Kuo Ping Yu, a Dearly Loved Friend and Employee, Has Passed Away

 

Kuo Ping Yu, a very dear friend of Joyce Hays and Jules Mitchel, and father of Mimi Yu, who has been at Target Health for over 10 years, has passed away. Those of you who knew Kuo Ping, knew his smile and commitment to his family and to our company. Kuo Ping Yu was with THI for over 13 years and we knew he was a very special person the first time we met him, and indeed he was. We told him, he would bring us luck. When he brought us, after a trip to Hong Kong with his family, a twenty (or more) pound jade fish, we knew we were right. This precious jade sculpture, still in a place of honor, reminds us of our dear friend, each day.

 

Our thoughts and prayers are with the Yu family during this very difficult time. A bamboo plant that Kuo Ping gave us to commemorate our new office  at 261 Madison when we moved in right after 9/11, still faces south towards the new World Trade Center. You will be greatly missed, KP Yu, by many. We will never forget you. Peace be with you, dear Kuo Ping.

 

Target Health a Finalist for SCRS Eagle Award as One of Top CROs that Sites Like to Work With

 

The Society for Clinical Research Sites (SCRS) has informed Target Health that for the 3rd year in a row it has been recognized as a finalist of the SCRS Eagle Award. This nomination is truly an accomplishment since it comes directly from the clinical research sites. Once again, since we are competing with the large and even publically traded companies, we trust that any asymmetry will be taken under consideration.

 

In terms of the SCRS Eagle Award, each year the SCRS conducts a survey from the sites’ perspective to determine the sponsor and CRO that sites find most desirable to work with. This year, the SCRS Eagle Award Survey reached the entire SCRS membership of over 3,000 sites in 49 countries. CRO finalists include INC Research, Medpace, PRA, Quintiles, and Target Health. Sponsor finalists include Amgen, Eli Lilly, GlaxoSmithKline, Merck, Nektar, Novartis, Novo Nordisk, and Pfizer.

 

Finalists were selected from nominations provided by SCRS members. Qualifying nominees are in the 75th percentile or higher of the total nominations submitted for the Eagle Award. Voting is then open to all sites globally, SCRS members and non-members. Winners will be honored at the 2016 SCRS Eagle Award Gala on Saturday, October 15th, in Boca Raton, Florida during the 11th Annual Global Site Solutions Summit.

 

For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 165). 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, and if you like the weekly newsletter, ON TARGET, you’ll love the Blog.

 

Joyce Hays, Founder and Editor in Chief of On Target

Jules Mitchel, Editor

 

QUIZ

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Climate Change & Human Health in the US

American Southwest: Global Change.gov

 

This map summarizes the number of times over the past 30 years that each state has been affected by weather and climate events that have resulted in more than a billion dollars in damages. The Southeast has been affected by more billion-dollar disasters than any other region. The primary disaster type for coastal states such as Florida is hurricanes, while interior and northern states in the region also experience sizeable numbers of tornadoes and winter storms. (Figure source: NOAA NCDC; Global Change.gov)

 

In the American Northwest, rising summer temperatures and changing water flows threaten salmon and other fish species. Courtesy of NOAA; Global Change.gov

 

 

Climate change is a significant threat to the health of the American people and is already affecting human 1) ___. The impacts of human-induced climate change are increasing nationwide. Rising greenhouse gas concentrations result in increases in temperature, changes in precipitation, increases in the frequency and intensity of some extreme weather events, and rising sea levels. These climate change impacts endanger our health by affecting our food and water sources, the 2) ___ we breathe, the weather we experience, and our interactions with the built and natural environments. As the climate continues to change, the risks to human health continue to grow.

 

Current and future climate impacts expose more people in more places to public health threats. Already in the US, we have observed climate-related increases in our exposure to elevated temperatures; more frequent, severe, or longer-lasting extreme events; degraded air quality; diseases transmitted through food, water, and disease vectors (such as ticks and mosquitoes); and stresses to our mental health and well-being. Almost all of these threats are expected to worsen with continued climate change. Some of these health threats will occur over longer time periods, or at unprecedented times of the year; some people will be exposed to threats not previously experienced in their locations. Overall, instances of potentially beneficial health impacts of climate change are limited in number and pertain to specific regions or populations. For example, the reduction in cold-related deaths is projected to be smaller than the increase in 3) ___-related deaths in most regions.

 

Every American is vulnerable to the health impacts associated with climate change. Increased exposure to multiple health threats, together with changes in sensitivity and the ability to adapt to those threats, increases a person’s vulnerability to climate-related health effects. The impacts of climate change on human health interact with underlying health, demographic, and socioeconomic factors. Through the combined influence of these factors, climate change exacerbates some existing health threats and creates new public health challenges. While all Americans are at risk, some populations are disproportionately vulnerable, including those with low income, some communities of color, immigrant groups (including those with limited English proficiency), Indigenous peoples, children and pregnant women, older adults, vulnerable occupational groups, persons with disabilities, and persons with preexisting or chronic medical conditions.

 

The Midwest has a highly energy-intensive economy with per capita emissions of greenhouse 4) ___ more than 20% higher than the national average. The region also has a large and increasingly utilized potential to reduce emissions that cause climate change. A longer frost-free season increases stress on crops. Most of the Midwest’s population lives in urban environments. Climate change may intensify other stresses on urban dwellers and vegetation, including increased atmospheric pollution, heat island effects, a highly variable water cycle, and frequent exposure to new pests and 5) ___. Further, many of the cities have aging infrastructure and are particularly vulnerable to climate change related flooding and life-threatening heat waves. The increase in heavy downpours has contributed to the discharge of untreated sewage due to excess water in combined sewage-overflow systems in a number of cities in the Midwest.

 

Global sea level rose about eight inches in the last century and is projected to rise another 1 to 4 feet in this century. Large numbers of southeastern cities, roads, railways, ports, airports, oil and gas facilities, and water supplies are vulnerable to the impacts of sea level rise. Major cities like New Orleans, with roughly half of its population below sea level, Miami, Tampa, Charleston, and Virginia Beach are among those most at risk. As a result of current sea level rise, the coastline of Puerto Rico around Rincon is being eroded at a rate of 3.3 feet per year. Puerto Rico has one of the highest population densities in the world, with 56% of the population living in coastal municipalities. Sea level rise and storm surge can have impacts far beyond the area directly affected. 6) ___ level rise combines with other climate-related impacts and existing pressures such as land subsidence, causing significant economic and ecological implications. According to a recent study co-sponsored by a regional utility, coastal areas in Alabama, Mississippi, Louisiana, and Texas already face losses that annually average $14 billion from hurricane winds, land subsidence, and sea level rise. Losses for the 2030 timeframe could reach $23 billion assuming a nearly 3% increase in hurricane wind speed and just under 6 inches of sea level rise. About 50% of the increase in losses is related to climate change. Louisiana State Highway 1, heavily used for delivering critical oil and gas resources from Port Fourchon, is sinking, at the same time sea level is rising, resulting in more frequent and more severe 7) ___ during high tides and storms. A 90-day shutdown of this road would cost the nation an estimated $7.8 billion.

 

Freshwater supplies from rivers, streams, and groundwater sources near the coast are at risk from accelerated saltwater intrusion due to higher sea levels. Porous aquifers in some areas make them particularly vulnerable to saltwater intrusion., For example, officials in the city of Hallandale Beach, Florida, have already abandoned six of their eight drinking 8) ___ wells. Climate change will alter Northwest forests in addition to California 9) ___ by increasing wildfire risk, insect and disease outbreaks, and by forcing longer-term shifts in forest types and species. Many impacts will be driven by water deficits, which increase tree stress and mortality, tree vulnerability to insects, and fuel flammability. By the 2080s, the median annual area burned in the Northwest would quadruple relative to the 1916-2007 period to 2 million acres (range 0.2 to 9.8 million acres) under a scenario that assumes continued increases in emissions through mid-century and gradual declines thereafter.

 

The Southwest produces more than half of the nation’s high-value specialty crops, which are irrigation-dependent and particularly vulnerable to extremes of moisture, cold, and heat. Reduced yields from increasing temperatures and increasing competition for scarce water supplies will displace jobs in some rural communities. Heat waves, heavy downpours, and sea level rise pose growing challenges to many aspects of life in the Northeast. Infrastructure, agriculture, fisheries, and ecosystems will be increasingly compromised. Many states and cities are beginning to incorporate climate change into their 10) ___planning.

