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Differences in Central Line Associated Bloodstream Infections Prior to and During the Pandemic

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Differences in Central Line Associated Bloodstream Infections Prior to and During the Pandemic


Data has shown central line associated bloodstream infections (CLABSI) increased during the COVID-19 pandemic. However, a greater understanding of what the determinants were for this activity were not widely studied or understood.

As such, a group of investigators associated with Charlotte, NC-based Advocate Health evaluated what factors including whether race impacted risk for development of CLABSI prior to and during the COVID-19 pandemic in patients with indwelling central venous catheter (CVC).

Specifically, they conducted a retrospective cohort study across 11 acute care hospitals in the southeastern US during a study period between 2019-2021. Within this period, there was the pre-pandemic period from 1/1/2019 – 2/29/2020, and the pandemic period defined as 3/1/2020 – 12/31/2021. The data collected included demographic factors including self-reported race and ethnicity, comorbidities, COVID-19 status and central line characteristics. The primary outcome was the first CLABSI that was diagnosed during the admission.

“Of the 46,259 patients with central lines, 313 developed a CLABSI during the study period (109 pre- and 204 during- pandemic, a significant proportional increase), the investigators wrote. “Risk factors for CLABSI in the pre-pandemic period included cancer diagnosis, receipt of total peripheral nutrition (TPN) during hospital stay, intensive care unit encounter, and longer length of stay and average line days.”

Coinvestigator Catherine Passaretti, MD, vice president, Southeast Region epidemiologist, Advocate Health, and clinical professor of infectious diseases, Wake Forest University, says they witnessed differences in CLABSI between black and white patients during COVID-19. “Black patients had a higher risk of CLABSI during the pandemic that we did not see before…that difference between black and white patients really stood out for patients without COVID.”

In fact, Black patients without COVID-19 were 1.6 times (95% CI 1.09, 2.41) more likely to develop CLABSI compared to White patients, the investigators note. There were other risk factors for infection including Medicare insurance (OR 1.68), presence of a dialysis catheter (OR 1.57, or higher body mass index (OR 1.01).

Does Stress Play a Role as a Risk Factor?
In addition, the stressors placed on health care during the pandemic may have contributed to risk factors as clinicians were challenged to care for a surging public health issue.

“Health care was very different at the height of the pandemic when the study took place. So certainly, care delivery and stressors on health care, potentially contributed,” Passaretti said. “So how do we better prepare for stress in healthcare settings? How do we make sure that care provided for infection prevention, even during times of stress is equivalent across the board so we don’t lose ground?”

Passaretti believes creating best practices during these periods may be a solution to consider.

“[We need to understand] how do stress and burnout play into health care behavior, and then making sure we hardwire basic practices in even during times of stress.”



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Creamy Sausage and Potato Soup

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Creamy Sausage and Potato Soup


This website may contain affiliate links and advertising so that we can provide recipes to you. Read my disclosure policy.

Buttery yellow potatoes and flavorful Italian sausage cooked together in a creamy, herb-filled soup base. The perfect hearty recipe to warm you up from the inside-out!

Nothing compares to enjoying a warm bowl of soup when it’s chilly outside! Especially when the soup is homemade, hearty, and packed with flavor. This creamy sausage and potato soup is the perfect recipe to make, but I’ll leave these other recipes here just in case you need more tasty soups in your life. Crack chicken soup, cheeseburger soup, and 8-can taco soup!

A serving of sausage and potato soup in a stoneware bowl.

Potato and Sausage Soup

I’m a sucker for potato soup. Loaded baked potato soup, zuppa toscana, you name it! This creamy sausage and potato soup is the best addition to the list and is SO delicious. It’s nice and creamy without being too rich or heavy, and the flavor is out of this world.

The broth is chock full of fresh herbs, garlic, red pepper flakes, and parmesan cheese. If you’re not already convinced, then it has chunks of buttery petite yellow potatoes, tender carrots, and juicy Italian sausage in each bite. You need this soup in your life.

Ingredient List

This is everything that you’ll need for the most hearty, savory broth and mouthwatering texture. I know you’re going to love this creamy sausage and potato soup as much as I do, and want to have it on repeat!

