Thesis (M Social Work)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Fetal alcohol syndrome (FAS) is a condition which occurs when women drink alcohol during pregnancy. The use of alcohol during pregnancy has permanent and serious consquences which manifests in developmental delays and causes harmful effects to the central nervous system. FAS is seen as completely preventable and irreversable which lasts into adulthood. The prevalence rate of FAS in the Western Cape is the highest in the world. FAS is not just a health problem but also a social welfare problem, since the care for adolescents with FAS brings about exceptional demands for the carer. For this reason it became vital to explore the educational roles of the carers of adolescents with FAS. This research study firstly describes the characteristics of FAS within the physical, cognitive and social development of the adolescents with FAS. Secondly, the study describes and explores the educational roles of the carers of adolescents with FAS. The study combines both quantitative and qualitative research. The exploratory and descriptive research designs were used and a purposive sampling method was used. The participants were interviewed individually with the help of a semi-structured questionnaire. The findings of the empirical investigation show that the carers of FAS adolescents according to their perceptions and experiences know what is expected of them within their respective educational roles and they do make an effort to fulfil this role to the best of their ability. Further findings show that due to aspects like poverty and illiteracy of the participants, the carers need the support of the social worker in order for them to fulfil their educational roles. Recommendations resulting from the empirical investigation indicated that social workers need to support the carers of adolescents with FAS in parenting programmes which is simple and practical for the carers to understand and to implement. Further recommendations focus on awareness programmes and actions where the carers also take part in educating the community in terms of FAS. Through these actions the carers of adolescents with FAS can build a support system for themselves whithin the community. Therefore the community can be utilized by the carers of adolescents with FAS as a valuable resource in the fulfilment of their educational roles. / AFRIKAANSE OPSOMMING: Fetale-alkoholsindroom (FAS) is ‘n toestand wat veroorsaak word wanneer vroue alkohol drink tydens swangerskap. Alkoholgebruik tydens swangerskap het blywende en ernstige nagevolge wat manifesteer in ontwikkelingsagterstande en skade in die senuweestelsel. FAS word dus beskou as heeltemal voorkombaar, maar is onomkeerbaar en duur voort tot in volwassenheid. Die voorkomsyfer van FAS is wêreldwyd die hoogste in veral die Wes-Kaap. FAS is nie net ‘n gesondheidsprobleem nie, maar ook ‘n maatskaplike probleem aangesien die versorging van adolessente met FAS besondere eise aan versorgers stel. Om hierdie rede is dit noodsaaklik om die opvoedingsrolle waaroor versorgers van FAS-adolessente moet oor beskik te ondersoek. Hierdie navorsingstudie beskryf eerstens die kenmerke van FAS binne die fisiese-, kognitiewe- en sosiale ontwikkeling van die adolessent met FAS. Tweedens beskryf studie die opvoedingsrolle waaroor versorgers van FAS-adolessente moet oor beskik. Die studie kombineer beide kwalitatiewe en kwantitatiewe navorsing. Die verkennende en beskrywende navorsingsontwerp is gebruik en daar is ‘n doelbewuste steekproef gedoen. Individuele onderhoude is met die deelnemers gevoer met behulp van gestruktureerde vraelyste. Die bevindinge van die empiriese ondersoek toon dat die versorgers van FAS-adolessente volgens hulle persepsie en belewenisse, weet wat van hulle verwag word in die verskillende opvoedingsrolle en dat hulle wel pogings aanwend om hierdie rolle te probeer vervul. Verdere bevindings toon dat as gevolg van aspekte soos armoede en ongeletterdheid van die deelnemers die maatskaplike werker ondersteuning sal moet bied aan die versorgers van FAS-adolessente in die vervulling van hul opvoedingsrolle. Aanbevelings vanuit die empiriese ondersoek dui daarop dat die versorgers van FASadolessente deur veral die maatskaplike werker ondersteun moet word deur ouerleidingsprogramme wat eenvoudig en prakties aangebied behoort te word sodat die versorgers die inhoud maklik kan verstaan en kan toepas. Verdere aanbevelings fokus op bewusmakingsprogramme en -aksies waarin die versorgers ‘n rol kan speel om sodoende die gemeenskap ook op te voed ten opsigte van FAS. Hierdeur kan die versorgers van FASadolessente vir hulleself ‘n ondersteuningsnet binne die gemeenskap bou en die gemeenskap as ‘n waardevolle hulpbron benut in die vervulling van hul opvoedingsrolle.

