Thesis (MEdPsig)--University of Stellenbosch, 2006. / ENGLISH ABSTRACT: The research in this qualitative study focuses on the role of the Educational Psychologist in facilitating inclusion of a learner with Fetal Alcohol Syndrome (FAS). The international movement towards inclusive education, with emphasis on the inclusion of all learners irrespective of their special needs in mainstream schools, gained momentum in the South African context with the announcement of Education White Paper 6, Special Needs Education: Building an Inclusive Education and Training system. More learners with FAS are accommodated in mainstream schools and research has indicated that most cases of FAS in the world prevailed in the Western Cape. FAS is one of the leading causes of mental retardation and the challenges which the inclusion of learners with FAS pose to those who have to facilitate inclusive education, has urged this study. The study seeks to explore the role of the Educational Psychologist in the process of facilitating inclusion of a learner with FAS. An eco-systemic approach underpins the study. A single learner with FAS within the context of the family and education system was chosen by means of purposive sampling as the focus of a qualitative, case study. The eco-systemic approach makes it possible to explore special needs in terms of intrinsic factors (within the learner) and extrinsic factors (within the system) in order to address the needs of the system. Semistructured interviews were held with respondents from different levels of the eco-system in which the learner functions. A review of personal records and field notes were used to gather information related to the education and learning process. The data were analysed using aspects of content analyses. Four themes emerged: support to the learner, support to the school, support to the parents and support to the school community. The findings indicated that the inclusion of learners with FAS predicts a change and an expansion in the role of the educational psychologist. Early identification, early intervention and a multi-functional team approach seem to improve the long-term prognoses of learners with FAS. The facilitation of inclusive education for learners with FAS poses a challenge to the educational psychologist to render individual support, but also to provide support in a holistic systemic manner, focusing on those who work and live with the individual learners. The learning, behaviour and developmental barriers which learners with FAS may experience were highlighted with the hope to guide those who work with these learners. Several positive and negative factors were indicated and recommendations were made. / AFRIKAANSE OPSOMMING: Hierdie kwalitatiewe studie fokus op die rol van die Opvoedkundige Sielkundige in die fasilitering van inklusiewe onderwys aan 'n leerder met Fetale Alkohol Sindroom (FAS). Die internasionale beweging na inklusiewe onderwys, wat die insluiting van alle leerders, ongeag hulle spesiale behoeftes, by hoofstroomskole onderskryf, het ook in Suid-Afrika neerslag gevind met die uitreiking van die Onderwys Witskrif 6, Special Needs Education: Building an Inclusive Education and Training System. Meer leerders met FAS word by hoofstroomskole ingesluit en navorsing het getoon dat die voorkomssyfer van FAS in die Wes-Kaap die hoogste ter wêreld is. Die feit dat FAS tans een van die vernaamste oorsake van verstandelike gestremdheid is, en die uitdagings wat die insluiting van leerders met FAS aan diegene wat inklusiewe onderwys moet fasiliteer bied, het hierdie navorsingsondersoek genoop. Die doel van hierdie studie is om 'n in diepte ondersoek te doen na die rol van die Opvoedkundige Sielkundige in die fasilitering van inklusiewe onderwys aan 'n leerder met FAS. 'n Ekosistemiese benadering het die teoretiese raamwerk van die studie gevorm. 'n Enkele leerder met FAS is binne die konteks van sy familie en die onderwyssisteem, met behulp van doelgerigte steekproefneming, gekies om die fokus van die kwalitatiewe gevallestudie te vorm. Die ekosistemiese benadering maak dit moontlik om spesiale behoeftes ten opsigte van faktore wat primêr by die leerder (intrinsiek) voorkom, sowel as faktore wat in die sisteem (ekstrinsiek) voorkom, te ondersoek en te verseker dat die behoeftes van die sisteem aangespreek word. Semi-gestruktureerde onderhoude is gevoer met respondente uit die verskillende vlakke van die ekosisteem waarbinne die leerder funksioneer. 'n Oorsig van persoonlike rekords en verslae asook veldnotas is gebruik om inligting oor die leerder, die onderrig en die leerposes te bekom. Inhouds-analise is gebruik om die data te analiseer. Vier temas het uit die data na vore gekom, naamlik: ondersteuning aan die leerder, ondersteuning aan die skool, ondersteuning aan die ouers en ondersteuning aan die skoolgemeenskap. Die bevindinge dui daarop dat die insluiting van 'n leerder met FAS 'n roluitbreiding en 'n veranderende rol vir die Opvoedkundige Sielkunde in die vooruitsig stel. Vroeë identifikasie, vroeë intervensie en 'n multi-funksionele spanbenadering kan die langtermyn prognose van leerders met FAS verbeter. Die rol wat die Opvoedkundige Sielkundige op die verskillende vlakke van die ekosisteem kan speel, ten einde inklusiewe onderwys aan 'n leerder met FAS te fasiliteer, lê opgesluit in die mate waarin geïndividualiseerde, maar tog ook holisties omvattende ondersteuning aan diegene wat met hierdie leerders werk, gelewer kan word. Uit die bevindinge het suksesvolle en minder suksesvolle aspekte duidelik geword. Dit het daartoe bygedra dat die leer-, gedrag- en ontwikkelingshindernisse, sowel as die sterkpunte van die leerder met FAS, duidelik geword het en wenke vir toekomstige gebruik verbesonder kon word. Op grond van die bevindinge en aan die hand van literatuur is aanbevelings gemaak.

