Open Access. Powered by Scholars. Published by Universities.®

Social and Behavioral Sciences Commons™

Open Access. Powered by Scholars. Published by Universities.®

Utah State University

Discipline
Keyword
Publication Year
Publication
Publication Type
File Type

Articles 1471 - 1500 of 5493

Full-Text Articles in Social and Behavioral Sciences

Extending Ethos In Digital Rhetorics, Andrew J. Hillen Aug 2020

Extending Ethos In Digital Rhetorics, Andrew J. Hillen

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

This dissertation researched the concept of ethos, or appeal to authority or trust, on the social media platform, Twitter. Looking at collections of tweets, I found that the characteristics of the Twitter platform, as well as the general qualities of writing online, pushed users to use short cuts to trust, such as focusing in on specific buzz words, or through referencing well known organizations and individuals. Users also used internet culture as its own source of authority. They demonstrated that they were up to date on the latest trends and memes, and so were trustworthy accounts to follow. Users appealed …


A Translational Examination Of Alternative-Response Discrimination Training And Resurgence, Kaitlyn O. Browning Aug 2020

A Translational Examination Of Alternative-Response Discrimination Training And Resurgence, Kaitlyn O. Browning

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Individuals with neurodevelopmental disorders such as autism spectrum disorders often engage in severe forms of problem behavior. Reward-based behavioral interventions are highly effective at reducing levels of problem behavior and teaching more appropriate and adaptive alternative behaviors. Despite successful reduction in problem behavior during treatment, problem behaviors are susceptible to reoccurrence or relapse. Resurgence is a type of behavioral relapse that is particularly relevant to the treatment of problem behavior and may occur following the worsening of conditions of a more recently learned alternative behavior. That is, if the rewards that were used to teach the alternative behavior are removed …


Anti-State Criminal Violence As Civil Defense, Tyler S. Thomas Aug 2020

Anti-State Criminal Violence As Civil Defense, Tyler S. Thomas

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Anti-state criminal violence is a puzzle. Criminal organizations should avoid violent interactions with the state, yet in several countries like Brazil, Mexico, and Colombia there has been widespread anti-state violence orchestrated by organized criminal groups for the past 25 years. Why?

Building on existing literature, I develop a theory with which to explain anti-state criminal violence. I argue that organized crime is more likely to commit anti-state violence when state enforcement agents commit a serious grievance against the local population with whom the criminals share a social identity. I develop this theory using the case of the Michoacán Family, later …


Cultural And Contextual Influences On Mental Health, Stigma, And Substance Use Among Mena U.S. College Students, Molly Mechammil Aug 2020

Cultural And Contextual Influences On Mental Health, Stigma, And Substance Use Among Mena U.S. College Students, Molly Mechammil

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

The aim of this dissertation was to investigate whether certain cultural and contextual factors influence Middle Eastern/North African (MENA) college students' mental health, alcohol/marijuana use, and experiences with mental health stigma and help seeking. Research with MENA college students is very limited, which leaves mental health providers with limited information on how to best support MENAs. MENAs report high rates of discrimination, and other research shows that many they may use religion as a way to cope with stressors such as discrimination. I examined whether religious coping might buffer the effects of discrimination on mental health outcomes. I also considered …


A Translational Investigation Of Reinforced Behavioral Variability: Implications For Promoting Behavioral Variability In Individuals With Autism Spectrum Disorder, Ann Galizio Aug 2020

A Translational Investigation Of Reinforced Behavioral Variability: Implications For Promoting Behavioral Variability In Individuals With Autism Spectrum Disorder, Ann Galizio

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Behavioral variability is sometimes adaptive and can be maintained by the delivery of reinforcement. Individuals with autism spectrum disorder (ASD) often show restricted and repetitive behaviors. Therefore, interventions to promote behavioral variability in individuals with ASD are needed. The present line of research was designed to inform such interventions by investigating reinforced behavioral variability from basic, applied, and translational perspectives. Each of these laboratory studies involved participants making sequences of well-defined responses, which were compared to previous responses. Responses that meet a variability contingency (i.e., were sufficiently different from previous responses) produced rewards. Studies 1 and 2 were basic experiments, …


