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ADA asks Congress to ensure appropriate PPE for all health care workers

The ADA is calling on Congress to help ensure there is appropriate personal protective equipment available to all health care providers — including dentists — who continue to provide emergency care during the COVID-19 pandemic.




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ADA urges HHS to federally recognize licensed dentists to administer point of service COVID-19 tests

The ADA sent a letter to the U.S. Department of Health and Human Services April 17 asking the agency to “issue federal recognition that licensed dentists may administer point of service tests authorized by the Food and Drug Administration” during the COVID-19 pandemic.




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Senate votes to expand small business aid

The Senate passed new coronavirus relief legislation April 21 calling for much-needed funding for depleted federal loan programs that could help businesses nationwide, including dentists and dental practices, recover from the economic fallout of the pandemic.




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Oil prices fall on rising U.S. rigs, fading Venezuelan risk

Oil prices fell Monday as the number of rigs in the United States saw a weekly rise, analysts said




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CDC: 40% of U.S. teens are sexually active

The CDC estimates that 40 percent of U.S. teens are sexually active -- 42 percent of females and 38 percent of males 15 and 19 years of age -- numbers that have dropped significantly since 1988.




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Measles vaccinations in U.S. children fall up to 60 percent since pandemic, CDC says

Pediatric vaccination against measles has declined by as much as 60 percent nationally since the start of the COVID-19 outbreak, according to new data released Friday by the Centers for Disease Control and Prevention.




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Prognostic Significance of Long-term HbA1c Variability for All-Cause Mortality in the ACCORD Trial

OBJECTIVE

The association between high glycemic variability and all-cause mortality has been widely investigated in epidemiological studies but rarely validated in glucose-lowering clinical trials. We aimed to identify the prognostic significance of visit-to-visit HbA1c variability in treated patients in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial population.

RESEARCH DESIGN AND METHODS

We studied the risk of all-cause mortality in relation to long-term visit-to-visit HbA1c variability, expressed as coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV), from the 8th month to the transition. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratio (HR) and 95% CI.

RESULTS

Compared with the standard therapy group (n = 4,728), the intensive therapy group (n = 4,755) had significantly lower mean HbA1c (6.6% [49 mmol/mol] vs. 7.7% [61 mmol/mol], P < 0.0001) and lower CV, VIM, and ARV (P < 0.0001). In multivariate adjusted analysis, all three HbA1c variability indices were significantly associated with total mortality in all patients as well as in the standard- and intensive-therapy groups analyzed separately. The hazard ratios for a 1-SD increase in HbA1c variability indices for the all-cause mortality were 1.19 and 1.23 in intensive and standard therapy, respectively. Cross-tabulation analysis showed the third tertile of HbA1c mean and VIM had significantly higher all-cause mortality (HR 2.05; 95% CI, 1.17–3.61; P < 0.01) only in the intensive-therapy group.

CONCLUSIONS

Long-term visit-to-visit HbA1c variability was a strong predictor of all-cause mortality. HbA1c VIM combined with HbA1c mean conferred an increased risk for all-cause mortality in the intensive-therapy group.




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Risk of Major Adverse Cardiovascular Events, Severe Hypoglycemia, and All-Cause Mortality for Widely Used Antihyperglycemic Dual and Triple Therapies for Type 2 Diabetes Management: A Cohort Study of All Danish Users

OBJECTIVE

The vast number of antihyperglycemic medications and growing amount of evidence make clinical decision making difficult. The aim of this study was to investigate the safety of antihyperglycemic dual and triple therapies for type 2 diabetes management with respect to major adverse cardiovascular events, severe hypoglycemia, and all-cause mortality in a real-life clinical setting.

RESEARCH DESIGN AND METHODS

Cox regression models were constructed to analyze 20 years of data from the Danish National Patient Registry with respect to effect of the antihyperglycemic therapies on the three end points.

