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Burns EJ, de Vocht F, Siqueira N, Ure C, Audrey S, Coffey M, Hare S, Hargreaves SC, Hidajat M, Parrott S, Scott L, Cook PA. An 'alcohol health champions' intervention to reduce alcohol harm in local communities: a mixed-methods evaluation of a natural experiment. PUBLIC HEALTH RESEARCH 2024; 12:1-135. [PMID: 39268883 DOI: 10.3310/htmn2101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024] Open
Abstract
Background Globally alcohol consumption is a leading risk factor for premature death and disability and is associated with crime, social and economic consequences. Local communities may be able to play a role in addressing alcohol-related issues in their area. Objectives To evaluate the effectiveness and cost-benefit of an asset-based community development approach to reducing alcohol-related harm and understand the context and factors that enable or hinder its implementation. Design A mixed-methods evaluation. Area-level quasi-experimental trial analysed using four different evaluation methods (a stepped-wedge design where each area was a control until it entered the intervention, comparison to matched local/national controls and comparison to synthetic controls), alongside process and economic evaluations. Setting Ten local authorities in Greater Manchester, England. Participants The outcomes evaluation was analysed at an area level. Ninety-three lay persons representing nineareas completed questionnaires, with 12 follow-up interviews in five areas; 20 stakeholders representing ten areas were interviewed at baseline, with 17 follow-up interviews in eight areas and 26 members of the public from two areas attended focus groups. Interventions Professionals in a co-ordinator role recruited and supported lay volunteers who were trained to become alcohol health champions. The champion's role was to provide informal, brief alcohol advice to the local population and take action to strengthen restrictions on alcohol availability. Main outcome measures Numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs, street-level crime and antisocial behaviour in the intervention areas (area size: 1600-5500 residents). Set-up and running costs were collected alongside process evaluation data exploring barriers and facilitators. Data sources Routinely collected quantitative data on outcome measures aggregated at the intervention area and matched control and synthetic control areas. Data from policy documents, licensing registers, meeting notes, invoices, time/cost diaries, training registers, questionnaires, interviews, reflective diaries and focus groups. Results The intervention rolled out in nine out of ten areas, seven of which ran for a full 12 months. Areas with better-established infrastructure at baseline were able to train more champions. In total, 123 alcohol health champions were trained (95 lay volunteers and 28 professionals): lay volunteers self-reported positive impact. Champions engaged in brief advice conversations more readily than taking action on alcohol availability. There were no consistent differences in the health and crime area-level indicators between intervention areas and controls, as confirmed by using three different analysis methods for evaluating natural experiments. The intervention was not found to be cost-beneficial. Limitations Although the sequential roll-out order of the intervention was randomised, the selection of the intervention areas was not. Self-reported impact may have been subject to social desirability bias due to the project's high profile. Conclusions There was no measurable impact on health and crime outcomes. Possible explanations include too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes. Future work Future similar interventions should use a coproduced community outcomes framework. Other natural experiment evaluations should use methodological triangulation to strengthen inferences about effectiveness. Trial registration This trial is registered as ISRCTN81942890. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Elizabeth J Burns
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Cathy Ure
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Margaret Coffey
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Susan Hare
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzy C Hargreaves
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Steve Parrott
- School of Health Sciences, University of York, York, UK
| | - Lauren Scott
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Penny A Cook
- School of Health and Society, University of Salford, Greater Manchester, UK
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Tanfield Y, Burrows K, Middllemiss M. Assessing and supporting children and young people with probable or diagnosed fetal alcohol spectrum disorder: The experience of clinicians working within child and adolescent mental health services. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39138612 DOI: 10.1111/acer.15376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Fetal alcohol spectrum disorders (FASD) are a group of conditions that occur due to prenatal alcohol exposure (PAE), which impacts physical, behavioral, and cognitive ability. The literature demonstrates that healthcare professionals lack knowledge and understanding of FASD, resulting in children and young people (CYP) often getting misdiagnosed with neurodevelopmental disorders or the diagnosis of FASD missed, increasing their risk of experiencing secondary mental health difficulties. Child and Adolescent Mental Health Services (CAMHS) are the commissioned service to diagnose neurodevelopmental conditions and support CYP with mental health difficulties, therefore, it is likely that CYP with probable or diagnosed FASD will present in CAMHS. There is currently no research exploring the awareness and understanding of FASD within these services. METHODS Constructivist grounded theory was utilized to explore the barriers and facilitators clinicians experience when assessing and supporting CYP with probable or diagnosed FASD within CAMHS. A sample of 12 CAMHS clinicians from an NHS Mental Health Trust situated in the Northeast of England were interviewed. Interviews were transcribed and analyzed and grounded theory techniques were utilized to generate an end model. RESULTS The end model was developed on a box analogy with four categories. 'Unable to Open the Box' captures barriers CAMHS clinicians experience when exploring FASD, 'Things that Help Open the Box' captures facilitators CAMHS clinicians experience when exploring FASD, 'Asking Others About the Box' captures systemic influences CAMHS clinicians may experience when exploring FASD, and 'Making the Box Easier to Open in Future' captures how we can support CAMHS clinicians moving forward to explore FASD. CONCLUSIONS This model provides new insights into the barriers and facilitators CAMHS clinicians experience when assessing and supporting CYP with probable or diagnosed FASD, highlighting key clinical implications. Recommendations for future research are outlined to expand the knowledge base for this area.