Thesis (M Social Work)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Non-biological caregivers often take children into their care when their own biological caregivers have failed to provide them with a safe and loving home. These children are often also affected with Fetal Alcohol Spectrum Disorders (FASD). Learning of a child’s disability can be a big shock to non-biological caregivers especially if it is misunderstood, available professional help is scarce and intervention resources are not readily available. These non-biological caregivers are often not prepared for the financial, emotional and physical investment that is required to fully support the children and their development. This can cause various emotional reactions and implications that are challenging for the caregivers. It is critical to recognise parenting experiences and challenges as a means of developing and promoting intervention strategies and support that will respond to the needs of the children with FASD and their non-biological caregivers especially from a South African perspective. There is a need for social workers to take on responsibility for addressing FASD as they have the professional capacity to help families living with FASD to develop and maintain stable and nurturing households. One way in which this can be achieved is through the initiation and facilitation of support groups. The goal of the study was to gain an understanding on the experiences of non-biological caregivers of children with FASD and of the utilisation of support groups to help them cope better. The researcher made use of a combination of an exploratory and descriptive research design. By using both a quantitative and qualitative approach in a complimentary manner, the researcher was able to gain an in depth insight into the lives of the non-biological caregivers and how they experience this disability and support groups that are utilised as a means of helping them cope. Permission to conduct the study was granted by the committee for Human Research at the University of Stellenbosch. The literature study firstly investigated the implication of FASD on affected children. Secondly, the extents to which non-biological caregivers are affected by the consequences of this disability were discussed. After this the utilisation of support groups as a method of supporting non-biological caregivers, with the emphasis on a mutual-aid and educational approach as theoretical underpinning was described. The empirical study was completed with 16 participants through face-to-face, semi-structured interviews. An interview schedule based on the findings of the literature study was utilised. The criteria for inclusion were that participants had to have attended at least 5 support group sessions and had to be a non-biological caregiver of FASD children who had attended the support groups specifically related to this disorder. The results of this study mostly confirmed the findings from the literature study which showed that support groups play a vital role in providing necessary support to non-biological caregivers who are often unprepared for the realities of caring for a FASD child. Recommendations are aimed at the social work profession in South Africa who need to align itself in providing necessary support to non-biological caregivers through the use of support groups and various other methods of service rendering. Suggestions for future research are also made in line with how non-biological caregivers can be supported in their unique caregiver responsibilities. / AFRIKAANSE OPSOMMING: Nie-biologiese versorgers neem dikwels kinders in hul sorg wanneer kinders se biologiese ouers versuim om vir hulle ‘n veilige en liefdevolle huis en omgewing te skep. Hierdie kinders kan ook ly aan of geaffekteer word deur Fetale Alkohol Spektrum Versteuring (FASV). Dit kan ‘n groot skok wees wanneer versorgers uitvind dat die kind geaffekteer is daardeur, veral as hierdie versteuring misverstaan word. Professionele hulp is skaars, en intervensies en hulpbronne is nie vryelik beskikbaar nie. Versorgers is dikwels nie voorbereid op die finansiële, emosionele en fisiese eise wat nodig is om ten volle die kind se ontwikkeling te ondersteun nie. Dit kan dit lei tot verskillende emosionele reaksies met verskeie gevolge wat opsigself ook verskeie uitdagings vir die nie- biologiese versorgers veroorsaak. Dit is van kritieke belang om die ervarings en uitdagings van ouerskap te verken in die bevordering en ontwikkeling van intervensiestrategieë ter ondersteuning van die behoeftes van die kinders met FASV en hul versorgers, veral vanuit ‘n Suid-Afrikaanse perspektief. Daar word vereis van maatskaplike werkers om verantwoordelikheid te neem vir die aanspreek van FASV, aangesien hulle die professionele kapasiteit het om families wat geaffekteer is te help, en om hulle by te staan sodat ‘n stabiele en koesterende huishouding ontwikkel en volgehou kan word. Een manier waarop dit bereik kan word, is deur die vestiging en fasilitering van ondersteuningsgroepe. Die doel van hierdie studie was om ‘n begrip te ontwikkel oor die ervarings van nie-biologiese versorgers van kinders met FASV se benutting van ondersteuningsgroepe. Die navorser het gebruik gemaak van ‘n kombinasie van ‘n verkennende en beskrywende navorsing. Deur die gebruik van beide ʼn kwantitatiewe en kwalitatiewe benadering, is die navorser in staat gestel om ‘n indiepte insig in die lewens van die versorgers te bekom, en ondersoek in te stel oor hul ervarings van die versteuring/gestremdheid deur ondersteuningsgroepe wat as intervensie aangewend is. Toestemming om die studie te doen is deur die Etiese Komitee vir Menslike Navorsing aan die Universiteit van Stellenbosch bekom. Eerstens is die literatuurstudie voltooi waarin die navorser ondersoek ingestel het oor die implikasies van FASV op geaffekteerde kinders. Tweedens is daar bespreek hoe nie-biologiese versorgers geraak word deur die gevolge van hierdie versteuring/gestremdheid. Daarna is ondersteuningsgroepe as ‘n metode van ondersteuning aan versorgers ondersoek, en klem is gelê op ‘n wedersydse hulpbenadering en ‘n opvoedkundige benadering as teoretiese grondslag. Die empiriese studie is voltooi met 16 deelnemers deur middel van individuele, een-tot-een, semi-gestruktureerde onderhoude. ‘n Onderhoudskedule, wat gebaseer is op die bevindinge van die literatuurstudie, is gebruik. Die kriteria vir deelname aan die studie en groep het ingesluit dat deelnemers ten minste vyf sessies van ‘n ondersteuningsgroep moes bywoon en ook ‘n pleegouer wees van ‘n FASV kind. Die resultate van hierdie studie het meestal die bevindinge uit die literatuurstudie bevestig en het getoon dat ondersteuningsgroepe ‘n belangrike rol speel in ondersteuning aan nie-biologiese versorgers, wat dikwels onvoorbereid is op die werklike problematiek van die versorging van ‘n kind met FASV. Aanbevelings word gerig aan die maatskaplikewerk-professie in Suid-Afrika, ten einde ondersteuningsgroepe en ander metodes van dienslewering te bied, ter ondersteuning aan die versorgers van FASV kinders. Voorstelle vir verdere navorsing word ook gemaak sodat daar ‘n ondersteuningsnetwerk opgebou kan word vir die versorgers van ‘n FASV kind ten einde aan hulle unieke versorgingsbehoeftes te voorsien.

Dissertation (PhD)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: Introduction: Fetal alcohol syndrome (FAS) consists of multi-system abnormalities and is caused by the excessive intake of alcohol during pregnancy. The teratogenic effect of alcohol on the human fetus has now been established beyond reasonable doubt and FAS is the most important human teratogenic condition known today. The syndrome, first described by Lemoine in1968 in the French literature and in the English literature by Jones and Smith in 1973, has since been corroborated by numerous animal and human studies. This study has grown out of several epidemiological, prenatal and infant studies in areas of the Western Cape that are currently being undertaken by the Foundation for Alcohol Related Research (FARR). Preliminary data from studies in Wellington have confirmed that a significant proportion of school-entry children have