Framing Climate Change In Local Context: Newspaper Coverage Of Climate Change In Three Mountain Towns In The Intermountain West Compared To National Coverage, Tyler J. Spradlin Aug 2020

Framing Climate Change In Local Context: Newspaper Coverage Of Climate Change In Three Mountain Towns In The Intermountain West Compared To National Coverage, Tyler J. Spradlin

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Past research has focused on how journalists cover and frame the issue of climate change or global warming in mainly nationally circulated newspapers. This study compares and contrasts the framing of climate change between two nationally circulated newspapers, The New York Times and The Washington Post, and three intermountain west community newspapers, Jackson Hole News & Guide in Jackson Hole, WY, Summit Daily in Summit County, CO, and Park Record in Park City, UT. This research incorporates the five generic frames, responsibility, conflict, human-interest, economic consequences, and morality frames defined by Semetko and Valkenburg (2000) …


“To Ask Freedom For Women”: The Night Of Terror And Public Memory, Candi Carter Olsen Jul 2020

“To Ask Freedom For Women”: The Night Of Terror And Public Memory, Candi Carter Olsen

Journalism and Communication Faculty Publications

On the night of November 14, 1917, 31 suffragists and members of the National Woman’s Party (“NWP”) were taken to Occoquan Workhouse in Virginia and tortured and beaten. This so-called “Night of Terror” captured national headlines at the time and has been memorialized through digital sites today. This article examines versions of the Night of Terror from the NWP’s official newspaper, The Suffragist, national newspapers of the day gathered from the Chronicling America database, and modern digital memorials of the event to understand the ways that the mediated telling of events create the fractured popular memories that are retold …


Under Discussion: Free Speech, Cancel Culture, And Compassion, Rachel Robinson-Greene Jul 2020

Under Discussion: Free Speech, Cancel Culture, And Compassion, Rachel Robinson-Greene

Languages, Philosophy, and Communication Studies Faculty Publications

In July, 2020, Harper’s Magazine published a letter signed by 153 prominent authors and thinkers. Signatories included figures such as Noam Chomsky, Gloria Steinem, and J.K. Rowling. Their main contention was that an “illiberal left” has emerged in recent political discourse — a left that allows no room for divergent points of view and that deals with “wrongdoers” swiftly and mercilessly.


Evaluation Of Topics In Utah's One‐Hour Divorce Education Program, Olena Kopystynska, Joshua Turner, David G. Schramm, Brian Higginbotham Jul 2020

Evaluation Of Topics In Utah's One‐Hour Divorce Education Program, Olena Kopystynska, Joshua Turner, David G. Schramm, Brian Higginbotham

Human Development and Family Studies Faculty Publications

Divorce education programs are mandatory in most states. Despite the ongoing debate in the field regarding the appropriate duration of these programs, the goal of the current study was to identify the following five content areas in divorce education that may be most relevant for predicting favorable outcomes: (1) impact of divorce on children, (2) impact of divorce on family relationships, (3) financial responsibilities of divorcing parents for children, (4) benefits of positive coparenting, and (5) impact of domestic violence on children and family relationships. Using divorcing parents' self‐reported data (N = 3,275) from a one‐hour online divorce education …


Are Financing Constraints Binding For Investment? Evidence From A Natural Experiment, Katarzyna Anna Bilicka Jul 2020

Are Financing Constraints Binding For Investment? Evidence From A Natural Experiment, Katarzyna Anna Bilicka

Economics and Finance Faculty Publications

This paper shows that the availability of cash flows dominates the effects of cost of capital for investment at the firm level. Using an exogenous tax reform in Canada as a quasi-natural experiment, I find that a temporary and unexpected increase in the cost of capital for firms with low availability of retained earnings has no effect on investment of those firms. A subsequent direct increase in the availability of cash flows has large effects on investment. This suggests that internal financing constraints are binding for firms, as they prefer to use low cost retained earnings to finance their investment.


