Strawberry-Rhubarb Slab Pie

This pie is great on its own — but sublime with a dollop of fresh whipped cream. And, a slab pie is a great way to serve a crowd.

Ingredients

• For the Crust

  • 5 cups all-purpose flour (spooned and leveled), plus more for rolling
  • 2 tablespoons granulated sugar
  • 1 teaspoon fine salt
  • 2 cups (4 sticks) cold unsalted butter, cut into 1/2-inch pieces
  • 1 cup ice water

• For the Filling

  • 2 pounds strawberries, hulled and halved (6 cups)
  • 2 pounds rhubarb, cut into 3/4-inch pieces (6 cups)
  • 3/4 cup granulated sugar
  • 1/3 cup packed light-brown sugar
  • 1/3 cup quick-cooking tapioca
  • 1 1/2 packed teaspoons grated orange zest, plus 2 tablespoons orange juice
  • 2 large egg yolks, lightly beaten with 2 teaspoons water
  • 1/3 to 1/2 cup sanding sugar (optional)

Directions

1. Make crust: In a food processor, pulse flour, granulated sugar, and salt until combined. Add butter and pulse until mixture resembles coarse meal, with a few pea-size pieces of butter remaining. With machine running, add 1 cup ice water. Pulse until dough is crumbly but holds together when squeezed; do not overmix. Divide dough into 2 disks, wrap each tightly in plastic, and refrigerate until firm, at least 1 hour (or up to overnight).
2. Preheat oven to 400 degrees. Make filling: In a large bowl, toss together strawberries, rhubarb, granulated sugar, light-brown sugar, tapioca, and orange zest and juice.
3. Lightly flour a work surface and rolling pin. Roll out 1 disk to a 12-by-16-inch rectangle. Transfer dough to a 10-by-14-inch jelly-roll pan. Press gently to fit into pan and fill with fruit mixture. Roll out remaining disk to an 11-by-15-inch rectangle. Place atop pie, pressing along edges to seal. Trim edges of dough, leaving 1 1/2-inch overhang all around. Fold overhang under, tucking it into pan. Crimp edges. Brush crust all over with egg-yolk mixture and sprinkle with sanding sugar, if desired.
4. With a paring knife, cut slits on top to vent. Place pie in oven, then reduce temperature to 375 degrees. Bake until crust is deep golden brown and juices are bubbling in center, 55 to 65 minutes. Let cool on a wire rack, 1 hour. Serve warm or at room temperature.

MarthaStewart

Fish Fillets with Tomatoes, Squash, and Basil

You can use any white flaky fish in this versatile—and quick—dish.

Fish Fillets with Tomatoes, Squash, and Basil
Ingredients

2 cups very thinly sliced assorted summer squash (such as zucchini, yellow crookneck, and pattypan)
1/4 cup thinly sliced shallots
1/4 cup thinly sliced fresh basil, divided, plus 1/4 cup basil leaves
20 cherry tomatoes, halved
4 tablespoons dry white wine
4 tablespoons extra-virgin olive oil, divided
Kosher salt, freshly ground pepper
4 6-ounce skinless white flaky fish fillets (such as Atlantic cod or halibut)

Preparation

Place four 14×12″ sheets of parchment paper, or heavy-duty foil if grilling, on a work surface. Divide squash among parchment sheets, arranging on one side of sheet in thin layers. Sprinkle shallots and sliced basil over, dividing equally. Scatter tomato halves around squash. Drizzle each packet with 1 Tbsp. wine and 1/2 Tbsp. oil (add 1/2 Tbsp. water to each if grilling). Season with salt and pepper. Place a fish fillet atop each portion. Season with salt and pepper; drizzle 1/2 Tbsp. oil over each.
Fold parchment over mixture and crimp edges tightly to form a sealed packet. DO AHEAD: Can be made 4 hours ahead. Chill. Let stand at room temperature for 15 minutes before continuing.
Preheat oven to 400°. Place packets in a single layer on a large rimmed baking sheet. Alternatively, build a medium fire in a charcoal grill, or heat a gas grill to medium-high. Bake or grill fish until just cooked through (a toothpick poked through the parchment will slide through fish easily), about 10 minutes. Carefully cut open packets (steam will escape). Garnish with basil leaves.

