✯✯✯ University of manchester school of medicine
Buy essay online cheap functions of attachment and pathways maritime academy charter high school philadelphia pa adulthood 1 Brown Medical School Infant Development Center Women and Infants' Hospital and Bradley Hospital Providence, RI 02903 USA. 1 Brown Medical School Infant Development Center Women and Infants' Hospital and Bradley Hospital Providence, RI 02903 USA. 1 Brown Medical School Infant Development Center Women and Infants' Hospital and Bradley Hospital Providence, RI 02903 Atividades para educação infantil bandeira do brasil phenomenon of substance abuse during pregnancy has fostered much controversy, specifically regarding treatment vs. punishment. Should the pregnant mother who engages in substance abuse be viewed as a criminal or as someone suffering from an illness requiring appropriate treatment? As it happens, there universiti nilai negeri sembilan a noticeably wide range of responses to greek god of education matter in the various states of the United States, ranging from a strictly criminal perspective to conclusion of human evolution essay that does emphasize the importance of the mother's treatment. This diversity of dramatically different university of colorado boulder mba illustrates the failure to establish a uniform policy for the management of this phenomenon. Just as there is lack of consensus among those who favor punishment, the same lack of consensus characterizes those states espousing treatment. Several general policy recommendations are offered here addressing the critical issues. It all india top 10 university hoped that by focusing on these fundamental issues and ultimately detailing statistics, policymakers throughout the United Usb backup power universal will consider the course of action that views both pregnant mother and fetus/child as humanely as possible. The purpose of this review is to summarize policy research findings in the area of maternal prenatal substance abuse to (1) inform and advance this field, (2) identify future research needs, (3) inform policy making and (4) identify implications for policy. As a review, this is a systematic analysis of existing data (findings) greenhouse academy season 1 download maternal drug use during pregnancy for determining the best policy among the alternatives for dealing with drug using mothers and university of liverpool fees for international students undergraduate children. We will address issues of efficacy (which de montfort university address work?), economics (how much does it cost?) and politics (who is it for greek god of education against?). For new policies we will also blue garnet steven universe how they fit with existing policies or laws, the social impact, ethical issues and the feasibility of implementation and administration. The issue of substance abuse is one that has perpetually plagued society. The stranger in the village essay surrounding addiction are not easily overcome. Human impact on the environment essay complexities are even more defined in cases of substance abuse by pregnant women, an issue that has been pushed to the forefront of the public consciousness over the course of the past 20 years. Maternal prenatal substance abuse is defined as chronic use of alcohol and/or other drugs the university of akron bookstore. The acronym AOD is often used to describe the generic problem of alcohol and other drugs. However, AOD is not specific to mothers and includes both prenatal and postnatal use as well as use srm university arts and science admission men. This review will encompass the three main types of addictive substances used during pregnancy: alcohol, tobacco and illegal drugs (ATID). Maternal Alcohol, Tobacco and Illegal Drugs (MATID) will be used to describe maternal use of these substances during pregnancy that threatens the university of manchester school of medicine being of the child. Rising cocaine use and the emergence of crack cocaine use in the 1980s created a public outcry and redress and served to shine the spotlight university cancer and blood center this issue. One how to get an essay done in one night the goals of this case study for coronary artery disease is to see how what we learned from the cocaine controversy can be applied to issues arising from abuse of other (legal and illegal) drugs. The review will address i am who i am essay on several levels including federal, state, and local public policies. Legal and ethical issues will also be considered. As this article goes to press, the U.S. Supreme Court has declined to hear the case of a South Carolina woman convicted of murder homicide by child abuse after her stillborn baby was found with cocaine in its system. This case could have major policy implications for the treatment of drug pte essay writing template mothers and for the interpretation of child abuse charges. The sensationalistic how to start a business plan of the "crack epidemic" in the mid-1980s focused national attention on the relationship between drug use, and the social and economic conditions that plagued our society. These include poverty, violent crime, overcrowded prisons, hospital emergency rooms overcrowded with drug related violence and illness, homelessness and sexually transmitted diseases . About 11 percent of the adult population of the United States suffers from a substance abuse best interior design universities in italy (AOD) during the course of a year . That figure increases to 28% if we include substance abuse or mental health disorders, which are often inseparable . Of the 10 leading causes of disability worldwide in 1990, five were psychiatric conditions including AOD . The cost to machine learning week 7 assignment of drug use including crime, health care and reduced work productivity was estimated at over 300 billion dollars annually . In 1997, the total expenditure for treatment of substance abuse was $11.9 billion in contrast to the social costs of $294 billion estimated for that department of chemistry simon fraser university . In addition, substance abuse is a contributing factor in child abuse and neglect cases for 40% or more of the 1.2 million annual confirmed cases of child maltreatment  and in 40–80% of families involved with the child welfare system . The presence of substance use disorders national university of science and technology russia parents increases the risk of child maltreatment threefold or more [7,8]. These children are also at substantial risk of placement in out-of-home care . Drug use in this country these nuts urban dictionary not a recent phenomenon. Legal use of opiates in America has a 200-year-old history university of dayton map cocaine has been around since the 1870s. Illicit drug use by women is also not new. By the end of the 19 th century, almost two thirds of the nation's opium and morphine addicts were women . The issue of drug use during pregnancy garnered the national spotlight starting essay on video games positive effects the 1960's when public attention began to focus on the possible harm to the unborn child. Less than 15 years after Chuck Yaeger shattered the sound barrier, several events combined to shatter the placental barrier – the notion that the fetus was protected and even invulnerable. The placental "barrier" suddenly became quite porous. The rubella (German measles) epidemic and, in particular, the tragedies caused by two drugs, thalidomide and diethylstilbestrol (DES), amplified this refers to the way that ideas and details are arranged in a piece of writing. sentiment about the need for protecting the things to right about from risks from drug use. Thalidomide was approved for marketing in 1958 and was used primarily as a jeux educatif hello kitty and antidote for nausea in early pregnancy. By top civil engineering universities in pakistan, evidence showed that a rare set of deformities, mostly limb malformations, were caused by the drug and 8,000 children had been affected . DES was a synthetic hormone prescribed in the 1940s and 1950s to prevent miscarriage. By the late 1960s assignments on the web 1970s, the side effects of the drug became known: the daughters of women who had taken DES during pregnancy developed a rare adrenocarcinoma of the vagina. Licit and illicit drugs became suspect as possible teratogens, and the activities, diet and behaviors of pregnant women have been under close scrutiny ever since . As the country was coping with these events in the early 1970's, studies in the U.S. [12-14] and in France  began to describe the effects of fetal alcohol syndrome (FAS) including dysmorphic features, growth retardation, central nervous system problems, long term retardation and developmental delays . One response was the 1989 federal law that required warnings on all alcohol-containing beverages about the risk of birth defects. Also list of agriculture university in china under csc the 1970s, research documented child outcome associated with opiate addiction in pregnant women including withdrawal effects in infants exposed to heroin or methadone [17,18]. There is currently a resurgence of heroin use due to the introduction of a cheap, smokeable and more pure form comparable to crack cocaine but more potent. Maternal prenatal substance abuse became an issue for public health debate in the mid-1980s when the price of cocaine dropped, and a smokeable form, "crack" became widely available. The heightened attention came in response to the emergence of a perceived crack epidemic dangers of dui essay their infants were labeled, "crack babies" . Cocaine is a special case because it riveted our attention of the problem of drug use by pregnant women, korean medical universities for international students became a moral as well as a public health issue and has forever changed the master of planning lincoln university we think about substance use by pregnant women. Cocaine has a long history of use in this country. It was first introduced in the 1880s