RESULTS

A total of 66,807 people with type 2 diabetes were treated with metformin (MET) including a combination of second- and third-line therapies. People on MET plus sulfonylurea (SU) had the highest risk of all end points, except for severe hypoglycemia, for which people on MET plus basal insulin (BASAL) had a higher risk. The lowest risk of major adverse cardiovascular events was seen for people on a regimen including a glucagon-like peptide 1 (GLP-1) receptor agonist. People treated with MET, GLP-1, and BASAL had a lower risk of all three end points than people treated with MET and BASAL, especially for severe hypoglycemia. The lowest risk of all three end points was, in general, seen for people treated with MET, sodium–glucose cotransporter 2 inhibitor, and GLP-1.

CONCLUSIONS

Findings from this study do not support SU as the second-line treatment choice for patients with type 2 diabetes. Moreover, the results indicate that adding a GLP-1 for people treated with MET and BASAL could be considered, especially if those people suffer from severe hypoglycemia.




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Commercially Available Insulin Products Demonstrate Stability Throughout the Cold Supply Chain Across the U.S.

OBJECTIVE

A recent publication questioned the integrity of insulin purchased from U.S. retail pharmacies. We sought to independently validate the method used, isotope dilution solid-phase extraction (SPE) liquid chromatography mass spectrometry (LC-MS), and expand analysis to two U.S. Pharmacopeia (USP) methods (high-performance LC with ultraviolet detection and LC-MS).

RESEARCH DESIGN AND METHODS

Each method was used to evaluate nine insulin formulations, purchased at four pharmacies, within five geographic locations in the U.S.

RESULTS

All human and analog insulins measured by the USP methods (n = 174) contained the expected quantity of active insulin (100 ± 5 units/mL). When using isotope dilution SPE-LC-MS, units-per-milliliter values were well below product labeling due to unequal recovery of the internal standard compared with target insulin.

CONCLUSIONS

Insulin purchased from U.S. pharmacies is consistent with product labeling.




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The Association of Energy and Macronutrient Intake at Dinner Versus Breakfast With Disease-Specific and All-Cause Mortality Among People With Diabetes: The U.S. National Health and Nutrition Examination Survey, 2003-2014

OBJECTIVE

This study aims to evaluate the association of energy and macronutrient intake at dinner versus breakfast with disease-specific and all-cause mortality in people with diabetes.

RESEARCH DESIGN AND METHODS

A total of 4,699 people with diabetes who enrolled in the National Health and Nutrition Examination Survey from 2003 to 2014 were recruited for this study. Energy and macronutrient intake was measured by a 24-h dietary recall. The differences () in energy and macronutrient intake between dinner and breakfast ( = dinner – breakfast) were categorized into quintiles. Death information was obtained from the National Death Index until 2015. Cox proportional hazards regression models were developed to evaluate the survival relationship between and diabetes, cardiovascular disease (CVD), and all-cause mortality.

RESULTS

Among the 4,699 participants, 913 deaths, including 269 deaths due to diabetes and 314 deaths due to CVD, were documented. After adjustment for potential confounders, compared with participants in the lowest quintile of in terms of total energy and protein, participants in the highest quintile were more likely to die due to diabetes (hazard ratio [HR]energy 1.92, 99% CI 1.08–3.42; HRprotein 1.92, 99% CI 1.06–3.49) and CVD (HRenergy 1.69, 99% CI 1.02–2.80; HRprotein 1.96, 99% CI 1.14–3.39). The highest quintile of total fat was related to CVD mortality (HR 1.67, 99% CI 1.01–2.76). Isocalorically replacing 5% of total energy at dinner with breakfast was associated with 4% and 5% lower risk of diabetes (HR 0.96, 95% CI 0.94–0.98) and CVD (HR 0.95, 95% CI 0.93–0.97) mortality, respectively.

CONCLUSIONS

Higher intake of energy, total fat, and protein from dinner than breakfast was associated with greater diabetes, CVD, and all-cause mortality in people with diabetes.




