Usage Of Norms Research Articles

A-146 Neuropsychological Evaluation and Outcomes of Acute Lymphoblastic Leukemia Treated with Chemotherapy in a Transgender Adolescent Male: A Case Study

Abstract Objective: Transgender youth face enormous barriers to accessing medically necessary gender-transition-related care, including neuropsychological evaluation. Normative data for cognitive and psychological measures have not been developed for transgender individuals, creating a dilemma for neuropsychologists. Sex-based differences in certain domains and literature identifying brain-based changes with hormone therapy are additional factors. The aim of this study is to discuss unique considerations when evaluating medically complex transgender individuals. Method: A 14-year-old transgender male (assigned female at birth) with a history of acute lymphoblastic leukemia treated with chemotherapy, presented for evaluation to assess late effects of treatment and psychiatric complexities. He experienced gender dysphoria since childhood, identified as non-binary during early adolescence, and recently identified as male. He had not yet begun medical treatment (puberty blockers, hormone therapy) related to gender-affirming care. Results: Thoughtful consideration informed by current literature was made regarding test selection, norm usage, and data interpretation. Gender combined norms were used when available. Norms based on preferred or birth-assigned gender were used within the context of known sex-based differences in certain domains and low likelihood of brain-based changes at this time. Results revealed average or better performance across most domains, mild weakness in visual-motor integration and motor-dependent processing speed, and anxiety. Conclusion: Outcomes were believed related to chemotherapeutic late effects along with complex psychosocial factors. This case highlights the need for a thoughtful approach to the neuropsychological evaluation of transgender youth from test and norm selection to data interpretation along with consideration of unique psychosocial factors which are likely to be present for transgender individuals.

Classifying sanctions and designing a conceptual sanctioning process model for socio-technical systems

AbstractWe understand a socio-technical system (STS) as a cyber-physical system in which two or more autonomous parties interact via or about technical elements, including the parties’ resources and actions. As information technology begins to pervade every corner of human life, STSs are becoming ever more common, and the challenge ofgoverningSTSs is becoming increasingly important. We advocate a normative basis for governance, whereinnormsrepresent the standards of correct behaviour that each party in an STS expects from others. A major benefit of focussing on norms is that they provide a socially realistic view of interaction among autonomous parties that abstracts low-level implementation details. Overlaid on norms is the notion of asanctionas a negative or positive reaction to potentially any violation of or compliance with an expectation. Although norms have been well studied as regards governance for STSs, sanctions have not. Our understanding and usage of norms is inadequate for the purposes of governance unless we incorporate a comprehensive representation of sanctions.We address the aforementioned gap by proposing (i) a sanction typology that reflects the relevant features of sanctions, and (ii) a conceptual sanctioning process model providing a functional structure for sanctioning in STS. We demonstrate our contributions via a motivating scenario from the domain of renewable energy trading.