 

Surface temperatures in New York City on a summer’s day show the “urban heat island,“ with temperatures in populous urban areas being approximately 10?F higher than the forested parts of Central Park. Dark blue reflects the colder waters of the Hudson and East Rivers. (Figure source: Center for Climate Systems Research, Columbia University);

Global Change.gov

 

 

In recent years, scientific understanding of how climate change increases risks to human health has advanced significantly. Even so, the ability to evaluate, monitor, and project health effects varies across climate impacts. For instance, information on health outcomes differ in terms of whether complete, long-term datasets exist that allow quantification of observed changes, and whether existing models can project impacts at the timescales and geographic scales of interest. Differences also exist in the metrics available for observing or projecting different health impacts. For some health impacts, the available metrics only describe changes in risk of exposure, while for others, metrics describe changes in actual health outcomes (such as the number of new cases of a disease or an increase in deaths). There is a growing risk that climate change poses to human health in the United States.

 

September 2016 Obama On Climate Change

Obama interviewed by NYTimes 09/08/16

health; 2) air; 3) heat; 4) gases; 5) diseases; 6) Sea; 7) flooding; 8) water; 9) forests; 10) urban

 

James Hansen, Climate Guru, Cares About Public Health

 

Editor’s note: Target Health Inc. supports all efforts to solve the world’s greatest problem, the global emergency, Climate Change. Among many issues, climate change affects human health, hence, readers will continue to find news regarding climate change, in our weekly newsletter, ON TARGET.

 

James Edward Hansen (born 29 March 1941) is an American adjunct professor in the Department of Earth and Environmental Sciences at Columbia University and formerly at NASA. He is best known for his research in climatology, his 1988 Congressional testimony on climate change that helped raise broad awareness of global warming, and his advocacy of action to avoid dangerous climate change. In recent years he has become a climate activist to mitigate the effects of climate change, on a few occasions leading to his arrest. In 2000, Hansen advanced an alternative view of global warming, arguing that the 0.74+0.18oC rise in average global temperatures over the previous 100 years had been driven mainly by greenhouse gases other than carbon dioxide, such as methane. However, even then he supported limiting CO2 emissions “because the future balance of forcings is likely to shift toward dominance of CO2 over aerosols.“

 

Hansen was born in Denison, Iowa to James Ivan Hansen and Gladys Ray Hansen. He was trained in physics and astronomy in the space science program of James Van Allen at the University of Iowa. As a college student at the University of Iowa, Hansen was attracted to science and the research done by James Van Allen’s space science program in the physics and astronomy department. A decade later, his focus shifted to planetary research that involved trying to understand the climate change on earth that will result from anthropogenic changes of the atmospheric composition. He obtained a B.A. in Physics and Mathematics with highest distinction in 1963, an M.S. in Astronomy in 1965 and a Ph.D. in Physics, in 1967, all three degrees from the University of Iowa. He participated in the NASA graduate traineeship from 1962 to 1966 and, at the same time, between 1965 and 1966, he was a visiting student at the Institute of Astrophysics at the University of Kyoto and in the Department of Astronomy at the University of Tokyo. Hansen then began work at the Goddard Institute for Space Studies in 1967. After graduate school, Hansen continued his work with radiative transfer models, attempting to understand the Venusian atmosphere. Later he applied and refined these models to understand the Earth’s atmosphere, in particular, the effects that aerosols and trace gases have on Earth’s climate. Hansen’s development and use of global climate models has contributed to the further understanding of the Earth’s climate. In 2009 his first book, Storms of My Grandchildren, was published. In 2012 he presented a 2012 TED Talk: Why I must speak out about climate change.

 

From 1981 to 2013, he was the head of the NASA Goddard Institute for Space Studies in New York City, a part of the Goddard Space Flight Center in Greenbelt, Maryland.

 

As of 2014, Hansen directs the Program on Climate Science, Awareness and Solutions at Columbia University’s Earth Institute. The program is working to continue to “connect the dots“ from advancing basic climate science to promoting public awareness to advocating policy actions. Hansen has stated that one of his research interests is radiative transfer in planetary atmospheres, especially the interpretation of remote sensing of the Earth’s atmosphere and surface from satellites. Because of the ability of satellites to monitor the entire globe, they may be one of the most effective ways to monitor and study global change. His other interests include the development of global circulation models to help understand the observed climate trends, and diagnosing human impacts on climate.