Bonappetit

Cervical cancer screening: One in four in Wales miss test

One in every four women in Wales fail to go for a smear test, figures show

One in four women fail to go for cervical cancer screening in Wales, with Cardiff recording the nation’s lowest figures, figures show.

The charity Jo’s Cervical Cancer Trust calls the decline worrying and more women are being urged to go for a test.

Almost 40,000 in Cardiff did not have the test in 2010/11 and a bus advert campaign will target the city.

Campaigners blame increasingly busy lives, surgery opening times and a fear of the test for the low uptake.

“

They they told me there and then what they thought it was – I was absolutely distraught – I cannot even begin to explain how I felt”

Karen Holroyd Charity campaigner

For women in the younger and older age groups, numbers slip below the national average with 24.3% of 25 to 29-year-olds and 24.8% of 60 to 64-year-olds missing the test.

Karen Holroyd, from Barry, Vale of Glamorgan, missed tests and was diagnosed with the disease at the age of 30.

“I urge everyone to have their smear tests, I realise now how important they really are,” the mother-of-one told BBC Wales.

In February 2010 Ms Holroyd began experiencing heavy bleeding which was was put down to an infection.

Ms Holroyd admits she had not gone for a smear test “for years”.

In August that year she was seen by a different doctor who immediately carried out an internal examination, and was sent to the emergency gynaecology unit at the University Hospital of Wales in Cardiff.

“They they told me there and then what they thought it was.”

Early menopause

A biopsy revealed Ms Holroyd had had stage 2B cervical cancer which had spread to her lymph nodes.

“I was absolutely distraught. I cannot even begin to explain how I felt,” she said.

She immediately began chemotherapy, radiotherapy and brachytherapy.

“

Another major contributing factor to women not attending is embarrassment and fear of the procedure – it’s a simple five minute procedure that could save their life”

Jo’s Cervical Cancer Trust

“That obviously affected my fertility, it brought on early menopause and my partner and I had only just been discussing having children,” she said.

Last June, Ms Holroyd was told the primary cancer had gone but the disease was still present in her lymph nodes which could be controlled, not cured, with chemotherapy.

“I went home and did my own research and found out I could have a type of radiotherapy, called CyberKnife, which targets the area more specifically than normal radiotherapy,” she said.

After initially being told she would have to fund the treatment herself, Ms Holroyd launched the campaign Karen’s Cause and was eventually granted the treatment on the NHS.

The tumours have now shrunk and Ms Holroyd is awaiting further test results.

“It’s so important to make sure you have your smear tests,” she added.

‘More career-driven’

Until 18 June, buses in Cardiff will carrying the message “Cervical screening saves lives” down the side in conjunction with Cervical Screening Awareness Week from 10-16 June.

A Jo’s Cervical Cancer Trust spokeswoman said: “There are a whole variety of reasons as to why women are missing out on the test.

“We’re much busier now, more career-driven and don’t have the time to take time off to fit in with GPs’ opening hours.

“Some girls have a fear of the test because it’s quite intimate, they think it will hurt.”

Robert Music, director of Jo’s Cervical Cancer Trust, said: “Each year, the UK screening programme saves 5,000 lives, yet one in four Welsh women are not attending their cervical screening test.

“With such a worrying decline in numbers, our campaign is also targeting Cardiff, where uptake is 73.7% – the lowest in the country.

“Adverts urging eligible women to get screened will adorn buses across the city with a potential to reach 92% of the city’s population.”

“Another major contributing factor to women not attending is embarrassment and fear of the procedure.

