Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire

Introduction The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK. Methods A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined. Results 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50–80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0–3.0) and 2.0 plastic surgeons (IQR:1.0–3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures. Conclusions The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored

Virtual Fixtures for Secondary Tasks

Abstract: The insertion of data in personal devices (e.g. mobile phones, GPS devices) tends to distract us from the primary task (e.g driving) that we are executing because of the necessity of deviating our visual attention to a secondary task. In this work we have tested the benefits introduced by the haptic feedback as a facility for a very common secondary tasks, namely the insertion of strings in an input device. Experiments demonstrate that the presence of virtual fixtures improves performances during input tasks and decreases the distraction of the user from the primary task

Virtual Fixtures for Secondary Tasks

The insertion of data in personal devices (e.g. mobile phones, GPS devices)tends to distract us from the primary task (e.g driving) that we are executingbecause of the necessity of deviating our visual attention to a secondary task. In thiswork we have tested the benefits introduced by the haptic feedback as a facility for avery common secondary tasks, namely the insertion of strings in an input device. Experimentsdemonstrate that the presence of virtual fixtures improves performancesduring input tasks and decreases the distraction of the user from the primary task