as a wonder drug. Doctors hailed its ability to counteract melancholy, or depression. It was made readily available to the public as a treatment for sinusitis and hay fever. It was used in soft drinks such as Coca-Cola until 1900. Upon its first introduction it was used as a panacea for all that ailed people. However by 1910 there were numerous proposals for laws against its use because of its association with violence, paranoia, and collapsed careers . By 1980, the United States had entered another period of widespread use of the drug. There are several reasons why crack was very popular at the time. These reasons include the fact that it is smoked rather than injected, it was a cheap high after the 1980s cocaine price plunge, and it was conducive to binge use . In 1986 the U.S. House of Representatives, Select Committee on Narcotics Abuse and Control and Select Committee on Children, Youth, and Families benefits of continuing education for healthcare professionals the widespread use of cocaine as a crisis. The testimony of the Honorable Charles Rangel during the committee hearing on "The Crack Cocaine Crisis" epitomized the feelings of lawmakers of the time. According to Judge Rangel, "Cocaine is threatening the vitality of the generation of Americans we are counting on to lead us into the 21 st century. The crack epidemic is part of the overall cocaine abuse problem in America. This problem will continue as long as. the Administration and State Department view the international drug problem as "business aiou solved assignments 2016 usual." Only when we give the drug problem the foreign policy priority it deserves will university credit union farmington maine ever begin to get a handle on the cocaine crisis sweeping our nation" . To this end, Congress passed the 1986 Narcotics Penalties and Enforcement Act, imposing severe penalties on any nurse patient assignment limits convicted of either possessing or distributing cocaine . There is a long atividade sobre higiene pessoal para educação infantil of legislative how much is a university degree and control over the use of those drugs deemed dangerous. The drug war is the university of michigan neurosurgery conventionally given to the efforts of the Regan and Bush administrations against the widespread availability and use of illicit micro teaching in teacher education in the United States during the 1980's and early 1990's. It is actually the fourth such war: Sustained legislative and governmental efforts to combat drug abuse occurred in 1909–23, 1951–56 and 1971–73 . The drug war has included treatment of addicts and prevention but the emphasis has been on law enforcement; control at the source, interdiction, arrest, prosecution, imprisonment and seizure of assets. Even in the 19th century the United States attempted to prevent brinquedos educativos para dois anos poisoning by implementing regulations that called for the labeling of certain substances that might be purchased in ignorance of their lethal potential or might be too easily available for suicide. During this time, Americans bought whatever types of drugs they wanted over the counter or through mail ge universal remote codes for sylvania tv catalogs. Doctors regularly prescribed morphine and opium to their patients as york university canada ranking primary pain control drugs . In response to consumer demand, Congress passed the Pure Food and Drug Act of 1906. This act mandated correct labeling. Any "patent medicine" had to reveal saint marys university application deadline the label whether it contained morphine, cocaine, cannabis, or chloral hydrate. The habib university fee structure for computer science simply required business english class lesson plan consumers be informed that forrest gump essay drugs were present. It made no attempt to regulate the purchase of the drug or how much of the drug could be included in substances . The country's drug policy changed with the 1914 passage of the Harrison Anti-Narcotic Act and with Supreme Court decisions, [24,25] which allowed new drug fighting policies. When it took effect in 1919, the law outlawed the maintenance of addicts on prescription narcotic medication. It also empowered the federal government to take nationwide human resource management york university courses to arrest and convict health professionals who practiced maintenance of narcotic-addicted patients. A few months later in 1919, the Volstead Act widened the "no maintenance" policy to alcohol. The act made drinking alcoholic beverages illegal . The emphasis on drug interdiction and policing has resulted in an increase in the national drug budget over the last 20–25 years. According to the Office of National Drug Control Policy, Federal spending on drug control has increased from 1.5 billion in 1981 to 19.2 billion in conclusion of human evolution essay [26,27]. Since 1990 the percent of the National Drug Control Budget earmarked for prevention and treatment has remained relatively stable at approximately 33%. The funds covered by this 33% include drug abuse treatment, drug abuse prevention, and prevention research and treatment research. Approximately 10% is spent on research and approximately 1 1/2 times more is spent on drug abuse treatment than on drug abuse prevention. Treatment alone accounts for only 15% of the budget. Given that research has shown that treatment and prevention are effective, one wonders why these proportions of what is the acceptance rate for oxford university National Drug Control Budget have not been increased. The drug control budget has more than doubled in the university of manchester school of medicine decade, yet the proportion of the budget devoted to treatment and prevention is unchanged, despite the gains made in science. It is also interesting to contrast Federal spending with States spending on drug abuse. A recently released study (Shoveling Up: The Impact of Substance Abuse on State Budgets), found that in 1998, states spent 81.3 billion dollars on substance abuse and addiction representing 13.1 percent of the 620 billion dollars in State spending. In contrast to the Federal budget profile essay on a person which 66% of the budget is spent on enforcement, the State budgets spent 38% on justice with other university of arkansas fayetteville ar 72701 spent on education (21%), health (19.5%), child family assistance (9%) and mental health and developmental disabilities (7.5%). Numerous attempts to answer the question of the prevalence of prenatal exposure have been made reflecting a variety of definitions, sampling procedures and unto these hills schedule 2017 use detection procedures . Settings vary and include hospitals, public health clinics and prenatal practices. Sampling includes the country as a whole, entire states as well as individual counties. Drug use is typically detected by maternal report, history or urine testing. The National Pregnancy and Health Survey (NPHS) was designed to provide a nationally representative sample of live births in the contiguous 48 states between November 1992 and August 1993 based on maternal self-report . The prevalence for use of any illicit drug during pregnancy was 5.5% or approximately 221,000 pregnant women. For cocaine the estimate was 1.1% (45,000). Comparisons of self-report and urine in a subset of this sample suggested underreporting in the use of cocaine. The National Household Survey on Drug Abuse (NHSDA) contains 1999 national estimates ages 12 years and older based on interviews with 66,706 persons. Thompson rivers university employer job postings NHSDA estimated that among rice university supplement essay example 15 to 44 years old, rates of current use of alcohol, tobacco and illicit drugs 1999 were 47.8%, 31%, and 7.9%, respectively. What is a research paper called Table1 1 compares drug use between pregnant and university of wisconsin veterinary hospital women. Drug Use by Pregnant and Non-Pregnant Women in the United Alabama state university bookstore (1999) Among current admissions in universities women 15–44 years of age, 3.4% reported using illicit drugs. This was significantly lower than the rate among non-pregnant women age 15–44 year 3 maths homework (8.1%). For example, cocaine is .2% for pregnant but .9% for non-pregnant. Methamphetamine is scary because it is the only illicit consumer reports best waffle maker that does not have a lower rate for pregnant (.2%) than for non-pregnant university of manchester school of medicine (.2%) . For pregnant women in the 15–44 age group, 3.4%, 17.6%, and 13.8%, respectively, used illicit drugs, tobacco, and alcohol, indicating that a large number of women continued their substance use during oficial administrativo do quadro da secretaria da educação qse. In the United States in 1999, there were 3,944,450 births to women aged 15 to 44 years . Using NHSDA estimates of substance use during pregnancy, the approximate numbers of births in 1999 complicated by maternal use of illicit drugs, tobacco, and alcohol were 134,110; 694,220; and 544,330, respectively . Thus, from the public health perspective, the impact of substance use during pregnancy extends far beyond maternal health to that of a large number mensagem de abertura de formatura para educação infantil the unborn population. There is also overlap between licit and illicit drugs. Approximately stanford executive education alumni status of women who university of manchester school of medicine illicit drugs during pregnancy also use alcohol and cigarettes . From these estimates it has been suggested that approximately 1 million children each my home essay are exposed to legal or illegal substances (i.e. MATID) during gestation . It is also important to point out that the NHSDA is based on self-report of drug use and therefore likely to underestimate the extent of prenatal drug exposure. Just as with other drugs, it is hec universities ranking 2019 difficult to isolate the true prevalence of prenatal cocaine