 

From Wkimedia Commons. Automated Airport Weather Station, Available Under the Creative Commons Attribution-ShareAlike License;

 

 

A typical automated airport weather station which records the routine hourly weather observations of temperature, weather type, wind, sky condition, and visibility. These surface stations are located around the world, and are used to derive a global temperature. The first GISS (NASA Goddard Institute for Space Studies) global temperature analysis was published in 1981. Hansen and his co-author analyzed the surface air temperature at meteorological stations focusing on the years from 1880 to 1985. Temperatures for stations closer together than 1000 kilometers were shown to be highly correlated, especially in the mid-latitudes, providing a way to combine the station data to provide accurate long-term variations. They conclude that global mean temperatures can be determined even though meteorological stations are typically in the Northern hemisphere and confined to continental regions. Warming in the past century was found to be 0.50.7oC, with warming similar in both hemispheres. When the analysis was updated in 1988, the four warmest years on record were all in the 1980s. The two warmest years were 1981 and 1987. With the 1991 eruption of Mount Pinatubo, 1992 saw a cooling in the global temperatures. There was speculation that this would cause the next couple years to be cooler because of the large serial correlation in the global temperatures. Bassett and Lin found the statistical odds of a new temperature record to be small. Hansen countered by saying that having insider information shifts the odds to those who know the physics of the climate system, and that whether there is a new temperature record depends upon the particular data set used.

 

The temperature data was updated in 1999 to report that 1998 was the warmest year since the instrumental data began in 1880. They also found that the rate of temperature change was larger than at any time in instrument history, and conclude that the recent El Nino was not totally responsible for the large temperature anomaly in 1998. In spite of this, the United States had seen a smaller degree of warming, and a region in the eastern U.S. and the western Atlantic Ocean had actually cooled slightly. 2001 saw a major update to how the temperature was calculated. It incorporated corrections due to the following reasons: time-of-observation bias; station history changes; classification of rural/urban station; the urban adjustment based on satellite measurements of night light intensity, and relying more on rural station than urban. Evidence was found of local urban warming in urban, suburban and small-town records. The anomalously high global temperature in 1998 due to El Nino resulted in a brief drop in subsequent years. However, a 2001 Hansen report in the journal Science states that global warming continues, and that the increasing temperatures should stimulate discussions on how to slow global warming. The temperature data was updated in 2006 to report that temperatures are now 0.8oC warmer than a century ago, and conclude that the recent global warming is a real climate change and not an artifact from the urban heat island effect. The regional variation of warming, with more warming in the higher latitudes, is further evidence of warming that is anthropogenic in origin. In 2007, Stephen McIntyre notified GISS that many of the U.S. temperature records from the Historical Climatology Network (USHCN) displayed a discontinuity around the year 2000. NASA corrected the computer code used to process the data and credited McIntyre with pointing out the flaw. Hansen indicated that he felt that several news organizations had overreacted to this mistake. In 2010, Hansen published a paper entitled “Global Surface Temperature Change“ describing current global temperature analysis.

 

Hansen has also contributed toward the understanding of black carbon on regional climate. In recent decades, northern China has experienced increased drought, and southern China has received increased summer rain resulting in a larger number of floods. Southern China has had a decrease in temperatures while most of the world has warmed. In a paper with Menon and colleagues, through the use of observations and climate models results, they conclude that the black carbon heats the air, increases convection and precipitation, and leads to larger surface cooling than if the aerosols were sulfates. A year later, Hansen teamed with Makiko Sato to publish a study on black carbon using the global network of AERONET sun photometers. While the location of the AERONET instruments did not represent a global sample, they could still be used to validate global aerosol climatologies. They found that most aerosol climatologies underestimated the amount of black carbon by a factor of at least 2. This corresponds to an increase in the climate forcing of around 1 W/m2, which they hypothesize is partially offset by the cooling of non-absorbing aerosols. Estimations of trends in black carbon emissions show that there was a rapid increase in the 1880s after the start of the Industrial Revolution, and a leveling off from 1900-1950 as environmental laws were enacted. China and India have recently increased their emissions of black carbon corresponding to their rapid development. The emissions from the United Kingdom were estimated using a network of stations that measured black smoke and sulfur dioxide. They report that atmospheric black carbon concentrations have been decreasing since the beginning of the record in the 1960s, and that the decline was faster than the decline in black-carbon-producing fuel use.

