Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
256
result(s) for
"Fox, Cameron"
Sort by:
The use and potential impact of digital health tools at the community level: results from a multi-country survey of community health workers
Background
Community health workers (CHWs) are increasingly viewed as a critical workforce to address health system strengthening and sustainable development goals. Optimizing and widening the capacity of this workforce through digital technology is currently underway, though there is skepticism regarding CHWs’ willingness and optimism to engage in digital health. We sought to understand CHWs’ perceptions on the use of digital health tools in their work.
Methods
We obtained survey data from 1,141 CHWs from 28 countries with complete study information. We conducted regression analyses to explore the relationship between CHWs’ training and perceived barriers to digital health access with current use of digital devices/tools and belief in digital impact while adjusting for demographic factors.
Results
Most of the CHWs worked in Kenya (
n
= 502, 44%) followed by the Philippines (
n
= 308, 27%), Ghana (
n
= 107, 9.4%), and the United States (
n
= 70, 6.1%). There were significant, positive associations between digital tools training and digital device/tool use (Adjusted Odds Ratio (AOR) = 2.92, 95% CI = 2.09–4.13) and belief in digital impact (AOR
high impact =
3.03, 95% CI = 2.04–4.49). CHWs were significantly less likely to use digital devices for their work if they identified cost as a perceived barrier (AOR
mobile service cost =
0.68, 95% CI = 0.49–0.95; AOR
phone/device cost =
0.66, 95% CI = 0.47–0.92). CHWs who were optimistic about digital health, were early adopters of technology in their personal lives, and found great value in their work believed digital health helped them to have greater impact. Older age and greater tenure were associated with digital device/tool use and belief in digital impact, respectively.
Conclusions
CHWs are not an obstacle to digital health adoption or use. CHWs believe that digital tools can help them have more impact in their communities regardless of perceived barriers. However, cost is a barrier to digital device/tool use; potential solutions to cost constraints of technological access will benefit from further exploration of reimbursement models. Digital health tools have the potential to increase CHW capacity and shape the future of community health work.
Journal Article
Positive Psychology Interventions in Practice
\"This book presents recent advancements in positive psychology, specifically its application across broad areas of current interest. Chapters include submissions from various international authors in the field and cover discussion and presentation of relevant research, theories, and applications. The volume covers topics such as CBT, Psychotherapy, Coaching, Workplaces, Aging, Education, Leadership, Emotion, Interventions, Measurement, Technology, Design, Health, Relationships, Experiences, Communities. With the growing interest in the applications of positive psychology across diverse fields within psychology and beyond, this book will make a worthwhile contribution to the field. It will also fill the current need for a volume that highlights specifically the various recent advancements in positive psychology into diverse fields and as such will be of benefit to a wide range of professionals, including psychologists, educators, clinicians, therapists, and many others.\" -- Publisher's website.
Book
Preexisting oncogenic events impact trastuzumab sensitivity in ERBB2-amplified gastroesophageal adenocarcinoma
Patients with gastric and esophageal (GE) adenocarcinoma tumors in which the oncogene ERBB2 has been amplified are routinely treated with a combination of cytotoxic chemotherapy and the ERBB2-directed antibody trastuzumab; however, the addition of trastuzumab, even when tested in a selected biomarker-positive patient population, provides only modest survival gains. To investigate the potential reasons for the modest impact of ERBB2-directed therapies, we explored the hypothesis that secondary molecular features of ERBB2-amplified GE adenocarcinomas attenuate the impact of ERBB2 blockade. We analyzed genomic profiles of ERBB2-amplified GE adenocarcinomas and determined that the majority of ERBB2-amplified tumors harbor secondary oncogenic alterations that have the potential to be therapeutically targeted. These secondary events spanned genes involved in cell-cycle regulation as well as phosphatidylinositol-3 kinase and receptor tyrosine kinase signaling. Using ERBB2-amplified cell lines, we demonstrated that secondary oncogenic events could confer resistance to ERBB2-directed therapies. Moreover, this resistance could be overcome by targeting the secondary oncogene in conjunction with ERBB2-directed therapy. EGFR is commonly coamplified with ERBB2, and in the setting of ERBB2 amplification, higher EGFR expression appears to mark tumors with greater sensitivity to dual EGFR/ERBB2 kinase inhibitors. These data suggest that combination inhibitor strategies, guided by secondary events in ERBB2-amplified GE adenocarcinomas, should be evaluated in clinical trials.
Journal Article
Low heritability and high phenotypic plasticity of salivary cortisol in response to environmental heterogeneity in a wild pinniped
Individuals are unique in how they interact with and respond to their environment. Correspondingly, unpredictable challenges or environmental stressors often produce an individualized response of the hypothalamic‐pituitary‐adrenal (HPA) axis and its downstream effector cortisol. We used a fully crossed, repeated measures design to investigate the factors shaping individual variation in baseline cortisol in Antarctic fur seal pups and their mothers. Saliva samples were collected from focal individuals at two breeding colonies, one with low and the other with high density, during two consecutive years of contrasting food availability. Mothers and pups were sampled concurrently at birth and shortly before weaning, while pups were additionally sampled every 20 days. We found that heritability was low for baseline cortisol, while within‐individual repeatability and among‐individual variability were high. A substantial proportion of the variation in baseline cortisol could be explained in pups and mothers by a combination of intrinsic and extrinsic factors including sex, weight, day, season, and colony of birth. Our findings provide detailed insights into the individualization of endocrine phenotypes and their genetic and environmental drivers in a wild pinniped. Furthermore, the strong associations between cortisol and life history traits that we report in fur seals could have important implications for understanding the population dynamics of species impacted by environmental change. Stress is ubiquitous, but individuals differ. In Antarctic fur seals, individual stress levels can be explained by sex, weight, age, density, and food availability. Stress can influence how an individual behaves and interacts with its environment, so gaining a better understanding of those factors that explain variation in the stress response is important for population monitoring and conservation.
