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Crab and fennel tarts (pictured above)

Prep 1 hr
Chill 1-2 hr
Cook 30 min
Makes 12

For the pastry
175g butter, diced
200g plain flour, plus extra for dusting
2 tsp grated parmesan
1 egg yolk
15ml ice-cold water
1 tsp salt

For the filling
Juice of 1 lemon
100ml olive oil
Salt and black pepper
1 fennel bulb, finely diced
20g dill (or fennel top), chopped
300g white crab meat
150g brown crab meat
10g parsley, chopped
1 pinch cayenne pepper

Heat the oven to 200C/390F/gas 6. Grease a 12-hole muffin tin with butter and sprinkle each mould with flour.

To make the pastry, rub the butter into the flour and parmesan using your fingertips or a food processor. Add the egg yolk and water, and work into a smooth dough. Chill in the fridge for at least an hour.

Roll out the pastry as thin as you can and, using a 7cm pastry cutter, cut out 12 rounds and use to line the moulds. Prick the pastry with a fork, then chill again for at least half an hour.

Blind bake the cases for 15 minutes, or until golden brown.

Whisk the lemon juice in a large bowl with the oil, salt and pepper to make a vinaigrette, then stir the chopped fennel, dill and white crab meat into the dressing.

To assemble, use a teaspoon to put the brown crab meat at the bottom of the tart cases. Top with the white crab and fennel mixture on top and season with cayenne pepper.

Egg, shrimp and caper buns

Egg shrimp and caper buns.



Egg, shrimp and caper buns. Photograph: Ola O Smit for the Guardian

Prep 30 min
Chill 1-2 hr
Cook 15 min
Makes 12

For the bun dough
7g dried yeast
600g plain flour
1 tbsp salt
375ml milk
40g butter
40g caster sugar

For the filling
6 eggs
100g brown shrimp
30g capers
4 tbsp good mayonnaise
10g tarragon, chopped
Salt and black pepper

Heat the oven to 190C/375F/gas 5.

For the buns, put the yeast, flour and salt in the bowl of a stand mixer with a dough hook attached.

In a small saucepan, warm the milk, butter and sugar over a low heat until the butter is just melted. Turn on the mixer and add the warm milk to the flour until well mixed. Knead in the machine until you have a shiny dough.

Cover the bowl with clingfilm and put in a warm place to prove until doubled in size – one to two hours. Dust a work surface with flour and split the dough into 12 equal pieces, roll into balls and place on a greaseproof tray, cover with clingfilm and leave to double again in size. When ready, bake for 10-15 minutes, until golden brown.

To make the filling, boil the eggs for seven minutes and rinse under cold water. Peel the eggs and chop finely, then add the shrimp, capers, mayonnaise and tarragon, mix well, and season to taste. To serve, split and butter the buns and fill with the egg and shrimp.

Grilled flatbread, anchovy and tomato

Grilled flatbread, anchovy and tomato.



Grilled flatbread, anchovy and tomato. Photograph: Ola O Smit for the Guardian

Prep 1 hr
Rest 1-2 hr, ideally overnight
Cook 10 min
Serves 6

For the flatbreads
2½ tsp dried yeast
700ml warm water
120g yoghurt
250g wholemeal bread flour
600g bread flour
1 tbsp salt
Olive oil, for brushing

For the topping
5 ripe tomatoes
1 tsp capers
100ml olive oil
Juice and zest of ½ lemon
½ bunch parsley, chopped
Salt and black pepper
1 tin anchovy fillets in oil
Celery leaves (optional)

In a large bowl, dissolve the yeast in the warm water, then add the yoghurt. Add the flours, and salt, then mix with your fingertips until a dough forms. Cover the bowl with clingfilm and leave to rise at room temperature.

After an hour, knead the dough until it comes away from the sides of the bowl. If it looks a little wet, add a bit of flour. Cover and chill, ideally overnight; otherwise, leave to stand at room temperature until it has doubled in size.

An hour before serving, grate the tomatoes into a bowl using the large side of a box grater. Add the capers, oil and lemon juice to make a fresh tomato dressing.

Heat a griddle pan on high, then divide the dough into six portions. On a floured surface, roll out each portion into ½cm-thick rounds.

Brush the grill rack with oil, dust the flatbreads with a little more flour, then cook the breads until lightly charred on one side. Using tongs, turn over and cook one to two minutes longer, until cooked through.

