The Influence of COVID-19 on Irrational Consumption Behavior in a Chinese Sample: Based on a Serial Mediating Model.

Based on the scarcity theory, this study focuses on exploring the relationship between the severity of public health emergencies (i.e., COVID-19) and individual irrational consumer behaviors through the serial mediating variables of perceived scarcity (PS) and negative mentality (NM). An online questionnaire was used to collect data from participants in China and we obtained 466 effective (115 male and 351 female) questionnaires in total. The findings showed that the relationship between each pair of factors - perceived pandemic severity, PS, NM, and irrational consumption behaviors - was significantly positive. Although the perception of the severity of this public health emergency did not directly predict irrational consumer behavior, the effect was mediated by PS and NM independently and serially. These findings reveal that people who strongly perceive scarcity and are prone to negative attitudes are more likely to demonstrate irrational consumer behaviors (such as rushing to buy and hoard living supplies) once the public perceives a public health emergency as severe. This effect occurs because the PS that results from the epidemic affects people's cognition, emotion, and behavior.

The do-not-resuscitate order for terminal cancer patients in mainland China: A retrospective study.

With the development of palliative care, a signed do-not-resuscitate (DNR) order has become increasingly popular worldwide. However, there is no legal guarantee of a signed DNR order for patients with cancer in mainland China. This study aimed to estimate the status of DNR order signing before patient death in the cancer center of a large tertiary affiliated teaching hospital in western China. Patient demographics and disease-related characteristics were also analyzed.This was a retrospective chart analysis. We screened all charts from a large-scale tertiary teaching hospital in China for patients who died of cancer from January 2010 to February 2015. Analysis included a total of 365 records. The details of DNR order forms, patient demographics, and disease-related characteristics were recorded.The DNR order signing rate was 80%. Only 2 patients signed the DNR order themselves, while the majority of DNR orders were signed by patients' surrogates. The median time for signing the DNR order was 1 day before the patients' death. Most DNR decisions were made within the last 3 days before death. The time at which DNR orders were signed was related to disease severity and the rate of disease progression.Our findings indicate that signing a DNR order for patients with terminal cancer has become common in mainland China in recent years. Decisions about a DNR order are usually made by patients' surrogates when patients are severely ill. Palliative care in mainland China still needs to be improved.

A multicenter study on the validation of the Burnout Battery: a new visual analog scale to screen job burnout in oncology professionals.

OBJECTIVES: The objective of the study is to develop a novel tool-the Burnout Battery-for briefly screening burnout among oncology professionals in China and assessing its validity. METHODS: A multicenter study was conducted in doctors and nurses of the oncology departments in China from November 2014 to May 2015. The Burnout Battery was administered with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Doctors' Job Burnout Questionnaire. RESULTS: Of 538 oncology doctors and nurses who completed all the survey, using MBI-HSS as the standard tool for measuring burnout, 52% had emotional exhaustion, 39.4% had depersonalization, and 59.3% had a low sense of personal accomplishment. Receiver operating characteristic curve analyses showed that the best cut-off of the Burnout Battery was the battery with 3 bars, which yielded best sensitivity and specificity against all the 3 subscales of MBI-HSS. With this cut-off, nearly half of Chinese oncology professionals (46.8%) had burnout. The Burnout Battery correlated significantly with subscales of the MBI-HSS and the Doctors' Job Burnout Questionnaire. In multiple logistic regression analysis, those who worked more than 60 hours per week and who thought clinical work was the most stressful part of their job were more likely to experience burnout. CONCLUSION: Chinese oncology professionals exhibit high levels of burnout. The Burnout Battery appears to be a simple and useful tool for screening burnout. Working long hours and perceiving clinical work as the most stressful part of the job were the main factors associated with burnout.

Attitudes of Chinese Oncology Physicians Toward Death with Dignity.

