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Despite the arid climate of Maricopa County, Arizona, vector-borne diseases have presented significant health challenges to the residents and public health professionals of Maricopa County in the past, and will continue to do so in the foreseeable future. Currently, West Nile virus is the only mosquitoes-transmitted disease actively, and natively,

Despite the arid climate of Maricopa County, Arizona, vector-borne diseases have presented significant health challenges to the residents and public health professionals of Maricopa County in the past, and will continue to do so in the foreseeable future. Currently, West Nile virus is the only mosquitoes-transmitted disease actively, and natively, transmitted throughout the state of Arizona. In an effort to gain a more complete understanding of the transmission dynamics of West Nile virus this thesis examines human, vector, and environment interactions as they exist within Maricopa County. Through ethnographic and geographic information systems research methods this thesis identifies 1) the individual factors that influence residents' knowledge and behaviors regarding mosquitoes, 2) the individual and regional factors that influence residents' knowledge of mosquito ecology and the spatial distribution of local mosquito populations, and 3) the environmental, demographic, and socioeconomic factors that influence mosquito abundance within Maricopa County. By identifying the factors that influence human-vector and vector-environment interactions, the results of this thesis may influence current and future educational and mosquito control efforts throughout Maricopa County.
ContributorsKunzweiler, Colin (Author) / Boone, Christopher (Thesis advisor) / Wutich, Amber (Committee member) / Brewis-Slade, Alexandra (Committee member) / Arizona State University (Publisher)
Created2013
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Corporations in biomedicine hold significant power and influence, in both political and personal spheres. The decisions these companies make about ethics are critically important, as they help determine what products are developed, how they are developed, how they are promoted, and potentially even how they are regulated. In the last

Corporations in biomedicine hold significant power and influence, in both political and personal spheres. The decisions these companies make about ethics are critically important, as they help determine what products are developed, how they are developed, how they are promoted, and potentially even how they are regulated. In the last fifteen years, for-profit private companies have been assembling bioethics committees to help resolve dilemmas that require informed deliberation about ethical, legal, scientific, and economic considerations. Private sector bioethics committees represent an important innovation in the governance of emerging technologies, with corporations taking a lead role in deciding what is ethically appropriate or problematic. And yet, we know very little about these committees, including their structures, memberships, mandates, authority, and impact. Drawing on an extensive literature review and qualitative analysis of semi-structured interviews with executives, scientists and board members, this dissertation provides an in-depth analysis of the Ethics and Public Policy Board at SmithKline Beecham, the Ethics Advisory Board at Advanced Cell Technology, and the Bioethics Committee at Eli Lilly and offers insights about how ideas of bioethics and governance are currently imagined and enacted within corporations. The SmithKline Beecham board was the first private sector bioethics committee; its mandate was to explore, in a comprehensive and balanced analysis, the ethics of macro trends in science and technology. The Advanced Cell Technology board was created to be like a watchdog for the company, to prevent them from making major errors. The Eli Lilly board is different than the others in that it is made up mostly of internal employees and does research ethics consultations within the company. These private sector bioethics committees evaluate and construct new boundaries between their private interests and the public values they claim to promote. Findings from this dissertation show that criticisms of private sector bioethics that focus narrowly on financial conflicts of interest and a lack of transparency obscure analysis of the ideas about governance (about expertise, credibility and authority) that emerge from these structures and hamper serious debate about the possible impacts of moving ethical deliberation from the public to the private sector.
ContributorsBrian, Jennifer (Author) / Robert, Jason S (Thesis advisor) / Maienschein, Jane (Committee member) / Hurlbut, James B (Committee member) / Sarewitz, Daniel (Committee member) / Brown, Mark B. (Committee member) / Moreno, Jonathan D. (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their

Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their childbearing goals. Despite the recognized importance of subsidized family planning, services remain funded in a piecemeal fashion. Since the 1940s there have been numerous federal funding sources for family planning, including the Title V Maternal and Child Health Services Program, Office of Economic Opportunity grants, Title XX Social Services Program, Title X Family Planning Program, Medicaid, and the State Children’s Health Insurance Program, alongside state and local support. Spending guidelines allow states varying degrees of flexibility regarding allocation, to best serve the local population. With nearly two billion dollars spent annually on subsidized family planning, criticism often arises surrounding effective local program spending and state politics influencing grant allocation. Political tension regarding the amount of control states should have in managing federal funding is exacerbated in the context of family planning, which has become increasingly controversial among social conservatives in the twenty-first century. This thesis examines how Arizona’s political, geographic, cultural, and ethnic landscape shaped the state management of federal family planning funding since the early twentieth century. Using an extensive literature review, archival research, and oral history interviews, this thesis demonstrates the unique way Arizona state agencies and nonprofits collaborated to maximize the use of federal family planning grants, effectively reaching the most residents possible. That partnership allowed Arizona providers to reduce geographic barriers to family planning in a rural, frontier state. The social and political history surrounding the use of federal family planning funds in Arizona demonstrates the important role states have in efficient, effective, and equitable state implementation of national resources in successfully reaching local populations. The contextualization of government funding of family planning provides insight into recent attempts to defund abortion providers like Planned Parenthood, cut the Title X Family Planning Program, and restructure Medicaid in the twenty-first century.
ContributorsNunez-Eddy, Claudia (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / O'Neil, Erica (Committee member) / Arizona State University (Publisher)
Created2018
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Influenza has shown its potential to affect and even kill millions of people within an extremely short time frame, yet studies and surveys show that the general public is not well educated about the facts about influenza, including prevention and treatment. For this reason, public perception of influenza is extremely

Influenza has shown its potential to affect and even kill millions of people within an extremely short time frame, yet studies and surveys show that the general public is not well educated about the facts about influenza, including prevention and treatment. For this reason, public perception of influenza is extremely skewed, with people generally not taking the disease as seriously as they should given its severity. To investigate the inconsistencies between action and awareness of best available knowledge regarding influenza, this study conducted literature review and a survey of university students about their knowledge, perceptions, and action taken in relationship to influenza. Due to their dense living quarters, constant daily interactions, and mindset that they are "immune" to fairly common diseases like influenza, university students are a representative sample of urban populations. According to the World Health Organization (WHO), 54% of the world's population lived in cities as of 2014 (Urban population growth). Between 2015 and 2020, the global urban population is expected to grow 1.84% per year, 1.63% between 2020 and 2025, and 1.44% between 2025 and 2030 (Urban population growth). Similar projections estimate that by 2017, an overwhelming majority of the world's population, even in less developed countries, will be living in cities (Urban population growth). Results of this study suggest possible reasons for the large gap between best available knowledge and the perceptions and actions of individuals on the other hand. This may lead to better-oriented influenza education initiatives, more effective prevention and treatment plans, and generally raise excitement and awareness surrounding public health and scientific communication.
ContributorsGur-Arie, Rachel Ellen Haviva (Author) / Maienschein, Jane (Thesis director) / Laubichler, Manfred (Committee member) / Creath, Richard (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2014-12
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The study examines cross-cultural perceptions of wastewater reuse from 282 participants from four global sites representing varied levels of socio-economic and political development from the Global North and Global South: Spain, New Zealand, Fiji, and Guatemala. The data comes from the Global Ethnohydrology Survey conducted by the School of Human

The study examines cross-cultural perceptions of wastewater reuse from 282 participants from four global sites representing varied levels of socio-economic and political development from the Global North and Global South: Spain, New Zealand, Fiji, and Guatemala. The data comes from the Global Ethnohydrology Survey conducted by the School of Human Evolution and Social Change during the summer of 2013. The Global Ethnohydrology Study is a transdisciplinary multi-year research initiative that examines the range of variation in local ecological knowledge of water issues, also known as "ethnohydrology." Participants were asked about their willingness, level of disgust, and concern with using treated wastewater for various daily activities. Additionally, they were asked to draw schematic representations of how wastewater should be treated to become drinkable again. Using visual content analysis, the drawings were coded for a variety of treatment levels and specific treatment processes. Conclusions about the perceived health implications from wastewater reuse that can stem from drinking treated wastewater were made. The relationship between humans and wastewater is one that has many direct social and health impacts on communities at large. In reaction to global limitations of freshwater, wastewater serves as a valuable resource to tap into. This research examines the cross-cultural public health concerns about treated wastewater in order to draw conclusions that can aid in strategic implementation of advocacy and public education about wastewater reuse.
ContributorsPatel, Sarah Shakir (Author) / Wutich, Amber (Thesis director) / Rice, Jacelyn (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2015-05
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Understanding more about the similarities and differences in cultural perceptions of climate change-related disease causation can better inform culturally specific public health measures. Using interviews conducted with 685 adults in eight diverse global locations ranging from Fiji and China to England and Phoenix, Arizona, this study explores climate change-disease beliefs