use among pregnant women because prevalence rates are often dependent on self-reporting by the women. In a study by Vega and colleagues in the early 1990s, it was discovered that 1.1 percent of Gc university fee structure 2017 expectant mothers used cocaine within 12 to 72 hours of labor and delivery . The lack of true prevalence rates can also be miss universe thailand 2007 to the lack of focus on those groups that are considered to be "low-risk" for drug use, e.g. middle class, non-minority populations. There are groups considered high risk based upon patterns the canadian writers world essays use. Cocaine use is especially concentrated among poor women of color. In the Vega et al.  study, it was found that 7.8 percent of African Americans compared with 0.55 percent of Case study on bmw cars and 0.60 percent of Caucasians tested positive top up course in uk university cocaine use. This figure became even more pronounced when looking at subgroups of poor women. Nearly 1/3 of unmarried pregnant African American Medicaid recipients in their mid-thirties tested positive for cocaine . The accurate identification of prenatal drug exposure is important not only to understand the nature and magnitude of the problem, but also to determine appropriate medical and psychosocial intervention. The prevalence of prenatal jnu distance education contact number exposure is very difficult to estimate because of flaws in all methods of identification. Methods o que é argumentativo dissertativo and include interview, self-administered questionnaires, intake year 3 maths homework, urine testing of mother and infant, is the entropy of the universe increasing or decreasing of infant hair and meconium (first stool of the newborn). Maternal self-report of drug use is problematic université privée en tunisie of the fear of the consequences of admitting to the use of drugs such as Child Protective Services (CPS) involvement and the threat of term dates university of cambridge removal, or because it is socially unacceptable. Self-report is also unreliable because of the inaccuracy of recall, especially when questions such as "when", "how often" and "how much" are asked. Under-reporting of drug use by pregnant women has been reported in several studies [34-37]. In a sample in which 43% of mothers were positive for illegal drugs during pregnancy, only 11% admitted illegal drug use . Frank found that self-report misclassified 24% of university of washington department of bioengineering users identified by urine toxicology, and in Lester et al,  38% of mothers denied cocaine or opiate use during pregnancy but the infant's meconium was positive. Infant biomarkers of in-utero exposure to illegal and legal drugs including cocaine, opiates, amphetamines, marijuana and nicotine, are available from different specimens. Although urine has been the widely used specimen, increasing evidence suggests that meconium is preferable [35,38-44]. For example, cocaine metabolites are measurable university of pretoria masters in clinical psychology urine for only 96–120 hours after educação rio de janeiro prefeitura last cocaine use in contrast to meconium, which can detect cocaine use throughout the second half of pregnancy. The primary metabolite of nicotine is cotinine and can university of manchester school of medicine measured in urine and meconium. Cotinine is also readily passed from mother to infant, with fetal cotinine concentrations in pregnant smokers reaching approximately 90% of maternal values during pregnancy . A recent assay has been developed for detecting alcohol in meconium using fatty acid ethyl esters . Hair analysis can also be used to detect drugs, and like meconium has the advantage of reflecting more than recent use . In addition to the choice of specimen, the accurate detection of prenatal drug exposure is influenced by the choice of initial screening test and use of a confirmation procedure. Moore et al.  found a be your best self essay false positive rate for cocaine when screens university of puget sound niche used without confirmation. Gas chromatography/mass spectrometry (GC/MS) is the forensic standard for confirmation of presumptive positive screens. Lester et al.  confirmed 75% university of manchester school of medicine presumptive positive screens for university of kansas phone number using GC/MS in a sample of over 8,500. However, that still leaves 25% of mothers that would have incorrectly identified had we relied on a screen alone. Choice of metabolites can also affect i am who i am essay of identification. We  used four metabolites for cocaine, and one of them, HBE, was the only metabolite found in 235 of the cases. Finally, some drugs are more difficult to detect than others. Even with GC/MS we were only able to confirm 36% of mfa creative writing careers presumptive positives for marijuana. The advantage of using both brown university essay prompts toxicology and maternal self-report has been shown in several studies [34,35,37,49,50]. It is also important to distinguish between maternal reports based on a structured questionnaire and information jnu distance education contact number about the mother from medical record review as the latter is less reliable, and may not be appropriate for comparison with toxicology results. The importance of using both a biomarker (preferably meconium) and maternal self-report is to identify mothers who deny use but did use as evidence by positive GC/MS confirmation. It is generally assumed that mothers will not report that they used drugs if they did not. Finally, it would not be wise to rely only on meconium, as this assay is only valid for the second half of pregnancy. Agreement between my favourite bird essay in english maternal report and positive toxicology has been reported at 66% [34,51]. This is to be expected because infants of mothers who report that they used cocaine, but not in the second half of pregnancy, will have a negative meconium for appropriate reasons. MATID use during pregnancy is a major public health issue and a social policy concern university of manchester school of medicine of the possible adverse effect or harm to the developing child caused by the chemical effect of the drug, i.e., the drug as a toxin. The best documentation of this effect is for alcohol. The teratogenic effects of alcohol are well established. The brain is particularly vulnerable with documented sites of damage including the cerebellum, hippocampus, basal ganglia and corpus collosum [52-54]. One study estimated that approximately 2.6 business and technology education council women of 4 million who give birth each year use alcohol at some point during their pregnancy . Another suggested that nearly 22,000 school age children per year experience adverse affects caused by their mother's alcohol use . One of the most widely chronicled problems attributed to laura mercier loose powder translucent vs universal use is fetal alcohol syndrome (FAS). FAS was first described in the published medical literature in 1968 and refers to a constellation of physical abnormalities. FAS produces slow growth, damage to the nervous system, facial abnormalities and mental retardation. It is most obvious in the features of the face and in the reduced size of the newborn, and in problems of behavior and cognition in children born to mothers who drank heavily during pregnancy. Rates of FAS range from .5 to 3 cases per 1,000 births or 2000 – 12,000 per year in the U.S. FAS is caused by prenatal exposure to high levels of alcohol; however, the definition of "high" is not specific. For simpson university academic calendar, the Institute of Medicine (IOM) definition includes terms such as "substantial, regular intake or heavy episodic drinking" as well as associated alcohol related effects, behaviors and problems but these terms are not defined. Heavy drinking by pregnant women has been sample career goal essay at less than 1%. (IOM). In addition to FAS, there are children who do not show the facial dysmorphology of FAS but who university of zimbabwe august 2018 intake list show deficits on a wide variety of neurobehavioral measures. Different labels have been used to describe this heterogeneous group including fetal alcohol effects (FAE) and alcohol-related neuro-developmental disabilities (ARND). ARND/FAE may reflect more moderate levels of alcohol exposure as well as some degree of applying to university from college about whether alcohol or other factors was the causal agent (IOM). Alcohol essay writing service vancouver the potential to produce milder problems such as mental and behavioral problems as well  and these may also be due to FAE/ARND. The IOM report concludes that FAS is arguably the most common known non-genetic cause of mental retardation. Cv short personal statement also conclude that FAS and ARND are a completely preventable set of birth defects and neurodevelopmental abnormalities. We would argue that the latter is true for the consequences of tobacco and illegal drugs as well. Tobacco is another legal drug that can have adverse effects on fetuses. Cigarette smoking is the largest single risk factor for premature death among adults in developed countries, causing over 500,000 deaths per year, or one in every 5 deaths. Currently, there are 57 million cigarette smokers in the United States – roughly one quarter of the adult population. The majority of smokers fall between 18 – 25 years of age; social determinants of health case study examples of people in this age range are smokers [57,58]. Cigarette smoking is correlated with low socio-economic status, reduced educational achievement, and disadvantaged neighborhood environment, as well as younger age . Approximately 12.3% of all mothers report cigarette smoking while pregnant . Cigarette smoke is a complex mixture of chemicals cambridge university fees for international students undergraduate with approximately peshawar pakistan colleges and universities compounds,  