Add the parsley and salt and pepper to the tomato dressing right before serving, then spread it over the breads and top with the anchovy fillets. Garnish with celery leaves, if using, and serve.

Salt cod and sweetcorn fritters

Salt cod and sweetcorn fritters.



Salt cod and sweetcorn fritters. Photograph: Ola O Smit for the Guardian

Prep 30 min
Cook 10 min
Serves 4-6

160g flour
1 pinch salt
100ml water
100ml milk
100g butter
250g whole eggs
100g sweetcorn kernels
200g salt cod, poached and flaked
1 tsp sugar
10g dried fennel seeds
1 garlic clove, peeled and grated
10g chopped parsley
1 tsp dried chilli flakes
Oil, for frying
Mayonnaise, to serve

First, make a choux pastry. Put the flour and salt in a bowl. Put the water, milk and butter in a saucepan and bring to a boil. As soon as it boils, turn off the heat. Tip in the flour and quickly start beating with a wooden spoon or electric whisk. Keep mixing until the dough is lump-free and has formed a ball that pulls away from the sides of the pan.

Beat the eggs in a separate bowl and add to the dough a little at a time, beating well until fully incorporated. When it is ready, the mixture will be shiny and smooth.

Put all the other ingredients in a bowl and slowly combine with the choux batter.

Heat the oil in a large, deep saucepan to 180C/350F. Using a tablespoon, add small dollops of the fritter mixture to the hot oil in small batches.

Fry until deep brown, turning occasionally so they cook evenly. Remove with a slotted spoon and drain on a paper-covered baking tray in the oven to keep warm.

Pork hand pies with quince mustard

Pork hand pies with quince mustard.



Pork hand pies with quince mustard. Photograph: Ola O Smit for the Guardian

Prep 1 hr
Cook 40-50 min
Makes 12

1 onion, peeled and finely diced
1 knob butter
3g black pepper
3g fennel seeds
½ tsp ground mace
1 garlic clove, peeled and minced
150ml good dry cider
380g minced pork shoulder
100g minced bacon
10g sage, chopped
10g parsley, chopped
500g all-butter puff pastry
1 egg yolk, beaten
10ml double cream

To serve
100g quince paste
50g dijon mustard

Heat the oven to 190C/375F/gas 5.

To make the filling, fry the onion in the butter until soft and sweet. Add the spices, garlic and cider, and reduce until the liquid evaporates, then set aside to cool.

Put the pork, bacon, herbs and onion mixture in a bowl, season and mix well.

Roll out the pastry to about 3mm thick. Using an 11-12cm cutter, cut out 12 rounds for the pie bases. Then, using a 6-7cm cutter, cut out 12 lids. Line a 12-hole muffin tin with the pie bases, shaping the pastry to fit the sides – it should come slightly above the rim of each mould.

Put a heaped tablespoon of the filling into each case. Mix together the beaten egg and the double cream to make an egg wash, then brush the rims with the wash and top the pies with the lids. Crimp the edges and brush the tops with more egg. Prick holes in the top of the lids with a fork, then bake for 40-50 minutes, until golden brown.

To make the quince mustard, mix the mustard with the quince paste and serve with the pork pies.

Rye crackers with whipped goat’s curd and greens

Rye crackers with whipped goat’s curd and greens.



Rye crackers with whipped goat’s curd and greens. Photograph: Ola O Smit for the Guardian

Prep 10 min
Cook 30 min
Serves 4-6

For the crackers
150g rye flour
150g plain flour
5g dried yeast
2 tsp salt
1½ tsp linseeds
300ml warm water

For the topping
500g swiss chard
200g peas
1 garlic clove, peeled and thinly sliced
5g dried chilli
10g mint, chopped
10ml olive oil
150g goat’s curd
50ml milk
Juice and zest of ½ lemon

Heat the oven to 180C/350F/gas 4. Mix all the dry ingredients for the crackers in a bowl. Add the water and mix to obtain a smooth dough. Set aside to rest for 30 minutes.

Between two sheets of baking parchment, roll out the dough as thinly as possible. Peel off the top layer of parchment and bake on a baking tray for 10-12 minutes, then set aside to cool.

Separate the chard stalks from the leaves of and chop both into 5mm pieces. Cook the stalks in boiling water, then add the leaves a few minutes later. Cook until soft, remove with a slotted spoon – reserving the cooking water in the pot – and refresh in iced water.

Blanch the peas in the boiling water, then refresh in the iced water with the chard.

Fry the garlic and chilli in olive oil until golden brown. Add the chard and peas, and fry gently for another two to three minutes. Leave to cool, then stir in the mint.

