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Archive for January, 2013

Crispy Baked Chicken Wings

Crispy Baked Chicken Wings

Ingredients

Buffalo Sauce

  • 1 tablespoon unsalted butter, melted
  • 1/4 teaspoon cayenne pepper
  • 1/4 teaspoon freshly ground black pepper
  • 1/4 teaspoon kosher salt
  • 1/4 cup hot pepper sauce (such as Frank’s)

Ginger-Soy Glaze

  • 1/4 cup honey
  • 2 tablespoons soy sauce
  • 3 large garlic cloves, crushed
  • 1 2×1″ piece of ginger, peeled, sliced

Wings

  • 5 pounds chicken wings, tips removed, drumettes and flats separated
  • 2 tablespoons vegetable oil
  • 1 tablespoon kosher salt
  • 1/2 teaspoon freshly ground black pepper

Preparation

Buffalo Sauce

  • Mix first 4 ingredients in a medium bowl; let stand for 5 minutes. Whisk in hot sauce; keep warm. DO AHEADCan be made 1 week ahead. Let cool completely; cover and chill. Rewarm before using.

Ginger-Soy Glaze

  • Bring all ingredients and 1/4 cup water to a boil in a small saucepan, stirring to dissolve honey. Reduce heat to low; simmer, stirring occasionally, until reduced to 1/4 cup, 7–8 minutes. Strain into a medium bowl. Let sit for 15 minutes to thicken slightly. DO AHEADCan be made 5 days ahead. Cover; chill. Rewarm before using.

Wings

  • Preheat oven to 400°. Set a wire rack inside each of 2 large rimmed baking sheets. Place all ingredients in a large bowl; toss to coat. Divide wings between prepared racks and spread out in a single layer.
  • Bake wings until cooked through and skin is crispy, 45–50 minutes.
  • Line another rimmed baking sheet with foil; top with a wire rack. Add half of wings to ginger-soy glaze and toss to evenly coat. Place wings in a single layer on prepared rack and bake until glaze is glossy and lightly caramelized, 8–10 minutes.
  • Toss remaining half of wings in Buffalo sauce. Serve immediately (no need to bake).

Read More http://www.bonappetit.com/recipes/2012/02/crispy-baked-chicken-wings#ixzz2JZFGtjos

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Netbot, The Tweetbot for App.net Goes Free

Posted by  on January 31st, 2013
iPhone App – Designed for iPhone, compatible with iPad

Netbot and Netbot for iPad have gone free. While App.net has failed to take over the world, yet, if you are interested in this alternative to Twitter, you’ll be hard pressed to find a better client to use with it.

Read more: http://www.148apps.com/news/netbot-tweetbot-appnet-free/#ixzz2JZERAWIw

Lewisham Hospital: A&E cut over neighbouring trust debt

Protesters marching past Lewisham hospital
At least 15,000 people marched in protest against proposals on Saturday

The A&E department at Lewisham hospital in south-east London is to be downgraded and made smaller as part of cost-cutting measures.

Health Secretary Jeremy Hunt also said the maternity unit at Lewisham would be replaced with a midwife-led facility.

The cuts aim to help tackle debts of £150m at the neighbouring South London Healthcare NHS Trust (SLHT).

At least 15,000 people took part in a protest march against the plans on Saturday.

Mr Hunt told MPs: “I respect and recognise the sense of unfairness people feel because their hospital has been caught up in the financial problems of its neighbour.

“However solving the financial crisis next door is also in the interest of the people of Lewisham because they too depend on the services which are currently part of South London Healthcare Trust.”

Mr Hunt accepted six of the seven proposals put forward by special administrator Matthew Kershaw.


What is happening now in south London could define if and how the debate on the future of healthcare happens.”

Nick TriggleHealth Correspondent, BBC News

He said £36m would be allocated to expanding capacity at the hospitals which would take on high-risk births from Lewisham.

‘Dangerous precedents’

He said the SLHT, which is in administration, was the “most financially challenged in the country”, as it spends £60m a year, or 16% of its annual income, to service two PFI contracts signed in 1998.

Mr Hunt confirmed that the SLHT will be dissolved by October 2013 and its hospitals re-configured.

He decided to amend the seventh proposal which had called for the A&E to become an “urgent care centre”.

Instead up to three quarters of those currently attending Lewisham A&E could attend a new, smaller service at the hospital, he said.

Patients with more serious conditions could be taken to other hospitals.

