ASU Scholarship Showcase

In this study, we examine how development status and water scarcity shape people's perceptions of "hard path" and "soft path" water solutions. Based on ethnographic research conducted in four semi-rural/peri-urban sites (in Bolivia, Fiji, New Zealand, and the US), we use content analysis to conduct statistical and thematic comparisons of interview data. Our results indicate clear differences associated with development status and, to a lesser extent, water scarcity. People in the two less developed sites were more likely to suggest hard path solutions, less likely to suggest soft path solutions, and more likely to see no path to solutions than people in the more developed sites. Thematically, people in the two less developed sites envisioned solutions that involve small-scale water infrastructure and decentralized, community-based solutions, while people in the more developed sites envisioned solutions that involve large-scale infrastructure and centralized, regulatory water solutions. People in the two water-scarce sites were less likely to suggest soft path solutions and more likely to see no path to solutions (but no more likely to suggest hard path solutions) than people in the water-rich sites. Thematically, people in the two water-rich sites seemed to perceive a wider array of unrealized potential soft path solutions than those in the water-scarce sites. On balance, our findings are encouraging in that they indicate that people are receptive to soft path solutions in a range of sites, even those with limited financial or water resources. Our research points to the need for more studies that investigate the social feasibility of soft path water solutions, particularly in sites with significant financial and natural resource constraints.

Does school participatory budgeting (SPB) increase students’ political efficacy? SPB, which is implemented in thousands of schools around the world, is a democratic process of deliberation and decision-making in which students determine how to spend a portion of the school’s budget. We examined the impact of SPB on political efficacy in one middle school in Arizona. Our participants’ (n = 28) responses on survey items designed to measure self-perceived growth in political efficacy indicated a large effect size (Cohen’s d = 1.46), suggesting that SPB is an effective approach to civic pedagogy, with promising prospects for developing students’ political efficacy.

Many population centers in the American West rely on water from the Colorado River Basin, which has faced shortages in recent years that are anticipated to be exacerbated by climate change. Shortages to urban water supplies related to climate change will not be limited to cities dependent on the Colorado River. Considering this, addressing sustainable water governance is timely and critical for cities, states, and regions facing supply shortages and pollution problems. Engaging in sustainability transitions of these hydro-social systems will increase the ability of such systems to meet the water needs of urban communities. In this paper, we identify historical transitions in water governance and examine their context for three sites in the Colorado River Basin (Denver, Colorado, Las Vegas, Nevada, and Phoenix, Arizona) to provide insight for intentional transitions towards sustainable, or “water sensitive” cities. The comparative historical approach employed allows us to more fully understand differences in present-day water governance decisions between the sites, identify past catalysts for transitions, and recognize emerging patterns and opportunities that may impact current and future water governance in the Colorado River Basin and beyond.

Understanding the food-energy-water nexus is necessary to identify risks and inform strategies for nexus governance to support resilient, secure, and sustainable societies. To manage risks and realize efficiencies, we must understand not only how these systems are physically connected but also how they are institutionally linked. It is important to understand how actors who make planning, management, and policy decisions understand the relationships among components of the systems. Our question is: How do stakeholders involved in food, energy, and water governance in Phoenix, Arizona understand the nexus and what are the implications for integrated nexus governance? We employ a case study design, generate qualitative data through focus groups and interviews, and conduct a content analysis. While stakeholders in the Phoenix area who are actively engaged in food, energy, and water systems governance appreciate the rationale for nexus thinking, they recognize practical limitations to implementing these concepts. Concept maps of nexus interactions provide one view of system interconnections that be used to complement other ways of knowing the nexus, such as physical infrastructure system diagrams or actor-networks. Stakeholders believe nexus governance could be improved through awareness and education, consensus and collaboration, transparency, economic incentives, working across scales, and incremental reforms.

Cancer therapy selects for cancer cells resistant to treatment, a process that is fundamentally evolutionary. To what extent, however, is the evolutionary perspective employed in research on therapeutic resistance and relapse? We analyzed 6,228 papers on therapeutic resistance and/or relapse in cancers and found that the use of evolution terms in abstracts has remained at about 1% since the 1980s. However, detailed coding of 22 recent papers revealed a higher proportion of papers using evolutionary methods or evolutionary theory, although this number is still less than 10%. Despite the fact that relapse and therapeutic resistance is essentially an evolutionary process, it appears that this framework has not permeated research. This represents an unrealized opportunity for advances in research on therapeutic resistance.

Background: Medical and public health scientists are using evolution to devise new strategies to solve major health problems. But based on a 2003 survey, medical curricula may not adequately prepare physicians to evaluate and extend these advances. This study assessed the change in coverage of evolution in North American medical schools since 2003 and identified opportunities for enriching medical education.

Methods: In 2013, curriculum deans for all North American medical schools were invited to rate curricular coverage and perceived importance of 12 core principles, the extent of anticipated controversy from adding evolution, and the usefulness of 13 teaching resources. Differences between schools were assessed by Pearson’s chi-square test, Student’s t-test, and Spearman’s correlation. Open-ended questions sought insight into perceived barriers and benefits.

