Every breath: the benefits of a lung cancer support group

Introduction: Cancer support groups provide valuable peer support for patients, carers and families. Lung cancer is the biggest cause of UK cancer deaths, but few local support groups exist due to patients' social vulnerabilities and stigma. A need was identified for a support group in Bromley, South East London. The COVID pandemic provided additional challenges to meet and support others. Method(s): The group was initiated by patients and the lung Clinical Nurse Specialist (CNS). Patients and relatives were invited to participate in a "lung cancer awareness" hospital stand. Sharing experiences was hugely beneficial leading to a regular meeting outside hospital. Patients established aims to provide: A voice for people living with lung cancer A sense of community, belonging and purpose A reason for hope The group is inclusive to patients, families and bereaved relatives. It survived the pandemic as an online community. Result(s): Every breath support group has been invaluable and feedback highlights the importance of a safe space to be understood. It successfully achieved its aims and continues to grow, with over 60 active members. It is recognised as the Bromley Mayors Charity of the year. Group members provide patient representation to local NHS Integrated Care Networks, and patient perspectives educating health professionals. Examples of group member feedback: "Every Breath has been like a family to me... This group have helped me find peace in the unknown." "Lung Cancer is the dirty cancer ... we are here to help support those in need and ... to change the perception of Lung Cancer" Conclusion(s): Every Breath support group offers a model for lung cancer support. Patients and CNS team have reached out to other areas to support establishing groups. Peer support has huge psychosocial benefits and should be available to every lung cancer patient and their family. Disclosure: No significant relationships.Copyright © 2023 Elsevier B.V.

Economic impacts of COVID-19 on inbound and domestic tourism☆

COVID-19 has led to an unprecedented disruption in tourism spending. This has propagated through the whole economy, however the scale of these system-wide consequences can be hard to quantify. We calculate direct reductions in spending across domestic and inbound tourism categories and then use a computable general equilibrium model to quantify their economic impacts. The results – illustrated using a model for Scotland and focusing on 2021 - demonstrate the scale of the losses in the tourism industry and the economy as a whole that are attributable to changes in both domestic and inbound tourism demand. We find that the extent to which domestic tourism demand can mitigate the losses in inbound spending depends on the composition of demand.

Implementing smartphone technology in practice using the Collaborative for Surgical Site Infection Surveillance (CASSIS) project: preliminary finding

Background: Understanding the burden of surgical site infection (SSI) requires comprehensive, reliable and comparable data. However, many hospitals do not routinely collect information on wound healing after the patient leaves hospital. Aim: To evaluate five post-discharge surveillance strategies that collect patient/carer reported outcomes on wound healing following adult and paediatric surgery. Method: Between March 2020 and February 2021, colleagues from five specialist hospitals in England collaborated to collect baseline and compliance data for the different methods of postdischarge surveillance. The five methods included were telephone follow-up;postal questionnaires;postal questionnaires and contacting non-responders by telephone to asking patients to install a postoperative app on their personal smartphone (Medopad, Huma) and using a SSI surveillance text link, which did not need to be installed (Isla, Islacare Ltd). Results: Overall, 1432 patients out of 2116 patients provided information about their wound after discharge. The group of patients who were asked to install an app on their smart device had the lowest return rate for information on their wound, while the system that used a text link and did not need to be installed had one of the highest return rates. Conclusion: Understanding baseline practice and evaluating different methods of discharge surveillance may help to drive improvement in this area. Our early findings suggest that in practice, a SSI surveillance approach using a text link and photos, such as Isla, which is used in hospital before discharge by staff and post-discharge by patients warrants further attention.

Pediatric sleep-disordered breathing during the COVID-19 pandemic

Introduction: Children with sleep-disordered breathing (SDB) are evaluated using polysomnography (PSG) and parent- reported measures prior to tonsillectomy and adenoidectomy (T&A). Elective T&As continue to be delayed during the COVID-19 pandemic. Therefore, we hypothesized that the average severity of SDB was greater in children presenting during the pandemic. Method: We performed a prospective study of children aged 5 to 17 years who presented to our tertiary care academic pediatric otolaryngology practice for evaluation of SDB between June 15, 2020, and December 12, 2020. We assessed parentreported disease severity using the Pediatric Sleep Questionnaire Sleep-Related Breathing Disorder (PSQ-SRBD) scale and objective severity using PSG. We compared SDB severity in these children with an age- and sex-matched prepandemic cohort. We compared average total PSQ score, apnea-hypopnea index (AHI), and oxygen saturation (SpO2) nadir in these 2 groups using t tests. A P value <.05 was considered significant. Results: A total of 23 patients have been enrolled in this study through December 3, 2020. The mean ± standard deviation (SD) PSQ total score was 11.4 ± 4.7 during the pandemic compared with 10.5 ± 4.0 in the prepandemic control group (P = .24). The mean ± SD AHI was 13.5 ± 14.3 in the pandemic cohort compared with 15.6 ± 18.1 in the prepandemic control group (P = .45). Similarly, the mean ± SD SpO2 nadir was 0.9 ± 0.1 in the pandemic cohort compared with 0.9 ± 0.1 in the control group (P = .25). Conclusion: There was no difference in SDB severity between children referred during the pandemic compared with those referred prior to it. These results suggest that caregivers and pediatricians view SDB as a problem that merits further evaluation and management even in the context of the pandemic. A strength of this study is the age- and sex-matching of controls. Weaknesses include the small sample size and the selection bias related to a single center. Future studies will focus on expanding the enrollment and the effect of T&A on the pandemic cohort.

Dedication, innovation, and collaboration: A mixed-methods analysis of school meals in Connecticut during COVID-19

When school buildings across the U.S. closed in March 2020 due to the COVID-19 pandemic, many school districts mobilized to establish emergency school meal programs to operate outside the setting of school cafeterias. The aim of this convergent mixed-methods study is to (a) examine the structure and rates of participation in the spring 2020 meal programs in Connecticut, and (b) obtain insight about the challenges, strategies used, and lessons learned during this time by food service leaders. We obtained quantitative data from the Connecticut State Department of Education and district websites, and qualitative data from nine one-hour interviews with school food service leaders. Although the National School Lunch Program provides meals at standard price, reduced-price, or no cost based on student household income, all emergency meals during spring 2020 were provided at no cost following the school closures resulting from the COVID-19 public health emergency declaration. The average number of meals distributed from March to May 2020 was significantly lower than the overall participation rates (i.e., paid, free, and reduced-price meals combined) prior to COVID-19. However, participation rates in April and May 2020 approached those of free and reduced-price meal participation a year earlier. Four key action themes emerged from the interviews: (1) tailor the program to community needs and resources;(2) identify strategies to facilitate participation;(3) develop partnerships to coordinate school, municipal, and community efforts;and (4) establish programs that encourage resiliency. The interviewees also saw this event as an opportunity to improve the perception of school meals. Innovations developed during the spring 2020 school building closures provide a road map for best practices for the 2020-2021 school year and beyond.