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Affiliation(s)
- Yasmin Tanfield
- Medical Psychology Service, South Tees NHS Foundation Trust, James Cook University Hospital, Middlesbrough, UK
- School of Social Sciences, Humanities and Law, Teesside University, Teesside, UK
| | - Kathy Burrows
- School of Social Sciences, Humanities and Law, Teesside University, Teesside, UK
| | - Megan Middllemiss
- Singe Point of Access Service, Tees, Esk and Wear Valleys NHS Foundation Trust, Durham, Darlington, UK
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Stubbs T, Cannon L, Carter E, Naanai H, Okurame JC, Martiniuk ALC, Davies J, Thomas S, Bedford M, Elliott EJ, Rice LJ. Fetal alcohol spectrum disorder resources for health professionals: a scoping review. BMJ Open 2024; 14:e086999. [PMID: 39002966 PMCID: PMC11253770 DOI: 10.1136/bmjopen-2024-086999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/12/2024] [Indexed: 07/15/2024] Open
Abstract
OBJECTIVES This scoping review aimed to identify and critically appraise resources for health professionals to identify, diagnose, refer, and support individuals with fetal alcohol spectrum disorder (FASD)-including the extent to which the resources are appropriate for use in communities with First Nations Peoples. METHOD Seven peer-reviewed databases (April 2022) and 14 grey literature websites (August 2022) were searched. The reference lists of all sources that underwent full-text review were handsearched, and FASD experts were consulted for additional sources. Resources were assessed using the Appraisal of Guidelines for REsearch and Evaluation II instrument and an adapted version of the National Health and Medical Research Council FORM Framework and iCAHE Guideline Quality Checklist. RESULTS A total of 41 resources underwent data extraction and critical appraisal, as screening and/or diagnosis guidelines were excluded because they are covered in other reviews. Most were recently published or updated (n=24), developed in the USA (n=15, 36.6%) or Australia (n=12, 29.3%) and assisted with FASD patient referral or support (n=40). Most management guidelines scored 76%-100% on overall quality assessment (n=5/9) and were recommended for use in the Australian context with modifications (n=7/9). Most of the guides (n=15/22) and factsheets (n=7/10) received a 'good' overall score. Few (n=3/41) resources were explicitly designed for or with input from First Nations Australians. CONCLUSION High-quality resources are available to support health professionals providing referrals and support to individuals with FASD, including language guides. Resources should be codesigned with people living with FASD to capture and integrate their knowledge and preferences.
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Affiliation(s)
- Thomas Stubbs
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Lisa Cannon
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Emily Carter
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Habiba Naanai
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Josephine Chidinma Okurame
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Alexandra L C Martiniuk
- School of Public Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Office of the Chief Scientist, The George Institute for Global Health, Sydney, New South Wales, Australia
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Jadnah Davies
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Sue Thomas
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Mudge Bedford
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
- NDIS Remote Community Connector Team, Marra Worra Worra Aboriginal Cooporation, Fitzroy Crossing, Western Australia, Australia
| | - Elizabeth J Elliott
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Sydney Children's Hospital Network and Kid's Research, Westmead, Sydney, New South Wales, Australia
| | - Lauren J Rice
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
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McCarthy R, Blackburn C, Mukherjee RAS, Allely CS, Cook PA. "Taking part in the project has really changed our experience as a family" investigating parents' experience of participation in a study to screen for fetal alcohol spectrum disorder. Heliyon 2024; 10:e30076. [PMID: 38737269 PMCID: PMC11088246 DOI: 10.1016/j.heliyon.2024.e30076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024] Open
Abstract
Background Screening children for developmental disorders presents unique ethical and methodological challenges, particularly with disorders associated with high levels of shame and stigma. Fetal alcohol spectrum disorder (FASD) is a neurodevelopmental condition resulting from prenatal alcohol exposure. The potential distress caused by informing parents that their child may have FASD has been cited as a significant barrier to conducting such studies. However, limited research has investigated the impact of screening for FASD on parents and children. Aims This exploratory study aimed to examine the experiences of a small sample of parents participating in an active case ascertainment prevalence study screening for FASD in Greater Manchester, UK (ADD-GM study). Methods Interviews were conducted with six parents, whose children aged 8-10 years, underwent screening (including three cases of FASD). Thematic analysis was performed on the collected data to identify key themes and patterns. Results The analysis revealed that parents perceived participation in the study as worthwhile, and their children either enjoyed or were indifferent to the process of data collection. Parents of children identified with FASD reported that although the results were surprising, they did not find the experience overly distressing. Conclusion The findings suggest that parents generally view participation positively and perceive limited negative impact. These insights contribute to a better understanding of the challenges and benefits associated with screening children for FASD.