“We want to reverse this trend by reassuring those who are nervous about the test that it’s a simple five-minute procedure that could save their life,” the spokeswoman added.

BBC

CT scans on children ‘could triple brain cancer risk’

The study looked at the records of nearly 180,000 young patients

Multiple CT scans in childhood can triple the risk of developing brain cancer or leukaemia, a study suggests.

The Newcastle University-led team examined the NHS medical records of almost 180,000 young patients.

But writing in The Lancet the authors emphasised that the benefits of the scans usually outweighed the risks.

They said the study underlined the fact the scans should only be used when necessary and that ways of cutting their radiation should be pursued.

During a CT (computerised tomography) scan, an X-ray tube rotates around the patient’s body to produce detailed images of internal organs and other parts of the body.

In the first long-term study of its kind, the researchers looked at the records of patients aged under 21 who had CT scans at a range of British hospitals between 1985 and 2002.

Because radiation-related cancer takes time to develop, they examined data on cancer cases and mortality up until 2009.

Brain cancer and leukaemia are rare diseases.

“

The important thing is that parents can be reassured that if a doctor in the UK suggests a child should have a CT scan, the radiation and cancer risks will have been taken into account”

Professor Sir Alan Craft Report author

‘Significant increases’

The study estimated that the increased risk translated into one extra case of leukaemia and one extra brain tumour among 10,000 CT head scans of children aged under ten.

Dr Mark Pearce, an epidemiologist from Newcastle University who led the study, said: “We found significant increases in the risk of leukaemia and brain tumours, following CT in childhood and young adulthood.

“The immediate benefits of CT outweigh the risks in many settings.

“Doses have come down dramatically over time – but we need to do more to reduce them. This should be a priority for the clinical community and manufacturers.”

CT scans are useful for children because anaesthesia and sedation are not required.

This type of check is often ordered after serious accidents, to look for internal injuries, and for finding out more about possible lung disease.

Regulations on their use in the UK mean CT scans should only be done when clinically justified – and the researchers said their study underlined that point.

Professor Sir Alan Craft, a co-author and leading expert in child health, said: “The important thing is that parents can be reassured that if a doctor in the UK suggests a child should have a CT scan, the radiation and cancer risks will have been taken into account.

“There’s a much greater risk of not doing a CT scan when it’s suggested.

“This study will push us to be even more circumspect about using it. We have much stricter rules here about using CT than in the United States, for example.”

Dr Hilary Cass, the president of the Royal College of Paediatrics and Child Health, said: “We have to take very seriously the link between repeated CT scans and increased risk of these cancers amongst children and young people.

“But with both tumours rare, the absolute risk remains low.”

A Department of Health spokesman said: “The UK uses lower levels of radiation in CT scans than other countries.

“We also have clear regulations to ensure a CT scan is only carried out when clinically justified.”

BBC

Genome of 18-week-old foetus deciphered

A blood sample from mum and saliva from dad have been used to sequence the genome of a foetus in the womb, by US researchers.

At the time, the mother was just 18 weeks into the pregnancy.

The doctors said the findings, reported in Science Translational Medicine, could eventually lead to foetuses being screened for thousands of genetic disorders in a single and safe test.

However, they also caution it would raise “many ethical questions”.

The scientists at the University of Washington used pieces of the foetus’ DNA which naturally float around in the pregnant woman’s blood.

These fragments were then pieced together using the parents’ DNA as a guide to build a complete ‘map’ of the foetus’s genome.

“

This work opens up the possibility that we will be able to scan the whole genome of the foetus for more than 3,000 single-gene disorders through a single, non-invasive test”

Dr Jay Shendure University of Washington

They then compared the genetic map drawn 18 weeks into pregnancy with the foetus’ actual DNA taken from the umbilical cord after birth. It was 98% accurate.

Better tests

The researchers hope their findings will one day be used to test safely for genetic diseases.

