The evolution of cooperation is a fundamental problem in biology, especially for non-relatives, where indirect fitness benefits cannot counter within-group inequalities. Multilevel selection models show how cooperation can evolve if it generates a group-level advantage, even when cooperators are disadvantaged within their group. This allows the possibility of group selection, but few examples have been described in nature. Here we show that group selection can explain the evolution of cooperative nest founding in the harvester ant Pogonomyrmex californicus. Through most of this species’ range, colonies are founded by single queens, but in some populations nests are instead founded by cooperative groups of unrelated queens. In mixed groups of cooperative and single-founding queens, we found that aggressive individuals had a survival advantage within their nest, but foundress groups with such non-cooperators died out more often than those with only cooperative members. An agent-based model shows that the between-group advantage of the cooperative phenotype drives it to fixation, despite its within-group disadvantage, but only when population density is high enough to make between-group competition intense. Field data show higher nest density in a population where cooperative founding is common, consistent with greater density driving the evolution of cooperative foundation through group selection.
Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims for these two studies included quantitatively and qualitatively identifying the prevalence of PA counseling, perceived counseling knowledge and confidence, and educational training related to counseling. In study 1, survey respondents were currently practicing NPs and physician assistants. Participants completed a modified version of the Promotion of Physical Activity by Nurse Practitioners Questionnaire either online or in person during a population specific conference. The majority of both NP and physician assistant respondents reported routinely counseling patients about PA. There were no differences in perceived knowledge or confidence to provide PA counseling between the two populations. Approximately half of all respondents reported receiving training to provide PA counseling as part of their educational preparation for becoming a health practitioner. Nearly three-quarters of respondents reported interest in receiving additional PA counseling training. In study 2, five focus groups (FGs), stratified by practice type, were conducted with NPs and physician assistants. Both NPs and physician assistants reported discussing PA with their patients, particularly those with chronic illness. Participants reported that discussing lifestyle modifications with patients was the most common type of PA counseling provided. Increased confidence to counsel was associated with having PA knowledge and providing simple counseling, such as lifestyle modifications. Barriers to counseling included having more important things to discuss, lack of time during appointments, the current healthcare system, lack of reimbursement and perceived patient financial barriers. PA recommendation knowledge was highly variable, with few participants reporting specific guidelines. FG participants, while not familiar with the American College of Sports Medicines' "Exercise is Medicine" initiative indicated interest in its use and learning more about it. The findings of these two studies indicate that while NPs and physician assistants are knowledgeable, confident and currently providing some amount of PA counseling to patients, additional training in PA counseling is needed and desired.
