Sylvia Roozen

Worldwide Prevalence of Fetal Alcohol Spectrum Disorders: A Systematic Literature Review Including Meta‐Analysis

BACKGROUND Although fetal alcohol spectrum disorders (FASD) affect communities worldwide, little is known about its prevalence. The objective of this study was to provide an overview of the global FASD prevalence. METHODS We performed a search in multiple electronic bibliographic databases up to August 2015, supplemented with the ascendancy and descendancy approach. Studies were considered when published in English, included human participants, and reported empirical data on prevalence or incidence estimates of FASD. Raw prevalence estimates were transformed using the Freeman-Tukey double arcsine transformation so that the data followed an approximately normal distribution. Once the pooled prevalence estimates, 95% confidence intervals and prediction intervals were calculated based on multiple meta-analyses with transformed proportions using random effects models, these estimates were transformed back to regular prevalence rates. Heterogeneity was tested using Cochrans Q and described using the I(2) statistic. RESULTS Among studies that estimated prevalence in general population samples, considerable differences in prevalence rates between countries were found and therefore separate meta-analyses for country were conducted. Particularly high-prevalence rates were observed in South Africa for fetal alcohol syndrome (55.42 per 1,000), for alcohol-related neurodevelopmental disorder (20.25 per 1,000), and FASD (113.22 per 1,000), For partial fetal alcohol syndrome high rates were found in Croatia (43.01 per 1,000), Italy (36.89 per 1,000), and South Africa (28.29 per 1,000). In the case of alcohol-related birth defects, a prevalence of 10.82 per 1,000 was found in Australia. However, studies into FASD exhibited substantial heterogeneity, which could only partly be explained by moderators, most notably geography and descent, in meta-regressions. In addition, the moderators were confounded, making conclusions as to each moderators relevance tentative at best. CONCLUSIONS The worldwide pooled prevalence estimates are higher than assumed so far, but this was largely explained by geography and descent. Furthermore, prevalence studies varied considerably in terms of used methodology and methodological quality. The pooled estimates must therefore be interpreted with caution and for future research it is highly recommended to report methodology in a more comprehensive way. Finally, clear guidelines on assessing FASD prevalence are urgently needed, and a first step toward these guidelines is presented.

Fetal Alcohol Spectrum Disorders (FASD): an Approach to Effective Prevention

Purpose of ReviewThe objective of the current contribution is to propose an evidence-based, six-step approach to develop effective programs for prevention of fetal alcohol spectrum disorders.Recent FindingsDespite widespread campaigns aimed to reduce prenatal alcohol exposure, the number of affected children continues to be high. Current strategies to reduce prenatal alcohol exposure may be ineffective or counterproductive. However, proven principles of health promotion could be applied to reduce drinking in pregnancy. One such approach is Intervention Mapping (IM), a six-step procedure based on proven principles to change behaviors.SummaryFASD affects all communities and is an underestimated problem worldwide. Programs based on proven principles of behavior change are warranted. Program developers can use pre-existing protocols and strategies from evidence-based practice, such as Intervention Mapping. Developers who plan their preventive programs in a systematic and evidence-based manner increase the chances of success in reducing prenatal alcohol exposure and FASD.

Review and gap analysis: molecular pathways leading to fetal alcohol spectrum disorders

Alcohol exposure during pregnancy affects the development of the fetus in various ways and may lead to Fetal Alcohol Spectrum Disorders (FASD). FASD is one of the leading preventable forms of neurodevelopmental disorders. In the light of prevention and early intervention, knowledge on how ethanol exposure induces fetal damage is urgently needed. Besides direct ethanol and acetaldehyde toxicity, alcohol increases oxidative stress, and subsequent general effects (e.g., epigenetic imprinting, gene expression, and metabolite levels). The current review provides an overview of the existing knowledge about specific downstream pathways for FASD that affects e.g., the SHH pathway, cholesterol homeostasis, neurotransmitter signaling, and effects on the cytoskeleton. Available human data vary greatly, while animal studies with controlled ethanol exposition are only to a certain limit transferable to humans. The main deficits in knowledge about FASD are the lack of pathophysiological understanding and dose–response relationships, together with the lack of reliable biomarkers for either FASD detection or estimation of susceptibility. In addition to single outcome experiments, omics data should be generated to overcome this problem. Therefore, for future studies we recommend holistic data driven analysis, which allows integrative analyses over multiple levels of genetic variation, transcriptomics and metabolomics data to investigate the whole image of FASD development and to provide insight in potential drug targets for intervention.

