Suchergebnisse

The term "palliative care" has a negative connotation and may act as a barrier to early patient referrals. Rebranding has thus been proposed as a strategy to reduce the negative perceptions associated with palliative care. For example, using the term "supportive care" instead of "palliative care" in naming palliative care units has been proposed in several studies. In Taiwan, terms other than "palliative" and "hospice" are already widely used in the names of palliative care units. With this in mind, this study investigated the characteristics of palliative care unit names in order to better understand the role of naming in palliative care. Relevant data were collected from the Taiwan Academy of Hospice Palliative Medicine, the National Health Insurance Administration of the Ministry of Health and Welfare, and the open database maintained by the government of Taiwan. We found a clear phenomenon of avoiding use of the terms "palliative" and "hospice" in the naming of palliative care units, a phenomenon that reflects the stigma attached to the terms "palliative" and "hospice" in Taiwan. At the time of the study (September, 2016), there were 55 palliative care units in Taiwan. Only 20.0% (n = 11) of the palliative care unit names included the term "palliative," while 25.2% (n = 14) included the term "hospice." Religiously affiliated hospitals were less likely to use the terms "palliative" and "hospice" (χ2 = 11.461, P = .001). There was also a lower prevalence of use of the terms "palliative" and "hospice" for naming palliative care units in private hospitals than in public hospitals (χ2 = 4.61, P = .032). This finding highlights the strong stigma attached to the terms "palliative" and "hospice" in Taiwan. It is hypothesized that sociocultural and religious factors may partially account for this phenomenon.

Background: Relabeling has been proposed as a strategy to reduce the stigma associated with mental illnesses. Previous studies have shown that changing the names of psychiatry clinics has led to reduced feelings of being stigmatized among patients. In Taiwan, terms other than 'psychiatry' (in Chinese, jīng shén kē) are more commonly used in the names of psychiatry clinics. The term 'psychosomatic clinics' is widely used instead. Aims: This study investigated the characteristics of psychiatry clinic names in order to better understand the role of clinic names in primary care settings. Methods: Relevant data were extracted from an open database maintained by the government of Taiwan. These data included the names of community psychiatry clinics and hospital-based psychiatry clinics, population size and the degree of urbanization in the area served by each clinic. Results: At the time of this study, there were 254 community psychiatry clinics and 190 hospital-based psychiatry clinics in Taiwan. Only 18.9% of the community clinic names included the term 'psychiatry'. Additionally, 14.6% of community clinic names and 28.4% of hospital-based clinic names included the term 'psychosomatics'. The regions in which clinics without 'psychiatry' in their names were located had significantly larger populations and higher levels of urbanization than the regions in which clinics with 'psychiatry' in their names were located. Conclusion: A low prevalence of the term 'psychiatry' in community psychiatry clinic names was found in Taiwan. The stigma associated with psychiatry and other socio-cultural factors are hypothesized to explain this phenomenon.

ABSTRACTAs observed in real‐world practices, trade‐ins can be offered by either the manufacturer or the retailer. The party offering the trade‐in program faces the trade‐off between the fixed trade‐in cost incurred and the additional revenue generated. By conducting a game‐theoretic study, we analytically explore in this article the optimal choice of trade‐in provider in a dyadic supply chain with a single manufacturer and a single retailer. We show that the trade‐in models can bear a much higher manufacturing cost and induce a higher new product sale than the benchmark case without trade‐ins. It is possible that both the manufacturer and retailer prefer to undertake the trade‐in program, which would lead to a conflict; or both firms prefer to be a free rider instead of being the trade‐in provider, which would fall into a prisoner's dilemma. Moreover, the powerful manufacturer has an incentive to delegate the trade‐in service to the retailer when facing a higher fixed trade‐in cost, but the delegation option is always worse off for the retailer compared to the scenario in which the retailer provides trade‐ins by herself. We also show that the trade‐in scenarios always benefit the environment and consumers of the replacement segment, but hurt the primary segment consumers. The social welfare would actually be higher in the scenarios with trade‐ins if the fixed trade‐in cost is relatively low and the residual value of old products is relatively high.

Yi Feng,1,2 Ying Dai,1,2 Zhihua Gong,1,2 Jia-Nan Cheng,1,2 Longhui Zhang,1,2 Chengdu Sun,1,2 Xianghua Zeng,1,2 Qingzhu Jia,1,2 Bo Zhu1,2 1Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China; 2Chongqing Key Laboratory of Tumor Immunotherapy, Chongqing, People's Republic of China Background: A suppressive immune microenvironment and pathological angiogenesis are hallmarks of gastric cancer. Theoretically, immune checkpoint inhibitors (ICIs) stimulate pre-primed neoantigen-specific T cells, and antiangiogenic agents then facilitate their infiltration into the tumor niche by promoting vascular normalization. Currently, the interconnections of these two phenotypes and their relevance to the tumor microenvironment (TME) have not been fully characterized in gastric cancer.Materials and methods: Transcriptome profiling data retrieved from The Cancer Genome Atlas (TCGA) database were used to deconvolute the feature of TME for gastric cancer (N = 375). Machine learning, correlation, and prognosis analysis were applied to elucidate the correlations between angiogenesis, cytotoxic T lymphocyte infiltration, and patient survival.Results: Substantial heterogeneous infiltration of immune cell populations among cases was observed. Furthermore, among targetable pathways, angiogenesis was identified as the dominant factor in discriminating different infiltration statuses. Most importantly, the angiogenesis pathway was negatively correlated with the amount of activated CD8+ T cells only for patients with a higher infiltration, and the concomitance of low angiogenesis signaling and highly activated CD8+ T-cell infiltration was associated with a significant survival benefit.Conclusion: Our findings demonstrated a negative correlation between angiogenesis signaling and cytotoxic function in gastric cancer patients with a highly infiltrated immune niche. These data provided a rationale for potential combination strategy and further clinical investigations of ICIs plus antiangiogenesis agents for patients with gastric cancer with an inflamed TME. Keywords: gastric cancer, immune microenvironment, TCGA, angiogenesis, therapeutic implications

Noroviruses (NVs) are important causes of nonbacterial gastroenteritis in humans, but the role of NVs as a cause of diseases in the Chinese people, particularly in Chinese military personnel, remains unclear. This study investigated antibody prevalence and factors that associate with the prevalence of antibody to NVs among students attending a military medical university. Serum specimens were tested by an enzyme-linked immunosorbent assay for immunoglobulin G antibody to recombinant capsid antigens of three NVs (rNorwalk, rMxV, and rVA387). Of 588 serum samples tested, the antibody prevalence was 88.9, 54.1, or 90.0% for the three antigens, respectively. There were significant differences in the prevalence of antibody to rMxV between blood types (P < 0.05); the prevalence for type O was the highest (62.5%), and the prevalence for type B was the lowest (49.1%). The average optical density values for antibody to rNorwalk and rMxV were lowest among students with type B. The number of students who did not have antibody to any of the three antigens was the highest for blood type B (6.9%) compared to other blood types (0.8 to 3.4% [P < 0.006]). The antibody prevalence also varied with the hometown residencies of the students before joining the military, with the highest rates for students from rural areas, lower rates for students from small towns or villages, and the lowest rates for students from large cities. The numbers of students who did not have antibody to any of the three antigens were highest for students from the large cities, lower for students from small towns or villages, and lowest for students from rural areas. The distribution of ABO blood types did not differ among the three groups. These data suggest that NVs are prevalent in China and that both genetic and environmental factors play a role in NV infection.