Prevention of Fetal Alcohol Spectrum Disorder FASD Who is responsible?

by Clarren, Sterling; Salmon, Amy; Jonsson, Egon

• ISBN13: 9783527329977
• ISBN10: 3527329978
• Edition: 1st
• Format: Hardcover
• Copyright: 2011-05-16
• Publisher: Wiley-Blackwell

Summary

The perfect complementation to "Fetal Alcohol Spectrum Disorder" this title for the first time gives a complete overview of prevention strategies of FADS and their effectiveness on a global scale. A real Must-Have for everyone involved in decisions about FADS prevention measures.

Author Biography

Sterling Clarren is CEO and Scientific Director of the Canada Northwest FASD Research Net work and Clinical Professor of Pediatrics at the University of British Columbia, Canada, and the University of Washington, Seattle. He wrote the first major summary article of the clinical pattern of malformation associated with alcohol teratogenesis in the New England Journal of Medicine in 1978. He was co-author of the 4-Digit Diagnostic Code for FAS and related conditions. Sterling Clarren developed one of the first pediatric clinics focused on the difficult diagnosis of FAS and related conditions. In 2001 he was given the Henry Rosett Award by the Fetal Alcohol Study Croup of the Research Society on Alcoholism. In 2006, he received the Award for Career Excellence from the National Organization for FAS in Washington DC. He lectures internationally and has been a distinguished visiting professor at both Queen's University, and McGill University, Canada. Amy Salmon is Clinical Assistant Professor at the University of British Columbia's School of Population and Public Health and an Adjunct Assistant Professor at the University of Victoria's Centre for Community Health Promotion Research. She also holds a research appointment at the Women's Health Research Institute, the research arm of BC Women's Hospital and Health Centre, in Vancouver. Prior to assuming the role of Managing Director with the Canada Northwest FASD Research Network, Amy Salmon was an Investigator in Addictions Research at the BC Centre of Excellence for Women's Health. Amy Salmon's research has focused on the factors that improve or compromise access to health care for women with substance use problems, and on effects of participation in harm-reduction oriented community and hospital-based services. Egon Jonsson is Executive Director and CEO of the Institute of Health Economics, and Adjunct Professor at the University of Alberta and the University of Calgary, public health sciences. For 20 years he was a professor of health economics at the Karolinska Institute, Stockholm, Sweden. He was also Director of the Swedish Council on Health Technology Assessment SBU, worked for WHO Euro, and was a health policy advisor at the Ministry of Health in Hanoi, Vietnam. He is editor of the Health Care and Disease Management series and has co-edited two success ful Wiley-VCH titles during his time at SBU: Treating and Preventing Obesity and Treating Alcohol and Drug Abuse.