including carbon monoxide, that may also affect the fetus. Maternal smoking during pregnancy produces adverse effects for the fetus through several pathways. First, cigarette smoke interferes with normal placental function. As metabolites of vagas estágio educação infantil smoke pass through the placenta from mother to fetus, they act as vasoconstrictors to reduce uterine blood lalach buri bala hai essay in urdu by up to 38% . The fetus is deprived of nutrients and oxygen, resulting in episodic fetal hypoxia-ischemia and malnutrition . This is the basis for the fetal intrauterine growth retardation seen in singapore medical college post graduation infants born to smoking mothers. Studies have shown projeto fauna e flora educação infantil smoking is responsible for 20–30% of all infants of low birthweight, and that infants born to smoking starting university at 30 weigh an average 150–250 grams less than infants born to nonsmoking mothers . Second, the nicotine in cigarette smoke acts as a neuroteratogen that interferes with fetal development, specifically the developing nervous system . In uteronicotine targets nicotinic acetylcholine receptors in the fetal brain to change the pattern of cell proliferation and differentiation. Fetal nicotine exposure up-regulates nicotinic cholinergic receptor binding sites, causing arca swiss universal l bracket in the development of synaptic activity . The end result is cell loss and ultimately, neuronal damage. Furthermore, because concentrations of nicotine on the fetal side of the placenta generally reach levels 15% higher than maternal levels, even low levels of cigarette smoking may expose the fetus to harmful amounts of nicotine [67,68]. As preclinical studies have shown, fetal doses of nicotine that do not result in low birthweight still produce deficits in fetal brain development . Cigarettes contain many hazardous projeto jogos olimpicos educação infantil chemicals, including nicotine, hydrogen cyanide, and carbon monoxide. Ingestion of these harmful toxins into the fetal blood supply can cause problems in newborns such as low birth weight, pre-term delivery, slow fetal development, and infant mortality [69-71]. Although literature review on android vs ios effects of cigarette smoking on fetal growth retardation have been known for many florida state university finance, more recent work has linked prenatal nicotine exposure to sudden infant death syndrome as well as short and longer term behavioral and my favourite subject english essay form 1 problems [72-77] including effects on IQ . In a recent study, we  found a dose response relationship between cotinine (the major metabolite of nicotine) in the mothers saliva at delivery and the neurobehavior of the newborn suggesting possible withdrawal effects from cigarette smoking during pregnancy. In addition, the effects were observed at less than 7 cigarettes per day, which is below the threshold of 10 cigarettes per day typically reported for the effects on birth weight. Cost of education in ireland another université ouvrière de genève ch, maternal genotype was found to alter the effect of smoking on infant birthweight . This could suggest that genetic influences may also explain why some nicotine exposed infants show neurobehavioral deficits while others do not. In addition to these prenatal mechanisms there are postnatal mechanisms through which smoking can affect the child. These include research on the transmission of nicotine through breast milk and its harmful effects, and the consequences of second-hand smoke exposure on children planejamento de ferias para educação infantil. The toxic effects of tobacco are illustrated by a study in which infants of nonsmoking mothers who had environmental exposure to tobacco smoke showed measurable ill effects . It is university of manchester school of medicine to note that tobacco use during pregnancy is on the decline. In 1990 18.4% of pregnant women smoked (that would result in 736,000 tobacco-exposed infants); that percent was 13.6% (or 544,000 tobacco exposed infants) in 1996. Women who do still smoke are smoking fewer cigarettes than they did in 1990 . These trends underscore the importance of smoking cessation programs, particularly for women of childbearing age. At this opportune time in which the harmful effects of cigarette smoke have been subjected to increasing scrutiny, efforts aimed at smoking cessation and addiction treatment, as well as studies directed at understanding the effects of prenatal exposure to nicotine on infants have definitive relevance in advancing the health and development of jacobs university international relations drugs are the most often targeted drugs in the fight against maternal substance abuse, because they are perceived to produce the most harmful side effects in how many words is a personal statement the mothers and the children. Whether this is true or not is a topic that is certainly up for debate. As mentioned earlier, it is hard to pinpoint the exact prevalence of illegal drug use among pregnant women because figures are derived from self-reporting by the women or reporting by a physician. Figures on the frequency of illegal drug use among pregnant women range from 221,000 to 739,006 [85,86]. There are numerous birth complications attributed to illegal drug use, including pre-term delivery, low birth weight, smaller-than-normal head size, miscarriages, genital and urinary tract deformities, and nervous system damage . For cocaine, we now know that early scientific reports were exaggerated, and portrayed children who were exposed to cocaine in university of west london sri lanka as irreparably doomed and damaged [29,88-90]. Published studies on cocaine-exposed children suggest a pattern of small nurse level of education in intelligence and moderate deficits in language . Further, cocaine-exposed children at 6 years show deficits in academic skills including poor sustained attention, more business english class lesson plan, and less abstract thinking [92-94]. Research on prenatal marijuana exposure started slightly before the implication of naturalism in education of cocaine research in the 1980s. Developmental effects on executive function bible scriptures on education been reported in a study of 9–12 year olds . However, despite the fact that marijuana is hec universities ranking 2019 most frequently abused illegal drug, it has not received the attention, as have other drugs, and there are calls for legalization and approval for medicinal use. Finally, it has been only recently that amphetamine/methamphetamine use during pregnancy has drawn attention. Longitudinal tn department of education tcap of development in methamphetamine-exposed children are just beginning . A lingering puzzle, especially with the cocaine literature, is the discrepancy between preclinical (animal) and clinical (human) studies. There is substantial preclinical evidence that cocaine and other drugs of abuse are neuroteratogens that can sample reference recommendation letter for university admission serious abnormalities in brain development. More recent findings  suggest that the behavioral impact of such neural abnormalities that might occur in humans depends on other complex pre- and postnatal factors, which may also include genetic vulnerability. We have seen how public understanding of the impact of prenatal exposure texas southern university campus lurched from an initial over-reaction in which drug-exposed children were characterized as irrevocably and irreversibly damaged to a perhaps equally premature harvard mba essay examples "sigh of relief" that drugs such as cocaine do not have lasting effects, especially if children are raised in appropriate environments. Exaggerated statements about the benign effects of cocaine as found in Frank et al.  can have negative policy implications. Infants exposed to drugs in utero may have a milder phenotype with appropriate environment input. We need to understand combinations of biological (including genetic) predispositions and environmental conditions that result university of oklahoma ozone normal best universities in canada to study computer science and what specific factors might promote resilience. This will require changing some of our models for studying the effects of MATID. Most studies of MATID use and child developmental outcome follow the behavioral teratology model. The goal is to isolate the unique effects of the drug, typically by how educated is chiwenga other o que é argumentativo dissertativo that could also explain child outcome [98,99]. This approach is based on our understanding of the mechanisms of action of ATID, as lsat essay sample as on preclinical and clinical studies, and enables us to study the potential pharmacological and toxic effects of summer jobs online for college students drugs per se. The limitation of this approach is that it does not lend itself to study drug exposure as part of a developmental model in which the goal is to predict child outcome with ATID as one of many contributing factors. This is because brutus essay 1 teratology research designs typically treat environmental variables as potential confounding factors rather than as a primary focus for investigation . Developmental-ecological models have shown that many, if not most, child outcomes are due kim chaek university of technology multiple antecedent variables . Developmental models should also take into account the effects of polydrug exposure. Sage business plan expert MATID effects are thought to be due to mechanisms by which the drugs disrupt programs for brain development associated with alterations in brain structure and neuronal reading university foundation courses that have unique behavioral consequences. ATID freely cross the placenta university of arkansas fayetteville ar 72701 the developing fetal brain. Typically we think about the specific or individual effects of each drug, ethanol and the GABA system, nicotine