Friday, November 13, 2009

| 3 Thanksgiving superfoods you shouldn’t skip

3-Thanksgiving-superfoods-you-shouldn’t-skip It just wouldnt be Thanksgiving without these classic ingredients. But there are excellent reasons to eat them on other days, too: Theyre delicious, theyre easy to cook, and each happens to be a nutritional superstar.

Cranberries
A staple of the Thanksgiving table, these pucker-inducing berries are surprisingly versatile, brightening both savory and sweet dishes. Their high content of pectin makes cranberries particularly well suited for sauce. Cranberry sauce is one of the quickest and easiest holiday sides to make from scratch. Fresh cranberries are high in vitamin C. They are also a good source of antioxidants.

How to buy: Peak season for cranberries runs from October through December, though frozen cranberries are available year-round. You can stock up on fresh cranberries when in season and store them in the freezer. Whether fresh or frozen, cranberries are typically packaged in 12-ounce plastic bags, though you can sometimes find loose fresh berries during their season. Look for plump, firm berries that are bright red and shiny. Ripe berries should bounce, lending cranberries the alternative name bounceberries. Sweetened dried cranberries are also widely available in supermarkets.

How to use
Substitute dried cranberries for raisins in baked goods, eat them plain as a snack, or sprinkle them over a salad.
Mix fresh cranberries with apples , cinnamon, lemon juice, and sugar for a sweet-tart filling for a pie, crisp, or cobbler.
Add fresh cranberries to your favorite quick bread or muffin recipe.
To make a sweet topping for cheesecake or ice cream, simmer fresh cranberries with water and sugar over medium heat just until cranberries pop.
Combine fresh cranberries with sugar, apple cider, apple cider vinegar, fresh ginger , dried crushed red pepper, and one large Bosc pear . Simmer past the point where cranberries pop, until cranberry chutney is thick, about 20 minutes.

How to store: Because of their high acidity, cranberries store exceptionally well. Fresh cranberries, either in their original plastic bag or tightly wrapped, will keep in the refrigerator for up to 2 months. Frozen cranberries will keep up to a year.


Brussels Sprouts
A member of the cabbage family, the earthy, nutty-tasting Brussels sprout looks like a miniature head of cabbage. Ranging in diameter from 1/2 inch to 1 1/2 inches, Brussels sprouts grow on thick green branches, and are sold either on the branch or individually. Brussels sprouts get a bad rap because they are so easy to overcook, resulting in a mushy texture and pungent aroma. When cooked properly, Brussels sprouts should be crisp-tender, with a pleasant crunch and a complex, slightly sweet flavor. Brussels sprouts are a good source of vitamin A, vitamin C, and iron.

How to buy: Look for small to medium sprouts . They should be bright green, with the leaves tightly wrapped. Brussels sprouts are in season from late August through March, and are sometimes sold on the stalk at farmers markets and good produce markets.

How to use: Before cooking, prep Brussels sprouts by removing any tough or shriveling outer leaves and cutting a small X in the stem end of each sprout, to help ensure the interior cooks in the same amount of time as the exterior, preventing overcooking. To cook Brussels sprouts, drop them into boiling, salted water and let simmer for no more than 8 to 10 minutes, until they are crisp-tender. Sautéing Brussels sprouts in butter, oil, or rendered fat caramelizes their surface, bringing out their sweet, nutty flavor. You can sauté the leaves by themselves, or blanch whole Brussels sprouts and either halve or slice them before sautéing.

How to store: Refrigerate Brussels sprouts unwashed in an air-tight bag for up to a week.


Sweet Potatoes
This sweet root can be much more than just a vehicle for mini marshmallows. Though it comes in dozens of varieties , two types of sweet potatoes are the most prominent in the United States. The light sweet potato has pale-yellow skin and flesh, and is not sweet at all. When cooked, it has a crumbly texture, similar to that of a white baking potato. The second, better-known, type of sweet potato is the orange-fleshed variety generally labeled yam. It has red skin and sweet flesh, and is particularly popular in the American South.

How to use: Sweet potatoes can be mashed, roasted, baked, boiled, or sautéed, and can also be made into sweet-potato chips or fries.

How to buy: Sweet potatoes are available year-round, and are at their peak during the winter. Choose small to medium sweet potatoes that are heavy for their size. Avoid any with bruises or signs of sprouting. Orange-fleshed sweet potatoes should have uniformly colored skin. The skin of light sweet potatoes is naturally more mottled.

How to store: Keep sweet potatoes in a cool, dark place for up to a week. Do not refrigerate .


