- Ceri Jones, guide paediatric surgeon,
- John Francis, guide paediatric anaesthetist
- Noah’s Ark Kids’s Hospital, College Hospital of Wales, Cardiff CF14 4XW, UK
- Correspondence to: C Jones ceri.jones4{at}wales.nhs.uk
- Accepted 21 November 2022
Summary
Aims To determine the time required to realize optimum palatability of a cup of tea with out danger of hurt (oral scalding) utilizing the assets obtainable in a normal hospital employees room, and to determine the perfect accompanying biscuit for dietary content material, crunchiness, and integrity when dunking.
Design Potential, non-masked, biscuit primarily based, comparative research.
Setting Employees room within the surgical procedure division of a UK hospital.
Members 4 completely different types of spherical, non-chocolate biscuit: oat, digestive, wealthy tea, and shortie. A standardised cup of tea was decided on the idea of the investigators’ choice for color and palatability and pragmatic tea making strategies.
Foremost consequence measures The primary consequence was time to realize a protected temperature for consumption of tea, and the perfect biscuit to pair with the tea on the idea of dietary content material, absorptive skill, crunchiness, and integrity after dunking. Biscuits had been ranked first to final (in response to scores 1-4), with penalty factors given for antagonistic occasions resembling scalds and breakability.
Outcomes Baseline knowledge urged that after including 240 mL of freshly boiled water to an unwarmed mug containing a tea bag, the median temperature of a normal cup of tea was 82ºC (vary 81-84ºC). Optimum palatability and agreed common ingesting temperature of 61ºC was achieved at 400 (vary 360-420) seconds with 30 mL of cow’s milk and 370 (330-450) seconds with 40 mL of milk. The investigators thought-about tea color preferable with 40 mL of milk.
Conclusion Healthcare employees can safely devour a cup of tea after lower than 10 minutes, particularly if loved with a biscuit. Making time for a cup of tea could assist healthcare employees keep away from their break level.
Introduction
Over current years the general public sector has confronted immense challenges, such because the covid-19 pandemic.12 Throughout troublesome occasions, when morale and motivation have been examined, one quintessentially British refreshment has helped the nation to push by way of. Though the selection of sizzling drinks now obtainable is intensive, a cup of tea stays the popular choice3; when paired with a biscuit, this mixture is rocket gasoline for the Nationwide Well being Service.
Employees wellbeing is vital,45 and optimising employees hydration6 and vitamin will help to enhance temper and efficiency. We’ve witnessed how NHS employees keep away from breaks due to constraints on their time, typically grabbing substandard refreshments in a rush. As scientific proof is missing on greatest snack observe, most healthcare employees are compelled to depend on their very own expertise. Environment friendly tea making abilities and a very good high quality accompanying biscuit are vital for healthcare employees, who need to have a brew-tiful day.
Freshly boiled water is a crucial a part of the tea making course of, however this raises issues in regards to the danger of oral scalding if busy healthcare employees are tempted to devour a beverage earlier than it reaches a protected temperature. The selection of accompanying biscuit can be vital. If employees want dunking, will their biscuit of alternative survive immersion and maintain crunchiness?
We recognized the time taken to supply a protected, palatable cup of tea. Consistent with the custom of tea paired with a biscuit, we assessed 4 biscuit varieties for dietary content material and sturdiness after dunking.
Strategies
Biscuit choice
Based mostly on intensive analysis from years of frequenting employees rooms in NHS hospitals, we recognized 4 biscuits mostly present in employees biscuit tins—oat, digestive, wealthy tea, and shortie. We describe and quantify the fascinating traits (eg, dietary content material and integrity when being dunked) of those biscuits when paired with a protected, palatable cup of tea. To minimise the danger from heterogeneity, we restricted our choice to single layer, non-coated, non-filled biscuit varieties.