Fetal alcohol spectrum disorders: A problem to solve

Aim: The health-related behaviours of people with intellectual disabilities (ID) are strongly influenced by cultural and social factors such as organisational context yet this has rarely been investigated. This study explores the organisational barriers and solutions to the promotion of healthy lifestyle behaviours for this population. Method:Qualitative methodology was used. Focus groups and interviews were undertaken with staff and managers of residential services. Staff job descriptions were also collected from these services. Thematic content analysis was employed. Results: Three overarching themes were identified. The first two themes relate to organisational barriers to promoting health for individuals with ID. These themes focussed on highlighting how administration and routine tasks were prioritised over the promotion of regular physical activity and a healthy diet. The third theme relates to enablers or strategies for implementing health promotion activities. Conclusions: These findings have international implications on how organisations support people with ID to be more aligned with promoting health.They also highlight the need for organisational culture to facilitate knowledge translation and embrace evidence-based health promotion interventions.Aim: Life expectancy of people with intellectual disability (ID) has increased along with that in the general population. The aims were to estimate prevalence of older people with intellectual disabilities (ID) during 2004-2012, and identify differences in prevalence across counties in Sweden. Method: Individuals aged 55+ years were identified through two national registers; the LSS register and the death register from the Swedish National Board of Health and Welfare. Results: The prevalence of ID was 444 per 100,000 population among the youngest age group 55-59 years old, and it decreased steadily to 65 per 100,000 population among those aged 80+ years old. Higher prevalence was found among men in the youngest age group. Northern counties in Sweden had higher prevalence, whereas prevalence in the middle and the southern regions demonstrated a more widespread distribution. Conclusions: This national study fills the knowledge gap about spatial distributions of older people with ID in Sweden. There is a need to investigate allocated resources and the quality of social service and care provided to individuals with ID in different counties in Sweden. (Less)Full access scientific oral presentations first published: 22 july 2016 https://doi.org/10.1111/jir.12305 citations: 1 maastricht university find full textaboutsectionspdfpdf toolsrequest permissionexport citationadd to favoritestrack citation share give accessshare full text accessshare full text accessplease review our terms and conditions of use and check box below to share full-text version of article.i have read and accept the wiley online library terms and conditions of use.shareable linkuse the link below to share a full-text version of this article with your friends and colleagues. Learn more.copy urlshare a linkshare onemailfacebooktwitterlinkedinreddit psychological coping styles in mothers of children with rare genetic syndromes: associations with mental health d. Adams (conference@dawnadams.co.uk)*, n. Jackson, e. Karakatsani and c. Oliver cerebra centre for neurodevelopmental disorders & university of birmingham, united kingdom aim: to document coping styles used by mothers of children with rare genetic syndromes and explore how these relate to positive and negative maternal mental health. Method: 89 mothers of children with rare genetic syndromes completed questionnaires assessing maternal mental health (hospital anxiety and depression scale, positive and negative affect scale) and maternal coping styles (brief cope). Results: the most frequently reported coping style was problem-focussed coping, and the least frequent was religious/denial. Coping styles were not associated with child age or ability, but were significantly associated with maternal mental health. Higher levels of active avoidance were associated with higher levels of negative affect and increased levels of anxiety and depression. Conversely, higher levels of problem-focussed and positive coping styles were associated with higher levels of positive affect. Conclusions: although this study cannot comment on causation between coping styles and mental health, the identification of a relationship between coping styles and mental health (both positive and negative) highlights a key area for intervention.

Foetaal Alcohol Spectrum Stoornis - een overzicht van de huidige situatie

SamenvattingDe ontwikkeling van het ongeboren kind kan ernstig in gevaar worden gebracht door alcoholgebruik tijdens de zwangerschap. Deze prenatale blootstelling aan alcohol kan leiden tot levenslange lichamelijke afwijkingen, gedragsstoornissen en cognitieve beperkingen. De Foetaal Alcohol Spectrum Stoornis (FASD) treft alle samenlevingen en is wereldwijd een onderschat probleem. Over de ernst en omvang van het probleem is nog weinig bekend. Schaarse literatuur geeft inzicht in de met deze aandoening gepaard gaande gezondheids- en socio-economische kosten. FASD is vermijdbaar, vandaar het belang van preventie. Het vergroten van het publieke bewustzijn voor het onderwerp is wenselijk. Ook is meer kennis vereist voor de onderbouwing van behandelings- en begeleidingsprogramma’s. Evidence-based gezondheidsbevordering programma’s zijn noodzakelijk.AbstractFetal Alcohol Spectrum Disorder; a review of the current situation Fetal Alcohol Spectrum Disorder (FASD) has been recognized as one of the leading preventable forms of intellectual disabilities. The unborn baby is put at risk when ethyl alcohol is consumed during pregnancy. Prenatal exposure may lead to lifelong structural, behavioral and cognitive disorders. FASD affects all communities and is an underestimated problem worldwide. However knowledge about FASD is scarce. Literature is emerging nowadays to gain a better inside in the global burden, related behavioral patterns and underlying mechanism. Early FASD prevention is important to increase public awareness, knowledge and clinical management. Therefore evidence-based health promotion programs should be developed.

Prevalence of fetal alcohol spectrum disorder (FASD): a meta-analysis

Healthy Living: The European Congress of Epidemiology, 2015 Esther Bols • Luc Smits • Matty Weijenberg Springer Science+Business Media Dordrecht 2015

Legal and ethical questions posed by fetal alcohol spectrum disorder (FASD)

Forcing theorems based on topological features of invariant sets have played a fundamental role in dynamics and differential equations. This talk focuses on the recent work of Vandervorst, Van den Berg, and the author using braids to construct a forcing theory for scalar parabolic PDEs, second-order Lagrangian ODEs, and one-dimensional lattice dynamics. Mathematics Subject Classification (2000). Primary 37B30, 35K90; Secondary 34C25, 37L60, 57M25.

Improving health promotion related to Fetal Alcohol Spectrum Disorders (FASD)

Forcing theorems based on topological features of invariant sets have played a fundamental role in dynamics and differential equations. This talk focuses on the recent work of Vandervorst, Van den Berg, and the author using braids to construct a forcing theory for scalar parabolic PDEs, second-order Lagrangian ODEs, and one-dimensional lattice dynamics. Mathematics Subject Classification (2000). Primary 37B30, 35K90; Secondary 34C25, 37L60, 57M25.

Improving health promotion related to Fetal Alcohol Spectrum Disorders (FASD) : A systematic literature review

Forcing theorems based on topological features of invariant sets have played a fundamental role in dynamics and differential equations. This talk focuses on the recent work of Vandervorst, Van den Berg, and the author using braids to construct a forcing theory for scalar parabolic PDEs, second-order Lagrangian ODEs, and one-dimensional lattice dynamics. Mathematics Subject Classification (2000). Primary 37B30, 35K90; Secondary 34C25, 37L60, 57M25.