He said overall the proposals could save up to 100 lives per year through higher clinical standards.

He said it was on the advice of NHS Medical Director Professor Bruce Keogh that the decision was taken to retain Lewisham Hospital’s A&E in the best interests of patients.

Jeremy Hunt gives a statement on South London Healthcare NHS Trust
Jeremy Hunt said the A&E would stay open, but be made smaller

 

Andy Burnham, shadow health secretary, said the move would “set dangerous precedents”.

Joan Ruddock, Labour MP for Lewisham Deptford, said: “Today’s proposals are a sham and a shambles and unacceptable to those who represent people in Lewisham.”

Mr Hunt responded: “A sham and a shambles is what I inherited, not what I’m bequeathing.”

The changes are part of a radical overhaul proposed in response to SLHT losing around £1.3m a week.

Jos Bell, a Save Lewisham Hospital campaigner, called the announcement “a complete travesty”.

She rejected Mr Hunt’s estimate that journey times to other A&Es in the area would only take one minute longer.

Ms Bell, who collapsed with heart and respiratory failure in 2006, added: “I’m only alive because Lewisham is where it is.”

BBC

Census 2011: South Wales Valleys rank bottom for health

Obese child
Obesity costs NHS Wales an estimated £73m a year

Five of the 10 areas where people feel the least healthy in the whole of England and Wales are in the south Wales valleys, the 2011 census shows.

People were asked to report their health, with Cardiff emerging as the healthiest place with 81.4% happy.

The Welsh capital was one of only three local authority areas in Wales to show an improvement over the last 10 years.

Of Wales’ 22 councils, Blaenau Gwent had the lowest proportion of people who thought their health was good at 72.6%.

Merthyr Tydfil was second from bottom at 73%. Neath Port Talbot, Rhondda Cynon Taff and Caerphilly were also in the list of the least healthy in England and Wales.

By comparison, 81.4% of people in Cardiff said they were in good health and it is thought a younger population partly explains the city’s apparent healthy status.

The 2011 census also revealed health had improved in only three local authority areas in 10 years. It improved by a margin of less than one per cent in Cardiff, Swansea and Wrexham.

‘Deprivation’

Professor Dave Adamson, an expert on regeneration at Glamorgan University who has advised the Welsh government, said poor health was commonly found in deprived areas.

He said: “In the broadest sense it’s linked to deprivation and all the cultural things such as diet and they don’t expect to be well – they take poor health for granted.

“It’s a feature of deprived communities globally you might say, but certainly the evidence is there across the UK.”

He said health problems associated with poor diets, such as obesity and diabetes, were growing.

Last week UK minister Anna Soubry said children from poor backgrounds were more likely to be overweight.

Prof Adamson added: “There is an element of truth in it. The obesity figures do coincide quite significantly with poverty figures but it’s not an exclusive relationship.

“It’s because of the high dependency on high starch, high calorific cheap foods.”

The census found more than 360,000 people in Wales were limited in their daily activities because of a health problem or disability.

The council wards with the highest proportion of people who were limited “a lot” were Cymmer, Gwynfi and Sandfields West in Neath Port Talbot, and Maerdy in Rhondda Cynon Taf – all at 22% of the population.

By contrast, in the Menai ward in Bangor, Gwynedd, just 2% of the population said they were limited.

BBC

IVF delays due to NHS-only policy, fertility expert claims

Peter Bowen-Simpkins said the decision to end the contract with his Swansea clinic was purely ideological

A fertility expert claims women seeking IVF treatment are suffering delays because the Welsh government stopped funding for a private clinic.

Peter Bowen-Simpkins said the decision to end the contract with his Swansea clinic was purely ideological.

Patients are waiting 18 months for the NHS service at Cardiff’s University Hospital of Wales, known as IVF Wales.

But the Welsh government says it is supporting work to build more capacity for IVF services.

A new NHS IVF unit is due to open in Port Talbot in the spring, however it will be 18 months later than planned.


It feels to me like a totalitarian state who say this is what we are going to do despite the outcome”

Peter Bowen-SimpkinsLondon Women’s Clinic

In the meantime, some patients have been offered earlier treatment at NHS units in Bristol, which has cost the Welsh NHS more than £500,000.

A decision to end the use of private providers in the NHS came from the previous Labour-Plaid coalition government.

As a result, the Welsh Health Specialised Services Committee (WHSSC) – the NHS body that plans specialist treatments – did not renew a contract with London Women’s Clinic (LWC) in Swansea.

