Matching Items (226)
Description
Gender and sex are often conflated. Our laws, policies, and even science establish sex and gender as intrinsically linked and dimorphic in nature. This dissertation examines the relationship between sex and gender and the repercussions of this linked dimorphism in the realms of law, politics, and science. Chapter One identifies the legal climate for changing one's sexual identity post-surgical reassignment. It pays particular attention to the ability of postsurgical transsexuals to marry in their acquired sex. Chapter Two considers the process for identifying the sex of athletes for the purposes of participation in sex-segregated athletic events, specifically the role of testing and standards for categorization. Chapter Three explores the process of identifying and assigning the sex of intersex children. Chapter Four examines the process of prenatal sex selection and its ethical implications. Chapter Four also offers an anticipatory governance framework to address these implications.
ContributorsParsi, John (Author) / Crittenden, Jack (Thesis advisor) / Guston, David H. (Committee member) / Marchant, Gary (Committee member) / Arizona State University (Publisher)
Created2013
Description
ABSTRACT Whole genome sequencing (WGS) and whole exome sequencing (WES) are two comprehensive genomic tests which use next-generation sequencing technology to sequence most of the 3.2 billion base pairs in a human genome (WGS) or many of the estimated 22,000 protein-coding genes in the genome (WES). The promises offered from WGS/WES are: to identify suspected yet unidentified genetic diseases, to characterize the genomic mutations in a tumor to identify targeted therapeutic agents and, to predict future diseases with the hope of promoting disease prevention strategies and/or offering early treatment. Promises notwithstanding, sequencing a human genome presents several interrelated challenges: how to adequately analyze, interpret, store, reanalyze and apply an unprecedented amount of genomic data (with uncertain clinical utility) to patient care? In addition, genomic data has the potential to become integral for improving the medical care of an individual and their family, years after a genome is sequenced. Current informed consent protocols do not adequately address the unique challenges and complexities inherent to the process of WGS/WES. This dissertation constructs a novel informed consent process for individuals considering WGS/WES, capable of fulfilling both legal and ethical requirements of medical consent while addressing the intricacies of WGS/WES, ultimately resulting in a more effective consenting experience. To better understand components of an effective consenting experience, the first part of this dissertation traces the historical origin of the informed consent process to identify the motivations, rationales and institutional commitments that sustain our current consenting protocols for genetic testing. After understanding the underlying commitments that shape our current informed consent protocols, I discuss the effectiveness of the informed consent process from an ethical and legal standpoint. I illustrate how WGS/WES introduces new complexities to the informed consent process and assess whether informed consent protocols proposed for WGS/WES address these complexities. The last section of this dissertation describes a novel informed consent process for WGS/WES, constructed from the original ethical intent of informed consent, analysis of existing informed consent protocols, and my own observations as a genetic counselor for what constitutes an effective consenting experience.
ContributorsHunt, Katherine (Author) / Hurlbut, J. Benjamin (Thesis advisor) / Robert, Jason S. (Thesis advisor) / Maienschein, Jane (Committee member) / Northfelt, Donald W. (Committee member) / Marchant, Gary (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2013
Description
Neuroimaging has appeared in the courtroom as a type of `evidence' to support claims about whether or not criminals should be held accountable for their crimes. Yet the ability to abstract notions of culpability and criminal behavior with confidence from these imagines is unclear. As there remains much to be discovered in the relationship between personal responsibility, criminal behavior, and neurological abnormalities, questions have been raised toward neuroimaging as an appropriate means to validate these claims.
This project explores the limits and legitimacy of neuroimaging as a means of understanding behavior and culpability in determining appropriate criminal sentencing. It highlights key philosophical issues surrounding the ability to use neuroimaging to support this process, and proposes a method of ensuring their proper use. By engaging case studies and a thought experiment, this project illustrates the circumstances in which neuroimaging may assist in identifying particular characteristics relevant for criminal sentencing.
I argue that it is not a question of whether or not neuroimaging itself holds validity in determining a criminals guilt or motives, but rather a proper application of the issue is to focus on the way in which information regarding these images is communicated from the `expert' scientists to the `non-expert' making decisions about the sentence that are most important. Those who are considering this information's relevance, a judge or jury, are typically not well versed in criminal neuroscience and interpreting the significance of different images. I advocate the way in which this information is communicated from the scientist-informer to the decision-maker parallels in importance to its actual meaning.
