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Key Points Discusses the latest technologies in 3D imaging and printing that can be applied in dentistry. Suggests these technologies could be used in daily practice. 3D printing has been hailed as a disruptive technology which will change manufacturing. Used in aerospace, defence, art and design, 3D printing is becoming a subject of great interest in surgery. The technology has a particular resonance with dentistry, and with advances in 3D imaging and modelling technologies such as cone beam computed tomography and intraoral scanning, and with the relatively long history of the use of CAD CAM technologies in dentistry, it will become of increasing importance. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics and surgery, the manufacture of dental, craniomaxillofacial and orthopaedic implants, and the fabrication of copings and frameworks for implant and dental restorations. This paper reviews the types of 3D printing technologies available and their various applications in dentistry and in maxillofacial surgery.

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IntroductionTo evaluate the clinical outcomes and aortic remodelling rates following thoracic endovascular aortic repair (TEVAR) for acute or subacute type B aortic dissection (TBAD) based on technique.Material and MethodsAll TEVARs for acute/subacute TBAD between 01/01/2008 and 01/06/2020 were included. TEVARS were grouped by technique (TEVAR only, PETTICOAT and STABILISE). Aortic remodelling was assessed at three aortic levels on follow-up CT. Thirty-day technical/clinical success rates, re-intervention rates and complications were recorded.ResultsA total of 29 patients were included. The median age was 55 years (31–82). The median duration from initial presentation to TEVAR was 7 days (0–84). Intra-procedural complications included one aortic rupture from balloon moulding in a STABILISE case. Thirty-day mortality, stroke, spinal cord ischaemia and visceral ischaemia were 3% (n = 1), 3% (n = 1), 3% (n = 1) and 3% (n = 1), respectively. (All occurred in acute TBAD.) Overall survival was 50.5 months (18–115). Median follow-up was 31 months (1–115). Six patients (21%) required re-intervention, with a median time of 5 months (5–46) from first TEVAR. Overall complete aortic remodelling rates were: 89% at the proximal descending thoracic aorta, 78% at the distal thoracic aorta and 50% at the infra-renal abdominal aorta. At the infra-renal aorta, the STABILISE group (n = 11) had a higher complete aortic remodelling rate (82%) compared to TEVAR alone (n = 12) (20%).ConclusionEndovascular intervention for acute and subacute TBAD is safe with a high rate of technical success. STABILISE results in higher aortic remodelling at the infra-renal aorta (82%) compared to TEVAR alone (20%) but risks aortic rupture from balloon moulding.

This thesis explores the themes of connection and disconnection through a memoir, Numb is Not the Opposite of Pain, and a critical-reflective commentary. Drawing upon theories of shame, trauma and narrative structure, I explore and reflect on my own creative and critical practice-based research. My process involved: ❖ The development of a creative nonfiction memoir which narrates the use of emotional numbing to cope with both family trauma and the somatic numbness that is a symptom of multiple sclerosis. ❖ Reflections on my process, through private journaling and dialogue with others. ❖ Reading of creative and critical texts. Using the themes of connection and disconnection to narrate multiple strands of lived experience, my creative work challenges illness narratives in which, too often, one single story of experience is explored. It offers a narrative which encompasses both illness and trauma, seeking to create connection between seemingly disparate life events by threading them together cohesively, but without succumbing to a neat resolution. My critical work builds upon research in 'expressive writing' (Pennebaker and Beall, 1986) to suggest that writing can bring about emotional, cognitive, social and physical benefits. It explores how writing helped me to move from a fragmentary to a more cohesive form and from disconnected to reconnected experience. It argues that creative writing can create an opportunity to safely disconnect from difficult experiences and then to gradually reconnect with them in new ways. I conclude that fragmenting experience through writing can be a helpful step in being made whole again.