Results: Despite repeated follow-up, 60 schools (39%) responded to the survey. There was no evidence of sample bias. The three evolutionary principles rated most important were antibiotic resistance, environmental mismatch, and somatic selection in cancer. While importance and coverage of principles were correlated (r = 0.76, P < 0.01), coverage (at least moderate) lagged behind importance (at least moderate) by an average of 21% (SD = 6%). Compared to 2003, a range of evolutionary principles were covered by 4 to 74% more schools. Nearly half (48%) of responders anticipated igniting controversy at their medical school if they added evolution to their curriculum. The teaching resources ranked most useful were model test questions and answers, case studies, and model curricula for existing courses/rotations. Limited resources (faculty expertise) were cited as the major barrier to adding more evolution, but benefits included a deeper understanding and improved patient care.

Conclusion: North American medical schools have increased the evolution content in their curricula over the past decade. However, coverage is not commensurate with importance. At a few medical schools, anticipated controversy impedes teaching more evolution. Efforts to improve evolution education in medical schools should be directed toward boosting faculty expertise and crafting resources that can be easily integrated into existing curricula.

Complexities and uncertainties surrounding urbanization and climate change complicate water resource sustainability. Although research has examined various aspects of complex water systems, including uncertainties, relatively few attempts have been made to synthesize research findings in particular contexts. We fill this gap by examining the complexities, uncertainties, and decision processes for water sustainability and urban adaptation to climate change in the case study region of Phoenix, Arizona. In doing so, we integrate over a decade of research conducted by Arizona State University’s Decision Center for a Desert City (DCDC). DCDC is a boundary organization that conducts research in collaboration with policy makers, with the goal of informing decision-making under uncertainty. Our results highlight: the counterintuitive, non-linear, and competing relationships in human–environment dynamics; the myriad uncertainties in climatic, scientific, political, and other domains of knowledge and practice; and, the social learning that has occurred across science and policy spheres. Finally, we reflect on how our interdisciplinary research and boundary organization has evolved over time to enhance adaptive and sustainable governance in the face of complex system dynamics.

Introduction: Abundance of immune cells has been shown to have prognostic and predictive significance in many tumor types. Beyond abundance, the spatial organization of immune cells in relation to cancer cells may also have significant functional and clinical implications. However there is a lack of systematic methods to quantify spatial associations between immune and cancer cells.

Methods: We applied ecological measures of species interactions to digital pathology images for investigating the spatial associations of immune and cancer cells in breast cancer. We used the Morisita-Horn similarity index, an ecological measure of community structure and predator–prey interactions, to quantify the extent to which cancer cells and immune cells colocalize in whole-tumor histology sections. We related this index to disease-specific survival of 486 women with breast cancer and validated our findings in a set of 516 patients from different hospitals.

Results: Colocalization of immune cells with cancer cells was significantly associated with a disease-specific survival benefit for all breast cancers combined. In HER2-positive subtypes, the prognostic value of immune-cancer cell colocalization was highly significant and exceeded those of known clinical variables. Furthermore, colocalization was a significant predictive factor for long-term outcome following chemotherapy and radiotherapy in HER2 and Luminal A subtypes, independent of and stronger than all known clinical variables.

Conclusions: Our study demonstrates how ecological methods applied to the tumor microenvironment using routine histology can provide reproducible, quantitative biomarkers for identifying high-risk breast cancer patients. We found that the clinical value of immune-cancer interaction patterns is highly subtype-specific but substantial and independent to known clinicopathologic variables that mostly focused on cancer itself. Our approach can be developed into computer-assisted prediction based on histology samples that are already routinely collected.

In a meta-analysis published by myself and co-authors, we report differences in the life history risk factors for estrogen receptor negative (ER−) and estrogen receptor positive (ER+) breast cancers. Our meta-analysis did not find the association of ER− breast cancer risk with fast life history characteristics that Hidaka and Boddy suggest in their response to our article. There are a number of possible explanations for the differences between their conclusions and the conclusions we drew from our meta-analysis, including limitations of our meta-analysis and methodological challenges in measuring and categorizing estrogen receptor status. These challenges, along with the association of ER+ breast cancer with slow life history characteristics, may make it challenging to find a clear signal of ER− breast cancer with fast life history characteristics, even if that relationship does exist. The contradictory results regarding breast cancer risk and life history characteristics illustrate a more general challenge in evolutionary medicine: often different sub-theories in evolutionary biology make contradictory predictions about disease risk. In this case, life history models predict that breast cancer risk should increase with faster life history characteristics, while the evolutionary mismatch hypothesis predicts that breast cancer risk should increase with delayed reproduction. Whether life history tradeoffs contribute to ER− breast cancer is still an open question, but current models and several lines of evidence suggest that it is a possibility.

It has long been accepted that modern reproductive patterns are likely contributors to breast cancer susceptibility because of their influence on hormones such as estrogen and the importance of these hormones in breast cancer. We conducted a meta-analysis to assess whether this ‘evolutionary mismatch hypothesis’ can explain susceptibility to both estrogen receptor positive (ER-positive) and estrogen receptor negative (ER-negative) cancer. Our meta-analysis includes a total of 33 studies and examines parity, age of first birth and age of menarche broken down by estrogen receptor status. We found that modern reproductive patterns are more closely linked to ER-positive than ER-negative breast cancer. Thus, the evolutionary mismatch hypothesis for breast cancer can account for ER-positive breast cancer susceptibility but not ER-negative breast cancer.