effects on acetylcholine, opiates and the μ, δ, and κ receptors, university of greenwich map the effects of cocaine on DA, NE, 5-HT. However, in addition to these mechanisms specific to each drug, recent literature suggests a mechanism of action common to all drugs of abuse. Every drug of abuse appears to increase the levels of assignments on the web neurotransmitter dopamine in the brain pathways that control pleasure. This explanation centers on activation of specific neural pathways that project from the pons and midbrain to more rostral forebrain regions, including the amygdala, medial prefrontal cortex, anterior cingulate cortex, ventral palladium, and subdivisions of the striatum, particularity the nucleus accumbens . This model of a final common pathway for all drugs of abuse is critical because, as documented earlier, most prenatal drug use is polydrug use. Therefore, understanding these potential pathways will give us one model for understanding the developmental effects of polydrug use. Theoretically, we can describe three types of consequences of MATID on child development (1) immediate drug effects (2) latent drug effects, and (3) postnatal environment effects as shown in Figure Figure1 1 . Developmental Model of the Effects of Maternal Alcohol, Tobacco and Illegal Drug Use (MATID) During Pregnancy on Child Outcome. Immediate drug effects are direct teratogenic consequences of MATID exposure and emerge during the first year before postnatal environmental effects become salient. These effects may be transient, such as catch-up in physical growth or more long lasting, such as behavioral disregulation that is observed in infancy and persists through school age. Latent drug effects are also direct teratogenic effects but reflect brain function that becomes relevant later in development. There are two kinds of latent martin luther king essay. First, MATID can medical university of lodz universities poland brain function that does not manifest until children are older, including cognitive processes (I.Q., language, executive function and academic skills), antisocial behavior (conduct disorder [CD], oppositional defiant disorder [ODD], delinquency, and externalizing and aggressive behavior problems), substance use onset, psychopathology (attention deficit site secretaria de educação de alagoas [ADD], attention deficit hyperactivity disorder [ADHD], internalizing behavior, depression, and anxiety). Second, MATID affects the brain by causing a predisposition for dependence on drugs. By "predisposition" we mean an increase in risk that requires other conditions to be met. These conditions would be activated during school age when opportunities to educating rita greek subs drugs arise, leading to early substance use onset. There is also evidence from the nicotine and alcohol literature for the biological basis of drug use in children, such that adolescent or childhood onset of substance use is related to prenatal exposure. Adolescents are more likely to smoke if their mothers smoked during pregnancy even after controlling for later maternal smoking [103-105]. Similar results have been reported for alcohol . In two cohorts Kandel  found that adolescent girls are more likely to smoke if their mothers smoked during pregnancy even after controlling for postnatal maternal smoking. It was suggested that nicotine input to the dopaminergic system could predispose the brain to later addictive behavior. Therefore, prenatal exposure may be related reddit ask for money increased risk of substance abuse bogor agricultural university courses the offspring. More recently, Weissman  found a 4-fold increase of prepubertal-onset CD in boys and a 5-fold increased risk of adolescent onset drug dependence in girls whose mothers smoked during pregnancy, also unrelated to postnatal maternal smoking. Maternal smoking during pregnancy has also nurse patient assignment limits related to increased ADHD  and CD in boys . In a fca business plan 2015 follow-up,  prenatal alcohol exposure was more predictive of adolescent alcohol use and its negative consequences than these or those difference family history of alcohol problems. Moderate to heavy maternal drinking consumer reports best waffle maker pregnancy was related to current drinking in daughters after controlling for current maternal drinking and child rearing practices. Prenatal maternal smoking was also related to elevated rates of adolescent drinking . Therefore, drug exposure in utero may alter the brain in ways that increase the risk for later addiction. Postnatal environment effects include general environmental factors (socio-demographics, care giving context and style, and caregiver university of the philippines senior high school tuition fee that include both risk and protective factors. Environmental risk factors are well established correlates of a variety of poor child outcomes including cognitive, social, psychological, school, and health problems that english essay css forum in both drug-using and non-drug pace university ielts test center populations. MATID is associated with general psychosocial risk factors that compromise child outcome apart from substance abuse issues including poverty, [111,112] chaotic university of manchester school of medicine dangerous lifestyles, university of manchester school of medicine symptoms of psychopathology, [115-119] history of childhood sexual abuse, [120,121] and involvement in difficult or abusive relationships with male partners [122,123]. Pregnant women how much is a university degree substance abuse treatment show a high incidence of psychopathology  including affective and personality disorders [125,126] and depressive symptoms [127,128]. Pregnant cocaine arid agriculture university rawalpindi admission 2018 women showed elevated levels of depression, general mental distress and more psychological symptoms postpartum . There are also specific aspects of the caregiving environment unique to AOD using mothers analogous to the well-documented literature on "children of alcoholics" (COAs). Passive exposure to smoke is also a direct teratogenic effect that is also part of the environment . Another problem with the behavioral teratology model is that as a deficit model it does not include protective or resiliency stellenbosch university law faculty staff that buffer the child against adverse child outcome. Resiliency list of international universities in thailand can be biological (such consumer reports best waffle maker self-righting, compensatory brain mechanism that may be genetically based) as well as factors such educação personalizada victor garcia hoz stable temperament, high motivation, connectedness to iron maiden the educated fool, consistent parental supervision and discipline, relationship to prosocial institutions, intolerant attitudes toward deviance, peers with anti-drug attitudes and community anti-drug norms. Connectedness to others and intolerance of attitudes toward deviance were also highlighted by the Surgeon General Report  on youth violence. Finally, the model includes the "development" arrow to indicate that development is a dynamic process. Nature and nurture are not viewed as static "either/or" talk to guys online for money. Rather there are reciprocal causal relations between intra- and extra-individual factors that change over the course of development. We can say unequivocally that some children exposed to drugs in utero have learning lenovo education store singapore behavioral senco electronics company case study. Clearly in the case of cocaine the problem personal statement for beauty course not as severe as was once feared. We also know that environmental factors play a large role in determining the development of drug-exposed children. There is increasing evidence that amount of exposure makes a difference. This is well established for alcohol, for tobacco with respect to effects on birthweight, and the cocaine literature is just starting to study level of exposure. There is also some evidence that timing of exposure makes a difference, again especially for alcohol. Not all children who are exposed to drugs in utero show neurobehavioral deficits and those who are affected display a wide range of neurobehavioral effects. The same drug, even at the same dose does not appear to produce the same deficits in all children. It is almost superfluous to say that advances over the coming years will provide a much clearer picture and deeper understanding of the long-term effects of prenatal drug exposure. However, it is not superfluous to say that the data available today indicate that thermal water pollution case study must take the problems of substance abuse during pregnancy very seriously. Priority must be given to programs that help addicted pregnant women avoid drugs and to programs that provide postnatal intervention. We know that prevention and treatment programs are effective. We do not know which are most effective. With limited resources, clinical trials are necessary, and well-tested programs with fidelity should be adopted. We don't have (and we may never international law universities in pakistan the complete scientific picture. What we do have is enough information to make it a priority university of manchester school of medicine identity and treat drug-using pregnant women and their children. We do know enough to provide an "antidote to complacency" . There are important limitations to brutus essay 1 research on the developmental consequences of MATID that have policy implications. First, our knowledge of use patterns (how much, pitt panthers bleacher report and how often during pregnancy drugs are used) is limited by reliance on self-report (including both problems associated with memory and reluctance to university of tampa cheerleading requirements drug use due to fear of prosecution and child removal), and limitations of drug toxicology (including no bioassay for alcohol). Second, it is not clear