Table of Contents

Preface	p. XI
List of Contributors	p. XIII
Introduction	p. 1
The Content of This Book	p. 2
What is FASD?	p. 4
How Common is FASD?	p. 5
What is the Economic Burden of FASD?	p. 6
Annual Cost Per Person with FASD	p. 6
Comparing Costs	p. 7
Cost of Prevention versus Cost of Inaction	p. 8
Approaches to FASD Prevention	p. 9
Universal Prevention	p. 9
Screening for Prenatal Alcohol Exposure in Obstetric Settings	p. 11
Meconium Testing	p. 12
Maternal Self-Reporting	p. 12
Selective Prevention	p. 13
Indicated Prevention	p. 14
FASD Prevention in Aboriginal Communities	p. 16
Main obstacles to Preventing FASD	p. 17
Challenges in Measuring Effectiveness of FASD Prevention Initiatives	p. 18
Who is Responsible for the Prevention of FASD?	p. 19
References	p. 21
An Overview of Systematic Reviews on the Prevention, Diagnosis, and Treatment of Fetal Alcohol Spectrum Disorder	p. 27
Introduction	p. 32
Objective and Scope	p. 34
	p. 34
Elements of Assessment	p. 34
Results	p. 35
Search Results	p. 35
Characteristics of Systematic Reviews Included in the Overview	p. 36
Systematic Reviews on Prevention of FASD and Prenatal Alcohol Use	p. 37
General Characteristics	p. 37
Methodological Characteristics of Systematic Reviews on Prevention of FASD and Prenatal Alcohol Use	p. 40
Methodological Quality of Systematic Reviews on Prevention of FASD and Prenatal Alcohol Use	p. 42
Characteristics of the Evidence Presented in the Systematic Reviews on Prevention Approaches to FASD and Prenatal Alcohol Use	p. 43
Qualitative Synthesis of the Evidence on the Effectiveness of Prevention Approaches to FASD and Prenatal Alcohol Use	p. 44
Highlights of the Overall Results	p. 51
Systematic Reviews on the Diagnosis of FASD	p. 54
General Characteristics	p. 54
Methodological Characteristics of the Systematic Review on Diagnosis of FASD	p. 55
Methodological Quality of Systematic Reviews on Diagnosis of FASD	p. 55
Characteristics of the Evidence Presented in the Systematic Review on the Effectiveness of Diagnostic Approaches to FASD	p. 56
Qualitative Synthesis of the Evidence on the Effectiveness of Diagnostic Approaches to FASD	p. 57
Highlights of the Overall Results	p. 59
Systematic Reviews on the Treatment of FASD	p. 59
General Characteristics	p. 59
Methodological Characteristics of Systematic Reviews on Therapeutic Approaches to FASD	p. 61
Methodological Quality of Systematic Reviews on Therapeutic Approaches to FASD	p. 62
Characteristics of the Evidence Presented in the Systematic Reviews on Therapeutic Approaches to FASD	p. 62
Qualitative Synthesis of the Evidence on the Effectiveness of Therapeutic Approaches to FASD	p. 64
Highlights of the Overall Results	p. 69
Discussion	p. 69
FASD Prevention	p. 71
FASD Diagnosis	p. 72
FASD Treatment	p. 73
Methodological Quality of the Overview of Systematic Reviews	p. 73
Strengths and Limitations	p. 73
Conclusions	p. 74
Methodology	p. 74
Search Strategy	p. 74
Study Selection Process	p. 74
Data Extraction	p. 78
Methodological Quality Assessment	p. 78
Data Analysis and Synthesis of the Results	p. 81
Excluded Studies and Multiple Publications	p. 81
Excluded Research Studies	p. 81
Multiple Publications of Studies Included in the Review	p. 83
Summary Tables of Overall Characteristics of Systematic Reviews on Prevention, Diagnosis, and Treatment of FASD	p. 84
Methodological Quality of Systematic Reviews Included in the Overview	p. 93
References	p. 96
A Systematic Review of the Effectiveness of Prevention Approaches for Fetal Alcohol Spectrum Disorder	p. 99
Introduction	p. 105
Objective and Scope	p. 108
Methodological Approach	p. 108
Elements of Assessment	p. 108
Studies on the Effectiveness of FASD Preventive Approaches	p. 109
Search Results	p. 109
Characteristics of Included Studies	p. 110
General Characteristics	p. 110
Characteristics of the Populations	p. 111
Characteristics of the Interventions	p. 112
Components of the Interventions	p. 113
Characteristics of the Outcomes	p. 115
Types of Result Reported in the Individual Studies	p. 115
Methodological Quality of the Studies	p. 118
Highlights of the Overall Results	p. 119
Populations	p. 120
