HEALTH SERVICES/OUTCOMES RESEARCH
POSITIONS AND RESPONSIBILITIES: The Department of Pharmaceutical Systems and Policy at the West Virginia University (WVU School of Pharmacy seeks applications for an Assistant Professor to join our health services/outcomes research team. This 12-month tenure track position is available immediately. Primary responsibilities include graduate and professional program teaching, graduate student mentoring, and developing an independently funded research program in health services and outcomes research. Salary and start-up packages are competitive.
QUALIFICATIONS: Ph.D. or equivalent degree with a strong research focus in patient-reported outcomes (e.g., Health Related Quality of Life, patient satisfaction , or chronic disease epidemiology. Candidates should have a promise for excellence in research and teaching in relevant areas, as well as peer-reviewed publications. Experience and participation in funded research is an advantage and excellent communication skills are important. Candidates should interact effectively with collaborators from diverse disciplines and be eligible for appointment to the graduate faculty in order to teach and mentor graduate students engaged in health services and outcomes research.
APPLICATION: Interested persons should submit an application consisting of a letter of interest, curriculum vitae, and contact information for three professional references to: Usha Sambamoorthi, Ph.D., West Virginia University School of Pharmacy, PO Box 9510, Morgantown, WV 26506 or by e-mail to usambamoorthi@hsc.wvu.edu with a copy to acframe@hsc.wvu.edu. Applications will be considered as they are received and will be accepted until position is filled.
SCHOOL AND COMMUNITY: The School of Pharmacy has a nationally recognized Ph.D. graduate program in health outcomes research with 15 Ph.D. students, the majority of whom are supported by external research funding. It offers exciting opportunities through the Rational Drug Therapy Program which is supported by West Virginia state agencies, the AHRQ funded West Virginia Collaborative Health Outcomes Research of Therapies and Services (CoHORTS center, and the newly established Wigner Institute for Advanced Pharmacy Practice Education and Research. Established partnerships with the state Medicaid program and the state health insurance program, managed care organizations, several pharmaceutical companies, and the nearby National Institute of Occupational Safety and Health (N.I.O.S.H. and Mylan Pharmaceuticals offer potential opportunities for collaborative research. In addition, a newly launched School of Public Health and research faculty and graduate programs in business, communication, education, psychology, public administration, and sociology provide opportunities for multidisciplinary collaboration and research.
The School of Pharmacy is situated within a large state-assisted academic health sciences center which includes a 460-bed teaching hospital, a psychiatric hospital, rehabilitation hospital, and regional cancer center. West Virginia University (a Doctoral Research-Intensive University is the state's land-grant university with an enrollment of 29,000 students. WVU is located in Morgantown, a scenic rural area that has been featured in numerous publications for its high quality of life, cultural amenities, outdoor recreation, and is within easy driving distance to Pittsburgh, PA, and Washington, DC.
West Virginia University is an Equal Opportunity/Affirmative Action Employer. Women and minorities are encouraged to apply. The WVU Health Sciences Center is a smoke free campus. West Virginia University is the recipient of an NSF ADVANCE award for gender equity.
Apply Here
Health insurance is to become mandatory starting in 2014, and states are responsible for setting up one-stop marketplaces for insurance programs to sell to individuals and small businesses. The office of HHS addressed concerns each state may have by setting up policies for establishing Affordable Insurance Exchanges.
Documentation provides standards for establishing Exchanges, setting up a Small Business Health Options Program (SHOP , and a way for each state to perform basic functions of an Exchange, and certifying health plans for participating in the exchange. The guidelines also provide support to establish a streamlined, web-based system for consumers to apply for an enroll in qualified health plans and insurance affordability programs.
"These policies give states the flexibility they need to design an Exchange that works for them," said HHS Secretary Kathleen Sebelius, in a statement. "These new marketplaces will offer Americans one-stop shopping for health insurance, where insurers will compete for your business. More competition will drive down costs and Exchanges will give individuals and small businesses the same purchasing power big businesses have today."
The guidelines are a "final rule" HHS published on Affordable Health Insurance Exchanges, which combines policies from two Notices of Proposed Rulemaking (NPRMs published last summer. One rule, published July 15, 2011, outlined a proposed framework to enable states to build Affordable Insurance Exchanges created under the Affordable Care Act. A second NPRM, published August 17, 2011, outlined proposed standards for eligibility for enrollement in qualified health plans through the Exchange and insurance affordability programs, including premium tax credits.
By the start of 2014, each state will be responsible for setting up and providing Affordable Health Insurance Exchanges to all of its individual residents and businesses. That is unless the Supreme Court overturns healthcare laws passed under the Obama administration. To date 26 states and a business group have brought a suit to the high court claiming the healthcare reform should be overturned as unconstitutional because it requires most adults to buy private health insurance or pay a penalty, according to a Reuters report.
The Supreme Court will hear oral arguments March 26-28, with a ruling expected in early July.
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On the Net:
“Small quantities of processed meat such as bacon, sausages or salami can increase the likelihood of dying early by a fifth,” The Daily Telegraph reported today.
The news is based on a large study that looked at the diets and health of over 120,000 people over periods of up to 28 years, assessing their diets every four years and following the development of any heart problems or cancer.
Researchers found that regularly eating red meat, in particular processed meat, was associated with a significantly higher risk of dying prematurely. Each 85 gram daily serving of unprocessed red meat (equivalent to about three thin slices of roast beef was associated with a 13% increase in death risk during the study period, while one daily serving of processed meat (one hot dog or two slices of bacon was associated with a 20% increased risk.
The researchers then input their data into a theoretical model, which estimated that 9.3% of early deaths in men and 7.6% in women in the study could have been prevented if all the participants had consumed fewer than 0.5 servings a day (about 42 gram a day of red meat.
This was a well-conducted study but it could not conclusively prove that red meat raises the risk of premature death, although the results are of key interest and the evidence is mounting on the issue. According to UK dietary surveys, 4 in 10 men and 1 in 10 women eat more than 90 grams of red and processed meat a day. The Department of Health recommends that people eating more than 90 grams of red and processed meat a day limit their intake to no more than 70 grams a day in cooked weight. That is about the size of a large beefburger.
Where did the story come from?
The study was carried out by researchers from a number of research institutions, including the Harvard School of Public Health in the US. It was funded by the US National Institutes of Health, and the US National Heart, Lung and Blood Institute.
The study was published in the peer-reviewed medical journal, Archives of Internal Medicine.
This research was widely reported in the media, with several reports including comments from independent experts. The Daily Mail also included some critical comments on the research from the industry funded Meat Advisory Panel. The Sun’s claim that red meat kills was misleading.
What kind of research was this?
This was a prospective cohort study to investigate the association between red meat intake and early death in two large groups of men and women. It looked at both deaths from all causes and deaths from heart disease and cancer.
The researchers point out that red meat consumption has been associated with increased risk of chronic diseases but its association with the risk of mortality (death remains uncertain.
What did the research involve?
The researchers analysed data from two large US cohort studies of health and lifestyle that took place in the US between 1976 and 2008. One of these studies examined outcomes in a range of healthcare professionals and the other only in nurses. In these studies, health questionnaires were sent to participants every two years to collect health-related information, with food questionnaires sent out every four years.
For the present analysis, researchers assessed the diets of 37,698 men and 83,644 women who were free of both cancer and heart disease at the start of the studies (1986 and 1980 respectively .
Diet was assessed using the validated food frequency questionnaires they had completed, which included detailed questions on both processed and unprocessed meat consumption.
In each questionnaire, participants were asked how often on average they consumed each food of a standard portion size, with nine possible responses ranging from ‘never, or less than once a month’ to ‘six or more times a day’. The standard serving size was 85 grams (3oz for unprocessed red meat. Processed red meat included bacon (two slices, 13g hot dogs (one, 45 grams . The participants were sent these questionnaires every four years until 2006.
The researchers collected information about deaths among participants by reports from next of kin, through postal authorities and by searching a national death index. The cause of death was primarily taken from medical records and death certificates. The researchers used codes from an international classification of diseases to distinguish between deaths due to cancer and cardiovascular disease.
They used appropriate statistical methods to analyse the data, taking account of possible other factors such as bodyweight, smoking status, physical activity level, family history, blood pressure and cholesterol.
In a further analysis the researchers modelled how death rates would be affected if one daily serving of red meat was substituted with an alternative food such as fish, poultry, nuts, legumes, low fat dairy or wholegrain.
What were the basic results?
The 121,342 participants were followed up for up to 28 years, during which time there were 23,926 deaths, including 9,464 deaths due to cancer and 5,910 from heart disease and stroke (collectively classed as cardiovascular disease [CVD] .
The researchers compared the highest consumers of red meat with the lowest consumers of red meat to calculate the increases in risk due to each additional serving a day. This was an average across all groups and it is worth noting that even the people with the lowest consumption of red meat were still eating, on average, a quarter of a serving a day and so were not vegetarian. The researchers found:
- consuming one serving of unprocessed red meat a day was associated with a 13% increased risk of early death (95% confidence interval [CI], 1.07-1.20 , an 18% increase in risk of death from CVD (1.13-1.23 and a 10% increase in the risk of death from cancer (1.06-1.14
- one serving of processed meat daily was associated with a 20% increased risk of early death (CI 95% 1.15-1.24 , 21% increase in risk of death from CVD (1.13-1.31 and a 16% increase in the risk of death from cancer (1.09-1.23
When the researchers modelled the impact of replacing meat with other foods their model estimated that:
- substituting one serving of red meat a day with one serving a day of other foods was associated with between 7% and 19% lower mortality risk
- 9.3% of early deaths in men and 7.6% in women taking part in the study could be prevented at the end of follow-up if all the individuals consumed fewer than 0.5 servings a day (approximately 42g a day of red meat
How did the researchers interpret the results?
They say their study provides evidence that regular consumption of red meat, especially processed meat, is associated with an increased risk of death due to any cause, as well as due to CVD and cancer. Conversely, substitution with other protein sources is associated with a lower risk.
The authors propose that presence of saturated fat and iron in red meat might partly explain this association with higher risk of CVD, while the presence of other constituents such as sodium and nitrites might explain the additional risk associated with processed meats. They also point out that some of the compounds in red meat created by high temperature cooking are potential carcinogens.
