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This book discusses and provides insight on the legal and ethical dilemmas of managing those with Fetal Alcohol Spectrum Disorder (FASD). This book provides a clear perspective for those clinicians and legal professionals who are working with those with this disorder, and correspondingly increases their understanding when arranging effective supports for this population. Historically, the primary focus on FASD has been on children. However, this is a lifelong disorder and the implications of this disorder become even more prominent and complex in adulthood. Those with this condition can struggle with impulsiveness, and a host of cognitive difficulties. This correspondingly impacts their independence and employability, and produces an elevated risk for homelessness and other residential issues, involvement in substance use, being exploited, development of behavioural issues, and subsequent legal difficulties. Their cognitive difficulties result in challenges for legal systems around the world to understand their issues, and to design appropriate remedial strategies, recommendations for treatments and supports, and even for understanding the failure of many of these individuals to be able to change their behaviours effectively. This produces various legal and ethical dilemmas, which are discussed in detail in this volume by 28 authors from Europe, New Zealand and North America. These include discussions regarding the rights of the unborn child, the alcohol industry’s duty to warn, whether small amounts of alcohol during pregnancy can be condoned, and even the current use of involuntary hospitalization for addicted mothers. Other chapters discuss the need for training on FASD for front line officers, use of lies during interrogation of those with FASD, medical and legal interventions for offenders with FASD, access to diagnostic services and follow-up supports, and whether FASD can be considered a mitigating factor for sentencing. Furthermore, caregivers also provide their stories regarding the daily dilemmas that are faced in raising those with FASD.
This multi-author book will discuss the history and clinical presentation of Foetal Alcohol Spectrum Disorders(FASD) i.e Fetal Alcohol Syndrome (FAS) and Alcohol Related Neurodevelopmental Disorder (ARND). These developmental neuropsychiatric disorders result from prenatal exposure to alcohol during any gestational period of pregnancy. The book will particularly address the co-occurring presence of ADHD in patients with FASD. ADHD is the most frequent neuropsychiatric presentation of FASD throughout the lifespan and it is particularly difficult to manage because the underlying pathophysiology is related to prenatal neurotoxic brain injury. Although prenatal alcohol exposure , and the resulting FASD, is recognised as the commonest preventable cause of intellectual disability, many clinicians and educators are not aware that 75 to 80% of the patients with FASD have I.Q.s over 70. Thus, the neuropsychiatric presentation of FASD can often be unrecognised or misunderstood. FASD are the true clinical ' masqueraders' and ADHD is their most likely disguise! The authors are all experienced professionals from a wide range of disciplines working throughout the USA and Canada. They have been involved in the diagnosis, research and management of FASD for many years and this book will bring their collective knowledge regarding management from infancy to adulthood to an inter-professional audience.