Getting ready a normal cup of tea
We carried out a pilot experiment to find out the perfect volumes of water and cow’s milk (this being to our information essentially the most generally obtainable for healthcare employees) required for NHS employees to make a normal cup of tea in a well timed method; this baseline knowledge knowledgeable subsequent exams. We reviewed present literature to determine a standardised methodology; nonetheless, the findings had been inconsistent or had historic reasoning not in step with the modern office. One in every of us (JF) ready all cups of tea all through the research, and the opposite (CJ) monitored related occasions with a stopwatch and recorded knowledge. Because the exams concerned dangers, well being and security was considered and we refreshed our good cuppa preparation (GCP) coaching earlier than the research. Tools was checked totally, syringes had been designated for enteral use solely, and emergency gear, together with chilly water, kitchen roll, a mop, and a meals waste bin had been available.
All through the research, tea was ready in standardised, newly bought, unchipped porcelain mugs, every with a liquid holding capability of 310 mL. Taking into consideration the non-filled void for protected carriage and a snug slurp rim, we decided that the whole fluid quantity (water plus milk) couldn’t exceed 280 mL. We then agreed that 240 mL of water could be the usual and would permit the addition of 30-40 mL of milk.
The mutually agreed tea making course of concerned pouring 240 mL of freshly boiled water over a single tea bag in an unwarmed mug. JF stirred the tea bag gently with a metallic spoon for 60 seconds (checked by CJ), earlier than giving it a delicate squeeze and extracting it from the cup. The milk was taken straight from the fridge (temperature set to 4ºC) and as quickly because it was added to the tea, the stopwatch was began (time zero). The temperature of the tea was measured at 30 second intervals utilizing a thermometer (fig 1). We each slurped the tea to evaluate palatability and the potential for oral scalding. Testing for palatability was repeated each 30 seconds. Knowledge had been collected on the speed the tea temperature dropped and the general time required for a snug, and subsequently probably protected, ingesting temperature to be achieved. Two volumes of milk (30 mL and 40 mL) had been initially investigated, and we each reviewed the tea’s color, palatability, and cooling time—or time to drinkable tea (TTDT). Based mostly on our pilot experiment findings, we used 40 mL of semi-skimmed cow’s milk to arrange normal cups of tea for all six exams.
Standardised gear for tea making, temperature management, and color of tea
Biscuit exams
Time to drinkable tea; the influence of dunking
The primary biscuit take a look at was used to find out TTDT. JF ready a normal cup of tea, and the temperature was monitored all through the take a look at. CJ began the stopwatch at time zero (addition of 40 mL of milk); at this level JF chosen two biscuits from a packet and dunked every into the tea—one at 30 seconds and one at 60 seconds; these intervals representing pure first and second biscuit dunks throughout a tea break and decided over a few years of the authors’ time working within the NHS. We recorded tea cooling and TTDT knowledge for every biscuit selection and repeated the exams thrice with freshly ready cups of tea. The biscuit with the shortest TTDT was ranked first (rating 1) and the biscuit with the longest TTDT was ranked final (rating 4).
Dietary content material
To evaluate the dietary content material of every biscuit and to corroborate the findings with the data supplied by the producers, we weighed three randomly chosen biscuits from every of the 4 packets. We then in contrast the recorded weights with these proven on the related packet and reviewed the vitality content material (kcal). The biscuit with the best vitality content material was ranked first (1 level) and the one with the bottom vitality content material was ranked final (4 factors).
Saturation quantity
For the saturation quantity take a look at we hypothesised that these biscuits that absorbed essentially the most tea in every dunk would assist in the direction of TTDT. Bespoke doilies, constituted of kitchen roll, had been positioned on saucers, and one randomly chosen biscuit from every packet was then positioned on a doily. Utilizing a syringe, we dripped freshly brewed tea onto the centre of every biscuit in 1 mL increments. We then inspected the doilies for indicators of tea (fig 2) and recorded the quantity of tea required earlier than permeation to the doily. The biscuit that absorbed the biggest quantity of tea earlier than indicators of permeation was ranked first (rating 1).