Conclusion
This study had several strengths including its size, long follow-up period and detailed and repeated assessments of people’s meat intake. It also adjusted the results for other factors that might affect risk of mortality. However, relying on participants to self-report factors, such as their meat intake through questionnaires, introduces the possibility of error, although the questionnaires were validated. Furthermore, participants were mainly white health professionals, so the results may not be relatable to other populations.
This study cannot prove that regular consumption of red meat ‘kills’, as The Sun put it. Red meat is a good source of protein and certain nutrients such as iron, some vitamins and zinc, but it is already recognised that it is likely to raise the risk of cancer especially bowel cancer. The Department of Health advises adults who eat high levels of red and processed meat should reduce their intake to no more than 70 gram a day to reduce this risk. For advice on how to cut down, see our guidelines on red meat consumption.
Links To The Headlines
Eating red meat regularly 'dramatically increases the risk of death from heart disease'. Daily Mail, March 13 2012
Bacon sandwiches and fizzy drinks 'take years off your life'. Metro, March 13 2012
Fresh warning on red meat health risks. BBC News, March 13 2012
Eating red meat raises 'substantially' risk of cancer or heart disease death. The Guardian, March 13 2012
Red meat ‘kills’. The Sun, March 13 2012
Links To Science
Pan A, Sun Q, Bernstein AM et al. Red Meat Consumption and Mortality - Results From 2 Prospective Cohort Studies. Archives of Internal Medicine, March 12 2012
Hair Therapy
by brienne walshyou see the derm once a year, the dentist twice a year, your therapist biweekly (no judgment . but when was the last time you really took a long, hard look at the health of your hair? sure, regular trips to the stylist can help, but to really get your strands on track, glo brings you five at-home hair tests, along with quick and easy fixes. damaged and prone to breakage? not anymore.
How It Works
tie a lock of hair into a loose knot and set it on your palm. if the knot stays closed, then it means your hair has likely been over-processed.
The Quick Fix
"if your hair is fragile, then don't brush it when it's wet, because that's when it's most likely to break,” says new york city hairstylist tyler laswell. instead, brush it before you shower and then, "once it dries naturally, style it with your fingers."
How It Works
pull a strand of hair from the back of your head and place it in a clear bowl of room-temperature water. if the lock sinks, then it means that your hair is dry and porous, possibly from too many color treatments.
The Quick Fix
"when hair is colored, the cuticle that protects the strand is lifted so that color can be deposited, making it very porous," explains laswell. the best solution (besides quitting the colorist altogether ? "use products like serums and waxes, which help smooth down the cuticle and bring shine back to the hair."
How It Works
gently tug a small cluster of hair. if more than a few strands come out of your head, then get to the root of the problem, literally. "the healthier and more hydrated your scalp is, the healthier your hair will be," says laswell.
The Quick Fix
"don't shampoo your hair every day," says laswell. "you need natural oils to keep your scalp protected." if you feel like your hair is getting greasy, then rinse it with water and apply conditioner only at the ends.
How It Works
take a loose strand of hair and with your nail, curl it like you would a ribbon. when you pull the curl straight, it should spring back into place. if it doesn't reclaim its shape, then it needs more strength and conditioning.
The Quick Fix
"try a strengthening shampoo followed by a leave-in treatment," says laswell. "but don't use a treatment every time you wash your hair. anti-breakage products have very intense direct proteins and if they're over-used, then they can make the problem worse."
In this unique recipe, slabs of tofu are immersed in a nutty mixture of pistachio and breadcrumbs for a flavor-packed dish with an interesting texture.
Ingredients:
14 oz. tofu
2 tbsp. low-sodium soy sauce
1 1/2 slices whole-wheat bread
1/2 c. pistachio nuts
Ground pepper to taste
2 tbsp. spicy mustard
2 tbsp. maple syrup
1/2 tbsp. low-sodium soy sauce
1 tbsp. tofu mayonnaise
Directions:
Preheat oven to 400 degrees; prepare a baking sheet by either oiling it lightly or lining it with a silicone liner. Cut the tofu into 8 1/2-in. slices and dry them lightly with paper towels. Brush both sides of the tofu with the 2 tbsp. soy sauce and set aside to marinate for at least 10 minutes. While the tofu is marinating, place the bread into the food processor and pulse into fine crumbs. Measure out 1 cup of crumbs into a wide, shallow bowl (save any remaining crumbs for another use. Pulse the pistachios in the processor until they are reduced to fine crumbs. Add them to the breadcrumbs along with a generous grating of black pepper, and mix well. In another shallow bowl, combine the mustard, syrup, soy sauce, and mayo. Dip a slice of tofu into the mustard mixture, lightly coating all sides; then place it into the breadcrumbs, sprinkle crumbs over the top and sides, and lightly press them into the tofu. Place on the prepared baking sheet. Repeat with all slices of tofu. Put the tofu into the oven and bake for 20 minutes, or until breadcrumbs are golden brown. Serve with the sauce of your choice.
Makes 4 servings.
Recipe provided by FatFree Vegan Kitchen
Craving something sweet? Tofu actually makes a healthy base for low-cal desserts like this silky smooth pudding. Whip up this tasty treat using chocolate and, of course, lots of tofu, and then spoon the pudding into edible chocolate cups.
Ingredients:
For chocolate tofu pudding:
1 box tofu, drained
2 tbsp. agave nectar
1/2 c. chocolate chips, melted and cooled slightly
1/4 c. chocolate sauce (the kind you use for chocolate milk
For pudding cups:
2 c. chocolate chips
2 tbsp. vegetable oil
1 recipe chocolate tofu pudding
Raspberries
Whipped cream
Directions:
For chocolate tofu pudding:
Put all the ingredients in a Vitamix (or blender and puree until smooth. Refrigerate until ready to fill the chocolate cups (about 30 minutes . Once ready to fill the cups, scoop the pudding into a large zip-lock bag. Cut a small hole in the bottom corner of the bag and squeeze the pudding into the cups.
For pudding cups:
Line 24 mini muffin tins with paper liners. Melt the chips and vegetable oil in a small bowl in the microwave. Stir every 30 seconds and heat until chips are fully melted. Spoon about 1 heaping tsp. melted chocolate into each muffin liner and spread up the sides with the back of a spoon. Put the tin in the freezer to get the chocolate firm. Add a second layer of chocolate to the cups, freeze again. Keep frozen until your ready to remove the paper. Refrigerate the filled pudding cups for about 4 hours, so the pudding sets and gets a little firmer. Top with whipped cream and raspberries.
Makes 24 cups.
Recipe provided by Fat Girl Trapped in a Skinny Body
These slightly crispy bean curd strips get a smoky sweet flavor boost with a low-cal blend of sauces and spices. While you can serve them with kale and rice (as pictured , feel free to combine the tofu with other ingredients to round out a healthy, satisfying meal.
Ingredients:
1 package extra-firm tofu
1 1/2 tbsp. safflower oil
1 1/2 tbsp. maple syrup
1 tbsp. rice vinegar
1/2 tsp. liquid smoke
1/4 tsp. garlic powder
1/4 – 1/2 tsp. cayenne pepper
Directions:
Drain your tofu and cut into 8 equal slices. Lay the slices out flat on a doubled over kitchen towel with another doubled over towel on top. Lay a large cutting board on top and place a few heavy books on top. Press for 25 – 35 min. Preheat oven to broil with a rack on the top slats. Whisk all other ingredients together in a large bowl. Slice tofu into 1/4 in. wide strips or small squares. Place tofu in the large bowl with the wet ingredients and stir very gently until well coated. Lay tofu out on a parchment-lined pan and broil for four to eight minutes, until golden brown with slightly darker edges. Time varies depending on your oven. Flip and broil for another four to eight minutes until golden brown. Typically, the second side browns a bit faster. Remove from the oven and serve immediately.
Makes 3-4 servings.
Recipe provided by The Edible Perspective
Crunchy asparagus spears offer a tasty (and nourishing counterpoint to soft blocks of bean curd, while a drizzle of spicy hoisin sauce lends this dish a surprising kick of flavor. Not only is this meal a surefire way to impress dinner guests, it’s also low in calories and fat.
Ingredients:
7 oz. firm tofu
1/2 tsp. sesame seeds
2 tbsp. hoisin sauce
2 tbsp. low-sodium soy sauce
1 tsp. Sriracha sauce
1 tsp. white sugar (optional
10 spears asparagus
1/2 tsp. five spice
Directions:
Turn the grill or a grill pan to high. In a small, dry skillet over medium heat toast the sesame seeds until golden. Pour onto a plate and save for garnish. Cut the tofu block in half, then turn one half on its side and cut it in half so that you have two pieces that are about 1 inch thick. Save the bigger half for another use or double the recipe. Set the cut pieces on a clean paper towel and blot dry.
To make the sauce:
In a small bowl mix together the hoisin, soy, Sriracha, and sugar. Set aside. Place the asparagus on the grill (optional: rub spears with a touch of oil and grill for five minutes rotating the spears until evenly grilled. Divide between two plates. Set the dry tofu on a plate and sprinkle both sides with the five spice. Rub the grill with a touch of vegetable oil on a towel so the tofu doesn't stick. Place the tofu on the grill and don't touch for one minute so that it can sear without sticking. Turn the tofu 45 degrees to create the "X" pattern grill marks. Cook 30 seconds. Using a spatula carefully flip the tofu over and grill for one more minute. While it is grilling, brush or spoon some of the sauce onto the tofu. Remove tofu from grill and place on top of the asparagus spears. Drizzle the remaining sauce over each plate (you will have some extra . Sprinkle with the sesame seeds.
Makes 2 servings.
Recipe provided by Jeffrey Saad, Cooking Channel host of United Tastes of America, restauranteur, chef, and author of Jeffrey Saad’s Global Kitchen: Recipes Without Borders (available March 20th
Who needs chicken nuggets when you can munch on nutritious tofu nuggets instead? These mealtime treats are easy to make and perfect for dipping into a variety of sauces. Our suggestion? A simply delicious vegan honey mustard spread made from 1 tsp. agave, 2 tbsp. mustard, and 1 tbsp. vegan mayo.
Ingredients:
1 pckg. firm tofu (frozen, thawed, and pressed
1 c. unsweetened non-dairy milk
3 tbsp. vegetable bouillon
3 tbsp. mustard
1 c. panko bread crumbs
1 c. whole-wheat flour
Salt and pepper (optional
Directions:
Preheat oven to 400 degrees. Take your firm tofu (frozen, thawed, and pressed for better texture , and slice it into 1 in. cubes. Mix vegan “milk”, vegetable bouillon, and mustard together. Dip cubed tofu into the “milk” mixture. Roll it into whole-wheat flour. Dip into the milk mixture again. Roll in panko crumbs. Place onto greased cookie sheet. Bake for 15 to 20 minutes. Enjoy with your hot sauce, vegan ranch dressing, ketchup, mustard, etc.
Makes 16 nuggets.
Recipe provided by Veg Obsession
Whether you need a hearty dinner entree or just want a wholesome snack, these sweet and sour tofu slices make a great option. A mix of sweet jam (like mango chutney and lemon juice infuse the tofu with an irresistible tangy flavor that won’t interfere with your healthy diet.
Ingredients:
1 block extra-firm tofu
1/2 c. sweet jam/jelly/preserves
1/3 c. honey (if you don’t eat honey, use agave, maple, or yacon syrup
1/4 c. lemon juice (in a pinch, you can use apple cider vinegar
Optional but recommended:
1/4 c. apple cider vinegar
1/2 tsp. ginger powder
2 tbsp. EVOO (or coconut, flax, hemp, grapeseed oil
Directions:
Mix marinade in a bowl and allow tofu to marinate for at least 15 minutes up to overnight. Bake on a foil-lined cookie sheet at 450 degrees for 20 minutes on the first side (tip: the honey is going to caramelize, so use foil for an easy cleanup . Then, flip and bake for approximately 10 more minutes. Watch the honey because the sugars can burn. Put extras in a container and store in fridge for up to four to five days.
Makes 18 long, thin slices.
Recipe provided by Love Veggies and Yoga
Sometimes all it takes is a handful of great seasonings to make a mouthwatering tofu dish. In this easy recipe, just coat each piece in assorted spices like chili powder, cumin, and cayenne for a spicy dish that won’t even come close to breaking the calorie bank!
Ingredients:
1 block tofu
1/4 tsp. cayenne
1/4 tsp. granulated onion
1/4 tsp. granulated garlic
1/4 tsp. chili powder
1/4 tsp. cumin, ground
1/4 tsp. coriander, ground
1/4 tsp. black peppercorns, ground
1 tbsp. paprika
1/2 tsp. thyme
Directions:
Coat tofu in spice. In a hot skillet, brown tofu with no oil or water. When edges brown, flip and cover cook until cooked though. Time depends on the thickness of the tofu.
Makes 4 4 oz. servings.
Recipe provided by Chef Anthony Stewart of the Pritikin Longevity Center in Miami, Florida
Who knew that pumpkin butter and honey would make such great accompaniments to tofu? These sweet-tasting slices have a spongy texture and leave you perfectly satisfied.
Ingredients:
1 block extra-firm tofu
1/4 c. pumpkin butter
1/3 c. honey (or agave or maple
1 tsp. ground ginger
1/4 c. apple cider vinegar
Optional:
Dash of tamari or soy sauce
Pinch of nutmeg/cayenne/chili powder/cumin/pumpkin pie spice/cinnamon
Drizzle of EVOO/coconut/hemp oil
Directions:
Whisk to combine all ingredients. Marinate the sliced tofu for 15 minutes to 24 hours. Bake on a foil-lined cookie sheet at 450 degrees for 20 minutes and flip and cook another five minutes or so. Note: I used tofu that had previously been frozen, thawed, and pressed.
Makes 18 long, thin slices.
Recipe provided by Love Veggies and Yoga
If you love pesto but find it too fattening (thanks to loads of olive oil, pine nuts, and Parmesan cheese , try this creative concoction made with silken tofu and veggies. Find ways to adorn your favorite dishes, such as whole-wheat pasta or pizza, with this delicious sauce, which clocks in at approximately 436 calories per cup.
Ingredients:
1/2 c. peas
50 g. spinach
30 fresh basil leaves
1/4 c. unsalted cashews
1 clove garlic
5 tbsp. olive oil
4 tbsp. silken tofu
A grind of black pepper
Directions:
Blanch the peas for a couple of minutes to soften slightly. Wilt the spinach by placing in a colander and pouring over a kettleful of boiling water. When wilted, rinse with cold water and squeeze out as much liquid as you can. Whizz all the ingredients together and season with freshly ground black pepper.
Makes 2 cups.
Recipe provided by Tinned Tomatoes
This healthy recipe takes only a few minutes of prep time, but the results are tantalizing! Soaking slices of tofu in balsamic vinegar, garlic, and oregano gives the dish some extra bite. Serve with your favorite veggies to round out your meal.
Ingredients:
1 block extra-firm tofu
1/2 c. balsamic vinegar
3 tbsp. chopped garlic
2 tbsp. dried oregano
Directions:
Cut tofu into slices. Mix balsamic vinegar, garlic, and oregano together, and marinate tofu for 30 minutes. Grill, bake, or pan-sear.
Makes 4 servings.
Recipe provided by Chef Anthony Stewart of the Pritikin Longevity Center in Miami, Florida
Think tofu is bland and flavorless? These mouthwatering recipes will change your mind about the soft, creamy blocks of bean curd forever! Not only is tofu great for low-cal diets, it brims with good-for-you soy protein, iron, and omega-3 fatty acids. Tofu is also one of the most versatile foods, making it a great base for both savory entrees and sweet desserts.
You won’t need the luck o’ the Irish when you’re whipping up this low-cal key lime pie. Thanks to fat-free cream cheese and light yogurt, this no-bake dessert won’t max out your daily calorie intake.
Ingredients:
2 tbsp. cold water
1 tbsp. fresh lime juice
1 1/2 tsp. unflavored gelatin
4 oz. fat-free cream cheese, softened
3 containers (6 oz. each Yoplait Light Thick & Creamy key lime pie yogurt
1/2 c. frozen (thawed reduced-fat whipped topping
2 tsp. grated lime peel
1 reduced-fat graham cracker crumb crust (6 oz.
Directions:
In 1-quart saucepan, mix water and lime juice. Sprinkle gelatin on lime juice mixture; let stand 1 minute. Heat over low heat, stirring constantly, until gelatin is dissolved. Cool slightly, about 2 minutes. In medium bowl, beat cream cheese with electric mixer on medium speed until smooth. Add yogurt and lime juice mixture; beat on low speed until well blended. Fold in whipped topping and lime peel. Pour into crust. Refrigerate until set, about 2 hours.
Makes 8 servings.
Recipe provided by Betty Crocker
Tempted to order McDonald’s seasonal Shamrock Shake? Try whipping up this guilt-free version at home. This icy bevvie blends low-fat cottage cheese with protein powder, and every sip is infused with a hint of cool minty flavor. Plus, you can’t beat the pretty green hue for the perfect St. Patty’s Day delight!
?Ingredients:
?1/2c. low-fat cottage cheese (or vanilla yogurt
?1 scoop vanilla or plain protein powder
?1/8 tsp. mint extract (or to taste
?2-3 packets stevia or sweetener of choice (or to taste
?5-10 ice cubes (more or less depending on how thick you like it
?4-6 oz. water (alter according to desired thickness
?A few drops of green food coloring, or a handful of spinach to make it green
?1-2 tbsp. Sugar-Free Instant Pistachio Pudding Mix (optional
?Pinch of guar of xanthan gum (optional
?Directions:
?Put all the base ingredients in the blender, and blend away until desired consistency! Swirl in one drop of red food coloring just before serving, and top with whipped cream and crushed candy cane if desired!
Makes 1 serving.
Recipe provided by Dashing Dish
Veggie burgers often get a bad rap, but this wholesome recipe will change your mind. Made with chick peas, veggies, and just the right amount of seasoning, these patties are loaded with both flavor and good-for-you perks.
Ingredients:
1 15-oz. can Progresso chick peas (garbanzo beans , drained, rinsed
1 egg
1 clove garlic, finely chopped
1 tsp. smoked paprika
1/2 tsp. ground coriander
1/2 tsp. ground cumin
1/2 tsp. coarse (kosher or sea salt
1 c. chopped fresh spinach
1/2 c. shredded carrot
2 tbsp. chopped fresh cilantro
3/4 c. Progresso panko bread crumbs
2 tbsp. canola oil
Toppings, as desired (avocado halves, cilantro leaves, cucumber slices, tomato slices, sweet pepper strips, lettuce leaves
Sauces, as desired (spicy mustard, Sriracha, ketchup, citrus vinaigrette
Directions:
In food processor bowl, place chick peas, egg, garlic, smoked paprika, coriander, cumin, and salt. Cover; process with on-and-off pulses about 45 seconds or until nearly smooth. Stir together bean mixture, spinach, carrot, and cilantro until well combined. Stir in bread crumbs. Shape mixture into 4 patties, about 3 1/2 in. in diameter and 1/2 in. thick. In 10-in. nonstick skillet, heat 2 tbsp. canola oil over medium heat until hot. Cook patties in oil 8 to 10 minutes, turning once, until brown and crisp. Serve veggie burgers stacked with toppings and drizzled with sauce.
Makes 4 servings.
Recipe provided by Betty Crocker
These minty green-colored oats make a festive St. Patrick’s Day breakfast. The mint and chocolate flavors go hand in hand to boost the oats with an almost dessert-like flavor, while chia seeds add nutritional value in the form of omega-3s and fiber.
Ingredients:
1/2 c. oats mixed with 1 1/2 c. water
1 tbsp. chia seeds
1 scoop SunWarrior Protein Powder
2-3 tsp. mint extract
1 tsp. cacao powder
Green food coloring
Directions:
Microwave 1/2 c. oats with 1 1/2 c. liquid (water or milk . After oats are cooked add chia seeds, protein powder, mint extract, cacao powder, and food coloring. Mix all together. You could make the oats night before and refrigerate overnight for cold oats or cook in the morning and enjoy hot. For the chocolate frosting, mix 1 scoop SunWarrior Vanilla Protein Powder, 2 tbsp. cocoa powder, stevia, and water.
Makes 1 serving.
Recipe provided by Healthy Diva Eats
You can’t get greener than a bowl of kale! Thanks to a zesty mix of lemon juice, apple cider vinegar, and minced garlic, this recipe yields a salad bursting with flavor. Each serving is low in calories and fat but high in fiber and antioxidants, so dig in!