As a solution, I engage Roger Pielke's model of honest brokering as a solution to ensure the appropriate use of neuroimaging in determining criminal responsibility and sentencing. A thought experiment follows to highlight the limits of science, engage philosophical repercussions, and illustrate honest brokering as a means of resolution. To achieve this, a hypothetical dialogue reminiscent of Kenneth Schaffner's `tools for talking' with behavioral geneticists and courtroom professionals will exemplify these ideas.
This project explores the limits and legitimacy of neuroimaging as a means of understanding behavior and culpability in determining appropriate criminal sentencing. It highlights key philosophical issues surrounding the ability to use neuroimaging to support this process, and proposes a method of ensuring their proper use. By engaging case studies and a thought experiment, this project illustrates the circumstances in which neuroimaging may assist in identifying particular characteristics relevant for criminal sentencing.
I argue that it is not a question of whether or not neuroimaging itself holds validity in determining a criminals guilt or motives, but rather a proper application of the issue is to focus on the way in which information regarding these images is communicated from the `expert' scientists to the `non-expert' making decisions about the sentence that are most important. Those who are considering this information's relevance, a judge or jury, are typically not well versed in criminal neuroscience and interpreting the significance of different images. I advocate the way in which this information is communicated from the scientist-informer to the decision-maker parallels in importance to its actual meaning.
As a solution, I engage Roger Pielke's model of honest brokering as a solution to ensure the appropriate use of neuroimaging in determining criminal responsibility and sentencing. A thought experiment follows to highlight the limits of science, engage philosophical repercussions, and illustrate honest brokering as a means of resolution. To achieve this, a hypothetical dialogue reminiscent of Kenneth Schaffner's `tools for talking' with behavioral geneticists and courtroom professionals will exemplify these ideas.
ContributorsTaddeo, Sarah (Author) / Robert, Jason S (Thesis advisor) / Marchant, Gary (Committee member) / Hurlbut, James B (Committee member) / Arizona State University (Publisher)
Created2014
Description
A novel clustered regularly interspaced short palindromic repeats/CRISPR-associated (CRISPR/Cas) tool for simultaneous gene editing and regulation was designed and tested. This study used the CRISPR-associated protein 9 (Cas9) endonuclease in complex with a 14-nucleotide (nt) guide RNA (gRNA) to repress a gene of interest using the Krüppel associated box (KRAB) domain, while also performing a separate gene modification using a 20-nt gRNA targeted to a reporter vector. DNA Ligase IV (LIGIV) was chosen as the target for gene repression, given its role in nonhomologous end joining, a common DNA repair process that competes with the more precise homology-directed repair (HDR).
To test for gene editing, a 20-nt gRNA was designed to target a disrupted enhanced green fluorescent protein (EGFP) gene present in a reporter vector. After the gRNA introduced a double-stranded break, cells attempted to repair the cut site via HDR using a DNA template within the reporter vector. In the event of successful gene editing, the EGFP sequence was restored to a functional state and green fluorescence was detectable by flow cytometry. To achieve gene repression, a 14-nt gRNA was designed to target LIGIV. The gRNA included a com protein recruitment domain, which recruited a Com-KRAB fusion protein to facilitate gene repression via chromatin modification of LIGIV. Quantitative polymerase chain reaction was used to quantify repression.
This study expanded upon earlier advancements, offering a novel and versatile approach to genetic modification and transcriptional regulation using CRISPR/Cas9. The overall results show that both gene editing and repression were occurring, thereby providing support for a novel CRISPR/Cas system capable of simultaneous gene modification and regulation. Such a system may enhance the genome engineering capabilities of researchers, benefit disease research, and improve the precision with which gene editing is performed.
To test for gene editing, a 20-nt gRNA was designed to target a disrupted enhanced green fluorescent protein (EGFP) gene present in a reporter vector. After the gRNA introduced a double-stranded break, cells attempted to repair the cut site via HDR using a DNA template within the reporter vector. In the event of successful gene editing, the EGFP sequence was restored to a functional state and green fluorescence was detectable by flow cytometry. To achieve gene repression, a 14-nt gRNA was designed to target LIGIV. The gRNA included a com protein recruitment domain, which recruited a Com-KRAB fusion protein to facilitate gene repression via chromatin modification of LIGIV. Quantitative polymerase chain reaction was used to quantify repression.
