The need to research refractory breathlessness

High-quality research is needed to improve quality of life for people with chronic refractory breathlessness in COP

Evacuation Preparedness of Public Transportation in Rural Coast Communities of the North Gulf Region

In 2005, devastating hurricanes Katrina and Rita hit the Gulf Coast of the United States of America, leaving 1,300 people dead, 705 people missing, and destroying over 90,000 square miles of property valued at $80 billion (Nationwide Plan Review-2006). During these natural disasters, coastal communities required mass evacuation and major emergency transportation services, and experienced fuel shortages, traffic congestion, significant delay in civil supplies, frustration and risk during evacuation, and a lack of public transportation for vulnerable populations which literally left them behind. Coastal communities along the I-10 corridor from Florida to Louisiana are predominantly rural. Since the devastating 2005 hurricanes, rural communities within 100 miles of the immediate coastline have experienced rapid growth that has impacted already limited infrastructure. Nearly 40 percent of the country’s transit-dependent population, primarily senior citizens, persons with disabilities, and low-income individuals, live in rural areas. Due to a lack of travel services, rural populations are more automobile dependent than their urban counterparts. When evacuation occurs, rural coastal communities are at high risk and difficult to evacuate in a timely manner due to larger geographical areas, low density and limited resources. Before 2005, public transportation operators in the U.S. did not take the lead on evacuation planning, nor were they viewed as a viable option for evacuation. Now, there is increased national awareness and interest in the role of public transportation in evacuation. Public transportation can perform multiple roles in evacuation and be a successful partner in four tasks of emergency management plans; (1) mitigation, (2) preparedness, (3) response and (4) recovery. Due to public transportation’s capabilities to perform multi-task, it can play an important role in rural communities’ mobilities in emergencies. Now is the time to investigate the role of public transportation and school buses in emergency management for rural areas

Breathlessness Research Interest Group

Breathlessness is increasingly recognized as 'the pain of non malignant-disease': a common, distressing symptom in both malignant and non-malignant disease and for which palliation is currently limited in its effectiveness. This meeting was convened to bring together clinical and non-clinical researchers from different academic specialities interested in intractably breathless patients in order to foster advances in research

Airflow relieves chronic breathlessness in people with advanced disease : An exploratory systematic review and meta-analyses

BACKGROUND:: Chronic breathlessness is a neglected symptom of advanced diseases. AIM:: To examine the effect of airflow for chronic breathlessness relief. DESIGN:: Exploratory systematic review and meta-analysis. DATA SOURCES:: Medline, CINAHL, AMED and Cochrane databases were searched (1985-2018) for observational studies or randomised controlled trials of airflow as intervention or comparator. Selection against predefined inclusion criteria, quality appraisal and data extraction was conducted by two independent reviewers with access to a third for unresolved differences. 'Before and after' breathlessness measures from airflow arms were analysed. Meta-analysis was carried out where possible. RESULTS:: In all, 16 of 78 studies (n = 929) were included: 11 randomised controlled trials of oxygen versus medical air, 4 randomised controlled trials and 1 fan cohort study. Three meta-analyses were possible: (1) Fan at rest in three studies (n = 111) offered significant benefit for breathlessness intensity (0-100 mm visual analogue scale and 0-10 numerical rating scale), mean difference -11.17 (95% confidence intervals (CI) -16.60 to -5.74), p = 0.06 I2 64%. (2) Medical air via nasal cannulae at rest in two studies (n = 89) improved breathlessness intensity (visual analogue scale), mean difference -12.0 mm, 95% CI -7.4 to -16.6, p < 0.0001 I2 = 0%. (3) Medical airflow during a constant load exercise test before and after rehabilitation (n = 29) in two studies improved breathlessness intensity (modified Borg scale, 0-10), mean difference -2.9, 95% CI -3.2 to -2.7, p < 0.0001 I2 = 0%. CONCLUSION:: Airflow appears to offer meaningful relief of chronic breathlessness and should be considered as an adjunct treatment in the management of breathlessness