• Alignment of stakeholder agendas to facilitate the adoption of school-supervised asthma therapy

      Trivedi, Michelle; Patel, Janki; Hoque, Shushmita; Mizrahi, Raphael; Biebel, Kathleen; Phipatanakul, Wanda; Lemon, Stephenie C; Byatt, Nancy; Gerald, Lynn B; Rosal, Milagros; et al. (WILEY, 2019-12-19)
      Background School-supervised inhaled corticosteroid (ICS) therapy improves pediatric asthma medication adherence, outcomes, and morbidity. However, school-supervised ICS therapy has not been widely adopted into practice. We developed Asthma Link (TM) as a sustainable, low-cost model of school-supervised asthma therapy, designed for real-world adoption. Initial outcomes of Asthma Link (TM) demonstrated a significant improvement in health outcomes. Objective In this study, we examined the perspectives of Asthma Link (TM) participants to identify systems-level barriers and facilitators to refine the Asthma Link (TM) protocol and facilitate real-world uptake of school-supervised asthma therapy. Methods Using qualitative research methods, we interviewed 29 participants in Asthma Link (TM) from 2016 to 2018. Semi-structured interviews were conducted over the phone. Interviews were transcribed and the transcripts were coded to identify major themes within and across stakeholder groups. Results Stakeholders agreed on many facilitators for successful Asthma Link (TM) execution including the brief and easy to follow procedures and the perceived beneficial health impacts for children involved. Some of the barriers identified were deviations from the protocol and insurance companies denying coverage for two inhalers. However, the participants did propose solutions to address these barriers. Conclusion Asthma Link (TM) is a low-cost, sustainable model of school-supervised asthma therapy that leverages the established infrastructure and collaboration of medical providers, school staff, and families. In this study, we elicited the perspectives from these stakeholder groups and identified an agreement in several facilitators, barriers, and proposed solutions that will ultimately inform refinement of the program protocol and support real-world adoption of Asthma Link (TM) and other similar models.
    • C-infinity Smoothing for Weak Solutions of the Inhomogeneous Landau Equation

      Henderson, Christopher; Snelson, Stanley; Univ Arizona, Dept Math (SPRINGER, 2019-11-06)
      We consider the spatially inhomogeneous Landau equation with initial data that is bounded by a Gaussian in the velocity variable. In the case of moderately soft potentials, we show that weak solutions immediately become smooth, and remain smooth as long as the mass, energy, and entropy densities remain under control. For very soft potentials, we obtain the same conclusion with the additional assumption that a sufficiently high moment of the solution in the velocity variable remains bounded. Our proof relies on the iteration of local Schauder-type estimates.
    • Correlating Removal Rate to Directivity in Copper Chemical Mechanical Planarization

      McAllister, Jeffrey; Dadashazar, Hossein; Sampurno, Yasa; Gyu Kim, Sung; Park, Dongyoul; Kwon, Heeill; Lee, Yongbin; Philipossian, Ara; Univ Arizona, Dept Chem & Environm Engn (ELECTROCHEMICAL SOC INC, 2019-11-19)
      The relationship between directivity (Delta) and removal rate (RR) during copper chemical mechanical planarization (CMP) was investigated. We measured the high-frequency shear and normal forces generated by stick-slip (which has been routinely used to explain micro- and nano-scale interactions that lead to material removal), and found there to be a strong correlation between Delta (defined as the ratio of variances in shear force to those of normal force) and copper RR so long as the tribological mechanism remained constant. In cases where the tribological mechanism changed from "boundary lubrication" (BL) to "mixed lubrication" (ML), the slope of the straight-line correlation between Delta and RR was maintained, albeit it was shifted significantly lower. This was due to the ML regime consisting of hydrostatic or buoyant forces supporting the wafer, which led to less variability in frictional forces or less stick-slip events. Additionally, it was found that Delta and RR increased with sliding velocity while in BL due to an increase in stick-slip events. Conversely, Delta and RR decreased at lower sliding velocities while in ML due to an increase in hydrostatic or buoyant force supporting the wafer. (C) 2019 The Electrochemical Society.
    • Impact of Polisher Kinematics and Conditioner Disc Designs on Fluid Transport during Chemical Mechanical Planarization