Two years after the contract with LWC came to an end, a new NHS IVF unit at Neath Port Talbot hospital is due to open in April, but it is 18 months later than planned.

‘Crazy’

LWC medical director Peter Bowen-Simpkins said the “crazy” decision to end the contract with the company’s Swansea clinic was purely ideological.


Analysis

Aled ap DafyddBBC Wales political reporter

We need to turn the clock back to get a proper timeline on this.

Up until March 2011 women, mainly in west Wales, were receiving private treatment on the NHS at the London Women’s Clinic (LWC) in Swansea. The previous Welsh government decided to end all private involvement in the NHS and as a consequence LWC’s funding came to an end.

Over £1m was invested in a new IVF facility at Neath Port Talbot Hospital to take its place. It was supposed to open in autumn 2011 so there would only have been a six month gap between the private contract coming to an end and the new NHS service being up an running.

But it’s still not open.

The clinic’s medical director, Peter Bowen-Simpkins, says the decision to discontinue funding before the new NHS service was open is based purely on ideology.

IVF Wales treating patients from Cardiff and the Vale they are now having to treat women from Abertawe Bro Morgannwg.

This has cost the NHS over £500,000.

He said: “It’s appalling that the assembly can disadvantage the very people it’s supposed to be supporting.

“As a consequence of what has happened we’ve gained because people have been forced into the private sector because of the NHS.

“I feel very strongly that the Welsh assembly made a decision that has actually produced a waiting list which is about two years whereas before it was about six weeks.

“It’s costing them a lot more and the results are likely to be worse because patients are getting older.”

Mr Bowen-Simpkins went on: “It feels to me like a totalitarian state who say ‘this is what we are going to do despite the outcome’.

“The very people who probably have supported the government are the ones who are going to be disadvantaged, the ones who can’t afford it (private treatment) and are going to have to travel a very long way.”

Figures up to November 2012 show 210 women from south and west Wales have been treated by North Bristol NHS trust and a further 90 were waiting for treatment. This has cost the Welsh NHS more than £500,000.

LWC claims it was saving taxpayers’ money as the amount it received was less than was given to IVF Wales for comparable treatment.

WHSSC said the decision was not based on money and that it is working with Abertawe Bro Morgannwg Health Board to make sure the facility at Neath Port Talbot will open in the spring.

A Welsh government spokesperson said: “Whilst we understand the London Women’s Clinic motive, as a private company who wish to generate a profit, the Welsh government is clear in its support of the work being done to build more capacity for IVF services in NHS Wales.”

The Welsh government expects the Neath Port Talbot facility to be ready to treat patients from April, subject to accreditation from the Human Fertilisation and Embryology Authority.

BBC

Many hospitals not sharing crime data, audit shows

Man in a hoodie holding a knife

Similar schemes have seen a fall in incidents of violent crime

A coalition pledge to make hospitals share violent crime data with police is being carried out in only a third of areas in England, an audit shows.

The government has written to hospitals and chief constables for an explanation after the Department of Health audit.

Accident and emergency departments are meant to share information about where knife or gun attacks are happening with the police and local council.

This was part of the government’s programme for government in 2010.

‘Disappointed’

In 2010 the coalition promised in its programme for government to make hospitals share non-confidential information with the police so crime hotspots could be identified.


I would want to say to hospitals and local authorities this is straightforward, ethical information-sharing that makes for safer communities – just get on with it”

Prof Jonathan ShepherdCardiff University

In the government’s mid term report, which measured progress against their programme for government they said “we have established a national scheme requiring hospitals to share information on gun and knife crime”.

But an audit carried out for the Department of Health has revealed that is happening effectively in only a third of community safety partnership areas, and not at all in one-fifth.

The charity Victim Support said it was very disappointing that the plan was not being implemented.

Susannah Hancock, its assistant chief executive, said: “The NHS is the second most likely public service after the police to come into contact with victims of violent crime, many of whom will not have reported such incidents to the police at all. ”

It is thought that police are aware of fewer than a third of assaults that lead to the victim being treated in hospital.

Pioneering research carried out in Cardiff tested the idea of regularly sharing collated information about the type and location of attacks, with all confidential patient information removed.

As a result, the city saw a 35% fall in the numbers of assault victims turning up at A&E for treatment between 2000 and 2005.

Professor Jonathan Shepherd, from Cardiff University, said the research showed sharing information costs little, and saves money in the longer term for the NHS and the criminal justice system. He said the findings of the audit were surprising, giving the strong evidence, and the commitment from government.