This study expanded upon earlier advancements, offering a novel and versatile approach to genetic modification and transcriptional regulation using CRISPR/Cas9. The overall results show that both gene editing and repression were occurring, thereby providing support for a novel CRISPR/Cas system capable of simultaneous gene modification and regulation. Such a system may enhance the genome engineering capabilities of researchers, benefit disease research, and improve the precision with which gene editing is performed.
ContributorsChapman, Jennifer E (Author) / Kiani, Samira (Thesis advisor) / Ugarova, Tatiana (Thesis advisor) / Marchant, Gary (Committee member) / Arizona State University (Publisher)
Created2018
Description
The purpose of this study was to create a screening tool specifically for the identification of sex trafficking victims in the medical setting through the analysis of existing human trafficking screening tool studies geared towards use in the medical setting. Screening questions from these studies were compiled and modified into a survey that was distributed to healthcare professionals through the nationwide HEAL (Health Professional Education, Advocacy, Linkage) Trafficking listserv. Each screening tool study demonstrated benefits and disadvantages that were helpful in the sampling and selection of screening tool questions. The small sample size and a lack of data on the attitudes of medical professionals on sex trafficked victims were noted as limitations to this study. Further implications for this study would include validating the screening tool questions in a medical setting to determine the sensitivity of the survey in identifying patients as possible sex trafficking victims.
ContributorsCatano, Karen Samantha (Co-author) / Byun, Jiwon (Co-author) / Roe-Sepowitz, Dominique (Thesis director) / Lee, Maurice (Committee member) / School for the Science of Health Care Delivery (Contributor) / College of Integrative Sciences and Arts (Contributor) / W.P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The term "Children with Special Health Care Needs," often abbreviated as CSHCN, is an umbrella term, encompassing a wide variety of children with a range of health conditions. As of 2011, CSHCN constituted 15-20% of all children age 0-17 in the United States (Bethell et al., 2013). Despite this, CSHCN "account for 80% of all pediatric medical expenses." (Hardy, Vivier, Rivara, & Melzer, 2012). This project specifically compares children with physical disability and behavioral disability in hopes of gaining a greater insight into both groups, assessing/comparing differences, and evaluating whether or not having a co-morbidity has a mediating or contending effect on care coordination.
ContributorsDevineni, Asha (Author) / McCullough, Mac (Thesis director) / Reddy, Swapna (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
The Paradise Valley Family Resource Center (PVFRC) is a not for profit, community based organization funded by First Things First and a part of the Paradise Valley Unified School District (PVUSD) in Phoenix, Arizona. The mission of this organization is to connect and strengthen families with children from birth to five years old in the Phoenix valley. The PVFRC longed to be more cognizant of what the needs of the community they serve are, and how they, as an organization, can administer programs of value to the community. Hence, the PVFRC entered a partnership with the Community Action Research Experiences (CARE) program at Arizona State University to develop a research proposal to improve their effectiveness and efficiency at achieving their mission. The purpose of this research project was to identify and evaluate the needs of the families with children ages birth to five within the community, to improve upon existing programs and services or to implement new programs, and to discover more effective modes of awareness and advertisement to the community about the programs and services the PVFRC provides. The main research questions of the experiment included asking participants about what programs and services they need, wish, or want to exist at the PVFRC, what barriers or gaps they see or experience regarding attending the PVFRC, how did participants learn about the PVFRC, and what are the best ways to contact families in their community. The methods of the research included conducting focus group interviews with families who utilize the programs and services at the PVFRC and with early childhood professionals in the Paradise Valley Unified School District (PVUSD), which included social workers and preschool teachers. A total of 25 participants were interviewed (10 families, 6 social workers, and 9 preschool teachers) and responses from the interviews were coded by the researcher. The results of the research was that the PVFRC is meeting many needs and current families are satisfied, participants desire some changes to current programs and services, and the best modes of advertisement and awareness were "word of mouth" and the internet. It was recommended that in order to better achieve their mission, it is advised that the PVFRC make appropriate changes to programs and services as suggested by the participants, connect with mom's or parents groups in the community, collaborate with preschool teachers on the front line, and increase their online presence through the use of social media and their website.