Understanding more about the similarities and differences in cultural perceptions of climate change-related disease causation can better inform culturally specific public health measures. Using interviews conducted with 685 adults in eight diverse global locations ranging from Fiji and China to England and Phoenix, Arizona, this study explores climate change-disease beliefs within and across diverse cultures and comparisons between cultural and scientific models. A cultural consensus analysis was employed to identify a "culturally correct" model for each study site. Next, a scientific model was generated based on current scientific consensus regarding climate change- disease connections. Using the Quadratic Assignment Procedure (QAP), we determined the amount of correlation shared between the scientific model and each cultural model. The analysis revealed a high level of intercorrelation between the models of English speaking, economically developed sites such as Phoenix, Arizona. Additionally, cultural models from the non-English speaking sites were highly intercorrelated with one another. Overall, the English speaking sites tended to have more complex models with a greater density of causal links. Cultural models from the English speaking sites also demonstrated high levels of correlation with the scientific model. In comparison, the cultural models from the non-English speaking sites exhibited little correlation with the scientific model. Based on these findings, we suggest that cultural beliefs related to climate change-related disease causation may be influenced by complex local factors. For example, differences in education and media influences along with localized differences in climate change impacts may, in part, contribute to divergences between the cultural models.
Created2014-05
Description
While women in higher income countries can expect to survive a diagnosis of breast cancer, women in lower- and middle-income countries such as Bangladesh have mortality rates near 50%, suggesting that there are significant barriers to care seeking for breast problems. Given limited literature on barriers to care among native,

While women in higher income countries can expect to survive a diagnosis of breast cancer, women in lower- and middle-income countries such as Bangladesh have mortality rates near 50%, suggesting that there are significant barriers to care seeking for breast problems. Given limited literature on barriers to care among native, rural South Asian populations, this study thus sought to understand 1) the impacts of breast problems on women and their families, including the extent of abuse among women with breast problems, and 2) the barriers and facilitators of care for women with breast problems in rural Bangladesh.

Sixty-three study participants (43 women and 20 men) were interviewed about their experiences. Interviewers elicited barriers to care, facilitators of care, and questions about the attitudes and behaviors of family and community members were in structured interviews.

The study found that breast problems and their treatment put significant resource and emotional strains on the family. Furthermore, over a third of women in this study reported abuse of some kind, with emotional abuse, neglect, and abandonment being the most frequently reported.

The study reinforced barriers to care identified in the literature for South Asian populations, but only a quarter of participants reported stigma of any kind. Lack of knowledge about breast cancer and inability to pay for care were the most frequently reported barriers, followed by access to care and fear of treatment. Facilitators of care among women who received a biopsy point to the importance of support by the husband and husband’s family, as well as the ability to identify economic support for and knowledge about care.

This study contributes to the understanding of two overarching themes: structural violence and the value of women, as well as how these themes influence poor outcomes for women with breast cancer in rural Bangladesh. Suggestions for future studies and short and long-term interventions to address study findings are offered.
ContributorsSteiness, Heather Lynn Story (Author) / Hruschka, Daniel J (Thesis advisor) / Wutich, Amber (Committee member) / Ginsburg, Ophira (Committee member) / Arizona State University (Publisher)
Created2016
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Vaccinations are important for preventing influenza infection. Maximizing vaccination uptake rates (80-90%) is crucial in generating herd immunity and preventing infection incidence. Vaccination of healthcare professionals (HCP) against influenza is vital to infection control in healthcare settings, given their consistent exposure to high-risk patients like: those with compromised immune systems,