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Affiliation(s)
- Robyn McCarthy
- Directorate of Allied and Public Health, University of Salford, Salford, UK
| | - Carolyn Blackburn
- School of Education and Social Work, Birmingham City University, Birmingham, UK
| | - Raja AS. Mukherjee
- Directorate of Allied and Public Health, University of Salford, Salford, UK
- Fetal Alcohol Spectrum Disorder Service, Surrey & Borders Partnership NHS, Foundation Trust, Redhill, UK
| | - Clare S. Allely
- Directorate of Allied and Public Health, University of Salford, Salford, UK
| | - Penny A. Cook
- Directorate of Allied and Public Health, University of Salford, Salford, UK
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Louw JG, Broodryk M, White L, Acker D, Viljoen DL, Olivier L. A multi-year, multi-site study of the prevalence of fetal alcohol syndrome in South Africa. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:867-879. [PMID: 38548386 DOI: 10.1111/acer.15306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND South Africa has the highest reported prevalence of fetal alcohol spectrum disorders (FASD) globally. The most recent study reported a weighted, estimated FASD prevalence of 310 per 1000 in a community in the Western Cape Province. Because there is as yet no reliable estimate of the national burden of FASD in South Africa, further epidemiological studies are needed in diverse settings. This paper reports on a multiyear, multisite FASD epidemiological study that took place from 2015 to 2022 at eight study sites in four provinces. METHODS The cross-sectional epidemiological study used an active case-ascertainment method, specifically in primary schools. All children were recruited when they were enrolled in Grade 1 at a participating school. All consented participants progressed through a tiered-screening recruitment and diagnostic process. RESULTS Overall, 3033 children were included in the study. A total of 3001 children were screened for FASD in the first tier, with 1086 progressing to the second and 495 to the third tier. Of the 495 children referred, 475 were discussed during the final case conference. A total of 309 participants were diagnosed with FAS across the eight study sites. The highest reported prevalence was in the Northern Cape Province, with a rate of 199.3/1000 (95% CI, 147.6-251) using all eligible participants as the denominator. The lowest prevalence was in the Eastern Cape Province, with a rate of 57.4/1000 (95% CI, 36.5-78.3). The pooled FAS prevalence for the eight study sites was 80.2/1000 (95% CI, 70.4-89.9). CONCLUSIONS As with previous studies, we found a concerningly high prevalence of FASD in South Africa. Given the scope of the problem it should be a high priority for health and welfare services to address.
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Affiliation(s)
- Jacobus Gidion Louw
- Foundation for Alcohol Related Research, Cape Town, South Africa
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Mandi Broodryk
- Foundation for Alcohol Related Research, Cape Town, South Africa
| | - Liska White
- Foundation for Alcohol Related Research, Cape Town, South Africa
| | - Debbie Acker
- Foundation for Alcohol Related Research, Cape Town, South Africa
| | | | - Leana Olivier
- Foundation for Alcohol Related Research, Cape Town, South Africa
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Zeng X, Cai Y, Wu M, Chen H, Sun M, Yang H. An overview of current advances in perinatal alcohol exposure and pathogenesis of fetal alcohol spectrum disorders. J Neurodev Disord 2024; 16:20. [PMID: 38643092 PMCID: PMC11031898 DOI: 10.1186/s11689-024-09537-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/08/2024] [Indexed: 04/22/2024] Open
Abstract
The adverse use of alcohol is a serious global public health problem. Maternal alcohol consumption during pregnancy usually causes prenatal alcohol exposure (PAE) in the developing fetus, leading to a spectrum of disorders known as fetal alcohol spectrum disorders (FASD) and even fetal alcohol syndrome (FAS) throughout the lifelong sufferers. The prevalence of FASD is approximately 7.7 per 1,000 worldwide, and is even higher in developed regions. Generally, Ethanol in alcoholic beverages can impair embryonic neurological development through multiple pathways leading to FASD. Among them, the leading mechanism of FASDs is attributed to ethanol-induced neuroinflammatory damage to the central nervous system (CNS). Although the underlying molecular mechanisms remain unclear, the remaining multiple pathological mechanisms is likely due to the neurotoxic damage of ethanol and the resultant neuronal loss. Regardless of the molecular pathway, the ultimate outcome of the developing CNS exposed to ethanol is almost always the destruction and apoptosis of neurons, which leads to the reduction of neurons and further the development of FASD. In this review, we systematically summarize the current research progress on the pathogenesis of FASD, which hopefully provides new insights into differential early diagnosis, treatment and prevention for patents with FASD.
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Affiliation(s)
- Xingdong Zeng
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, 215031, China
| | - Yongle Cai
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, 215031, China
| | - Mengyan Wu
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, 215031, China
| | - Haonan Chen
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, 215031, China
| | - Miao Sun
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, 215031, China.
| | - Hao Yang
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, 215031, China.
