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Archive for March 14, 2012

Roasted Salmon with Spicy Cauliflower

If you don’t like anchovies, you can leave them out of this low-carb dish.
Everyday Food, March 2007

  • Prep Time 15 minutes
  • Total Time 45 minutes
  • Yield Serves 4

Ingredients

  • 4 garlic cloves
  • 2 to 4 anchovy fillets (optional)
  • 1/4 to 1/2 teaspoon red-pepper flakes
  • Coarse salt and ground pepper
  • 2 tablespoons olive oil
  • 2 tablespoons anchovy oil (from can of anchovies) or olive oil
  • 1 head cauliflower (about 2 pounds), cored and cut into large florets
  • 4 skinless salmon fillets, (6 to 8 ounces each)
  • 4 thin lemon slices, halved, plus 4 wedges, for serving

Directions

  1. Preheat oven to 450 degrees. Gather garlic, anchovies (if using), and red-pepper flakes into a pile. Using a chefs knife, coarsely chop; season generously with salt. Using flat side of knife blade, mash mixture into a paste.
  2. Place paste into a large bowl; add oils, and mix to combine. Add cauliflower, and toss to coat. Spread mixture in a single layer on a large rimmed baking sheet. Roast until starting to soften, about 15 minutes.
  3. Season salmon with salt and pepper. Remove baking sheet from oven; push cauliflower to sides, and place fillets in the center. Arrange two half-slices of lemon on each fillet. Return to oven; bake until fish is opaque throughout, 10 to 15 minutes. Serve with lemon wedges.

Read More : marthastewart

Mango passion fruit roulade

 

A deliciously rich and creamy recipe – it’s hard to believe it’s low in fat and gluten free

 

  • Cook 30 mins
  • Prep 40 mins

Nutrition per serving

223 kcalories, protein 5.0g, carbohydrate 45.0g, fat 4.0g, saturated fat 1.0g, fibre 2.0g, salt 0.17g.

Ingredients

Serves 6

  • 3 large egg whites
  • 6 oz caster sugar
  • 1 level tsp cornflour
  • 1 tsp malt vinegar
  • 1 tsp vanilla extract
  • icing sugar , to dust
  • 8 oz fat-free Greek yogurt
  • 1 large ripe mango , peeled, stoned and diced
  • 4 passion fruits , pulp only
  • icing sugar (optional) and a few physalis, to decorate
  • raspberry sauce , to serve

    Method

    1. Preheat the oven to 150C/ gas 2/fan 130C. Line a 33x23cm swiss roll tin with non-stick baking parchment. Beat the egg whites with an electric whisk until frothy and doubled in bulk. Slowly whisk in the caster sugar until thick and shiny. Mix the cornflour, vinegar and vanilla extract, then whisk into the egg whites.
    2. Spoon into the tin and level the surface carefully, so you don’t push out the air. Bake for 30 minutes until the meringue surface is just firm.
    3. Remove from the oven and cover with damp greaseproof paper for 10 minutes. Dust another sheet of greaseproof paper with icing sugar. Discard the damp paper and turn the meringue out on to the sugarcoated paper. Peel off the lining paper, then spread yogurt over the meringue and scatter with mango and passion fruit. Use the paper to roll up the roulade from one short end. Keep the join underneath. Sift a little icing sugar on top if you like, decorate with physalis and serve with raspberry sauce.

Read More : GoodFood

Heroin Cheaper, More Effective than Methadone For Hard Cases: Study

What’s the best way to treat the most serious heroin addiction? Giving addicts therapeutic doses of heroin itself may be cheaper and more effective than methadone, according to a new Canadian study.

Researchers divided a group of heroin addicts in two Canadian cities who had repeatedly not been helped by conventional treatment, into two therapy groups. One was provided heroin plus intensive social and medical support while the other received an equally enhanced methadone program as part of the clinical trial.

The new analysis showed that even though heroin treatment can be as much as ten times more expensive than methadone, lifetime social costs related to chronic addiction were cut by an average of $40,000 Canadian for each of these previously untreatable heroin patients. The research also suggested that addicted people given heroin under medical supervision would live a year longer on average than those in methadone treatment.