FAS. The prevalence ofF AS in this community exceeds that for Down syndrome by a factor of30 times. The frequency ofFAS in high-risk populations of the Western Cape is the highest reported anywhere in the world. With this background, and the paucity of FAS literature related to dentistry, the aim of this study was to determine the craniofacial and oral manifestations ofF AS in a sample of school-going children in the Western Cape. Methodology: This study is a descriptive, case-control, cross-sectional study using a random cluster sampling method. On the day of examination, children were weighed, and their height and head circumference were measured. They then had photographs and radiographs taken, followed by an oral examination. For each child, the following information was recorded on the data capture sheet: date of birth, gender, head circumference, weight and height, enamel opacities, dental fluorosis, plaque index, gingival bleeding index, dentition status, oral mucosal lesions and dentofacial anomalies. Results: The total sample of90 children with diagnosed FAS and 90 controls, were matched for age, gender and social class. There were no significant age differences between the two groups (p=0.3363) and the mean ages were 8.9 and 9.1 for the FAS and control groups respectively. Head circumference (HC) differed significantly between the two groups (p<O.OOO 1) and the three photographic diagnostic measurements were all influenced by head circumference. The prevalence of enamel opacities between FAS and controls was not significantly different and averaged around 15% for both groups. The opacities were found largely in the maxillary central incisor and lower first molar teeth. More than three quarters of both the cases and the controls demonstrated the presence of plaque and almost two thirds demonstrated gingival bleeding on probing. FAS patients had statistically significantly (p<O.OO 1) more dentofacial anomalies than the controls. The mean dmft score for the FAS sample was slightly higher, though not significantly different from that of the controls and the decayed component (d) made up the largest part of the index in both groups. None of the FAS children had any missing or filled teeth, and in the case of the controls these were also rarely found. Thirty nine children (21.67%) of the total sample were caries-free. Discussion: This study represents one of the largest sample sizes documenting the craniofacial and oral and dental manifestations of the FAS to date. Forty two per cent of the FAS sample manifested growth retardation and this was statistically significant (p<O.OOOl) when compared to their controls. Analysis of the face using anthropometry supports many of the previous clinical descriptions of the effects of neonatal alcohol exposure and offers some new perspectives on the FAS facial phenotype. The characteristic dysmorphic facial features found included ptosis of the upper eyelids, epicanthic folds, short upturned nose, thin vermillion border of the upper lip and a smooth philtrum. Overall the analysis of the caries data for this study in respect of differences between cases and controls was found to be unremarkable. The lack of difference in the primary and permanent dentitions between the cases and controls could have been anticipated in this population due to the high prevalence of dental caries among children from the Western Cape. The FAS children showed significantly lower dental ages when compared to the controls. Dental maturation has previously been shown to be mildly, but consistently, delayed in children with delayed development and therefore this is a not surprising finding for the FAS children in this study. Differences between skeletal age and chronological age were noted for both boys and girls, but as a whole, in the present study groups (FAS and controls) showed little variation in skeletal development. Measurements related to the face height and mandibular size appear to be the most important in distinguishing the FAS children from the controls. Most (5 out of8) of the discriminating linear measurements