A retrospective study of pathology reports of melanomas excised by general practitioners (GPs) was undertaken in the course of a population-based study of melanoma, with a telephone survey of the current practice of those GPs who had excised melanomas. The objectives of this study were to identify all cases of cutaneous melanoma excised by GPs in the North-East Thames Region between 1989 and 1993, and to review the management of those patients. The main outcome measures of the study were: (i) the patterns of distribution of GP excisions within the region; (ii) the histological subtypes of melanomas excised, the accuracy of the pre-excision clinical diagnosis and the adequacy of treatment of the GP-treated tumours compared with the control group; and (iii) the reported current practice in the management of pigmented skin lesions by the GPs who had excised melanomas. Eight hundred and nineteen melanomas were excised in the region during the study period, of which 59 were excised by GPs. The Breslow thickness of tumours was similar in both GP-excised and non-GP-excised groups. Tumours were more likely to be amelanotic in the GP-excised group (P < 0.001). Incomplete excision was significantly more likely in the GP group (P < 0.001). The GPs made a confident clinical diagnosis of melanoma in only 17% of patients prior to surgery. The reported referral rate to specialists by this subset of GPs of patients with pigmented lesions was low, and at interview half of the GPs reported that they felt confident enough to manage patients with suspected skin cancers on their own. The majority of the GPs did not routinely obtain histological examination of skin lesions they believed to be benign. In conclusion, there are problems with the accuracy of clinical diagnosis and inadequacy of excision of melanomas removed in primary care. In the majority of cases, however, patients were subsequently appropriately treated by referral to specialist units. There was an under-usage of pathological examination of samples by the GPs interviewed.

The objective of this research was to determine whether whey, a by-product from a cheese manufacturing process, could be used as an animal Feed. Sheep were judged as a suitable alternate ruminant to carry out preliminary trials to allow scientific investigation of the suitability and the value of the whey. Also these trials were used to demonstrate to farmers the potential benefit of using whey in their feeding diets and to answer any preliminary concerns. Benefits and achievements results it could be concluded that for farms: Whey replaces 100% of water intake at the farm, Whey provides a low-cost alternative to liquid feeds, at a fraction of the cost (less than 10% of molasses), 19 liters of liquid whey permeate can replace the same amount of energy and protein as provided by 2.4 kg of a 88% crude protein feed mix/roughage, Roughage intake per kg gain can be reduced from 3kg to 1kg (75% weighing (200kg/head) being fattened to 400kg, an additional income of $30/head will be achieved, Whey can improve the feed palatability, texture, and dust control of feedlot rations. It provides a balanced nutrition of energy, protein, minerals, and a safety factor to compensate for poor or variable quality diets, being a pump able supplement, whey can save on feeding overheads as it requires less labour and feeding and mixing equipment, and can provide an economic and convenient method to feed urea supplements, vitamins, minerals and feed additives. For Dairy Factories: