UK medical students' perspectives on practical prescribing teaching and learning provisions: a cross-sectional survey.

PURPOSE: To determine medical students' perspectives on the provision for the teaching and learning of processes that lead to and include the writing of a clear, safe and legal prescription (practical prescribing) in UK medical schools. METHODS: We designed a cross-sectional survey of UK medical students in years three, four and five. Students were asked about their experiences and views of practical prescribing teaching and learning they had encountered on their medical course. RESULTS: A total of 1023 medical students responded (7% response rate), from 25 UK medical schools: 22%, 37% and 41% in the third, fourth and final years, respectively. Teaching of practical prescribing was widespread, with 94.3% of final year (n = 396, 95% confidence interval [CI] = 92-97%), 86.8% of fourth year (n = 328, CI = 83-90%) and 73.8% of third year (n = 166, CI = 67-80%) students reporting they had received it. Availability of this teaching appeared to vary by medical school. Self-directed learning was the most frequently reported mode of delivery (90.9%, n = 809). Validated pre-prescribing and simulation were perceived by students in each year group as the most effective methods. Clinical pharmacologists, clinical pharmacists and junior doctors were perceived by the students as being the most effective professional groups at teaching practical prescribing. CONCLUSIONS: UK medical students reported a variety of methods utilised in the teaching and learning of practical prescribing. However, methods they perceived to be very effective (simulation and pre-prescribing) do not appear to be widely available or are only reserved for the final year of study. Combining such methods with involvement of professional groups perceived to be most effective should be explored.

Closing the Gap: Mouse Models to Study Adhesion in Secondary Palatogenesis.

Secondary palatogenesis occurs when the bilateral palatal shelves (PS), arising from maxillary prominences, fuse at the midline, forming the hard and soft palate. This embryonic phenomenon involves a complex array of morphogenetic events that require coordinated proliferation, apoptosis, migration, and adhesion in the PS epithelia and underlying mesenchyme. When the delicate process of craniofacial morphogenesis is disrupted, the result is orofacial clefting, including cleft lip and cleft palate (CL/P). Through human genetic and animal studies, there are now hundreds of known genetic alternations associated with orofacial clefts; so, it is not surprising that CL/P is among the most common of all birth defects. In recent years, in vitro cell-based assays, ex vivo palate cultures, and genetically engineered animal models have advanced our understanding of the developmental and cell biological pathways that contribute to palate closure. This is particularly true for the areas of PS patterning and growth as well as medial epithelial seam dissolution during palatal fusion. Here, we focus on epithelial cell-cell adhesion, a critical but understudied process in secondary palatogenesis, and provide a review of the available tools and mouse models to better understand this phenomenon.

Partial sleep deprivation impacts impulsive action but not impulsive decision-making.

Sleep deprivation may lead to increased impulsivity, however, previous literature has focused on examining effects of total sleep deprivation (TSD) rather than the more common condition, partial sleep deprivation (PSD) or 'short sleep'. Moreover, it has been unclear whether PSD impacts impulse-related cognitive processes, and specifically if it differentially affects impulsive action versus impulsive decision-making. We sought to determine if short compared to long sleep (6 vs. 9h/night) impacts impulsive action via behavioral inhibition (Go/No-Go), and/or impulsive decision-making processes of risk taking (Balloon Analogue Risk Task [BART]) and preferences for immediate over delayed rewards (Delay Discounting). In a within-subject design, 34 participants (71% female, mean age=37.0years, SD=10.54) were assigned to four consecutive nights of 6h/night (short sleep) and 9h/night (long sleep) in their own home in random counterbalanced order. Sleep was measured via wrist-worn actigraphs to confirm adherence to the sleep schedules (mean short sleep=5.9h, SD=0.3; mean long sleep=8.6h, SD=0.3, p<0.001). The Go/No-Go, BART, and Delay Discounting tasks were completed following both sleep conditions. Participants had more inhibition errors on the Go/No-Go task after short (mean false alarms=19.79%, SD=14.51) versus long sleep (mean=15.97%, SD=9.51, p=0.039). This effect was strongest in participants reporting longer habitual time in bed (p=0.04). There were no differences in performance following long- versus short-sleep for either delay discounting or the BART (p's>0.4). Overall, these results indicate that four days of PSD diminishes behavioral inhibition abilities, but may not alter impulsive decision-making. These findings contribute to the emerging understanding of how partial sleep deprivation, currently an epidemic, impacts cognitive ability. Future research should continue to explore the connection between PSD and cognitive functions, and ways to minimize the occurrence and negative consequences of short sleep.