Neuronal plasticity deficits underlie many of the neurobehavioral problems seen in Fetal Alcohol Spectrum Disorders (FASD). Recently, we showed that third trimester alcohol exposure lead to a persistent disruption in ocular dominance (OD) plasticity. For instance, few days of monocular deprivation results in a robust reduction of cortical regions responsive to the deprived eye in normal animals, but not in ferrets exposed early to alcohol. This plasticity deficit can be reversed if alcohol-exposed animals are treated with a phosphodiesterase type 1 (PDE1) inhibitor during the period of monocular deprivation. PDE1 inhibition can increase cAMP and cGMP levels, activating transcription factors such as the cAMP response element binding protein (CREB) and the Serum response factor (SRF). SRF is important for many plasticity processes such as LTP, LTD, spine motility and axonal pathfinding. Here we attempt to rescue OD plasticity in alcohol-treated ferrets using a Sindbis viral vector to express a constitutively active form of SRF during the period of monocular deprivation. Using optical imaging of intrinsic signals and single unit recordings we observed that overexpression of a constitutively active form of SRF (Sindbis SRF+), but neither its dominant negative (SRF-) nor GFP, restored OD plasticity in alcohol-treated animals. Surprisingly, this restoration was observed throughout the extent of the primary visual cortex and most cells infected by the virus were positive for GFAP rather than NeuN. Hence, we further tested whether overexpression of SRF exclusively in astrocytes is sufficient to restore OD plasticity in alcohol-exposed ferrets. To accomplish that, first we exposed cultured astrocytes to the SRF+, SRF- or control GFP viruses. After 24h, these astrocytes were implanted in the visual cortex of alcohol-exposed animals or saline controls one day before MD. Optical imaging of intrinsic signals showed that alcohol-exposed animals that were implanted with astrocytes expressing SRF, but not SRF- or GFP, showed robust restoration of OD plasticity in all visual cortex. These findings suggest that overexpression of SRF exclusively in astrocytes can improve neuronal plasticity in FASD.

OF THE THESIS Name: Bc. Petra Symonová Specialization: Adiktologie Head of the thesis: Mgr. Lenka Šťastná, PhD. Pages: 77 The name of thesis: Alcohol use during pregnancy. Prevalence and awareness of the harmful effects of alcohol use in pregnant women - clients of the Institute for Mother and Child in Prague. Abstract: Background: With the increasing trend of alcohol use in a population, but also increases the number of women who are dependent on alcohol in pregnancy. Since your problem but ashamed and fears of condemnation of the behavior of companies admit the problem and continued to try to hide it, and therefore it is not possible to quickly capture and begin to solve. Alcohol consumed during pregnancy the mother may hurt not only her but also her fetus. Since we do not know the exact amount that is 'safe' should be gynecologists recommended total abstinence. This fact, however, in many cases, unfortunately, beyond reality. Goals: The main objective of this work was to determine the prevalence of alcohol use among pregnant women. Other objectives were to determine what are the knowledge of pregnant women about alcohol use in pregnancy, where and whether they are informed of pregnant women about the harmful effects of alcohol use during pregnancy and to determine whether the health of the fetus...