“I feel disappointed that it hasn’t been taken up faster than this, and I would want to say to hospitals and local authorities this is straightforward, ethical information-sharing that makes for safer communities – just get on with it.”

‘Win-win’

Arrowe Park hospital, in the Wirral, has seen some impressive results from setting up systems to share information every month with the police and local council. Anyone arriving at A&E with an injury caused by a violent assault is taken through a standard set of questions about the location and circumstances of the attack.

The information has all patient data removed from it before it is shared. Between 2004 and 2010, the number of alcohol-related assault victims arriving for treatment fell by 30%.

Chris Oliver, from the Wirral University Hospital Trust, said the results had convinced busy staff in A&E to get involved: “It’s owned by everyone within the department. The reception staff are very proactive when going through the questions. It’s very rewarding for our staff to see the reduction in people coming into the department. It’s a win-win.”

The Department of Health said Health Minister Anna Soubry had written this week to all hospital chief executives and chief constables in England to remind them of the government’s commitment on sharing information.

The letter says there are no legal reasons for not sharing anonymous information, and asks for any “good reasons why it cannot be done” in areas which have failed to put systems in place.

Despite this slow progress in implementing the approach in England, the idea has attracted international interest and there are pilot schemes under way in other countries.

BBC

健康防护:美食当前肾也没负担

最近回台看到一则新闻,一个12岁女童四年多来几乎天天吃鸡排配碳酸饮料,吃到肾脏衰竭需终生洗肾,让人感叹,这些都是我经常在课堂上呼吁大家的医学常识啊!但还是有许多人不了解其重要性,真让人不胜唏嘘!

鸡排是高盐、高油及高蛋白食物,如果长期大量食用,体内会产生过量含氮废物,加上碳酸饮料的助力,都会加重肾脏负担。农历春节即将到来,免不了又是一番吃吃喝喝,面对各式各样的美食,我们究竟该注意哪些事项呢?

1.适量摄取蛋白质(重质不重量)

低蛋白饮食:减少尿素氮生成、减少肾脏负担。然而蛋白质限制太严格会导致营养不良,建议每日2至4两肉类,三分二动物性蛋白质。某些植物蛋白质代谢后易产生较多氮废物(尿毒),宜少吃(如绿豆、红豆、黄豆、豆类制品、瓜子、花生、腰果、杏仁果等)。

2.限制盐分

钠易让水分积存体内,造成水肿、高血压并加重肾脏负担。含钠高的食物:腌渍、罐头等加工食品(如味素、乌醋、豆酱、豆鼓、蕃茄酱、沙茶酱、味噌等)。

含钠量高的蔬菜(如紫菜、海带、胡萝卜、芹菜、蚕豆),不宜大量食用。

3.限制钾的量

排钾量90%由肾脏负责。含钾高的食物:如紫菜、发菜、苋菜、菠菜、香菇、草菇、甘薯、马铃薯、芋头、龙眼干、葡萄干、香蕉、奇异果、香瓜、木瓜、草莓、杨桃、咖啡、红茶、绿茶、咖哩粉等。

4.限制磷,适时补充钙质

肾功能下降时会导致磷排出困难,造成血磷堆积,刺激副甲状腺素制造分泌,加速骨质破坏,造成钙流失。

故肾功能不佳者常会出现低钙、高磷和骨质疏松的合并症。食物都含有磷,患者可借助钙片和食物一起吃,在肠胃道直接与磷结合,阻挡磷的吸收;故肾功能退化时,须限制含磷食物,适时补充钙。

含磷高食物:咖啡、可可粉、绿茶、乌龙茶、红茶、啤酒、可乐、巧克力、花生糖等。

5.限制水分,依状况而定

需要控制水分的情况为:一天尿量不到400ml;水肿情况严重;体内囤积胸水及腹水;接受透析疗法。

6.摄取充足的热量

热量不足,身体将会代谢蛋白质转化为热量,产生废物加重肾脏负担。热量高蛋白质含量低的食物,如黄豆油、玉米油、橄榄油、花生油、菜籽油;藕粉、冬粉;冰糖、蜂蜜、水果糖、姜糖等。

因日常生活作息及饮食习惯改变,肾功能异常病患逐年增加,建议应多注意身体是否水肿、尿量减少等异常状况,若有家族病史或过敏体质者,更须小心防范肾脏病。

本报特约: 李延平医生

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