Classification of the reduced vertical component of the ground reaction force in late stance in cerebral palsy gait.

Children with cerebral palsy (CP) often experience significant problems supporting their bodyweight (BW) and decelerating the downward velocity of the centre of mass (CoM) in late stance. This is seen as a decreased second peak of vertical ground reaction force (GRF) nominated FZ(2). This study categorises gait data by the degree of reduced FZ(2). Kinetic data were analysed from a CP database. Data from 129 patients, able to walk barefoot unaided, were investigated. Of these, 84 had kinetic data, 59 diplegics (both legs) and 15 hemiplegics (affected leg only), thus providing data from 133 legs. A reduced FZ(2) was observed in 116 legs (87%). Of the 133 legs, 44% failed to generate FZ(2)>BW. By including the Type 2 data this figure rises to, a staggering 66% who are having difficulty supporting BW at this stage of the stance phase. Only 12% of the legs showed a normal pattern (FZ(2) approximately equal to FZ(1)). In conclusion, the majority of CP children referred to the gait laboratory exhibited some degree of reduced FZ(2) and can be categorised as having a 'Ben Lomonding' gait pattern. 'Ben Lomonding,' is the term used to describe this phenomenon of reduced FZ(2), as the shape of the GRF graph resembles the shape of the Scottish mountain, Ben Lomond, which has two peaks, the second peak being much smaller than the first. Crucially, clinicians should be aware that nearly half of the CP children in this study were in difficulty supporting their BW in late stance and must use compensatory mechanisms to prevent collapse of the affected limb.

Ecological specialization and population size in a biodiversity hotspot: how rare species avoid extinction.

Species with narrow environmental niches typically have small geographic ranges. Small range size is, in turn, often associated with low local abundance. Together, these factors should mean that ecological specialists have very small total populations, putting them at high risk of extinction. But some specialized and geographically restricted species are ancient, and some ecological communities have high proportions of rare and specialized endemics. We studied niche characteristics and patterns of distribution and abundance of terrestrial vertebrates in the rainforests of the Australian Wet Tropics (AWT) to identify mechanisms by which rare species might resist extinction. We show that species with narrow environmental niches and small geographic ranges tend to have high and uniform local abundances. The compensation of geographic rarity by local abundance is exact, such that total population size in the rainforest vertebrates of the AWT is independent of environmental specialization. This effect would tend to help equalize extinction risk for specialists and generalists. Phylogenetic analysis suggests that environmental specialists have been gradually accumulating in this fauna, indicating that small range size/environmental specialization can be a successful trait as long as it is compensated for by demographic commonness. These results provide an explanation of how range-restricted specialists can persist for long periods, so that they now form a major component of high-diversity assemblages such as the AWT.

Identification and dynamics of a cryptic suture zone in tropical rainforest.

Suture zones, shared regions of secondary contact between long-isolated lineages, are natural laboratories for studying divergence and speciation. For tropical rainforest, the existence of suture zones and their significance for speciation has been controversial. Using comparative phylogeographic evidence, we locate a morphologically cryptic suture zone in the Australian Wet Tropics rainforest. Fourteen out of 18 contacts involve morphologically cryptic phylogeographic lineages, with mtDNA sequence divergences ranging from 2 to 15 per cent. Contact zones are significantly clustered in a suture zone located between two major Quaternary refugia. Within this area, there is a trend for secondary contacts to occur in regions with low environmental suitability relative to both adjacent refugia and, by inference, the parental lineages. The extent and form of reproductive isolation among interacting lineages varies across species, ranging from random admixture to speciation, in one case via reinforcement. Comparative phylogeographic studies, combined with environmental analysis at a fine-scale and across varying climates, can generate new insights into suture zone formation and to diversification processes in species-rich tropical rainforests. As arenas for evolutionary experimentation, suture zones merit special attention for conservation.