In the context of fetal alcohol spectrum disorders, we investigated how the nitric oxide (NO) signaling pathway influences intracellular calcium (Ca2+) to mediate alcohol resistance, using a primary cell culture model of cerebellar granule neurons (CGN). Alcohol during fetal brain development triggers abnormally high apoptotic cell death in vulnerable neuronal populations, culminating in serious behavioral and cognitive deficits that persist into adulthood. Prior studies demonstrated that the NO signaling pathway [neuronal nitric oxide synthase → NO → soluble guanylyl cyclase → cyclic guanosine monophosphate → protein kinase G (PKG)] mitigates alcohol toxicity, consequently diminishing neuronal loss both in vivo and in vitro. Endoplasmic reticulum (ER) Ca2+ release, a key apoptotic mechanism, requires the inositol 1,4,5-trisphosphate receptor (IP3R), a known PKG substrate. Our studies focused on this crucial intersection point where the NO signaling cascade can influence Ca2+-mediated apoptotic mechanisms, and exposed a downstream mechanism where NO can moderate alcohol neurotoxicity. We hypothesized that as alcohol disturbs neuronal Ca2+ homeostasis to trigger cell death, the NO signaling pathway counters it by limiting Ca2+ release from the ER. We examined first the role of the phospholipase C (PLC) pathway [PLC → inositol 1,4,5-trisphosphate → IP3R → Ca2+] in developmental neurotoxicity through our in vitro CGN model, extending previous in vivo studies. We found that alcohol terminates developing neurons by eliciting abnormal Ca2+ release from the ER rather than from an extracellular source, via a PLC - IP3R-dependent signaling mechanism. Inhibiting either calcineurin or Ca2+ / calmodulin-dependent protein kinase ii (CaMKii), which participate in parallel Ca2+-activated apoptotic cascades, shielded CGN cultures from alcohol. Blocking the mitochondrial Ca2+ uniporter or the mitochondrial permeability transition pore also provided neuroprotection. That the activated pathways must interact to generate cell death likely explains why inhibiting one of multiple parallel signaling cascades limits alcohol toxicity. We next demonstrated that activating the NO pathway downstream at PKG eliminated both alcohol-related neuronal death and the accompanying rapid rise in intracellular Ca2+, an effect that markedly resembled IP3R inhibition. Experiments that temporally manipulated the addition of PKG activators in relation to alcohol exposure linked PKG's obstruction of alcohol-induced Ca2+ elevations to alcohol resistance. In contrast, brain-derived neurotrophic factor (BDNF), which does not rely on PKG to provide neuroprotection, failed to block alcohol-induced Ca2+ elevations while preventing alcohol toxicity. This indicates that although PKG blocks alcohol-induced Ca2+ elevations, averting these Ca2+ elevations is not necessary for neuroprotection. BDNF may confer alcohol resistance through an as yet unidentified process downstream from the disruption of intracellular Ca2+. In summary, we established that 1) alcohol induces toxic Ca2+ elevations originating from the ER through a PLC - IP3R-dependent pathway, and that 2) PKG-mediated alcohol resistance is linked to preventing the intracellular Ca2+ surges. These findings support the hypothesis that the NO signaling pathway shields developing neurons from alcohol by limiting Ca2+ release from the ER.

"August 2002" / Bibliography: leaves 141-176. / ix, 179 leaves : ill. (some col.) ; 30 cm / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Changes in maternal-foetal zinc homeostasis resulting in a foetal deficiency may be an important contributing factor in ethanol-realted teratogenicity. Ethanol induces expression of hepatic metallothionein, causing zinc transfer from the plasma to the liver. Rodent studies show that changes in plasma zinc correlate with a high incidence of abnormal fetuses in MT+/+ mice. Demonstrates a clear link between maternal hepatic MT induction, decreased foetal zinc supply, and teratogenicity, which has major implications for binge alcohol consumption in early pregnancy. The demonstration that zinc treatment is effective in preventing teratogenicity indicates potential treatment strategies. / Thesis (Ph.D.)--University of Adelaide, Dept. of Physiology, 2003

Diagnosis of fetal alcohol spectrum disorders (FASD) is challenging and typically requires confirmation of in utero alcohol exposure. Due to the poor reliability of maternal self-reports, biomarkers have emerged to address the problem of obtaining exposure history. A relatively novel method for detecting prenatal alcohol exposure is analysis of meconium for fatty acid ethyl esters (FAEEs), which are non-oxidative ethanol metabolites. Screening newborns using meconium FAEEs may facilitate early diagnosis and intervention in alcohol-affected individuals. The overall objective of this thesis is to further investigate, validate, and assess the clinical utility of meconium FAEE analysis as a screening tool for the identification of neonates at-risk for FASD. This objective was addressed in four separate studies. The first study assessed whether meconium FAEE concentrations can be predictive of ethanol-induced organ injury in fetal sheep, and determined that the levels of these esters could be used to identify fetuses at-risk for organ dysfunction that do not display overt physical signs of ethanol teratogenicity. The second study investigated the effect of delayed meconium collection and contamination with postnatal stool on FAEE analysis, and determined it to be a risk factor for false positive test results. In the third study, maternal willingness to partake in an open meconium screening program was assessed and found to be low enough to diminish the utility of meconium FAEE testing for population-based open screening. Lastly, a systematic review examining the capacity for FAEE synthesis and the enzymology of this non-oxidative metabolic pathway in mammalian organs and tissues revealed that FAEE synthesis is mediated by numerous enzymes and isoenzymes, many of which have other primary physiological functions, and that their contribution to overall FAEE-synthesis may be tissue-specific. Overall, the results of this research provide new information on the benefits, limitations, and utility of meconium FAEE testing as a screening tool for identifying prenatal alcohol exposure − a test that may be of great clinical value in the diagnosis and management of FASD.

