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BackgroundFetal alcohol spectrum disorder (FASD) is a developmental disorder that manifests through a range of cognitive, adaptive, physiological, and neurobiological deficits resulting from prenatal alcohol exposure. Although the North American prevalence is currently estimated at 2–5%, FASD has proven difficult to identify in the absence of the overt physical features characteristic of fetal alcohol syndrome. As interventions may have the greatest impact at an early age, accurate biomarkers are needed to identify children at risk for FASD. Building on our previous work identifying distinct DNA methylation patterns in children and adolescents with FASD, we have attempted to validate these associations in a different clinical cohort and to use our DNA methylation signature to develop a possible epigenetic predictor of FASD.MethodsGenome-wide DNA methylation patterns were analyzed using the Illumina HumanMethylation450 array in the buccal epithelial cells of a cohort of 48 individuals aged 3.5–18 (24 FASD cases, 24 controls). The DNA methylation predictor of FASD was built using a stochastic gradient boosting model on our previously published dataset FASD cases and controls (GSE80261). The predictor was tested on the current dataset and an independent dataset of 48 autism spectrum disorder cases and 48 controls (GSE50759).ResultsWe validated findings from our previous study that identified a DNA methylation signature of FASD, replicating the altered DNA methylation levels of 161/648 CpGs in this independent cohort, which may represent a robust signature of FASD in the epigenome. We also generated a predictive model of FASD using machine learning in a subset of our previously published cohort of 179 samples (83 FASD cases, 96 controls), which was tested in this novel cohort of 48 samples and resulted in a moderately accurate predictor of FASD status. Upon testing the algorithm in an independent cohort of individuals with autism spectrum disorder, we did not detect any bias towards autism, sex, age, or ethnicity.ConclusionThese findings further support the association of FASD with distinct DNA methylation patterns, while providing a possible entry point towards the development of epigenetic biomarkers of FASD.Electronic supplementary materialThe online version of this article (10.1186/s13148-018-0439-6) contains supplementary material, which is available to authorized users.

Observation is a research data-collection method used generally to capture the activities of participants as well as when and where things are happening in a given setting. It checks description of the phenomena against what the researcher perceives to be fact in a rich experiential context. The method's main strength is that it provides direct access to the social phenomena under consideration. It can be used quantitatively or qualitatively, depending on the research question. Challenges in using observation relate to adopting the role of participant or non-participant researcher as observer. This article discusses some of the complexities involved when nurse researchers seek to collect observational data on social processes in naturalistic settings using unstructured or structured observational methods in qualitative research methodology. A glossary of research terms is provided.

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Nuffield Home Economics is the first major curriculum development for pupils in the 13-16 age-range. The materials are designed to cover home economics education in two phases: a basic course for pupils up to the age of 14 years and a 2-year second-phase course to include the 16+ examination. The subject is divided into four areas of study: I. Food science. Food as a resource; the biological, chemical and physical nature of food; the principles of food handling; the methods of preparation and cooking and their effects on food (Nuffield Home Economics, 1983d,e, 2. Nutrition. The study of people and food; evidence of the effects of different diets on growth and health; current viewpoints (Nuffield Home Economics, 3. Fibres and fabrics. Materials and their properties; the importance of textiles in daily life from bandages to car tyres; the principles behind textiles, dress and fashion (Nuffield Home Economics, 1983a,b,c). 4. People and homes. Homes as shelters and ways of meeting individual and family needs; the scientific principles underlying the effective and economic management of the home and its equipment; child care and development (Nuffield Home Economics, 1984e,f,g).

Excessive use of alcohol can be a cause for many disease and injury conditions. These include amongst many others, myocardial infarction, diabetes mellitus, atrial fibrillation, nonischaemic cardiomyopathy, fetal alcohol spectrum disorder (FASD), congenital heart defects (CHD) and liver cirrhosis. Even low levels of prenatal alcohol (ethanol) exposure, such as in a single dose, can produce birth defects termed fetal alcohol syndrome (FAS) which is the highest marker on the spectrum. Diabetes is regarded as a major cause of cardiovascular disease whilst prenatal alcohol exposure (PAE) can range from no observable adverse effects to mortality. CHD are stated to be the most prevalent cause of mortality in individuals with FASD. The dimension of the problems is still greatest in the Western world although it is stated to be the leading cause of mental retardation in North America.FASD is a neurodevelopmental disability which can be occasioned when a pregnant woman consumes alcohol. The diagnostic criteria for FASD includes growth impairment, abnormal facial features and neurocognitive impairments. The most frequently reported abnormal facial features in FASD are thin upper lip, indistinct or smooth philtrum and short palpebral fissure length. Other features are microganthia, low set ears, ptosis, absent or indistinct philtral ridge, epicanthal folds, cleft palate, flat nasal bridge and midface hypoplasia. The neurocognitive features commonly reported in FASD are microcephaly, intellectual disability, attention-deficit hyperactivity disorder (ADHD) and behavioural impairments. Central nervous system (CNS) injury is also seen and is debilitating. Structural abnormalities of the CNS can include microcephaly, agenesis/absence of the corpus callosum and multiple severe brain malformations. This review article seeks to address the association of FASD with diabetes and CHD.