- School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
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Scott LJ, Hidajat M, Burns EJ, Ure C, Hargreaves SC, Audrey S, Coffey M, Hare S, Siqueira N, Parrott S, Cook PA, de Vocht F. Does a local Alcohol Health Champion programme have a measurable impact on health and crime outcomes? A natural experiment evaluation of Communities in Charge of Alcohol (CICA) based on triangulation of methods. Addiction 2024; 119:499-508. [PMID: 37827515 DOI: 10.1111/add.16363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND AND AIM Drinking alcohol may cause harm to an individual's health and social relationships, while a drinking culture may harm societies as it may increase crime rates and make an area feel less safe. Local councils in Greater Manchester, UK, developed the Communities in Charge of Alcohol (CICA) intervention, in which volunteers were trained to give alcohol-related advice to the public and taught how to influence policies to restrict when, where and how alcohol is sold. As part of a larger study, the aim of the current project is to measure the impact of CICA on health and crime outcomes at the lower super output (LSOA) geographical aggregation. DESIGN Quantitative evaluation using four time series analytic methods (stepped-wedge design, and comparisons to local controls, national controls and synthetic controls) with findings triangulated across these methods. A cost-benefit analysis was carried out alongside the effectiveness analysis. SETTING AND PARTICIPANTS The general public in Greater Manchester, UK, between 2010 and 2020. MEASUREMENTS The primary outcome of interest was alcohol-related hospital admissions. Secondary outcomes were accident and emergency (A&E) attendances, ambulance callouts, recorded crimes and anti-social behaviour incidents. FINDINGS Triangulation of the results did not indicate any consistent effect on area-level alcohol-related hospital admissions, A&E attendances, ambulance callouts, reported crimes or anti-social behaviour associated with the implementation of CICA. The primary stepped-wedge analysis indicated an increase in alcohol-related hospital admissions following the implementation of CICA of 13.4% (95% confidence interval -3.3%, +30.1%), which was consistent with analyses based on other methods with point estimates ranging from +3.4% to 16.4%. CONCLUSION There is no evidence of a measurable impact of the Communities in Charge of Alcohol (CICA) programme on area-level health and crime outcomes in Greater Manchester, UK, within 3 years of the programme start. The increase in alcohol-related hospital admissions was likely the result of other temporal trends rather than the CICA programme. Possible explanations include insufficient follow-up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions or that the intervention has no direct impact on the selected outcomes.
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Affiliation(s)
- Lauren J Scott
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Elizabeth J Burns
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Cathy Ure
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzy C Hargreaves
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Margaret Coffey
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Susan Hare
- School of Health and Society, University of Salford, Greater Manchester, UK
- Fallowfield Community Guardians c/o School of Health and Society, University of Salford, Greater Manchester, UK
| | | | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
| | - Penny A Cook
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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May PA, Marais AS, Kalberg WO, de Vries MM, Buckley D, Hasken JM, Snell CL, Barnard Röhrs R, Hedrick DM, Bezuidenhout H, Anthonissen L, Bröcker E, Robinson LK, Manning MA, Hoyme HE, Seedat S, Parry CDH. Multifaceted case management during pregnancy is associated with better child outcomes and less fetal alcohol syndrome. Ann Med 2023; 55:926-945. [PMID: 36919586 PMCID: PMC10026770 DOI: 10.1080/07853890.2023.2185808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Pregnant women participated in multifaceted case management (MCM) to prevent Fetal Alcohol Spectrum Disorders (FASD). METHODS Women recruited from antenatal clinics for a longitudinal child development study were screened for alcohol use. Forty-four pregnant women were defined as high-risk drinkers on the Alcohol Use Disorder Identification Test (AUDIT) by an AUDIT score ≥8 and participated in 18 months of MCM to facilitate reduction or cessation of alcohol consumption. Forty-one women completed MCM. Fifty-five equally high-risk women who received standard antenatal care comprised the comparison/control group. Development in offspring was evaluated by a blinded interdisciplinary team of examiners through 5 years of age. RESULTS At five years of age, more children (34%) of MCM participating women did not meet the criteria for FASD vs. non-MCM offspring (22%). Furthermore, a statistically significant (p = .01) lower proportion of MCM offspring (24%) was diagnosed with fetal alcohol syndrome (FAS) compared to controls (49%). Children of MCM participants had significantly (p < .05) better physical outcomes: lower total dysmorphology scores, larger head circumferences, longer palpebral fissures, and higher midfacial measurements. Neurodevelopment results showed mixed outcomes. While Bayley developmental scores indicated that MCM offspring were performing significantly worse on most domains through 18 months, group scores equalized and were not significantly different on Kaufman Assessment Battery neurobehavioral measures by five years. Regression analyses indicated that offspring of women who received standard antenatal care were associated with significantly more negative outcomes than MCM offspring: a diagnosis of FAS (OR = 3.2; 95% CI: 1.093-9.081), microcephaly (OR = 5.3; 95% CI: 2.1-13.5), head circumference ≤10th centile (OR = 4.3; 95%CI: 1.8-10.4), and short palpebral fissures (OR = 2.5; 95% CI: 1.0-5.8). CONCLUSION At age five, proportionally fewer children of MCM participants qualified for a diagnosis of FAS, and proportionally more had physical outcomes indicating better prenatal brain development. Neurobehavioral indicators were not significantly different from controls by age five.KEY MESSAGESMultifaceted Case Management (MCM) was designed and employed for 18 months during the prenatal and immediate postpartum period to successfully meet multiple needs of women who had proven to be very high risk for birthing children with fetal alcohol spectrum disorders (FASD).Offspring of the women who participated in MCM were followed up through age five years and were found to have significantly better physical outcomes on multiple variables associated with fetal alcohol syndrome (FAS) and FASD, such as larger head circumferences and fewer minor anomalies, than those children born to equally at-risk women not receiving MCM.Fewer children of women receiving MCM were diagnosed with FASD than the offspring of equally-at-risk controls, and significantly (p = .01) fewer MCM offspring had FAS, the most severe FASD diagnosis.