Tests do already exist such as those for Down’s syndrome. To test for Down’s syndrome a sample is taken from the sac around the developing foetus, which comes with a risk of miscarriage.

They also say new genetic defects, which are not present in the parents, could be picked up if the technique could be improved. Such mutations form in the eggs, sperm or at conception.

There were 44 new mutations in the foetus and the screen at 18 weeks found 39 of them. However, the screening also detected 25 million possible new mutations or false positives.

One of the researchers, Dr Jay Shendure, said: “This work opens up the possibility that we will be able to scan the whole genome of the foetus for more than 3,000 single-gene disorders through a single, non-invasive test.”

‘Challenging’

Professor of molecular medicine at the University of Leeds, David Bonthron, told the BBC: “It’s interesting, very clever and also technically very challenging.”

He said genetics was advancing at an incredible pace, but cautioned: “I can’t envisage clinical use anywhere really for several years at least.”

He said such tests would raise the question: “What are you going to do with the information?

“That’s a societal question, it’s a question about what society thinks is acceptable.”

Josephine Quintavalle, from the Pro-life Alliance, said: “Information itself may be neutral but genetic testing in utero currently almost inevitably leads to abortion of the unborn child.

“The easier and more comprehensive the test the more likely it is that such abortions will increase.”

BBC

Spine manipulation for neck pain ‘inadvisable’

Chiropractors use spinal manipulation to relieve neck and back pain

 

A common chiropractic treatment for neck pain, which involves applying thrusts to the neck area of the spine, should be abandoned, say experts.

Writing in the British Medical Journal, Neil O’Connell and colleagues say that cervical spine manipulation carries a low risk of stroke, resulting from damage to the major neck arteries.

They say the technique is “unnecessary and inadvisable”.

But other experts believe it is a valuable addition to patient care.

Spinal manipulation can be used to treat neck and back pain or other musculoskeletal conditions. It is a technique used by physiotherapists, osteopaths and most commonly by chiropractors.

Cervical spine manipulation focuses on the neck and involves a range of high-speed manual manoeuvres that stretch, mobilise or manipulate the upper spine in order to relieve pain.

‘Serious complications’

Neil O’Connell, from the Centre for Research and Rehabilitation at Brunel University and colleagues argue that cervical spine manipulation “may carry the potential for serious neurovascular complications”.

“

Cervical spine manipulation may carry the potential for serious neurovascular complications.”

They also say that studies “provide consistent evidence of an association between neurovascular injury and recent exposure to cervical manipulation.”

Such injuries include tearing the lining of the vertebral artery, which is located in the neck and supplies blood to the brain, and stroke.

O’Connell and colleagues refer to a Cochrane review of randomised trials of neck manipulation or mobilisation which found that as a stand-alone treatment, the technique provides only moderate short-term pain relief.

They point to other recent, high-quality trials which suggest that manipulation is no better than other treatments such as physical exercise.

In their view, the risks of using manipulation for neck pain outweigh the benefits.

They conclude: “The potential for catastrophic events and the clear absence of unique benefit lead to the inevitable conclusion that manipulation of the cervical spine should be abandoned as part of conservative care for neck pain.”

Safe treatment

However, not all experts agree.

Writing in the same edition of the BMJ, Professor David Cassidy, from the University of Toronto, and colleagues argue that cervical spine manipulation should not be abandoned as a treatment for neck pain.

They point to high quality evidence that “clearly suggests that manipulation benefits patients with neck pain” and raises doubt about any direct relation between manipulation and stroke.

But they want to see more research into the pros and cons of this and other techniques with the aim of identifying safe and effective treatments.

The British Chiropractic Association said chiropractors were highly trained in spine care.

“The cherry-picking of poor quality research needlessly raises alarm in patients and does little to help the people suffering from neck pain and headaches to choose the most appropriate treatment,” it said.