Whip the goat’s curd and milk to obtain a smooth paste. Break the cracker into pieces, spread with the curd mixture, top with the greens and dress with the lemon juice and zest.

All recipes by Marksman Public House, London E2, @marksman_pub

  • Food styling: Ellie Mulligan. Prop styling: Anna Wilkins



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Walk quickly for 10 minutes, three times a day

Weight-bearing exercise (walking, running) helps to keep bones strong. Ideally, you need a mix of “feet on the ground” activity and muscle resistance such as weights, press-ups and swimming. No one knows precisely how much exercise is needed; the NHS says adults aged 19 to 64 should do at least 150 minutes of moderate-intensity aerobic activity every week. Three 10-minute periods of fast walking every day is a good target. There is little evidence that exercise prevents fractures once you have weak bones (called osteopenia if it is mild and osteoporosis if more severe), but people who keep active into old age are less likely to fall – and if you don’t fall, you are less likely to break a bone.

Don’t smoke – especially when you are young

Smoking has an impact on bone-building cells, especially in people younger than 30, who are still accumulating bone. Smokers are at increased risk of osteoporosis and fractures and stopping smoking is likely to improve bone strength. It is a complicated association: smokers may also be thinner than the healthy weight range; if you fall but have no padding, you are more likely to fracture a bone. After the menopause, women make some oestrogen – which keeps bones strong – in their fat layer. Once your ovaries stop producing oestrogen, you can’t make much of it if you don’t have any fat.

Don’t get too thin

No one is saying that it helps to be overweight; you need to be able to keep moving, of course, and the heavier you are, the more force will land on your bones if you fall. But small-framed, low-weight people have less total bone mass. As a result, losing even small amounts of weight may result in bones that break easily.

HRT helps

Women are four times more likely than men to get osteoporosis, since their levels of oestrogen fall after the menopause. Hormone replacement therapy can help maintain strong bones and prevent fragility fractures (fractures that occur on minimal force). Once you have osteoporosis, though, it is not very effective.

You don’t need calcium supplements, but consider vitamin D

Vitamin D tablets



People with a restricted diet my benefit from taking vitamin D supplements. Photograph: Alamy

A healthy, balanced diet should provide the recommended 700 millgrams a day of calcium that you need to make new bone as old bone is replaced. There is no good evidence that calcium supplements are needed if you are at low risk of osteoporosis. There has been some concern that taking extra calcium may lead to harmful deposits around the heart, increasing the risk of heart attack. The consensus is that dietary sources are preferable to supplements, except if you can’t get enough calcium from your diet because you have a condition such as Crohn’s disease that prevents adequate absorption of dietary calcium. You need about 10 micrograms a day of vitamin D for healthy bones; 90% comes from the action of sunlight on our skin and 10% from diet (such as oily fish). People who never expose their skin to sunlight or have a restricted diet may need vitamin D supplements. The NHS recommends that breast-fed babies up to one year old and all children aged one to four should have a daily supplement, while children over five and adults should consider one in the winter months.

Don’t trip up

The main risk of having thin bones is fragility fractures. Elderly people who fall and break a hip may never regain their independence. Vertebral fractures may be silent initially, but tend to recur and can become multiple and extremely painful and disabling. One of the most useful things you can do for a frail relative or friend is check their home for potential hazards such as loose carpet. Occupational therapy assessment, to fit hand rails to steps and baths, can be accessed via local authority websites or a GP referral.

Know your risk

You are at increased risk of osteoporosis if you are elderly, female, underweight or immobile; if you have had previous fractures; and if you smoke, drink a lot of alcohol (more than 30 units a week) or take steroids for a condition such as rheumatoid arthritis. You can do your own risk assessment (there is a useful risk calculator on the University of Sheffield’s website). In some cases, a bone density scan is useful. This can be arranged by your GP, but the scan needs to be taken in context of your overall risk. If you are at high risk, you will probably be advised to have treatment to build up your bones, even if the scan is normal.

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For an essential guide to the city, sign up for How to Boston, Boston.com’s weekly culture and lifestyle newsletter.

Dinner-only upstairs Mooncusser Fish House and the more casual ground floor Moon Bar opened last July in the triangular building where Stuart Street, Arlington Street, and Columbus Avenue meet in the Back Bay. Mooncusser has been earning its seafood street cred since; Yankee Magazine’s editors recently named its seafood the best of Boston and Cambridge in the publication’s 2018 Editors’ Choice Awards.