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Affiliation(s)
- Philip A May
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, USA
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, USA
| | - Anna-Susan Marais
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Wendy O Kalberg
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, USA
| | - Marlene M de Vries
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - David Buckley
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, USA
| | - Julie M Hasken
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Cudore L Snell
- School of Social Work, Howard University, Washington, DC, USA
| | - Ronel Barnard Röhrs
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dixie M Hedrick
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Heidre Bezuidenhout
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lise Anthonissen
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Erine Bröcker
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Luther K Robinson
- Department of Pediatrics, State University of New York, Buffalo, NY, USA
| | - Melanie A Manning
- Department of Pathology and Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - H Eugene Hoyme
- Sanford Children's Genomic Medicine Consortium, Sanford Health, Sioux Falls, SD, USA
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Charles D H Parry
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
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Burleigh CR, Lynn RM, Verity C, Winstone AM, White SR, Johnson K. Fetal alcohol syndrome in the UK. Arch Dis Child 2023; 108:852-856. [PMID: 37451833 PMCID: PMC10511982 DOI: 10.1136/archdischild-2023-325571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To determine the incidence of fetal alcohol syndrome (FAS) in the UK in children aged 0-16 years. DESIGN Active surveillance was undertaken through the British Paediatric Surveillance Unit between October 2018 and October 2019 inclusive. Data were collected from reporting clinicians using standardised questionnaires. PATIENTS Children aged 0-16 years in the UK and Ireland with a diagnosis of FAS seen in the previous month. This study did not include children with fetal alcohol spectrum disorder. MAIN OUTCOME MEASURES Demographic details (including age and ethnicity), details of exposure, growth parameters, neurological and cognitive diagnoses, and service usage. RESULTS 148 notifications were received. After exclusions and withdrawals, there were 10 confirmed and 37 probable cases (analysed together). Just 24 of these children were newly diagnosed with FAS during the surveillance period, giving an estimated incidence rate of 3.4/100 000 live births (95% CI 2.2 to 5.0); their median age at diagnosis was just over 5 years and they were diagnosed between 3 months and 14 years 3 months of age. CONCLUSIONS The estimated incidence rate of FAS is lower than reported by similar studies and there was a wide variation in the age that cases were diagnosed. This, combined with the fact that many cases were notified and then withdrawn or excluded, suggests that in the UK there is a lack of consistency and certainty in diagnosing FAS. The study findings strongly support the need to educate key professionals involved in the care of infants and children at risk of FAS.