      McAllister, Jeffrey; Dadashazar, Hossein; Mariscal, Juan Cristobal; Sampurno, Yasa; Philipossian, Ara; Univ Arizona, Dept Chem & Environm Engn (ELECTROCHEMICAL SOC INC, 2019-11-25)
      Fluid film thicknesses were measured and general flow patterns were analyzed during conditioning on a polishing pad using a recently developed UV-enhanced fluorescence experimental technique. The method was used to analyze how conditioners with different working face designs and polisher kinematics (platen angular velocities) affected fluid flow characteristics on the pad surface. In general, fluid film thicknesses followed the same general trends across the pad surface for both disc designs and platen speeds. Regardless of the parameters used, the fluid film was the thickest in sections nearest to the wafer track and was significantly thinner near the center and edge of the pad. For both discs, the time for film thicknesses to reach steady-state increased with distance from the radius. In general, the full-face conditioner had a smaller maximum attainable fluid thickness (MAFT) and time to reach steady-state (TTRSS) as it most effectively expelled (i.e. squeegeed) the fluid off the pad surface. In contrast, the partial-face conditioner had a larger MAFT and TTRSS as its more intricate design allowed for greater fluid retention and generated more back-flow. (c) 2019 The Electrochemical Society.
    • Parametric uncertainty assessment in hydrological modeling using the generalized polynomial chaos expansion

      Hu, Junjun; Chen, Sheng; Behrangi, Ali; Yuan, Huiling; Univ Arizona, Dept Hydrol & Atmospher Sci (ELSEVIER, 2019-12)
      An integrated framework is proposed for parametric uncertainty analysis in hydrological modeling using a generalized polynomial chaos expansion (PCE) approach. PCE represents model output as a polynomial expression in terms of critical random variables that are determined by parameter uncertainties, thus offers an efficient way of sampling without running the original model, which is appealing to computationally expensive models. To demonstrate the applicability of generalized PCE approach, both second- and third-order PCEs (PCE-2 and PCE-3) are constructed for Xinanjiang hydrological model using three selected uncertain parameters. Uncertainties in streamflow predictions are assessed by sampling the random inputs. Results show that: (1) both PCE-2 and PCE-3 are capable of capturing the uncertainty information in hydrological predictions, generating consistent mean, variance, skewness and kurtosis estimates with the standard Monte Carlo (MC) methodology; (2) Using more collocation points and more polynomial terms, PCE-3 approximation slightly improves the model simulation and provides more matched distribution with that of MC compared to PCE-2; (3) the computational cost using the PCE approach is greatly reduced by 71% (20%) with PCE-2 (PCE-3). In general, PCE-2 is recommended to serve as a good surrogate model for Xinanjiang hydrological modelling in future with much higher computation speed, more efficient sampling, and compatible approximation results.
    • Initial assessment of an interprofessional team-delivered telehealth program for patients with epilepsy

      Axon, David Rhys; Taylor, Ann M; Vo, Dylan; Bingham, Jennifer; Univ Arizona, Coll Pharm (ELSEVIER, 2019-12-01)
      Introduction: Epilepsy affects 3.5 million people in the United States (US). Rural-dwelling individuals have less access to healthcare and consequently poorer health outcomes. This study describes the outcomes of an interprofessional telehealth program for rural-dwelling individuals with epilepsy in one US state. Methods: An academic medication therapy management pharmacist provided clinical services to rural-dwelling individuals with epilepsy between November 2015 and June 2018, using video-conferencing technology and follow-up telephonic consultation. Data collected included: demographics, prescribed seizure medications, comorbidities, drug-drug and drug-disease interactions, adverse drug reactions, therapeutic duplications, doserelated safety concerns, adherence concerns, and recommendations to resolve identified issues. Data were summarized using appropriate descriptive statistics. Results: A total of 168 patients (51% male, mean age 28 +/- 15 years), participated in this pilot study. Most participants (94%) were prescribed at least one seizure medication including: benzodiazepines (n = 89), Iamotrigine (n = 58), and levetiracetam (n = 56). The majority (55%) had at least one comorbidity including: mood disorders (n = 49) and psychiatric disorders (n = 26). Common medications with reported precautions for people with a seizure history were: selective serotonin reuptake inhibitors (n = 18), second-generation atypical antipsychotics (n = 17) and benzodiazepines (n = 16). Participants had at least one: drug-disease interaction (33%), drug-drug interaction (54%), adverse drug reaction (37%), therapeutic duplication (13%); dose-related safety concerns (35%); and medication utilization concerns (13%). Discussion: This pharmacist-delivered pilot program was effective in: reaching underserved patients with epilepsy, identifying and recommending resolutions to medication-related problems, and demonstrating the value of pharmacists in an interprofessional team. Further work is warranted to identify telehealth strategies to reduce medication associated problems.
    • Social contributors to cardiometabolic diseases in indigenous populations: an international Delphi study