Saturation quantity take a look at for every biscuit
Crunch discount
To check for crunchiness after a biscuit had been dunked, JF first chosen three biscuits at random from every packet after which decided the baseline crunch rating of every biscuit selection by breaking the biscuits in half subsequent to a decibel meter (app on smartphone). Three extra biscuits had been then chosen from every packet. Utilizing one other syringe, 2 mL of freshly brewed tea was then dripped onto the centre of every biscuit. Every handled biscuit was instantly damaged in half subsequent to the decibel meter and the crunch rating recorded. For comparative functions, each dry and moist crunch volumes had been recorded (three units of knowledge for every biscuit selection) and the share discount in crunch volumes had been calculated. The biscuit with the smallest discount in crunch quantity was ranked first (rating 1).
Dunk break level
The dunk break level take a look at was used to determine the biscuit that will be greatest for dunking. One in every of every biscuit selection was held firmly between thumb and index finger (the common dunking grip) earlier than being dunked into a normal cup of tea so far as the fingertips. The biscuit was gently moved forwards and backwards till the dunked portion broke away and sank (the dunk break level). JF dunked the biscuits whereas CJ recorded the dunk break level. The biscuit that took the longest to achieve the dunk break level was ranked first (rating 1).
Pragmatic dunk break level
The take a look at for pragmatic dunk break level imitates the actual world of tea and biscuit pairing extra intently. JF chosen a biscuit from every packet in flip and dunked it (utilizing the common dunking grip) for 2 seconds right into a cup of freshly brewed tea. The biscuit was then held away from the cup and the time recorded till the biscuit fell aside. The biscuit that maintained its integrity for the longest after being dunked was ranked first (rating 1). Biscuits got penalty factors in the event that they broke aside earlier than being moved away from the cup (the floater impact).
Statistical evaluation
For all six exams, every biscuit selection was ranked primarily based on median and imply scores, with a rating of 1 (ranked first) assigned to the biscuit with the perfect end result and a rating of 4 (ranked final) assigned to the biscuit with the worst end result. We added the scores for every take a look at collectively, with every take a look at given equal weighting within the scoring course of. The biscuit with the bottom general rating was thus thought-about the perfect biscuit.
Affected person and public involvement
Members of the general public weren’t concerned within the design of the research. The manuscript, nonetheless, has been acquired with curiosity.
Outcomes
Getting ready a normal cup of tea
Baseline knowledge urged that the preliminary median temperature of a normal brewed cup of tea was 82ºC (vary 81-84ºC) after including 240 mL of freshly boiled water to a single teabag in an unwarmed mug. After gently stirring for 60 seconds, eradicating the tea bag, and including the milk we noticed temperature drops of 10ºC (vary 9-10ºC) with the addition of 30 mL milk and 11ºC with the addition of 40 mL milk. The tea additional cooled by 1ºC each 30 seconds. Optimum palatability and agreed common ingesting temperature was 61ºC, which was achieved at 400 (360-420) seconds with 30 mL of milk and 370 (330-450) seconds with 40 mL of milk. We most popular the color of tea with 40 mL of milk.
Time to drinkable tea: influence of dunking
The TTDT for all 4 biscuits decreased throughout dunking at 30 and 60 second intervals (desk 1). The digestive confirmed essentially the most vital discount (median TTDT 240 (vary 210-240) seconds) and was ranked first (1 level), with the wealthy tea displaying the least discount (median 300 (300-330) seconds) and ranked fourth (4 factors).
Baseline time to drinkable tea (TTDT) and dunking by biscuit selection in a freshly brewed normal cup of tea
Dietary content material
No discrepancies had been discovered between the recorded weights of biscuits and the weights given on the packets for all 4 biscuit varieties (desk 2). The oat biscuit had the best vitality content material (70 kcal/biscuit; 1 kcal=4.18 kJ) and was ranked first (1 level), and the wealthy tea had the bottom vitality content material (43 kcal/biscuit) and was ranked fourth (4 factors).