 

Hansen noted that in determining responsibility for climate change, the effect of greenhouse gas emissions on climate is determined not by current emissions, but by accumulated emissions over the lifetime of greenhouse gases in the atmosphere. By this measure, the U.K. is still the largest single cause of climate change**, followed by the U.S. and Germany, even though its current emissions are surpassed by the Peoples Republic of China [Editor’s note: The Industrial Revolution began in Great Britain]

 

The Industrial Revolution, which took place from the 18th to 19th centuries, was a period during which predominantly agrarian, rural societies in Europe and America became industrial and urban. Prior to the Industrial Revolution, which began in Britain in the late 1700s, manufacturing was often done in people’s homes, using hand tools or basic machines. Industrialization marked a shift to powered, special-purpose machinery, factories and mass production. The iron and textile industries, along with the development of the steam engine, played central roles in the Industrial Revolution, which also saw improved systems of transportation, communication and banking. While industrialization brought about an increased volume and variety of manufactured goods and an improved standard of living for some, it also resulted in often grim employment and living conditions for the poor and working classes. A number of factors contributed to Britain’s role as the birthplace of the Industrial Revolution. For one, it had great deposits of coal and iron ore, which proved essential for industrialization. Additionally, Britain was a politically stable society, as well as the world’s leading colonial power, which meant its colonies could serve as a source for raw materials, as well as a marketplace for manufactured goods. As demand for British goods increased, merchants needed more cost-effective methods of production, which led to the rise of mechanization and the factory

system.

 

Jim Hansen talk in Feb 2016

Jim Hansen Website

 

Editor’s note: We will continue to publish information about Climate Change, James Hansen and others.

 

Nondrug Approaches to Treat Common Pain

 

Millions of Americans suffer from persistent pain that may not be fully relieved by medications. They often turn to complementary health approaches to help, yet primary care providers have lacked a robust evidence base to guide recommendations on complementary approaches as practiced and available in the United States. The new review gives primary care providers — who frequently see patients with chronic pain — tools to inform decision-making on how to help manage that pain.

 

According to an article published in Mayo Clinic Proceedings. 2016;91(9):1292-1306, data from a review of U.S.-based clinical trials suggest that some of the most popular complementary health approaches — such as yoga, tai chi, and acupuncture — appear to be effective tools for helping to manage common pain conditions. The review was conducted by a group of scientists from the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health.

 

For the study, the authors reviewed 105 U.S.-based randomized controlled trials, from the past 50 years, that were relevant to pain patients in the US and met inclusion criteria. Although the reporting of safety information was low overall, none of the clinical trials reported significant side effects due to the interventions. The review focused on U.S.-based trial results on seven approaches used for one or more of five painful conditions — back pain, osteoarthritis, neck pain, fibromyalgia, and severe headaches and migraine — and found promise in the following for safety and effectiveness in treating pain:

 

— Acupuncture and yoga for back pain

— Acupuncture and tai chi for osteoarthritis of the knee

— Massage therapy for neck pain in adequate doses and for short-term benefit

— Relaxation techniques for severe headaches and migraine.

 

Though the evidence was weaker, the authors also found that massage therapy, spinal manipulation, and osteopathic manipulation may provide some help for back pain, and relaxation approaches and tai chi might help people with fibromyalgia.

 

Crowd-Sourced Data Unearths a Plethora of Depression Genes

 

It’s well known that at least some depression runs in families and some risk is inherited. Yet, prior to this study, conventional genome-wide approaches had failed to reliably identify chromosomal sites associated with the illness in populations with European roots. Since depression is thought to be like fever — common set of symptoms likely rooted in multiple causes — lumping together genetic data from people with different underlying illness processes likely washed out, or statistically diluted, subtle evidence of effects caused by risk genes.

 

According to an article published online in Nature Genetics (1 Aug 2016), for the first time ever, 15 genome sites have been discovered that can be linked to depression in people of European ancestry. Many of these regions of depression-linked genetic variation turn out to be involved in regulating gene expression and the birth of new neurons in the developing brain. For the study, the authors analyzed data already shared by people who had purchased their own genetic profiles via an online service and elected to participate in its research option. This made it possible to leverage the statistical power of a huge sample size to detect weak genetic signals associated with a diagnosis likely traceable to multiple underlying illness processes. This novel use of crowd-sourced data was confirmed with results from traditional genetics approaches in the study, funded by the National Institutes of Health.

