Východiska: Mobilní aplikace MOÚ MindCare má za sebou první rok fungování na Masarykově onkologickém ústavu (MOÚ) v rámci randomizované kontrolované studie hodnotící její efektivitu. Cílem příspěvku je shrnout první výsledky vyplývající z procesu náboru pacientů a poukázat na úskalí implementace eHealth programu na podporu duševního zdraví do běžné praxe. Metody: Nábor pacientů do studie MOÚ MindCare probíhá na MOÚ od června roku 2022. Cesty náboru jsou tvořeny z několika úrovní. V rámci mediální propagace byly zvoleny následující komunikační kanály: reklamní bannery v čekárnách, podcasty a rozhlasové vysílaní, webové stránky, sociální sítě a cca 5 000 ks letáků. Druhou úrovní komunikace je aktivní oslovování pacientů studiovými koordinátory přímo na MOÚ. K 30. červnu 2023 bylo do studie zaregistrováno celkem 408 pacientů. Součástí sběru dat je zaznamenávání základních údajů o pacientech (demografické údaje, klinické stadium onemocnění, záměr léčby atp.), ale i důvody odmítnutí vstupu do studie. Stejně tak je sledováno předčasné ukončení v jednotlivých fázích studie. Výsledky: Výsledky naznačují, že pacientky s diagnózou karcinom prsu vykazují vyšší adherenci k účasti ve studii. Nejčastějšími důvody odmítnutí vstupu do studie je: nezájem o psychologickou intervenci, nedostatek času, absence chytrého telefonu nebo nedostatečná technická zdatnost. Z rozhovorů s oslovenými pacienty je zřejmé, že duševní zdraví, a zejména pak vlastní péče o něj, není stále dostatečně srozumitelným tématem, a to i přesto, že velké množství osob léčící se s onkologickou diagnózou zažívá v některé fázi onemocnění distres. Závěr: Z naších prvních zkušeností vyplývá, že způsob náboru, kontext a průběh studie, pohlaví respondentů a také jejich diagnóza mají zásadní vliv na adherenci k programu a drop out ze studie.
Background: The MOÚ MindCare mobile application has completed its first year of operation at the Masaryk Memorial Cancer Institute (MMCI) as part of a randomized controlled trial evaluating its effectiveness. The aim of this contribution is to summarize the first results stemming from the patient recruitment process and to highlight the challenges of implementing an eHealth program to support mental health in routine practice. Methods: Patient recruitment for the MOÚ MindCare study has been conducted at the MMCI since June 2022. The recruitment strategies involve several levels. For media promotion, the following communication channels were chosen: advertising banners in waiting rooms, podcasts, radio broadcasts, websites, social media, and approx. 5,000 leaflets. The second level of communication involves active engagement with patients by study coordinators directly at the MMCI. As of June 30, 2023, a total of 408 patients have been registered in the study. Data collection includes recording basic patient information (demographics, clinical stage of illness, treatment intentions, etc.), as well as reasons for study refusal and premature termination in various study phases. Results: The results show that patients diagnosed with breast cancer show higher adherence to study participation. The most common reasons for study refusal include disinterest in psychological intervention, lack of time, absence of a smartphone, or insufficient technical ability. From conversations with approached patients, it is evident that mental health, particularly self-care, remains an insufficiently comprehensible topic, even though we know that a considerable number of individuals undergoing cancer treatment experience distress at some stage of the illness. Conclusion: Based on our first experiences, recruitment methods, study context, respondents’ gender, and their diagnosis have a significant impact on program adherence and study drop-out rates.
- MeSH
- dospělí MeSH
- duševní zdraví MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mobilní aplikace MeSH
- nádory * psychologie MeSH
- randomizované kontrolované studie jako téma MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- telemedicína * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
BACKGROUND: A growing body of literature shows that psychological distress is not only a major threat to psychological well-being but can also have a significant impact on physical health. In cancer patients, it can negatively affect prognosis and posttreatment recovery processes. Since face-to-face psychological interventions are often inaccessible to cancer patients, researchers have recently been focusing on the effectiveness of eHealth adaptations of well-established approaches. In this context, there has been a call for high-quality randomised controlled trials that would allow for a direct comparison of different approaches, potentially addressing different needs and preferences of patients, and also for more systematic research focusing on how psychological interventions affect not only psychological but also biological markers of stress. Both of these questions are addressed in the present study. METHODS: A randomised controlled trial will be carried out to test and compare the effectiveness of three eight-week eHealth programmes for the mental health support of cancer patients. All programmes will be delivered through the same application for mobile devices MOU MindCare. N = 440 of breast cancer survivors will be recruited at the end of their adjuvant treatment (chemotherapy, radiotherapy, or both) and randomly assigned to one of the three interventions - Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), Positive Psychology (PP), or Autogenic Training (AT) - or the treatment-as-usual (TAU) control group. Psychological and biological markers of stress and adaptive functioning will be assessed at baseline (T0), post-treatment (T1), three-month follow-up (T2), and nine-month follow-up (T3). Primary outcomes will include heart-rate variability and self-report measures of depression, anxiety, perceived stress, general