The differences are mainly due to the fact that heroin therapy tends to keep patients in treatment for much longer periods of time. This leads to larger drops in drug use and crime, and improved health. The new analysis extrapolated lifetime costs for both types of treatment based on the clinical trial results and earlier research on the costs of repeat treatment sessions when patients relapsed.

“We found that a treatment strategy featuring [heroin] may be more effective and less costly than methadone maintenance among people with chronic opioid dependence refractory to treatment,” the authors conclude, “Our model indicates that [heroin] would decrease societal costs, largely by reducing costs associated with crime and would increase both the duration and quality of life of treatment recipients.”

The results of the clinical trial—which were published in the New England Journal of Medicine—showed that participants in the heroin therapy group cut their illegal drug use and crime by 67% compared to 48% of those on methadone. Only 22% of those in the heroin group dropped out of the trial, compared to 46% of people taking methadone. Employment and health improvements were also greater in the heroin group. A Cochrane review last year of eight heroin trials including nearly 1,400 participants had similar results, suggesting the financial and societal savings of heroin-based treatment.

These savings accrued despite the higher upfront cost of heroin treatment, which requires injections that need be taken under medical supervision at the treatment center — and users typically shoot heroin 2-3 times a day. The supervision helps reduce harm from overdoses and other life-threatening health problems, which were found to be common during the clinical trial. By contrast, methadone is generally given orally and stable users can be given multiple “take home” doses, just like ordinary prescriptions.

But politics and the fact that different approaches work best for different patients means that heroin is unlikely to ever completely replace methadone, which remains the most effective treatment for heroin addiction in terms of saving lives, reducing disease and cutting crime. One main issue is practicality: users need to inject heroin every 4-6 hours to avoid withdrawal, which isn’t easily conducive to the demands of work and family life. Methadone, on the other hand, lasts 24-36 hours and can ultimately become just another prescription for long term therapy.

Then there is the controversy over treating addictions with the drugs that addicts prefer. Despite the fact that Germany, Holland, the U.K., Denmark and Switzerland all have successful heroin maintenance programs, simply setting up the trial in Canada prompted vigorous political opposition.

It’s also likely that these results won’t apply broadly to most addicts. The participants were among the most serious cases who had been unsuccessful in overcoming their addictions with methadone despite repeated attempts.  This group represents only about 15-20% of heroin addicts. And even here, one-fifth of those who started on heroin decided at some point to switch to methadone, likely due to the issues of having to inject so often.

The study did not look at other maintenance treatments, like buprenorphine (Suboxone, Subutex), which is another alternative. Buprenorphine is safer than methadone because at high doses it produces withdrawal rather than an increased high. This reduces overdose risk. However, it also means that people who need high doses to avoid craving don’t benefit— again meaning that methadone will always have some place in the maintenance armamentarium.

The new analysis was published in the Canadian Medical Association Journal (CMAJ).

 

Read More: Time

Sugary Drinks Linked To Heart Risk in Men

Sugar-sweetened sodas can lead to weight gain and diabetes, but a new study finds just how harmful the beverages can be on the heart, especially for men.

Researchers from the Harvard School of Public Health found that those drinking about 6.5 sugared beverages a week were 20% more likely to have a heart attack during the study’s nearly two decades than those who never consumed them.

The results came from 22 years of follow up of the eating habits and heart disease rates among 42,883 men enrolled in the Health Professionals Follow-Up Study. Every few years from January 1986 to December 2008, the participants, aged 40-75,  answered questionnaires about their diet and health habits. They also provided blood samples halfway through the study so the researchers could measure possible confounding effects, such as cholesterol and glucose levels, as well as factors that could explain how excess sugar contributes to heart disease, such as inflammatory protein markers.