studied lie in the front of the skull area. Most of the discriminating measurements are vertical measurements and only two of the measurements are lines between soft tissue points. When comparing the photographic analyses of the facial features versus the cephalometric assessments; the four facial features most typical of aF AS child had a Positive Predictive Value (PPV) of92% and a Negative Predictive Value (NPV) of90% and the eight linear measurements from the cephalometric analyses had a PPV of 92% and a NPV of 95%. One can therefore conclude that the external facial features are probably more reliable in discriminating between the two groups than the cephalometric measures. For further analyses, other models where a single angular measurement explains a combination of linear measurements need to be investigated. This might further improve the discriminating abilities of the cephalometric measurements as a whole. Conclusions: This study has shown the importance of the oral and craniofacial features ofFAS. FAS can no longer be viewed as just a rare and peculiar childhood disorder. Awareness and recognition of children with FAS is important so that they can be correctly diagnosed and referred appropriately. Prevention of the secondary disabilities and most importantly, the prevention of FAS in subsequent programmes can be planned. The dentist who treats children with FAS must recognise that such patients might be emotionally and mentally handicapped and may make treatment difficult and there may be a need for the child to be treated with behaviour modification and/or premedication before restorative treatment. The dentist should also be aware of the need for an accurate medical history, and possible medical consultations, before treatment can be undertaken safely. / AFRIKAANSE OPSOMMING: Fetale alkoholsindroom (FAS) bestaan uit multisisteem abnormaliteite en word veroorsaak deur oormatige inname van alkohol tydens swangerskap. Die teratogeniese uitwerking van alkoholop die menslike fetus word nie meer betwyfel nie en FAS is die belangrikste menslike teratogeniese toestand tans bekend. Die sindroom, soos aanvanklik deur Jones en Smith in 1973 beskryf, is sedertdien deur vele studies op mens en dier bevestig. Hierdie studie het gegroei uit vele epidemiologiese-, prenatale- en kleuterstudies in dele van die Weskaap wat tans onderneem word deur die Stigting vir Alkoholverwante Navorsing. Voorlopige data van die studies in Wellington bevestig dat 'n betekenisvolle deel van skoolbeginners FAS het. Die prevalensie van FAS in hierdie gemeenskap oortref dié van Down se sindroom met 'n faktor van 30. Die frekwensie van FAS in die Weskaap is die hoogste wat in die wêreld gerapporteer is. Met hierdie agtergrond, en die skaarste aan FAS literatuur wat op tandheelkunde betrekking het, was die doel van hierdie studie om die kraniofasiale en mondmanifestasies van fetale alkoholsindroom in 'n monster van skoolkinders in die Weskaap te ondersoek. Metodologie: Hierdie studie was 'n beskrywende, gevallebeheerde deursneestudie waarin 'n lukrake gebondelde monstermetode gebruik is. Op die dag van die ondersoek is die kinders geweeg en hulle lengte en kopomtrek bepaal. Hierna is foto's en x-straalopnames geneem, gevolg deur 'n mondondersoek. Die volgende inligting is vir elke kind aangeteken: geboortedatum, geslag, kopomtrek, massa en lengte, glasuur-opasiteite, tandfluorose, plaakindeks, gingivale bloedingsindeks, gebitstatus, mukosale letsels en dentofasiale anomalieë. Resultate: Die totale monster, bestaande uit 90 kinders met gediagnoseerde fetale alkoholsindroom en 90 bypassende kontroles, is vergelyk ten opsigte van ouderdom, geslag en sosiale klas. Daar was geen betekenisvolle ouderdomsverskille tussen die twee groepe nie (p- =0.3363). Kopomtrek het betekenisvol tussen die twee groepe verskil (p<0.0001), en die drie fotografiese diagnostiese afmetings is almal beïnvloed deur kopomtrek. Die prevalensie van glasuur-opasiteite tussen die FAS- en kontrolegroep was nie betekenisvol nie en het rondom 15% vir beide gewissel. Die opasiteite is hoofsaaklik gesien in