonny’s Blue† by James Baldwin takes places in Harlem around the 1950’s. The story is about two brothers. One of the brothers is the narrator of the story whose name is unknown. The narrator tells the story of the struggles in Harlem but mainly the struggles of his brother with drugs, and his passion for jazz music. Through out the story the narrator avoids giving a sense of his own struggles with himself. However, in the end the reader

Substance Abuse And Addiction Among Nurses - 1121 Words

What sources did you use to search for literature grounded in evidence-based practice relating to your research question or problem of interest? The question of interest I choose is; impaired nurses that choose not to seek help, are disciplinary policy that are punitive a factor in the choice not to seek help. I used Medline, a few nursing journal sites, and the EBSCO Library to look for information related to my research question. The article I found is Don’t ask don’t tell: substance abuse and addiction among nurses, this article is from the Journal of Clinical Nursing. Identify and explain the elements of a nursing article. Give a brief explanation of each section. Does the article you found contain all the elements of a well-written research article? Methodology: This paper is a quantitative research. The research combined the information gathered from three research papers that had already been completed. One research paper looked at the history of addiction in nursing and used a comparison of disciplinary and alternative to disciplinary policies. The second paper focused on the development of an alternative-to-dismissal policy for substance abuse in a school of nursing and using telephone and email interviews, and the ï ¬ nal paper reported ï ¬ ndings of what types of polices seem to be working to retain and rehabilitate nurses who suffer from addiction in the USA (Monroe, 2011). Lastly, this paper introduces international policy for nurses with addictions (Monroe,Show MoreRelated Substance Abuse Within the Nursing Profession Essay1230 Words   |  5 Pages As Heise states, substance abuse among nurses a growing problem that is often overlooked by society. Addiction has been a problem in the nursing profession for over one hundred years (as cited in Monroe Kenaga, 2010). According to the American nurses association, it is speculated that 6%-8% of nurses have a drug or alcohol related problem (as cited in Trinkoff Storr, 1998). Substance abuse not only affects the individual abuser, but also can negatively impact those around them, most significantlyRead MoreDrug Abuse And Substance Abuse1658 Words   |  7 PagesThe National Institute on Drug Abuse (NIDA) defines drug abuse as, â€Å" It becomes drug abuse when people use illegal drugs or use legal drugs inappropriately.† This may include; the repeated uses of drugs to produce pleasure, alleviates stress, and/or alters or avoids reality. The perception of addiction and substance abuse has been widely known for many years, but the medical community has failed to accept and publicly this issue among it own members. Drug abuse by nurses is prevalent in today societyRead MoreSubstance Abusers Do Not Have A Specific895 Words   |  4 PagesS ubstance abusers do not have a specific â€Å"look.† They come in the forms of all races, colors, ethnicities, genders, ages, and careers. According to Thomas and Siela (2011), â€Å"About 1 in 10, or 10-15% of all nurses, may be impaired or in recovery from alcohol or drug addiction. Although nurses aren’t at a higher increase risk than the public sector, their overall pattern of dependency is unique because they have greater access to drugs in the work environment† (Introduction, para 1). Substance abuseRead MoreSubstance Abuse and Chemical Dependency1703 Words   |  7 Pageswebsite, Substance abuse is used to describe a pattern of substance (drug) use leading to significant problems or distress such as failure to attend work/school, substance use in dangerous situations (driving a car), substance-related legal problems, or continued substance use that interferes with friendships and or family relationships. Substance abuse, as a disorder, refers to the abus e of illegal substances or the abusive use of legal substances. Alcohol is the most common legal drug of abuse. ChemicalRead MoreSubstance Abuse Is An Ever Growing Problem1510 Words   |  7 PagesWhy has substance abuse in the field of nursing been on the rise for the past 100 years? Could it be because of the high levels of stress along with the incredible toll working in the field of nursing takes on the body? Several different reasoning’s have been brought forth throughout the years, but nothing changes the fact that this is an increasing problem that has to be dealt with within the profession. â€Å"Addiction among nurses has been recognized by professionals in the field for over 100 yearsRead MoreNursing Shortage in the United States1680 Words   |  7 PagesStates is currently experiencing a shortage of nurses . â€Å"The