Wednesday, January 30, 2013

Blueberry Almond Scones (The Chronicles of Home)

Today, our food contributor Jennifer is sharing a healthy recipe for blueberry almond scones.  I really want to try these because my son loves blueberries!

I can't even tell you how much I look forward to Jennifer's recipe posts.  You may know Jennifer from her decor and DIY blog, The Chronicles of Home.  If you haven't visited or aren't a follower, I'm sure she'd love to have you!



Blueberry Almond Scones

For the most part, I'm a creature of habit when it comes to breakfast.  Weekday mornings my daughters and I usually eat one of three things - (1) smoothies and whole grain toast with peanut butter, (2) egg on whole grain toast with fresh fruit, or (3) whole grain hot cereal with dried fruit.  And, honestly, I'm okay with this routine.  All of those things work for me on harried weekday mornings and I feel good about eating them and feeding them to my daughters as often as I do.  

Then the weekends roll around and the last thing I want are any of these things since I've just spent five days in a row eating them!  That's where the more "special" breakfast dishes come in, like multigrain pancakes or sweet potato hash.  Scones are another of my weekend favorites and I've been tinkering with my recipe lately to try to make it a little healthier.

In this version I used a double shot of blueberries - both fresh and dried - to get a variation in flavor and texture and to double down on all the antioxidant goodness.  I added sliced almonds for some crunch and protein.  I often use half whole wheat and half white flour in baking recipes to get some whole grain worked in without totally sacrificing the light texture of white flour.

I also played with coconut oil here in place of the typical butter in scones.  Here's my take on coconut oil, and keep in mind that I'm not a nutritionist, just a health-minded home cook who's done a little research.  Coconut oil is a heavily saturated fat just like butter.  There's some research that suggests the kind of saturated fat in coconut oil may be better for those with cholesterol issues than butter.  But for me, there are a lot of "may be's" in the research that's out there and in the end I think it's best to use some moderation in your consumption of coconut oil just like you would with butter.

I liked the use of coconut oil in this recipe because it added a very light, subtle undertone of coconut flavor to the scones and still gave them the flakiness of a regular scone made with butter.  These scones will be heartier and a bit more dense than one you might get at your local Starbucks, but I've found I actually like the healthy-indulgent version better!


Ingredients
3/4 c. white flour
1/2 c. whole wheat flour
3 tbsp. sugar
1 1/2 tsp. baking powder
1/4 tsp. salt
6 tbsp. refined coconut oil (butter can be substituted)
1/2 c. fresh blueberries
1/4 c. dried wild blueberries
1/4 c. sliced almonds
1/3 c. buttermilk
1 egg
2 tsp. vanilla

Preheat oven to 400ยบ.  Line baking sheet with parchment paper.

Whisk flours, sugar, baking powder, and salt in a medium bowl.  Cut coconut oil in with a pastry cutter until it's the consistency of coarse sand.

Gently stir in fresh blueberries, dried blueberries, and almonds.

In a small bowl whisk the buttermilk, egg, and vanilla to blend.  Pour over dry ingredients and fold with a rubber spatula until just combined.

Drop batter in 8 mounds onto prepared baking sheet (about 1/2 c. of batter each).

Bake until golden, about 15 minutes.  Remove from oven and let cool slightly before serving.


Thank you Jennifer!

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Tuesday, January 29, 2013

Let's not jeopardize higher education at the cost of Medicaid



As a Dean, I am committed to higher education, both in the public and private sectors. As a parent, I have spent a small fortune on tuition to educate my three children at “elite” private universities. I understand the cost structure of higher education, both as a provider and a consumer. Perhaps this is why I find myself very concerned about the little-known connection between paying for health care for the poor (Medicaid), and the cost of higher education.

According to The Wall Street Journal (Dec 14, 2012), state subsidies for higher education fell 21% between the school years of 2001 and 2011. In that same period, tuition at four-year public universities has risen nearly 45% and now averages nearly $9,000 per year.

The WSJ story goes on to site several prominent educational policy experts who admit that states have to focus on Medicaid first, prisons second, and that universities are further down the list. Now, connect these dots with Sara Rosenbaum’s recent piece in the New England Journal of Medicine (Threading the Needle – Medicaid and the 113th Congress; December 20, 2012), where she says essentially that Medicaid spending, under Health Reform, will continue to expand.

Rosenbaum hopes that the proposed “organizational changes” under the ACA, like Patient-Centered Medical Homes, Accountable Care Organizations, and other topics previously covered in my blog, could possibly stem the tide of red ink for health entitlements before Medicaid undergoes a severe budgetary reduction by lawmakers.