  • Italian Sausage: Any type of ground Italian sausage will work! Sweet, mild, or hot, depending on your desired spice level.
  • Minced Yellow Onion: Adds sweetness and flavor.
  • Minced Garlic: So the soup has that mouthwatering savory flavor.
  • Chopped Carrots: For some extra texture and heartiness.
  • Chopped Kale: This leafy green adds a vitamin boost and extra texture.
  • Italian Seasoning: A blend of herbs like oregano, basil, and thyme for classic Italian flavor.
  • Fresh Parsley: Chopped to add herby flavor to the sausage and potato soup.
  • Red Pepper Flakes: Adjust amount for desired heat level.
  • Salt and Pepper: Season to your preference.
  • Chicken Broth: Forms the base of the soup.
  • Heavy Cream: Creates a rich and creamy texture. You can also use half and half if you’d like.
  • Petite Yellow Potatoes: These are also called baby gold potatoes. Chopped small, they add bits of hearty texture to the soup. I love their creamy, buttery texture so much!
  • Grated Parmesan: Melts into the soup for a pop of salty flavor.

How to Make Creamy Sausage and Potato Soup

Grab your soup pot and get ready to make some of this hearty, meaty goodness! It only takes 20 minutes for it all to cook up, making it a great choice for a weeknight dinner.

  1. Cook Sausage: Heat a large heavy bottom pot over medium high heat, add the italian sausage and onion and saute until the sausage is cooked through.
  2. Add Seasonings: Add in the garlic, Italian seasoning, fresh parsley, and red pepper flakes and saute for just another minute until the garlic becomes fragrant.
  3. Add Chicken Broth and Vegetables: Quarter the potatoes and add them to the pot along with the chicken broth, carrots, salt and pepper.
  4. Simmer: Bring everything to a boil then reduce the heat to low, cover and simmer until the potatoes are fork tender, about 15 minutes.
  5. Mix In Cream and Cheese: Add the heavy cream and parmesan cheese to the pot and stir, cook the kale until it wilts, about 5 minutes. Remove the soup from heat and then serve fresh!
4-photo collage of the creamy sausage and potato soup being prepared.

Cooking Tips

You know I’m all about ease and using ingredients that you already have in the fridge, so here are a few ways to customize your sausage and potato soup!

  • Other Veggies: Swap the kale for spinach or add chopped zucchini, celery, bell peppers, or broccoli for extra color and nutrients.
  • Use Half and Half: You can use half and half in place of the heavy cream. It won’t be quite as rich but still creamy! This is a great option to make your soup a little lighter.
  • More Toppings: For more flavor and texture, add chopped green onions or crumbled bacon to your sausage and potato soup.

Serve With These For Dipping!

Other Cooking Methods

  • Instant Pot: Brown the sausage and saute the veggies as usual, then toss in everything else except the cream and cheese. Pressure cook on high for 10 minutes, let the pressure release naturally, then stir in the cream and cheese.
  • Slow Cooker: Brown the sausage in a separate pan if you like, then toss it in your Crockpot with all the other ingredients (except the cream and cheese). Cover and cook on low for 6 hours. When you’re ready to eat, simply stir in the cream and cheese and serve.

Creamy sausage and potato soup in a large pot, being scooped up with a ladle.

Storing Leftover Sausage and Potato Soup

Store leftovers in the fridge in an airtight container for up to 4 days.

Reheat individual portions in the microwave for one minute intervals until warmed through, or over the stove on medium heat.

Closeup of a serving of soup.

More Tried & True Soup Recipes

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  • Heat a large heavy bottom pot over medium high heat, add the italian sausage and onion and saute until the sausage is cooked through.

  • Add in the garlic, Italian seasoning, fresh parsley, and red pepper flakes and saute for just another minute until the garlic becomes fragrant.

  • Quarter the potatoes and add them to the pot along with the chicken broth, carrots, salt and pepper.

  • Bring everything to a boil then reduce the heat to low, cover and simmer until the potatoes are fork tender, about 15 minutes.

  • Add the heavy cream and parmesan cheese to the pot and stir, cook the kale until it wilts, about 5 minutes. Remove the soup from heat and serve fresh!

Calories: 589kcalCarbohydrates: 8gProtein: 17gFat: 55gSaturated Fat: 28gPolyunsaturated Fat: 4gMonounsaturated Fat: 19gCholesterol: 155mgSodium: 1164mgPotassium: 401mgFiber: 1gSugar: 4gVitamin A: 4800IUVitamin C: 5mgCalcium: 196mgIron: 2mg

Nutrition information is automatically calculated, so should only be used as an approximation.