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Affiliation(s)
| | - Richard M Lynn
- Honrary Senior Research Fellow, University College London, London, UK
| | - Chris Verity
- Children's Services, PIND Research Group, Addenbrooke's Hospital, Cambridge, UK
| | - Anne Marie Winstone
- Children's Services, PIND Research Group, Addenbrooke's Hospital, Cambridge, UK
| | - Simon R White
- MRC Biostatistics Unit, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Kathryn Johnson
- Leeds Neonatal Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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10
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Carrick A, Hamilton CJ. Heated Behaviour in the Classroom for Children with FASD: The Relationship between Characteristics Associated with ADHD, ODD and ASD, Hot Executive Function and Classroom Based Reward Systems. CHILDREN 2023; 10:children10040685. [PMID: 37189934 DOI: 10.3390/children10040685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/17/2023] [Accepted: 03/30/2023] [Indexed: 04/07/2023]
Abstract
Possession of characteristics related to Attention Deficit Hyperactive Disorder, Oppositional Defiance Disorder, and Autism Spectrum Disorder in children prenatally exposed to alcohol contributes to challenges within the diagnostic pathway for Foetal Alcohol Spectrum Disorder (FASD). The presentation of these characteristics, though problematic for the children affected, may not result in referral for diagnosis; focusing on diagnostic thresholds masks the dimensional nature of these characteristics. Children with traits which are undiagnosed may not receive effective support and are often identified as exhibiting challenging behaviour. In the UK, children with undiagnosed Special Educational Needs (SEN) are more likely to experience school exclusion. Common across each condition are challenges to executive function associated with emotional regulation (hot-executive function). This study explored the relationship between characteristics of Attention Deficit Hyperactive Disorder, Oppositional Defiance Disorder, Autistic-Like Traits, and hot executive functions on the helpfulness of reward-based interventions for children with suspected or diagnosed FASD. Data were collected online using caregiver referral questionnaire screeners for each measure (Child Autism Quotient Questionnaire, Vanderbilt ADHD Parental Rating Scale and The Childhood Executive Functioning Inventory) for children aged 6–12 years with suspected or diagnosed FASD (n = 121). Between-group comparisons showed no significant difference in the reporting of Attention Deficit Hyperactive Disorder characteristics, Oppositional Defiance Disorder characteristics, Autistic-Like Traits, and executive function, regardless of diagnostic state. Multiple regression analyses indicated that these personality characteristics and executive functions were associated with the perception of the reward system helpfulness. However, this pattern was qualified by both the type of hot executive function challenged (significant for Regulation not Inhibition) and whether the child had an FASD diagnosis. Thus, a dimensional approach may strengthen our understanding of the child’s classroom experience and help overcome barriers to effective intervention and support.
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Affiliation(s)
- Andrea Carrick
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Colin J. Hamilton
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
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11
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Romeo JS, Huckle T, Casswell S, Connor J, Rehm J, McGinn V. Foetal alcohol spectrum disorder in Aotearoa, New Zealand: Estimates of prevalence and indications of inequity. Drug Alcohol Rev 2023; 42:859-867. [PMID: 36809679 DOI: 10.1111/dar.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/21/2022] [Accepted: 01/08/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Foetal alcohol spectrum disorder (FASD) is 100% caused by alcohol. The lifelong disability caused by prenatal alcohol exposure cannot be reversed. Lack of reliable national prevalence estimates of FASD is common internationally and true of Aotearoa, New Zealand. This study modelled the national prevalence of FASD and differences by ethnicity. METHODS FASD prevalence was estimated from self-reported data on any alcohol use during pregnancy for 2012/2013 and 2018/2019, combined with risk estimates for FASD from a meta-analysis of case-ascertainment or clinic-based studies in seven other countries. A sensitivity analysis using four more recent active case ascertainment studies was performed to account for the possibility of underestimation. RESULTS We estimated FASD prevalence in the general population to be 1.7% (95% confidence interval [CI] 1.0%; 2.7%) in the 2012/2013 year. For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. In the 2018/2019 year, FASD prevalence was 1.3% (95% CI 0.9%; 1.9%). For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. The sensitivity analysis estimated the prevalence of FASD in the 2018/2019 year to range between 1.1% and 3.9% and for Māori, from 1.7% to 6.3%. DISCUSSION AND CONCLUSIONS This study used methodology from comparative risk assessments, using the best available national data. These findings are probably underestimates but indicate a disproportionate experience of FASD by Māori compared with some ethnicities. The findings support the need for policy and prevention initiatives to support alcohol-free pregnancies to reduce lifelong disability caused by prenatal alcohol exposure.
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Affiliation(s)
- Jose S Romeo
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Taisia Huckle
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sally Casswell
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Jennie Connor
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jurgen Rehm
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,PAHO/WHO Collaborating Centre for Addiction and Mental Health, Technische Universität Dresden, Klinische Psychologie and Psychotherapie, Dresden, Germany.,Zentrum für Interdisziplinäre Suchtforschung der Universität Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Valerie McGinn
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand.,FASD Centre, Aotearoa, Auckland, New Zealand
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12
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Webster BM, Carlisle ACS, Livesey AC, Deeprose LR, Cook PA, Mukherjee RAS. Evaluating the Difference in Neuropsychological Profiles of Individuals with FASD Based on the Number of Sentinel Facial Features: A Service Evaluation of the FASD UK National Clinic Database. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020266. [PMID: 36832394 PMCID: PMC9955101 DOI: 10.3390/children10020266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/01/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023]
Abstract
(1) It might be implied that those with Fetal Alcohol Spectrum Disorder (FASD) with fewer sentinel facial features have a "milder" neuropsychological presentation, or present with fewer impairments than those with more sentinel facial features. The aim of this service evaluation was to compare the neuropsychological profile of people with FASD with varying numbers of sentinel facial features. (2) A clinical sample of 150 individuals with FASD, aged between 6 and 37 years, completed various standardised assessments as part of their diagnostic profiling. These included the documented level of risk of prenatal alcohol exposure (4-Digit Diagnostic Code), sensory needs (Short Sensory Profile), cognition (Wechsler Intelligence Scale for Children-4th Edition; WISC-IV), and communication and socialisation adaptive behaviours (Vineland Adaptive Behavior Scale-2nd Edition; VABS-II). As FASD has high comorbidity rates of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), these were also reviewed. The profiles of the 'FASD with 2 or 3 sentinel facial features' group (n = 41; 28 male, 13 female) were compared with the 'FASD with 0 or 1 sentinel facial features' group (n = 109; 50 male, 59 female) using Chi² tests, independent sample t-tests, and Mann-Whitney U analyses (where appropriate). (3) There were no significant differences between the two comparison groups across any measure included in this service evaluation. (4) Whilst sentinel facial features remain an important aspect in recognising FASD, our service evaluation indicates that there is no significant relationship between the number of sentinel facial features and the neuropsychological profile of people with FASD in terms of severity of presentation.