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The Influence of Baseline Diastolic Blood Pressure on the Effects of Intensive Blood Pressure Lowering on Cardiovascular Outcomes and All-Cause Mortality in Type 2 Diabetes

OBJECTIVE

To examine whether low baseline diastolic blood pressure (DBP) modifies the effects of intensive systolic blood pressure (SBP) lowering on cardiovascular outcomes in type 2 diabetes mellitus (T2DM).

RESEARCH DESIGN AND METHODS

The Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial (ACCORD BP), a two-by-two factorial randomized controlled trial, examined effects of SBP (<120 vs. <140 mmHg) and glycemic (HbA1c <6% vs. 7.0–7.9% [<42 vs. 53–63 mmol/mol]) control on cardiovascular events in T2DM (N = 4,731). We examined whether effects of SBP control on cardiovascular composite were modified by baseline DBP and glycemic control.

RESULTS

Intensive SBP lowering decreased the risk of the cardiovascular composite (hazard ratio [HR] 0.76 [95% CI 0.59–0.98]) in the standard glycemic arm but not in the intensive glycemic arm (HR 1.06 [95% CI 0.81–1.40]). Spline regression models relating the effects of the intervention on the cardiovascular composite across the range of baseline DBP did not show evidence of effect modification by low baseline DBP for the cardiovascular composite in the standard or intensive glycemic arms. The relation between the effect of the intensive SBP intervention and baseline DBP was similar between glycemic arms for the cardiovascular composite three-way interaction (P = 0.83).

CONCLUSIONS

In persons with T2DM, intensive SBP lowering decreased the risk of cardiovascular composite end point irrespective of baseline DBP in the setting of standard glycemic control. Hence, low baseline DBP should not be an impediment to intensive SBP lowering in patients with T2DM treated with guidelines recommending standard glycemic control.




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A Personal Challenge to All Parents

Confession time. I tend to write this blog with my professional hat on, keeping my personal life, personal. Today, I am writing as a mother of two very dear, but very spirited children. People tend to think since I am a School Psychologist, that I know exactly what to do in my own family, and that I should have it all together. The reality is that I have struggles just like everyone else. Sometimes, my kids just don't listen. Sometimes, I feel overwhelmed too. Sometimes, I don't respond in the most positive manner.

Sometimes it can be very difficult to be positive. I know this from experience. While I'm usually an optimistic person, who tends to find good in situations (at least eventually), I sometimes struggle in the heat of the moment. Especially, when I am running late or stressed about something, I have much less tolerance for resistance and disobedience from my children.

In the last few weeks I've really been having a difficult time with the morning routine. There are a lot of procedures that need to occur efficiently in order for everyone to get to work and school on time. I do not like that I have turned into a Drill Sargent with very little patience for any deviation from the schedule. There are mornings that I tell my children to get dressed multiple times and am ignored multiple times. As the clock ticks and it's time to rush out the door with two children (age 5 and 3) who haven't gotten dressed yet, I become more and more negative. By the time we get to the daily "Yes you are wearing a coat- it's 25 degrees outside!" argument with the second child, I have lost all patience. When they walk to the car, I'm behind carrying everything and making sure the door shuts, and have been known to yell "RUN!, RUN TO THE CAR, RUN!" and eventually pick up the meandering child and put her in the car at my own pace. How's that for a start to one's day? I don't feel very good about those days.

Thankfully, not every morning is like that. There are also days that everyone is calm and everyone got ready (although hurriedly), but we got to school/work on time and in good spirits. Specifically I think of a day earlier this week that I handed all the clothes to my five year old and asked him to get himself dressed and see if he could help his little sister a little bit. He helped her step by step, and was extremely proud of himself. I enthusiastically praised him for his help and everyone went to school and work happy that day.