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To begin your coverage, make sure you pay your premium

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To begin your coverage, make sure you pay your premium


Published on December 21, 2023

To start your new 2024 Marketplace coverage, pay the first premium. This is the amount you pay every month to the health insurance company to keep your coverage.

How to pay your monthly premium to start your coverage

Follow your insurance company’s instructions on how to pay.

  • Pay online. You might be able to pay your first premium through your Marketplace account or through your insurance company.
  • If you can’t pay online, your insurance company should tell you how to pay your premium. If they didn’t, reach out to them.
  • If you aren’t sure you paid, check your Marketplace account to find out if your coverage is active.



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A Day in the Life

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A Day in the Life


By Katie M. Golden, as told to Kara Mayer Robinson

As someone living with chronic migraine, every day is different. There’s no cure for this genetic neurologic disease, but there are things I do to manage my day-to-day life.

I’m 40 years old and I live in Santa Monica, CA. I’m a professional writer and an advocate for people with chronic pain conditions. I find strength to get through my days with this personal mantra: Never let your pain go to waste.

Let me explain.

I had my first migraine attack when I was 5 years old. Throughout grade school, college, and into my professional life, I continued to have migraine attacks. During some of these periods, I definitely met the criteria for having chronic migraine disease. But I didn’t realize it until later.

Eleven years ago, I had a migraine attack that I couldn’t shake. I missed 2 straight months of work and was completely bedridden.

After 3 months, my headache specialist told me I had chronic migraine. Because I was continuously having attacks with no breaks in between, I learned it was called chronic intractable migraine, or status migraine.

In the past 11 years, I’ve had very few pain-free days. I’m never without some level of head pain and associated symptoms. 

How It Feels to Have Chronic Migraine

Light and sound sensitivity, nausea, and vomiting are what most people think of when they hear the word migraine. I wish that was all I had to deal with.

I experience:

  • Cognitive impairment
  • Loss of words
  • Trouble making decisions
  • Extreme fatigue
  • Numbness and tingling
  • Clumsiness
  • Ringing in my ears
  • Sensitivity to touch

My migraine attacks can be very painful and disabling. The pain is louder than any rock concert I’ve ever been to. My face feels like it’s melting or drooping. My body tenses up and all I can think about is getting to bed.

This can last for 4 hours or a week. When the worst of it is over, I have to push myself during the recovery period so that I can break out of the cycle.

How I Manage the Pain

I take medications and supplements every day to try to prevent my pain from spiking. I know it’s time to reach for acute medication when the pounding in my left temple and the stabbing pain behind my eyes is all I can think about. But it doesn’t always help.

About once a year, I have inpatient treatment that lasts for 5 days. My doctors give me a cocktail of medications that help to bring my average pain levels down a few notches. The effects last 6-8 months.

There are a few things I do when I’m in the thick of a horrible migraine. Getting a massage or using an at-home massage roller or ball helps. I like using essential oils like lavender or peppermint. I also love using a weighted blanket. And although it’s incredibly hard, I try to get up and walk. The sooner I start moving, the sooner I begin to feel better. 

Ups and Downs

There’s really no typical day for me. What each day is like depends on how intense my pain is and for how long. Since I have chronic intractable migraine, I always have some level of pain.

On high-functioning days, my pain is low and tolerable.

I’m most productive in the morning. I eat breakfast. I try to do some form of exercise, even if it’s just for 20 minutes. I also take medication to keep the pain level tolerable.

I may take time to write, make doctor’s appointments, or do a small amount of housework. If my pain level spikes, I may take a nap. When I wake up, I may feel a little better.

Sometimes I have bursts of energy and want to get everything done. But I’ve learned that too much activity can burn me out for days to come. I spread out my errands and household chores throughout the week.

I also try to keep a regular sleep schedule. But my head pain generally spikes at night, which can make it hard to get to sleep. I may take more medication to prevent it from getting worse and to control my symptoms for the next day.

On high-pain days, I’m lucky if I make it out of bed.

On these low-functioning days, any plans I had are thrown out the window. Leaving my apartment is out of the question. Reading, watching TV, or even looking at my phone makes it worse. I may go to sleep, hoping the pain signals stop firing while I’m resting.