U.S. Department of Labor, Bureau of Labor Statistics ( 2009 ) estimated that more than one million new and replacement nurses will be needed by 2018 to meet the increased demands of the health care workforce† (). The stressful conditions under whic h nurses work, due in part to the nursing shortage, are among the risk factors that contribute to nurses’ abuse of illicit drugs and alcohol. Nurses are unique in that they work in an environmentRead MoreCharacteristics Of Recording Reporting1739 Words   |  7 PagesCHARACTERISTICS OF RECORDING REPORTING Recording and reporting are most essential tools of a nurse where the nurse is responsible for all the information relating to the patient is recorded and reported even communicated accurately. They contain specific information about patient’s healthcare. These characteristics are interwoven and are five in number. They include accuracy, conciseness, thoroughness, currentness and organization. CRITICAL EVALUATION – Personal Life Whatsoever I do especiallyRead MoreSuicide And Substance Abuse Among Nurses1687 Words   |  7 Pages Suicide and Substance Abuse Among Nurses Associating nurses with the word suicide or drug addict is a taboo concept. Nurses are seen as the gate keepers to those that are sick and disabled. Due to the increase in incivility and workplace bullying in healthcare nurses are experiencing an increase in mental health conditions such as depression and anxiety disorders. Organizations currently do not impose mental health screening for new and current nurses ranging from a numerous amount of reason. UntilRead MoreEthical Issues Of Nurses With Substance Abuse Disorder2444 Words   |  10 PagesIssues that the Nurse, Employer, and society encounter when dealing with a nurse that is an addict Diane Jennette University of West Florida Abstract The responsibility of regulating nursing practice that ensures public safety, health and welfare and accountability to the public for proper governance falls on the State Boards of Nursing (BONs). Substance abuse is the most common disease that affects healthcare workers (Darbro, 2009). The disease of substance abuse disorder is preventableRead MorePublic Health Problem : Substance Abuse Among Nurses1024 Words   |  5 PagesHealth Problem: Substance Abuse Among Nurses Introduction As a healthcare professional, we are responsible for the delivery of high quality patient care. Substance abuse among nurses is an issue that threatens professional standards and can lead to poor patient outcomes (Rohma,2012). According to Healthy People 2020, an estimated 22 million Americans struggled with drug or alcohol abuse in the year 2005 (U.S. Department of Health and Human Services [HHS],2013). Given that the nurses have easy access

Professional Ethics Business Process Engineering

Question: Discuss about theProfessional Ethics for Business Process Engineering. Answer: Introduction Information technology has positively affected how activities are conducted within most business entities. Actually, there are immeasurable pros attributed to the tremendous invention experienced in this discipline. For instance, organizations have embraced the use of technology in almost all the organization processes. And they include but not limited to storage of information, processing and dissemination of the information within the organization systems, conduct of research and development, business process engineering, production, product design, product packing, and more others. Because of the desire for quality and cost minimization,organizations have completely incorporated IT in the systems. To facilitate such plans, the need for professional ethics surfaced. (Jordan 2010, p. 89-93) An IT expert is expected to subscribe to a particular set of ethical postulates. Just like other professionals like the accounting professional, law experts, journalists, physicians, teachers, an IT professional is required to uphold a specific level of professional ethics. If there could be no regulations and guidelines depicting the societal expectations of IT experts, cases of personal perpetration of criminal activities by IT employees could be high. Instances like the involvement in malicious programs in the systems of the organization could be common. Further, the creation of virus in the systems of the organization could be commonly experienced. To curb such acts that can be resulted from a poor relationship between the organization and an IT professional, the body governing the profession managed to establish satisfactorily codes of ethics which is explored in detail. (Russo 2006, p. 56-60) Purpose of the Report To acknowledge the existence of information technology as a discipline, there is an established code of ethics professionals in this particular field need to ascribe to. The report is structured to address the ethical issues to an IT professional. In addressing the ethical issues, the report will give an insight of the roles of an IT expert and other metrics pertaining Information