Here is my view: – we are in a total jam and most persons don’t recognize it. We have a very difficult choice ahead. Continue to pay for the care of the poor – especially poor children – or, raise public university tuition to the point that the middle class will be priced out of a college education.
 
I surely don’t want to pit higher education against health care! I just want to make sure that we all understand that current spending for health care is unsustainable. Higher education will become another casualty if we are not careful. What should health care deans do?

Monday, January 28, 2013

Mixology || Curling Pudding (or Twist-out Definer)

Do you want to make your own curling pudding or twist cream?  Or do you want a product that holds without the dryness or flakiness?  Here is a recipe worth trying:

Ingredients (large batch):
1 tbsp castor oil
1/4 cup shea butter
1 1/4 cup your favorite gel

Instructions:
Whip the shea butter with the castor oil using a hand mixer (ideal) or a fork. Then mix in the gel thoroughly.  Use to define curls or apply before twisting for a defined twist-out.

"Soul" Food Mondays || We Make Our Days

We make our days pleasant or miserable. If we insist on being miserable, irritable and nasty, more than likely the day will give us exactly what we give it. A day is too valuable to waste on misery and unhappiness. ~IYANLA VANZANT

Your perception becomes your reality.  A miserable outlook may translate into a miserable truth.  We make our days.

How much alcohol is optimal? Maybe less than you think

I have been regularly recommending to users of the software HCE () to include a column in their health data reflecting their alcohol consumption. Why? Because I suspect that alcohol consumption is behind many of what we call the “diseases of affluence”.

A while ago I recall watching an interview with a centenarian, a very lucid woman. When asked about her “secret” to live a long life, she said that she added a little bit of whiskey to her coffee every morning. It was something like a tablespoon of whiskey, or about 15 g, which amounted to approximately 6 g of ethanol every single day.

Well, she might have been drinking very close to the optimal amount of alcohol per day for the average person, if the study reviewed in this post is correct.

Studies of the effect of alcohol consumption on health generally show results in terms of averages within fixed ranges of consumption. For example, they will show average mortality risks for people consuming 1, 2, 3 etc. drinks per day. These studies suggest that there is a J-curve relationship between alcohol consumption and health (). That is, drinking a little is better than not drinking; and drinking a lot is worse than drinking a little.

However, using “rough” ranges of 1, 2, 3 etc. drinks per day prevents those studies from getting to a more fine-grained picture of the beneficial effects of alcohol consumption.

Contrary to popular belief, the positive health effects of moderate alcohol consumption have little, if anything, to do with polyphenols such as resveratrol. Resveratrol, once believed to be the fountain of youth, is found in the skin of red grapes.

It is in fact the alcohol content that has positive effects, apparently reducing the incidence of coronary heart disease, diabetes, hypertension, congestive heart failure, stroke, dementia, Raynaud’s phenomenon, and all-cause mortality. Raynaud's phenomenon is associated with poor circulation in the extremities (e.g., toes, fingers), which in some cases can progress to gangrene.

In most studies of the effects of alcohol consumption on health, the J-curves emerge from visual inspection of the plots of averages across ranges of consumption. Rarely you find studies where nonlinear relationships are “discovered” by software tools such as WarpPLS (), with effects being adjusted according.

You do find, however, some studies that fit reasonably justified functions to the data. Di Castelnuovo and colleagues’ study, published in JAMA Internal Medicine in 2006 (), is probably the most widely cited among these studies. This study is a meta-analysis; i.e., a study that builds on various other empirical studies.

I think that the journal in which this study appeared was formerly known as Archives of Internal Medicine, a fairly selective and prestigious journal, even though this did not seem to be reflected in its Wikipedia article at the time of this writing ().

What Di Castelnuovo and colleagues found is interesting. They fitted a bunch of nonlinear functions to the data, all with J-curve shapes. The results suggest a lot of variation in the maximum amount one can drink before mortality becomes higher than not drinking at all; that maximum amount ranges from about 4 to 6 drinks per day.

But there is little variation in one respect. The optimal amount of alcohol is somewhere around 5 and 7 g/d, which translates into about the following every day: half a can of beer, half a glass of wine, or half a “shot” of spirit. This is clearly a common trait of all of the nonlinear functions that they generated. This is illustrated in the figure below, from the article.



As you can seen from the curves above, a little bit of alcohol every day seems to have an acute effect on mortality reduction. And it seems that taking little doses every day is much better than taking the equivalent dose over a larger period of time; for instance, the equivalent per week, taken once a week. This is suggested by other studies as well ().