maksillêre sentrale snytande en mandibulêre eerste molare. Meer as driekwart van beide groepe het plaak getoon, en byna tweederdes het gingivale bloeding met sondering gehad. Die gevallegroep het statisties betekenisvol meer (p<O.OO1) dentofasiale anomalieë getoon. Die gemiddelde dmft telling vir die FAS groep was effens hoër, alhoewel nie betekenisvol nie, as die kontrolegroep, en die "delayed" (vertraagde erupsie) komponent (d) het die grootste deel van die indeks uitgemaak in beide groepe. Geen van die FAS kinders het enige afwesige tande (m) of hers telde tande (f) gehad nie, soos ook gevind in die kontrolegroep. Nege-en-dertig kinders (21.67%) van die totale monster was kariesvry. Bespreking: Hierdie studie verteenwoordig een van die grootste monstergroottes tot op datum waarin ondersoek ingestel is na die kraniofasiale en mond- en tandmanifestasies van die fetale alkoholsindroom. Twee-en-veertig persent van die FAS monster het vertraagde groei getoon en dit was statisties-betekenisvol (p<O.OOOl)vergeleke met die kontrolegroep. Antropometriese analise van die gesig steun die vele kliniese beskrywings van neonatale blootstelling aan alkohol, en bied ook nuwe perspektiewe op die FAS gesigsfenotipe. Die kenmerkende dismorfiese gesigseienskappe wat gevind word, sluit ptose van die boonste ooglede, epikantusvoue, kort opgedraaide neus, dun vermiljoen rand van die bolip en 'n gladde filtrum in. In die geheel was die analise van die karies data ten opsigte van verskille tussen gevalle en kontroles onopvallend. Die afwesigheid van 'n verskil in die primêre en sekondêre gebitte in die gevalle en kontroles kon in hierdie bevolking verwag gewees het as gevolg van die hoë voorkoms van tandkaries onder kinders in die Weskaap. Die FAS kinders het betekenisvol-laer gebitouderdomme gehad as die kontrolegroep. Gebitmaturasie is in geringe maar deurlopende mate vertraag in kinders met vertraagde ontwikkelings, soos voorheen al getoon, en is daarom nie verbasend vir die FAS kinders in hierdie studie nie. Verskille tussen skeletale ouderdom en chronologiese ouderdom is gevind in beide seuns en dogters, maar in die geheel het dié huidige groepe (FAS en kontroles) min variasie in skeletale ontwikkeling getoon. Dit wil voorkom of afmetings wat verband hou met die gesigshoogte en grootte van die mandibula die belangrikste is om FAS kinders van die kontrolegroep te onderskei. Meeste (5 uit 8) van die diskriminerende lineêre afmetings wat bestudeer is, lê op die voorkant van die skedel. Die meeste is vertikale afmetings, terwyl slegs twee lyne tussen sagte weefsel punte. Waneer die fotografiese analises van die gesigseienskappe vergelyk word met die sefalometriese waarnemings, word gevind dat die vier gesigseienskappe tipies van 'n FAS kind 'n Positiewe Voorspelbare Waarde (PVW) van 92% en 'n Negatiewe Voorspelbare Waarde (NVW) van 90% het, en die agt lineêre afmetings vanaf die sefalometriese analise 'n PVW van 92% en 'n NPV van 95% het. Daar kan dus afgelei word dat die eksterne gesigseienskappe waarskynlik meer betroubaar is om te onderskei tussen die twee groepe. Vir verdere analise behoort ander modelle waar 'n enkel hoekige afmeting 'n kombinasie van lineêre afmetings verduidelik, ondersoek te word. Dit mag die diskriminerende vermoëns van sefalometriese afmetings in die geheel verder bevorder. Gevolgtrekking: Hierdie studie het die belang van orale en kraniofasiale eienskappe van FAS getoon. Die toestand kan nie langer as 'n seldsame en eienaardige aandoening van kinders beskou word nie, en bewustheid en herkenning van fetale alkoholsindroom pasiënte is belangrik sodat hulle korrek gediagnoseer en op gepaste wyse verwys kan word. Die tandarts wat FAS pasiënte behandel, moet besef dat sulke pasiënte emosioneel en geestelik belemmer mag wees en dus hantering en behandeling bemoeilik. Daar mag 'n behoefte ontstaan vir gedragsmodifikasie enlofpremedikasie voor herstellende behandeling. Verder moet die tandarts bewus wees van die behoefte aan 'n akkurate mediese geskiedenis, en moontlik konsultasie met 'n geneesheer, voor behandeling veilig ingestel kan word.