Effects of drag factor on physiological aspects of rowing.

This study examined the effects of two resistances, or "drag factors" on selected physiological variables during incremental progressive rowing tests (seven 3-min stages) on a Concept2 ergometer. Subjects were seven male and seven female university club rowers. Their mean age, body mass and height were 19.6 +/- 1.5 years, 72.7 +/- 8.0 kg, and 172.2 +/- 7.5 cm, respectively. Progressive tests were conducted using drag factors 100 (D100) and 150 (D150) before the spring racing season. Values were determined for the following physiological variables: ventilation (V.E), oxygen uptake (V.O2), heart rate (HR), blood lactate concentration (BLC), respiratory exchange ratio (R) and rowing economy (W/V.O2). Comparisons across all six submaximal stages showed no significant difference between D(100) and D(150) for any of the variables measured (p > .05). Maximal V.E(max) was significantly greater at D100 than D150 (p < .02). Maximal V.O(2), HR, BLC, R, stroke rate (SR) and W/V.O2 were greater at D100 than at D150, though not significantly so. The mean D100-D150 differences in V.E and SR for each stage were significantly correlated (r = 0.76, p < .01), suggesting drag factor may affect V.E via SR.

Are pikas exposed to and affected by selenium deficiency?

Regional extirpations of pikas (Ochatona princeps) within the last few decades have been attributed to global warming. Other recent global alterations such as increased nitrogen (N) deposition and associated selenium (Se) deficiency may further stress pika populations. In 2003 and 2004, we live-trapped pikas from three populations in Wyoming and measured Se values in their hair. We also sampled hair and liver from museum specimens collected throughout the Northern Rocky Mountains in 1987 and 1988. Our results suggest that liver and hair values were related, and that pika hair reflected the Se concentrations of the geologic parent materials. We determined that animals residing in several remote areas in the Rocky Mountain region could be Se deficient and that increase in N deposition correlated with an increase rather than a decrease in Se values in pika hair. In addition, we found no relation between Se contents in hair and body condition index, suggesting that low Se levels may not have negative effects on individual pikas. Whether Se levels influence reproductive success of pikas is unknown and should be the focus of future studies.

Parafibromin is a nuclear protein with a functional monopartite nuclear localization signal.

Parafibromin is a nuclear protein with a tumour suppressor role in the development of non-hereditary and hereditary parathyroid carcinomas, and the hyperparathyroidism-jaw tumour (HPT-JT) syndrome, which is associated with renal and uterine tumours. Nuclear localization signal(s), (NLS(s)), of the 61 kDa parafibromin remain to be defined. Utilization of computer-prediction programmes, identified five NLSs (three bipartite (BP) and two monopartite (MP)). To investigate their functionality, wild-type (WT) and mutant parafibromin constructs tagged with enhanced green fluorescent protein or cMyc were transiently expressed in COS-7 cells, or human embryonic kidney 293 (HEK293) cells, and their subcellular locations determined by confocal fluorescence microscopy. Western blot analyses of nuclear and cytoplasmic fractions from the transfected cells were also performed. WT parafibromin localized to the nucleus and deletions or mutations of the three predicted BP and one of the predicted MP NLSs did not affect this localization. In contrast, deletions or mutations of a MP NLS, at residues 136-139, resulted in loss of nuclear localization. Furthermore, the critical basic residues, KKXR, of this MP NLS were found to be evolutionarily conserved, and over 60% of all parafibromin mutations lead to a loss of this NLS. Thus, an important functional domain of parafibromin, consisting of an evolutionarily conserved MP NLS, has been identified.