Living With Unpredictability

The people closest to me know and understand the unpredictable nature of this disease. If I make plans, it’s always with the caveat that it depends on how I feel. I try not to overpromise. I still get FOMO, or fear of missing out. But I know my limitations and how my body will feel if I do too much.

How Lifestyle Changes Help

Yoga, walking, and mindfulness have helped me. But sometimes even minor physical exertion can make my pain worse.

It’s taken a long time for me to become in tune with my migraine body. It took me 2 years of working with a trainer to get back to my yoga mat and learn how to use modified versions of poses.

I can’t change the way my life is from day to day. But I try to use my experiences with chronic migraine to help others. I’m now the migraine advocacy liaison for the U.S. Pain Foundation. I’m also the director of patient relations for the Coalition for Headache and Migraine Patients (CHAMP). It comes back to my personal mantra: Never let your pain go to waste.



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Antimicrobial Stewardship in Turkey – A Clinical Pharmacist’s Perspective

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Antimicrobial Stewardship in Turkey – A Clinical Pharmacist’s Perspective


In this article, a pharmacist from Turkey with advanced training in the area of infectious diseases provides insights on antimicrobial stewardship in Turkey.

Interview with: Emre Kara, MSc., Ph.D.

Interviewer: Timothy P. Gauthier, Pharm.D., BCPS, BCIDP

Article Posted 1 August 2023

A man colonized with extensively drug resistant Acinetobacter baumannii gets on a plane. A woman colonized with pan-drug resistant Pseudomonas aeruginosa gets on a train. How many hours or days will they travel for? Where will they visit along their journey? What will be their final destination? Will they inadvertently spread their drug-resistant pathogens to other people or environments over the coming days, weeks, months, or years?

The threat of antibiotic resistance is relevant to us all and antimicrobial stewardship is necessary for all nations of the world. That is the driving force behind this series of articles which has been ongoing since 2018, bringing insights from Nigeria, India, Bangladesh, Uganda, Thailand, Japan, Costa Rica, Australia, New Zealand, Canada, Spain, and the United Kingdom. Here, we seek to learn from others and share stories of our progress on stewardship globally.

In this article we will be focusing on antimicrobial stewardship in Turkey. I had the good fortune of connecting with Dr. Emre Kara at the European Congress on Clinical Microbiology and Infectious Diseases in 2022, who lives and works in Turkey as a pharmacist practicing in the area of antimicrobial stewardship. He was open to doing this interview providing his insights on antimicrobial stewardship in Turkey and correspondence over about a year and a half led to this article.

We hope you will find it interesting, here are insights on antimicrobial stewardship in Turkey…

1. How did you get interested in antimicrobial stewardship as a pharmacist and what path did you take to reach where you are today? 

Clinical pharmacy in Turkey is still developing. The first clinical pharmacy education started with a bachelor’s degree at Marmara University in 1991 and Hacettepe University in 1994. Since 1996 at Marmara University and 2014 at Hacettepe University, academicians with a doctorate in clinical pharmacy have carried out postgraduate education. This program has later spread to the health sciences institutes of many universities. Formal postgraduate training started in 2018 (clinical pharmacy specialization training). This 3-year program consists of theoretical courses, case presentations, intensive clinical training and a thesis.

I graduated from Pharmacy in June 2014. Three months later, I started my clinical pharmacy education as one of the first six postgraduate students of Hacettepe University Faculty of Pharmacy, Clinical Pharmacy Department Master’s Program. 

In the first year, we attended clinical rounds in internal medicine wards and had theoretical courses. During our bedside patient follow-up, we ran into an infectious diseases (ID) consultant who was following some of the ward patients. We introduced ourselves and made some recommendations for a few patients. Later on, the ID consultant started to ask if we had any recommendations. After a while, we participated in the ID ward rounds with the ID consultants Dr. Unal and Dr. Inkaya. This is how my first contact with infectious diseases started.

As the second year of my master’s education was close, I was in a hurry to decide on the topic and method for my master’s thesis with my advisor (Dr. Demirkan). Considering the cases I frequently observed in the infectious diseases ward and the framework of the literature review, we thought that drug-related problems in people living with HIV were an important issue and needed to be studied. We decided to perform this study in the outpatient HIV clinic. Thus, my master’s thesis, which will continue for the next one year in the infectious disease outpatient clinic, has begun. During this period, I had the opportunity to attend many meetings, seminars, conferences and congresses on infectious diseases held both in Hacettepe Hospitals and other institutions and cities. I improved myself in infectious diseases issues.