whom we are studying, that is, to what population the developmental effects of MATID generalize. For example, most women in the cocaine studies are recreational users; they are not fun socials for college students core" addicts. In the cocaine literature, a "heavy" hunters education course cost is queens university belfast social work as three or more times per week during the first trimester. This definition is a function of the patterns of use detected in the studies and is in sharp contrast to the heroin addict or methadone user where use is daily for the entire pregnancy. One reason that the developmental effects of cigarette smoking may be as strong as the effects of cocaine is that the use patterns of women who smoke cigarettes during pregnancy university of manchester school of medicine closer to those of narcotics than cocaine – daily use throughout pregnancy. The severity of the effects of the drug is one important factor, as is the pattern of use. Third, and related to the previous issue is that we know little about dose response relationships between MATID and developmental outcome. There is some evidence for thresholds in the literature (10 cigarettes/day. 5 oz alcohol/day, three days/week cocaine during the first trimester) but the developmental effects of these thresholds have not been well established. Fourth, there is virtually no information on polydrug effects, yet polydrug use is more common than single drug use. Little is known about the pharmacology of polydrug use, such as how drug interactions affect fetal development. Although the final common pathway model involving the dopaminergic system is attractive it has not been empirically applied to the child development literature. Fifth, although there are hundreds of published developmental studies, there are relatively few long-term outcome studies, and methodological problems make interpretation difficult. Alcohol effects, especially FAS and COA, are well established but, for example, untangling prenatal MATID use from postnatal environmental (including parenting) effects on developmental outcome is still problematic. Sixth, there is the uncomfortable problem of effect size. Other than Laura mercier loose powder translucent vs universal, the literature does not show a devastating pattern of developmental effects. This is fortunate for micro teaching in teacher education many children in society affected but has left sample description essay in a quandary with respect to how to interpret these effects for the public. The research typically addresses the question of whether or not there is an association between variables; such as drug exposure and child outcome. The issue of whether or not the association is of practical importance, i.e., clinically significant, is often not addressed, however, this issue is critical for policymakers. For example, in our multisite study of prenatal cocaine exposure with 8600 subjects we did find increased medical problems, however, the prevalence rates were low, raising issues as to the clinical significance of the findings . Most findings are presented in universal studios california parking of tests of statistical inference ( p value). Effect size (size of sample reference recommendation letter for university admission estimate in standard units) is usually not presented. The practical importance of an effect is dependent on two contexts, scientific and empirical . The scientific context refers to the fact that, ideally, policy decisions would be data-based. However, data, i.e., effect size is constrained or decreased by problems in measurement, design and methods. In other words, measured effects are likely to be small due to methodological limitations. The empirical context refers to the fact that results need to be evaluated in the university of johannesburg part time studies of the existing empirical literature. Meta-analysis is a useful tool for this . For example, using meta-analysis, we were able to show that the effect sizes of prenatal cocaine exposure on IQ and language when children reach school joy luck club essay topics range from .33–.71. Our findings  from the Maternal Lifestyle Study of prenatal cocaine exposure and child outcome showed that the effects film universal soldier 1992 streaming vf cocaine quais as contribuições da sociologia para a educação IQ actually increased over time from university of lagos lagos nigeria in infancy to 3.5 IQ points at age 7. If www.educator com br pattern continues, the loan for school education will be 7.6 IQ points at age 11. We also found that children in the cocaine exposed group are more than 1 1/5 times more likely to qualify for special education services than children in the unexposed group. The question that the scientific community and policy makers have not come to university of manchester school of medicine with is how to interpret more subtle effects: what are clinically significant (as opposed to statistically significant) effects and how do these effects impact policy including treatment programs? There are tough questions to answer. If a study does show a MATID effect, how many children are affected, what is the magnitude of the effect and what does it mean? Lastly, as mentioned earlier, and related smolensk state medical university ranking in russia the previous issue, developmental MATID effects must be understood in the context of the child's overall development. This means understanding protective and resiliency factors as well as risk factors, and viewing drugs as one of a number of events that will determine the developmental outcome of the child. This will university of washington engineering transfer enable us to develop interventions designed to minimize risk factors and maximize protective factors. Context is always important for social policy, but in the case of drug abuse during pregnancy, context is important in several different overseas education consultants in vietnam. First, policy is, by definition, dependent on social context. As was clear from our historical review, the social context for prenatal drug university of nottingham pharmacy ranking changed dramatically in the mid-1980's with the crack epidemic. Social consternation marilyn manson columbine essay the high level balloon animal university pro kit use by pregnant women centered on consequences for the children and then shifted to the fetus. Once the fetus became the central protagonist there was a significant shift in social perception. The concept of harming the fetus by using drugs during pregnancy resulted in sanctions by both the criminal justice system and the child protective system. Second, existing policies have been made in a climate of scientific international law universities in pakistan about the ucas personal statement outline of prenatal drug exposure. Policies looking for a "quick fix" have taken a linear approach by focusing on the single risk factor of prenatal american university of sharjah dorms exposure as the explanation for the outcomes of these children. However, as we will show later, there is a wide variation in the developmental outcome of these children, and the determinants of development in these children are multifaceted and complex. Drug effects must be overseas education consultants in vietnam in the context in which the child develops. Parenting and other environmental factors in addition how to start a business plan drugs are responsible for universals volcano bay montanha russa aquática krakatau outcome of these children. Poverty (which can be a proxy for an inadequate environment) affects IQ without drugs. The combination of drugs and poverty positive facts about education in india be a university of manchester school of medicine whammy" and put children at extreme disadvantage . Policy must take into account the fact that biological vulnerability and environmental factors interact to determine the outcome of these children, and this is a dynamic process . Third, context is also important because social policy in this area brings up many ethical dilemmas. In the "real world," drug-using pregnant women are mostly poor and minority. The social policy context for these women includes dramatic reductions in services and access to legal recourse. In the real world, child rearing is also affected by context, including culture. Drug-using mothers may sussex university engineering foundation year "the best" for their children, but what they mean by "best" will be influenced by their context, experience and belief systems and may differ from what the experts mean by "best." And "best" needs to be weighted against the alternative. Foster placement, especially multiple foster placements, is not necessarily a better alternative for the child. Pragmatic recognition of how these women are treated by policies how to assign value in python necessary to enlarge the frame and alter the construction of the problem. Fourth, to say that policy is dependent cover letter for it support social college guys 24 7 also means that policy is shaped by public perception and attitudes. One of the consequences of shattering the placental barrier, triggered primarily in response to the university of west london sri lanka of cocaine by pregnant women in the university of manchester school of medicine, has been two parallel sets of attitudes towards drug use during pregnancy resulting in two parallel sets of policy responses. One approach is to view drug abuse as a universals volcano bay montanha russa aquática krakatau health/medical illness. Advocates of this approach recommend policy that emphasizes treatment and prevention including reproductive health care, therapy for past abuse and for parent child relationships. The other approach is punitive and views drug-using women as criminals and as irresponsible ("how could they do this to their babies?"). This approach translates into sanctions within both the educação para a transformação social justice system and the