Indeed, the results show that men who sip more sugary beverages like sodas, lemonade and fruit drinks, have a higher risk of heart disease possibly due to increased levels of inflammation and harmful lipids in their blood, which are biomarkers for heart disease. The increased risk of heart disease remained even after the scientists  accounted for other risk factors that could affect heart disease rates such as  smoking, physical inactivity, alcohol use and family history of heart disease.

“This adds to the growing evidence that sugary beverages are detrimental to our health,” says study author Dr. Frank Hu, professor of nutrition and epidemiology in the Harvard School of Public Health. “There should be a concerted effort to reduce sugary beverage consumption in our population.” The same effect was not seen among those who drank artificially sweetened drinks, which don’t contain sugar. Men who drank sugar-sweetened beverages infrequently — only twice a week or twice a month — also did not experience an increased risk. Still, says Hu, that doesn’t mean it’s a good idea to consume diet drinks. “Less than one diet soda per day is probably okay, but we need more research. We also have much better alternatives like water and sweetened coffee and tea. We should consume those instead.”

And what about women? Although this study focused on men, in a 2009 study, Hu and his colleagues found that women who drank more than two servings of sugary beverages daily had a nearly 40 percent higher risk of heart disease than women who rarely drank sugary beverages.

“The results are basically the same for both men and women,” says Hu. “We should avoid sugary beverages as much as possible. These drinks should be occasional treats rather than a regular part of our diets.

The American Heart Association recommends limiting the daily amount of calories we consume in added sugars. Women should aim for no more than 100 calories per day, or about 6 teaspoons of sugar. For men, the recommendation is to top off at 150 calories per day, or about 9 teaspoons.

The study was published in the American Heart Association journal Circulation.

Read More : Time

Planned repeat C-sections ‘safer’


Surgeons prepare an expectant mother for a C-section delivery

Women opting for a C-section after a previous Caesarean delivery are less likely to suffer severe complications, two studies suggest.

Australian researchers found the risk of stillbirth was lower in women who had a planned repeat C-section rather than trying for a natural labour.

Meanwhile, a UK study found the chance of womb rupture was reduced when mothers had an elective repeat section.

But risks are low for both natural birth and Caesareans, say experts.

A woman should discuss their individual options with their midwife or obstetrician, said the Royal College of Obstetricians and Gynaecologists.

Women who have had a C-section face a dilemma in their next pregnancy about whether to try for a vaginal birth, or to have a repeat section.

 

Choosing a vaginal birth or a Caesarean section carries different risks and benefits but overall either choice is safe with only very small risks”

Dr Virginia Beckett Royal College of Obstetricians and Gynaecologists

The current UK guidelines state that women should be able to choose after discussing the issue with their doctor.

Two papers published in the journal PLoS Medicine followed the health outcomes of pregnant women and their babies after a previous C-section.

The UK research is the first to compile national data about the risk of womb rupture – a serious complication of pregnancy, which can cause severe blood loss in the mother and put the baby at risk.

The team from the National Perinatal Epidemiology Unit at Oxford University identified 159 cases of womb rupture between April 2009 and April 2010, with the vast majority of cases – 139 – in women who had already had a Caesarean.

In women who had a previous C-section, the risk of the womb rupturing during labour was seven times higher if they tried for a natural labour, compared with a planned C-section. The risk of the baby dying was three times higher.

However, the overall risk was low – 2 in 10,000 of every UK pregnancies.

Dr Marian Knight of the National Perinatal Epidemiology Unit told the BBC: “This does give a true idea of the risk [of womb rupture] for the first time [in the UK] – in fact it’s lower than what we’ve been estimating before.

“The important thing to remember is the absolute risks – seven times a small risk is still a small risk.”

UK study

  • Overall risk of womb rupture – 0.2 per 1,000 pregnancies
  • Risk of womb rupture after a previous section – 0.21% in women trying for a natural labour and 0.03% in women having a planned C-section
  • The risk of the baby dying was 1 in 6,000 in women trying for a natural labour after a previous section, compared with 1 in 18,000 for women having a planned C-section after a previous section
  • Other factors that raised the risk of womb rupture were two or more previous C-sections, a C-section less than 12 months previously and induction of labour

A second study followed more than 2,000 pregnant women planning their second delivery after a previous Caesarean section at 14 hospitals in Australia.