Functional MRI of working memory in paediatric head injury.

A case study examining the recovery of a 9 year old boy who sustained a severe head injury is reported. The subject sustained damage to the left parietal-occipital and right frontal-parietal regions. Structural and functional imaging and cognitive data were collected at the time of injury and 1 year post-injury. Cognitive assessment revealed improvement over time. Functional imaging at the time of injury revealed minimal activation in the right posterior temporal region. Imaging 1 year post-injury revealed increased activation in the right pre-frontal cortex, bilateral pre-motor cortex and bilateral posterior parietal cortex. This activation pattern is consistent with the performance of unaffected individuals on working memory tasks. These findings differ from those in the adult literature and suggest an alternative pattern of recovery of function in children.

Detecting cheating in written medical examinations by statistical analysis of similarity of answers: pilot study.

OBJECTIVE: To assess whether a computer program using a variant of Angoff's method can detect anomalous behaviour indicative of cheating in multiple choice medical examinations. DESIGN: Statistical analysis of 11 examinations held by the Royal College of Paediatrics and Child Health. SETTING: UK postgraduate medical examination. PARTICIPANTS: Examination candidates. MAIN OUTCOME MEASURES: Detection of anomalous candidate pairs by regression of similarity of correct answers in all possible pairs of candidates on the overall proportion of correct answers. Anomalous pairs were subsequently assessed in terms of examination centres and the seating plan of candidates, to assess adjacency. RESULTS: The 11 examinations were taken by a total of 11,518 candidates, and Acinonyx examined 6,178,628 pairs of candidates. Two examinations showed no anomalies, and one examination found an anomaly resulting from a scanning error. The other eight examinations showed 13 anomalies compatible with cheating, and in each pair the two candidates had sat the examination at the same centre, and for six examinations with seating plans, the candidates in the anomalous pairs had been seated side by side. The raw probabilities of the anomalies varied from 3.9x10(-11) to 9.3x10(-30) (median = 1.1x10(-17)), with Bonferroni-corrected probabilities in the range 2.4x10(-5) to 4.1x10(-24) (median = 1.6x10(-11)). This suggests that one anomalous pair is found for every 1000 or so candidates taking this postgraduate examination. CONCLUSIONS: This statistical technique identified a small proportion of candidates who had very similar patterns of correctly answered questions. The likelihood is that one candidate has copied from the other, or that there was collusion, or that a technical error occurred in the exams department (as happened in a single case). Analysis of similarities can be used to identify cheating and as part of the quality assurance process of postgraduate medical examinations.

Electrostatic and conformational effects on the electronic structures of distortional isomers of a mixed-valence binuclear Cu complex.

The electronic structure of the binuclear copper complex [Cu(2)(L)](3+) [L = N(CH(2)CH(2)N(H)CH(2)CH(2)N(H)CH(2)CH(2))(3)N] has been investigated by resonance Raman and electroabsorption spectroscopy. Crystallographic Cu(2) distances of 2.364(1) and 2.415(1) A determined for the nitrate and acetate salts, respectively, are consistent with a substantial metal-metal interaction. The Cu-Cu bonding interaction in the binuclear complex is modulated both in the solid state and in solution by the ligand environment through coupling to ligand torsional modes that are, in turn, stabilized by hydrogen bonding. Electroabsorption data on the three major visible and near-infrared electronic transitions of Cu(2)L, lambda(max) (epsilon(max)) = 1000 nm ( approximately 1200 M(-1) cm(-1)), 748 nm (5600 M(-1) cm(-1)), and 622 nm (3350 M(-1) cm(-1)), reveal a difference dipole moment between the ground and excited states (Deltamu(A)) because of symmetry breaking. The difference polarizability for all three of the transitions is negative, indicating that the ground state is more polarizable than the excited state. A general model to explain this behavior in terms of the proximity of accessible transitions involving copper d electrons is proposed to explain the larger polarizability of the ground state. Raman excitation profiles (REPs) provide evidence for multiple conformational states of [Cu(2)(L)](3+). Separate REPs were obtained for each of the components of the two major Raman bands for nu(1) (a Cu-Cu stretching mode) and nu(2) (a Cu-Cu-N(eq) bending mode). The Raman data along with quantum chemical ZINDO/S CI calculations provide evidence for isomeric forms of Cu(2)L with strong coupling between the conformation of L and the Cu-Cu bond length.