So what is the difference between the crazy mornings and the relatively calm mornings? I want to say- "my kids." I want to say "some mornings they choose to focus on getting dressed and I don't have to argue with them, so we are happy." And while they do play a small part, the biggest factor is ME. I'm the difference. When I am more calm, I have the mindset to be more positive and encouraging, which the children actually respond to. When I am frantic, I think they retreat and are much more prone to act out or start throwing their own fits (about coats or shoes). Yes, there are days that my kids don't listen the first time. However, they are 3 and 5 years old. Also, they don't care if I am late, it means nothing to them. So, what is the main thing I can do to change our crazy mornings. It's not a magic cure to make my kids get ready in a hurried and frantic manner that will get everyone out the door on time. The answer is getting myself up earlier, so I am not stressing about my tardiness and I can focus on helping everyone else get ready.

So here's the challenge to all parents- Take a look at a part of your day that is prone to go poorly with your kids. Think about what you can do yourself to help change the situation. I don't mean what your children could or should do or what you need to do to change your child. Let's take a hard look at yourself first, and see what you can do to yourself to make a positive change in a situation. For my mornings- it's pretty obvious- like it or not, I need to wake up earlier. I'm always saying I should wake up earlier, but that snooze button is quite tempting every morning. Since I'm blogging about it, I now have many people out there to keep me accountable. I'm thinking that if I were not rushed and frantic, then I would be more patient with my kids and able to start using more positive methods for getting them to get ready. While there is an issue that I'm being ignored sometimes- right now I'm just going to focus on making a change to myself. I'm guessing it will spill into everyone else.

Let's all find one small thing we can do ourselves that will help be a blessing for our entire family.




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UPI News Quiz: Asian baseball, Grimes' baby, scary insects

Asian baseball, Grimes' baby, scary invasive insects -- how well did you follow the news this week? Take the UPI News Quiz for May 8, 2020.




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Halley's Comet will spark Eta Aquarids meteor shower late Monday

Halley's Comet only orbits the sun once every 75 years, but each year in early May, the Earth passes through some of the debris that it left behind.




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Trade can spread economic toll of local disasters globally, study finds

Damage from a natural disaster in one place can spread globally due to urban trade networks, a Yale study said Monday.




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Texas court stays execution of Randall Mays

A Texas appeals court has issued a stay of execution for a death row inmate on grounds he is intellectually disabled.




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U.S. stocks rise again on Wall Street despite job losses

The United States' bellwether stock index, the Dow Jones Industrial Average, climbed another 455 points Friday, posting its first weekly gain in three weeks.




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California to send mail-in ballots to all voters

California Gov. Gavin Newsom on Friday signed an executive order requiring mail-in ballots be sent to all eligible voters for the November election.




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'Valley Girl' musical reinvents classic '80s music

Director Rachel Lee Goldenberg discusses how her "Valley Girl" musical remake puts a twist on the hit music of the '80s.




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Watch: Tinsley Mortimer, Scott Kluth planning 'small' wedding

"Real Housewives of New York" star Tinsley Mortimer gave an update on her wedding plans amid the coronavirus pandemic.




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'RuPaul's Drag Race' announces 'All Stars 5' cast

'RuPaul's Drag Race' announced the 10 competitors from previous seasons who will get another chance in the fifth 'All Stars' season, premiering June 5 on VH1.




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The Canadian Express Entry System for Selecting Economic Immigrants: Progress and Persistent Challenges

Since its launch in 2015, the Express Entry system has changed how economic immigration to Canada happens and how it fits into public and political debates. And while it has proven successful in cutting through application backlogs, some challenges remain. This report looks at how and why this points-based system was introduced, what its impact has been, and how it could be further finetuned.




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“Merit-Based” Immigration: Trump Proposal Would Dramatically Revamp Immigrant Selection Criteria, But with Modest Effects on Numbers

The Trump administration’s plan to create a "merit-based" U.S. immigration system, lessening the longstanding focus on family reunification in favor of more economic migrants, has met with a lackluster response from Democrats and Republicans alike. This Policy Beat article explores how the Trump proposal would reshape immigration to the United States, and how it compares to selection systems in other countries and past debates about changing the U.S. system.