?Ingredients:
?1/2 bunch raw kale, washed, de-stemmed, and dried
?1 tbsp. tahini
?1 tbsp. apple cider vinegar (or water
?1 tbsp. lemon juice
?1 tbsp. Bragg’s liquid aminos (tamari or soy sauce would work too
?2 tbsp. nutritional yeast
?1 tsp. minced garlic (1-2 cloves garlic
?Sesame seeds to taste as garnish (optional
?Directions:
Break or cut kale into bite size pieces and place in a large bowl. Puree all ingredients except kale and sesame seeds in a blender or food processor to blend the dressing. Pour dressing over kale and massage into the kale with your hands until all pieces of kale are coated. Let the salad sit in the fridge for an hour or so to marinate. You can skip this step if you need to eat right away, but allowing some time to marinate will wilt the kale a bit and make it a little more palatable, particularly for those who are skeptical of eating raw kale. Sprinkle on some sesame seeds before serving if so desired.
Makes 4 servings.
Recipe provided by Eating Bird Food
While these crunchy cakes are more yellow in color than green, they’re still a perfect St. Patty’s Day treat for your family and friends. Each scrumptious morsel is totally satisfying and packed with vitamin-rich zucchini, yet strikingly low in calories, carbs, and fat.
Ingredients:
1 large zucchini, grated
1 large egg
1 c. panko bread crumbs
Salt and pepper to taste
1 tbsp. Adobo spices
1/2 c. Parmesan cheese, grated
Directions:
Remove excess liquid from freshly grated zucchini by placing them between paper towels and squeezing. In a large bowl, combine all the ingredients. Mix thoroughly. Heat a large pan on medium, and spray with Pam. Shape spoonfuls of the zucchini batter into 2-in. (diameter patties, and drop onto the sizzling pan. Cook each side for about a minute and a half, or until the outside is golden brown. Finish the cakes off in the oven. Stick them on a baking pan and broil them for 1-2 minutes. Serve hot, alone or with ranch dressing.
Makes about 12 cakes.
Recipe provided by Just Putzing Around the Kitchen
A clever take on Dr. Seuss’ Green Eggs and Ham, this easy-to-make recipe doesn’t even require fake food coloring! Instead, harness the healthy powers of a veggie like fresh kale or spinach to tinge the scrambled eggs with a green hue.
Ingredients:
6 eggs (pastured and/or organic eggs recommended
1 tbsp. milk (whole milk recommended
2 tbsp. onion, roughly chopped
1 c. fresh kale or spinach leaves, washed with big stems removed
Salt and pepper to taste
Butter for frying (organic and/or grass-fed butter recommended
Directions:
Combine first 5 ingredients in a blender (including the salt and pepper and blend until the greens are pureed into little bits. Heat a big pat of butter in a frying pan over medium-low heat. Once the butter has melted pour the egg mixture into the warm pan. Let it sit for a couple minutes before you begin to stir and scramble with a spatula. Cook until eggs are done all the way through.
Makes 3 servings.
Recipe provided by 100 Days of Real Food
A delectable fusion of healthy vegetables, this green soup is great to serve on St. Patty’s Day (and also ideal for detoxing the next day! . Avocado, broccoli, and arugula not only lend the soup its rich emerald shade, but ensure that every sip is brimming with nutritional benefits too.
Ingredients:
1/2 Haas avocado
8-10 decent-sized broccoli clusters (stems kept at least 1 in. long
1/3 onion of choice
2 handfuls arugula
1 tbsp. olive oil
Salt (about 1 tsp. or to taste
1 tbsp. apple cider vinegar
Red pepper flakes (about 1/4 tsp. or to taste
Drizzle of honey or agave
Juice from half a lemon
1 in. minced ginger root
1 c. water
Directions:
Lightly steam the broccoli. Remove from heat when bright green. Saute onions in olive oil until just soft. Place cooked broccoli and onions and all the other ingredients in a blender, food processor, or use hand immersion blender. Add 1/2 c. water and blend. Keep adding more water until you reach desired consistency. Add any additional salt to taste. Enjoy hot or cold!
Makes 2 servings.
Recipe provided by Honest Fare
For a hearty lunch or dinner idea, look no further than these roasted green peppers. Stuffed with quinoa and other healthy ingredients (like edamame, tomatoes, and mushrooms , these tender peppers offer a vegetarian-friendly meal that’s sure to impress guests.
Ingredients:
1/2 tbsp. olive oil
1 c. frozen edamame, thawed
5 white mushrooms, sliced
1 roma tomato, diced
1 c. fresh spinach
2 organic green bell peppers
1 tbsp. teriyaki stir-fry sauce
1/2 c. uncooked quinoa, rinsed and cooked
1/3 c. water
Directions:
Heat oil in a skillet over medium-high heat. Add edamame, mushrooms, and tomato, stirring until cooked, roughly 5-7 minutes. Add spinach and cook until spinach is wilted. Add in the stir-fry sauce and cook until coated. Remove from heat and place in a medium-sized bowl with cooked quinoa. Toss to combine. Set aside to let the filling cool until just warm. Meanwhile, preheat the oven to 350 degrees. Slice the tops off the peppers, and then core and seed them. Stuff each pepper with the filling, packing it down until each pepper is filled to the top. Place the peppers in a baking dish and replace the tops. Add the water to the bottom of the dish. Cover everything with aluminum foil and bake for 30 minutes. Remove foil, then bake for an additional 20-25 minutes until peppers are soft and juicy. Remove peppers from baking dish and serve.
Makes 2 servings.
Recipe provided by Eating Bender
This delicious soup calls for a lot of ingredients, but the result is well worth rounding them up! The combination of spices and veggies, especially the kick from jalapeno and green chiles, makes this concoction one tasty dish.
Ingredients:
1 tbsp. vegetable oil
1 medium onion, diced
1 red pepper, trimmed and chopped
?1 carrot, coarsely chopped
?1 jalapeno chile, seeded, trimmed, and minced
?1 4-oz. can chopped green chiles, drained
?4 garlic cloves, minced
?1/2 tsp. cumin
?Salt and freshly ground black pepper
?2 tbsp. all-purpose flour
?2 1/4 c. chicken broth
?1 1/2 lbs. boneless, skinless chicken breasts, cut into 1-in. chunks
?1 c. corn kernels (frozen is fine
?2 tbsp. fresh lime juice
?2 tbsp. chopped fresh cilantro
Directions:
Heat the oil in a Dutch oven over medium heat. Add the onion, bell pepper, carrot, and jalapeno. Cook about 4 minutes, until the vegetables are soft. Stir in the green chiles, garlic, cumin, 1/2 tsp. salt, and 1/4 tsp. pepper, and cook 1 minute, until aromatic. Stir in the flour until incorporated. Stir in the broth and chicken, bring to a simmer, and cook for 5 minutes. If using fresh corn, stir it in and cook for 5-10 minutes. If frozen, cook the chicken 5-10 minutes, until no longer pink, then add the corn and cook 1-2 minutes more. Stir in the lime juice and cilantro and add extra salt and pepper to taste. Serve with corn tortillas, charred over the stove flame.
Makes 4 servings.
Recipe provided by Cara Eisenpress of Big Girls, Small Kitchen
Whether you dress up in green or hit up your local watering hole for a pint of brilliantly colored beer, there’s nothing like ringing in St. Patrick’s Day with some festive cheer. This year, celebrate by cooking up some edible treats that are all SHAPE (and leprechaun -approved!
Lisa Schnirring, staff writer for the Center for Infectious Disease Research and Policy (CIDRAP news service, explained that the Centers for Disease Control and Prevention (CDC lacks the estimated $2.75 million needed to establish the Food Safety Integrated Centers of Excellence this year.
The centers, mandated under the new Food Safety Modernization Act, were to be modeled on the close working relationship among the University of Minnesota School of Public Health, the Minnesota Department of Health, and the Minnesota Department of Agriculture, which has been credited for helping trace Salmonella outbreaks in 2009 to peppers and peanut butter.
The CDC will continue to prepare for the eventual creation of the centers, in case funding becomes available, and support various initiatives, such as developing outbreak training materials and standardized questionnaires for use in investigations. It will also work to update PulseNet, the national foodborne illness surveillance system.
CIDRAP quoted University of Minnesota School of Public Health food safety expert Craig Hedberg, PhD, who said the CDC's decision was not surprising, given federal budget constraints, but "a great lost opportunity."
It's hard to know these days which way the proverbial worm is turning when it comes to shifts in drug policy. Election years tend to do that. Despite an historical turn of events in Central America which saw Presidents of drug trafficking nations come together to call for world wide decriminalization of drugs, in an effort to end the violence and corruption of the drug trade, the US continues to demur, absurdly claiming that the "War on Drugs" has been a success. Even stranger is Canada's recent announcement that they plan to follow the US model of a "tough on crime" approach to drug policy, which threatens to swell their correctional system in the same ways as in the US. Still, good news abounds with recent studies showing that LSD can cure alcoholism, psychedelics can cure PTSD, and cannabis smoking is not nearly as harmful as the prohibition governments claim. ~ CS
Google+ Presents: It's Time To End The War On Drugs
To liberalise or prohibit, that is the question. And to answer it the masters of live debate have joined forces with the masters of web technology to create a never-seen-before combination of Oxford debating and Silicon Valley prowess.
Prohibitionists argue that legalising anything increases its consumption. The world has enough of a problem with legal drugs like alcohol and tobacco, so why add to the problem by legalising cannabis, cocaine and heroin?
The liberalisers say prohibition doesn’t work. By declaring certain drugs illegal we haven’t reduced consumption or solved any problem. Instead we’ve created an epidemic of crime, illness, failed states and money laundering.
Julian Assange and Richard Branson; Russell Brand and Misha Glenny; Geoffrey Robertson and Eliot Spitzer. Experts, orators and celebrities who’ve made this their cause – come and see them lock horns in a new Intelligence?/Google+ debate format. Some of our speakers will be on stage in London, others beamed in from Mexico City or Sao Paulo or New Orleans, all thanks to the “Hangout” tool on Google+.