Vaccinations are important for preventing influenza infection. Maximizing vaccination uptake rates (80-90%) is crucial in generating herd immunity and preventing infection incidence. Vaccination of healthcare professionals (HCP) against influenza is vital to infection control in healthcare settings, given their consistent exposure to high-risk patients like: those with compromised immune systems, children, and the elderly (Johnson & Talbot, 2011). Though vaccination is vital in disease prevention, influenza vaccination uptake among HCP is low overall (50% on average) (Pearson et al., 2006). Mandatory vaccination policies result in HCP influenza vaccination uptake rates substantially higher than opt-in influenza vaccination campaigns (90% vs. 60%). Therefore, influenza vaccination should be mandatory for HCP in order to best prevent influenza infection in healthcare settings. Many HCP cite individual objections to influenza vaccination rooted in personal doubts and ethical concerns, not best available scientific evidence. Nevertheless, HCP ethical responsibility to their patients and work environments to prevent and lower influenza infection incidence overrules such individual objections. Additionally, mandatory HCP influenza vaccination policies respect HCP autonomy via including medical and religious exemption clauses. While vaccination as a prevention method for influenza is logically sound, individuals’ actions are not always rooted in logic. Therefore, I analyze HCP perceptions and actions toward influenza vaccination in an effort to better explain low HCP uptake rates of the influenza vaccine and individual objections to influenza vaccination. Such analysis can aid in gaining HCP trust when implementing mandatory HCP influenza vaccination policies. In summary, mandatory HCP influenza vaccination policies are ethically justified, effective, scientifically-supported method of maximizing HCP influenza vaccine uptake and minimizing the spread of the influenza virus within healthcare settlings.
ContributorsGur-Arie, Rachel (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, Ben (Thesis advisor) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2016
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In the fifteen years between the discovery of fetal alcohol syndrome (FAS) in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. I examine how scientific,

In the fifteen years between the discovery of fetal alcohol syndrome (FAS) in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. I examine how scientific, social, moral, and political narratives dynamically interacted to construct the risk of drinking during pregnancy and the public health response of health warning labels on alcohol. To situate such phenomena I first observe the closest regulatory precedents, the public health responses to thalidomide and cigarettes, which established a federal response to fetal risk. I then examine the history of how the US defined and responded to the social problem of alcoholism, paying particular attention to the role of women in that process. Those chapters inform my discussion of how the US reengaged with alcohol control at the federal level in the last quarter of the twentieth century. In the 1970s, FAS allowed federal agencies to carve out disciplinary authority, but robust public health measures were tempered by uncertainty surrounding issues of bureaucratic authority over labeling, and the mechanism and extent of alcohol’s impact on development. A socially conservative presidency, dramatic budgetary cuts, and increased industry funding reshaped the public health approach to alcoholism in the 1980s. The passage of labeling in 1988 required several conditions: a groundswell of other labeling initiatives that normalized the practice; the classification of other high profile, socially unacceptable alcohol-related behaviors such as drunk driving and youth drinking; and the creation of a dual public health population that faced increased medical, social, and political scrutiny, the pregnant woman and her developing fetus.
ContributorsO'Neil, Erica (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / Ellison, Karin (Committee member) / Wetmore, Jameson (Committee member) / Arizona State University (Publisher)
Created2016
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Under-representation of women doctors in medical work force despite their overwhelming majority in medical schools is an intriguing social issue for Pakistan raising important questions related to evolving gender relations in Pakistani society. Previous research on the broader issue of under-representation of women in science has focused primarily on the

Under-representation of women doctors in medical work force despite their overwhelming majority in medical schools is an intriguing social issue for Pakistan raising important questions related to evolving gender relations in Pakistani society. Previous research on the broader issue of under-representation of women in science has focused primarily on the structural barriers to women’s advancement. It does not account for the underlying subtle (and changing) gendered power relations that permeate everyday life and which can constrain (or enable) the choices of women. It also does not address how women are not simply constructed as subjects within intersecting power relations, but actively construct meaning in relation to them. It raises interesting questions about the cultural shaping of subjectivities, identities and agency of women within the web of power relations in a society such as Pakistan.

To analyze the underlying dynamics of this issue, this dissertation empirically examines the individual, institutional and social factors which enable or affect the career choices of Pakistani women doctors. Based on the ethnographic data obtained from in-depth, person centered, open ended interviews with sixty women doctors and their families, as well as policy makers and the stake holders in medical education and health administration in Lahore, Pakistan this dissertation seeks to address the complex issues of empowerment and agency in the context of Pakistani women, both in individual and collective sense.

Participation in medical education is ostensibly an empowering act, but dissecting the social relations in which this decision takes place reveals that becoming a doctor actually enmeshes women further in the disciplinary relations within their families and society. Similarly, the medical workplaces of Pakistan are marked by entrenched gendered hierarchies constraining women’s access to resources and their progression through medical career. Finally, the political implications of defining work in medicine, and devaluing care in capitalist economies is explored.
ContributorsMasood, Ayesha (Author) / Tsuda, Takeyuki (Thesis advisor) / Wutich, Amber (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2017