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Rethinking U.S. Immigration Policy: New Realities Call for New Answers

The U.S. immigration system is in desperate need of an overhaul. What has been missing is an alternate vision for a path forward that treats immigration as a strategic resource while also accounting for heightened security and rule-of-law imperatives, which together can further U.S. interests, values, and democratic principles as a society. This concept note outlines a new MPI initiative, Rethinking U.S. Immigration Policy, that seeks to fill this gap.




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A Tribute to My Colleagues and All Those Working in Mental Health

During a time when the world is focused on the current COVID-19 pandemic, a physical health crisis, and all those treating the physical symptoms of this pandemic, we must not...




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[ Religion & Spirituality ] Open Question : Does God love it when you call him Big Poppa?




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[ Law & Ethics ] Open Question : Why isn't COVID called the Wuhan Flu?

Sounds better than some made up nonsense. Might as well have called it the rumoponosisack 77 syndrome H.




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The International Migration System: Reflections on the Challenges and Opportunities Ahead

A reflection by MPI's co-founder, Demetrios Papademetriou, as he takes leave from his day-to-day role at MPI on the challenges and opportunities ahead for international migration systems over the next few decades. After opening remarks, Papademetriou engages in a conversation with incoming MPI President Andrew Selee about the trends and realities confronting policymakers and publics.




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Turning the Tide: Addressing the Long-Term Challenges of EU Mobility for Sending Countries

Amid ongoing debates about the costs and benefits of free movement, this MPI Europe webchat examines big-picture trends of East-West migration; considers possible policy responses at regional, national, and EU levels to alleviate some of the challenges; and reflects on realistic actions that could be taken under the incoming European Commission.




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Science Confirms: You Really Can't Buy Happiness

When Warren Buffett announced last week that he will be giving away more than $30 billion to improve health, nutrition and education, people all over America reflected on his remarkable generosity, pondered all the noble things the gift would achieve and asked themselves what they would do if...




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Bush: Naturally, Never Wrong

Psychologists once conducted a simple experiment with far-reaching implications: They asked people to describe an instance in their lives when they had hurt someone and another instance when they had been hurt by someone else. The incidents that people described were similar whether they saw...




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Count Today's Calories, And Check Your Wallet

What do the war in Iraq, your Christmas shopping and this week's Thanksgiving dinner have in common?




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Wondering Wall Street's Mood? Look Up

Forget about buying low and selling high. If you are worried about the recent volatility in the stock market, perhaps you should let the weather be your guide.




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Creating a Home in Canada: Refugee Housing Challenges and Potential Policy Solutions

One of the major challenges Canada faced during its extraordinary push to resettle 25,000 Syrian refugees during a four-month period was to find housing for these newcomers. This report explores how the government, resettlement case workers, and private citizens tackled this challenge—balancing cost and location, access to services, and more—and how lessons learned can improve refugee housing practices for other countries going forward.




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Seasonal Worker Programs in Europe: Promising Practices and Ongoing Challenges

Seasonal worker programs in the European Union have a long history, but have yet to find the sweet spot of working for migrants, employers, and countries of destination and origin alike. This policy brief explores some of the challenges common to these programs—drawing on examples in Europe, Australia, and New Zealand—and highlights promising practices.




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All Eyes Turn to Congress, Following Trump Decision to Terminate DACA Program

By winding down DACA over six months, President Trump may have addressed a short-term political dilemma. But this action ensures debate will rage on in search of a lasting solution, as many in Congress and beyond recognize the loss of work authorization and deportation relief will affect not only DACA recipients and their families, but also employers, universities, and communities alike, as this commentary explores.