Diagnosis of fetal alcohol spectrum disorders (FASD) is challenging and typically requires confirmation of in utero alcohol exposure. Due to the poor reliability of maternal self-reports, biomarkers have emerged to address the problem of obtaining exposure history. A relatively novel method for detecting prenatal alcohol exposure is analysis of meconium for fatty acid ethyl esters (FAEEs), which are non-oxidative ethanol metabolites. Screening newborns using meconium FAEEs may facilitate early diagnosis and intervention in alcohol-affected individuals. The overall objective of this thesis is to further investigate, validate, and assess the clinical utility of meconium FAEE analysis as a screening tool for the identification of neonates at-risk for FASD. This objective was addressed in four separate studies. The first study assessed whether meconium FAEE concentrations can be predictive of ethanol-induced organ injury in fetal sheep, and determined that the levels of these esters could be used to identify fetuses at-risk for organ dysfunction that do not display overt physical signs of ethanol teratogenicity. The second study investigated the effect of delayed meconium collection and contamination with postnatal stool on FAEE analysis, and determined it to be a risk factor for false positive test results. In the third study, maternal willingness to partake in an open meconium screening program was assessed and found to be low enough to diminish the utility of meconium FAEE testing for population-based open screening. Lastly, a systematic review examining the capacity for FAEE synthesis and the enzymology of this non-oxidative metabolic pathway in mammalian organs and tissues revealed that FAEE synthesis is mediated by numerous enzymes and isoenzymes, many of which have other primary physiological functions, and that their contribution to overall FAEE-synthesis may be tissue-specific. Overall, the results of this research provide new information on the benefits, limitations, and utility of meconium FAEE testing as a screening tool for identifying prenatal alcohol exposure − a test that may be of great clinical value in the diagnosis and management of FASD.

Fetal Alcohol Spectrum Disorders (FASD) are the most common cause of cognitive impairment in the United States (Sokol et al., 2003). In young school children in North America and some Western European countries, recent reports have estimated the prevalence of FASD to be as high as 2-5% (May et al., 2009). Currently there are no widely accepted treatment options for FASD, mainly due to the fact that the underlying neurological deficits that occur with prenatal ethanol exposure (PNEE) are still largely unknown. This thesis examines the long-lasting changes that occur in the hippocampus following PNEE using biochemical and electrophysiological techniques. We find that PNEE produces a reduction of the endogenous antioxidant glutathione (GSH), resulting in an increase in oxidative stress that is accompanied by long-lasting reductions in long-term potentiation (LTP) of synaptic efficacy. Interestingly, males exhibited greater deficits in synaptic plasticity than females, despite similar reductions in GSH in both sexes. By depleting GSH in control animals we determined that LTP in the DG of female animals is more resistant to changes in GSH, which may explain the sexual dichotomy observed in these studies of PNEE. Based on these findings, ethanol-exposed animals received postnatal dietary supplementation with either a precursor of GSH, N-Acetylcysteine (NAC) or Omega-3 fatty acids. These supplements helped to counteract the effects of PNEE and improved hippocampal function. The findings in this thesis support the hypothesis that increasing antioxidant capacity can enhance hippocampal function, which in turn may improve learning and memory in FASD, providing a therapeutic avenue for children suffering with these disorders. / Graduate / 0570 Nutrition / 0317 Neuroscience / anna.r.patten@gmail.com