The web will have its say, and so can you at the event in London. Be part of the buzz of the audience, be part of an event beamed across the web to millions. Come and witness the future of the global mind-clash at the first of our Versus debates, live at Kings Place
Source: Intelligence 2 from Google +
North America
America's plague of incarceration
The message is (or should be deeply disturbing. Shouldn't the USA be ashamed at having the world's largest prison system and highest incarceration rate (754 per 100 000 people ? The richest country in the world has so many of its citizens in prison that it can't afford to house them with even basic minimum medical care (more than half of all prisoners have mental health or drug problems . Prison overcrowding itself has become so terrible in California, that in May, 2011, the US Supreme Court affirmed a lower court order that California release some 46 000 prisoners because of the inhuman conditions under which they were being held. In the Court's words, “A prison that deprives prisoners of basic sustenance, including adequate medical care, is incompatible with the concept of human dignity and has no place in a civilised society.”
Source: "A Plague of Prisons: The Epidemiology of Mass Incarceration in America," The Lancet.
International Women's Day: U.S. Must Address Impact of Mass Incarceration on Women.
More women are ending up behind bars than ever. Between 1980 and 1989, the number of women in U.S. prisons tripled. And the number of women in prison has continued to rise since. In the last 10 years, the number of women under jurisdiction of state or federal authorities increased 21 percent to almost 113,000. During the same time period, the increase in the number of men in prison was 6 percentage points lower, at about 15 percent. The increase in women in the federal population was even larger- over 41 percent from 2000 to 2010.
Most women are incarcerated for nonviolent offenses. Over one-fourth are in prison for a drug offense, while 29.6 percent were convicted of a property crime. Addiction plays a large part in a number of women's property crimes, and a lack of available or appropriate treatment only serves to drive their contact with the justice system.
Source: Justice Policy Institute
From Cell to Screen: The Story of Mumia Abu-Jamal -- Part I
Stephen Vittoria is that rare commodity in Hollywood today: a filmmaker with a conscience. To be more precise, a filmmaker with a strong political conscience. After making two feature films,>Black and White& Hollywood Boulevard (1996 , as well as three feature documentaries:Save Your Life -- The Life and Holistic Times of Dr. Richard Schulze (1998 ,;Keeper of the Flame (2005 and the award-winning art house hit One Bright Shining Moment: The Forgotten Summer of George McGovern (2005 , a portrait of the South Dakota senator who tried to unseat Richard Nixon from the White House in 1972.
For his latest exploration into America's socio-political landscape, Vittoria joins forces with radio producer Noelle Hanrahan to bring Long Distance Revolutionary, the story of Mumia Abu-Jamal, to the screen. Born Wesley Cook in Philadelphia, Abu-Jamal made his name as a tireless writer and journalist during the racially-charged 1970s that often portrayed the City of Brotherly Love as anything but. With his intense coverage of the MOVE organization, a black empowerment group whose ongoing battle with the police and city hall came to a fiery end in 1985, Abu-Jamal become a constant thorn in the side of the city's powerful establishment. Things came to a sudden head for Abu-Jamal himself on the evening of December 9, 1981 when he was accused of murdering a Philadelphia police officer. He received a death sentence the following year, and has been on Pennsylvania's death row until early this year, when his death sentence was commuted to a life sentence in December, 2011.
Abu-Jamal's case remains one of the most controversial and heatedly debated in American legal history, with participants on both sides either protesting his innocence in the murder of Officer Daniel Faulkner or his absolute guilt with equal passion and more often, great vehemence.
Source: Huffington Post
What’s In a Name? A Lot, When the Name is “Felon”
At a recent conference of journalists at John Jay College, I raised an issue I have about language in the media: the frequent use of the word “felon” to describe a person who has been convicted of a crime.
“Felon” is an ugly label that confirms the debased status that accompanies conviction. It identifies a person as belonging to a class outside many protections of the law, someone who can be freely discriminated against, someone who exists at the margins of society.
In short, a “felon” is a legal outlaw and social outcast.
Source: The Crime Report
Addiction: Medical Disease or Moral Defect?
Scientific theories that addiction hijacks the brain have just increased the stigma that they were meant to stop. At least in the moralistic bad old days, addicts were still viewed as having free will. Here's an alternative to both of these no-win approaches.
Source: The Fix
Scientists Explore Hallucinogen Treatments for PTSD, Sex Abuse Victims
Mind-altering compounds, such as LSD and psilocybin, stirred controversy in the 1960s. As the counter-culture’s psychedelic drugs of choice, the widespread use - and abuse - of hallucinogens prompted tougher anti-drug laws.
Deadlines looming at the office. Prepping the house for last-minute guests. Muscle pain from a weekend hiking excursion. Chances are you’ve been in one of these situations – probably more than once – and felt the stress and pain that goes with them. Wouldn’t a massage be great?
If you think a massage is just a mere luxury you can do without, you may want to reconsider. Results of a study conducted by researchers at Cedars-Sinai Medical Center in Los Angeles, Calif., found significant biological changes that occur in a person after a 45-minute massage. The study reviewed two types of massage, both a deep-tissue Swedish massage, and a light massage.
After studying the people who had the deep-tissue massage, the research showed decreased levels of the stress hormone, cortisol, and decreased levels of a hormone (arginine vasopressin that can cause an increase in cortisol. Also, there was an increase in the number of the white blood cells -- lymphocytes -- that are part of the immune system.
Related: 2012 Salon and Spa Trends
What about the people in the study who had the light massage? Compared to the folks who had the deep-tissue massage, the light massage subjects had more of an increase in oxytocin levels. Oxytocin is a hormone associated with contentment. They also had bigger decreases in the hormone that stimulates the adrenal glands to release cortisol (the stress hormone .
Feel the power
If you’ve ever had a massage, you know that it’s good for relieving stiffness and pain in certain areas of your body, and even helping you relax. It also helps reduce stress and boost immunity. What more could you ask for?
Michele Merhib Maruniak, a registered massage therapist and founder of the Elements Therapeutic Massage franchise, says that most of the clients seen at her studios initially come in for an immediate need, like pain relief for sore muscles. “Our clients keep returning on a regular basis because they begin to notice that they are sleeping better, feeling better and have higher energy levels.”
Attitude adjustment
Attitudes have shifted about massage therapy. Maruniak says that massage was once seen as a gift for a special occasion (think day-at-the-spa birthday treat . “There was a societal shift and people began to look at massage as more health-care related,” she says. “Now, people see massage as part of their overall wellness and a way to be proactive about their body and health.”
Related: Are 'Glass Half-Full' People Healthier?
More than a feeling
Massage is good to help relieve muscle pain, but it’s so much more, according to Maruniak. “Our muscles have memory,” says Maruniak. “When you have a massage on a regular basis, say two times a month, your muscles will relax more quickly and the therapeutic work will be easier to accomplish.”
When asked about the other benefits of massage, Maruniak notes that massage can provide so much for people. “Massage releases toxins from the muscles and helps people stay more alert and balanced. It’s is a natural mood elevator and stress reducer. There are studies that show people who have regular massages feel healthier overall. They sleep better, their blood pressure lowers, and some of my clients tell me their massages help relieve their migraines.”
Before you dismiss massage is an indulgence you can do without, consider its results: relief for stiff muscles, reduced stress, elevated mood and a boost for your immunity. Hand-down, massage is one activity to add to the “to do” list.
More from GalTime:
- Kick Off Your Stilettos for a High Heel Spa Treatment
- Recharge with a Wellness Vacation
- Experts Predict the "Worst Allergy Season" in 10 Years!
- Sexual Anorexia: What is It?
Read more: http://galtime.com/profile/48610/24214/patricia-conte#ixzz1p82xVl2A
Since October of last year, humedica has been running a health centre at the Melkadida refugee camp in the south of Ethiopia. What had started with makeshift, but nevertheless professional treatment and supply tents, is now taking shape in form of completely new and improved buildings.
Originally, the idea of building a humedica health centre arose from the simple wish to expand medical care at Melkadida also to the more remote areas and parts of the refugee camp.
In the beginning there was only one major health centre that offered medical treatment at one end of the camp. For those who were seriously ill or very weak, the trip through the entire camp was often too long, and hence they had no access to any kind of help.
Since the beginning of October 2010, the so-called “Health Post” of humedica has been under construction, in order to make support for ill and injured persons at the camp more easily accessible. Up to now, examination and treatment rooms, a pharmacy and waiting areas, registration and administration rooms had been accommodated in several tents.
Together with local staff, the humedica doctors and nurses offered their skills and knowledge to those in need of help under the simplest conditions. Nevertheless, the patients receive highly qualified treatment even now.
In order to expand the possibilities of the health post, construction works for a newly built health centre started a few weeks ago. At an impressive pace, the tents were replaced by stable and spacious buildings of corrugate iron, which is the preferred material for so-called “semi-permanent structure”. Therefore, the inauguration of the new health centre is expected to take place at the beginning of March.
Apart from treatment rooms, a pharmacy, and waiting and administration areas, the new building will also contain a small laboratory and a separate area for psycho-social treatment offered by our partner organisation Jesuit Refugee Service (JRS .
Furthermore, a mother-child ward will soon be set up, where birth preparation and follow-up examinations will be offered, and where women will have the opportunity of bearing their children in a hygienic, clean and medical environment.
While so far, ill and injured patients could only be treated as out-patients at the health post, the new building will also dispose of an in-patient ward, where patients can be treated and observed for short periods of a few days.
In order to improve the vaccination situation for the camp inhabitants, in particular for children, an additional vaccination centre will be set up. Epidemic diseases, such as measles or polio are a continuous threat to the health and even the lives of individuals in an environment like a refugee camp, where many people live together in close quarters.
The expansion and alteration of the humedica health centre will provide more space, better hygiene, more stable structures and a larger scope of medical treatment possibilities. However, it does not only mean medical care for the people at the Melkadida refugee camp. For many of them, the health post also is a ray of hope, which shows them that they are not alone in their misery.
Please continue to support our relief measures at the Horn of Africa by means of your donation also in future. Thank you very much.
humedica e. V.
Donation reference “Famine relief Africa”
Account 47 47
Bank code 734 500 00
Sparkasse Kaufbeuren
You can also achieve great results by means of sending a short text message: simply send a text message containing the reference DOC to +49 8 11 90. Your mobile bill will be charged with 5 euros, and 4.83 euros of this amount will be channelled directly into the humedica project work.
Men wanting to become fathers should “put down that English breakfast” the Daily Mail has today declared, as research has linked a diet high in saturated fat to a reduced sperm count.
The study used surveys to examine the diets of 99 men attending a US fertility clinic, comparing how their food intake related to the quality of their sperm samples.