Community health workers (CHWs) can bridge the gap between health and social services and the communities they serve. CHWs can work collaboratively with healthcare professionals, such as pharmacists, in addressing peoples' social determinants of health. However, little is known about how CHWs and pharmacists collaborate. We aimed to explore the interprofessional collaboration between pharmacists and CHWs in Australia and New Zealand and identify the challenges and strategies in their collaborative practice. Semi-structured interviews were conducted with pharmacists and CHWs in Australia and New Zealand, to explore (i) CHW-pharmacist interprofessional collaboration experiences, (ii) how pharmacists perceived CHWs' roles and vice-versa, (iii), challenges to collaborative practices and (iv) strategies to foster their collaboration. Interviews took around half-an-hour and were audio-recorded, transcribed verbatim, and inductively thematically analysed. Twenty-nine participants (16 pharmacists and 13 CHWs) were interviewed, 19 worked in Australia and 10 in New Zealand. Participants reported that CHWs connected the patient and the pharmacist and helped bridge cultural gaps, shared patient-related information with the pharmacist, supported patient medication management and adherence, and referred patients to pharmacists. CHWs helped patients to take up pharmacy services and reinforced pharmacists' recommendations. There was a lack of clarity regarding each other's role, but pharmacists and CHWs acknowledged the benefit of each other's roles. Key challenges to collaborative practices were poor communication between CHWs and pharmacists, and lack of guidelines on the collaborative practices. Strategies to promote collaboration included clarification of their roles, improving the working relationship and knowledge of the mutual benefits of collaboration. The study identified some collaborative practices between CHWs and pharmacists. However, challenges remain, including a lack of clarity regarding CHWs' roles by pharmacists. Future research should focus on improving knowledge of the mutual benefits of collaboration, and codesigning a CHW-pharmacist collaborative intervention with guidelines to standardise and foster collaboration. Patients, service users, care-givers, people with lived experience or members of the public were not involved in the study design or conduct of study, analysis or interpretation of the data or in preparation of the manuscript.

AimsTo determine if a patient and a group of young people would choose the same candidates for a paediatric consultant post as the formal interview panel.MethodsIn 2017 we interviewed for 3 consultant jobs. The interview process had 3 components:Formal interview panel, the Advisory Appointments CommitteeInterview panel of 4 young people and a consultant. The young people wrote their own questions.Clinical scenario with a patient, their parent and a senior nurseEach candidate was scored for each part of the interview process.All interviewers were asked for feedback about the process.ResultsThe table 1 below indicates the ranking of the candidates by all 3 processes. There was general consensus amongst all 3 groups as to the best 3 candidates (Candidate B scored only 3 points less than Candidate C in the young person interview)Abstract G111(P) Table 1 Candidate A Candidate B Candidate C Candidate D Candidate E Young person interview54321Clinical scenarioYoung person, parent, nurse53421Advisory Appointments Committee43521All interviewers felt that it had been an enjoyable experience and would be happy to do it again. The comments from the young people included ‘I found the interviews very interesting and a really good experience’, ‘I think the idea to involve young people in the interview process is a very good one. Thank you for the opportunity’, ‘A good opportunity to see the consultants and how they related to us’ and ‘Hope we have done a good job in choosing people that will be an asset to the ward’.ConclusionIt is important to include patients, parents and young people in the interview process to show that we value their opinions enough to involve them in important decisions that affect them. The voice of the child is extremely important to capture. The clinical scenario is a way to assess communication skills with patients and carers. These skills cannot be demonstrated in a formal interview process but are an important part of the job particularly in paediatrics. The members of the young person interview panel felt that they had been given an opportunity to ask questions that they thought would identify a good children’s doctor.

Short spreading sequences facilitate efficient multiuser detectors and have hence been incorporated into practical code division multiple access systems such as 3rd Generation Partnership Project UTRA-TDD. However, as the number of users approaches the spreading code length, the asymptotic performance and the numerical stability of linear multiuser detection algorithms degrade. Given some simplifications such as synchronous users, it is shown that received diversity effectively mitigates these degradations and allows the system to be operated with a high load. A lower bound on the mean asymptotic multiuser efficiency is presented and the numerical stability of linear multiuser detection algorithms for systems with receive diversity is analysed. It is further shown that the performance variability is significantly reduced by received diversity.

An iterative multi-user detector for code-division multiple-access (CDMA) signals that is able to operate under highly loaded conditions with a non-binary modulation scheme is presented. The results presented demonstrate that the receiver is able to achieve near single-user bit error rate performance.

An iterative multi-user detector for code-division multiple-access (CDMA) signals that is able to operate under highly loaded conditions with a non-binary modulation scheme is presented. The results presented demonstrate that the receiver is able to achieve near single-user bit error rate performance.