Biogeographical concordance and efficiency of taxon indicators for establishing conservation priority in a tropical rainforest biota.

Prioritizing areas for conservation requires the use of surrogates for assessing overall patterns of biodiversity. Effective surrogates will reflect general biogeographical patterns and the evolutionary processes that have given rise to these and their efficiency is likely to be influenced by several factors, including the spatial scale of species turnover and the overall congruence of the biogeographical history. We examine patterns of surrogacy for insects, snails, one family of plants and vertebrates from rainforests of northeast Queensland, an area characterized by high endemicity and an underlying history of climate-induced vicariance. Nearly all taxa provided some level of prediction of the conservation values for others. However, despite an overall correlation of the patterns of species richness and complementarity, the efficiency of surrogacy was highly asymmetric; snails and insects were strong predictors of conservation priorities for vertebrates, but not vice versa. These results confirm predictions that taxon surrogates can be effective in highly diverse tropical systems where there is a strong history of vicariant biogeography, but also indicate that correlated patterns for species richness and/or complementarity do not guarantee that one taxon will be efficient as a surrogate for another. In our case, the highly diverse and narrowly distributed invertebrates were more efficient as predictors than the less diverse and more broadly distributed vertebrates.

Carcass traits, cut yields, and compositional end points in high-lean-yielding pork carcasses: effects of 10th rib backfat and loin eye area.

Pork carcasses (n = 133) were used to investigate the influence of carcass fatness and muscling on composition and yields of pork primal and subprimal cuts fabricated to varying levels of s.c. fat. Carcasses were selected from commercial packing plants in the southeastern United States, using a 3 x 3 factorial arrangement with three levels of 10th rib backfat depth (< 2.03, 2.03 to 2.54, and > 2.54 cm) and three levels of loin eye area (LEA; < 35.5, 35.5 to 41.9, and > 41.9 cm2). Sides from the selected carcasses were shipped to the University of Georgia for carcass data collection by trained USDA-AMS and University of Georgia personnel and fabrication. Sides were fabricated to four lean cuts (picnic shoulder, Boston butt, loin, and ham) and the skinned belly. The four lean cuts were further fabricated into boneless cuts with s.c. fat trim levels of 0.64, 0.32, and 0 cm. The percentages of four lean cuts, boneless cuts (four lean cuts plus skinned, trimmed belly) at 0.64, 0.32, and 0 cm s.c. fat, fat-free lean, and total fat were calculated. Data were analyzed using a least squares fixed effects model, with the main effects of 10th rib backfat and LEA and their interaction. Fatness and muscling traits increased (P < 0.05) as 10th rib backfat and LEA category increased, respectively. However, fat depth measures were not affected greatly by LEA category, nor were muscling measures greatly affected by backfat category. The percentage yield of cuts decreased (P < 0.05) as backfat category increased. Cut yields from the picnic shoulder, Boston butt, and belly were not affected (P > 0.05) by LEA category, whereas the yield of boneless loin and ham increased (P < 0.05) as LEA category increased. Compositionally, the percentage of four lean cuts, boneless cuts at varying trim levels, and fat-free lean decreased incrementally (P < 0.05) as backfat depth increased, whereas parentage total fat and USDA grade increased (P < 0.05) as backfat depth increased. As LEA increased, percentage boneless cuts trimmed to 0.32 and 0 cm s.c. fat and fat-free lean increased and total fat decreased; however, the difference was only significant in the smallest LEA category. Collectively, these data show that decreased carcass fatness plays a greater role in increasing primal and subprimal cut yields and carcass composition than muscling even in lean, heavily muscled carcasses.