Technology matters. With the study of this paper, the reader will get an insight of the societal expectation from the profession. (Jordan 2010, p. 89-93) Report Structure The report has been introduced an abstract followed by the following areas as highlighted below. First and foremost, the report has started with the identification of the purpose. As noted above, the purpose is highlighted as the analysis of ethical issues in the Information Technology Profession. Secondly, the report has explored the description of the case study. Also the case study has laid the basis for the identification and description of the ethical issues. Then the following areas have explored a full analysis of the ethical issues, discussions, and analysis of ethical matters and ended with recommendations for the appropriate actions in dealing with the matters from the analysis. (Corrao et al. 2015) Case Study Description River Valley limited is a private organization registered to offer IT consultancy services to small and medium-sized enterprises. Since the registration of the firm, everything has been great. For the past years the firm has experienced a rise in profits for a successive period of about five years. Unfortunately information a customers computer configuration and password was found disclosed to the unauthorized employee. It was reported that an organization named ABC limited was losing thousands of dollars through frauds that was facilitated by the use of the password. During the system audit, it was discovered that most entries were reversed by fraudulent cashiers who ended up pocketing the organizations money. When the case was taken to the court of law, the defendant mentioned the River Valley Limited as the one who disclosed the passwords. (Ahmed et al. 2012) To worsenthe matter, another case was reported accusing the same consulting firm. The customer complained of a wrong configuration of the system by the employees of the consulting firm. The client regretted why he contracted the firm to configure a computer system that was easily hacked leading to the loss of crucial records. The data lost was very confidential and carried relevant information about finances, and other projections about the organization. This was not the only case. Within a period of 3 months, various cases compromising professional codes of standards had been filed in courts against the firms. It reached a level where the body regulating ethical standards for Information Technology had considered deregistering the firm. Meanwhile, a notice had been served to the firm to pause from normal operations until the cases filed against it at the court be solved. (Jacob-Timm 2009, p. 205-217) Identification and Description of Ethical Issues Notably, the case presented against the River Valley Limited absolutely relates to ethical issues. And all of the instances mentioned compromised ethical standards expected to be upheld by an information technology professional. A consultancy firm is expected to be a role model, shape, mentor, and impart the expected ethical standards in the workers. It was unfortunate for the above firm as it is the one leading in the perpetration of profession misconduct. (Dekraai et al. 2008) Therefore, the above scenario presents matters relating to confidentiality, competency, integrity and honesty. Perhaps, there could be more types of professional misconducts because the firms breached the primary and basic codes of standards. From most of the research conducted by scholars about the most common professional compromise that organizations commits, the conclusion has been based on the analysis of basic principles. Simply, the case justify generalizing the entire firm to be ethically maimed. (Jacob-Timm 2009, p. 205-217) From the expectation, the firm should have incorporated adherence to professional ethics among its vision statement. This could have been the culture deeply rooted within the employees and could have prevented the occurrence of the instance. Some of the code of ethics expected of Information Technology professionals includes confidentiality, integrity, and competence. These are the requisite metrics that all the professions require to uphold in the conduct on while relating to anyone in the organization. In addition, there are other ethical provisions that are specifically designed to guide the conduct of an information technology expert. They range from promoting information technology, access computing to and communication sources only when authorized to do so, improving the understanding of computing and its consequences, and honouring of contracts, agreements, and assigned responsibilities by the authority. (Corrao et al. 2015) How Information Technology Professional Misconduct Can Affect the Shareholders In reference to the above case, both stakeholders of the consultancy firm and the involved organization will be affected. The current operation management and operations strategies entirely depend on Information Technology. A decision