Researchers from the Australian Research Centre for Health of Women and Babies found that women who had a planned Caesarean section experienced less severe bleeding than women who gave birth naturally. There was also a reduced risk of the baby dying in the womb in the Caesarean group.

The experts calculated that one baby death – or near death – would be prevented for every 66 planned repeat Caesarean sections.

They concluded: “Among women with one prior Caesarean, planned elective repeat Caesarean compared with planned vaginal birth after Caesarean was associated with a lower risk of foetal and infant death or serious infant outcome.”

Major surgery

Commenting on the studies, Dr Virginia Beckett, spokesperson for the UK’s Royal College of Obstetricians and Gynaecologists (RCOG), said: “Choosing a vaginal birth or a Caesarean section carries different risks and benefits but overall either choice is safe with only very small risks.

Australian study

  • Followed 2,345 women who had already had one previous C-section
  • Of these women, 1,108 elected for a planned C-section and 1,237 chose a vaginal birth
  • In the group planning a vaginal birth, around 40% succeeded, while the others had C-sections after a trial of labour
  • There were 2 stillbirths in this group compared with no stillbirths in the women who had elective C-sections

“It is important that women discuss all the options for their individual case with their midwife or obstetrician.

“Despite there being a slightly higher risk of rupture following a previous Caesarean, the procedure itself carries risks such as risk of blood clots, longer recovery period and the potential need for elective Caesarean in future pregnancies.”

Sue Macdonald, the Royal College of Midwives’ education and research manager, said: “The information from the study will add to the evidence base and knowledge for midwives and obstetricians and allow them to be able to discuss with women their options for birth after a Caesarean section and whether a normal birth would be possible.”

 

Read More : BBC

Poor hospital care ‘puts many lives at risk’ in developing world


People at the extremes of life are more at risk

 

Poor hospital care poses a risk to the lives of many patients in the developing world, say researchers.

A study of 26 hospitals in eight countries in the Middle East and Africa found more than one death per day in every hospital was due to preventable accidents and poor treatment.

Many deaths were due to poor staff training and supervision rather than a lack of resources, scientists said.

The study was published in The British Medical Journal.

An international team of researchers examined the hospital records of over 15,000 patients.

The research was carried out across 26 hospitals in Egypt, Jordan, Kenya, Morocco, South Africa, Tunisia, Sudan and Yemen.

Developing and adapting patient safety practices to the different cultural contexts are essential”

Dr Itziar Larizgoitia World Health Organization patient safety working group

Experts found that on average 8.2% suffered what they term an adverse event. These were defined as unintended injuries that resulted in permanent disability or death that came about as a result of healthcare management.

However, in some hospitals, the situation was much worse with almost one in five patients affected by accidents and poor treatments. The researchers say that adverse events happen in the developed world too, but they point out that the chances of dying from an adverse event in a developing world hospital are much higher.

Dr Ross Wilson, chief medical officer of the New York City health and hospital corporation, and the lead author of the paper, said: “Patients are suffering from poor supervision and poor performance of the clinical staff rather than a shortage of equipment or staff.

“Most commonly the diagnosis has been made but the appropriate treatment doesn’t follow.”

Weak systems

Dr Itziar Larizgoitia is the co-ordinator of the World Health Organization (WHO) patient safety working group. He says that hospital care is a global heath concern but it is important not to blame doctors and nurses.

“It is not the intent of health professionals to fail on patients. Rather, the harm caused by health care is often the result of failing processes and weak systems.

“Often doctors and nurses in developing countries have not received adequate training, are not adequately supervised, do not have protocols to follow nor the means to record patients’ information, or in some cases, do not even have running water with which to wash their hands.”

As well as the levels of training, the age of the patient and the length of their stay in hospital are also factors that can increase the chances of suffering an adverse event, according to Dr Wilson.

“The older you are the more at risk you are and if you have that event the more at risk you are of significant consequences like permanent disability or death.

