Happy Holidays and Happy New Year to Our Loyal Readers

 

As we enter our 23rd year of operations, we want wish all of our friends and colleagues Happy Holidays and Happy New Year. ON TARGET now goes to over 5,600 each week and to virtually every country in the world. We know no politics when it comes to health for all, and hope that ON TARGET helps to contribute a more harmonious world.  See you next year!!!

 

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ON TARGET is the newsletter of Target Health Inc., a NYC – based, full – service, contract research organization (eCRO), providing strategic planning, regulatory affairs, clinical research, data management, biostatistics, medical writing and software services to the pharmaceutical and device industries, including the paperless clinical trial.

 

For more information about Target Health contact Warren Pearlson (212 – 681 – 2100 ext. 104). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel or Ms. Joyce Hays. The Target Health software tools are designed to partner with both CROs and Sponsors. Please visit the Target Health Website.

 

Joyce Hays, Founder and Editor in Chief of On Target

Jules Mitchel, Editor

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European Public Health Crisis: Sick, Desperate and Soon Freezing

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Winter is coming: the new crisis for refugees in Europe

 

Fleeing violence, millions of innocent Syrians are trapped in situations where disease and poverty threaten children and families seeking refuge in settlement & refugee camps. From Lesbos to Lapland, refugees are bracing for a winter chill that many will never have experienced before. Some will have to endure it outside

Record numbers of migrants and 1) ___ have crossed the Mediterranean to Europe in October through December 2015 – just in time for the advent of winter, which is already threatening to expose thousands to harsh conditions. The latest UN figures, which showed 218,000 made the perilous Mediterranean crossing last month, and 6,000 more arrive each day to Greece, confirm fears that the end of summer and soon the end of fall, has not stemmed the flow of refugees as has been the pattern in previous years, partly because of the sheer desperation of those fleeing an escalating war in 2) ___ and other conflicts.

 

The huge numbers of people arriving at the same time as winter, is raising fears of a new humanitarian crisis within Europe’s borders. Cold weather is coming to Europe at greater speed than its leadership’s ability to make critical decisions. A summit of EU and Balkan states recently agreed to some measures for extra policing and shelter for 100,000 people. But well over 700,000 refugees and migrants, have arrived in 3) ___ this year along unofficial and dangerous land and sea routes, from Syria, Eritrea, Afghanistan, Iraq, North Africa and beyond. Tens of thousands, including the very young and the very old, find themselves trapped in the open, as the skies darken and the first night frosts take hold. Hypothermia, pneumonia and opportunistic diseases are the main threats now, along with the growing desperation of refugees trying to save the lives of their families.

 

Editor’s note: According to one of our relatives living in Germany, 1 million refugees have been admitted into Germany alone. Fights have broken out over blankets, and on occasion between different national groups. Now traffickers are following the columns of refugees, picking off young unaccompanied stragglers.

 

The United Nations refugee agency, UNHCR, is distributing outdoor survival packages, including sleeping bags, blankets, raincoats, socks, clothes and shoes, but the number of people it can reach is limited by its funding, which has so far been severely inadequate. Volunteer agencies have tried to fill the gaping hole in humanitarian provisions in Europe. Human Rights Watch, has said that all along the route into Europe through the 4) ___ “there is virtually no humanitarian response from European institutions, and those in need rely on the good will of volunteers for shelter, food, clothes, and medical assistance.“ Europe has found itself ill-prepared to deal with its biggest influx of refugees since 5) ___. It is a race against time and the elements – a race Europe is not guaranteed to win. “There is a risk of collapse,“ said Federica Mogherini, the EU foreign policy chief. “Either we take this big step and adapt or yes, we do have a major crisis.“

 

The fighting in Syria seems to have no end- one example of families trapped in deteriorating camp conditions, is the one in this photo.

 

 

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Their infant and all relatives, have died and their home is destroyed. Only days before, their young son (on the right) fell and broke his arm. There is no pain medication or doctor to perform the surgery he needs in order to heal. Authorities will not let the family through, to start the grueling trek through Europe to a final destination until paperwork is processed. Amidst its own economic crisis, Greece’s resources are severely strained. Some refugee camps are only designed for 200, yet thousands are trying to survive in them, without adequate sanitation, food or 6) ___. These camps are becoming ticking time bombs of disaster. Pregnant women, children and the elderly, require special care and medication.

 

Medical Teams International’s primary goal in Middle Eastern war zones is health outreach. Basic health and dental care prevents and reduces the impact of disease on children, women, and men in refugee settlements. Additionally, they train volunteers to provide health services at mobile medical units. Missing are psychologists providing much needed counseling, treatment and medication for childhood and adult trauma victims of 7) ___. International medical teams like Doctors Without Borders, are focused on the largely unmet need of chronic and preventable problems e.g. dental, cardiovascular, respiratory, diabetes, as well as surgery. In Greece, the situation focuses on meeting the deadly infrastructure strains facing refugees in registration camps. The lack of clean 8) ___ and sanitation in crowded, makeshift settlements is an urgent concern. Diseases like cholera and polio can easily spread ? even more life-threatening without enough medical services. Mercy Corps is currently addressing the urgent needs of nearly 4 million people both inside Syria and in neighboring countries. We have the second-largest operation inside Syria, next to the U.N., reaching an estimated 500,000 people every month. Water shortages have spiked. Hospitals and schools don’t have enough water to maintain sanitation standards.

 

One story out of millions of similar refugee stories

 

According to Michael W. Doyle, who heads Columbia University’s Global Policy Initiative, one problem is that all we have now is an asylum system designed at the end of World War II, to take in a few thousand citizens. This inadequate system is now confronted with an exodus of millions every year. Government aid budgets don’t extend to those amounts, and the wider aid community simply doesn’t have the means to manage so many disasters at the same time, aid agencies say. An unusual, deadly convergence of wars and 9) ___ change disasters erupting around the world, (not to mention robotics putting people out of work), pushed the number of people displaced from their homes to 59.5 million by the end of 2014. (and that doesn’t count the numbers of refugees in 2015). “We are all stretched beyond the breaking point,“ said Andrea Koppel, vice president of advocacy at Mercy Corps. “We don’t have the people, let alone the money, to meet the needs of all those who have been affected. There aren’t enough people, including 10) ___ and their assistants, with the skill sets to deploy to those places. The international donors are stretched. There just isn’t enough to go around. “And we are asking ourselves the question, is this the new normal? And if so, what do we need to do to cope?“

 

ANSWERS: 1) refugees; 2) Syria; 3) Europe; 4) Balkans; 5) WW2; 6) medicine; 7) PTSD; 8) water; 9) climate; 10) physicians

 

Asklepius, Ancient God of Healing, Precursor of Hippocrates

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Asclepius with his serpent-entwined staff, Archaeological Museum of Epidaurus, Greece

 

Western culture’s demands of integrity, sacrifice, and compassion from its physician healers have roots in the mythic traditions of ancient Greece. By understanding these traditions, modern physicians can better understand their patients’ expectations and the high expectations physicians often have for themselves.

 

The mythic figure Asklepios was the focus of Greek and Roman medical tradition from approximately 1500 BCE to 500 CE. As a physician-hero, Asklepios exemplified the ideal physician and the pitfalls he or she may face. With the progressive deification of Asklepios and the spread of his worship first in Greece and then in the Roman empire, Asklepios became generally recognized as the god of healing and served as an object of supplication, particularly for the poor and disregarded. Asklepian traditions for medical service provide historical insight into the role of modern physicians and their obligations to care for the underserved. Asclepius was a god of medicine in ancient Greek religion and mythology. Asclepius represents the healing aspect of the medical arts; his daughters are Hygieia (“Hygiene“, the goddess/personification of health, cleanliness, and sanitation), Iaso (the goddess of recuperation from illness), Aceso (the goddess of the healing process), Aglaea/AEgle (the goddess of beauty, splendor, glory, magnificence, and adornment), and Panacea (the goddess of universal remedy). He was associated with the Roman/Etruscan god Vediovis. He was one of Apollo’s sons, sharing with Apollo the epithet Paean (“the Healer“). The rod of Asclepius, a single snake-entwined staff, remains a symbol of medicine today. Those physicians and attendants who served this god were known as the Therapeutae of Asclepius.

 

Although Asclepius was the son of Apollo, according to the earliest accounts, his mother was a mortal woman named Coronis. His mother was killed for being unfaithful to Apollo and although pregnant, she was laid out on a funeral pyre to be burned to death. As the story goes, the unborn child was rescued from her womb. Or, in another version, his mother died in labor and was laid out on the pyre to be consumed, but his father, Apollo, rescued the child, cutting him from her womb. From this he received the name Asklepios, “to cut open.“ Apollo carried his baby son, to the centaur Chiron who raised Asclepius and instructed him in the art of medicine. It is said that in return for some kindness rendered by Asclepius, a snake licked Asclepius’ ears clean and taught him secret knowledge (to the Greeks snakes were sacred beings of wisdom, healing, and resurrection). Asclepius bore a rod wreathed with a snake, which became associated with healing. To this day a species of non-venomous pan-Mediterranean serpent, the Aesculapian snake (Zamenis longissimus) is named for the god. Asclepius became so proficient a healer that he surpassed both Chiron and his father, Apollo. Asclepius was therefore able to evade death and to bring others back to life from the brink of death and beyond. This caused an influx of human beings and Zeus resorted to killing him to maintain balance in the numbers of the human population.

 

 

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Asclepios with his daughter Hygieia. Wikipedia

 

Asclepius was married to Epione, with whom he had five daughters: Hygieia, Panacea, Aceso, Iaso, and Aglaea, and three sons: Machaon, Podaleirios and Telesphoros. He also sired a son, Aratus, with Aristodama. The names of his daughters each rather transparently reflect a certain subset of the overall theme of “good health“. At some point, Asclepius was among those who took part in the Calydonian Boar hunt. Another version of Asclepius’ death is that Zeus killed Asclepius with a thunderbolt because he, Asclepius, brought Hippolytus back alive from the dead and accepted gold for it. Other stories say that Asclepius was killed because after bringing people back from the dead, Hades thought that no more dead spirits would come to the underworld, so he asked his brother Zeus to stop him. This angered Apollo who in turn killed the Cyclopes who made the thunderbolts for Zeus. For this act, Zeus suspended Apollo from the night sky and commanded Apollo to serve Admetus, King of Thessaly for a year. Once the year had passed, Zeus brought Apollo back to Mount Olympus and revived the Cyclopes that made his thunderbolts. After Asclepius’ death, Zeus placed his body among the stars as the constellation Ophiuchus (“the Serpent Holder“). Some sources also state that Asclepius was later resurrected as a god by Zeus to prevent any further feuds with Apollo. It was also claimed that Asclepius was instructed by Zeus to never revive the dead without his approval again.

 

 

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Majestic Zeus-like facial features of Asclepius head (Melos). Wikipedia

 

The most famous temple of Asclepius was at Epidaurus in north-eastern Peloponnese, dated to the fifth century BCE. Another famous healing temple (or asclepieion) was built approximately a century later on the island of Kos, where Hippocrates, the legendary “father of medicine“, is thought to have begun his career. Other asclepieia were situated in Trikala, Gortys (in Arcadia), and Pergamum in Asia. From the fifth century BCE onwards, the cult of Asclepius grew very popular and pilgrims flocked to his healing temples (Asclepieia) to be cured of their ills. Ritual purification would be followed by offerings or sacrifices to the god (according to means), and the supplicant would then spend the night in the holiest part of the sanctuary – the abaton (or adyton). Any dreams or visions would be reported to a priest who would prescribe the appropriate therapy by a process of interpretation. Some healing temples also used sacred dogs to lick the wounds of sick petitioners. In honor of Asclepius, a particular type of non-venomous snake was often used in healing rituals, and these snakes – the Aesculapian Snakes – slithered around freely on the floor in dormitories where the sick and injured slept. These snakes were introduced at the founding of each new temple of Asclepius throughout the classical world.