Dietary content material, saturation quantity, crunch discount, and dunk break level by biscuit selection
Saturation quantity
The wealthy tea was ranked first (1 level) within the saturation quantity take a look at (desk 2), absorbing a median of 9 (vary 8-9) mL of tea earlier than permeating to the doily. The outcomes for the oat biscuit and digestive had been comparable. The shortie was ranked fourth (4 factors), absorbing a median of 4 (3-4) mL of tea in the course of the three exams.
Crunch discount
The digestive was ranked first (1 level) for crunch discount (desk 2), with a 15% discount in crunch quantity. The outcomes for the oat biscuit and wealthy tea had been comparable, and the shortie was ranked fourth (4 factors), with a 32% discount in crunch quantity.
Dunk break level
The oat biscuit ranked first within the dunk break level take a look at, with a imply dunk time of 34.3 seconds to dunk break level (desk 3). The shortie was ranked second, with a imply 31.7 seconds to dunk break level, adopted by the digestive (ranked third) and wealthy tea (ranked fourth), with 28.3 seconds and 21.3 seconds, respectively.
Dunk break level by biscuit selection
Pragmatic dunk break level
The oat biscuit ranked first within the imply pragmatic dunk break level take a look at, with 29 seconds in contrast with 17.5 seconds for the shortie (ranked second) and eight.5 seconds for the digestive (ranked third). The wealthy tea was ranked fourth; it was additionally given three further penalty factors for having the bottom dunk break level in all three repeat exams.
Total biscuit scores and greatest performing biscuit
The oat biscuit ranked first in spite of everything six exams (desk 4). The digestive ranked second—it crumbled in three exams of absorptive functionality and structural integrity (saturation quantity, dunk break level, and pragmatic dunk break level). The shortie was ranked third, whereas the wealthy tea (the one biscuit given penalty factors) was ranked fourth; the penalty factors didn’t instantly affect the wealthy tea’s rating.
Total take a look at scores by take a look at and biscuit selection
Dialogue
Good hydration and vitamin are basic, whether or not within the context of protocols for enhanced restoration after surgical procedure,7 hint factor alternative on the intensive care unit, or just avoiding “hangriness.”8 Optimising fluid and vitality consumption is important for peak efficiency. As with elite athletes who require professional food regimen administration to optimise efficiency,9 healthcare employees additionally have to carry out at their greatest. Tea and biscuits are a part of British tradition, and it could be useful to harness the rejuvenation supplied by the pairing of those two and to ship them to healthcare employees instantly.
Though the research outcomes various, vital findings had been that it takes round 400 seconds for a cup of tea to achieve optimum palatability (61ºC) with 30 mL of milk, and simply 370 seconds with 40 mL of milk. A healthcare employee can count on to take pleasure in a cup of tea in lower than 10 minutes and paired with an oat biscuit (ranked first general in all six exams) will help in the direction of improved sustenance.
Strengths and limitations of this research
Leafing by way of the literature and steeping ourselves within the proof, we had been unable to determine a practical recipe for brewing a normal cup of tea. Though we respect that opinions differ broadly on methods to brew a palatable cup of tea,10 ready 3-4 minutes for tea to brew is unrealistic for all however essentially the most senior of NHS managers. We’re assured that our research strategies replicate an actual world method to tea making in NHS employees rooms. Every biscuit was assessed and scrutinised in an open and unbiased method, though each of us acknowledge a private choice for the shortie.
Our research addressed the multifactorial nature of tea making and biscuit alternative to higher inform NHS employees when having a tea break. We used the time wanted to brew and devour a normal cup of tea as a proxy for the time wanted to have a restorative tea break, and we recognized the cooling impact of a dunked biscuit which may assist in the consumption of this beverage. Though we carried out six exams, the enjoyment of dunking a biscuit by no means waned and, at occasions, really supplied hilarity. This joyfulness enhanced the tea break expertise and this might have an vital place in teambuilding and connectedness between completely different hierarchies and disciplines; a robust affect to be thought-about.