can be reached by a particular department but the followed activities like processing, implementation and monitoring of a project be facilitated by the information technology. The data relating to the inventory, customers behaviours, sales projections, marketing strategies, research and development and more others primarily depend on the Information technology. Thus, it will be imperative that the loss of the information because of inappropriate system configuration can stimulate untrustworthy employees from misappropriating organization resources. Eventually, the share value and profits attributable to shareholders will decrease. (Fisher 2009, p. 1-7) Possible Actions and Consequences It is ironical that the affected organization dearly pays for a mistake done by the contracted party. It the organization could have got a glimpse of the awaiting uncertainty, the option could be not to contract the River Valley firm. Some of the possible actions that should be undertaken by both the two parties include; For the organization, it should contract a reputable firm with a vast experience in computer and software configurations. This could enhance standard and quality of the service offered. In addition, the contract should depict the expected competence, the level of service and consequences that will follow if the organization incurs losses as a result of the installed and configured software. (Burns et al. 2008) For the case of the consultancy firm, it should employ experienced individuals. And they should be people who have mastered ethical code of standards. Ethical adherence should be totally incorporated into the organization culture. Also, the firm should regularly make a follow-up to their clients and ascertain how their configurations and systems are working. The regular monitoring can enhance discovery of defects before it really occurs. Most importantly, the firm should check on the competency levels and quality and standard of the systems and software. (Haas et al. 2013) For the case of the consulting firm, the tended image can probably result to reduced number of customers. Also, the court ruling may require them to compensate for the damages caused to the clients. If such penalties are imposed on the firm, then obviously the closure risks become inevitable. Plus the projected reduced income as a result of the reduced number of customers. Worse of all, the board regulating professional codes of ethics in information technology may decide to withdraw the registration certificate. This can eventually render the pull out the firm from existence. In the long-run, the shareholders will end up spending more money in handling these messes. (Jacob et al. 2015) To sum up, Information Technology discipline is the nerve centre of all the operations in the organization. If either the organization or any party faults from adhering to the principles, the impacts will be felt by the entire organization. Thus, the management must ensure that the department is headed by an experienced expert who will ensure all the ethical demands are appropriately adhered to by his/ her team members. (Weithorn 2013, p. 235-260) The Rationale for Appropriate Action Honestly, the negligence of adherence to the professional code of ethics can be observed as a personal responsibility. For this situation, the mess could have been avoided if at all due care and professionalism was observed by the firm. For instance, the disclosure of the organization password to unauthorized employees was unprofessional. To discourage such behaviour, those found with liability should not be spared. The law should be applied to them in the full force to act as an example to others in the same profession. In reference to this case, the perpetrators of the offense should be given pay for damages. Further, the law should prohibit such people from working again as professions. (McNamara 2008, p. 456-467) The government and the professional bodies covering ethical codes should remain vigilant and enact appropriate regulations to fully address such matters. Particular metrics should be developed to assist organizations to assess the ability of the firms to execute the assigned duties. Also, a draft of the contract should be forwarded to a lawyer to avoid either of the parties from failing to execute his/her responsibilities. Therefore, the management of any organization should embrace prevention rather than waiting for uncertainties. Thus, it should not remain a matter of chance or fate. (Russo 2006, p. 56-60) To sum up, the management, the employees, shareholders, interested parties, and the government should combine efforts and champion embrasure of professional ethics. If at all professionalism becomes a culture to all the private and public organizations, vices such as corruption can be eliminated. Countries that have faced high cases of corruption have experienced a low level of economic development. Take an example of Nigeria, from West Africa, has experienced low economic growth rate despite being rich in the supply of oil. Information Technology being the heart of the most organization, the employees working in this department should be exposed to a thorough vetting process. This is meant to ensure the right person is given for the right job. References Ahmed, N., Farhan, A. (2012). Ethical Principles of Psychologists and Code of Conduct: American Psychologist, 57(43), 1060 1073 Burns, M. K., Jacob, S., Wagner, A. (2008). Ethical And Legal Issues Associated With Using Responsiveness-To-Intervention To Assess Learning Disabilities: School Psychology. 