 

To increase their odds of detecting these weak genetic signals, the authors adopted a strategy of studying much larger samples than had been used in the earlier genome-wide studies. They first analyzed common genetic variation in 75,607 people of European ancestry who self-reported being diagnosed or treated for depression and 231,747 healthy controls of similar ethnicity. These data had been shared by people who purchased their own genetic profiles via the 23 and Me website and agreed to participate in the company’s optional research initiative, which makes data available to the scientific community, while protecting privacy. The authors integrated these data with results from a prior Psychiatric Genomic Consortium genome-wide-association study, based on clinician-vetted diagnoses of more than 20,000 patients and controls of European ancestry. They then followed-up with a closer look at certain statistically suspect sites from that analysis in an independent 23 and Me “replication“ sample of 45,773 cases and 106,354 controls.

 

In all, 17 genetic variations were found that could be linked to depression at 15 genome locations. In addition to hinting at a link between depression and brain gene expression during development, there was also evidence of overlap between the genetic basis of depression and other mental illnesses. While the genome sites identified still account for only a fraction of the risk for depression, the authors noted that the results support the strategy of complementing more traditional methods with crowd-sourced data.

 

FDA Issues Final Rule on Safety and Effectiveness of Antibacterial Soaps

 

Washing with plain soap and running water remains one of the most important steps consumers can take to avoid getting sick and to prevent spreading germs to others. If soap and water are not available and a consumer uses a hand sanitizer instead, the U.S. Centers for Disease Control and Prevention (CDC) recommends that it be an alcohol-based hand sanitizer that contains at least 60 percent alcohol.

The FDA issued a final rule establishing that over-the-counter (OTC) consumer antiseptic wash products containing certain active ingredients can no longer be marketed. Companies will no longer be able to market antibacterial washes with these ingredients because manufacturers did not demonstrate that the ingredients are both safe for long-term daily use and more effective than plain soap and water in preventing illness and the spread of certain infections. Some manufacturers have already started removing these ingredients from their products.

This final rule applies to consumer antiseptic wash products containing one or more of 19 specific active ingredients, including the most commonly used ingredients – triclosan and triclocarban. These products are intended for use with water, and are rinsed off after use.  This rule does not affect consumer hand “sanitizers“ or wipes, or antibacterial products used in health care settings. The agency issued a proposed rule in 2013 after some data suggested that long-term exposure to certain active ingredients used in antibacterial products – for example, triclosan (liquid soaps) and triclocarban (bar soaps) – could pose health risks, such as bacterial resistance or hormonal effects. Under the proposed rule, manufacturers were required to provide the agency with additional data on the safety and effectiveness of certain ingredients used in over-the-counter consumer antibacterial washes if they wanted to continue marketing antibacterial products containing those ingredients. This included data from clinical studies demonstrating that these products were superior to non-antibacterial washes in preventing human illness or reducing infection.

Antibacterial hand and body wash manufacturers did not provide the necessary data to establish safety and effectiveness for the 19 active ingredients addressed in this final rulemaking. For these ingredients, either no additional data were submitted or the data and information that were submitted were not sufficient for the agency to find that these ingredients are Generally Recognized as Safe and Effective (GRAS/GRAE). In response to comments submitted by industry, the FDA has deferred rulemaking for one year on three additional ingredients used in consumer wash products – benzalkonium chloride, benzethonium chloride and chloroxylenol (PCMX) – to allow for the development and submission of new safety and effectiveness data for these ingredients. Consumer antibacterial washes containing these specific ingredients may be marketed during this time while data are being collected.

Since the FDA’s proposed rulemaking in 2013, manufacturers already started phasing out the use of certain active ingredients in antibacterial washes, including triclosan and triclocarban. Manufacturers will have one year to comply with the rulemaking by removing products from the market or reformulating (removing antibacterial active ingredients) these products.

 

Tender Fresh Veggie Salad with Tuna Sauce

Easy to make, simple healthy ingredients, and oh-h how tasty! This is an appetizer that’s so-o good, you don’t want an entre, you just want to make an entire meal of this delicious recipe. It took me a while to get the ingredients and the amounts, just right. Try it; you’ll love it! ©Joyce Hays, Target Health Inc.

 

Not only is this individual salad attractive, but it is truly delicious and was fun to create. We have been enjoying peak corn, right off the cob with no cooking necessary, for all of August, that’s how sweet it is this year. This healthy eating section will carry, during September, recipes in which fresh cob corn, is one of the key ingredients. ©Joyce Hays, Target Health Inc.