ContributorsHoran, Mary Jensen (Author) / Foster, Stacie (Thesis director) / Brougham, Jennifer (Committee member) / Dumka, Larry (Committee member) / T. Denny Sanford School of Social and Family Dynamics (Contributor) / School of Molecular Sciences (Contributor) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Breast and other solid tumors exhibit high and varying degrees of intra-tumor heterogeneity resulting in targeted therapy resistance and other challenges that make the management and treatment of these diseases rather difficult. Due to the presence of admixtures of non-neoplastic cells with polyclonal cell populations, it is difficult to define cancer genomes in patient samples. By isolating tumor cells from normal cells, and enriching distinct clonal populations, clinically relevant genomic aberrations that drive disease can be identified in patients in vivo. An in-depth analysis of clonal architecture and tumor heterogeneity was performed in a stage II chemoradiation-naïve breast cancer from a sixty-five year old patient. DAPI-based DNA content measurements and DNA content-based flow sorting was used to to isolate nuclei from distinct clonal populations of diploid and aneuploid tumor cells in surgical tumor samples. We combined DNA content-based flow cytometry and ploidy analysis with high-definition array comparative genomic hybridization (aCGH) and next-generation sequencing technologies to interrogate the genomes of multiple biopsies from the breast cancer. The detailed profiles of ploidy, copy number aberrations and mutations were used to recreate and map the lineages present within the tumor. The clonal analysis revealed driver events for tumor progression (a heterozygous germline BRCA2 mutation converted to homozygosity within the tumor by a copy number event and the constitutive activation of Notch and Akt signaling pathways. The highlighted approach has broad implications in the study of tumor heterogeneity by providing a unique ultra-high resolution of polyclonal tumors that can advance effective therapies and clinical management of patients with this disease.
ContributorsLaughlin, Brady Scott (Author) / Ankeny, Casey (Thesis director) / Barrett, Michael (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor) / School for the Science of Health Care Delivery (Contributor)
Created2015-05
Description
Considering the overwhelming prevalence of BPH, how can it best be managed in light of the aging population? The purpose of this investigation is to illustrate that BPH and LUTS are conditions that are highly conducive to health literacy technology interventions. This objective will be met by: a) Providing an overview of the clinically relevant information regarding BPH, including anatomy, physiology, epidemiology, symptoms, and medical treatment for the disease; b) Establishing the necessity for novel health care delivery solutions by identifying past successes and challenges associated with technologic advances in related fields; c) Providing evidence of a lack of a systematic approach to BPH education, especially as it relates to health literacy. The relative successes and failures of previously established clinical decision aids will be discussed, leading to recommendations on how to improve upon these standards. Finally, the procedures and results of a pilot study will be analyzed in an effort to further highlight the necessity of engaging patients in the clinical decision making process.
ContributorsMelikian, Robert Jeffrey (Author) / Santanam, Raghu (Thesis director) / Humphreys, Mitchell (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / School of Historical, Philosophical and Religious Studies (Contributor) / School for the Science of Health Care Delivery (Contributor)
Created2014-12
Description
Ruptures in the anterior cruciate ligament are a prevalent injury, particularly in young athletes. This injury is frequently treated with surgical repair utilizing autologous tissue, cadaver allografts or synthetic grafts. However there is no definitive answer on which is the best graft option. This review aims to compare clinical results of patellar tendon autograft (PT), hamstring autograft (HT), cadaver allograft and LARS synthetic ligament in ACL reconstruction. The ASU library was systematically searched for comparison studies or meta-analyses that compared or described ACL reconstruction graft options. The results of the studies were analyzed according to re-tear rate, return to pre-injury level of activity, KT-1000 laxity scores, post-operative muscle strength, International Knee Documentation Committee Score (IKDC), Lysholm score, Lachman test and donor site morbidity. Allografts showed the highest re-tear rate and increase in laxity when compared with the PT autograft and HT autograft. PT autograft provided the most stability according to the KT-1000 results. Knee extensor muscle strength was not graft dependent, but knee flexor strength decreased significantly in HT autograft patients. All grafts showed comparable results for IKDC, Lysholm scores and Lachman tests. There was increased anterior knee pain in PT autograft patients however this did not seem to have an affect on the stability or durability of the graft. The PT autograft is the best choice for individuals undergoing ACL reconstruction on the basis of lower re-tear rates and greater joint stability.
ContributorsNormen, Eliza Armstrong (Author) / Broman, Tannah (Thesis director) / Harper, Erin (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor) / School for the Science of Health Care Delivery (Contributor)
Created2015-05