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Affiliation(s)
- Bethany M. Webster
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Alexandra C. S. Carlisle
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Alexandra C. Livesey
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Lucy R. Deeprose
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
| | - Penny A. Cook
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
- School of Health and Society, University of Salford, Salford M6 6PU, UK
| | - Raja A. S. Mukherjee
- Fetal Alcohol Spectrum Disorders (FASD) Specialist Clinic, Gatton Place, St Matthews Rd, Redhill, Surrey RH1 1TA, UK
- School of Health and Society, University of Salford, Salford M6 6PU, UK
- Correspondence:
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13
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Martinez-Cengotitabengoa M, Jackson CL, Pugh EJ, Long-Martinez D, Sanchez-Martinez A, Sanchez-Martinez M, Bermudez-Ampudia C, Martinez-Cengotitabengoa MT. Global intellectual ability and adaptive functioning in children with FASD with and without sentinel facial features. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:123-128. [PMID: 36745739 DOI: 10.1080/00952990.2022.2164503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder characterized by cognitive and adaptive impairment. FASF can be presented or not with sentinel facial features (SFF). The presence of such SFF have been positively correlated with cognitive impairment in children with FASD.Objectives: The current study explores difference in global intellectual functioning and how cognition affects adaptive behavior in children with and without SFF.Methods: A total of 88 children and adolescents (55 males, 33 females) with confirmed FASD diagnosis were included in the study, of which 16 had sentinel facial features. Childrens' neuropsychological functioning was assessed using the Wechsler Intelligence Scale for Children (WISC-V) and The Behavioral Assessment of the Dysexecutive Syndromes for Children (BADS-C). Adaptive behavior was explored through the Adaptive Behavior Assessment System (ABAS-3).Results: Children with SFF performed more poorly in tasks assessing processing speed (t = 2.495, t = .020) and executive functioning (t = 4.147, t = .001). Those children also had lower IQ scores than children without SFF (t = 2.658, t = .016). BADS-C overall scaled score was related to three of the four domains of the ABAS scale (conceptual, social, and practical) but only in the group of FASD children without SFF (B = 0.547, t = .020; B = 0.544,t = .049; B = 0.431,t = .040, respectively).Conclusions: The present study founds poorer cognitive outcomes in children who have FASD with sentinel facial features. In children without SFF, stronger executive functioning is also related to significantly stronger reported conceptual, social, and practical adaptive behaviors. Better understanding of cognitive and adaptive functioning in children with FASD may help in the design of tailored evidenced-based interventions.
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Affiliation(s)
- Monica Martinez-Cengotitabengoa
- School of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain.,Psychology Clinic of East Anglia, Norwich, UK.,Osakidetza Basque Health Service, Barakaldo, Spain
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14
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May PA, de Vries MM, Marais AS, Kalberg WO, Buckley D, Hasken JM, Abdul-Rahman O, Robinson LK, Manning MA, Seedat S, Parry CD, Hoyme HE. The prevalence of fetal alcohol spectrum disorders in rural communities in South Africa: A third regional sample of child characteristics and maternal risk factors. Alcohol Clin Exp Res 2022; 46:1819-1836. [PMID: 35971629 PMCID: PMC9588757 DOI: 10.1111/acer.14922] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/13/2022] [Accepted: 08/09/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND This study is the ninth cross-sectional community study of fetal alcohol spectrum disorders (FASD) conducted by the multidisciplinary Fetal Alcohol Syndrome Epidemiology Research team in the Western Cape Province of South Africa. It is the third comprehensive study of FASD in a rural, agricultural region of South Africa. METHODS Population-based, active case ascertainment methods were employed among a school-based cohort to assess child physical and neurobehavioral traits, and maternal risk factor interviews were conducted to identify all children with FASD to determine its prevalence. RESULTS Consent was obtained for 76.7% of 1158 children attending first grade in the region's public schools. Case-control results are presented for 95 with fetal alcohol syndrome (FAS), 64 with partial fetal alcohol syndrome (PFAS), 77 with alcohol-related neurodevelopmental disorder (ARND), 2 with alcohol-related birth defects (ARBD), and 213 randomly-selected controls. Four techniques estimating FASD prevalence from in-person examinations and testing yielded a range of total FASD prevalence of 206-366 per 1000. The final weighted, estimated prevalence of FAS was 104.5 per 1000, PFAS was 77.7 per 1000, ARND was 125.2 per 1000, and total FASD prevalence was 310 per 1000 (95% CI = 283.4-336.7). Expressed as a percentage, 31% had FASD. Although the rate of total FASD remained steady over 9 years, the proportion of children within the FASD group has changed significantly: FAS trended down and ARND trended up. A detailed evaluation is presented of the specific child physical and neurobehavioral traits integral to assessing the full continuum of FASD. The diagnosis of a child with FASD was significantly associated with maternal proximal risk factors such as: co-morbid prenatal use of alcohol and tobacco (OR = 19.1); maternal drinking of two (OR = 5.9), three (OR = 5.9), four (OR = 38.3), or more alcoholic drinks per drinking day; and drinking in the first trimester (OR = 8.4), first and second trimesters (OR = 17.7), or throughout pregnancy (OR = 18.6). Distal maternal risk factors included the following: slight or small physical status (height, weight, and head circumference), lower BMI, less formal education, late recognition of pregnancy, and higher gravidity, parity, and older age during the index pregnancy. CONCLUSION The prevalence of FASD remained a significant problem in this region, but the severity of physical traits and anomalies within the continuum of FASD is trending downwards.
