Addressing fetal alcohol sSpectrum disorder : problem intractability and the search for solutions
Bibliographic record
Abstract
The scientific evidence base for Fetal Alcohol Spectrum Disorder (FASD) has rapidly advanced over the past four decades, but attempts to redress the problem have neither significantly reduced alcohol consumption by pregnant women nor addressed the lifetime consequences of FASD for individuals living with FASD or their families. This thesis seeks to explain why the problem of FASD appears so resistant to solution. FASD is characterised by complexity, ambiguity, a lack of agreement on definition and solutions, and resistance to traditional linear solutions: it is a wicked problem. Stakeholders engaging with wicked problems bring diverse frames of reference and preferred definitions of the problem and its solution. The level of contestability and who dominates determines the selected strategy, which may be authoritative, collaborative or competitive. Using a multiple method approach, this research uses archival records and qualitative data from semi-structured interviews, first to tell the story of FASD in the United States of America, Canada and Australia, and then to determine any similarities and differences in public policy approaches over the past forty years. The research finds that those who originally demanded attention to FASD expanded their group to engage those with the status and authority to influence policy solutions. In all countries, privileged medical and academic elites are endowed with technical authority, and their preferred solutions require the problem to be fragmented into measurable parts, with a focus on building an evidence base. FASD is now on governments' formal agendas, but attempts to manage FASD have led to authoritative policy solutions. Original demands have not been addressed: instead, government policy decision-making controls the entry of the problem into the public arena. This research proposes that this is influenced by the overarching problem of alcohol harms in societies where alcohol use is socially and culturally accepted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.054 | 0.074 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.010 | 0.035 |
| Scholarly communication | 0.018 | 0.015 |
| Open science | 0.003 | 0.013 |
| Research integrity | 0.006 | 0.011 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".