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RESEARCH
Christmas 2013: Research
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f7198 (Published 14 December 2013)
Cite this as: BMJ 2013;347:f7198
Parag R Gajendragadkar, cardiology specialist registrar1, Daniel J Moualed, ENT surgery specialist registrar2, Phillip L R Nicolson, haematology specialist registrar3, Felicia D Adjei, core medical trainee1, Holly E Cakebread, foundation year doctor1, Rudolf M Duehmke, cardiology specialist registrar1, Claire A Martin, cardiology specialist registrar1
Author Affiliations
Correspondence to: P R Gajendragadkar gajendragadkar@gmail.com
Accepted 28 November 2013
Abstract
Objective To quantify the consumption of chocolates in a hospital ward environment.
Design Multicentre, prospective, covert observational study.
Setting Four wards at three hospitals (where the authors worked) within the United Kingdom.
Participants Boxes of Quality Street (Nestl?) and Roses (Cadbury) on the ward and anyone eating these chocolates.
Intervention
Observers covertly placed two 350 g boxes of Quality Street and Roses chocolates on each ward (eight boxes were used in the study containing a total of 258 individual chocolates). These boxes were kept under continuous covert surveillance, with the time recorded when each chocolate was eaten.
Main outcome measure Median survival time of a chocolate.
Results 191 out of 258 (74%) chocolates were observed being eaten. The mean total observation period was 254 minutes (95% confidence interval 179 to 329). The median survival time of a chocolate was 51 minutes (39 to 63). The model of chocolate consumption was non-linear, with an initial rapid rate of consumption that slowed with time. An exponential decay model best fitted these findings (model R2=0.844, P<0.001), with a survival half life (time taken for 50% of the chocolates to be eaten) of 99 minutes. The mean time taken to open a box of chocolates from first appearance on the ward was 12 minutes (95% confidence interval 0 to 24). Quality Street chocolates survived longer than Roses chocolates (hazard ratio for survival of Roses v Quality Street 0.70, 95% confidence interval 0.53 to 0.93, P=0.014). The highest percentages of chocolates were consumed by healthcare assistants (28%) and nurses (28%), followed by doctors (15%).
Conclusions
From our observational study, chocolate survival in a hospital ward was relatively short, and was modelled well by an exponential decay model. Roses chocolates were preferentially consumed to Quality Street chocolates in a ward setting. Chocolates were consumed primarily by healthcare assistants and nurses, followed by doctors. Further practical studies are needed.
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Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years. Other non-financial relevant interests: PRG is particularly sentimental about, and incredibly fond of, Lindt Lindor white chocolate truffles; DJM advocates abstinence as the only effective way to avoid chocolate over-consumption; PLRN is influenced by the intoxicating smells emanating from the Cadbury?s chocolate factory at Bournville near his home; FDA supports her native Ghana?s cocoa exports by eating a single Heroes chocolate (Cadbury) every night; HEC declares an interest in polishing off leftover Bounty chocolates (Mars); RDM?s Germanic background means that he is hard-wired, like his brethren, to love all milk chocolate; and CAM reports a preference for Milkybar buttons (Nestl?).
RESEARCH
Christmas 2013: Research
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f7198 (Published 14 December 2013)
Cite this as: BMJ 2013;347:f7198
Parag R Gajendragadkar, cardiology specialist registrar1, Daniel J Moualed, ENT surgery specialist registrar2, Phillip L R Nicolson, haematology specialist registrar3, Felicia D Adjei, core medical trainee1, Holly E Cakebread, foundation year doctor1, Rudolf M Duehmke, cardiology specialist registrar1, Claire A Martin, cardiology specialist registrar1
Author Affiliations
Correspondence to: P R Gajendragadkar gajendragadkar@gmail.com
Accepted 28 November 2013
Abstract
Objective To quantify the consumption of chocolates in a hospital ward environment.
Design Multicentre, prospective, covert observational study.
Setting Four wards at three hospitals (where the authors worked) within the United Kingdom.
Participants Boxes of Quality Street (Nestl?) and Roses (Cadbury) on the ward and anyone eating these chocolates.
Intervention
Observers covertly placed two 350 g boxes of Quality Street and Roses chocolates on each ward (eight boxes were used in the study containing a total of 258 individual chocolates). These boxes were kept under continuous covert surveillance, with the time recorded when each chocolate was eaten.
Main outcome measure Median survival time of a chocolate.
Results 191 out of 258 (74%) chocolates were observed being eaten. The mean total observation period was 254 minutes (95% confidence interval 179 to 329). The median survival time of a chocolate was 51 minutes (39 to 63). The model of chocolate consumption was non-linear, with an initial rapid rate of consumption that slowed with time. An exponential decay model best fitted these findings (model R2=0.844, P<0.001), with a survival half life (time taken for 50% of the chocolates to be eaten) of 99 minutes. The mean time taken to open a box of chocolates from first appearance on the ward was 12 minutes (95% confidence interval 0 to 24). Quality Street chocolates survived longer than Roses chocolates (hazard ratio for survival of Roses v Quality Street 0.70, 95% confidence interval 0.53 to 0.93, P=0.014). The highest percentages of chocolates were consumed by healthcare assistants (28%) and nurses (28%), followed by doctors (15%).
Conclusions
From our observational study, chocolate survival in a hospital ward was relatively short, and was modelled well by an exponential decay model. Roses chocolates were preferentially consumed to Quality Street chocolates in a ward setting. Chocolates were consumed primarily by healthcare assistants and nurses, followed by doctors. Further practical studies are needed.
---------------------------
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years. Other non-financial relevant interests: PRG is particularly sentimental about, and incredibly fond of, Lindt Lindor white chocolate truffles; DJM advocates abstinence as the only effective way to avoid chocolate over-consumption; PLRN is influenced by the intoxicating smells emanating from the Cadbury?s chocolate factory at Bournville near his home; FDA supports her native Ghana?s cocoa exports by eating a single Heroes chocolate (Cadbury) every night; HEC declares an interest in polishing off leftover Bounty chocolates (Mars); RDM?s Germanic background means that he is hard-wired, like his brethren, to love all milk chocolate; and CAM reports a preference for Milkybar buttons (Nestl?).
and nurses (28%), followed by doctors (15%).
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