 

The original Hippocratic Oath began with the invocation “I swear by Apollo the Physician and by Asclepius and by Hygieia and Panacea and by all the gods.

 

 

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Asclepius – a fragment of mosaic bathroom in Kyustendil (Bulgaria). Source: Wikipedia

 

Some later religious movements claimed links to Asclepius. For example in the 2nd century CE the controversial miracle-worker Alexander (this is not Alexander III of Macedonia, also called Alexander the Great) claimed that his god Glycon, a snake with a “head of linen“ was an incarnation of Asclepius. The Greek language rhetorician and satirist Lucian produced the work Alexander the False Prophet to denounce the swindler for future generations. He described Alexander as having a character “made up of lying, trickery, perjury, and malice; [it was] facile, audacious, venturesome, diligent in the execution of its schemes, plausible, convincing, masking as good, and wearing an appearance absolutely opposite to its purpose.“ However, this particular religious fraud, amassed great wealth, due to his ability to convince people that he had healing powers.

 

In Rome, the College of Aesculapius and Hygia was an association (collegium) that served as a burial society and dining club that also participated in Imperial cult. The botanical genus Asclepias (commonly known as milkweed) is named after the great healer and includes the medicinal plant A. tuberosa or “Pleurisy root“.

 

Asclepius was depicted on the reverse of the Greek 10,000 drachmas banknote of 1995-2001.

 

Asclepius is mentioned by Hercules in the Hercules: The Legendary Journeys episode “Siege at Naxos.“ He is mentioned to be Hercules’ cousin who taught him how to mix healing herbs and medicines. In “The Apple,“ Hercules told Iolaus that Asclepius often said “An apple a day keeps Asclepius away“ and that he never quite knew what was meant by that. In “Centaur Mentor Journey,“ Asclepius was one of the students mentored by the centaur Ceridian. When Ceridian was dying, Hercules suggested that Asclepius might be able to help. Ceridian knew better.

 

In the fantasy novel The Son of Neptune, the Roman Lar Gaius Vitellius Reticulus was a descendant of Asclepius. Later, in The Blood of Olympus, a novel from the same series, Asclepius was mentioned by Apollo, his father, when Leo Valdez speaks to him. The god himself appears when Leo, Piper McLean, and Jason Grace visit his office to retrieve the physician’s cure, which can bring the recently deceased back to life. He quickly diagnoses Jason with myopia and gives him a pair of glasses. Later, he uses the Pylosian mint (the “cursed“ daisy) and the Makhai to formulate the physician’s cure and gives the trio instructions on its use.

 

In the short story “The Two Temples“ by Herman Melville, the narrator, hired by a lady as a personal physician, describes his job as “the post of private Aesculapius and knightly companion.“

 

In the manga Saint Seiya: Next Dimension, the Ophiuchus Gold Saint is loosely based on the figure of Asclepius, since it is said that he was regarded as a god and had the power to heal others, which is why the gods punished him and erased his existence.

 

In the “Trauma Center“, multiple protagonists of the game hold an inherited ability called the ‘Healing Touch’, which is said to be an ability originally held by Asclepius.

 

Asclepius is alluded to in a Mars Volta song, “Askepios.“ The song makes mention of both un-death and resurrection. In popular American culture, Asclepius was seen in Marvel Comics where he appeared in Ares #4.

 

Today, there is a pharmaceutical company named, Asklepion, with a fine reputation of creating products that heal. Asclepius lives on!

