The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Involving children and young people in research : principles into practice

In this chapter the authors discuss the involvement of children and young people in social care within the wider context of children’s participation and rights, and models of child participation. They then outline how a focus on children’s rights has, to some extent, been reflected in increasing interest in children and young people’s involvement in research, both as participants (or research ‘subjects’) and through their active involvement in the research process, presenting a model for involvement developed by the NCB Research Centre. The practical implications of this model for social care research are then explored through case studies of three NCB Research Centre projects: involving young people in public health research; evaluating the Youth4U Young Inspectors programme with a team of young evaluators; and involving young people in a study exploring why children who have been in care are disproportionately likely to be remanded or sentenced to custody. In the final section the authors consider the lessons from these projects for the involvement of children and young people in research and the implications for social care policy and practice

Guidelines for research with children and young people

These guidelines have been produced for researchers who are contemplating involving children and young people in their research project – whether as participants or in a more active role. The guidelines set out the National Children's Bureau Research Centre’s general approach to research with children and young people, and provide practical guidance for the researcher, through all stages of the research process from planning to dissemination. Section 3 focuses on research in which children and young people are participants (that is, as sources of data). Section 4 considers other ways in which children and young people can be involved in the research process