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CancerCOVID - Allocating resources for cancer care in times of the Sars-CoV-2 outbreak. Evidence and ethical implications

ABSTRACT: Interventions: Group 1: A qualitative interview study as well as a cross-sectional questionnaire survey is conducted with patients, oncologists and nurses working in the field of oncology (subproject 1). This is complemented by retrospective analysis of quantitative data derived from the registry of colon cancer centres (subproject 2) and data from the statutory health insurance (subproject 3). Primary outcome(s): Aim: Assessment of ethical and psychosocial challenges in cancer care via semi-structured interviews with stakeholders (oncologists, nurses, patients) between January and July 2021. Assessment of psychosocial burden of oncologists, nurses and patients between February and July 2021 via questionnaires. patients: Mini-SCL, EORTC QLQ-C30, NCCN Distress Thermometer, FACT-19 oncologists: PHQ-9, PHQ-15, GAD-7, Maslach Burnout Inventory, Moral Distress Thermometer, FACT-19, sociodemographic questionnaire nurses: PHQ-9, PHQ-15, GAD-7, Maslach Burnout Inventory, Moral Distress Thermometer, FACT-19, BERNCA, sociodemographic questionnaire Study Design: Allocation: ; Masking: ; Control: ; Assignment: ; Study design purpose: other

DISEASE(S): Colorectal Cancer, Pancreatic Cancercoronary Heart Disease, Diabetes Mellitus, Multiple Sclerosis

PROVIDER: 2439669 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: This study tests an expressive writing intervention. Expressive writing is the writing of deep thoughts and feelings about a cancer diagnosis and treatment. Participants engage in 4 writing sessions of 30 minutes duration each, spaced one week apart. Participants are allocated to one of two groups: Intervention group or Waitlist control group. The Intervention group participates in the intervention up to 4 weeks post their final cancer treatment session. The intervention is carried out individually by participants in their own homes, with phone assistance from a research assistant. Primary outcome(s): Improvement in physical symptoms and symptom distress (Symptom Experience Index)[Questionnaire is administered immediately prior to intervention, immediately after the intervention and at 4 months follow-up. The Waitlist control group fills out a questionnaire at timepoints identical to the Intervention group, plus an additional questionnaire immediately after their writing intervention.];Reduction in psychological distress[Questionnaire is administered immediately prior to intervention, immediately after the intervention and at 4 months follow-up. The Waitlist control group fills out a questionnaire at timepoints identical to the Intervention group, plus an additional questionnaire immediately after their writing intervention.];Anxiety and depression (Brief Symptom Inventory)[Questionnaire is administered immediately prior to intervention, immediately after the intervention and at 4 months follow-up. The Waitlist control group fills out a questionnaire at timepoints identical to the Intervention group, plus an additional questionnaire immediately after their writing intervention.];Increase in post-traumatic growth (Post-traumatic Growth Inventory)[Questionnaire is administered immediately prior to intervention, immediately after the intervention and at 4 months follow-up. The Waitlist control group fills out a questionnaire at timepoints identical to the Intervention group, plus an additional questionnaire immediately after their writing intervention.] Study Design: Purpose: Educational / counselling / training; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy

Project description:While Apis cerana cerana, like Apis mellifera, undergoes a behavioral transition from in-hive nursing to outdoor foraging duties, nothing is known about the genes underlying this social signal-triggered aged-related transition in this species. Here, we simultaneously sequenced the head transcriptomes of the 7-day-old normal nurses (N7BY), 18- and 22-day-old normal foragers (N18CJ and N22CJ), 7-day-old precocious foragers (Tq7CJ) and 22-day-old overaged or reverted nurses (Tq22BY) of A. cerana cerana by RNA-seq and made a 3-tier comparison (from pairwise to group-wise and between-group) to unravel the genes associated with this transition. Six pairwise comparisons revealed 165-492 differentially expressed genes between nurses vs. foragers. Subsequent 3 group-wise and 1 between-group comparisons narrowed the transition-associated genes down to 18 nurse- and 41 forager-unique genes and 29 (14 and 15 genes upregulated in nurses and foragers, respectively) differentially expressed genes between the 3 types of foragers and 2 types of nurses. The uniquely expressed genes are usually low-abundance long noncoding RNAs, transcription factors, transcription coactivators, RNA-binding proteins, kinases or phosphatases involved in signaling transduction and/or gene expression regulation, whereas the differentially expressed genes are often high-abundance downstream genes that directly perform the tasks of nurses or foragers, such as major royal jelly proteins for nurses and the genes involved in sugar/protein digestion, lipids/fatty acids metabolism, plant allelochemicals detoxification and defense against pathogens and predators for foragers. Mapping of the clean reads to the published A. mellifera genome uncovered that the 3 types of foragers had a greater percentage of reads from annotated exons and intergenic regions, whereas the 2 types of nurses had a greater percentage of reads from introns. Taken together, these results suggest that the reciprocal nurse-forager behavioral transition of the A. cerana cerana is regulated by a social signal-triggered intron-exon/intergenic epigenetic shift and the resulted transcriptional shift of the nurse- and forager-associated genes.

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CancerCOVID - Allocating resources for cancer care in times of the Sars-CoV-2 outbreak. Evidence and ethical implications

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