BBC

Brain training ‘helps treat depression’

The study asked participants to think of positive images and showed them how their brains responded

 

A brain training technique which helps people control activity in a specific part of the brain could help treat depression, a study suggests.

Cardiff University researchers used MRI scanners to show eight people how their brains reacted to positive imagery.

After four sessions of the therapy the participants had seen significant improvements in their depression.

Another eight who were asked to think positively but did not see brain images as they did so showed no change.

The researchers said they believed the MRI scans allowed participants to work out, through trial and error, which sort of positive emotional imagery was most effective.

The technique – known as neurofeedback – has already had some success in helping people with Parkinson’s disease.

Brain activity

But the team acknowledge that further research, involving a larger number of people, is needed to ascertain how effective the therapy is, particularly in the long term.

Prof David Linden, who led the study which was published in the PLoS One journal, said it had the potential to become part of the “treatment package” for depression.

About a fifth of people will develop depression at some point in their lives and a third of those will not respond to standard treatments.

Prof Linden added: “One of the interesting aspects of this technique is that it gives patients the experience of controlling aspects of their own brain activity.

“Many of them were very interested in this new way of engaging with their brains.”

Chris Ames, from the mental health charity Mind, said: “While these initial results are interesting, the research is clearly at an early stage.

“Further research should give a better idea of how beneficial this technique could be as a treatment for depression.”

BBC

電話治療抑鬱症別有優勢

據疾病控製和預防中心估計，每10個美國成年人中就有一個抑鬱症患者。現在一項新的研究稱，雖然麵對麵療法更有效，電話治療比麵對麵治療更容易對抑鬱症患者進行持續治療。

每10個美國成年人中就有一個抑鬱症患者。

這項研究包含了300多位被診斷為抑鬱症的患者。醫生對這些人進行了分組，分別採用麵對麵認知行為療法和電話認知行為療法。

18個月的治療後，麵對麵治療的人比電話治療的人更容易放棄治療。居住在偏遠地區的人，例如農村裏麵患有慢性病和殘疾的病人，因為地理障礙與醫生見麵很 不方便，不能得到及時治療。於是電話治療為那些患者提供了機會，其可接受性正在提高，增加了個人持續治療的潛力。

該研究作者在《美國醫學協會雜誌》中寫道：“在最初接觸電話治療方案的期間就有效果。這些效果可能是因為通過電話傳遞資訊可以克服障礙和治療病人時的矛盾心理。就醫障礙似乎影響了早起治療，因此電話治療在第一療程中克服了這種障礙，效果最為突出。

然而，通過電話提供醫療護理有利有弊。治療結束後6個月，參加麵對麵治療的人抑鬱症狀比其他人更輕。一些專家認為，雖然以電話為基礎的療法有更大的反 應，但傳統的麵對麵療法更加有效，因為他們不僅僅是通過談話治療，也可以通過非語言和抑鬱的人溝通，如肢體語言，表情等。臨床心理學家瑪麗·阿爾沃德對 《洛杉磯時報》說：“你們需要有一個親密的關係，才可以使人們麵對他們的恐懼。”

作者最後總結說雖然電話治療的效果沒有麵對麵效果明顯，但值得肯定的是， 與麵對麵治療相比，在成功治療抑鬱症以後，繼續檢測方麵電話治療更有優勢。

醫藥日報

五種真正有效的草藥補品

當越來越來多針對健康和健身問題的速成解決方案出現（時），人們很難知道哪一個真正有效。無數的時尚飲食計畫、現代健身器材、新版補品和“心靈身體”自助書籍，幾乎耗盡了各種資源。不僅如此，其中的很多方法根本不起作用。好吧，讓我們看一些有效的。

 

        合成品 vs 天然品

實際上，這根本算不上爭論。儘管FDA和製藥公司生產出安全有效的藥品，但當天然品出現時,很多人還是儘量避免合成或處方藥。

草藥補品有著悠久的歷史，有的甚至達到千百年，它通過自身的有機化合物為身體提供營養，很多補品變成了我們飲食中的一部分。當然為了找到最安全，最有效的補品也需要進行篩選。