We restricted our biscuit alternative, excluding chocolate and cream variants with their potential for prime desirability as we believed it vital to restrict the distraction and potential finger licking that often happens when consuming biscuits with cream or chocolate fillings. The sticky and licked finger situation shouldn’t be appropriate with a healthcare atmosphere and must be reserved for non-work time. Future analysis will embody an commentary of sandwich model biscuits, such because the traditional custard and bourbon lotions; maybe research on the biscuit crammed with jam could possibly be enlightening.
The British public could have many anecdotal views on methods to brew and luxuriate in a cup of tea—the late Queen Elizabeth II and Paddington Bear included.11 Though tea making services are accessible to most NHS employees, constraints on time imply that sure compromises have to be made when getting ready a cup of tea. One debatable and standard tradition level that was addressed was when so as to add milk.10 The investigators of the present research can verify that though it might be affordable when utilizing nice bone china cups so as to add milk first to guard the cup from sizzling tea, this isn’t related to NHS employees, who typically have a large alternative of mugs obtainable. Such mugs have stood the take a look at of time, and infrequently simply discovering milk is a triumph.
Comparability with different research
Earlier analysis into biscuit dunking has predominantly targeted on how rapidly biscuits break as a preferred science experiment for schoolchildren aged 5-7 years. A earlier research utilized the Washburn equation—a extra mathematical method to the optimum dunk because it describes capillary stream in porous supplies.12
Conclusion
NHS employees can simply benefit from the pairing of a cup of tea with a biscuit in lower than 10 minutes. Biscuit dunking has a useful impact on tea cooling and must be inspired, and the oat biscuit was the perfect at reaching this in comparison with the digestive, wealthy tea, and shortie. Making time for a cup of tea is a crucial day by day ritual, and it must be inspired to assist enhance the temper and efficiency of healthcare employees.
What’s already identified on this subject
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Sustaining sufficient vitamin and hydration improves temper and efficiency
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Earlier research have reported on the consequences of dunking biscuits, resembling permeability and breakage
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A cup of tea is vital in UK standard tradition
What this research provides
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A cup of tea with biscuits might be loved inside simply 10 minutes
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Of 4 biscuits studied (oat, digestive, wealthy tea, and shortie) the oat biscuit maintained its integrity higher when being dunked in a normal cup of tea
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The pragmatic dunk break level of the oat biscuit was 29 seconds in contrast with <9 seconds for the digestive
Ethics statements
Moral approval
Regardless of precise biscuit hurt being deliberate we efficiently buttered up the native analysis and improvement division and got full approval to dunk, break, and eat the participant biscuits.
Knowledge availability assertion
Dataset is obtainable from corresponding writer ([email protected])
Footnotes
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Contributors: The authors contributed equally to the design, implementation, funding, and drafting of the manuscript. Each authors are guarantors. The corresponding writer attests that every one listed authors meet authorship standards and that no others assembly the standards have been omitted.
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Funding: No funding was obtainable for this research. The investigators bought research supplies (mugs, biscuits, tea luggage, and milk) out of pocket.
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Competing pursuits: All authors have accomplished the ICMJE uniform disclosure type at www.icmje.org/coi_disclosure.pdf and declare: no assist from any organisation for the submitted work; no monetary relationships with any organisations which may have an curiosity within the submitted work within the earlier three years; no different relationships or actions that would seem to have influenced the submitted work.
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The manuscript’s guarantors (each authors) affirm that the manuscript is an trustworthy, correct, and clear account of the research being reported; that no vital elements of the research have been omitted; and that any discrepancies from the research as deliberate (and, if related, registered) have been defined.
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Dissemination to individuals and associated affected person and public communities: We’ve not disseminated the data at current however proceed to share the data inside our regional multidisciplinary workforce conferences.
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Provenance and peer evaluation: Not commissioned; externally peer reviewed.
