Short-Term Outcomes of COVID-19 Pandemic on Non-Small Cell Lung Cancer Screening and Management.

Background To assess the impact of coronavirus disease 2019 (COVID-19) pandemic on non-small cell lung cancer (NSCLC) screening, staging, and management in a single health care system. Materials and Methods From November 2015 to December 2020, a total of 1,547 NSCLC cases was reported at our institution including 1,329 cases pre-COVID-19 and 218 cases during COVID-19. Pre-COVID-19 was defined as November 2015 to February 2020, while during COVID-19 was March 2020 to December 2020. Data were collected from tumor registry and medical record review. Patients with mesothelioma, lymphoma, small cell, or mixed small cell cancer were excluded from the study. Results Both pre-COVID-19 and during COVID-19 cohorts had similar comorbidities including age (70 vs. 71 years), current smokers (35 vs. 32%), and chronic obstructive lung disease (32 vs. 28%). The number of low-dose computed tomography lung cancer screening scans decreased by 25% during COVID-19 compared with pre-COVID-19 era. There were more cases of stage 1A NSCLC pre-COVID-19 (31 vs. 25%) and more stage 4 cancer during COVID-19 (42 vs. 33%); p = 0.01. The proportion of patients treated with radiotherapy was similar between pre-COVID-19 and during COVID-19 (49 vs. 50%), but fewer patients underwent surgery during COVID-19 (17 vs. 27%; p = 0.004). The median time to radiotherapy (67 days) and surgery (29 days) was similar between the groups. The unadjusted overall 6-month mortality after lung cancer diagnoses was higher during COVID-19 compared with pre-COVID-19 (28 vs. 22%; p = 0.04). Conclusion The COVID-19 pandemic resulted in delayed lung cancer screening scans, and more patients had diagnosis of advanced NSCLC; however, short-term mortality was unchanged.

Developing social presence in online learning among nurses: Exploration of the community of inquiry models domain of social using a qualitative descriptive design.

There is marked increase in the demand for online learning in nursing curriculums. However, online learning has been criticised for being detached and impersonal resulting in low levels of engagement. In a world that is rapidly shifting to online learning as a result of the global COVID-19 pandemic creating quality online learning environments has become more pressing. The Community of Inquiry (COI) is a well-established model used to frame online environments in many disciplines including nursing. The COI model proposes that social, cognitive and teacher presences must exist in the online learning space for learning to occur. It is argued that social presence remains less understood despite being one of the essential elements. Therefore, the objectives of this study were to understand how facilitators and participants engage with and use a social presence in an online seminar. It is concluded that when facilitators include the use of a social presence in the design of the online learning space in-depth engagement with online content also increases. This can happen rapidly (less than an hour) and continue for several weeks. It is deduced that a social presence enhances a sense of realness among participants of online learning and through an increased sense realness engagement increases.