Journal Article
Life-history stage influences immune investment and oxidative stress in response to environmental heterogeneity in Antarctic fur seals
Immune defenses are crucial for survival but costly to develop and maintain. Increased immune investment is therefore hypothesized to trade-off with other life-history traits. Here, we examined innate and adaptive immune responses to environmental heterogeneity in wild Antarctic fur seals. In a fully crossed, repeated measures design, we sampled 100 pups and their mothers from colonies of contrasting density during seasons of contrasting food availability. Biometric and cortisol data as well as blood for the analysis of 13 immune and oxidative status markers were collected at two key life-history stages. We show that immune responses of pups are more responsive than adults to variation in food availability, but not population density, and are modulated by cortisol and condition. Immune investment is associated with different oxidative status markers in pups and mothers. Our results suggest that early life stages show greater sensitivity to extrinsic and intrinsic effectors, and that immunity may be a strong target for natural selection even in low-pathogen environments such as Antarctica.
An investigation into the immune profiles of Antarctic fur seals provides detailed insights into how organisms manage the allocation of and trade-offs among resources in a variable environment.
Journal Article
Movement patterns and activity levels are shaped by the neonatal environment in Antarctic fur seal pups
Tracking studies of juveniles are rare compared to those of adults, and consequently little is known about the influence of intrinsic and extrinsic factors on activity during this critical life stage. We used hourly GPS data, collected from 66 Antarctic fur seal pups from birth until moulting, to investigate the explanatory power of multiple individual-based and environmental variables on activity levels. Pups were sampled from two nearby breeding colonies of contrasting density during two subsequent years, and a two-state hidden Markov model was used to identify modalities in their movement behaviour, specifically ‘active’ and ‘inactive’ states. We found that movement was typified by central place exploration, with active movement away from and subsequent return to a location of inactivity. The probability of such directed exploration was unaffected by several factors known to influence marine mammal movement including sex, body condition, and temperature. Compared to pups born at the high-density colony, pups at low-density were more active, increased their activity with age, and transitioned earlier into the tussock grass, which offers protection from predators and extreme weather. Our study illustrates the importance of extrinsic factors, such as colony of birth, to early-life activity patterns and highlights the adaptive potential of movement.
Journal Article
Src Mutation Induces Acquired Lapatinib Resistance in ERBB2-Amplified Human Gastroesophageal Adenocarcinoma Models
ERBB2-directed therapy is now a routine component of therapy for ERBB2-amplified metastatic gastroesophageal adenocarcinomas. However, there is little knowledge of the mechanisms by which these tumors develop acquired resistance to ERBB2 inhibition. To investigate this question we sought to characterize cell line models of ERBB2-amplified gastroesophageal adenocarcinoma with acquired resistance to ERBB2 inhibition. We generated lapatinib-resistant (LR) subclones from an initially lapatinib-sensitive ERBB2-amplified esophageal adenocarcinoma cell line, OE19. We subsequently performed genomic characterization and functional analyses of resistant subclones with acquired lapatinib resistance. We identified a novel, acquired SrcE527K mutation in a subset of LR OE19 subclones. Cells with this mutant allele harbour increased Src phosphorylation. Genetic and pharmacologic inhibition of Src resensitized these subclones to lapatinib. Biochemically, Src mutations could activate both the phosphatidylinositol 3-kinase and mitogen activated protein kinase pathways in the lapatinib-treated LR OE19 cells. Ectopic expression of SrcE527K mutation also was sufficient to induce lapatinib resistance in drug-naïve cells. These results indicate that pathologic activation of Src is a potential mechanism of acquired resistance to ERBB2 inhibition in ERBB2-amplified gastroesophageal cancer. Although Src mutation has not been described in primary tumor samples, we propose that the Src hyperactivation should be investigated in the settings of acquired resistance to ERBB2 inhibition in esophageal and gastric adenocarcinoma.
Journal Article
Highly Pathogenic Avian Influenza Viruses (HPAIV) Associated with Major Southern Elephant Seal Decline at South Georgia
The emergence of highly pathogenic avian influenza viruses (HPAIV) has caused widespread mortality wildlife globally. In 2023, mass mortalities of southern elephant seals
Mirounga leonina
were observed in South America, and the virus subsequently reached the sub-Antarctic, affecting multiple species. The remoteness of these islands has limited assessment of its true impact. Here we present evidence of HPAIV’s effect on the number of breeding females at the world’s largest southern elephant seal population at South Georgia. Following the virus’ arrival in 2023, we recorded a 47% (SD = 14.2%) decline in the number of breeding females at the three largest breeding colony beaches in 2024 compared to 2022. The apparent loss of nearly half the breeding female population has serious implications for recruitment and future stability of the population. These findings highlight the urgent need for continued, intensive monitoring to track the long-term effects on this species.
Arrival of highly pathogenic avian influenza (HPAI) at the sub-Antarctic island of South Georgia in 2023 has triggered dramatic declines in attendance of female southern elephant seals during the 2024 breeding season.
Journal Article
Mental health: build predictive models to steer policy
Combine economic, social and medical data to forecast need and design services to address the growing crisis.
Combine economic, social and medical data to forecast need and design services to address the growing crisis.
Journal Article