Plasma lipids and cardiovascular risk: a POSCH report. Program on the Surgical Control of the Hyperlipidemias.

Quantifying the relationship between changes in lipid variables and clinical endpoints has been difficult. We studied the predictive value of various lipid variables on three endpoints in the Program on the Surgical Control of the Hyperlipidemias (POSCH): overall mortality, coronary heart disease (CHD) mortality, and CHD mortality and confirmed nonfatal myocardial infarction (MI) combined. We measured lipid variables for the annual visits from baseline to 5 years for actual follow-up values, actual and percentage differences between baseline and follow-up values, as well as the parameters comparing baseline only to 5 years for actual differences, percentage differences, and the ratio of baseline to 5 years. The lipid variables included were total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, triglycerides, and the LDL cholesterol/HDL cholesterol ratio. The analytic method used was that of Cox regression, with age and sex as secondary covariates, and each lipid or ratio of lipids as the primary (univariate) covariate. As a result, 108 univariate Cox regressions were conducted. The combined findings for the control and the intervention groups are presented. The number of events for the combined group were: overall mortality, 190; CHD mortality, 119; and CHD mortality and confirmed nonfatal MI, 262. The highest hazard ratios were found for the lipid variable of the LDL cholesterol/HDL cholesterol ratio (e.g. 1.196 for a 1-unit increase). Only for the combined endpoint of CHD mortality and confirmed nonfatal MI was there a substantial number of statistically significant relationships (P<0.01) of lipid variables and parameters of assessment.

Effectiveness of two cooking systems in destroying Escherichia coli O157:H7 and Listeria monocytogenes in ground beef patties.

A rapid, high-temperature double-sided grilling-broiling (DGB) system was compared to a single-sided broiling (SSB) system for cooking of foodservice ground beef patties to reduce microbial numbers and maintain textural quality. Patties (110 g) containing either Escherichia coli O157:H7 or Listeria monocytogenes (10(6-7) CFU/g) were cooked to target internal temperatures of 60 or 68 degrees C on each cooking system and immediately removed from the grills without the additional holding time at 60 or 68 degrees C that is recommended for foodservice cooking of ground beef patties. Actual final internal temperature attained, position on the grill, degree of doneness, cooking time, after-cook weight, texture characteristics, and bacterial counts of the patties were monitored. The DGB reduced E. coli O157:H7 and L. monocytogenes populations in ground beef patties by 5.7 log10 and 5.4 log10 CFU/g, respectively, when cooked to a target temperature of 60 degrees C (actual final internal temperature of 71.2 degrees C) and by 6.1 log10 and 5.6 log10 CFU/g, respectively, when cooked to a target temperature of 68 degrees C (actual final internal temperature of 75.8 degree C). The SSB reduced E. coli O157:H7 and L. monocytogenes populations by 1.3 log10 and 1.8 log10 CFU/g, respectively, when cooked to a target temperature of 60 degrees C (actual final internal temperature of 62.7 degrees C) and by 2.9 log10 and 3.6 log10 CFU/g, respectively, when cooked to a target temperature of 68 degrees C (actual final internal temperature of 69.3 degrees C). The DGB system effected a higher, more rapid temperature increase in patties cooked to either target temperature compared to the SSB system. This higher temperature was more effective in destroying pathogens in beef patties. Texture analyses determined that patties cooked on the DGB system had significantly higher values for springiness, adhesiveness, and product height as compared to the SSB system, and patties cooked on either system had significantly higher hardness, gumminess, chewiness, and product height values at the target temperature of 68 degrees C as compared to 60 degrees C.

Retinal ganglion cell axon guidance in the mouse optic chiasm: expression and function of robos and slits.