The curves above do not clearly reflect a couple of problems with alcohol consumption. One is that alcohol seems to be treated by the body as a toxin, which causes some harm and some good at the same time, the good being often ascribed to hormesis (). Someone who is more sensitive to alcohol’s harmful effects, on the liver for example, may not benefit as much from its positive effects.

The curves are averages that pass through points, after which the points are forgotten; even though they are real people.

The other problem with alcohol is that most people who are introduced to it in highly urbanized areas (where most people live) tend to drink it because of its mood-altering effects. This leads to a major danger of addiction and abuse. And drinking a lot of alcohol is much worse than not drinking at all.

Interestingly, in traditional Mediterranean Cultures where wine is consumed regularly, people tend to generally frown upon drunkenness ().

Sunday, January 27, 2013

Blue Monday Be Gone

I'm happy to report that I completed week 10 of the Live Fit Challenge last week, which means I only have two weeks to go to finish it.  Some people have asked what I plan to do after that, and honestly, I'm not sure.   Lately, our weather has been beautiful, which makes me want to run outside more.

via
In these next two weeks, I'm going to watch my diet extra close during the week so I can finish strong! How are your workouts going?  I learned that Monday, January 21 was "Blue Monday" the day when, among other reasons, people are depressed at failing in their new years resolutions.  I say, forget that! If you fall down, just dust yourself off and get back up! My 2-year old does that 10 times a day!

I'm not sure I shared my 2013 goals here . . .


I'm doing terrible in the coffee/tea department, but all-in-all, I would say I'm making a valiant effort at the rest.  A work in progress.

Be back tomorrow with a few of my favorite HEALTHY cookbooks.  

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...over and done

Fresh winds are blowing - a distant, subtle fragrance in the air - flux and evolution - all good. No more to add this week other than the events, exhibition, funding, commission and training offered below.


A reminder that if you want to come to the Networking Event at MMU on Thursday 7th Feb that has input of guests from Italy and Turkey and a focus on the arts in relation to recovery, you have to register at artsforhealth@mmu.ac.uk and details of the venue and other information, will be sent early next week.

The following short film is another eye-flickering response to some of the conversations I’ve had with people about re-imagining this arts/health field in relation to the here and now. (see previous blogs) Please don’t click on the film if you react badly to flashing images. 

Birth Rites Collection
The shortlisted entries for the Birth Rites Collection’s bi-annual art prize will be showcased at the University of Salford’s MediaCityUK campus on Saturday 2 February. The Collection was established by Helen Knowles, an artist and curator who aims to encourage a wider debate about the politics and practice of childbirth through the use of art. It was inspired by Helen’s contrasting experiences of giving birth to her first child in a hospital by cesarean and her second born at home. The exhibition at MediaCityUK will feature the drawings, films, photographs and sculptures of 15 shortlisted artists from all over the world. The prize is a month at artistic retreat The Trelex Residency in Geneva (including the cost of flights and a stipend) plus a place in the Birth Rites Collection.


The short-listed artworks include Emma Lazenby’s BAFTA-winning short animation about a midwife, Mother of Many (see below), photographs of women's faces at the moment of birth by Dominika Dzikowska, "illegitimate hallucinations", by Giorgio Sadotti and YouTube videos of childbirth flanked by photographs of people watching them by Claire Lawrie. 

The winner of the competition will be announced at the event by curator Helen Knowles and fellow judge Hermione Wiltshire, an artist and senior lecturer in photography at the Royal College of Art.

Helen said: “The taboo and under-represented subject of birth has been shown to be of great importance as a topic for artists to explore. We have had a great number of excellent submissions to the competition and this show presents a broad spectrum of works which were found to be the most poignant. Imagery on this fundamental life-process is a great way for people to get to grips with what it means to give birth today." 

The Birth Rites Collection is housed at the University of Salford in the midwifery department and the Royal College of Gynaecologists and Obstetricians in London. Birth Rites, Saturday 2 February, 11.00am – 5.00pm, The Egg, University of Salford, MediaCityUK. Prize to be awarded at 2pm.


Music in Healthcare Settings Training
We are proud to announce details of our next Music in Healthcare Settings training programme for musicians, to take place on 11, 12, 15, 16 and 17 April 2013 in Derby, UK. More details and an application form are available from our website here: Places are limited - applicants are advised to send an application asap. http://www.opusmusic.org/?p=437 

Tesco Charity Trust Community Awards (UK)
Deadline: Sun 30 Jun 2013
The Tesco Charity Trust Community Awards Scheme has announced that its funding programme for children’s education and children’s welfare will re-open for applications on 1 December 2012. The scheme awards one-off donations of between £500 and £4,000 to registered charities, schools and not-for-profit organisations. The funding they give can go towards providing practical benefits, such as equipment and resources for projects that directly benefit children living in the local communities around Tesco stores in the UK.

