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Archive for June 8, 2012

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.


  • 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)


  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.


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
Fish Fillets with Tomatoes, Squash, and Basil

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)


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.


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.


CT scans on children ‘could triple brain cancer risk’

CT scan

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.”


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.”


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.”


Spine manipulation for neck pain ‘inadvisable’

Chiropractic neck manipulation

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.


Brain training ‘helps treat depression’

Stressed man
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.”


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