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Monday, November 9, 2009

| Costs of defensive medicine spur heated debate

Costs-of-defensive-medicine-spur-heated-debate BOSTON - Dr. James Wang says he tries to tell his patients when extra medical procedures arent necessary. If they insist, though, he will do it — not so much to protect their health as his own practice.

After being sued for allegedly failing to diagnose a case of appendicitis, Wang says he turned to whats known as defensive medicine, ordering extra tests, scans, consultations and even hospitalization to protect against malpractice suits.

You are thinking about what can I do to prevent this from happening again, he said, adding that he did nothing wrong but agreed to a minor settlement to avoid a trial.

The practice is under scrutiny as Congress attempts to get an accurate price tag for the sweeping national health care overhaul. A pivotal floor vote on the Democrats bill could come as early as Saturday.

Doctors say the hidden costs of the tests along with malpractice insurance and lawsuit awards are major drivers behind the soaring cost of care. Trial attorneys say bad medicine, not lawsuits, is to blame.

Party line divide
The debate has split along party lines, with Democrats typically siding with lawyers groups and Republicans agreeing with doctors.

The feuding between doctors groups like the American Medical Association, who have long battled rising malpractice premiums, and trial attorneys, who say malpractice lawsuits discourage bad medicine, has made it tough to put an accurate price tag on the cost of the issues.

That, in turn, is hampering Congress from getting an accurate tally for any sweeping national health care overhaul as it seeks to balance those costs against expanded coverage.

Doctors say the price of defensive medicine and malpractice insurance accounts for up to 10 percent of health care spending. Lawyers say malpractice settlement costs amount to less than 0.5 percent of the $2.5 trillion spent each year on health care.

The cost of annual malpractice premiums can vary wildly depending on specialty, geographic location and insurance carrier.

Doctors practicing internal medicine, who typically have the lowest premiums, can pay as little at $3,375 in Minnesota and as much as $57,859 in Florida. Obstetricians and gynecologists, who typically have the highest premiums, can spend as much as $201,808 in Florida and as little as $20,626 in Minnesota, according to the Medical Liability Monitor, which tracks premiums costs.

Although Wang, an OB-GYN, said he typically avoids extra procedures and takes time to explain to patients when they are not necessary, he will sign off on them if a patient demands.

Its one thing to order up a test to protect my patients, Wang said. Its something else if I order up a test to protect myself.

Snowball effect
And, doctors say, defensive medicine can also produce a snowball effect, with one unnecessary test leading to more unnecessary tests.

More than 80 percent of the nearly 900 doctors who responded to a 2008 survey by the Massachusetts Medical Society reported practicing defensive medicine. The group estimated the cost of the extra tests at $281 million and the cost of unnecessary hospital admissions at $1.1 billion.

A 2005 study of 824 doctors in Pennsylvania by researchers at the Harvard School of Public Health and Columbia Law School found 93 percent reported practicing defensive medicine.

Lawyers fault the studies, noting they rely on self-reporting by doctors.

They also argued some doctors have a financial interest in laboratories that conduct extra tests or procedures — a conflict of interest they say could add to the level of unnecessary tests. Doctors say its fear of lawsuits, not financial incentives, that is driving the extra testing.

American Medical Association ethical guidelines state that doctors must always make referral decisions based on the best interests of their patients and under no circumstances may physicians place their own financial interests above the welfare of their patients.

Lawyers defend the use of malpractice claims saying they discourage bad medicine and guard patients rights.

Medical malpractice lawsuits bring to the forefront how faulty and flawed the whole system is, said Jeffrey Catalano, a trial attorney specializing in malpractice cases. The reason for escalating costs is that too many people are getting injured by preventable medical mistakes.

A 2009 analysis from the nonpartisan Congressional Budget Office estimates that government health care programs could save $41 billion over 10 years if nationwide limits on jury awards for pain and suffering and other similar curbs were enacted. Those savings are nearly 10 times greater than CBO estimated just last year.

As Congress examines what to do about the issues, some places are examining programs and proposals to limit those costs.

The University of Michigan Health System uses a system that allows doctors to acknowledge mistakes and offer compensation, saving time, money and feelings. As a result, according to the university, malpractice claims fell from 121 in 2001 to 61 in 2006, while the backlog of open claims dropped from 262 in 2001 to 106 in 2006 and 83 in 2007.

The drive for less adversarial approaches has also sparked a just say sorry movement, trumpeted in part by the Sorry Works! Coalition, which advocates for disclosure, an apology when appropriate and prompt compensation when necessary.

Not everyone is enamored with the movement.

An apology just means that the doctor is going to tell the truth, said Chris Milne, president of the Massachusetts Academy of Trial Attorneys.

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