 

Poverty and Childhood Risk of Neurological Impairment

 

According to an article published in the International Journal of Epidemiology (16 December 2015), children from low income environments appear to have a higher risk of neurological impairment than those from more economically secure circumstances. This neurological impairment appears to be distinct from the risk of cognitive and emotional delays known to accompany early-life poverty. In most cases, the level of neurological impairment that was identified would not be apparent to a casual observer. That level could, however, increase, the risk for childhood learning difficulties, attention deficit disorders and psychological conditions such as anxiety disorders and schizophrenia.

 

The study analyzed data from the Collaborative Perinatal Project (CPP) which enrolled pregnant women from 1959 through 1966, obtaining health information on more than 50,000 pregnancies and the children resulting from them. Children in the study received comprehensive neurological examinations at birth, 4 months, 1 year and 7 years of age. The physicians performing the examinations looked for obvious deformities, abnormalities in posture, motor skills, response to skin stimulation and muscle strength. The children also received evaluations of the autonomic nervous system — the part of the nervous system governing functions not under conscious control, such as breathing, heartbeat and digestion.

 

Based on interviews at the start of the study, the authors classified the parents into three groups: those having a low, medium, or high likelihood of socioeconomic disadvantage based on such factors as educational level, income relative to the U.S. poverty level, occupation, employment status, and whether there were two parents living in the home. Results showed that when the authors factored in the likelihood for pregnancy and birth complications, which were more common among women in poverty, little difference in neurological impairment at birth was observed between the children, despite their parents’ socioeconomic disadvantage. However, beginning at age 4 months, the chance of having a neurological abnormality was higher in the most disadvantaged children (12.8%), compared to the least disadvantaged (9.3%). By age 7, the likelihood of a neurological abnormality increased to 20.2% among the most disadvantaged, compared to 13.5% among the least disadvantaged. The greater frequency of pregnancy complications in the most disadvantaged group did not account for its higher percentage of neurological impairment.

 

Although there have been advances in the techniques used to diagnose neurological impairment in the years since the data were collected, the study authors said that the diagnostic approaches used in the study are still effective for detecting neurological problems. Studies indicate that people living in poverty are at higher risk for substance abuse, anxiety, depression, and child abuse, and the authors theorize that these factors could explain the higher rates of neurological impairment their study found for children raised in impoverished environments. The authors wrote that further research into how childhood poverty might contribute to neurological impairment could lead to ways to prevent neurological impairment from occurring. They added that the percentage of children living below the federal poverty threshold is higher today than it was when the CPP data were collected.

 

Does Happiness Itself Directly Affect Mortality? The Prospective UK Million Women Study

 

Poor health can cause unhappiness and poor health increases mortality. Previous reports of reduced mortality associated with happiness could be due to the increased mortality of people who are unhappy because of their poor health. Also, unhappiness might be associated with lifestyle factors that can affect mortality. As a result, a study, published online in The Lancet (9 December 2015), was performed to determine whether, after allowing for the poor health and lifestyle of people who are unhappy, did any robust evidence remain that happiness or related subjective measures of wellbeing directly reduced mortality.

 

The Million Women Study is a prospective study of UK women recruited between 1996 and 2001 and followed electronically for cause-specific mortality. Three years after recruitment, the baseline questionnaire for the present report asked women to self-rate their health, happiness, stress, feelings of control, and whether they felt relaxed. The main analyses were of mortality before Jan 1, 2012, from all causes, from ischemic heart disease, and from cancer in women who did not have heart disease, stroke, chronic obstructive lung disease, or cancer at the time they answered this baseline questionnaire. The study used Cox regression, adjusted for baseline self-rated health and lifestyle factors, to calculate mortality rate ratios (RRs) comparing mortality in women who reported being unhappy (i.e., happy sometimes, rarely, or never) with those who reported being happy most of the time.

