Working whilst studying: a survey of medically-qualified dental students.

Medically-qualified junior trainees who are interested in oral and maxillofacial surgery (OMFS) are faced with the challenging decision to undertake the minimum three years required to obtain a Bachelor of Dental Surgery (BDS) with its associated expenses and loss of income from full-time employment, or to follow a different career path. Trainees have reported duration of training and financial factors, such as cost of attaining additional qualifications and loss of income, as common reasons for loss of interest in OMFS. This survey of students enrolled on King's College London's three-year BDS dentistry entry programme for medical graduates (DPMG)shows that most studentsundertake paid part-time work in various settings and specialties alongside their studies. The average number of hours worked by students whilst studying is reported to be 27.0/week. Students report a wide range of incomes from various sources including secondary-care shifts in the NHS and private sector, as well as non-secondary-care activities such as non-surgical facial aesthetics. Direct correlation is noted between the number of hours worked and earnings, with comparable potential income in OMFS and non-OMFS specialties. Participants working in OMFS report greater educational and training value compared with non-OMFS work.

The e-scooter pandemic at a UK Major Trauma Centre: A cost-based cohort analysis of injury presentation and treatment.

OBJECTIVES: The aim of the study was to describe injuries related to electric scooter at a Major-Trauma-Centre in the UK, We reviewed data from January 2020-December 2020. METHODS: All patient-records mentioning electric-scooter at a major-MTC. Records were reviewed, and data were stratified according to two groups: electric scooter riders and other road users. A predefined survey was completed in all cases where 'e-scooter or electric scooter' was present. This contained variables such as patient demographics, mechanism of injury (including head and body protection), acuity, intoxication, treatment facility and clinical utilisation. Among incidents involving electric scooters, summary statistics on continuous and categorical variables of interest were reported. Healthcare modelling utilising time driven activity-based costing and Patient-Level-Activity-Costing used to conduct a post hoc analysis of health provider costs. RESULTS: 202 e-scooter injuries were identified. Riders were more likely to be young males aged 18-35, a minority of reported cases being associated with the influence of alcohol or drugs (7.4%). They fall independently involving no other party (87%); sustaining both minor and major injuries; with a significant proportion requiring urgent and emergent surgery 23.7% (n = 40) with 60.1% (n = 121) requiring further secondary care follow-up; whilst 16% require immediate admission with a mean LOS of 5.9 days, including 8-ITU admissions. The overall mortality rate was 0.5% (n = 1), and cost per patient was £1482.46/patient, reducing to £927.25/patient if immediate surgery (<12 h s) was not required. CONCLUSION: Due to an emphasis on social distancing, changes in UK law, e-scooters injuries have increased. Most injuries are reported in riders, and are minor, however the mean health episode cost was over £1000.00/patient due to the minority of serious injuries. Research on interventions to prevent e-scooter injuries including protective clothing like helmet wearing is needed to address this growing area of concern, and unnecessary costly healthcare utilisation.

Titanium cranioplasty in children and adolescents.

Full thickness calvarial defects present considerable challenges to reconstructive surgeons. In paediatric cases, the use of biomaterials as a substrate for cranioplasty rather than autologous bone is controversial. Alloplastic cranioplasty in adults is supported by several large case series however long term outcome of biomaterial use in paediatric cases is limited. Retrospective seven year analysis of departmental database and clinical records identified 22 patients aged under 18 who had undergone 23 custom made titanium cranioplasties by a single surgeon using the same technique. Data including patient demographics, reason for craniectomy and complications experienced following surgery was obtained. The mean age at operation was 12 years 9 months. The mean defect size was 44.3 cm(2). No significant complications related to the cranioplasty were recorded in the early post operative period or during long term review (average follow up 4 years 6 months). No cranioplasty implant required removal. This retrospective case series shows that custom made patient specific titanium cranioplasty is a viable alternative to autologous bone as a reconstructive material in paediatric patients under specific circumstances.