Information Search And Financial Markets Under Covid-19, Behzod B. Ahundjanov, Sherzod Akhundjanov, Botir B. Okhunjanov Jul 2020

Information Search And Financial Markets Under Covid-19, Behzod B. Ahundjanov, Sherzod Akhundjanov, Botir B. Okhunjanov

Applied Economics Faculty Publications

The discovery and sudden spread of the novel coronavirus (COVID-19) exposed individuals to a great uncertainty about the potential health and economic ramifications of the virus, which triggered a surge in demand for information about COVID-19. To understand financial market implications of individuals’ behavior upon such uncertainty, we explore the relationship between Google search queries related to COVID-19—information search that reflects one’s level of concern or risk perception—and the performance of major financial indices. The empirical analysis based on the Bayesian inference of a structural vector autoregressive model shows that one unit increase in the popularity of COVID-19-related global search …


The Moral Challenges Of Opening Up Schools During The Pandemic, Rachel Robinson-Greene Jul 2020

The Moral Challenges Of Opening Up Schools During The Pandemic, Rachel Robinson-Greene

Languages, Philosophy, and Communication Studies Faculty Publications

As we inch ever closer to August, the question of if and how schools will open in the fall is increasingly pressing on everyone’s minds. Many decisions related to COVID-19 are presented as morally controversial when they really shouldn’t be. The issue of opening the schools, on the other hand, is complex. No matter what decision is made, some individuals and groups will experience significant hardship.


Finding A Fit: Biological Science Doctoral Students’ Selection Of A Principal Investigator And Research Laboratory, Michelle A. Maher, Annie M. Wofford, Josipa Roksa, David F. Feldon Jul 2020

Finding A Fit: Biological Science Doctoral Students’ Selection Of A Principal Investigator And Research Laboratory, Michelle A. Maher, Annie M. Wofford, Josipa Roksa, David F. Feldon

Instructional Technology and Learning Sciences Faculty Publications

In the laboratory-based disciplines, selection of a principal investigator (PI) and research laboratory (lab) indelibly shapes doctoral students’ experiences and educational outcomes. Framed by the theoretical concept of person–environment fit from within a socialization model, we use an inductive, qualitative approach to explore how a sample of 42 early-stage doctoral students enrolled in biological sciences programs made decisions about fitting with a PI and within a lab. Results illuminated a complex array of factors that students considered in selecting a PI, including PI relationship, mentoring style, and professional stability. Further, with regard to students’ lab selection, peers and research projects …


Contested Dam Development In Iran: A Case Study Of The Exercise Of State Power Over Local People, Elham Hoominfar, Claudia Radel Jul 2020

Contested Dam Development In Iran: A Case Study Of The Exercise Of State Power Over Local People, Elham Hoominfar, Claudia Radel

Sociology, Social Work and Anthropology Student Research

In this article, we address the interaction of the Iranian State, an agent of power, with affected village residents, as four dam projects are planned and implemented. Dams, recently positioned as a green energy source, are a central component to Iran’s national development strategies; yet historically their construction has been a source of significant conflict and resistance around the world. We focus on ten villages facing displacement or partial loss of lands at the time of the research, and we answer the question: During dam building and resettlement processes, how have residents experienced their role in decision making and the …


A Landscape Perspective On Climate-Driven Risks To Food Security: Exploring The Relationship Between Climate And Social Transformation In The Prehispanic U.S. Southwest, Colleen Strawhacker, Grant Snitker, Matthew A. Peeples, Ann P. Kinzig, Keith W. Kintigh, Kyle Bocinsky, Brad Butterfield, Jacob Freeman, Sarah Oas, Margaret C. Nelson, Jonathan A. Sandor, Katherine A. Spielmann Jul 2020

A Landscape Perspective On Climate-Driven Risks To Food Security: Exploring The Relationship Between Climate And Social Transformation In The Prehispanic U.S. Southwest, Colleen Strawhacker, Grant Snitker, Matthew A. Peeples, Ann P. Kinzig, Keith W. Kintigh, Kyle Bocinsky, Brad Butterfield, Jacob Freeman, Sarah Oas, Margaret C. Nelson, Jonathan A. Sandor, Katherine A. Spielmann

Sociology, Social Work and Anthropology Faculty Publications

Spatially and temporally unpredictable rainfall patterns presented food production challenges to small-scale agricultural communities, requiring multiple risk-mitigating strategies to increase food security. Although site-based investigations of the relationship between climate and agricultural production offer insights into how individual communities may have created long-term adaptations to manage risk, the inherent spatial variability of climate-driven risk makes a landscape-scale perspective valuable. In this article, we model risk by evaluating how the spatial structure of ancient climate conditions may have affected the reliability of three major strategies used to reduce risk: drawing upon social networks in time of need, hunting and gathering of …