 

You can use one endive leaf or two. When you use two, it looks like a canoe filled with colorful crunchy veggies. Enjoy! © Joyce Hays, Target Health Inc.

 

 

(Recipe for two people)

 

Ingredients

 

2 fresh corn on cob, all kernels scraped from cob

1 celery stalk, from the heart of the celery, very finely chopped

4 radishes, thinly sliced

1/3 cup chopped fresh cilantro

1/2 apple, chopped into small pieces

1 hardboiled egg, use white only, chop into small pieces

1/2 black olive per person, sliced thinly, for garnish

Flat leaf parsley, chopped, for garnish

1 fat fresh asparagus: make 2 curls for garnish

2 whole endive leaves

 

Tuna Sauce Ingredients

 

1 can (7-8 oz) tuna fish in oil (not water, unless you insist)

1 fresh garlic clove

1 tablespoon anchovy paste

1 tablespoon capers

2 tablespoons fresh lemon, juice

1/4 cup extra-virgin olive oil

3 tablespoons Kraft mayonnaise

Pinch black pepper

Pinch chili flakes

 

This was a great corn year and it’s still in season. Don’t even need to cook it, it’s so sweet this year.

 ©Joyce Hays, Target Health Inc.

 

Using same cutting board for celery, egg white, radish, kale and or cilantro, etc. 

Joyce Hays, Target Health Inc.

 

Directions

 

Make the Tuna Sauce (use the last 9 items on list above)

 

1.  Put the tuna fish in a food processor.

 

2.  Add the anchovy paste, capers, lemon juice, oil. Start the food processor and turn the ingredients into a very fine, smooth paste. If the sauce is too thick, very slowly, add tiny amounts of olive oil (or 1 teaspoon) of chicken broth until you get the right consistency.

 

3. Transfer the mix to a bowl and stir in the mayonnaise, and mix until obtaining a paste.

Keep this sauce in the fridge until you’re ready to serve it.

 

Making the tuna sauce is as easy as 1 – 2 – 3! All you really need is a food processor.

©Joyce Hays, Target Health Inc.

 

 

Prepare Salad

 

Into a bowl, add the first six items on the list of ingredients, above. Stir to combine all the ingredients. Set aside until ready to serve.

 

Put all your veggies into a medium size bowl. ©Joyce Hays, Target Health Inc.

 

 

Prepare the garnishes (black olive, parsley, 2 asparagus curls) and set aside. Make curls from the whole asparagus stalk, and use the 1 or 2 curls that have part of the asparagus tip.

Clean the endive leaves and set aside.

 

Serving

 

When ready to serve, get out small salad plates. Put 1 whole endive leaf on each plate. On each endive leaf, add 1 or two tablespoons from your salad bowl. Next, add 2 or more Tablespoons of tuna sauce, over the salad. Garnish with a few slices of black olive and a tiny sprinkling of well-chopped parsley and 1 asparagus curl on each plate. Serve.

 

Getting ready to prepare each individual salad plate, using the above ingredients.

©Joyce Hays, Target Health Inc.

 

On a small appetizer or salad plate, place one or two endive leaves. Fill them with the corn

 veggie mixture. ©Joyce Hays, Target Health Inc.

 

Put a little or a lot of tuna sauce over and/or under the veggies.

©Joyce Hays, Target Health Inc.

 

Finally, on top of the tuna sauce, garnish with one thin peel of raw asparagus, and 1/2 of a thin slice of

black olive. ©Joyce Hays, Target Health Inc.

 

This past summer, mangoes were as good as it gets. We simply slurped them down.

Summer desserts consisted of bowls and bowls of this beyond yummy fruit. I can’t remember

a better summer for mangoes. ©Joyce Hays, Target Health Inc.

 

 

Save

 

Save any unused veggies and the egg yolk, for something else, like another salad the next day, or soup, or whatever you think of. Michael Pollan and many others are in the news, more and more, telling of how Americans at home, on farms, in stores and in restaurants, discard tons of usable food. Not only do we have hungry homeless Americans, but all food represents many carbon footprints, which in turn, are strongly and directly related to climate change.

 

Well chilled, Santa Margherita Pinot Grigio is a tasty reliable wine, that goes well with the

salad recipe, above. Tonight, we’re raising our glasses “Goodbye summer!“

©Joyce Hays, Target Health Inc.

 

 

From Our Table to Yours !

 

Bon Appetit!