Abstract: Background: Fetal Alcohol Syndrome (FAS), located on the severe end of a spectrum of disorders known as Fetal Alcohol Spectrum Disorders (FASDs), is one of the most detrimental, and publicized, teratogenic outcome of alcohol consumption during pregnancy within the United States. During pregnancy, alcohol that is consumed by the mother passes through the placenta and transfers to the baby via the umbilical cord. The same prenatal transference of alcohol that leads to FAS and FASDs might also be contributing to an increased likelihood of hypertension in youth. Additionally, factors such as stress influenced by familial instability, an increased likelihood of developing congenital and conotruncal heart defects, and a reduction in nephron count might be leading to an increased likelihood of hypertension in FAS-affected youth. The purpose of this study is to examine the relationship between prenatal exposure to alcohol, manifested through FAS, and hypertension in children, adolescents, and young adults. Methods: A case-control study design was incorporated to analyze the association between FAS status and hypertensions status; cases (n=165) were collected from a FAS clinical database in Atlanta, Georgia. Controls (n=177) were taken from the National Health and Nutrition Examination Survey (NHANES). Chi-square analyses were used to examine the extent to which FAS status, sex, race/ethnicity, medication use, and obesity status each relate to hypertension status. A logistic regression was performed analyzing the relationship between FAS status (y/n: independent) and hypertension status (y/n: dependent) whilst controlling for sex, race/ethnicity, medication use, and obesity status. Results: The univariate relationships between FAS status and hypertension status (OR=4.491, p<.001) as well as medication use and hypertension status (OR= 2.951, p=.002) proved to be statistically significant (p<.05). Through the regression, FAS status significantly predicted hypertension status (β = 1.646, OR = 5.184, p< .001) after accounting for sex, race/ethnicity, medication use, and obesity status. Those with a race/ethnicity categorized as either Non-Hispanic African American (β =1.259, OR = 3.523, p = .049) or Hispanic (β = 1.192, OR = 3.294, p = .061) were significantly more likely to have hypertensions than those categorized as non-Hispanic Caucasian. Conclusion: The major findings of this study suggest a significant relationship between FAS and hypertension in youth. Race/ethnicity also proved important in predicting hypertensive blood pressure readings independent of FAS diagnosis. The most obvious biological mechanism catalyzing the relationship between FAS and hypertension is prenatal alcohol exposure. Because prenatal alcohol exposure is the primary definitional and diagnostic factor of FAS, associative connectivity may exist independently between prenatal alcohol exposure and blood pressure at various levels of severity along an alcohol exposure dose-response spectrum. Further research is needed to isolate and measure the effect that prenatal alcohol exposure has on blood pressure independently of FAS as well as to assess the extent to which the risk for hypertension in alcohol-affected individuals increases with age and through the life course.

"I'm sure you'll figure out that since I'm telling you this story, I didn't die when it happened… But someone did." Thus begins the story of Matt Eyering and his journey from Staten Island to the small New Mexican town of Socorro. He goes for one reason: to exact revenge on his estranged mother. But all sorts of odd characters live in this forgotten place along the Rio Grande, and none of them intends to let Matt pursue his goals smoothly. From revolutionaries to drug lords, romance to addiction, revenge to life threatening illness, what begins as a quest for vindication explodes into an adventure through a gauntlet of small-town politics, class discrimination, racial tension, organized crime, and self-discovery. It is a touching and serious, yet humorous exploration of the human condition, and of life in a place most of America conveniently ignores.

Fetal alcohol spectrum disorders (FASD) are caused by alcohol exposure during pregnancy and is the leading cause of mental retardation. Alcohol exposure during development results in the loss of neurons in the developing brain. The underlying molecular mechanisms are unclear and there currently is no cure for FASD. Ethanol-induced neuronal death is accompanied by neuroinflammation. Chemokine monocyte chemoattractant protein 1 (MCP-1) and its receptor C-C chemokine receptor type 2 (CCR2) are critical mediators of neuroinflammation and microglial activation. Using a third trimester equivalent mouse model of ethanol exposure, we found that treatment of Bindarit (MCP-1 synthesis inhibitor) and RS504393 (CCR2 antagonist) significantly reduced ethanol-induced microglia activation/neuroinflammation, and neuroapoptosis in the developing brain. Moreover, ethanol plus MCP-1 caused more neuronal death in a neuron/microglia co-culture system than neuronal culture alone, and Bindarit and RS504393 attenuated ethanol-induced neuronal death in the co-culture system. Ethanol activated TLR4 and GSK3β, two key mediators of microglial activation in the brain and cultured microglial cells (SIM-A9). Blocking MCP-1/CCR2 signaling attenuated ethanol-induced activation of TLR4 and GSK3β. Further, we determined whether knocking out of MCP-1/CCR2 ameliorates neonatal alcohol exposure-induced long-lasting behavioral deficits in adolescent and adult mice. C57BL/6 and MCP-1-/-/CCR2-/- mice were exposed to alcohol (5 g/kg) by subcutaneously injection on PD4. A series of behavioral tests including Open Field (PD 35-36 and PD 70-71), Rotor-Rod (PD 38 and PD 73), Balance Beam (PD 40 and PD75) and Morris Water Maze (PD 42 and PD77) were performed in the adolescence and adulthood. We found that MCP-1-/-/CCR2-/- mice were resistant to neonatal alcohol exposure-induced deficits in motor function in the Rotor-Rod and Balance Beam tests; MCP-1 and CCR2 deficiency also protected mice against neonatal ethanol exposure induced long lasting deficits in learning and memory in the Morris Water Maze testing. Collectively, these results suggest that MCP-1/CCR2 signaling plays an important role in ethanol-induced microglial activation/neuroinflammation and neurodegeneration in the developing brain and also plays an important role in developmental alcohol exposure induced long-lasting behavioral deficits in adolescence and adulthood.