The Plurality Of Farmers’ Views On Soil Management Calls For A Policy Mix, Michael Braito, Heidi Leonhardt, Marianne Penker, Elisabeth Schauppenlehner-Kloyber, Georg Thaler, Courtney G. Flint Jul 2020

The Plurality Of Farmers’ Views On Soil Management Calls For A Policy Mix, Michael Braito, Heidi Leonhardt, Marianne Penker, Elisabeth Schauppenlehner-Kloyber, Georg Thaler, Courtney G. Flint

Sociology, Social Work and Anthropology Faculty Publications

While soil degradation is continuing to threaten the global agricultural production system, a common understanding of how to encourage sustainable soil management is missing. With this study, we aim to provide new insights on targeted policies that address the heterogeneity of farmers. We scrutinized the plurality of views on soil management among arable farmers in the Austrian (and European) policy context. To do so, we applied Q methodology, a method that identifies different perspectives on a topic present in a population and analyzes this subjectivity statistically. We interviewed 34 arable land farmers who varied in their farming backgrounds. The results …


Pan-Arctic Analysis Of Cultural Ecosystem Services Using Social Media And Automated Content Analysis, Claire A. Runge, Vera Helene Hausner, Remi M. Daigle, Christopher Monz Jul 2020

Pan-Arctic Analysis Of Cultural Ecosystem Services Using Social Media And Automated Content Analysis, Claire A. Runge, Vera Helene Hausner, Remi M. Daigle, Christopher Monz

Environment and Society Faculty Publications

In the Arctic, as in many parts of the world, interactions with the natural world are an important part of people's experience and are often recorded in photographs. Emerging methods for automated content analysis of social media data offers opportunities to discover information on cultural ecosystem services from photographs across large samples of people and countries. We analysed over 800,000 Flickr photographs using Google's Cloud Vision algorithm to identify the components of the natural environment most photographed and to map how and where different people interact with nature across eight Arctic countries. Almost all (91.1%) of users took one or …


Covid-19 And Systemic Racism, Rachel Robinson-Greene Jul 2020

Covid-19 And Systemic Racism, Rachel Robinson-Greene

Languages, Philosophy, and Communication Studies Faculty Publications

As more information about COVID-19 and its effects comes to light, it is clear that the impacts of the disease are not the same everywhere or for everyone. Some communities are hit harder than others. In many cases, COVID-19 hot spots highlight systemic problems that existed before “coronavirus” was a household word. The public action that a society takes when things get rough reflects its values, in this case, its judgments about who and what is really important. Unsurprisingly, the circumstances of marginalized groups are not sufficiently taken into account in the construction of social programs and systems. When these …


Utah State University: English Composition Library Instruction Program – A Program Within Programs, Katie Strand, Dory Rosenberg, Mckenzie Hyde Jun 2020

Utah State University: English Composition Library Instruction Program – A Program Within Programs, Katie Strand, Dory Rosenberg, Mckenzie Hyde

Library Faculty & Staff Publications

This case study book chapter presents missions, allocation of resources and labor, supervisory structures, prioritization approaches, and other processes and structures required to make the English Composition Library Instruction Program work. The program consists of an integration with Utah State University’s English 1010 and English 2010 courses. Both of these courses have their own separate objectives and learning outcomes, and the overall goal is that once students finish (or test out of) both courses, they will have developed foundational research and writing skills related to rhetorical argumentation. Our goal in describing our program is to showcase an example of an …


Recognition And Stigma Of Prescription Drug Abuse Disorder: Personal And Community Determinants, Robert Shupp, Scott Loveridge, Mark Skidmore, Brandn Green, Don Albrecht Jun 2020

Recognition And Stigma Of Prescription Drug Abuse Disorder: Personal And Community Determinants, Robert Shupp, Scott Loveridge, Mark Skidmore, Brandn Green, Don Albrecht

Extension Research

Background

Prescription drug abuse (PDA) disorders continue to contribute to the current American opioid crisis. Within this context, our study seeks to improve understanding about stigma associated with, and symptom recognition of, prescription drug abuse.