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Promoting Refugee Integration in Challenging Times: The Potential of Two-Generation Strategies

At a time when the U.S. refugee resettlement system is facing unprecedented challenges, innovative and cost-effective tools for supporting refugee integration are in demand. This report explores how a two-generation approach to service provision could help all members of refugee families—from young children to working-age adults and the elderly—find their footing.




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MPI Analysis of All State ESSA Accountability Plans Finds Fractured Picture of Education Policy for English Learners &amp; Differing Approaches

WASHINGTON – Four years since the Every Student Succeeds Act (ESSA) was signed into law, all 50 states, the District of Columbia and Puerto Rico have developed accountability plans that include blueprints for serving English Learners (ELs), as well as measuring these students’ progress and being accountable for their outcomes. This marked a significant development, as EL performance was previously not well integrated with factors that determined whether a school was performing well or poorly.




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As European policymakers take stock of seasonal worker programmes, MPI Europe brief outlines principles to improve these schemes for all parties

Findings will be discussed during 25 February MPI Europe – SVR webinar




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As Millions Are Pushed from Jobs amid Pandemic, the Loss of Employer Health Coverage &amp; Limited Access to Public Coverage for Many Immigrants Hold Major Implications for Them – and U.S. Overall

WASHINGTON – As more than 33 million U.S. workers have lost their jobs since March amid the pandemic-induced economic crisis, immigrants are among the most vulnerable: They are more likely than the U.S. born to be laid off and to live in communities with high COVID-19 infection rates, and less likely to have health insurance coverage and access to a doctor or other usual source of health care.





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All Natural Apple Syrup

This syrup is delicious and well worth the time involved. While it tastes sweet it is natural and sugar-free. Add a tablespoonful to any chopped fresh fruit - berries, mango, pineapple, papaya, banana, grapes - and it will balance and enhance the flavours. It's also great served over waffles, crepes or ice cream.




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Muhallabiya (citris pudding)

This recipe was featured on Foodie Tuesday, a weekly segment with Richelle Hunt on Drive, 774 ABC Melbourne, 3:30 PM, courtesy of Hana Assafiri. Hana's new book is called "Moroccan Soup Bar: Recipes of a Spoken Menu."




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Chocolate brownies with crystallised ginger and macadamia nuts

140g unsalted butter 200g dark chocolate 100g light brown sugar 100g caster sugar 2 teaspoons vanilla extract 2 eggs 1 egg yolk 85g plain flour 55g macadamia nuts, lightly toasted, chopped 30g crystallised ginger, chopped Sifted cocoa powder, to dust





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Swedish meatballs

400g pork/beef mince 1 egg 1 onion, grated 1/4 cups fresh breadcrumbs 1/2 tsp. allspice 1/4 tsp. ground cloves Pinch of nutmeg 1 tbsp. olive oil 20g butter 150ml beef stock 2 tbsp. brown sugar Lingonberry sauce, sour cream, dill and parsley potatoes, baby cos leaves and cucumber wedges to serve





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Medallions of Beef, with pan juice sauce, wilted cherry tomatoes, wine and basil

Medallions of Beef, with pan juice sauce, wilted cherry tomatoes, any old wine and basil. Really nice with a potato salad, with fresh spring peas and crispy bacon pieces. Something I do very often is knock up quick tasty dinner utilising your favourite heavy-based frying pan.





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Japanese sweet ginger meatballs

1 bunch of spring onions, finely chopped 250 g minced beef 250 g minced pork 20 g grated ginger 1 egg 2 tsps. roasted sesame oil 1 tbsp. cornflour, plus extra for dusting sunflower oil, for shallow frying 1 tbsp. white sesame seeds salt and ground white pepper For the sweet ginger sauce: 30 g grated ginger 3 tbsps. soy sauce 125 ml dashi stock or 1 tsp instant dashi powder mixed with water 2 tbsps. sugar 3 tbsps. mirin 3 tbsps. rice vinegar 1 tsp cornflour