Applications should be made between 1 December – 30 January and 1 May – 30 June. The deadline for applications is Wednesday 30 January and Sunday 30 June 2013. To find out more about the Awards and how to apply, please click on the carrier bag below. 



Greggs Foundation Grants
Deadline: Mon 18 Feb 2013
Local not-for-profit organisations can apply for grants of up to £2,000 through the Greggs Foundation regional grants Programme. The programme is administered by committees of volunteers from Greggs shops, bakeries and offices who are based in England, Scotland and Wales.  They use their knowledge of the local area to make small grants to local organisations, in particular those that make a difference to people in need in the heart of Greggs’ local communities. The Greggs Foundation prioritises local organisations that help people in need in their local area, with previous funding helping towards trips, activities and equipment. Additionally the Foundation prioritises the following people:

  • Voluntary carers
  • People with disabilities
  • Homeless people
  • Older people
The deadline for applications is Monday 18 February 2013. Read more by clicking on the pies. 



Grants to Help New, Innovative Visual Arts Projects (UK)
The Elephant Trust has announced that the next deadline for applications is the 15th April 2013.  The Trust offers grants to artists and for new, innovative visual arts projects based in the UK. The Trust's aim is to make it possible for artists and those presenting their work to undertake and complete projects when confronted by lack of funds. The Trust supports projects that develop and improve the knowledge, understanding and appreciation of the fine arts. Priority is now being given to artists and small organisations and galleries who should submit well argued, imaginative proposals for making or producing new work or exhibitions. Arts Festivals are not supported. The Trust normally awards grants of up to £2,000, but larger grants may be considered. Read more at: 

Public Art Commission: Liverpool & Sefton Health Partnership Ltd in co-operation with Mersey Care NHS Trust
Liverpool & Sefton Health Partnership Ltd (LSHP) Art Commission
(in co-operation with Mersey Care NHS Trust)
LSHP is calling for applications from experienced and suitably qualified artists/artist teams for the commission of a high impact piece of art at the entrance of the mental health facility which provides a message of hope, optimism and wellbeing for Mersey Care NHS Trust’s service users, staff and neighbours. 

The local community and service users will be at the heart of this project and the selected artist/artist teams must demonstrate how they will work with the community and service users to develop a sense of ownership of the building and its surrounds. Therefore the artist/artist team must also outline the approach they will take to engage and work with the local community and mental health service users. LSHP will expect applicants to showcase previous commissions where they have experience of successful public engagement.
Applicants are requested to read the full contents of the  Artist Brief and Application Process document carefully as it contains important information about the application process and terms of reference. Deadline: 12.00noon, Friday 22rd March 2013. full details by clicking on the Olympia Theatre below.




Is Photography inherently racist?
Adam Broomberg & Oliver Chanarin  
To Photograph the Details of a Dark Horse in Low Light 
The Goodman Gallery in Johannesburg is presenting two new related bodies of work by Adam Broomberg and Oliver Chanarin. The following text is taken from the gallery website. In 1970, Caroline Hunter, a young chemist working for the Polaroid Corporation, stumbled upon evidence that her multinational employees were indirectly supporting apartheid. With the collusion of local distributors Frank & Hirsch, Polaroid was able to provide the ID-2 camera system to the South African state, to efficiently produce images for the infamous passbooks. The camera included a boost button designed to increase the flash when photographing subjects with dark skin. Alongside her partner Ken Williams they formed the Polaroid Workers Revolutionary Movement, and campaigned for a boycott. By 1977, Polaroid finally did withdraw from South Africa, and the international divestment movement – which eventually crippled apartheid – was on its way. The radical notion that prejudice might be inherent in the medium of photography itself is interrogated by the artists Broomberg and Chanarin in this presentation of new works produced on salvaged polaroid ID-2 systems.


Early colour film was known to be predicated on white skin and in 1977 when Jean-Luc Godard was invited on an assignment to Mozambique, he famously refused to use Kodak film on the grounds that the film stock was inherently ‘racist’. The title of Broomberg and Chanarin’s exhibition was originally the coded phrase used by Kodak to describe the capabilities of a new film stock developed in the early ’80s to address the inability of their earlier films to accurately render dark skin. In response to a commission to ‘document’ Gabon, Broomberg and Chanarin recently made two trips to the country to photograph a series of rare Bwiti initiation rituals, using only Kodak film stock that had expired in the late 1970s. Working with outdated chemical processes they succeeded in salvaging just a single frame from the many expired colour rolls they exposed during their visit. In this wide-ranging meditation on the relationship between photography and race, the artists continue to scrutinise the photographic medium, leading viewers through a convoluted history lesson; a combination of found images, rescued artifacts and unstable new photographic works.