quality of life, and positive mental health. Secondary outcomes will include the levels of serum cortisol and immunomarkers, sleep quality, fatigue, common health symptoms, and several transdiagnostic psychological variables that are expected to be specifically affected by the MBCT-Ca and PP interventions, including dispositional mindfulness, emotion regulation, self-compassion, perceived hope, and gratitude. The data will be analysed using the mixed model repeated measures (MMRM) approach. DISCUSSION: This trial is unique in comparing three different eHealth interventions for cancer patients based on three well-established approaches to mental health support delivered on the same platform. The study will allow us to examine whether different types of interventions affect different indicators of mental health. In addition, it will provide valuable data regarding the effects of stress-reducing psychological interventions on the biomarkers of stress playing an essential role in cancer recovery processes and general health.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
Although the link between microbial infections and Alzheimer's disease (AD) has been demonstrated in multiple studies, the involvement of pathogens in the development of AD remains unclear. Here, we investigated the frequency of the 10 most commonly cited viral (HSV-1, EBV, HHV-6, HHV-7, and CMV) and bacterial (Chlamydia pneumoniae, Helicobacter pylori, Borrelia burgdorferi, Porphyromonas gingivalis, and Treponema spp.) pathogens in serum, cerebrospinal fluid (CSF) and brain tissues of AD patients. We have used an in-house multiplex PCR kit for simultaneous detection of five bacterial and five viral pathogens in serum and CSF samples from 50 AD patients and 53 healthy controls (CTRL). We observed a significantly higher frequency rate of AD patients who tested positive for Treponema spp. compared to controls (AD: 62.2 %; CTRL: 30.3 %; p-value = 0.007). Furthermore, we confirmed a significantly higher occurrence of cases with two or more simultaneous infections in AD patients compared to controls (AD: 24 %; CTRL 7.5 %; p-value = 0.029). The studied pathogens were detected with comparable frequency in serum and CSF. In contrast, Borrelia burgdorferi, human herpesvirus 7, and human cytomegalovirus were not detected in any of the studied samples. This study provides further evidence of the association between microbial infections and AD and shows that paralleled analysis of multiple sample specimens provides complementary information and is advisable for future studies.
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Alzheimer's disease (AD) is a chronic neurodegenerative disease associated with the overproduction and accumulation of amyloid-β peptide and hyperphosphorylation of tau proteins in the brain. Despite extensive research on the amyloid-based mechanism of AD pathogenesis, the underlying cause of AD is not fully understood. No disease-modifying therapies currently exist, and numerous clinical trials have failed to demonstrate any benefits. The recent discovery that the amyloid-β peptide has antimicrobial activities supports the possibility of an infectious aetiology of AD and suggests that amyloid-β plaque formation might be induced by infection. AD patients have a weakened blood-brain barrier and immune system and are thus at elevated risk of microbial infections. Such infections can cause chronic neuroinflammation, production of the antimicrobial amyloid-β peptide, and neurodegeneration. Various pathogens, including viruses, bacteria, fungi, and parasites have been associated with AD. Most research in this area has focused on individual pathogens, with herpesviruses and periodontal bacteria being most frequently implicated. The purpose of this review is to highlight the potential role of multi-pathogen infections in AD. Recognition of the potential coexistence of multiple pathogens and biofilms in AD's aetiology may stimulate the development of novel approaches to its diagnosis and treatment. Multiple diagnostic tests could be applied simultaneously to detect major pathogens, followed by anti-microbial treatment using antiviral, antibacterial, antifungal, and anti-biofilm agents.
A variety of DNA lesions, secondary DNA structures or topological stress within the DNA template may lead to stalling of the replication fork. Recovery of such forks is essential for the maintenance of genomic stability. The structure-specific endonuclease Mus81-Mms4 has been implicated in processing DNA intermediates that arise from collapsed forks and homologous recombination. According to previous genetic studies, the Srs2 helicase may play a role in the repair of double-strand breaks and ssDNA gaps together with Mus81-Mms4. In this study, we show that the Srs2 and Mus81-Mms4 proteins physically interact in vitro and in vivo and we map the interaction domains within the Srs2 and Mus81 proteins. Further, we show that Srs2 plays a dual role in the stimulation of the Mus81-Mms4 nuclease activity on a variety of DNA substrates. First, Srs2 directly stimulates Mus81-Mms4 nuclease activity independent of its helicase activity. Second, Srs2 removes Rad51 from DNA to allow access of Mus81-Mms4 to cleave DNA. Concomitantly, Mus81-Mms4 inhibits the helicase activity of Srs2. Taken together, our data point to a coordinated role of Mus81-Mms4 and Srs2 in processing of recombination as well as replication intermediates.
- MeSH
- "flap" endonukleasy fyziologie MeSH
- DNA primery MeSH
- DNA vazebné proteiny fyziologie MeSH
- DNA-helikasy fyziologie MeSH
- endonukleasy fyziologie MeSH
- fluorescenční mikroskopie MeSH
- polymerázová řetězová reakce MeSH
- rekombinace genetická * MeSH
- Saccharomyces cerevisiae - proteiny fyziologie MeSH
- Saccharomyces cerevisiae metabolismus MeSH
- sekvence nukleotidů MeSH
- techniky dvojhybridového systému MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