      Stoner, L; Matheson, A G; Perry, L G; Williams, M A; McManus, A; Holdaway, M; Dimer, L; Joe, J R; Maiorana, A; Univ Arizona, Dept Family & Community Med (W B SAUNDERS CO LTD, 2019-11-01)
      Objective: The objective of this study was to identify priority social factors contributing to indigenous cardiometabolic diseases. Study design: A three-round Delphi process was used to consolidate and compare the opinions of 60 experts in indigenous cardiometabolic health from Australia, New Zealand and the United States. Methods: Round one: three open-ended questions: (i) historical, (ii) economic and (iii) sociocultural factor contributors to cardiometabolic disease risk. Round two: a structured questionnaire based on the results from the first round; items were ranked according to perceived importance. Final round: the items were reranked after receiving the summary feedback. Results: Several key findings were identified: (i) an important historical factor is marginalisation and disempowerment; (ii) in terms of economic and sociocultural factors, the panellists came to the consensus that the socio-economic status and educational inequalities are important; and (iii) while consensus was not reached, economic and educational factors were also perceived to be historically influential. Conclusion: These findings support the need for multilevel health promotion policy. For example, tackling financial barriers that limit the access to health-promoting resources, combined with improving literacy skills to permit understanding of health education. (C) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
    • Beavers alter stream macroinvertebrate communities in north-eastern Utah

      Washko, Susan; Roper, Brett; Atwood, Trisha B.; Univ Arizona, Sch Nat Resources & Environm (WILEY, 2019-12-15)
      Understanding changes in macroinvertebrate communities is important because they play a large role in stream ecosystem functioning, and they are an important food resource for fish. Beaver-induced changes to stream morphology could alter macroinvertebrate communities, which in turn could affect food webs and ecosystem function. However, studies investigating the effects of North American beaver activities on macroinvertebrates are rare in the inter-mountain west, an area with high potential for beaver-assisted restoration. The aim of this study was to quantify differences in the macroinvertebrate community between unaltered segments of streams and within beaver ponds in north-eastern Utah, U.S.A. We assessed macroinvertebrate species richness, biomass, density, functional feeding group composition, mobility group composition, and macroinvertebrate habitat characteristics to test the hypothesis that macroinvertebrate communities will differ among habitat types (undammed stream segments and beaver ponds) in beaver-occupied streams. Beaver pond communities significantly differed from lotic reach communities in many ways. Beaver ponds were less diverse with 25% fewer species. Although there was variability among streams, in general, beaver ponds had 75% fewer individuals and 90% lower total macroinvertebrate biomass compared to lotic reaches. Regarding functional feeding groups, beaver ponds contained more engulfers, while lotic reaches contained more scrapers, filterers, and gatherers. For mobility groups, beaver ponds had more sprawlers, while lotic reaches had more clingers. Swimmers were also more prevalent in lotic reaches, although this is probably due to the abundance of Baetis within lotic reaches. More beaver pond taxa were classified as lentic-dwelling insects, while more lotic reach taxa were categorised as preferring lotic habitats. The creation of ponds by beavers fundamentally altered the macroinvertebrate community in north-eastern Utah streams. Such changes to stream macroinvertebrate communities suggest that recolonisation of beavers across North America may be altering stream functioning and food webs. Our study highlights the need to further investigate the effects of beaver recolonisation on stream communities.
    • Flickers of Freedom and Moral Luck