Thursday, January 24, 2013

Healthy Recipes || Banana-less Green Smoothies

I have nothing against bananas (and actually enjoy their health benefits), but have you noticed how they are a critical ingredient in most "green smoothie" recipes?  I presume this inclusion is because blending bananas into such smoothies is a quick and easy way to sweeten or mask the taste of ... well, the green vegetables.  However, if for whatever reason, you do not want to add bananas to your green smoothies, there are banana-less recipes out there.  Here are a few:

{Image Source}
RECIPE #1 - Source
Ingredients:
1 cup seedless green grapes
1 cup packed baby spinach
1/2 cup ice
1/4 cup coconut milk

RECIPE #2 - Source
Ingredients:
 2 cups cantaloupe
1/4 avocado
1 tbsp mint leaves
1 tbsp basil leaves
splash of water
4-5 ice cubes

RECIPE #3 - Source
Ingredients:
1 medium cucumber
1/2 Bosc pear
3-4 ice cubes

RECIPE #4 - Source
Ingredients:
2 kiwis
1/2 cup chocolate almond milk
1/4 cup water
1 cup curly green kale
1 cup ice

For more recipes (with or without bananas), check out www.greenlemonade.com.

Reader's Question: Moisturizing Twist Extensions

For questions, use the "Contact Me" tab OR leave a comment!



Reader's Question:
I have twist extensions... How do I keep my hair moisturised?

My Answer:

In my opinion, the best way to moisturize twists (or any other braid) extensions is to use a water-based spritz followed by sealing with an oil.  This method allows for sufficient moisture without contributing to meshing, loc-ing, or severe product buildup.  Heavier products, especially thick butters, can build up near the roots and facilitate meshing or loc-ing, especially in kinkier strands.  If you REALLY want to use them, though, I suggest staying as far away from your roots as possible and only using the butter once or twice between washes.

That being said, what are some good spritzes and oils to use?  Well, let us start with the oils.  Light and somewhat odorless oils, such as grapeseed and jojoba, are my top suggestions.  Coconut oil may be used, but be aware that your extensions will smell of the oil (and that may or may not be okay, depending on how you feel).  Olive oil is less odorous but heavy.

Now for the spritzes:  A water-based one is a good start.  A water- and glycerin-based one may be even better, depending on what your hair likes.  I list a few spritz recipes in this post.  If you would rather buy one, I suggest looking for those geared towards braids (e.g., African Pride).

Finally, the moisturizing regimen while wearing twist extensions: Spritz anywhere from daily to weekly, depending on what your hair requires.  I would not suggest going beyond a week (particularly in the later stages of the wear) because the extensions themselves may be drying.  This is especially possible if you used synthetic hair for braiding.  As for sealing, that can occur anywhere from every few days to weekly.  Sealing daily can attract dirt to the hair quicker than usual thus leading to increased frequency in washing.

I hope this answers your question!


Wednesday, January 23, 2013

With new year, push for ACOs is in full swing





The new year is barely weeks old and already the rush to create Accountable Care Organizations (ACOs) is in full swing. By the end of this month, the nation will be sporting upwards of 300 such organizations. Some estimates put the total number of covered lives at 30 million, split equally between Medicare and commercial insurance plans.

Hospitals are competing on this new playing field and as a result, some have called the ACO an “awesome consulting opportunity!” With all of this frenzy, I remain skeptical that we have arrived at the right set of measures to allow us declare one ACO a success and another a failure. What is truly needed is a set of definitive measures, beyond readmission rates and the like, that can tell us how a specific population is doing.

Recent reports from two sources are worth noting in this regard. Michael Stoto, a professor at Georgetown University doing a sabbatical at Academy Health in Washington, DC, is using his time there to work on a comprehensive model for population health and appropriate metrics.  I look forward to seeing the finished product, as it is essential to the nation as we move forward in implementing population health initiatives. 

Another great source is Matt Stiefel’s piece from a recent Institute of Medicine roundtable at Kaiser Permanente, linking the Triple Aim to Population Health and the ACO movement. Finally, my piece for The Governance Institute, entitled the Population Health Mandate, tackles some of the identical issues. The abstract is available to the general public. Members of The Governance Institute may download the complete article.

Taken together, these three pieces begin to build the platform we will need to make ACOs truly accountable for the care they provide. The secret sauce is population health and the understanding that health policy, quality and safety, and care coordination all have an impact on what we do at the bedside for every patient.