Interventions	p. 120
Outcomes	p. 120
Methodological Quality	p. 121
Evidence on the Effectiveness of Universal Prevention Approaches for FASD	p. 121
Characteristics of Included Studies	p. 121
General Characteristics	p. 121
Characteristics of the Populations	p. 122
Characteristics of the Interventions	p. 122
Components of the Interventions	p. 125
Characteristics of the Outcomes	p. 125
Types of Result Reported in the Individual Studies	p. 125
Methodological Quality of the Studies	p. 128
Results of Qualitative Synthesis of the Evidence	p. 130
Clinical Trials	p. 130
Observational Studies	p. 131
Summary of the Overall Results	p. 137
General Characteristics	p. 137
Populations	p. 137
Interventions	p. 137
Outcomes	p. 137
Methodological Quality of the Studies	p. 138
Evidence on the Effectiveness of Universal Prevention Approaches	p. 138
Evidence on the Effectiveness of Selective Prevention Approaches for FASD	p. 145
Characteristics of Included Studies	p. 145
General Characteristics	p. 145
Characteristics of the Populations	p. 145
Characteristics of the Interventions	p. 146
Components of the Interventions	p. 147
Characteristics of the Outcomes	p. 149
Types of Result Reported in the Individual Studies	p. 149
Methodological Quality of the Studies	p. 152
Results of Qualitative Synthesis of the Evidence	p. 154
Clinical Trials	p. 154
Observational Studies	p. 162
Summary of the Overall Results	p. 164
General Characteristics	p. 164
Populations	p. 165
Interventions	p. 165
Outcomes	p. 165
Methodological Quality of the Studies	p. 165
Evidence on the Effectiveness of Selective Prevention Approaches	p. 165
Evidence on the Effectiveness of Indicated Prevention Approaches for FASD	p. 173
Characteristics of Included Studies	p. 173
General Characteristics	p. 173
Characteristics of the Populations	p. 174
Characteristics of the Interventions	p. 174
Components of the Interventions	p. 175
Characteristics of the Outcomes	p. 176
Types of Result Reported in the Individual Studies	p. 178
Methodological Quality of the Studies	p. 178
Results of Qualitative Synthesis of the Evidence	p. 180
Clinical Trials	p. 182
Observational Studies	p. 182
Summary of the Overall Results	p. 184
General Characteristics	p. 184
Populations	p. 185
Interventions	p. 185
Outcomes	p. 185
Methodological Quality of the Studies	p. 185
Evidence on the Effectiveness of Indicated Prevention Approaches	p. 185
Analysis of Publication Bias	p. 189
Discussion	p. 189
Characteristics of the Study. Populations	p. 189
Characteristics of the Interventions	p. 192
Characteristics of Study Outcomes	p. 192
Methodological Quality of the Studies	p. 192
Main Findings	p. 193
Universal Prevention Approaches	p. 93
Selective Prevention Approaches	p. 194
Indicated Prevention Approaches	p. 195
Strengths and Limitations	p. 195
Methodological Issues and Research Directions in the Evaluation of FASD Prevention Interventions	p. 196
Conclusions	p. 198
Acknowledgments	p. 199
Competing Interest	p. 200
Methodology	p. 200
Search Strategy	p. 200
Study Selection Process	p. 207
Data Extraction	p. 208
Methodological Quality Assessment	p. 208
Data Analysis and Synthesis of the Results	p. 213
Excluded Studies, Multiple Publications and Studies Pending Full Publication	p. 213
Excluded Research Studies	p. 213
Multiple Publications of Studies Included in the Review	p. 212
Studies Pending Full Publication	p. 223
Summary Tables of Overall Characteristics of Studies on Prevention Approaches to FASD	p. 224
Operational Definitions of Prevention Approaches to FASD	p. 235
Study Evidence Tables	p. 240
Characteristics of the Interventions	p. 304
Methodological Quality of the Studies Included in the Review	p. 320
References	p. 330
Five Perspectives on Prevention of FASD	p. 337
Pre-Conception Initiatives	p. 337
Inventory of Primary Prevention Campaigns	p. 340
Primary Care Physician Perspective	p. 343
Mentoring Programs for At Risk Mothers	p. 345 PCAP Stu
Strength and Support: A Women's Perspective	p. 350
Recommendations	p. 356
References	p. 357
Appendices	p. 359
Abbreviations	p. 359
Glossary	p. 360
References	p. 364
Index	p. 365
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