Fetale alkoholsindroom (FAS) is ‘n voortgaande probleem in Suid–Afrika, veral in die Wes–Kaap. Baie kinders met FAS word in pleegsorg geplaas vanweë hul ouers se drankmisbruik en onvermoë om die kinders te versorg. Daar is reeds baie navorsing gedoen in akademiese en sosiale omgewings oor die voorkoms en simptome van FAS. Minder is bekend oor die hanteringsbehoeftes by pleegouers van pleegkinders met FAS en derhalwe is dit die navorser se doelwit om navorsing te doen in hierdie veld. Die doel van hierdie studie was om die behoeftes wat pleegouers ondervind in die hantering van hul voorskoolse pleegkinders met FAS te verken en te beskryf. Die navorsingsvraag vir die studie lui soos volg: “Wat is pleegouers se hanteringsbehoeftes ten opsigte van hul voorskoolse pleegkinders met FAS?” Hierdie navorsingsvraag is aangespreek deur kwalitatiewe navorsing, en die studie kan geklassifiseer word as verkennende en beskrywende navorsing. Die navorser het vir die doel van hierdie studie gebruik maak van ‘n niewaarskynlikheidsteekproef deur middel van doelbewuste steekproefneming. Die navorser het 17 pleegouers, van twee gesinsorgorganisasies gewerf. Fokusgroeponderhoude binne twee fokusgroepe is benut om die hanteringsbehoeftes by pleegouers van voorskoolse pleegkinders met FAS te identifiseer. Die onderhoude is getranskribeer vir die doeleindes van dataanalisering en aan die hand van Creswell (2007) se stappe ontleed. Sewe temas is geïdentifiseer, naamlik (1) Dissiplinering van voorskoolse pleegkinders met FAS; (2) Hantering van gedrag van die voorskoolse pleegkind met FAS; (3) Ondersteuningsdienste aan pleegouers of pleegkinders; (4) Inligting of ondersteuning rondom FAS; (5) Verwerping van die voorskoolse pleegkind met FAS; (6) Emosionele impak van die voorskoolse pleegkind met FAS op die pleegouer; en laastens (7) Rol van die biologiese ouers van die voorskoolse pleegkind met FAS. Hierdie temas is in subtemas verdeel en aan die hand van toepaslike narratiewe uit die fokusgroepe bespreek en met literatuur gekontroleer. Gevolgtrekkings en aanbevelings is na aanleiding daarvan gemaak. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012.

Fetale alkoholsindroom (FAS) is ‘n voortgaande probleem in Suid–Afrika, veral in die Wes–Kaap. Baie kinders met FAS word in pleegsorg geplaas vanweë hul ouers se drankmisbruik en onvermoë om die kinders te versorg. Daar is reeds baie navorsing gedoen in akademiese en sosiale omgewings oor die voorkoms en simptome van FAS. Minder is bekend oor die hanteringsbehoeftes by pleegouers van pleegkinders met FAS en derhalwe is dit die navorser se doelwit om navorsing te doen in hierdie veld. Die doel van hierdie studie was om die behoeftes wat pleegouers ondervind in die hantering van hul voorskoolse pleegkinders met FAS te verken en te beskryf. Die navorsingsvraag vir die studie lui soos volg: “Wat is pleegouers se hanteringsbehoeftes ten opsigte van hul voorskoolse pleegkinders met FAS?” Hierdie navorsingsvraag is aangespreek deur kwalitatiewe navorsing, en die studie kan geklassifiseer word as verkennende en beskrywende navorsing. Die navorser het vir die doel van hierdie studie gebruik maak van ‘n niewaarskynlikheidsteekproef deur middel van doelbewuste steekproefneming. Die navorser het 17 pleegouers, van twee gesinsorgorganisasies gewerf. Fokusgroeponderhoude binne twee fokusgroepe is benut om die hanteringsbehoeftes by pleegouers van voorskoolse pleegkinders met FAS te identifiseer. Die onderhoude is getranskribeer vir die doeleindes van dataanalisering en aan die hand van Creswell (2007) se stappe ontleed. Sewe temas is geïdentifiseer, naamlik (1) Dissiplinering van voorskoolse pleegkinders met FAS; (2) Hantering van gedrag van die voorskoolse pleegkind met FAS; (3) Ondersteuningsdienste aan pleegouers of pleegkinders; (4) Inligting of ondersteuning rondom FAS; (5) Verwerping van die voorskoolse pleegkind met FAS; (6) Emosionele impak van die voorskoolse pleegkind met FAS op die pleegouer; en laastens (7) Rol van die biologiese ouers van die voorskoolse pleegkind met FAS. Hierdie temas is in subtemas verdeel en aan die hand van toepaslike narratiewe uit die fokusgroepe bespreek en met literatuur gekontroleer. Gevolgtrekkings en aanbevelings is na aanleiding daarvan gemaak. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012.