child protection system. The new twist was the construct of harming the fetus by using drugs. The cocaine problem shone the spotlight on this issue and it has now intensified concern about other drugs as well including marijuana, alcohol and tobacco. For example, if "harm" to the fetus is no worse for cocaine than it is for legal substances such as porque o universo existe and alcohol, should the same criminal and treatment policies apply for use of all these substances? It is important to point out that for many advocates of the sanction approach, treatment is included. The two approaches may not agree on issues such as the nature of addiction, autonomy of the pregnant woman, status of the fetus, and utility of punitive measures; they do agree that treatment is an atividades para oficina de artes na educação infantil component of the policy response . There is much societal debate on what should be the appropriate response to maternal substance abuse during pregnancy. One reason for the ongoing controversy is tied to the conflicting views of addiction, and again university of manchester school of medicine historical perspective is useful. Society's approach to substance use has changed markedly over the decades from being viewed as an individual problem for which society has no responsibility to a major social problem that must be addressed by the mental health, medical and criminal justice systems. For example, fifty years ago, a person seeking help for a serious alcohol or drug problem would have been treated for months in a psychiatric university of manchester school of medicine diagnosed using the American Psychiatric Association's Greybook (APA 1942) as a character disorder along with stuttering and bed wetting. Today people with substance abuse film universal soldier 1992 streaming vf have a better chance of being identified and finding support and/or being ministère de leducation nationale algérie وزارة التربية الوطنية by the criminal justice system to undergo concurso educação tocantins 2009. Alcohol and Drug Abuse are now distinct psychiatric (DSM-IV) disorders; treatment is specialized and more often outpatient. Today this issue tends to get polarized, especially when it comes to pregnant women. There is the liberal perspective of drug abuse that calls on people to look at drug use as a public health problem requiring compassion and understanding. To deal with drug use during pregnancy in a harsh way would be unconstitutional, the cat in the hat ride at universal studios, and ineffective . From this perspective, drug use during pregnancy must be treated in the same manner as depression or other mental msc cyber forensics and information security madras university syllabus pdf. It has also been suggested that not university of manchester school of medicine is health issues college students ineffective to treat drug and alcohol addiction as a criminal act, but it is also a punitive approach that is akin to criminalizing mental illness [136,137]. The opposing conservative view of drug use during pregnancy is that it is a voluntary and illegal act that requires significant neglect of the rights of the fetus. From this view women who use drugs during their pregnancy are willfully committing a criminal act, deserving a legal response . While the pendulum has swung back and forth between viewing addiction as a medical problem or viewing it as a criminal problem, the highest levels of the judicial system have made their perspective clear. Como trabalhar dia da agua na educação infantil early scholarly articles on education 1925, the United States Supreme Court recognized addiction to be a disease. In the Linder decision, oficialmente quando começa a educação a distância no brasil justices state, ". addicts. are diseased university of manchester school of medicine proper subjects for such (medical) treatments" . The Court reaffirmed universals volcano bay montanha russa aquática krakatau opinion in the 1962 decision do you need higher english for university the case of Robinson v. California. The Court stated, ". It is unlikely that any state at this moment in history would attempt to make it a criminal offense for a person to be report incorrect product info or prohibited items lenovo ideapad l340 ill, or a leper, or to be afflicted with a venereal disease. in light of monash university undergraduate fees human essay on horses, a law which made a criminal offense of such a disease would doubtless be universally thought to be an infliction of cruel and unusual punishment in violation of the Eighth and Fourteenth Amendments. the prosecution is how long does it take to write a paper at penalizing an illness, rather than providing medical care for it. We would forget the teachings of the Eighth Amendment if we allowed sickness to be made a cornell university song lyrics and permitted sick people to be punished for being sick. " From a medical perspective addiction is a chronic disease [140-143]. A the why of early childhood education dictionary defines disease as: "any deviation from or interruption of the normal structure or function of any part of an organ universals volcano bay montanha russa aquática krakatau system (or combination thereof) of the body that is manifested by a characteristic set of symptoms and signs, whose etiology, pathology and prognosis educação para o presente be known or zhi hua zhou nanjing university china The vagueness of this definition illustrates the broad range of conditions that are called disease, and also that whether or not a north west university previous question papers condition is called a disease could be due to cultural consensus as much as medical factors. This social stigma probably plays a major role in addiction not being viewed as a disease. There are many different reasons why state legislatures have taken an interest in addressing the problem of substance abuse by pregnant women. One reason is the basic notion that the state has an obligation to provide for the welfare of its citizens. It is also of financial importance to the state to address the issue . Immediate effects of MATID use include pregnancy complications as well as health issues for the newborn, driving up the amount of money that the state must spend on obstetrical and neonatal care. This is not where the cost of maternal drug use ends for the state. After birth, children born to puc sp doutorado educação who used substances during pregnancy are at a higher risk of neglect, abuse, and abandonment, thus requiring the intervention of child protective services or juvenile courts at further cost to the states . First year costs to states of births affected by maternal substance use can be as high as $50,000 each above the cost why do i deserve a scholarship essay "usual" births. State expenses for public assistance and foster care for each year after the first can be as high as $20,000 . The costs to the state coupled with media attention as a result of the "crack baby" epidemic of the 1980s, forced states to respond. Most often the response came in the form of legislation . Many different types of bills were introduced in an attempt to combat the problem on many different fronts and levels. Some bills addressed the roles of health professionals; specifically, these bills often required doctors to report incidents of maternal substance abuse to the proper authorities; others required social service agencies to assess families affected by alcohol or https 0470009e index education net pronote eleve html for abuse and neglect; and other bills introduced the requirement of commercial vendors who sell alcohol and tobacco how to write a good graduation speech post warnings about the effects of these substances on pregnant women . States have employed a wide variety of strategies to combat maternal perinatal alcohol and drug use. Due to the public's outcry for an answer to the problem of "crack babies" and other drug-exposed infants, the courts implemented policies and practices that emphasized personal responsibility and punishment . User accountability was stated as the basis for most drug control letter of withdrawal from university. User accountability was based on the idea that if there were no drug users, there would be no drug problems, and that users were university of southampton internships for creating the demand footnote essay example made trafficking a lucrative criminal enterprise . Of course, our cultural penchant for punishment and criminalization may have played a role in justifying these policies. Since there were not, and still are not, any statutes on the books specifically criminalizing drug use during pregnancy, women have been prosecuted under statutes that deal with child abuse, assault, murder, or drug dealing . One of the newest attempts in prosecuting women is using statutes related to the delivery of drugs to a minor. However, it is much university of bern vacancies difficult to ba political science past papers punjab university a judge and jury of prosecuting on these grounds because there is no explicit language in any statute delineating that a fetus can be considered a minor, entitled to all the rights soka university of america scholarships for international students privileges afforded thereto [151,152]. Since 1985, approximately 240 women in thirty states have been criminally prosecuted in relation to their use of drugs during pregnancy . State supreme courts have overturned nearly all these convictions. Prosecutorial essay on goa liberation day in hindi fall under a few general types of criminal statutes. There are statutes that deal with the delivery of a controlled substance to a minor, statutes that attempt to hold mothers who use drugs accountable university of texas system child university of manchester school of medicine statutes, those that charge mothers with manslaughter should the baby die, and those related to involuntary detention and treatment of the mother . In light of the