The virtual ear, nose and throat follow-up clinic: a 10-year quality improvement project

Background/Aims Ear, nose and throat services have seen one of the greatest increases in service demand over the last 6 years. This study aimed to determine if a virtual clinic system could reduce the volume of patients who need to be seen in person in an ear, nose and throat outpatient clinic. Methods Clinical outcome data for one consultant's team in a single ear, nose and throat department between 2009–19 were analysed. Data were prospectively collected on all patients who used the virtual clinic in this 10-year period and the outcomes analysed. Results A total of 3071 patients entered the virtual clinic during the 10-year period. Of these, 61% were discharged from the clinic via virtual follow-up and 39% required an in-person review appointment. On average, 187 patients per year did not have to attend an in-person follow-up appointment, with estimated cost savings of £27 000 per year. Conclusions The virtual ear, nose and throat clinic service has clear benefits for patients and services, delivering healthcare without unnecessary in-person appointments through a shared, clinician–patient decision process.

Estimating demand for mental health care among Australian children and adolescents: Findings from the Young Minds Matter survey

Objective: Mental health service use by individuals without a diagnosed mental disorder is sometimes termed ‘met un-need’. However, provision of services for this group may be necessary to provide appropriate assessment, referral and early intervention. This study quantified child and adolescent use of, and perceived need for, mental health services to inform population-level service planning. Methods: Young people in Australia’s Young Minds Matter survey ( n = 5837, 5–17 years), were categorised into four ‘need’ groups: (1) 12-month mental disorder diagnosis; (2) remitted for more than 12 months (or experiencing a condition not surveyed); (3) 12-month subthreshold mental health problem; and (4) no indication of need for help (i.e. did not meet the requirements of the first three categories). Service demand (use of, or perceived need for, a mental health service) and number of sessions received were estimated for each, separately for children (5–11 years) and adolescents (12–17 years). Results: Some 20.1% (95% CI: [18.6, 21.7]) of children and 32.3% (95% CI: [30.5, 34.2]) of adolescents expressed a demand for mental health services in the past year. Service demand decreased across the need groups. Perceived need without service use was higher among those with a 12-month subthreshold mental health problem (13.8/20.2%) than those who had experienced a mental health problem that had remitted for more than 12 months (or were experiencing a condition not surveyed) (9.3/12.6%). In addition, 23.6% of children and 24.6% of adolescents with a demand for mental health services were classified as experiencing no indication of need for help. Conclusions: This study quantified the number of children and adolescents in Australia who are likely to require mental health services. Findings suggest that not everyone in this group who has an expressed service demand meets diagnostic thresholds, but among those who do, service demand is higher.

The Significance of Trust in Washington State's Aging Network COVID Response

In late summer of 2020, we interviewed 45 senior leaders of social services and health care organizations serving older adults throughout Washington State about service demand, new challenges, and organizational adaptations. These organizations work with people made particularly vulnerable in the pandemic. A significant share reported that half or more of their clients live at or below the poverty line (54%), are people of color (29%), or have limited English language proficiency (20%). The state’s aging network leveraged strong partnerships, expertise, and community knowledge to provide trusted essential services to older Washingtonians and their caregivers. The role of trust as an enabler of emergency response and connection in the context of gentrification, the digital divide, employment loss, and language service gaps will be discussed, as will lack of trust as a barrier to service access, particularly for Latinx immigrant and migrant older adults.

A Prototype of a Robot Capable of Tracking Anyone with a High Body Temperature in Crowded Areas

<p>People's health and the world economy around worldwide are under the impact of the virus. Controlling the propagation of coronavirus is extraordinarily challenging after the seventeen months since the pandemic outbreak. This research will represent the efficiency of robots in helping humanity in facing the Corona pandemic and the global health crisis. According to the quick and widespread Covid-19 contagion globally, healthcare service demand increased staff with less availability. In this crisis, robotics is the safe solution at a low price to support people to fight Covid-19.</p><p>Furthermore, it is essential to relax lockdown restrictions after the increase in the number of people vaccinated. In this context, we designed a mobile robot with a thermal temperature scanner for pedestrians and identified those with abnormal temperatures over 39°C in public places and track them in real time. This robot features a long-lasting, lightweight battery and a high-quality thermal camera. Our primary target is to reduce the risk of transmission between people. We use a single-board computer and a thermal camera to detect unusual fevers near real-time to achieve this design and prototyping. In addition, we use image processing to detect target pedestrians and a control system to guide the robot. This robot can bypass any potential obstacles that can prevent it from moving around and cause problems. The development of this robot mainly focuses on the real-time measurement of body temperature at a distance of two meters. The compensation algorithm can coordinate between the mechanical parts of the robot and high-efficiency design.</p>

Research on Innovation of Grass-roots Working Mechanism Based on Accurate Supply Service: Take Shunde Taxation Bureau’s Innovation Reform as an Example

In recent years, with the continuous improvement of China’s economic level and the accelerating social transformation, the social demand for grass-roots public services has begun to diversify and refine. As an important part of grass-roots public services, tax service is also facing the transformation of service demand. However, the traditional grass roots working mechanism of tax departments has limited effect under the new situation, it is difficult to meet the increasingly refined service needs of taxpayers, and there is a gap between the fragmented working mechanism at the grass- roots level and diversified service demands. It is urgent to respond to social needs and deliver services accurately through institutional reform and innovation. Firstly, this paper analyzes the problems existing in the grass-roots working mechanism of tax departments in China. Then, by introducing a series of measures for the reform and innovation of grass-roots working mechanism based on precise supply service in Shunde District Taxation Bureau of Foshan City, State Taxation Administration of The People’s Republic of China (hereinafter referred to as “Shunde Taxation Bureau”), and based on analyzing the achievements of its reform and innovation, this paper summarizes the reference and enlightenment of its reform experience to the innovation of grass roots working mechanism of tax departments in China.

Perancangan dan Pengembangan Aplikasi E-commerce Pada Catering Anugrah

The increasing use of the Internet by a society marked by soaring costumer and businessmen, to encourage the emergence of an internet service demand in excess of what can be obtained in the real world. This includes the opportunity to sell goods online commodity. Business people in general are still conducting business transactions manually through direct face to face or over the phone. But sometimes this method is not very effective, because not everyone knows the phone number of the company. Should be developed based E-commerce system that focuses on individual-based business transactions using the Internet (technology-based digital networks) with application of E-commerce transactions can be done more quickly and more intensively. Therefore the grace of catering company wants to advertise his wares by using websites that have a sales system based on e-commerce with the aim of selling efficiency of the way the previous sales system. The method used in the design and development of e-commerce in the catering grace Semarang is a Research and Development (R & D) in this study only up to the stage six (6) to produce the end product is a prototype, so it was not until the stage of implementation of the product. The sixth step is Research and information collecting, Planning, Develop prelminaryformof product, Preliminary field testing, revision and Main Main product field testing. The results of the research prototype applications products that have been tested in the field and meet the objectives stated in the design and application development e-commerce in the catering grace Semarang

Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic.

Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3yr olds) in July 2021. Influenza remained suppressed throughout. A higher Paediatric Early Warning Score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p=0.04, Mann-Witney U test), no other differences in PEWS were seen. Conclusions SARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.

The ambulance service advanced practitioner's role in supporting care homes: a qualitative study of care staff experiences

Background/aims The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. Methods This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. Results The three key themes from the interviews were variations in service demand, the service user's expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Conclusions Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.