Researchers found that men with a higher fat diet had both lower sperm counts and sperm concentrations. The third of men with the highest total fat intake had 43% lower total sperm count and 38% lower sperm concentration than men with the lowest third. Researchers said this association was driven mainly by saturated fat intake. Higher omega-3 intake was also linked to improved sperm quality.
While these results have received a lot of attention on the internet, the design of this small study means it cannot prove a cause and effect relationship between diet and sperm quality. This is because it did not follow the participants over time to see how their diet related to later sperm quality. To confirm or refute the results, larger studies that follow more men over time are required.
This study cannot, and does not, prove that a high-fat diet causes lower fertility. However, a balanced diet has many known health benefits and the study does reinforce the idea that a healthy diet is essential for good health and wellbeing.
Where did the story come from?
The study was carried out by researchers from the Harvard Medical School in Boston and was funded by grants from the National Institute of Environmental Health Sciences and National Institute of Diabetes and Digestive Kidney Diseases in the US.
It was published in the peer-reviewed medical journal Human Reproduction.
Media reports generally over-stated the implications of the results of this small cross-sectional study. However, both the Daily Mail and BBC did include quotes from experts in the field warning of the numerous limitations of this type of study, balancing out the initial attention-grabbing headlines.
What kind of research was this?
This study looked at the association between diet and semen quality using a cross-sectional analysis, meaning it looked at both factors at a single point in time. A cross-sectional study can never prove a cause and effect relationship, as without observing factors over time it is not possible to know which event came first.
In this study, for example, it was not possible to tell whether men with low sperm counts happened to have had a bad diet or whether eating a bad diet actively caused their sperm counts to reduce. A cohort study, which follows people over a set time, would shed more light on whether differences in diet are likely to be causal. It might also be technically possible to conduct a trial looking at men’s sperm quality before and after modifying their diet, although such trials can be harder to perform than studies with a cohort design.
The research authors suggest there is a lack of research on modifiable factors that influence male fertility. As a result, they aimed to investigate a suspected association between dietary fats and semen quality among men attending a fertility clinic.
What did the research involve?
A total of 173 men were recruited from couples attending the Massachusetts General Hospital Fertility Center in the US. The men were attending the centre in order to use their own semen to conceive using assisted reproductive technology.
Dietary information was assessed using a validated 131-item food frequency questionnaire that asked men how often, on average, during the previous year they had consumed specific amounts of each food, beverage or supplement listed in the questionnaire.
Semen was collected after a period of 48 hours of ejaculation abstinence. Sperm counts, concentration and percentage motility (the percentage of the sperm that were mobile were measured within 45 minutes of collection using standard laboratory techniques.
Reference standards from the World Health Organization were used to assess sperm concentration and motility. The way the sperm looked (morphology was also assessed.
Fatty acid levels in the sperm and seminal fluid were also analysed in a sub-set of 23 of the men based on the availability of stored semen.
There were 99 men with complete data on semen quality and dietary habits. They were divided into three groups according to the proportion of their total calories that were derived from fats. Low, intermediate and high fat intake groups were defined as consuming 26%, 32% and 37% of their total calories from fat respectively. Participants were also grouped depending on the major fat categories they consumed (saturated, monounsaturated, polyunsaturated, and omega-6 and Omega 3 . The analysis took account of differences in:
- total energy intake
- age
- abstinence time
- BMI
- smoking
- intake of alcohol and caffeine
What were the basic results?
Men in the study were largely Caucasian (89% and had an average age of 36.4 years. The majority were also overweight or obese (71% and reported never smoking (67% . Overall, 41% of the men had semen categorised as normal, 12% had a low sperm concentration, 53% had less than half their sperm able to move and 32% had abnormal sperm morphology. The main findings were as follows:
- The third of men with the highest total fat intake had 41% lower total sperm count (95% CI -14% to -62% and 38% lower sperm concentration (95% confidence interval [CI] -10% to -58% than the third of men with the lowest.
- Researchers reported that the association between total fat intake and sperm count and concentration appeared to be driven by saturated fat intake.
- Men in the highest third of saturated fat intake had 41% lower sperm concentration then men in the lowest (95% CI -14% to -60% . This was after statistical adjustment for total energy intake, age, abstinence time, BMI, smoking, intake of alcohol and caffeine.
- Higher intake of omega-3 polyunsaturated fats was related to more favourable sperm morphology. The third of men with the highest intake of omega-3 fatty acids had 1.9% (95% CI 0.4% to 3.5% higher rates of normal sperm morphology than men in the lowest third.
- In the subsample of 23 men, higher levels of saturated fatty acids in sperm, and to a lesser extent in seminal fluid, were associated with lower sperm concentration and motility. Conversely, higher levels of omega-3 were related to higher sperm concentration and motility.
- There were no results reported on whether the men tested were able to conceive a child with their partners.
How did the researchers interpret the results?
The researchers conclude that: ‘In this preliminary cross-sectional study, high intake of saturated fats was negatively related to sperm concentration whereas higher intake of omega-3 fats was positively related to sperm morphology’.
They that say further studies with larger samples are required to confirm these findings.
Conclusion
This small, cross-sectional study has attempted to find any associations between higher fat intake and lower sperm count and concentration. It also examined whether higher intake of omega-3 polyunsaturated fats was associated with a higher proportion of sperm showing ‘normal’ appearance and physical characteristics.
However, given that the study assessed diet and sperm quality at the same point in time, it cannot prove there is a cause and effect relationship between the two. It is not possible to know, for example, whether a bad diet causes low sperm counts or whether men with low sperm counts tend to have both a bad diet and lower sperm count due to some unknown factor linking the two. The small number of participants involved also increases the risk that the results have been influenced by chance.
The study has other limitations that should be considered when interpreting and assessing the implications of its findings. These include:
- Dietary intake is notoriously hard to measure accurately in studies of this kind. The method used in this study is adequate but still asked participants to recall food and drink consumed in the past year. This long recall timespan is likely to be subject to inaccuracy.
- Most men in this study were overweight, but lower sperm concentration was only found in those who had higher fat intakes. This is interesting as previous studies may have grouped men according to their weight and missed such an association, as they did not measure dietary fat intake.
- There were no results reported on whether the men tested were able to conceive a child with their partners. It is possible that even men with the lowest quality sperm may have been able to conceive naturally or with the assistance of reproductive technology.
- All the men in the research were attending a fertility clinic in order to use assisted reproductive treatment, although the specific reasons for this are unclear. This means we cannot tell how typical their sperm was compared to that of the general population or how well the results apply to other men not seeking this type of help.
- The researchers made multiple comparisons, increasing the risk they would discover a link by chance alone.
This study cannot, and does not, prove that a high-fat diet causes lower fertility. Larger, prospective cohort studies that follow more diverse groups of men, which assess their diet and sperm quality over time, are needed to confirm or refute these findings. However, this study does reinforce the general perception that a healthy diet may is essential for good health and wellbeing. There are many existing reasons to limit dietary saturated fat if you are a man or a woman as it is known to be linked to many diseases including cardiovascular disease.
Analysis by Bazian
Links To The Headlines
Want to become a father? Put down that English breakfast: Study shows diets high in saturated fat damage sperm. Daily Mail, March 14 2012
Diet 'linked' to low sperm counts. BBC News, March 14 2012
Links To Science
Attaman JA, Toth TL, Furtado J et al. Dietary fat and semen quality among men attending a fertility clinic. Human Reproduction, First published online March 13 2012
Chattanooga Police Department
CONTACT: Officer Nathan Hartwig
Public Information Officer
Community Safety Fair
Wednesday, March 07, 2012
The Chattanooga Police Department and Virginia College have teamed together to sponsor a Community Safety Fair which is to be held on March 24, 2012 from 11:00 a.m. until 4:00 p.m. at the Virginia College’s Eastgate Campus. The purpose of the Safety Fair is to provide health and safety information to the public and to create positive interaction with members from all aspects of our community. The Fair is free of charge and is open to the public, including both adults and children.
There will be several classroom seminars such as Crime Prevention, Identity Theft, Gangs, Code Enforcement, Health Wellness, Fire Prevention, Chattanooga Zoo, and Animal Bite Prevention. There will also be numerous displays set up in the parking lot which will include the Chattanooga Police Bomb Squad, S.W.A.T., Beat the Heat Race Car, Big Brothers Big Sisters, Virginia College Blood Pressure Booth, Citizen’s Police Academy Alumni Association, Face Painting (provided by Virginia College Cosmetology students , Parks and Recreation, Safe Internet Surfing (provided by the F.B.I. , READMOBILE, The Chattanooga Aquarium and Zoo, and Child Car Seat Safety Checks. A lunch will be provided consisting of a hotdog,soda, and snacks. There will also be a free raffle for numerous prizes.
Tents will be set up outside, so whether rain or shine, the event will go on. Save the date of Saturday, March 24th, and come enjoy a day of Safety Awareness and community interaction!
We would also like to thank our sponsors: Coca Cola, Home Depot, Target, Walmart, Firehouse Subs, Chattanooga Bakery, and others.
For more information, you can contact any of the following:
Captain Jeannie Snyder
Chattanooga Police Department
Office: 423-643-5334 / Cell: 423-421-4754
Richard A Johnson
Virginia College School of Business and Health
Chattanooga, TN 37411
Office: 423-893-2043 / Cell: 423-544-6033
Officer Wayne Jefferson
Chattanooga Police Department
Office: 423-643-5090 / Cell: 423-421-3722
Officer Nathan Hartwig
Chattanooga Police Department
Office: 423-643-5571 / Cell: 423-208-6212
Five California boys found with genetically matching E. coli O157:H7 infections in the fall of 2011 have been conclusively linked to raw milk produced by Organic Pastures, a Fresno dairy, according to a report published Monday by the California Department of Public Health.
Following an investigation by the state health department and the California Department of Food and Agriculture, public health investigators concluded that Organic Pastures raw milk was the only common exposure between the five boys, who each drank it within the week prior to falling ill.
Raw milk is milk that has not been pasteurized to eliminate harmful pathogens from cow excrement, such as E. coli O157:H7 and Campylobacter, which may contaminate fresh milk.
Environmental samples from the dairy detected E. coli that was genetically identical to the five children's infections. According to the report, the particular E. coli type in the outbreak is uncommon in California and had not been seen in the state since January 2010.
