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

There's many a slip 'twixt the cup and the lip

The retiring academic may look back on, inter alia, years of conference attendance. Speech error researchers are uniquely fortunate because they can collect data in any situation involving communication; accordingly, the retiring speech error researcher will have collected data at those conferences. We here address the issue of whether error data collected in situations involving conviviality (such as at conferences) is representative of error data in general. Our approach involved a comparison, across three levels of linguistic processing, between a specially constructed Conviviality Sample and the largest existing source of speech error data, the newly available Fromkin Speech Error Database. The results indicate that there are grounds for regarding the data in the Conviviality Sample as a better than average reflection of the true population of all errors committed. These findings encourage us to recommend further data collection in collaboration with like-minded colleagues

Operant acceleration during a pre-reward stimulus

Stimuli of 20, 40, and 80 sec duration terminated with five non-response-contingent food pellets were superimposed upon lever pressing reinforced with single pellets on a DRL 30-sec schedule. Two rhesus monkeys served as subjects. No change in response frequency was observed during the 20- and 40-sec stimuli. During the 80-sec pre-food stimulus, overall response frequency increased to approximately 150% and 220% of pre-stimulus levels, and the temporal distributions of interresponse times shifted toward the shorter intervals. When the 80-sec stimulus was no longer terminated with food, the response frequency decreased and the temporal distributions of interresponse times gradually approached pre-stimulus levels. An increased frequency of short interresponse times and an increase in response rate was again observed when the pellet termination procedure was reinstituted with the 80-sec stimulus. No change in response frequency or interresponse times was observed in the absence of the conditioning stimulus, and performance efficiency, as reflected in the ratio of responses to reinforcements during non-stimulus periods, remained stable throughout the experiment

Green salt pilot plant final report /

"AEC research and development report.""March 22, 1943."At head of title : Mallinckrodt Chemical Works.Mode of access: Internet