Now, a new ingredient has been added to the equation. As of Monday, during weekday lunch hours, Moon Bar’s big, circular bar morphs into a luncheon counter, and a takeout window on Stuart Street opens up. Both serve roast beef sandwiches, lobster rolls, chowder, swordfish souvlaki, and seasonal salads.

The new joint is called Cusser’s Roast Beef and Seafood, and it’s not a pop-up, nor something co-owners Ian Calhoun, Carolyn Johnson, and Vincent Vela (who also head 80 Thoreau in Concord) did on a whim with the warm spring weather.

“It was always in our original design plans,” said Calhoun after the first lunchtime service Monday. “We wanted to use the winter to plan for using the window efficiently. We did a lot of testing and development. We would have opened it in April, but we were slow and so was the spring. I think this is perfect timing.”

The takeout window is the finishing touch to the Cusser’s concept, which is playfully inspired by North Shore-style casual roast beef and seafood spots. Calhoun said that coming from a fine dining background and not a fast food one meant doing some real legwork.

“In March I worked at my friend’s pop-up delis in Los Angeles,” he said. “We want to get it right.”

Whoopie pies at Cusser’s. —Brian Samuels Photography

While there’s plenty of fish on the lunch menu, the new twist comes courtesy of the roast beef sandwiches, which are served in two styles: a North Shore classic (barbecue sauce, mayo, cheese), and one that emulates 80 Thoreau’s spicy sauced burger (spicy mayo, pickled red onions, and cheddar).

Calhoun said this new direction fits the Mooncusser concept. Mooncussers were 18th-century shipwreckers who worked on land along the New England coast, luring ships onto rocks with fake beacons.

“Roast beef and seafood are rooted in the area that we’re in. But also, a mooncusser is a shipless pirate, so it makes sense he might be eating roast beef,” Calhoun laughed.

Cusser’s Roast Beef and Seafood is open from 11:30 a.m. to 2 p.m. Mondays through Fridays.

Cusser’s Roast Beef and Seafood, 304 Stuart St., Boston; cussersroastbeefandseafood.com

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Don’t forget your bug repellant as you make your summer plans.

The Centers for Disease Control and Prevention said in a report last week that the number of illnesses caused by mosquito, tick, and flea bites more than tripled in the United States between 2004 and 2016.

“Zika, West Nile, Lyme, and chikungunya—a growing list of diseases caused by the bite of an infected mosquito, tick, or flea—have confronted the U.S. in recent years, making a lot of people sick. And we don’t know what will threaten Americans next,” CDC Director Robert R. Redfield said in a statement. “Our Nation’s first lines of defense are state and local health departments and vector control organizations, and we must continue to enhance our investment in their ability to fight against these diseases.”

Local experts began cautioning in early April that ticks alone in particular would be a headache for New Englanders this spring and summer.

To learn more about the risks for tick, mosquito, and flea-borne diseases Massachusetts residents face, we turned to Deputy State Epidemiologist and State Public Health Veterinarian Dr. Catherine Brown and Dr. Linden Hu, associate chief for research in the Division of Geographic Medicine and Infectious Disease at Tufts Medical Center.

Here’s what they say Bay State residents should be on guard for as the ticks, mosquitos, and fleas emerge with the warm weather.

Illness from ticks is of the most concern in Massachusetts

Brown said she hopes most residents of the commonwealth are already aware that diseases carried by ticks are a “significant problem” in Massachusetts.

“The CDC findings really aren’t new,” she said. “They’re all based on data that are imported from the different states, and, in Massachusetts, we’ve recognized for a very long time that tick-borne diseases have been on the rise for decades now.”

Every year Massachusetts can be expected to have a “bad tick year,” Brown said, given the large number of blacklegged ticks in the state and that a “significant percentage” of the small arachnids are carrying disease.

It’s estimated that about 87,000 people a year contract Lyme disease in the state from tick bites, according to The Boston Globe.

The species of tick that carries Lyme disease —  the blacklegged tick (sometimes called the deer tick) — carries at least five different illnesses, according to Brown. Lyme is just the one with the greatest number of cases. The next two most common diseases carried by the blood-suckers are anaplasmosis and babesiosis.

As for the other diseases carried by mosquitoes and fleas that are mentioned by the CDC? She said illnesses from flea bites aren’t a problem in Massachusetts, but the state does have to worry about two mosquito-borne diseases.