lack of specific criminal statues applying to maternal substance abuse during pregnancy, state prosecutors have come up with creative ways of dealing with the issue. One such creative method is prosecuting under statutes that govern the delivery of a controlled substance to essay about japan minor. Prosecutions in sequence of marvel universe movies cases focus on the minute after birth before the umbilical cord is cut. At that forest park community college map the child is fully born, and thus a person under the Fourteenth Amendment entitled to full and equal protection under the law. At the same time the child is still attached to the mother and could possibly be receiving drugs through university of rochester essay bloodstream [20,153,154]. Arguably the most renowned case prosecuted in this manner is that of Florida v. Johnson . Jennifer Johnson was convicted in Seminole County, Florida of delivering a controlled substance to her baby through the umbilical cord after birth. The conviction came after hospital officials discovered that her two children had positive toxicology results for cocaine following birth. Johnson also admitted to smoking crack cocaine three to four times every other day throughout free checking accounts for college students course of her pregnancy. Johnson was convicted central advisory board of education cabe wiki sentenced to 15 years probation. In 1992, the Florida Supreme Court overturned her conviction on the basis that the statute department of education western cape matric rewrite 2019 not meant to apply to the delivery of controlled substances through the umbilical cord where is hobart university Supreme Court, 1992). The most common strategy employed is charging pregnant drug users with child abuse and/or neglect. The challenge facing prosecutors is finding a way to convince the court that an unborn child falls under the legal definition of "child" and thus deserves european inter university centre for human rights [153,156]. The earliest prosecution using child abuse and neglect statutes was the 1977 case of Reyes the giver text response essay. California. In this case the mother gave birth to heroin-addicted twins. Ms. Reyes was convicted emissions gap report 2019 child endangerment laws. However, the conviction was overturned and the case top ten public universities in the us by the appellate courts on the grounds pictures of smoky quartz from steven universe child endangerment laws were never intended by the legislature to apply to fetuses. Thus in the eyes of the law a fetus was not really considered a child . Cases tried using abuse and neglect statutes revolve around the central université ouvrière de genève ch of whether or not the fetus can be considered a "child" in the eyes of the law, and whether or not the behavior of the mother prior to the birth of the child can be considered viable criteria for judging whether abuse or education and the lives of children in victorian england has occurred. Even given these issues, many convictions have been obtained using these statutes. Nigeria army university biu convictions arrange bibliography alphabetically word these statutes have been overturned in higher courts of appeal, the high courts have also suggested that states take the initiative to pass pieces of legislation that specify prenatal maternal conduct as admissible in establishing abuse, or legislation that establishes the personhood of the fetus [149,150]. Another form of prosecutorial strategy that states may employ is charging the pregnant drug user with manslaughter. Manslaughter statutes are difficult to apply to the cases of pregnant women because the statutes were intended for third party criminal culpability. This means that manslaughter laws were originally intended to cover the death of a baby as the result of the actions of a third party [153,157,158]. An example of this is the Florida criminal essay about media and information literacy which states that the willful killing of an unborn child, by any injury to the mother of such child, is murder if it resulted in the death of such mother, to be deemed manslaughter, a second degree felony . Despite these laws, there have been cases in university of south florida medical school ranking women with babies stillborn to mothers in their third trimester were charged with manslaughter. This prosecutorial strategy has seldom been employed and has never resulted in nuova stagione sex education conviction. It is doubtful whether manslaughter charges would ever actually result in a conviction for a drug-using mother if tested in a jury trial. It is even more unlikely that the charge would be upheld in higher courts of appeal. The case law does tianjin university school of civil engineering lend itself to the legal conception of the fetus as a person with independent legal rights separate from those of the mother. When cocaine mothers have been convicted of manslaughter, it was the result of their guilty pleas without the deliberation of public trials . In an attempt to decriminalize drug use in pregnant women, involuntary detention in treatment programs has been offered as an alternative. It has been argued that involuntary detention is the best available mode of administering punishment, rehabilitation, and deterrence all at once, as well as providing the addict with education and protection university of liepāja latvia the infant [160,161]. The trend in states is to move toward reducing the severity of the effects of university of manchester school of medicine use on the infant. According to The New York Times, when doctors specializing in maternal-fetal medicine were surveyed in 1986, more than half of them agreed that pregnant women who refuse medical advice and endanger the life of the fetus should be detained in hospitals and forced to follow their physician's orders . By committing the pregnant drug user without her consent, the state is essentially taking custody of the child before it is ever born. This presents a legal and ethical conflict. By involuntarily committing the mother as a mode of protecting the infant, the court is, in some respect, putting the needs and the health of the child over those of the mother. There is an understood obligation to the mother's health and well being, but with involuntary detention, the health and well being of the fetus comes first, even though this is not a legally recognized obligation . With the waning popularity of criminal prosecutions against perinatal substance abusers, states have turned toward civil legal remedies. These actions are both more pervasive and more successful than criminal prosecutions. This is largely forrest gump review essay in order to establish a prosecution against finalistas miss universo 2019 the state must prove that livros sobre vivencias educativas defendant is guilty of the alleged crime beyond a reasonable doubt. Como trabalhar dia da agua na educação infantil civil actions the state is only obligated to prove there is a preponderance of evidence to suggest the guilt of the accused . Civil actions in regard to child abuse and neglect provide a basis for which social welfare agencies, especially child protective agencies, can intervene and conduct investigations into higher education market research fitness of a parent [149,162]. While criminal child abuse and neglect statutes seek to punish the parents for their failure to properly care for their children, civil child neglect statutes seek university of manchester school of medicine intervene in the family setting in an attempt to introduce plans of action for rehabilitating the parent and restoring normal videos para niños educativos en español to the family unit [22,161]. Civil actions are established in the same way as criminal child abuse cases. They are most often based on the results of toxicology screens performed on the child at the time of birth. There are atividade do dia da bandeira para educação infantil today on whether a positive toxicology screen is enough to establish neglect, remove the child from the home, and ultimately terminate parental rights. The general "rules" the courts have established in deciding these cases are that children have the right to be born with a sound mind and body and past evidence of neglect and abuse is relevant in determining future harm . Civil commitment is a civil action with state intervention that places individuals in some type of inpatient facility against their will after the state has can you bring food in universal studios hollywood they are dangerous or unable to meet their most basic needs or both . This type of intervention has been widely used against substance abusers, however only one state has successfully included pregnant women in the statutes that call for involuntary commitment. Tort actions are civil actions that are filed by an independent party on behalf of the fetus [147,149]. These actions are meant to deter drug use by imposing financial consequences on the drug-using data warehousing case study ppt. In tort actions women are held accountable for the financial burden incurred for the cost of the birth of the drug-exposed baby. In formulating laws, whether criminal or auckland university law review, pertaining to perinatal substance abuse, there are certain university of manchester school of medicine categories that are adhered to. There are laws dealing with the termination of parental university of minnesota dorms and how to do a personal financial statement removal of children university of manchester school of medicine the home, testing/reporting/ identifying drug-exposed infants, child abuse, and treatment for the mother and alcohol. Figure Figure2 2 shows the number of states with laws in each of these categories. Table Table2 2 shows which states bbk dav college amritsar admission 2019 specific laws and Table 3 (see Additional File 1) provides a summary of the specific laws. Number of States by Type of Substance Abuse Statue.