Three of the boys were hospitalized with hemolytic uremic syndrome (HUS , a potentially deadly disease characterized by the destruction of red blood cells and acute kidney failure. The five victims were residents of four separate counties: Contra Costa (2 brothers , Kings (1 , Sacramento (1 and San Diego (1 . They ranged in age from one to five years old, with a median age of four.
The investigators compared the boys' infections with 47 other cases of E. coli O157:H7 infection in young children with illness onsets in the same timeframe. They found that raw milk was much more closely associated with the five boys whose infections matched the Organic Pastures samples. In fact, none of the other 47 children with E. coli infections had consumed raw milk within a week of becoming ill.
Given that only approximately three percent of Californians drink raw milk, the report explains, the probability of all five victims consuming raw milk is less than one in 10 million.
The report cites a 2006 E. coli O157:H7 outbreak linked to Organic Pastures raw milk or raw colostrum that sickened six children. The dairy has previously initiated recalls of its raw milk products after detecting Campylobacter and Listeria monocytogenes in samples.
The report also noted that there might have been additional E. coli infections from the same lot of Organic Pastures raw milk that went undiagnosed and unreported. By the time the health department initiated its investigation, there were no remaining samples of milk from that lot available to test, as it had all expired or been consumed.
"Nonetheless, data from the epidemiologic, laboratory and environmental investigations strongly implicate Organic Pastures raw milk as the source of the illnesses," the report stated.
In November 2011, California State Veterinarian Dr. Annette Whiteford announced a statewide recall of all Organic Pastures raw milk products, with the exception of cheese aged to at least 60 days. The dairy was then placed on a quarantine order and not allowed to produce raw milk for retail for 30 days.
Health department officials inspected the dairy and found a number of sanitation problems, including poor equipment maintenance for preventing contamination, rodent droppings and flies in milk storage rooms, and colostrum buckets overturned onto cardboard lying on the floor.
Following the November 2011 outbreak, the state department of health forced Organic Pastures to discontinue production of its raw colostrum permanently, even though that product was not being suspected of causing the outbreak.
The health department's report concluded by offering support to public education efforts regarding the risks of raw milk consumption. Children, pregnant women, the elderly and those with weakened immune systems are most susceptible to the bacteria that may contaminate iraw milk.
A full environmental investigation report on Organic Pastures' facility is still forthcoming.
Asthma inhalers may be linked to birth defects, the Daily Mail has today reported. The newspaper said that new research has linked steroid asthma pumps "to a slightly increased risk of hormonal and metabolic disorders in babies"
The research was from a Danish study that looked at whether the risk of developing a variety of early childhood diseases was linked to their pregnant mother’s use of glucocorticoid steroid inhalers - a standard preventative treatment for asthma.
The national study looked at over 65,000 Danish women who gave birth between 1996 and 2002, 6.3% of whom had asthma, and followed the children to an average of six years. The researchers looked at a wide range of disease types but found the use of inhalers was only linked to an increased risk of developing an endocrine (hormonal or metabolic disorder during early childhood.
Further research into the long-term effects of inhaled corticosteroids is warranted, and additional research to confirm the finding of this research is needed. In the meantime, recommendations on the use of steroid inhalers are unlikely to change. Pregnant women prescribed inhaled steroids should continue to take these medications as advised as the benefits of using this medication are likely to outweigh the risks, especially in women who have severe asthma.
Where did the story come from?
The study was carried out by researchers from the University of Basel, Ruhr-University Bochum and other medical and research institutions throughout Europe and the US. The research was funded by the Danish National Research Foundation, the Swiss National Science Foundation, the German National Academic Foundation and Research Foundation of the University of Basel.
The study was published in the peer-reviewed American Journal of Respiratory and Critical Care Medicine.
This study was not widely reported in the media; however, the Daily Mail did focus on it in a story about prescription drugs and risk of birth defects. The story mentioned a range of different types of prescription drugs that could be linked to birth defects, although it mainly discussed a possible link between asthma inhalers and birth defects. While the story did mention that the research found only a slightly increased risk in one category of diseases, it did not report that this study found no significant increased risk for most diseases.
Throughout its article the Mail referred to a ‘major inquiry’ and an ‘investigation’ into the use of a variety of medications during pregnancy. The research in question is the EUROmediCAT study, a large ongoing project to look at the use of medication during pregnancy. The way the project was described might lead readers to assume it is some sort of emergency investigation or was set up as the result of a specific health scare. However, it is an ongoing scientific study and does not suggest any kind of health scare or emergency at present.
This Behind the Headlines article focuses on the study looking at inhalers and potential birth defects, rather than the EUROmediCAT study.
What kind of research was this?
This was a national cohort study that aimed to assess the association of women using glucocorticoid inhalers for asthma during pregnancy and their child’s risk of developing several types of disease during the first several years of life.
Previous research into the safety of inhaled glucocorticoids has suggested that they are safe to use during pregnancy, and are not associated with increased risk of birth defects. This research has provided the basis for many policies recommending the continued use of inhalers for the treatment of asthma during pregnancy. The researchers say, however, that these studies only examined the short-term risks, and that research should assess the children for longer to determine if there are any longer-term associations with a wider variety of diseases.
A prospective cohort study is an appropriate design for assessing associations such as long-term outcomes of medicine use, as it collects information on a range of factors before any outcomes develop, and then goes on to see how they might account for any relationship that develops.
What did the research involve?
This study analysed data from the Danish National Birth Cohort, which included births between 1996 and 2003. Women were invited to participate during their first antenatal visit, at around 6 to 12 weeks of pregnancy. Approximately 60% of the invited women decided to participate. Interviews during and after pregnancy were conducted, and researchers assessed the development of disease during early childhood by examining medical registries.
For this substudy looking specifically at the use of certain asthma medications, the researchers extracted data from the Danish National Birth Cohort on women with asthma who gave birth to a single baby (women carry twins or other multiples were not included in the analysis .
Women were considered as having asthma if the condition occurred at any time during the current pregnancy. Researchers recorded information on the type of asthma treatment at several times during the study - at weeks 12 and 30 of pregnancy and at six months after birth.
Researchers also collected information on the child relating to diagnoses in a number of disease types based on the International Classification of Diseases, version 10. They used a statistical technique called regression analysis to assess the association between use of inhaled corticosteroids and the development of these disease types during early childhood:
- infections and parasitic diseases
- neoplasms (cancers
- diseases of the blood or immune system
- endocrine or metabolic disorders
- mental disorders
- diseases of the nervous system
- diseases of the eye
- diseases of the ear
- diseases of the circulatory system
- diseases of the respiratory system
- diseases of the digestive system
- diseases of the skin
- diseases of the musculoskeletal system
- diseases of the genitourinary system
- any disease
During these analyses the researchers included several measures that have been shown to impact on early childhood health, including socioeconomic status, mother’s occupation, the number of previous pregnancies, child sex, and the use of any non-steroid inhalers during the pregnancy. This allowed them to assess the influence any of these factors might have on the relationship between maternal inhaler use and the risk of early childhood diseases.
What were the basic results?
There were 65,085 mother-child pairs enrolled in the original Danish National Birth Cohort. Of these, 4,083 (6.3% had asthma during pregnancy and were included in the current analysis. Of women with asthma, 1,231 (30% used steroid-inhalers during pregnancy, the most common of which was budesonide. The median (average child age at the end of the study was 6.1 years (range 3.6 to 8.9 years .
In all, 2,443 children developed a disease during early childhood. When the researchers compared the risk of developing diseases between the children of women who used inhaled corticosteroids compared to the children of women who did not, they found there was no significant difference in risk for the following categories:
- infections and parasitic diseases
- neoplasms
- diseases of the blood or immune system
- mental disorders
- diseases of the nervous system
- diseases of the eye
- diseases of the ear
- diseases of the circulatory system
- diseases of the respiratory system
- diseases of the digestive system
- diseases of the skin
- diseases of the musculoskeletal system
- diseases of the genitourinary system
- any disease
A total of 93 children (2.28% of the asthma cohort developed an endocrine or metabolic disorder during early childhood. The endocrine system is made up of various glands that release hormones into the blood. The metabolism is the system the body uses to turn food into energy.
The researchers calculated that children of women who used inhaled glucocorticoids during pregnancy had 62% increased risk of developing an endocrine or metabolic disorder, compared to children of women who did not use the inhalers (hazard ratio 1.62, 95% confidence interval 1.03 to 2.54, p=0.036 .
How did the researchers interpret the results?
The researchers concluded that use of glucocorticoids during pregnancy was not associated with an increased risk of the child developing most diseases during early childhood compared to the children of mothers with asthma who did not use the treatment. The only disease category in which use of inhalers was associated with an increased risk was endocrine and metabolic disorders.
Conclusion
This large cohort study suggests that the use of inhaled glucocorticoids for the treatment of asthma during pregnancy does not increase the risk of developing most types of disease during early childhood. As the researchers say, this data is ‘mostly reassuring’ and supports the use of these inhalers during pregnancy.
The study did find an increased risk of developing endocrine or metabolic disorders in children of mothers with asthma who used steroid inhalers during pregnancy. However, it is important to remember that the increased risk is relative to children of women with asthma who did not use inhaled steroids, and that only 93 children developed an endocrine or metabolic disorder of the 4,083 whose mothers who had asthma during pregnancy.
The study does not give absolute numbers of children with these conditions whose mothers did and did not use steroid inhalers, but the absolute risk for both groups is likely to be quite low.
The researchers say that their results regarding this increased relative risk for endocrine and metabolic diseases should be investigated further. They point to several limitations of their study, including the fact that they relied upon a clinical diagnosis of a disorder and did not consider other potentially more sensitive measures. In addition, the researchers did not have information on diagnoses made by the childrens’ GPs, and therefore may have missed out on a diagnosis of less severe disease.
They also say that some disease categories had very small number of diagnoses (such as cancers and blood and immune system diseases , which may have resulted in an imprecise estimation of the hazard ratios.
An editorial accompanying this study suggested that the results be interpreted with caution, given some of the study limitations, such as the fact that the analysis did not control for asthma severity or patients’ use of other treatments alongside their inhalers. They say that it is unclear whether the findings are the result of women using inhaled steroids for the management of more severe asthma.
Pregnant women who have been prescribed inhaled steroids for asthma should continue to take these medications as advised, as well-controlled asthma is important for the health of both the mother and the baby.
Women who have any concerns about the medical management of their asthma during their pregnancy should speak with their doctor.