“We have both West Nile virus and Eastern equine encephalitis — or Triple E,” Brown said. “Those are two things we talk about with the public every summer. But if you want to talk about true burden of disease and you compare just flat out the number of cases that we have in Massachusetts, just individual patients that have a disease carried by a mosquito versus numbers of patients that have a disease carried by a tick, the ticks win, unfortunately.”

Hu said that while Lyme might be the most prevalent in Massachusetts “by far” of the bite-transmitted diseases flagged by the CDC, he’s most concerned about the illnesses that don’t have treatment options, even if they’re not common in the state.

“Luckily we have treatments for many of these diseases,” he said. “The ones that are devastating — the ones we don’t have treatments for here in Massachusetts are Eastern equine encephalitis, deer tick virus, which is a new one that is luckily still very rare in Massachusetts but it’s increasing, and West Nile virus.”

The symptoms residents should look for with tick-borne diseases

A deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown. —Victoria Arocho / Associated Press

Brown said the most common symptoms to watch for with Lyme disease, anaplasmosis, and babesiosis are fever, chills, headaches, and muscle aches.

“Really all of the diseases carried by ticks start out the same way,” she said.

More specific symptoms develop for each illness as they progress, but she said each of the diseases start with those four.

“If you know that you have been bitten by a tick or you know you’ve been spending time outdoors during the months of April through November/December and you develop a fever, headache, chills, muscle aches, it’s a good idea to go ahead and contact your health care provider to talk to them about your potential risks,” Brown said.

With Lyme disease you may also see a rash around the site of the bite.

“It may or may not look like a classic bullseye,” she said. “But that’s really the only thing that can help differentiate Lyme disease from some of the other early stages of disease.”

Brown said that unless ticks are buried under snow — or the temperature is below freezing — the arachnids can be out and active, meaning the season for ticks in Massachusetts can last from April through November or December.

“Our peak tick season, when we see the largest number of our tick-borne-disease cases, really occurs in May through August,” she said.

What you can do to protect yourself

Brown said residents in Massachusetts should not be be afraid to go outside over ticks and the illnesses they can transmit.

“What’s appropriate is not fear, but awareness,” she said. “Knowing that ticks are in the environment but that there are also tools that people can use that will help people protect [themselves].”

There’s a “laundry list” of actions people can take to protect themselves from tick bites, which includes wearing pants and long-sleeve shirts when doing yard work, Brown said.

But the two particular measures recommended by the public health official are using an insect repellent with an EPA-registered active ingredient like Deet and performing a daily tick check after taking a shower or bathing your child.

“The reason for that is that way you can find any tick that has become attached, that you find it quickly and you can remove it promptly,” she said. “The shorter the amount of time that the tick has been attached, the less likely it is to have spread disease.”

Hu also recommended showering within a few hours anytime you think you’ve been exposed to ticks.

“If you shower within two hours of walking your dog or gardening, the ticks take a while to attach and bite, and, if you shower early, they just wash right off,” he said. “So that’s really easy to do. It’s been shown in studies to prevent disease.”

He also suggested buying clothing that is embedded with Permethrin repellent, which is both anti-tick and anti-mosquito.

“It doesn’t work 100 percent, but, again, you don’t have to think about it, it doesn’t make you smelly,” Hu said. “If you buy the commercially embedded clothing, it lasts for 80 washes or so, so something where you don’t have to think about it.”

How to check for ticks if they’re as small as poppy seeds

The CDC recently shared a photo illustrating just how small ticks can be by placing the insects on a poppy seed muffin.

“Can you spot all 5 ticks in this photo?” the federal agency asked.

Hu suggested the best way to check for ticks if you’re concerned you won’t be able to spot a poppy seed-sized blood-sucker is to run your fingers over your skin and feel for abnormal bumps.

“They do tend to like to hide in the tight areas where either clothing is tight against or the skin folds to make a nice enclosed area for them,” he said. “So that is where they tend to feed — like along the belt line and in the groin area, along the scalp and the ear for children. So as you’re showering, just take a feel through to make sure you don’t feel any unusual bumps.”

Brown agreed.

“You’re feeling for something very subtle, even as small as a poppy seed, but, if you feel that bump, then you know you should take a closer look at that and see if it’s a tick,” she said. 



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As the parent of any teen will know, young adults are highly attuned to trends — be it a clothing brand, the latest Youtuber, or an app — especially if they think their peers are involved. However, in the last few years, these fast-emerging trends have included novel drugs.