下麵是按照特定功能分類，選取的一些最有效的草藥補品。

彩葉草毛吼根提取物

很長一段時間，興奮劑黃麻作為減肥藥風靡一時，直到被發 現不利健康後被FDA禁止。而彩葉草毛吼根提取物卻不會刺激人，它的有效成分是orskolin，可以幫助增加體內脂肪酶的供給，從而有效燃燒儲存的脂 肪。據報導那些超過12周時間食用250毫克毛喉鞘蕊花的人脂肪比例平均下降了4個百分點。

        綠茶

研究表明綠茶中含有茶氨酸這樣的抗氧化劑，通過提高代謝能夠有效的減肥。在此基礎之上，綠茶中的咖啡因也是一種食欲抑製劑。同時綠茶也是幫你實現“小蠻腰”的首選飲料。

       白豆提取物

白豆提取物裏的活性成分是菜豆，有意思的是這種補品是作為 “澱粉阻滯劑”銷售的。雖然它不能抑製食欲，這位草藥補品之王卻會阻止碳水化合物轉變成糖。古老的阿茲臺克人偶然發現這種神奇的穀物，並且一直沿用至今。 它有豐富的的3脂肪酸、抗氧化劑、鈣、葉酸和鎂。它是以補品和糧食兩種方式出售，其價值已被證實，如保持膽固醇水準和血壓的平衡。它的含鈣量能夠增強骨骼 和高纖維有助消化。

蛇足石杉

一種有效的能對抗阿爾茨海默氏症的補品是蛇足石杉。它的活性成分是石杉堿甲，它幫助身體產生一種特定的酶時，從而增加一種叫做乙醯膽鹼的中樞神經係統化學物，而阿爾茨海默氏症恰恰是因為體內嚴重缺乏乙醯膽鹼造成的。

水飛薊

對於經常和毒素接觸的人來說這是一種很有效的補品。那些經常喝飲料的、定期服用阿司匹林的或經常處於香煙圍繞的環境的人，會發現這種補品很有用。它的活性成分是水飛薊素，通過修正肝細胞形成一種抵禦毒素入侵的保護屏障。

其實並沒有單一的保持健康的方案，可以將幾種明智的選擇綜合起來使用。就像很好地選擇飲食一樣，補品可以為你的身體提供天然的力量。

醫藥日報

壓力改變兒童的大腦發育

眾所周知，長期處於壓下的人會反應遲鈍，這是因為大腦前額皮質影響著大腦中更高層次的認知能力，急性和慢性的壓力會導致大腦前額葉皮質發生改變。而根據一項新的研究，壓力對大腦發育有負麵作用，還可能損害兒童的空間記憶能力和認知能力。

壓力對大腦發育有負麵作用，還可能損害兒童的空間記憶能力和認知能力。

威斯康星大學麥迪遜分校的研究人員做了一項研究，選定一些經歷持久壓力的兒童，讓他們從一係列箱子中尋找一個物品，結果發現他們的空間記憶測試成績明顯偏低。

研究員傑米·漢森聲明：“承受更大壓力的兒童的大腦有明顯的差異，壓力大的情況下，大腦白質和灰質的量會減少。”大腦中白質像接線員，溝通各個部位並收集 資訊。而灰質就像一個數學家，負責處理白質所收集、分享的資訊。而在強大的壓力下，大腦中白質和灰質的量減少，研究人員發現青春期的孩子承受更大的壓力， 因此大腦內的白質和灰質明顯偏少。

最近的調查結果可能會為那些經歷強大壓力的兒童提供更好的診斷和治療方案。”漢森總結道：“全國很多的團體在做工作記憶的幹預措施，瞭解壓力的作用可以幫助我們很多方麵的工作，可以引導教育孩子如何釋放壓力。”

醫藥日報