The ventral midline of the nervous system is an important choice point at which growing axons decide whether to cross and project contralaterally or remain on the same side of the brain. In Drosophila, the decision to cross or avoid the CNS midline is controlled, at least in part, by the Roundabout (Robo) receptor on the axons and its ligand, Slit, an inhibitory extracellular matrix molecule secreted by the midline glia. Vertebrate homologs of these molecules have been cloned and have also been implicated in regulating axon guidance. Using in situ hybridization, we have determined the expression patterns of robo1,2 and slit1,2,3 in the mouse retina and in the region of the developing optic chiasm, a ventral midline structure in which retinal ganglion cell (RGC) axons diverge to either side of the brain. The receptors and ligands are expressed at the appropriate time and place, in both the retina and the ventral diencephalon, to be able to influence RGC axon guidance. In vitro, slit2 is inhibitory to RGC axons, with outgrowth of both ipsilaterally and contralaterally projecting axons being strongly affected. Overall, these results indicate that Robos and Slits alone do not directly control RGC axon divergence at the optic chiasm and may additionally function as a general inhibitory guidance system involved in determining the relative position of the optic chiasm at the ventral midline of the developing hypothalamus.

Identification of optimal ranges in ribeye area for portion cutting of beef steaks.

Restaurant-ready (21-d aged, needle tenderized) loin steaks (strip, S; and T-bone, TB) representing three portion sizes (227, 284, and 340 g for S; 397, 454, and 510 g for TB) were portioned from 71 low-Choice beef carcasses representing seven ribeye size groups (70.9 cm2 and less to 103.2 cm2 and greater, in 6.3-cm2 increments). Steaks (n = 568) were cooked on a grooved grill to temperatures of either 67 or 77 degrees C and evaluated for cooking characteristics, sensory attributes (n = 284), and shear force (n = 284) to identify optimal ribeye areas for portioned steaks. As expected, thickness of all portioned steaks decreased (P < .05) as ribeye size increased, whereas thickness of steaks increased (P < .05) as portion size increased. The S were significantly thicker than TB. The TB cooked faster (P < .05) than did S for ribeye areas 77.4 to 83.8 cm2 in the average portion sizes and for ribeye areas 71.0 to 96.6 cm2 in the large portion sizes. However, S cooked significantly faster than did TB for ribeye areas less than 70.9 cm2 in the average portion sizes. The S had higher (P < .05) initial tenderness scores and lower (P < .05) shear values than did TB. Initial tenderness scores were lower (P < .05) for ribeye areas greater than 103.2 cm2 compared with ribeye areas less than 83.8 cm2 and 90.3 to 96.6 cm2, with all others being intermediate. Shear force tended (P = .08) to follow the initial tenderness results. The S cooked to both end point temperatures, and TB cooked to 67 degrees C had higher (P < .05) initial tenderness scores than did TB cooked to 77 degrees C. Tenderness was reduced in TB cooked to higher temperatures as well as in S and TB portioned from ribeye areas greater than 103.2 cm2. Steaks portioned from carcasses with ribeye areas between 77.4 to 96.6 cm2 can optimize both cooking time and tenderness for the foodservice sector.

A pharmaceutical needs assessment in a primary care setting.

BACKGROUND: As part of a reconfiguration of its general medical services, Ardach Health Centre has integrated a community pharmacist into the centre to provide pharmaceutical care. In order to systematically identify areas of 'pharmaceutical need', a needs assessment was carried out during October 1997. AIM: To prioritize and assist the planning of pharmaceutical care provision within the centre, such that maximum gain could be achieved from inevitable limited resources. METHOD: A four-stage pharmaceutical needs assessment method was created around a selection of techniques: gap analysis, the nominal group technique, and rapid participatory appraisal. This was then applied to a random sample of people drawn from the patient register of Ardach Health Centre and all the health care professionals associated with their care. RESULTS: Through the four-stage process, a pharmaceutical service priority league table was constructed to reflect the unmet pharmaceutical needs of patients and their primary health care providers. The table provided a structured framework around which pharmaceutical service provision within the health centre could be planned. CONCLUSION: We have developed a pragmatic, systematic method of identifying the prevalence of unmet pharmaceutical needs of a community. The assessment assisted service selection, balancing what should be done with what could be done and what could be afforded.