Alcoholism exerts a high genetic as well as epigenetic load and may be regarded as one of the most prevalent, identifiable, and preventable neuropsychiatric illnesses afflicting modern society today. Alcohol constituted 3.2% of all worldwide deaths in the year 2006 and is associated with >60 diseases, including foetal alcohol spectrum disorder (FASD), cancers, cardiovascular diseases, liver cirrhosis, neuropsychiatric disorders and life-threatening injuries. Fatal alcohol spectrum disorder (FASD) is a collective term representing foetal abnormalities associated with maternal alcohol abuse. FASD is a devastating developmental disorder resulting from alcohol exposure during foetal development. It is a considerable public health problem worldwide and is characterised by CNS abnormalities, dysmorphic facial features, and growth deficiency. Although it is well-established that intra-uterine alcohol exposure can lead to FASD, characterised by cognitive and behavioural impairments, alcohol abuse is still highly prevalent and contributes to a significant loss of economy and productivity throughout the entire world. Children with FASD become a serious and persistent socioeconomic burden to society, as they require specialised healthcare liabilities throughout their entire lives as a consequence of their parents irresponsible drinking behaviour. The primary aim of the inter-disciplinary and integrated genome research network (consisting of molecular biologists, psychopharmacologists, system biologists with mathematicians, human geneticists, and clinicians) is to better understand the genetics and epigenetics of alcohol addiction by identifying candidate genes and molecular mechanisms involved in the etiopathogenesis of FASD, and to provide recommendations to the government and scientific community for global dissemination of emerging knowledge and implementation of FASD interventions. In this book the author has presented the novel concept of charnolopharmacology, which plays a crucial role in determining the life and death of the foetus during intrauterine foetal alcohol exposure (FAE). More specifically, it proposes mitochondrial bioenergetics-based charnolopharmacotherapeutics for personalised theranostics of FASD, involving diversified charnolopathies, embryopathies, and infertility; resulting in poor quality of life. Although several concepts, mechanisms and potential therapies have been proposed recently to overcome the deleterious consequences of FASD, the author has now proposed charnolopharmacotherapeutics, which is based on ethanol-induced compromised mitochondrial bioenergetics and the induction of charnolopathies initially in the spermatocyte and oocyte during the prezygotic phase, and subsequently in the neural progenitor cells (NPCs) during the post-zygotic phase of pregnancy. Hence, drugs inhibiting CB formation and/or augmenting charnolophagy as a basic molecular mechanism of intracellular detoxification during the acute phase, stabilising charnolophagosome and preventing charnolosome sequestration and budding during chronic phase, will have therapeutic potential in FASD embryopathies, which is elegantly described in this book. The most unique feature of this book is that it introduces original concepts of mitochondrial bioenergetics, genomics, and epigenomics to successfully manage FASD. Particularly, mitochondrial bioenergetics-based CB prevention/inhibition, charnolophagy induction, and charnolophagosome and charnolosome stabilisation are novel therapeutic targets for safe and effective clinical management of FASD. These concepts and mechanisms are based on several years of basic research and original discoveries by the author.
This unique book has been written for those parenting children / young people with FASD (Foetal Alcohol Spectrum Disorders) by Dr Mary Mather, widely regarded as one of the UK's foremost medical experts on FASD and Julia Brown, CEO of The FASD Trust, the UK's leading charity in this field. Julia and her husband are parents of two children with FASD and she brings her practical, real life knowledge of strategies that are helpful on a daily basis, alongside Dr Mather's medical expertise explaining the reasons behind the child's behaviour and responses. Whilst this book is a must for any parent or carer with a child affected by FASD, it will also be of value to professionals particularly in social work, mental health and counselling / therapy who are supporting families affected by FASD.
Reflecting the recent increased public awareness of the topic, this is the first and most comprehensive resource for over a decade on the molecular basis, prevalence, treatment options, socioeconomic impact and prevention strategies of FADS. Edited by world-renowned experts, this compendium includes the latest research results to provide new insights and realistic estimations of FADS frequencies in Western communities. An invaluable resource for every professional dealing with the diagnosis, prevention and treatment of FADS, from researchers via health professionals to social workers.
Fetal alcohol spectrum disorders (FASDs) have emerged as a major phenomenon within the education, health, criminal justice and social care systems of many countries, with current prevalence figures suggesting that one in a hundred children and young people have FASDs. In this publication, academics, professionals and families from around the world have shared expertise and insights on FASDs. Their combined interdisciplinary perspective makes an invaluable contribution to how we understand and address the complex social, educational and health needs associated with this growing group of children and young people. Articulating fundamental knowledge, cutting edge initiatives and emerging trends in FASDs, this book provides an evidence base that will enable services to identify and respond to the need for action on FASDs. It recognises that families – natural, foster or adoptive – are at the heart of this process, and that their rich knowledge base, grounded in their lived experience, is crucial. Any education, social care, criminal justice or health professional working with children and young people with FASDs and their families will find this book a seminal and authoritative resource.

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