“In addition the longer you are in hospital the more at risk you are, but these are the same as in the developed world. People at the extremes of life are more at risk.”

The researchers are also concerned that the numbers of adverse events recorded might actually underestimate the real extent of the problem.

They point out that the death rate, at around one in three adverse events, was much higher than previously published research.

“The events are often more severe, we can’t tell if that’s because they are not detected sooner and responded to or if the patients are more fragile in some sense, but given the same level of problem, the patients in developing countries seem to have worse consequences.”

Cultural change

In terms of what can be done, researchers are in agreement that it is not just a question of resources. According to the WHO’s Dr Larizgoitia, cultural change at many levels is also required.

“Developing and adapting patient safety practices to the different cultural contexts are essential. Safety practices that work in one context may not work in another one.

“It is essential to understand which practices can work effectively in different contexts and it is also essential to facilitate and encourage the adoption of the culturally and context specific practices.”

The researchers say that in at least one of the eight countries surveyed, adverse events were the fifth most common form of death after diseases of the lung and digestive system, infectious diseases and cancer.

 

Read More : BBC

鋼牙時代已過 隱形牙套讓矯正不再冏

中國時報【台北訊】

 

在全球掀起一股「林來瘋」現象的同時,不僅激起了不少民眾的籃球運動熱,許多女性更也自願投入看籃球轉播的行列裡,而在民眾目不轉睛盯著球員精湛表 現時,一定有許多人都會發現,每每暫停或中場休息時,許多球員都會吐出嘴裡那保護牙齒的護牙套,而亮出那一口潔白又整齊的牙齒。

 

擁有一口明眸皓齒已是現今民眾及演藝人員眾所追求,敗犬女王楊謹華及犀利人妻隋棠..等都不僅因微笑迷死人,更因標準的國際禮儀〝笑露八齒〞而吸引 觀眾目光,名模林志玲更曾被中華民國齒顎矯正學會調查公認為「台灣人最喜愛的珍珠貝齒微笑名人」。在與人對談中如眼見一口齒如編貝的牙,確實是會讓人有心 曠神怡的感受,在人際關係、工作職場上,更間接有加分的效果。相反的,如眼前是滿口牙歪齒亂的對談者,不僅讓人無法用心的集中注意,內心想必也會心浮氣 燥,因此在一連串螢光幕藝人及廣告的推動下,矯正牙齒在台灣已蔚為風潮。

 

擁有白金菁英級的隱適美數位隱形牙套認證專科醫師吳碧礽醫師表示,現今台灣矯正牙齒已不再像從前被附予大鋼牙的稱號,從前民眾整齒都會因戴上鋼硬牙 套所造成的不適及不美觀而退避三舍,但台灣於2年前引進在國外行之有年的數位隱形矯正器,這款新式的數位隱形矯正器完全排除大剛牙整齒的困擾。數位隱形矯 正器是採數位中空模型設計,利用電腦設計矯正療程,整個矯正療程的一系列矯正套則採醫學塑料「聚氨酯」製成,不僅材質幾乎透明,更因其觸感柔軟能密合的服 貼在齒列上,大符降低了不適及疼痛感。大家對數位隱形牙套的接受度可以說是相當滿意。

 
吳碧礽醫師表示,從前許多民眾都會因戴上牙齒矯正器,因外觀不佳而內心感到自悲,與人對話也不禁自感尷尬,對於不斷與客戶見面的上班族來說更是一項困擾, 如今因數位隱形牙套其材質透明、觸感柔軟服貼,在不影響工作及心理的狀況下,獲得了許多粉領族、業務族及藝人的愛戴,像是國際巨星湯姆克魯斯就為了追求完 美笑容,在拍攝電影期間內,也使用隱形牙套來進行矯正。由此可知,隨著隱型牙套的問市,過去矯正牙齒、追求美麗所要承受的必要犧牲已不復在,取而代之的, 已經是在不知不覺中便悄悄地完成了美麗蛻變。

原文出处: 中國時報

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