Objective. As the novel coronavirus disease 2019 changed patient presentation, this study aimed to prospectively identify these changes in a single ENT centre. Design. A seven-week prospective case series was conducted of urgently referred patients from primary care and accident and emergency department. Results. There was a total of 133 referrals. Referral rates fell by 93 per cent over seven weeks, from a mean of 5.4 to 0.4 per day. Reductions were seen in referrals from both primary care (89 per cent) and the accident and emergency department (93 per cent). Presentations of otitis externa and epistaxis fell by 83 per cent, and presentations of glandular fever, tonsillitis and peritonsillar abscess fell by 67 per cent. Conclusion. Coronavirus disease 2019 has greatly reduced the number of referrals into secondary care ENT. The cause for this reduction is likely to be due to patients' increased perceived risk of the virus presence in a medical setting. The impact of this reduction is yet to be ascertained, but will likely result in a substantial https://www.cambridge.org/core/terms.

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Using narrative writing techniques, four authors use a “what if” approach to explore a future possible scenario, set in the year 2037, to reflect on looming changes in an increasingly technological human environment. The purpose of this imaginative exercise is not to pinpoint or predict future events, but to highlight large-scale forces that could push the future of learning in key directions. In this story, we follow a young student through a technology-me- diated experience of daily life. As they navigate their learning environment, we observe some of the challenges and opportunities that this student may face including personalized learning technologies, data tracking, and automated decision systems—all tools which come to firmly define this student’s envi- ronment and potential prospects. The authors follow the scenario by breaking down the major influences and forces behind this possible future reality. This analysis provides a view of the ethical dilemmas raised in such a future world and concludes with a series of proposed solutions: proactive governmental in- volvement, a reimagining of industry best practices, and an emphasis on con- text-aware, community-led, future-building initiatives.

Ontario K-12 classrooms increasingly use digital applications and platforms. Consequently, private companies collect more personal information, posing a potential threat to student privacy. Current privacy legislation does not specifically address education technology or its use by children, and current policies and practices do not sufficiently support schools and teachers. Because educational practices and legislative compliance are variable, Ontario schools cannot provide students with consistent personal information protection.  This brief considers a privacy pledge, provincial legislation, and a Ministry of Education commission as policy alternatives. In the interest of supporting student privacy, adapting to changing conditions, and providing both clear standards and flexibility to stakeholders, this brief recommends that a Ministry of Education commission be created to review and approve digital applications and platforms for classroom use.

Background In previous studies it has been suggested that proformas may improve the noting of shoulder dystocia (SD) management and outcomes. Objectives To determine the method and accuracy of recording of the number of SD cases in a District Hospital (DH) in 2007 and 2008. To measure the completeness of SD reporting forms. To report on how many cases of SD are reviewed by the risk management team. To make improvements to the current system of documenting and reporting SD. Method A purposeful and representative sample of 29 patients was triangulated from the trust database, birth register and clinical incident report forms. A proforma was used to check the documentation of SD management in the notes for the essential components. Results 81.8% of the true cases of SD had reporting forms present in their notes. Average completeness of the reporting forms was 82%. Where a proforma had been completed: paediatricians were noted to have been called in 50% of cases, obstetricians in 72% of cases. Clinical incident reports were made in 59.1%. Clinical incident reviews were carried out in all reported events. Conclusion The 100% standards of recording and reporting SD are not being met in the DH; however, the 100% standard for the reviewing of reported cases is being upheld. The reporting form has been revised to tackle the weaknesses highlighted in this audit and its effectiveness is due for re-audit.