      Sartorio, Carolina; Univ Arizona (WILEY PERIODICALS, 2019-07-28)
    • The effect of sleep deficiency on esophageal acid exposure of healthy controls and patients with gastroesophageal reflux disease

      Yamasaki, Takahisa; Quan, Stuart F; Fass, Ronnie; Univ Arizona, Coll Med, Asthma & Airway Dis Res Ctr (WILEY, 2019-12-01)
      Background Studies have demonstrated a bi-directional relationship between sleep deficiency and gastroesophageal reflux disease (GERD). However, there is limited data on how sleep deficiency affects esophageal acid exposure. We aimed to compare the effect of sleep deficiency on esophageal acid exposure of healthy controls versus GERD patients. Methods Eleven patients from each of 2 groups were randomized to undergo pH-testing after 2 consecutive days of 7-8 hours of sleep per night (normal sleep) or 2 consecutive days of 4 hours of sleep per night (deficient sleep). All subjects then crossed over to the other arm, after 1-week washout period. While subjects were instructed to follow the study sleep protocol, actigraphy ensured subjects followed required sleeping time during study period. Key Results After normal sleep, all healthy controls had normal esophageal acid exposure. After deficient sleep, 5 healthy controls demonstrated an abnormal pH test. Overall, there was a significant increase in reflux parameters after deficient sleep as compared with normal sleep (% total time-6.15 +/- 5.89 vs 1.74 +/- 1.54, % upright time-4.72 +/- 5.36 vs 0.87 +/- 1.28, P < .05, respectively). After normal sleep, 6 GERD patients (54.5%) demonstrated an abnormal pH-testing. After deficient sleep, 10 GERD patients (90.9%) demonstrated an abnormal pH-testing. GERD patients demonstrated significantly higher reflux parameters than healthy controls after normal sleep (% total time-5.02 +/- 3.45 vs 1.74 +/- 1.54, % upright time-4.11 +/- 3.98 vs 0.87 +/- 1.28, P < .05, respectively). Conclusions & Inferences Sleep deficiency increased esophageal acid exposure in both healthy controls and GERD patients. Sleep deficiency also resulted in abnormal pH tests in almost half of healthy controls.
    • Economic performance of membrane distillation configurations in optimal solar thermal desalination systems

      Karanikola, Vasiliki; Moore, Sarah E.; Deshmukh, Akshay; Arnold, Robert G.; Elimelech, Menachem; Sáez, A. Eduardo; Univ Arizona, Dept Chem & Environm Engn (ELSEVIER, 2019-12-15)
      In this study we provide a comprehensive evaluation of the economic performance and viability of solar membrane distillation (MD). To achieve this goal, process models based on mass and energy balances were used to find the minimum cost of water in MD systems. Three MD configurations: direct contact, sweeping gas, and vacuum MD, were compared in terms of economic cost and energy requirements in optimized, solar-driven desalination systems constrained to produce 10 m(3) d(-1) of distillate from 3.5% or 15% salinity water. Simulation results were used to calculate the water production cost as a function of 13 decision variables, including equipment size and operational variables. Non-linear optimization was performed using the particle swarm algorithm to minimize water production costs and identify optimal values for all decision variables. Results indicate that vacuum MD outperforms alternative MD configurations both economically and energetically, desalting water at a cost of less than $15 per cubic meter of product water (both initial salt levels). The highest fraction of total cost for all configurations at each salinity level was attributed to the solar thermal collectors-approximately 25% of the total present value cost. Storing energy in any form was economically unfavorable; the optimization scheme selected the smallest battery and hot water tank size allowed. Direct contact MD consumed significantly more energy (primarily thermal) than other MD forms, leading to higher system economic costs as well.
    • Alfvénic velocity spikes and rotational flows in the near-Sun solar wind