“Synthetic” versions of prohibited drugs are ones that have been chemically altered to evade laws banning their sale and use. As law enforcement and legislation race to keep up with the labs involved in the drug trade, new drugs are constantly being developed to feed the demand from people struggling with addiction — or kids wanting to be part of the next big thing.

Synthetic marijuana, first known as “Spice” or “K2”, is created by spraying various chemicals — some known as “cannabinoids” — on to incense or other dried plant materials. The product is then smoked. Packets are purchased online and at some convenience stores, even though synthetic marijuana is banned in Florida.

Dr. Wendy Stephan.jpg

Wendy Stephen, Ph.D., is a health education coordinator for the Florida Poison Information Center at University of Miami/Jackson Memorial Hospital.

Recently, poison centers in the Midwest sounded the alarm about three deaths associated with synthetic marijuana. The deaths in Illinois were associated with the contamination of these drugs with brodifacoum — a chemical commonly used as rat poison. This poison caused serious bleeding disorders (bruising, bleeding gums, blood in the urine or vomit) that led to over 100 hospitalizations and the need for prolonged treatment. Florida’s Poison Centers recently treated the first Florida case of exposure to brodifacoum, and there may be more before the source of the product is identified.

It is not clear why the poison was added to the drug, although researchers believe it was done intentionally. Even though the rat poison epidemic has most recently dominated the news, synthetic marijuana can have unpleasant effects on its own. In the past few years, the Florida Poison Information Center at University of Miami/Jackson Memorial Hospital has treated cases of people exposed to “fake weed.” These patients’ symptoms have ranged from agitation and rapid heart rate to vomiting and seizures.

The chemical in regular marijuana that causes a “high,” tetrahydrocannabinol (THC), has weak bonds to receptors in the brain whereas the synthetic versions can be hundreds of times more potent. Synthetic marijuana products have been found to contain a wide range of active chemicals and concentrations. These drugs have not been well studied in humans, so researchers do not yet know their long- or short-term effects on regular users. People who use these drugs are essentially experimenting on themselves. This is particularly concerning for young adults, whose brains continue to develop well into their 20s.

The good news is that the popularity of synthetic marijuana with Florida youth has declined sharply in recent years. According to the 2017 Florida Youth Substance Abuse Survey, only 3.5 percent of high school students report using it, compared with 13 percent back in 2012 right after it first appeared. E-cigarettes remain in fashion with about 31 percent of surveyed high school students reporting vaping in some form. Recent research indicates that teens may not know if the e-juice they are buying contains nicotine, a highly addictive substance. Some teens use e-cigs to vape THC or other illicit substances.

The current crisis highlights the need to talk to teens, and even tweens, about the dangers of novel drugs, both due to the risk of contamination but also the use of untried chemicals. As with any illegal drug, there is no going back for a refund and no suing the manufacturer for a bad experience or catastrophic medical expenses. Talk to children about the risks of novel drugs and encourage them to be smart consumers in general. Urge them to ask question and do some research.

As parents, you can also do some digging. Ask questions when you hear your kids talking about a substance you have never heard of. Ask what drugs your teen is hearing about online or in the hallways at school. Keep the door open to discussions about drugs to demystify the subject. After all, if parents know about it, it isn’t cool anymore!

The poison control center at University of Miami/Jackson Memorial Hospital is available 24 hours a day, seven days a week to answer questions about any type of drug, supplement or chemical. Calls to 1-800-222-1222 are confidential and free. Poison specialists are among the first to hear about the new drugs on the market and their effects. Make use of this important resource to help keep your family safe from this epidemic — and the next.

Wendy Stephen, Ph.D., is a health education coordinator for the Florida Poison Information Center at University of Miami/Jackson Memorial Hospital. For more information, visit UHealthSystem.com/patients/pediatrics.

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Almost 40% of Americans are more anxious than they were at this time last year, according to a new American Psychiatric Association (APA) poll.

The APA surveyed 1,000 U.S. adults about their sources and levels of anxiety, and found that 39% reported being more anxious than they were at this time last year. Another 39% said they were equally anxious, while only 19% said they were less anxious than last year.

Approximately 40 million American adults — roughly 18% of the population — have an anxiety disorder, according to the Anxiety and Depression Association of America.

Safety, health and finances seemed to be the greatest sources of anxiety, according to the APA poll. Sixty-eight percent of respondents said “keeping myself or my family safe” and “my health” made them either somewhat or extremely anxious. Sixty-seven percent said the same of “paying my bills or expenses.” Politics and interpersonal relationships followed at 56% and 48%, respectively.