46(12), 263279. Corrao, J., Melton, G. B. (2015). Legal Issues in School-Based Therapy: Handbook of behavior therapy in education, 24(78), 377399. Dekraai, M., Sales, B., Hall, S. (2008). Informed Consent, Confidentiality, And Duty To Report Laws In The Conduct Of Child Therapy: The practice of child therapy 23(8), 540559) Fisher, M. A. (2009). Replacing Who Is the Client With a Different Ethical Question: Professional Psychology: Research and Practice, 40(34), 17. Haas, L. J., Malouf, J. L. (2013). Keeping Up The Good Work: A practitioners guide to mental health ethics (4th ed.). Sarasota, FL: Professional Resource Press, 34(67), 78-89 Jacob, S., Decker, D. M., Hartshorne, T. S. (2015). Ethics and Law For School Psychologists: Hoboken, NJ: John Wiley Sons, 43(54), 67-71 Jacob-Timm, S. (2009). Ethical Dilemmas Encountered By Members of the National Association of School Psychologists: Psychology in the Schools, 36(6), 205217 Jordan A.D. (2010).Ethics and Law: Confronting the Dilemmas of Mitigation and Adaptation? Cambridge: Cambridge University Press, 67(43), 89-93 McNamara, K. (2008). Best Practices In The Application Of Professional Ethics: Best practices in school psychology. Bethesda: National Association of School Psychologists, 12(54), 456-467 Russo, C. J. (2006). Reutters the law of public education: New York Foundation Press, 96(7), 56-60 Weithorn, L. A. (2013). Involving Children in Decisions Affecting Their Own Welfare: Guidelines for professionals: Childrens competence to consent, 73(11), 235260

The Pathophysiology of Adhd Essay Example

The Pathophysiology of Adhd Essay Research on children with ADHD has shown a general reduction of brain volume, but with a proportionally greater reduction in the volume of the left-sided prefrontal cortex. These findings suggest that the core ADHD features of inattention, hyperactivity, and impulsivity may reflect frontal lobe dysfunction, but other brain regions particularly the cerebellum have also been implicated. 88] Neuroimaging studies in ADHD have not always given consistent results and as of 2008 are only used for research not diagnostic purposes. [89] A 2005 review of published studies involving neuroimaging, neuropsychological genetics, and neurochemistry found converging lines of evidence to suggest that four connected frontostriatal regions play a role in the pathophysiology of ADHD: The lateral prefrontal cortex, dorsal anterior cingulate cortex, caudate, and putamen. 90] In one study a delay in development of certain brain structures by an average of three years occurred in ADHD elementary school aged patients. The delay was most prominent in the frontal cortex and temporal lobe, which are believed to be responsible for the ability to control and focus thinking. In contrast, the motor cortex in the ADHD patients was seen to mature faster than normal, suggesting that both slower development of behavioral control and advanced motor development might be required for the fidgetiness that characterizes ADHD. It should be noted that stimulant medication itself may affect growth factors of the central nervous system. [92] The same laboratory had previously found involvement of the 7-repeat variant of the dopamine D4 receptor gene, which accounts for about 30 percent of the genetic risk for ADHD, in unusual thinness of the cortex of the right side of the brain; however, in contrast to other variants of the gene found in ADHD patients, the region normalized in thickness during the teen years in these children, coinciding with clinical improvement. 93] Additionally, SPECT scans found people with ADHD to have reduced blood circulation (indicating low neural activity),[94] and a significantly higher concentration of dopamine transporters in the striatum which is in charge of planning ahead. [95][96] A study by the U. S. Department of Energy’s Brookhaven National Laboratory in collaboration with Mount Sinai School of Medicine in New York suggest that it is not the dopamine transporter lev els that indicate ADHD, but the brains ability to roduce neurotransmitters like dopamine itself. The study was done by injecting 20 ADHD subjects and 25 control subjects with a radiotracer that attaches itself to dopamine transporters. The study found that it was not the transporter levels that indicated ADHD, but the dopamine itself. ADHD subjects showed lower levels of dopamine (hypodopaminergia) across the board. They speculated that since