      Kasper, J C; Bale, S D; Belcher, J W; Berthomier, M; Case, A W; Chandran, B D G; Curtis, D W; Gallagher, D; Gary, S P; Golub, L; et al. (NATURE PUBLISHING GROUP, 2019-12-12)
      The prediction of a supersonic solar wind1 was first confirmed by spacecraft near Earth2,3 and later by spacecraft at heliocentric distances as small as 62 solar radii4. These missions showed that plasma accelerates as it emerges from the corona, aided by unidentified processes that transport energy outwards from the Sun before depositing it in the wind. Alfvénic fluctuations are a promising candidate for such a process because they are seen in the corona and solar wind and contain considerable energy5-7. Magnetic tension forces the corona to co-rotate with the Sun, but any residual rotation far from the Sun reported until now has been much smaller than the amplitude of waves and deflections from interacting wind streams8. Here we report observations of solar-wind plasma at heliocentric distances of about 35 solar radii9-11, well within the distance at which stream interactions become important. We find that Alfvén waves organize into structured velocity spikes with duration of up to minutes, which are associated with propagating S-like bends in the magnetic-field lines. We detect an increasing rotational component to the flow velocity of the solar wind around the Sun, peaking at 35 to 50 kilometres per second-considerably above the amplitude of the waves. These flows exceed classical velocity predictions of a few kilometres per second, challenging models of circulation in the corona and calling into question our understanding of how stars lose angular momentum and spin down as they age12-14.
    • Media Coverage of Climate Change and Sustainable Product Consumption: Evidence from the Hybrid Vehicle Market

      Chen, Yubo; Ghosh, Mrinal; Liu, Yong; Zhao, Liang; Univ Arizona, Mkt, Eller Coll Management; Univ Arizona, Mkt; Univ Arizona, Eller Coll Management (SAGE PUBLICATIONS INC, 2019-12)
      As sustainable consumption becomes increasingly important, firms must better understand the drivers behind the consumption of these products. This article examines the effects of mass media in the context of the U.S. hybrid vehicle market. Drawing on monthly sales data, the authors provide evidence that the general coverage of climate change or global warming by major media outlets exerts an overall positive impact on the sales of hybrid vehicles. This impact mainly comes from the media reports that assert that climate change is occurring. In contrast, media coverage that either denies climate change or holds a neutral stance on the issue has little impact. The authors provide preliminary evidence that a social norm advocating for environmentally friendly consumption plays an important role in how media coverage affects consumer purchase. They provide implications for theory and practice and call for future research that examines the causal impact of media in general on consumer decisions, especially in domains that are crucial for the society.
    • A bifurcation theorem for nonlinear matrix models of population dynamics

      Cushing, J. M.; Farrell, Alex P.; Univ Arizona, Dept Math (TAYLOR & FRANCIS LTD, 2019-12-08)
      We prove a general theorem for nonlinear matrix models of the type used in structured population dynamics that describes the bifurcation that occurs when the extinction equilibrium destabilizes as a model parameter is varied. The existence of a bifurcating continuum of positive equilibria is established, and their local stability is related to the direction of bifurcation. Our theorem generalizes existing theorems found in the literature in two ways. First, it allows for a general appearance of the bifurcation parameter (existing theorems require the parameter to appear linearly). This significantly widens the applicability of the theorem to population models. Second, our theorem describes circumstances in which a backward bifurcation can produce stable positive equilibria (existing theorems allow for stability only when the bifurcation is forward). The signs of two diagnostic quantities determine the stability of the bifurcating equilibrium and the direction of bifurcation. We give examples that illustrate these features.
    • Testing the Rh=ct universe jointly with the redshift-dependent expansion rate and angular-diameter and luminosity distances

