Bilateral Vocal Cord Palsy Secondary to Rheumatoid Arthritis.

Rheumatoid arthritis (RA) can cause a number of laryngeal manifestations; however, most of these do not cause an airway emergency. Airway obstruction due to vocal cord fixation of one or both vocal cords occurs late in the disease process of RA and can present as an inspiratory stridor. We report the case of an elderly lady who presented with acute stridor secondary to RA-induced bilateral vocal cord palsy and describe the various management options that were considered.

Usability and acceptance of crowd-based early warning of harmful algal blooms.

Crowdsensing has become an alternative solution to physical sensors and apparatuses. Utilizing citizen science communities is undoubtedly a much cheaper solution. However, similar to other participatory-based applications, the willingness of community members to be actively involved is paramount to the success of implementation.

Development of a respiratory quality improvement faculty in an acute hospital using QI methodology.

National Health Service (NHS) clinical staff are required to demonstrate involvement in quality improvement (QI) and patient safety. Clinicians are often best placed to identify problems and design solutions for their own clinical environments, yet the rotational nature of training can impact on the design, implementation and sustainability of projects.The In-hospital Quality Improvement for Respiratory team was created in August 2020 within a busy respiratory department to inspire a culture of continuous improvement and provide a sustainable infrastructure to support and progress QI projects (QIPs).

Spatio-temporal variation and seasonal dynamics of stranded beach anthropogenic debris on Indonesian beach from the results of nationwide monitoring.

The first stranded macrodebris study on a national scale in Indonesia was conducted on 18 beaches from February 2018 to December 2019. The average weight and abundance of beach debris were higher between October and February (rainy season). The highest stranded macrodebris was located in Ambon, Manado, Takalar, and Padang.

Flexible portfolio training: a novel approach to future physician training.

Flexible portfolio training (FPT) is a novel Royal College of Physicians' training scheme developed in 2019 to tackle issues of burnout, retention and recruitment among medical registrars. Awareness of the FPT scheme may be lacking and this article intends to inform potential future FPT trainees and their supervisors. Open to applicants at the time of appointment to higher specialty training, the FPT scheme protects up to 20% of total training time for trainees to pursue an area of interest in one of four pathways (medical education, quality improvement, clinical informatics and research) without extending time to achieve their certificate of completion of training (CCT).