Aims

Model the stigma and symptom recognition of PDA in the general population.

Methods

A randomized, nation-wide, online, vignette-focused survey of the general public (N = 631) was implemented with an oversample for rural counties. Logit estimation was used for analysis, with regional and county-level sociodemographic variables as controls.

Results

Individual respondents that self-identify as having or having had “a prescription drug abuse issue” were …


Towards The Effective Implementation Of Collaborative Problem Solving In Undergraduate Engineering Classrooms: Co-Designing Guidelines For Teaching Assistants, Saadeddine Shehab, Luettamae Lawrence, Emma Mercier, Anthony Salvatore Margotta, Elizabeth Renee Livingston, Mariana Silva, Taylor Tucker Jun 2020

Towards The Effective Implementation Of Collaborative Problem Solving In Undergraduate Engineering Classrooms: Co-Designing Guidelines For Teaching Assistants, Saadeddine Shehab, Luettamae Lawrence, Emma Mercier, Anthony Salvatore Margotta, Elizabeth Renee Livingston, Mariana Silva, Taylor Tucker

Instructional Technology and Learning Sciences Faculty Publications

Typically, in higher education STEM classes, teaching assistants (TAs) perform teaching duties such as leading and running discussion sections where students apply concepts they have encountered in lectures. Nevertheless, research studies show that TAs struggle to effectively implement collaborative problem solving activities. One contributing factor is the lack of actual guidelines that can help TAs translate the theoretical ideas about implementing collaborative problem solving into concrete actions. This paper presents guidelines that can be used by TAs to implement collaborative problem solving activities in undergraduate engineering classrooms. Three researchers and two engineering teaching assistants participated in two, two-hour long workshops …


“How Well Does Your Structural Equation Model Fit Your Data?”: Is Marcoulides And Yuan’S Equivalence Test The Answer?, James Peugh, David F. Feldon Jun 2020

“How Well Does Your Structural Equation Model Fit Your Data?”: Is Marcoulides And Yuan’S Equivalence Test The Answer?, James Peugh, David F. Feldon

Instructional Technology and Learning Sciences Faculty Publications

Structural equation modeling is an ideal data analytical tool for testing complex relationships among many analytical variables. It can simultaneously test multiple mediating and moderating relationships, estimate latent variables on the basis of related measures, and address practical issues such as nonnormality and missing data. To test the extent to which a hypothesized model provides an appropriate characterization of the collective relationships among its variables, researchers must assess the “fit” between the model and the sample’s data. However, interpreting estimates of model fit is a problematic process. The traditional inferential test of model fit, the chi-square test, is biased due …


The Moral Pitfalls Of Color-Coded Coronavirus Warning Systems, Rachel Robinson-Greene Jun 2020

The Moral Pitfalls Of Color-Coded Coronavirus Warning Systems, Rachel Robinson-Greene

Languages, Philosophy, and Communication Studies Faculty Publications

As states around the country ease lockdown restrictions, some are putting into place systems advising people about threat levels. In some states, these are color-coded systems that strongly resemble the Homeland Security Advisory system, put into place by George W. Bush to inform people about the risk of threats from terrorism after the September 11th terrorist attacks.


Finding Av Needles In Manuscript Haystacks: Conducting An Audiovisual Assessment/Audit In Manuscript Archives, Benjamin Harry Jun 2020

Finding Av Needles In Manuscript Haystacks: Conducting An Audiovisual Assessment/Audit In Manuscript Archives, Benjamin Harry

Journal of Western Archives

Many twentieth-century audiovisual formats are becoming obsolete or are physically degrading, warranting the need to digitally reformat this content. The first step is to expeditiously document where and what types of audiovisual materials are hidden within archival manuscript collections. This article describes the efforts of the L. Tom Perry Special Collections (LTPSC) at Brigham Young University to quickly audit manuscript collections to determine the location and format details of audiovisual materials, a crucial first step to inform decisions about personnel requirements, equipment purchases, and grant seeking to facilitate the systematic digitization of audiovisual content.