 

Results from the study showed that of the 719,671 women in the main analyses (median age 59 years), 39% (282,619) reported being happy most of the time, 44% (315,874) usually happy, and 17% (121,178) unhappy. During the 10 years of follow-up, 4% (31,531) of participants died. Self-rated poor health at baseline was strongly associated with unhappiness. But after adjustment for self-rated health, treatment for hypertension, diabetes, asthma, arthritis, depression, or anxiety, and several sociodemographic and lifestyle factors (including smoking, deprivation, and body-mass index), unhappiness was not associated with mortality from all causes (adjusted RR for unhappy vs happy most of the time 0.98), from ischemic heart disease (0.97), or from cancer (0.98. Findings were similarly null for related measures such as stress or lack of control.

 

According to the authors, while poor health can cause unhappiness in middle-aged women, .after allowing for this association and adjusting for potential confounders, happiness and related measures of wellbeing do not appear to have any direct effect on mortality.

 

FDA Launches precisionFDA to Harness the Power of Scientific Collaboration

 

The following was abstracted from FDA Voice (15 December 2015)

 

Imagine a world where doctors have at their fingertips the information that allows them to individualize a diagnosis, treatment or even a cure for a person based on their genes. That’s what President Obama envisioned when he announced his Precision Medicine Initiative earlier this year. On 15 December 2015, FDA’s precisionFDA web platform was launched to help achieve this goal.

 

precisionFDA is an online, cloud-based, portal that will allow scientists from industry, academia, government and other partners to come together to foster innovation and develop the science behind a method of “reading“ DNA known as next-generation sequencing (or NGS). Next Generation Sequencing allows scientists to compile a vast amount of data on a person’s exact order or sequence of DNA. Recognizing that each person’s DNA is slightly different, investigators can look for meaningful differences in DNA that can be used to suggest a person’s risk of disease, possible response to treatment and assess their current state of health. Ultimately, what is learned about these differences could be used to design a treatment tailored to a specific individual. The precisionFDA platform is a part of this larger effort and through its use FDA wants to help scientists work toward the most accurate and meaningful discoveries. precisionFDA users will have access to a number of important tools to help them do this. These tools include reference genomes, such as “Genome in the Bottle,“ a reference sample of DNA for validating human genome sequences developed by the National Institute of Standards and Technology. Users will also be able to compare their results to previously validated reference results as well as share their results with other users, track changes and obtain feedback.

 

Through such collaboration FDA hopes to improve the quality and accuracy of genomic tests – work that will ultimately benefit patients. Over the coming months, FDA will engage users in improving the usability, openness and transparency of precisionFDA. One way FDA will achieve that is by placing the code for the precisionFDA portal on the world’s largest open source software repository, GitHub, so the community can further enhance precisionFDA’s features.

 

precisionFDA leverages FDA’s experience establishing openFDA, an online community that provides easy access to our public datasets. Since its launch in 2014, openFDA has already resulted in many novel ways to use, integrate and analyze FDA safety information. FDA states that it is confident that employing such a collaborative approach to DNA data will yield important advances in the understanding of this fast-growing scientific field, information that will ultimately be used to develop new diagnostics, treatments and even cures for patients.

 

Apple Clafloutis, Easy as Pie !

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While baking, breathe in the warm apple scent wafting in your kitchen. Mmmm! This recipe does not disappoint. You can say “clafloutis“ or “claflouti.“ ©Joyce Hays, Target Health Inc.

 

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Here’s a pear claflouti, I experimented with. Good, but we liked the apple better. ©Joyce Hays, Target Health Inc.

 

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Warm delicious apple claflouti! ©Joyce Hays, Target Health Inc.

 

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You won’t have much leftover, when you serve apple clafloutis. ©Joyce Hays, Target Health Inc.

 

 

Ingredients

 

1 teaspoon + butter as needed

1/2 cup almond flour, more for dusting pan

3 eggs

1/2 cup granulated sugar or sugar substitute

Pinch salt

3/4 cup heavy cream

3/4 cup almond milk

3 cups of apples, sliced paper-thin (4-8 apples depending on their size, peeled, cored and sliced with a mandolin, very thinly.

Powdered sugar or sugar substitute

Pinches of cinnamon

 

 

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Apples are still at their peak. ©Joyce Hays, Target Health Inc.