The present study examined the scores of 450 Kainaiwa children from Kindergarten to grade 3 on social, behavioral, cognitive and cultural measures. The subjects consisted of children in three different classification groups: Fetal Alcohol Syndrome (FAS), Special Education, and Regular Education. The purpose of the study was to examine group membership to determine whether or not children who were diagnosed as FAS presented unique intellectual, behavioral, social and cultural characteristics from those of their regular and special education peers. These results support the conclusion of previous research that FAS children differ significantly from their special and regular education peers. No statistically significant differences were found on cultural measures. This study provides useful information for future diagnosis and psychoeducational assessment for FAS children in early childhood.

Children with Fetal Alcohol Spectrum Disorder have significantly delayed motor skills, and deficiencies in reflex development. The reasons underlying these motor deficits are not fully understood. The purpose of this thesis was to investigate the effect of embryonic exposure to ethanol (EtOH) on motor neuron and muscle fiber morphology and physiology in zebrafish. We observed that EtOH-exposed fish took longer to hatch and exhibited fewer swimming bouts in response to touch. Immunolabelling of motor neurons indicated that EtOH-exposed fish had significantly higher rates of motor neuron axon defects. Examination of muscle fiber morphology revealed that EtOH exposure resulted in significantly smaller muscle fibers. Miniature endplate current (mEPC) recordings from muscle fibers revealed that event amplitudes, rise times, half widths, frequencies and decay times were affected by EtOH exposure. These findings indicate that motor neurons and muscle fibers of zebrafish are affected by embryonic EtOH exposure, which may be related to deficits in locomotion. / Physiology, Cell and Developmental biology

Background: Fetal alcohol syndrome (FAS) is a devastating disorder whose mechanisms may be best investigated using animal models. Here we present a novel zebrafish FAS model to investigate the effects of low to moderate alcohol exposure during early development on learning. Methods: At 24-hours postfertilization zebrafish embryos were exposed to low doses of ethanol (external concentrations = 0.00, 0.25, 0.50, 0.75 and 1.00% vol/vol) for a very short duration (2 hours). Upon adulthood associative learning in the zebrafish was tested in a plus maze. Results: This exposure led to no gross anatomical abnormalities or increased morbidity or mortality. Overall activity was not significantly affected by embryonic ethanol exposure. A trend towards a dose-dependent decrease in learning and memory performance was observed. Conclusions: We suggest that zebrafish will be an appropriate model with which one can analyze the behavioural effects of embryonic alcohol exposure and the mechanisms of the ensuing abnormalities.

Background: Fetal alcohol syndrome (FAS) is a devastating disorder whose mechanisms may be best investigated using animal models. Here we present a novel zebrafish FAS model to investigate the effects of low to moderate alcohol exposure during early development on learning. Methods: At 24-hours postfertilization zebrafish embryos were exposed to low doses of ethanol (external concentrations = 0.00, 0.25, 0.50, 0.75 and 1.00% vol/vol) for a very short duration (2 hours). Upon adulthood associative learning in the zebrafish was tested in a plus maze. Results: This exposure led to no gross anatomical abnormalities or increased morbidity or mortality. Overall activity was not significantly affected by embryonic ethanol exposure. A trend towards a dose-dependent decrease in learning and memory performance was observed. Conclusions: We suggest that zebrafish will be an appropriate model with which one can analyze the behavioural effects of embryonic alcohol exposure and the mechanisms of the ensuing abnormalities.