ADHD subjects had lower levels of dopamine to begin with, the number of transporters in the brain was not the telling factor. We will write a custom essay sample on The Pathophysiology of Adhd specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The Pathophysiology of Adhd specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The Pathophysiology of Adhd specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In support of this notion, plasma homovanillic acid, an index of dopamine levels, was found to be inversely related not only to childhood ADHD symptoms in adult psychiatric patients, but to childhood learning problems in healthy subjects as well. [97] One interpretation of dopamine pathway tracers is that the biochemical reward mechanism works for those with ADHD only when the task performed is inherently motivating; low levels of dopamine raise the threshold at which someone can maintain focus on a task which is otherwise boring. [98] Neuroimaging studies also found that neurotransmitters level (e. . dopamine and serotonin) in the synaptic cleft goes down during depression. [99][100] A 1990 PET scan study by Alan J. Zametkin et al. found that global cerebral glucose metabolism was 8% lower in medication-naive adults who had been hyperactive since childhood. [101] Further studies found that chronic stimulant treatment had little effect on global glucose metabolism,[102] a 1993 study in girls failed to find a decreased global glucose metabolism, but found significant differences in glucose metabolism in 6 specific regions of the brains of ADHD girls as compared to control subjects. The study also found that differences in one specific region of the frontal lobe were statistically correlated with symptom severity. [103] A further study in 1997 also failed to find global differences in glucose metabolism, but similarly found differences in glucose normalization in specific regions of the brain. The 1997 study also noted that their findings were somewhat different than those in the 1993 study, and concluded that sexual maturation may have played a role in this discrepancy. 104] The significance of the research by Zametkin has not been determined and neither his group nor any other has been able to replicate the 1990 results. [105][106][107] Critics, such as Jonathan Leo and David Cohen, who reject the characterization of ADHD as a disorder, contend that the controls for stimulant medication usage were inadequate in some lobar volumetric studies which makes it impossible to determine whether ADHD itself or psychotropic medication used to treat ADHD is responsible f or the decreased thickness observed[108] in certain brain regions. While the main study in question used age-matched controls, it did not provide information on height and weight of the subjects. These variables it has been argued could account for the regional brain size differences rather than ADHD itself. [109][110] They believe many neuroimaging studies are oversimplified in both popular and scientific discourse and given undue weight despite deficiencies in experimental methodology. [109] Diagnosis ADHD is diagnosed via a psychiatric assessment; to rule out other potential causes or comorbidities, physical examination, radiological imaging, and laboratory tests may be used. [111] In North America, the DSM-IV criteria are often the basis for a diagnosis, while European countries usually use the ICD-10. If the DSM-IV criteria are used, rather than the ICD-10, a diagnosis of ADHD is 3–4 times more likely. [13] Factors other than those within the DSM or ICD however have been found to affect the diagnosis in clinical practice. A childs social and school environment as well as academic pressures at school are likely to be of influence. [112] Many of the symptoms of ADHD occur from time to time in everyone; in patients with ADHD, the frequency of these symptoms is greater and patients lives are significantly impaired. Impairment must occur in multiple settings to be classified as ADHD. [32] As with many other psychiatric and medical disorders, the formal diagnosis is made by a qualified professional in the field based on a set number of criteria. In the USA these criteria are laid down by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edition. Based on the DSM-IV criteria listed below, three types of ADHD are classified: ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months ADHD Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months ADHD, Predominantly Hyperactive-Impulsive Type: if criterion 1B is met but criterion 1A is not met for the past six months. 113] The previously used term ADD expired with the most recent revision of the DSM. Consequently, ADHD is the current nomenclature used to describe the disorder as one distinct disorder which can manifest itself as being a primary deficit resulting in hyperactivity/impulsivity (ADHD, predominately hyperactive-impulsive type) or inattention (ADHD predominately inattentive type) or both (ADHD combined type).