      Wan, Hao-Yi; Cao, Shu-Lei; Melia, Fulvio; Zhang, Tong-Jie; Univ Arizona, Appl Math Program, Dept Phys; Univ Arizona, Dept Astron (ELSEVIER, 2019-12)
      We use three different data sets, specifically H(z) measurements from cosmic chronometers, the HII-galaxy Hubble diagram, and reconstructed quasar-core angular-size measurements, to perform a joint analysis of three flat cosmological models: the R-h = ct Universe, Lambda CDM, and wCDM. For R-h = ct, the 1 sigma best-fit value of the Hubble constant H-0 is 62.336 +/- 1.464 km s(-1) Mpc(-1), which matches previous measurements (similar to 63 km s(-1) Mpc(-1)) based on best fits to individual data sets. For Lambda CDM, our inferred value of the Hubble constant, H-0 = 67.013 +/- 2.578 km s(-1) Mpc(-1), is more consistent with the Planck optimization than the locally measured value using Cepheid variables, and the matter density Omega(m) = 0.347 +/- 0.049 similarly coincides with its Planck value to within 1 sigma. For wCDM, the optimized parameters are H-0 = 64.718 +/- 3.088 km s(-1) Mpc(-1), Omega(m) = 0.247 +/- 0.108 and w = -0.693 +/- 0.276, also consistent with Planck. A direct comparison of these three models using the Bayesian Information Criterion shows that the R-h = ct universe is favored by the joint analysis with a likelihood of similar to 97% versus. 3% for the other two cosmologies. (c) 2019 Elsevier B.V. All rights reserved.
    • The lapse function in Friedmann—Lemaître–Robertson–Walker cosmologies

      Melia, F.; Univ Arizona, Dept Phys, Program Appl Math; Univ Arizona, Dept Astron (ACADEMIC PRESS INC ELSEVIER SCIENCE, 2019-12)
      The Friedmann-LemaTtre-Robertson-Walker (FLRW) metric, the backbone of modem cosmology, is founded on the cosmological principle, which assumes homogeneity and isotropy throughout the cosmos. One of its simplifications is the choice of lapse function g(tt) = 1, regardless of which stress-energy tensor T-mu v is used in Einstein's field equations. It is sometimes argued that this selection is justified by gauge freedom, given that g(tt) in FLRW may be a function solely of t, not of the spatial coordinates, permitting a redefinition of the time. We show in this paper, however, that the comoving frame in the Hubble expansion is non inertial for all but a few special cases of the expansion factor a(t). Changing the gauge changes the frame of reference and cannot alter this property of the expansion profile, since it would of necessity reformat the metric using the coordinates of a noncomoving observer. We therefore suggest that the pre-selection of g(tt )= 1, independently of the equation of state in the cosmic fluid, incorrectly avoids the time dilation that ought to be present relative to the actual free-falling frame when (a) over dot not equal 0. (C) 2019 Elsevier Inc. All rights reserved.
    • Carrots and sticks: Experimental evidence of vote-buying and voter intimidation in Guatemala

      Gonzalez-Ocantos, Ezequiel; de Jonge, Chad Kiewiet; Meléndez, Carlos; Nickerson, David; Osorio, Javier; Univ Arizona, Sch Govt & Publ Policy (SAGE PUBLICATIONS LTD, 2019-12-17)
      How do parties target intimidation and vote-buying during elections? Parties prefer the use of carrots over sticks because they are in the business of getting voters to like them and expect higher legitimacy costs if observers expose intimidation. However, their brokers sometimes choose intimidation because it is cheaper and possibly more effective than vote-buying. Specifically, we contend that brokers use intimidation when the cost of buying votes is prohibitively high; in interactions with voters among whom the commitment problem inherent to clientelistic transactions is difficult to overcome; and in contexts where the risk of being denounced for violence is lower. We probe our hypotheses about the different profile of voters targeted with vote-buying and intimidation using two list experiments included in an original survey conducted during the 2011 Guatemalan general elections. The list experiments were designed to overcome the social desirability bias associated with direct questions about illegal or stigmatized behaviors. Our quantitative analysis is supplemented by interviews with politicians from various parties. The analysis largely confirms our expectations about the diametrically opposed logics of vote-buying and intimidation targeting, and illuminates how both are key components of politics in a country with weak parties and high levels of violence.
    • Estimating survival in advanced cancer: a comparison of estimates made by oncologists and patients