 

 

Directions

 

1. Heat oven to 350 degrees.

2. Peel and core the apples. Then slice them, paper-thin on your mandolin until you get a total of 3 cups of sliced apples.

 

 

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One by one, slice the peeled and cored apples, until you get a total of 3 cups. Always take care with the mandolin because it’s razor sharp. After I use it and wash it by hand under the faucet, I always put it back in its box, so no one will ever accidentally reach for it and get a bad cut. It’s worth taking care, since so many recipes are made easy by using this invaluable kitchen tool. No kitchen should be without it. ©Joyce Hays, Target Health Inc.

 

 

1. Prepare a 10-inch round deep pie plate by smearing it with butter. Next, dust it with flour, rotating pan so flour sticks to all the butter.

2. Next, invert dish to get rid of excess flour.

3. In a large bowl, whisk eggs until frothy. Do this by hand, not in the electric mixer. Add granulated sugar and salt and whisk until combined. Add cream and milk and whisk until smooth. Add 1/2 cup flour and stir just to combine, not more. Don’t stir the flour too much.

4. Layer the apple slices in the pie plate. Over each layer, sprinkle a tiny bit of cinnamon. Don’t make stacks of the slices. Distribute the slices all over the bottom of the dish, as one over-lapping layer. Then do the next layer and so on, until there is a whole lot of apple slices. They should come almost to the top. The thinner the apple slices, the better the dessert will be.

 

 

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Paper-thin apple slices, are layered and overlapped, with each layer receiving a small sprinkling of cinnamon. ©Joyce Hays, Target Health Inc.

 

 

1. Pour the batter over the apple slices, to as close to the top of dish as you can, without the batter dripping over the side. There might be some leftover batter, depending on size of your dish. Bake for about 40 minutes, or until clafoutis is nicely browned on top and a knife inserted into it comes out clean. Sift some powdered sugar over it and serve warm or at room temperature. Clafoutis does not keep; serve within a couple of hours of making it.

2. Its delicious as is, however, some might like it with vanilla ice cream or cool whip or vanilla-flavored whipped cream.

 

This recipe is so easy to make, yet when served, looks very professional, as if a fantastic chef put it together. You can chose to keep it very low in fat and in calories, or not. I have experimented with getting this recipe just right, with apples and pears, and find that apples come out the best. Anyway, in the fall and early winter, apples are the most flavorful to use.

 

This recipe is a French countryside recipe that originally called for not-pitted cherries. However, the basic idea, is to enable the quick gathering of whatever fresh fruit you have growing on your property, slice the fruit, whip together an easy batter, pour over the fruit and bake, while you make the rest of the meal. No kneading, freezing and rolling of dough, which takes a lot more time.

 

 

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Cool for a short time and then serve the clafoutis warm and plain or with your favorite topping. ©Joyce Hays, Target Health Inc.

 

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We’re trying out a higher-end Napa cabernet, Merryvale, recommended by the ma?tre d’ of a very reliable restaurant. Not that we’re wine connoisseurs, by any means, but comparing this Napa “cab“ to others we like, we would stick to the others. ©Joyce Hays, Target Health Inc.

 

We had a busy hectic weekend, like most people at this time of year, lucky just to catch our breath and relax with a glass of wine at our favorite bistro.

 

This will be our last ON TARGET newsletter in 2015. 

 

We all share this chaotic planet, with seeming insurmountable problems.  If you despair that all is lost, think about the extraordinary talent of our young people, world-wide.  We leave you with videos of the unbelievably beautiful voices of two very young angelic singers.  With youthful talent like this, there is hope.

 

Wish for peace!

 

 

Nine year old Dutch opera singer, Amira Willighagen,  “O Mio Babbino Caro“, from, Gianni Schicchi by Giacomo Puccini

 

Eleven year old American, Jackie Evancho “Ombra Mai Fu“ Xerxes, by GF Handel

 

 

From Our Table to Yours!

 

Bon Appetit!