Analysis by Bazian
Links To The Headlines
Are asthma inhalers linked to birth defects? Thousands of pregnant women at centre of inquiry into health problems in babies. Daily Mail, March 12 2012
Links To Science
Tegethoff M, Greene N, Olsen J et al. Inhaled Glucocorticoids during Pregnancy and Offspring Pediatric Diseases A National Cohort Study. American Journal of Respiratory and Critical Care Medicine. March 1 2012, vol. 185 no. 5 557-563
Related editorial
George J, Abramson MJ, and Walker SP. Asthma in Pregnancy: Are Inhaled Corticosteroids Safe?. American Journal of Respiratory and Critical Care Medicine. 2012; 185: 476-478.
One in four children have back problems because of heavy school bags, according to The Daily Telegraph.
The story is based on a Spanish study of over 1,400 schoolchildren. It found that over half the children had backpacks exceeding 10% of their body weight. The study also found that those carrying the heaviest backpacks had a 50% higher risk of back pain than those carrying the lightest, and a 42% higher risk of diagnosed back problems, although this last result was not statistically reliable.
While the weight of schoolbags can be a concern to parents, this particular research has several limitations that make its results questionable. In particular, it did not properly take account of other factors which might contribute to back problems in children, including a sedentary lifestyle and poor muscle tone.
Surveys done in the UK have found that nearly half of all teenagers have had occasional backache from poor posture, carrying overloaded bags and leading a sedentary, unhealthy lifestyle. Children should wear a well-designed backpack and be encouraged to exercise regularly, which will improve their muscle tone.
Where did the story come from?
The study was carried out by researchers from the University of Santiago de Compostela, Spain. The researchers did not indicate whether or not they received external funding.
The study was published in the peer-reviewed medical journal Archives of Disease in Childhood.
The Daily Telegraph’s opening paragraph suggesting bag weight was the source of back pain for one in four children was misleading. The study found that those who carried the heaviest rucksacks had a higher risk of back pain than those who carried the lightest. It did not show that their back pain caused by heavy rucksacks. This back pain could be due to many other factors, involved including a sedentary lifestyle.
As the study authors point out, a sedentary lifestyle and poor muscle tone is possibly the most important factor associated with back pain in children.
What kind of research was this?
This was a cross-sectional study looking at whether backpack weight is associated with back pain and longer-term back disorders in schoolchildren. A cross-sectional analysis looks at factors at a single point in time, and can only provide a ‘snapshot’ of health and lifestyle factors. As it does not follow people up over time, it cannot show that lifestyle factors lead to particular health outcomes.
The authors point out that back pain among schoolchildren is thought to be associated with a sedentary lifestyle and poor muscle tone. However, school backpacks have also been associated with back pain and it is thought they can create back disorders in adult life. Experts advise that schoolchildren should not carry loads exceeding 10% of their bodyweight.
What did the research involve?
The researchers initially recruited 2,135 pupils aged between 12 and 17, drawn from 11 schools in a province in north Western Spain. Of this number, their final analysis included 1,403 (65.7% . It is not clear why so many participants were excluded.
The children were weighed twice: once with the rucksack or backpack they normally carried but without coats and other items likely to add weight, and a second time without their rucksack. Their height was also measured and information was obtained from a questionnaire given to the children’s teachers and parents about their lifestyle, in particular, frequency of sports activities at school, and how long they were sedentary at home.
The researchers also collected data on the presence of any back disorders previously diagnosed by a doctor (such as scoliosis – curvature of the spine and whether the children had experienced back pain for more than 15 days in the previous year. It appears that the medical information came from parents or from the children, rather than their doctors.
Schoolbag weights were divided into four ranges by weight (quartiles and the data analysed to investigate any association between the different quartiles and the reported presence of back pain for more than 15 days. A separate analysis was carried out on the association between schoolbag weight and the presence of a diagnosed back condition.
The researchers also compared the characteristics of the children who were excluded from the study and those included in the final analysis, to ensure they minimised any risk of bias. They adjusted their results for gender, age, body mass index (BMI and sports activities. The question about sports did not look at how much sports children undertook but only whether they performed some type, recorded simply as yes or no.
What were the basic results?
The average age of participants was 14 years. Of the included children, 92.2% used a backpack with two shoulder straps and the average weight of their school bag was 7kg.
Further analysis revealed that:
- 61.4% of children had backpacks exceeding 10% of their bodyweight
- 18.1% carried backpacks exceeding 15% of their bodyweight
- 25.9% reported to have had back pain for more than 15 days in the previous year
- the most frequent diagnosed back disorder was scoliosis (70% of conditions reported
- children carrying school bags in the heaviest quartile had a 50% higher risk of back pain for more than 15 days than those whose bags were in the lowest quartile (odds ratio [OR] 1.50, confidence interval [CI] 95% 1.06 to2.12
- there was a non-significant association between carrying bags in the heaviest quartile and a higher risk of long term back conditions (OR 1.42, CI 95% 0.86 to 2.32
- girls had a higher risk of back pain than boys
How did the researchers interpret the results?
The researchers say carrying heavy backpacks increases the risk of back pain and possibly of back disorders. They point out that the excessive backpacks carried by many children would not be allowed for adults in employment. Parents and schoolchildren should be strongly advised about the risks posed by heavy schoolbags, they add.
Conclusion
This study has several limitations:
- it had a cross-sectional design (that is, it looked at factors at a single point rather than over time meaning it cannot tell us whether carrying heavy rucksacks resulted in the development of back pain
- it relied on parents or children remembering how often they had experienced back pain over the previous year, and whether they had been diagnosed with a spinal disorder, which introduces the possibility of a reporting error
- it did not take account of other factors which might cause back pain or spinal disorders, including poor physical fitness, poor posture and structural back problems
- although researchers asked how often children were engaged in sedentary activities, they do not seem to have taken account of this as a possible factor associated with back pain
- they did not look at whether children wore their backpack on one shoulder only, which could have contributed to risk of back pain
Also, the absolute differences in risk of back pain between children carrying the heaviest bags and those carrying the lightest was quite small: nearly 30% of those carrying the heaviest bags had back pain compared to 22.8% of those with the lightest bags. Also, the risk of a back disorder associated with the heaviest rucksack was not statistically significant.
That said, the study raises the important issue of back pain among children. Nearly half of all teenagers in the UK have had occasional backache associated with poor posture, carrying overloaded bags and leading an unhealthy lifestyle. Backpacks worn by children should be well-designed, appropriately adjusted and worn over both shoulders to balance out the weight. Heavy satchels and shoulder bags are best avoided.
Building strong back muscles is important too and children should be encouraged to exercise regularly, in line with current activity guidelines for children.
Links To The Headlines
School bags 'causing back pain'. BBC News, March 15 2012
Back pain warning over heavy schoolbags. The Daily Telegraph, March 15 2012
Caution, heavy load: Children are damaging their backs with excessively full school rucksacks. Daily Mirror, March 15 2012
Links To Science
Rodriguez-Oviedo P, Ruano-Ravina A, Perez-Rios M et al. School children's backpacks, back pain and back pathologies. Archives of Disease in Childhood, Published Online First March 10 2012
There was one thing missing from today's inquest into the death of Carole Cross following the 1988 Cornish water scandal
This is something we all check before going abroad – is the water safe to drink? We tut our way through tropical holidays where the inconvenience of buying bottled water makes us oh-so-grateful for the purity of green England's blue juice. Cornwall especially boasts some of the purest, most delicious tap water – better than the bottled stuff you can buy at M&S, even. I can personally vouch for it.
Turn back the clocks more than two decades to 6 July 1988. On that night South West Water Authority, the supplier to the small Cornish town of Camelford, received hundreds of complaints about the purity of the water coming out of residents' taps. It was dirty, smelly and unusable. Twenty tonnes of aluminium sulphate, a chemical used to treat cloudy water, had been accidentally dumped into the wrong tank by a relief delivery driver at Lowermoor water treatment works. Yet it would be almost three weeks until customers were finally advised to stop drinking it. By then, the water had already been causing stomach cramps, ulcers and diarrhoea among the local population.
Not only had the water company reacted late, residents were also completely misinformed. They were told to boil the water before drinking, which can in fact raise the concentration of aluminium in water threefold. Several dozen people later claimed there had been serious and permanent repercussions for their health.
Sixteen years later, a woman named Carole Cross would died from a rare form of neurological disease cerebral amyloid angiopathy. A coroner's report following her death in 2004 said "there was the very real possibility that her death was caused by aluminium". Today, at the conclusion of a two-year inquest into Cross's death, coroner Michael Rose concluded that:
from 9 July for a few days, Mrs Cross ingested a quantity of aluminium, precise measurements of which are not possible, because of the failure of the authority to ensure the public were encouraged to give urine and blood samples. I also regard the failure of the authority to visit every house after the incident to advise them to thoroughly flush their systems as a serious dereliction of duty. At the end of the day, I can say that the incident may either have contributed to or possibly caused Mrs Cross's death, but I do not have sufficient evidence to say so conclusively.
The water company faced trial in 1991, when it was fined ?35,000 including costs for supplying water "likely to endanger public health". An out-of-court settlement with 148 victims was made three years later with payouts reaching into the thousands. To date, about 700 Camelford residents have been awarded compensation, and the Camelford case causes unease and suspicion in the local community, where campaigners were looked upon as "hypochondriac claim-chasers" by doubtful members of the local community.
One victim, Nigel Jones, said in an interview with This is Cornwall: "I'm still angry about what happened to us and I am sure that people share those feelings. It has never been about money. No one is chasing claims … I just wanted to see genuine remorse and an apology, that massive word 'sorry' that no one can say. It would go an awful long way if that was said by the right people, in a heartfelt way."
A South West Water representative at the inquest said that "water treatment at Lowermoor and indeed every other works in the UK has been transformed since the privatisation of the water industry in 1989". Not quite the "sorry" Jones was looking for, then.
Could it happen today, in an age where the slightest glitch in public service or supply leads to trending tweets and disgruntled blogs? A world where every complaint has legs on a public platform? Well, apologies are dished out swiftly, publicy and with a fluttering bow; but do the promises stick?
Last summer, there were more than 40 recorded sewage spills from overflowing pipes (belonging to various water companies onto coastal beaches in Devon and Cornwall. Miles of stunning jagged rocks, sun-kissed sand, and stinking, polluted sea water. Not exactly a poster for the health of the water in the south-west.
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