ObjectiveBioZorb® is a tumor bed marker placed during partial mastectomy for targeted post-operative radiation. This study was designed to evaluate BioZorb® effect on radiation boost clinical target volume (CTV), planning target volume (PTV), median dose to ipsilateral lung (Gy), and heart irradiation in left-sided cancers.MethodsData was collected via a retrospective cohort study with two study arms: BioZorb® intra-operative placement versus no BioZorb® placement. Patients were stratified by BMI, age, tumor laterality and volume, and cancer stage. Mean, standard deviation, median, range of cubic centimeters of clinical and planning target volume, cardiac dose in left-sided cancers, ipsilateral lung dose, and volume of ipsilateral lung receiving 20 Gy were reported.ResultsOf 143 patients, median CTV (cm3) was 8.7 and 14.2 (P = 0.0048), median PTV (cm3) was 53.2 and 79.6 (P = 0.0010), median ipsilateral lung Gy was 7.53 and 6.74 (P = 0.0099) and volume (cc) of ipsilateral radiation lung at 20 Gy was 13.4 and 12 (P = 0.008), and median heart Gy in left-sided cancers was 2.01 and 2.21 (P = 0.9952) in BioZorb® and non-BioZorb® arms, respectively. Patients with BMIs of 25–30 had CTV medians of 7.8 and 11.1 in BioZorb® and non-BioZorb® arms, respectively (P = 0.0293).ConclusionThe BioZorb® arm showed statistically significant reductions in CTV and PTV but not ipsilateral lung or heart irradiation.

Background Transferring effective health and wellbeing interventions into community-based settings is challenging, with many only ever implemented in the academic settings in which they were developed. Over the last few years, Teaching Recovery Techniques (TRT), a community-based intervention for refugee youth reporting symptoms of post-traumatic stress, has been scaled up across Sweden using the model of a distribution network pathway. This means the lead organisation works with a distribution organisation using the latter's existing network of implementing organisations. Often the distribution partner is a national organisation with many local member agencies. The model offers possibility for quick spread, but only allows for a low level of control at the local site level. Therefore, it is important to understand the factors and agents that have facilitated the implementation and maintenance of TRT from successful sites, in order to inform ongoing efforts to scale up the intervention. Methods Semi-structured interviews were conducted with personnel from 'successful' TRT sites, defined as having conducted at least two TRT groups and maintaining full delivery of the programme. Interview data were analysed using content analysis. Results Our results indicated that active networking and collaboration were key to successful maintenance of TRT delivery. Active recruitment strategies, resource availability and management, and careful integration of the interpreter were also raised as important factors. Conclusions Although the interviewed professionals represented successful sites, they remained dependent on informal networks and collaboration for programme delivery. The possibility of integrating TRT into a local stepped-care model for post-traumatic stress in refugee children and adolescents will be presented. Key messages Transferring effective health and wellbeing interventions into community-based settings is challenging, with many only ever implemented in the academic settings in which they were developed. Active networking and collaboration are key to successful maintenance of community interventions.

Objective Sweden is an international exception in its public health response to the COVID-19 pandemic, with a higher number of deaths, albeit not pediatric, compared with other Nordic countries. The objective of this study was to investigate what worries children and adolescents living in Sweden expressed in relation to the pandemic. Methods Using an anonymous web-survey, 1,047 children (4-12 years; N ¼ 717) and adolescents (13-18 years; N ¼ 330) responded to five background and four open-ended questions, one of which was: Is there anything that you are worried about when it comes to 'Corona'? The responses were coded using manifest content analysis.Interrater reliability was .95, assessed on the code level. Results Worry was common (77%); mostly (60%) related to disease or death of elderly relatives, parents, the child him/herself or general worry for the elderly/risk groups. Existential worry (15%) comprised worries about the future, including economy and worries about the world perishing or the contagion becoming uncontrollable. A developmental trajectory was evident in the nature of responses. Adolescents' worries about the future included missing out on their youth and employment. They also worried about society (6%), for example, the future of democracy and the world economy. There was no indication of socioeconomic status or geographic area (urban vs. rural) affecting the presence of worrisome thoughts. Conclusions Worry about "Corona" was common. Universal preventative mental health intervention is warranted and could be conducted in the school setting. Intervention could be tailored by age, covering discussion on financial aspects with adolescents.

Purpose The survival rate amongst breast cancer survivors (BCS) have been increasing, with a 5-year survival rate of almost 90%. These women face many quality of life (QOL) issues either due to either cancer itself or the complex treatment regimen. Our retrospective analysis aims to identify at risk populations among the BCS and their most common concerns. Methods This is a single-institution, retrospective, descriptive analysis of patients who were seen at our Breast Cancer Survivorship Program from October 2016 to May 2021. Patients completed a comprehensive survey which assessed self-reported symptoms, their concerns and degree of worry and recovery to baseline. The descriptive analysis on the patient characteristics included age, cancer stage and treatment type. The bivariate analysis included the relationship between the patient characteristics and their outcomes. Analysis of group differences was completed with Chi-square test. When the expected frequencies were five or less, Fisher exact test was used. Logistic regression models were developed to identify significant predictors for outcomes. Results 902 patients (age 26–94; median 64) were evaluated. Majority of women had stage 1 breast cancer. The most common self-reported concerns affecting the patients were fatigue (34%), insomnia (33%), hot flashes (26%), night sweats (23%), pain (22%), trouble concentrating (19%), and neuropathy (21%). Though 13% of BCS felt isolated at least 50% of their time, the majority of patients (91%) reported having a positive outlook and felt that they have a sense of purpose (89%). Younger patients were more likely to worry about their cancer more than 50% of the time (p < 0.0001). Patients that were less likely to return back to at least 50% of their pre-treatment baseline were younger (age ≤ 45) (p = 0.0280), had higher stage breast cancer (Stage 2–4) (p = 0.0061), and had chemotherapy either alone or as part of their multi-modality treatment (p < 0.0001). Conclusion According to our study, younger patients, those with higher stage breast cancer and survivors who had chemotherapy may experience significant QOL issues. Fortunately, majority of BCS report a positive and optimistic outlook post treatment. Identifying common concerns after treatments and vulnerable populations are especially important to deliver quality care and to optimize interventions. Implications for Cancer Survivors Our study identified the most common self-reported concerns affecting BCS. In addition, our results suggest that younger patients, patients with higher stage breast cancer and survivors who had chemotherapy were more likely to have QOL issues. Despite this, our study showed, the majority of BCS reported positive outlooks and emotions.

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