Even as anxiety spiked, however, few respondents said they had sought out mental health care — despite the fact that 86% strongly or somewhat agreed that mental health has an impact on physical health, and half agreed that stigma associated with mental illness has decreased over the last decade. Only 28% said they had seen a mental health professional of any kind.

Fifty-eight percent, however, said they felt they had very or somewhat adequate mental health coverage under their current insurance plan. Only 12% felt their coverage was “not that adequate” or “not adequate at all.” Eighty-one percent said they would know how to access mental health care if they needed it.

The spike in anxiety is perhaps unsurprising, given past APA research that has found significant numbers of Americans also consider themselves stressed. As of December 2017, 63% of Americans said the future of the nation was a significant source of stress, and 59% felt that “the United States is at the lowest point they can remember in history,” according to the APA’s “Stress in America” survey.

Correction: The original version of this story misstated the name of the group that conducted the poll. It is the American Psychiatric Association, not the American Psychological Association.

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The Centers for Disease Control and Prevention (CDC) may have just ruined poppy seed muffins for the internet after replacing the seeds with tiny ticks in a photo the organization posted on Twitter.

At first glance, a photo shared by the CDC appeared to be a delicious muffin. But in another zoomed-in photo attached to the post, the health organization replaced the poppy seeds with tiny bugs.

“Ticks can be the size of a poppy seed. Can you spot all 5 ticks in this photo? Learn how to prevent tick bites,” the CDC tweeted on May 4, linking to an article on tick prevention on its website.

The article explains how to avoid ticks by using repellant, avoiding wooded areas and provided instructions on how to wash your clothes after spending a day outside. While the tips may be helpful, some Twitter users didn’t enjoy the “gross” imagery used by the site to capture their attention.

The tweet went viral with more than 1,500 retweets and the group received dozens of responses from users — some of whom claimed the post ruined the treat for them.

“Ugh I will never be able to eat poppy seed again,” one Twitter user complained.

“Staying away from them both after this tbh,” another wrote.

“They did not need to implicate the muffin to make their point,” one user argued.

“Wow, the CDC’s muffin-prevention movement is effective,” one woman added.

The CDC heard the complaints, replying three days later, on May 7: “Sorry we ticked some of you off! Don’t let a tick bite ruin your summer. Protect yourself.”

Again, the CDC linked to a post on its website about tick prevention. All jokes aside, health officials say it’s important to remain aware of the risks.

The number of illnesses caused by infected mosquitoes, ticks or fleas tripled from 2004 through 2016, according to a recent report released by the CDC. On average, 30,000 cases of Lyme disease are reported to the health agency each year.

Some Twitter users thanked the CDC for raising awareness.

“Important issue,” one user wrote.

“They just want to give you an idea of just how small they are, nothing to do with eating them!” another explained to a confused follower.

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SAN JOSE, Calif. (AP) – The Latest on the California gubernatorial debate (all times local):

8:10 p.m.

Democrats Gavin Newsom and Antonio Villaraigosa say they learned and grew from past adultery scandals.

The candidates for California governor were questioned about the affairs Tuesday during a televised debate in San Jose.

Also during the debate, Republican Assemblyman Travis Allen dismissed a harassment complaint filed against him as a minor issue ginned up by Democrats. He then called out Newsom for having an affair while he was mayor of San Francisco, saying “If you can’t trust Gavin with his best friend’s wife how can you trust him with your state?”

Newsom responded that Allen is a devout supporter of President Donald Trump, who’s been accused of sexual harassment.

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7:10 p.m.

Republican candidates for California governor have sparred over their competing efforts to repeal the state’s recent gas tax increase.

Huntington Beach Assemblyman Travis Allen and businessman John Cox both claim to be the strongest opponent of the 12-cent-per-gallon increase approved by the Legislature last year.

During Tuesday’s televised debate in San Jose, Allen said he was the first to launch an initiative drive against the gas tax.

Cox said his initiative was the only one to get enough signatures to qualify for the ballot. Elections officials are currently verifying the validity of those signatures to see whether voters will decide the issue in November.

Meanwhile, Democratic front runner Gavin Newsom says fixing roads requires more money, not less.

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7 p.m.

The leading candidates for California governor are calling for bold action to address the state’s epidemic of homelessness and its rising housing costs.

The candidates sparred in a San Jose debate televised statewide on Tuesday.

