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Stigmas, or discredited personal attributes, emanate from social perceptions of physical characteristics, aspects of character, and \"tribal\" associations (e.g., race; Goffman 1963). Extant research has emphasized the perspective of the stigma target, with some scholars exploring how social institutions shape stigma. Yet the ways stakeholders within the sociocommercial sphere create, perpetuate, or resist stigma remain overlooked. The authors introduce and define marketplace stigma as the labeling, stereotyping, and devaluation by and of commercial stakeholders (consumers, companies and their employees, stockholders, and institutions) and their offerings (products, services, and experiences). The authors offer the Stigma Turbine as a unifying conceptual framework that locates marketplace stigma within the broader sociocultural context and illuminates its relationship to forces that exacerbate or blunt stigma. In unpacking the Stigma Turbine, the authors reveal the critical role that market stakeholders can play in (de)stigmatization, explore implications for marketing practice and public policy, and offer a research agenda to further understanding of marketplace stigma and stakeholder welfare.

Stigmas, or discredited personal attributes, emanate from social perceptions of physical characteristics, aspects of character, and \"tribal\" associations (e.g., race; Goffman 1963). Extant research has emphasized the perspective of the stigma target, with some scholars exploring how social institutions shape stigma. Yet the ways stakeholders within the sociocommercial sphere create, perpetuate, or resist stigma remain overlooked. The authors introduce and define marketplace stigma as the labeling, stereotyping, and devaluation by and of commercial stakeholders (consumers, companies and their employees, stockholders, and institutions) and their offerings (products, services, and experiences). The authors offer the Stigma Turbine as a unifying conceptual framework that locates marketplace stigma within the broader sociocultural context and illuminates its relationship to forces that exacerbate or blunt stigma. In unpacking the Stigma Turbine, the authors reveal the critical role that market stakeholders can play in (de)stigmatization, explore implications for marketing practice and public policy, and offer a research agenda to further understanding of marketplace stigma and stakeholder welfare.

Background The delivery of cancer services changed significantly during the COVID-19 pandemic. This study aimed to describe changes in presentations, assess the change in recommendations by the MDT during the pandemic, and describe the subsequent long-term impact of these changes on survival rates in patients with EG cancer. Methods A retrospective cohort study was designed comparing three patient groups of those referred to EG MDT in the same 6-month period pre-pandemic (PP;2019) during the initial phase of the pandemic (P1;2020) and the year after the initial phase (P2;2021). The primary aim of this study was to describe and compare deviations from the standard of care across these three timeframes. Secondary outcomes included differences in the number of new cases with early and advanced oesophageal and gastric lesions, a comparison of survival rates among the groups, and an analysis of postoperative histopathology to identify any shifts in the tumour stage across the studied periods. Results A consistent demographic profile across these periods was maintained, but with a significant decrease in patient referrals during P1 (35.25% reduction from PP to P1 and 9.5% reduction from PP to P2), quicker ‘time to treatment’ during P1 (130.8 days in P1 vs 162 in PP and 178.9 in P2), and notable changes in treatment modalities. Additionally, we found an increased deviation from initial curative to palliative intent in the P2 group (6.4% changed in P2 vs 2.2% in PP and 3.5% in P2) primarily driven by disease progression. A further significant observation was the emergence of more aggressive tumour characteristics, particularly in the P2 group, albeit without a statistically significant difference in two-year overall survival rates among the groups ( p -value 0.31). Conclusion The COVID-19 pandemic significantly impacted oesophagogastric cancer care, with a reduction in patient referral rates during the initial pandemic phase and a subsequent increase in more advanced stage disease. Our findings from a major UK EG centre highlight accelerated treatment decision-making during the initial pandemic phase was possible and that standard of care was maintained. These insights provide valuable lessons for healthcare systems in managing cancer care during global health emergencies.

BackgroundSugira Muryango (SM) is a home-visiting intervention designed to promote early childhood development (ECD) and prevent violence in families with young children living in extreme poverty in rural Rwanda.MethodsWe present 4-year follow-up data collected in 2022 in n=1009 households (93%) from a cluster randomised trial. We compare outcomes in SM and usual care (UC) families using mixed-effect models. Results are reported as the average difference in change over time in the SM versus UC group for longitudinal outcomes and the average difference in SM versus UC groups for new outcomes.ResultsCompared with UC caregivers, caregivers who participated in SM report engaging in more stimulating interaction with their children (b=0.531; 95% CI: 0.468, 0.594) and are less likely to report use of harsh discipline (b=−0.189; 95% CI: −0.292, –0.087). The SM caregivers also provide more learning materials (b=0.218; 95% CI: 0.0219, 0.414), language stimulation (b=0.159; 95% CI: 0.080, 0.240), more varied interactions (b=147; 95% CI: 0.030, 0.260), fathers are reported to be more engaged in play (b=0.253; 95% CI: 0.039, 0.467) and SM households have better hygiene practices (b=0.189; 95% CI: 0.052, 0.326) compared with UC households. We do not observe treatment effects on children’s cognitive outcomes, self-regulation or behavioural problems. There is a small negative association between SM and height-for-age (b=−0.038; 95% CI: −0.062, –0.012).ConclusionsSM resulted in changes in caregivers’ behaviours to support children’s health and development. Despite positive caregiver effects, we did not observe effects on child development or behavioural outcomes. Programme updates may be required to support children’s continued cognitive growth.Trial registration numberNCT02510313.

Patients infected with the human immunodeficiency virus (HIV) have an increased cardiovascular risk. Although initially this increased risk was attributed to metabolic alterations associated with antiretroviral treatment, in recent years, the attention has been focused on the HIV disease itself. Inflammation, immune system activation, and endothelial dysfunction facilitated by HIV infection have been identified as key factors in the development and progression of atherosclerosis. In this review, we describe the epidemiology and pathogenesis of cardiovascular disease in patients with HIV infection and summarize the latest knowledge on the relationship between traditional and novel inflammatory, immune activation, and endothelial dysfunction biomarkers on the cardiovascular risk associated with HIV infection.