      Smith-Uffen, M E S; Johnson, S B; Martin, A J; Tattersall, M H N; Stockler, M R; Bell, M L; Detering, K; Clayton, J M; Silvester, W; Clarke, S; et al. (SPRINGER, 2019-11-28)
      Purpose To compare estimates of expected survival time (EST) made by patients with advanced cancer and their oncologists. Methods At enrolment patients recorded their "understanding of how long you may have to live" in best-case, most-likely, and worst-case scenarios. Oncologists estimated survival time for each of their patients as the "median survival of a group of identical patients". We hypothesized that oncologists' estimates of EST would be unbiased (similar to 50% longer or shorter than the observed survival time [OST]), imprecise (< 33% within 0.67 to 1.33 times OST), associated with OST, and more accurate than patients' estimates of their own survival. Results Twenty-six oncologists estimated EST for 179 patients. The median estimate of EST was 6.0 months, and the median OST was 6.2 months. Oncologists' estimates were unbiased (56% longer than OST), imprecise (27% within 0.67 to 1.33 times OST), and significantly associated with OST (HR 0.88, 95% CI 0.82 to 0.93, p < 0.01). Only 41 patients (23%) provided a numerical estimate of their survival with 107 patients (60%) responding "I don't know". The median estimate by patients for their most-likely scenario was 12 months. Patient estimates of their most-likely scenario were less precise (17% within 0.67 to 1.33 times OST) and more likely to overestimate survival (85% longer than OST) than oncologist estimates. Conclusion Oncologists' estimates were unbiased and significantly associated with survival. Most patients with advanced cancer did not know their EST or overestimated their survival time compared to their oncologist, highlighting the need for improved prognosis communication training. Trial registration ACTRN1261300128871
    • Germination variation facilitates the evolution of seed dormancy when coupled with seedling competition

      Kortessis, Nicholas; Chesson, Peter; Univ Arizona, Dept Ecol & Evolutionary Biol (Elsevier, 2019-12-01)
      Fluctuating environmental conditions have consequences for the evolution of life histories because they cause fitness variance. This variance can favor risk-spreading strategies, often known as bet-hedging strategies, in which growth or reproduction is spread over time or space, with some costs, but greater certainty of success. An important example is seed dormancy in annual plants, in which some fraction of seed remains dormant at any given germination opportunity with the potential of germinating later when environmental conditions may differ. Previous theory shows that environmental variation is critical for the evolution of dormancy. However, these studies have focused on temporal variation in reproduction, ignoring the strong observed effects of environmental variation on the germination fraction, a major contributor to fitness variance. We ask what effects germination fluctuations have on selection for dormancy by adding germination fluctuations to existing density-independent (d.i.) and density-dependent (d.d.) models of annual plant dynamics, extending previous analyses by including temporally fluctuating germination. Specifically, we ask how germination variance affects selection on the temporal average germination fraction, here used to define dormancy. When present alone, or when independently varying with other fitness components, germination fluctuations do not affect selection for dormancy in the d.i. model, despite generating fitness variance because this variance contribution is not reduced by higher dormancy. Germination fluctuations have strong effects in the d.d. model, favoring dormancy when present either alone or coupled with variation affecting plant growth. This is because germination variation causes seedling density to vary, which causes variable reproduction through variable intraspecific competition. Dormancy is advantaged under variable reproduction because it creates a more convex relationship between population growth and reproduction leading to benefits from nonlinear averaging. Predictive germination, a positive statistical association between germination and growth, weakens selection for dormancy under strong competition and strengthens it when competition is weak. Our results suggest that variable germination is a potential explanation for high levels of dormancy observed in nature, with implications for life-history theory for fluctuating environments.
    • Not the Desired Outcome: Groupthink Undermines the Work of a Literacy Council

      Jaeger, Elizabeth L.; Univ Arizona, Dept Teaching Learning & Sociocultural Studies (SAGE PUBLICATIONS INC, 2019-12-06)
      A history of school reform failure has prompted concern among literacy researchers and practitioners alike. This article considers the case of a school Literacy Council and its unsuccessful efforts to improve the school's literacy environment. Mobilizing Janis's notion of groupthink, I examine discourse among group members and suggest that characteristics of groupthink-problematic antecedents cultivating troubling decision-making symptoms-led to unsuccessful outcomes. During times of low stress, Literacy Council members collaborated effectively, but when the principal's unilateral curricular decision raised stress levels, the group succumbed to groupthink and experienced failure. This study offers implications for other groups which are shaken by a late-emerging threat. I argue that groupthink theory shines light on problems with group interaction. An awareness of precursors to and symptoms of groupthink may support work teams as they propose and enact important change.