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Factors Related to Treatment Refusal in Taiwanese Cancer Patients
Chiang, Ting-Yu,Wang, Chao-Hui,Lin, Yu-Fen,Chou, Shu-Lan,Wang, Ching-Ting,Juang, Hsiao-Ting,Lin, Yung-Chang,Lin, Mei-Hsiang Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8
Background: Incidence and mortality rates for cancer have increased dramatically in the recent 30 years in Taiwan. However, not all patients receive treatment. Treatment refusal might impair patient survival and life quality. In order to improve this situation, we proposed this study to evaluate factors that are related to refusal of treatment in cancer patients via a cancer case manager system. Materials and Methods: This study analysed data from a case management system during the period from 2010 to 2012 at a medical center in Northern Taiwan. We enrolled a total of 14,974 patients who were diagnosed with cancer. Using the PRECEDE Model as a framework, we conducted logistic regression analysis to identify independent variables that are significantly associated with refusal of therapy in cancer patients. A multivariate logistic regression model was also applied to estimate adjusted the odds ratios (ORs) with 95% confidence intervals (95%CI). Results: A total of 253 patients (1.69%) refused treatment. The multivariate logistic regression result showed that the high risk factors for refusal of treatment in cancer patient included: concerns about adverse effects (p<0.001), poor performance(p<0.001), changes in medical condition (p<0.001), timing of case manager contact (p=.026), the methods by which case manager contact patients (p<0.001) and the frequency that case managers contact patients (${\geq}10times$) (p=0.016). Conclusions: Cancer patients who refuse treatment have poor survival. The present study provides evidence of factors that are related to refusal of therapy and might be helpful for further application and improvement of cancer care.
Risk Factors for Cervical Cancer in Rural Areas of Wuhan China: a Matched Case-control Study
Zhang, Bin,Zhou, Ai-Fen,Zhu, Chang-Cai,Zhang, Ling,Xiang, Bing,Chen, Zhong,Hu, Rong-Hua,Zhang, Ya-Qi,Qiu, Lin,Zhang, Yi-Ming,Xiong, Chao-Du,Du, Yu-Kai,Shi, Yu-Qin Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12
Cervical cancer is a serious public health problem in developing countries. We investigated possible risk factors for cervical cancer in rural areas of Wuhan China using a matched case-control study with 33 women diagnosed with cervical cancer and 132 healthy women selected from the same area as matched controls. A questionnaire, which included questions about general demography conditions, environmental and genetic factors, the first sexual intercourse, first marriage age, age at first pregnancy, pregnancy first child's age, female personal health history, social psychological factors, dietary habits, smoking and alcohol status and other living habits was presented to all participants. At the same time, HPV infection of every participant was examined in laboratory testing. Results showed HPV infection (P<0.000, OR=23.4) and pregnancy first child's age (P<0.000, OR=13.1) to be risk factors for cervical cancer. Menopause (P=0.003, OR=0.073) was a protective factor against cervical cancer. However, there was no indication of associations of environmental (drinking water, insecticide, disinfectant) genetic (cancer family history), or life-style factors (smoking status, alcohol status, physical training, sleep quality), including dietary habits (intake of fruit and vegetable, meat, fried food, bean products and pickled food) or social psychological factors with cervical cancer. The results suggest that the risk of cervical cancer in Chinese rural women may be associated with HPV infection, menopause and the pregnancy first child's age.
Chien-Ning Hsu,Ya-Ting Lin,Yu-Hsu Chen,Tsung-Yu Tseng,Hsing-Fen Tsai,Shinn-Gwo Hong,Chao-Ling Yao 한국생물공학회 2023 Biotechnology and Bioprocess Engineering Vol.28 No.3
Repair and regeneration of vascular tissue is a crucial current research focus in the fields of biomedical engineering and regenerative medicine. Numerous studies revealed that cells are required to grow on an appropriate extracellular matrix to maintain or enhance functionality. In the present study, various surface modification methods were evaluated to fix fibronectin on the surface of a bio-based and aligned poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) film for vascular tissue engineering. After chemical modification, the properties of the fibronectin-fixed PHBV films were examined and compared with the original films, including -NH2 group expression, contact angle, mechanical properties, and fibronectin binding amount. Then, cytotoxicity and biocompatibility were measured by culture with L929 cells and endothelial progenitor cells (EPCs) of the fibronectinfixed PHBV films. In addition, cell morphology, cell growth kinetics, acetylated low-density lipoprotein uptake ability, lectin binding ability and specific gene expressions of cultured EPCs on fibronectin-fixed PHBV films were also analyzed. Taken together, our data demonstrated that the surface of the aligned PHBV films could be successfully modified to immobilize fibronectin. Importantly, EPCs cultured on the fibronectin-fixed PHBV films showed excellent cell biocompatibility, a rapid proliferation rate, an aligned growth direction and correct cell functions. We believed that fibronectin-fixed PHBV films can serve as a potential scaffold for vascular tissue engineering.
Yuan-Hwa Chou,Po-Chung Chu,Szu-Wei Wu,Jen-Chin Lee,Yi-Hsuan Lee,I-Wen Sun,Chen-Lin Chang,Chien-Liang Huang,I-Chao Liu,Chia-Fen Tsai,Yung-Chieh Yen 대한정신약물학회 2015 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.13 No.2
Bipolar disorder (BD) is a major psychiatric disorder that is easily misdiagnosed. Patient adherence to a treatment regimen is of utmost importance for successful outcomes in BD. Several trials of antipsychotics suggested that depot antipsychotics, including long-acting first- and second-generation agents, are effective in preventing non-adherence, partial adherence, and in reducing relapse in BD. Various long-acting injectable (LAI) antipsychotics are available, including fluphenazine decanoate, haloperidol decanoate, olanzapine pamoate, risperidone microspheres, paliperidone palmitate, and aripiprazole monohydrate. Due to the increasing number of BD patients receiving LAI antipsychotics, treatment guidelines have been developed. However, the clinical applicability of LAI antipsychotics remains a global cause for concern, particularly in Asian countries. Expert physicians from Taiwan participated in a consensus meeting, which was held to review key areas based on both current literature and clinical practice. The purpose of this meeting was to generate a practical and implementable set of recommendations for LAI antipsychotic use to treat BD; target patient groups, dosage, administration, and adverse effects were considered. Experts recommended using LAI antipsychotics in patients with schizophrenia, rapid cycling BD, BD I, and bipolar-type schizoaffective disorder. LAI antipsychotic use was recommended in BD patients with the following characteristics: multiple episodes and low adherence; seldom yet serious episodes; low adherence potential per a physician’s clinical judgment; preference for injectable agents over oral agents; and multiple oral agent users still experiencing residual symptoms.