Importance Of Adding Objective Data To Stakeholder Data In Needs Assessments, Jonathan J. Swinton, Tasha Killian, Paige Wray Jun 2020

Importance Of Adding Objective Data To Stakeholder Data In Needs Assessments, Jonathan J. Swinton, Tasha Killian, Paige Wray

Extension Research

When completing a needs assessment, Extension professionals should include both objective county data and stakeholder input data. Specifically, Extension professionals should identify potential areas of need, source available objective data, source data from relevant county stakeholders, and analyze similarities and differences in objective and stakeholder data. Needs assessments should be conducted in this manner to confirm the needs of a county; address risk of data skewed by subjective stakeholder opinion, particularly in small counties; and identify areas of greatest need. This method has been shown to be effective through implementation in a target rural county.


Mwdl Training Resources Task Force Committee Report, Andrea Payant Jun 2020

Mwdl Training Resources Task Force Committee Report, Andrea Payant

Library Faculty & Staff Presentations

A summary of the activities and outputs of the MWDL Training Resources Task Force for 2019-2020. The presentation includes information about the many training resources that have been made available through the MWDL portal on the Library Workflow Exchange platform, which were contributed and compiled by MWDL partners to improve quality of service.


Gender Difference In Longitudinal Social And Personal Factors Related To Frequency Of Alcohol Consumption Of South Korean Adults: A Fixed-Effects Model, Baksun Sung May 2020

Gender Difference In Longitudinal Social And Personal Factors Related To Frequency Of Alcohol Consumption Of South Korean Adults: A Fixed-Effects Model, Baksun Sung

Sociology, Social Work and Anthropology Student Research

The purpose of this study was to examine the longitudinal social and personal factors related to frequency of alcohol consumption by South Korean adults focused on comparisons between the men and women. Data came from the 2005-2016 Korea Welfare Panel Study. A fixed-effects model was used to examine the longitudinal correlations between dependent and independent variables. According to the present results, first, life satisfaction except for health satisfaction and marital status were not associated with alcohol consumption patterns by men. On the other hand, higher frequency of alcohol consumption by women is negatively associated with various life satisfaction variables and …


Reviewing Family Communication Scholarship: Toward A Framework For Conceptualizing A Communicative Perspective On Family Identity, Kaitlin E. Phillips, Jordan Soliz May 2020

Reviewing Family Communication Scholarship: Toward A Framework For Conceptualizing A Communicative Perspective On Family Identity, Kaitlin E. Phillips, Jordan Soliz

Languages, Philosophy, and Communication Studies Faculty Publications

In this manuscript we review multiple approaches to family communication research, and provide directions for future research as they relate to family culture. Specifically, we review family communication research that is either explicitly or implicitly tied to family culture. Given the importance of families and understanding the first social group that individuals often belong to, it is necessary to synthesize programs of research related to family culture. Thus, in order to further the progression of family research we provide an overview of where current research on family communication converges, present additional factors for family scholars to include in their work, …


The Quandary Of Contact Tracing Tech, Rachel Robinson-Greene May 2020

The Quandary Of Contact Tracing Tech, Rachel Robinson-Greene

Languages, Philosophy, and Communication Studies Faculty Publications

All over the country, states are re-opening their economies. This is happening in defiance of recommendations from experts in infectious disease, which suggest that states only re-open after they have seen a fourteen-day decline in cases, have capacities to contact trace, have sufficient personal protective equipment for healthcare workers, and have sufficient testing capabilities to identify hotspots and deal with problems when they arise.


Well-Being Of Parents Of Children Who Are Deaf Or Hard Of Hearing, Courtney P. Kasin, Karen F. Munoz, Clarissa W. Ong, John J. Whicker, Michael P. Twohig May 2020

Well-Being Of Parents Of Children Who Are Deaf Or Hard Of Hearing, Courtney P. Kasin, Karen F. Munoz, Clarissa W. Ong, John J. Whicker, Michael P. Twohig

Journal of Early Hearing Detection and Intervention

Purpose: The purpose of this study was to explore factors influencing the well-being of parents who have children who are deaf or hard of hearing (DHH) and to compare their experiences to non-clinical samples.

Method: A cross-sectional online survey was used to collect data (N = 296).

Results: Data analyses revealed the majority of parents of children who are DHH were functioning similarly to or better than the non-clinical samples in our comparison and within the non-clinical range for the included measures. No relationship was found between factors related to child age or timing of services (age at diagnosis, time …