Republican Travis Allen called for tough enforcement of loitering restrictions and other laws to crack down on the homeless. He also said people living on the street should be housed in state institutions.

Democrats called for more support services to help people facing homelessness address addiction and mental health issues and find permanent homes.

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12 a.m.

California’s top-two primary has created new incentives for odd political alliances.

The Democratic front-runner, Gavin Newsom, has a new ad attacking Republican rival John Cox as an ally of President Donald Trump and the NRA. It’s just the kind of message that could benefit Cox as he seeks to consolidate Republican voters ahead of the June 5 primary.

All gubernatorial candidates are on the same primary ballot and the top two, regardless of party, advance to the November runoff. That means candidates aren’t staying in their Republican or Democratic lanes as they would in a traditional primary.

Newsom wants to face a Republican. But Cox is locked in a struggle for second place with former Los Angeles Mayor Antonio Villaraigosa, a Democrat.

The three, alongside Republican Travis Allen and Democrats John Chiang and Delaine Eastin will be on stage Tuesday for a debate.

Copyright © 2018 The Washington Times, LLC.

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BOSTON (Reuters) – Jazz Pharmaceuticals Plc said on Tuesday it had agreed to pay $57 million to resolve a U.S. probe into its financial support of charities that offer assistance to Medicare patients seeking help to cover out-of-pocket drug costs.

The drugmaker said in a filing with the U.S. Securities and Exchange Commission that it reached an agreement in principle with the U.S. Justice Department to pay the sum as part of a civil settlement.

Jazz, which produces the expensive narcolepsy drug Xyrem, said in the filing it could not guarantee its efforts to reach a final settlement would be successful.

The drugmaker has a program aimed at ensuring its compliance with applicable legal and regulatory requirements for pharmaceutical companies, including requirements relating to support of organizations providing financial assistance to Medicare patients, Jazz told Reuters in an emailed statement.

The company is among more than a dozen pharmaceutical manufacturers that have disclosed receiving subpoenas seeking for information related to their support of patient-assistance charities.

Drug companies are prohibited from subsidizing co-payments for patients enrolled in the Medicare government healthcare program for the elderly. But companies may donate to nonprofits providing co-pay assistance as long as they are independent.

The U.S. Attorney’s Office in Massachusetts has been leading the industry-wide investigation.

In December, it announced a $210 million settlement with United Therapeutics Corp to resolve claims it used a charity as a conduit to illegally cover Medicare patients’ out-of-pocket costs in order to eliminate price sensitivity and boost sales.

Reporting by Nate Raymond in Boston; additional reporting by Kanishka Singh in Bengaluru Editing by Sandra Maler and Peter Cooney

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Supermarket shelves are rife with high-protein snacks these days, but while these can be a decent option in a pinch, there’s no need to subject yourself to the expense of shop-bought snacks because they’re absurdly easy to make yourself.

This recipe is a great example of how little effort snack prep can be. Once you get to the directions bit you’ll see there are only two steps, and even then we’ve had to stretch it a bit because a one-step method just looks silly. Stick everything in a blender, let it set for a few hours. You’re done.

A batch of balls should keep well in Tupperware in your office fridge so you have a go-to snack for the working week. While others succumb to the temptations of biscuits, chocolate bars and crisps you’ll be sitting pretty with your protein balls – which are also high in fibre, making them effective at delaying hunger pangs.

All the ingredients in the recipe have been selected for your health and/or your tastebuds. Peanut butter is a good source of monounsaturated fats, and it’s also packed with protein and fibre. Oats are a source of beta-glucans, a soluble fibre that can lower cholesterol via its interaction with the bacteria in your gut. Agave honey adds sweetness, but it’s low-GI, so it doesn’t have the fat-storing effect of other sweet foods that contain sucrose. Add some vanilla protein powder to all of the above and you’re two steps away from a delicious high-protein snack. Don’t like vanilla? No problem, pretty much any flavour of protein powder will work in this recipe – mocha powder in particular goes down a treat if you pair your snack with your mid-morning coffee.

Ingredients (Makes 10-12 Balls)

  • 180g peanut butter
  • 90g agave honey
  • 1 scoop of vanilla or other protein powder
  • 45g porridge oats

Method

  1. Mix all the ingredients together in a food processor (or by hand in a bowl) and form into walnut-sized balls.
  2. Place the balls in the fridge for a couple of hours until they harden.

Nutritional Information (Per Ball)

Calories 133
Protein 5g
Fat 8g
Carbohydrates 12g

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