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Affiliation(s)
- Philip A. May
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, 500 Laureate Way, Kannapolis, NC 28081, United States
- Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, United States
| | - Marlene M. de Vries
- Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Anna-Susan Marais
- Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Wendy O. Kalberg
- Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, United States
| | - David Buckley
- Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, United States
| | - Julie M. Hasken
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, 500 Laureate Way, Kannapolis, NC 28081, United States
| | - Omar Abdul-Rahman
- Department of Genetic Medicine, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska
| | - Luther K. Robinson
- Department of Pediatrics, State University of New York, 1001 Main Street, Buffalo, NY 14203, United States
| | - Melanie A. Manning
- Department of Pathology and Pediatrics, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, United States
| | - Soraya Seedat
- Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Charles D.H. Parry
- Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, Cape Town, 7505, South Africa
| | - H. Eugene Hoyme
- Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- Sanford Children’s Genomic Medicine Consortium, Sanford Health, 1600 W. 22 St. Sioux Falls, SD, 57117, United States
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15
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Okurame JC, Cannon L, Carter E, Thomas S, Elliott EJ, Rice LJ. Fetal alcohol spectrum disorder resources for health professionals: a scoping review protocol. BMJ Open 2022; 12:e065327. [PMID: 36100303 PMCID: PMC9472138 DOI: 10.1136/bmjopen-2022-065327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION People with fetal alcohol spectrum disorder (FASD) encounter a range of health and allied health providers and require specialised support to ensure health services are provided safely and effectively. Not all health professionals possess the knowledge or expertise required for the identification, assessment, referral and management of FASD. Accessible resources for understanding and managing FASD can help create awareness in health professionals and ensure patients receive the correct diagnosis and timely access to the necessary supports and services. The aim of this scoping review is to identify and analyse FASD resources for health professionals. METHODS AND ANALYSIS A comprehensive search of eight databases (MEDLINE, Scopus, PsycINFO, CINAHL, PubMED, EMBASE, Web of Science and Trip Medical Database) and nine grey literature databases (FASD Hub, NOFASD Australia, National Organisation for FASD, FASD United, HealthInfoNet, Proof Alliance, Child Family Community Australia, Foundation for Alcohol Research & Education and the Australian Department of Health websites) will be conducted using three search engines including PubMed, Ovid and Google advanced search (search dates: October 2021 to May 2022). Consultations will also be carried out with international and national experts in the diagnosis/management of FASD to obtain any additional relevant published or unpublished resources. Inclusion criteria were developed to guide the selection of resources that are publicly available, primarily focused on FASD and curated for health professionals for the identification, management or referral of FASD. Critical appraisal process will be executed using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) tool to assess the quality of selected resources. ETHICS AND DISSEMINATION Ethical approval is not required for the scoping review. Scoping review results will be presented at relevant national and international conferences and published in peer-reviewed journals. Search results will be made available to ensure reproducibility and transparency.
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Affiliation(s)
| | - Lisa Cannon
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Emily Carter
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Kimberley, Australia
| | - Sue Thomas
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Kimberley, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kids Research, The Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Lauren J Rice
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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“Now, with a bit more knowledge, I understand why I'm asking those questions.” Midwives’ perspectives on their role in the Greater Manchester Health and Social Care Partnership's programme to Reduce Alcohol Exposed Pregnancies (AEP). Midwifery 2022; 110:103335. [DOI: 10.1016/j.midw.2022.103335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/09/2022] [Accepted: 04/02/2022] [Indexed: 11/22/2022]
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17
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Affiliation(s)
- Neil Aiton
- One Stop Clinic, University Hospitals Sussex NHS Foundation Trust, Royal Sussex County Hospital, Brighton, UK
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