BACKGROUND: Death with dignity (DWD) refers to the refusal of life-prolonging measures for terminally ill patients by "living wills" forms in advance. More and more oncology physicians are receiving DWD requests from advance cancer patients in mainland China. OBJECTIVE: The study objective was to investigate the attitudes of Chinese oncology physicians toward the legalization and implementation of DWD. METHODS: A questionnaire investigating the understanding and attitudes toward DWD was administered to 257 oncology physicians from 11 hospitals in mainland China. RESULTS: The effective response rate was 86.8% (223/257). The majority of oncology physicians (69.1%) had received DWD requests from patients. Half of the participants (52.5%) thought that the most important reason was the patients' unwillingness to maintain survival through machines. One-third of participants (33.0%) attributed the most important reason to suffering from painful symptoms. Most oncology physicians (78.9%) had knowledge about DWD. A fifth of respondents did not know the difference between DWD and euthanasia, and a few even considered DWD as euthanasia. The majority of oncology physicians supported the legalization (88.3%) and implementation (83.9%) of DWD. CONCLUSIONS: Many Chinese oncology physicians have received advanced cancer patients' DWD requests and think that DWD should be legalized and implemented. Chinese health management departments should consider the demands of physicians and patients. It is important to inform physicians about the difference between DWD and euthanasia, as one-fifth of them were confused about it.

The discordance of information needs between cancer patients and their families in China.

OBJECTIVE: We aimed at studying information needs of patients and their families, and their attitude towards the counterparts' information needs. Factors influencing psychological status of patients were investigated. METHODS: Self-designed questionnaires for information needs and attitude were delivered to participants. Patient Health Questionnaire 9-item and Generalized Anxiety Disorder 7-item scale were used to evaluate psychological status of patients. RESULTS: 183 eligible pairs of patients and families were involved. Except for the patients' expected life span, most patients and families needed information for all other subscales of disease-related information. Most patients wished families know more information; however, caregivers tended to prevent this. The occurrence of patients' psychiatric disorders was related to their needs for expected life span (OR 3.06 95%CI 1.36-6.93), as well as the attitude of caregivers about whether to provide more information about treatment outcomes (OR 0.24 95% CI 0.10-0.63). CONCLUSIONS: Information discordance between cancer patients and their families tended to happen when it came to patients' prognostic information. The psychological status of cancer patients was found in association with their information needs and families' attitude towards it. PRACTICE IMPLICATIONS: To guide oncology professionals and cancer patients' families for information provision.

Norepinephrine induced epithelial-mesenchymal transition in HT-29 and A549 cells in vitro.

PURPOSE: Norepinephrine (NE) has been implicated in epithelial-mesenchymal transition (EMT) of cancer cells. However, the underlying mechanism is poorly understood. The goal of this study was to explore the effect of NE on cancer cell EMT and to investigate the potential mechanism. METHODS: HT-29 and A549 cells were treated with NE, ß-adrenergic receptor (ß-AR) antagonist (propranolol) or inhibitor of transforming growth factor-ß (TGF-ß) receptor type I kinase (Ly2157299). Morphology of cells was observed with optical and electron microscope and immunofluorescence staining. Cellular migration and invasion were tested with transwell migration assay and Matrigel invasion assay, respectively. TGF-ß1 and cyclic adenosine monophosphate (cAMP) were quantified. EMT markers and signaling pathway were measured by RT-PCR and western blot. RESULTS: NE stimulated TGF-ß1 secretion and intracellular cAMP synthesis, induced morphological alterations in HT-29 and A549 cells, and enhanced their ability of migration and invasion. EMT markers induction was observed in NE-treated cancer cells. The effect of NE could be inhibited by propranolol or Ly2157299. ß-AR/TGF-ß1 signaling/p-Smad3/Snail and ß-AR/TGF-ß1 signaling/HIF-1α/Snail were two signaling pathways. CONCLUSION: These findings demonstrated that TGF-ß1 signaling pathway was a significant factor of NE-induced cancer cells EMT. The data also suggested that psychological stress might be a risk factor which enhances the ability of migration or invasion of cancer cells.