In infectious diseases, in addition to the patient and the drug, the microorganism is the third component of the disease. The decision and research processes require analytical thinking, and the diagnosis and treatment process is similar to uncovering a mystery (like Sherlock Holmes), which was exciting. My curiosity and enthusiasm still continue. 

After completing my master’s degree, I started my doctorate education in the same department. During the first two years of my doctoral education, I attended many lectures, seminars, meetings and conferences. I also participated in ward rounds in internal medicine wards, intensive care units, adult and pediatric infectious diseases and oncology wards. For my doctoral thesis, we formed an antifungal stewardship team. We demonstrated that a pharmacist-driven antifungal stewardship program improved the quality of antifungal therapy and patient care in an institution where the use of systemic antifungals is restricted to the approval of ID physicians. The publication can be found here.

About one year after completing my doctoral thesis, I started to work as an assistant professor in the same department. I participate in the training program of our residents and several clinical projects in collaboration with the Department of Infectious Diseases. 

2. What is the status of antimicrobial stewardship in Turkey, based on what you see in your practice

Antimicrobial stewardship in Turkey, like clinical pharmacy, is still an emerging field of science. Almost all of our hospitals have an infection control committee and a rational drug use committee, but many of them do not actively offer antimicrobial stewardship. The number of hospitals in our country with a structured and active antimicrobial stewardship team is quite limited. The concept of antimicrobial stewardship is relatively new in Turkey. In our hospital, local algorithms were developed, and the morning report application was launched in 2019. In 2021, the implementation of a comprehensive audit and feedback for antimicrobial treatments was initiated under the leadership of Dr. Uzun, and samples of antimicrobial treatments were selected and evaluated (still ongoing). Studies will be planned for de-escalation and iv-oral switch programs for antimicrobials.

In addition, an antimicrobial stewardship committee was founded in 2022. This committee has an infectious diseases physician, infection control physician, chief physician, chief pharmacist, clinical pharmacist (myself), infection control nurse, and participants from hospital administration. Meetings are held approximately every three to six months, and studies are carried out to solve the problems in antimicrobial management. 

The use of many antimicrobial drugs has been restricted, including cefepime, piperacillin-tazobactam, meropenem, vancomycin, teicoplanin, linezolid, daptomycin, voriconazole, posaconazole, amphotericin B. Infectious diseases physicians’ approval is required to initiate or continue treatment with these drugs. This restriction is actually a helpful tool for antimicrobial stewardship. 

In our country, important steps have been taken to limit the use of antimicrobial drugs not only in hospitals but also outside the hospital. Currently, it is not possible to buy antimicrobial drugs from community pharmacies without a prescription. However, despite these restrictions, our country still continues to be among the countries with the highest consumption of antimicrobial drugs among OECD countries. 

3. What are pharmacists in Turkey doing to improve antimicrobial stewardship? 

We know that one of the cornerstones of antimicrobial stewardship is pharmacists (especially clinical pharmacists). Particularly, the role of pharmacists in choosing the correct dose, dosing interval, treatment duration and administration route of drugs has been proven positively by many studies. Considering the pharmacokinetic and pharmacodynamic (PK/PD) properties of drugs, the continuation of the treatment process is very important for the efficacy and safety of treatments. Pharmacists provide significant benefits in PK/PD with the knowledge they have learned and transferred to clinical practice during bachelor and postgraduate education.

Currently, approximately 20 pharmacists attend postgraduate clinical pharmacy education in our department and also participate in ward rounds in our hospital. In addition to infectious diseases, the services attended to ward rounds are oncology, intensive care units, internal medicine, nephrology, rheumatology, hematology, psychiatry, neurology, pediatric intensive care and newborn. Clinical pharmacy interns in these services receive training and gain experience. In addition, they convey their suggestions about both the service-specific drug treatments and the other drugs of the patients to the service team.

Our hospital has a 10-bed ward for infectious diseases. The main activity of the department of infectious diseases is consultation-based. Our infectious disease specialists (Dr. Unal, Dr. Akova, Dr. Uzun, Dr. Metan, Dr. Inkaya, Dr. Dizman, and Dr. Sonmezer) provide consultation services to all units of the hospital, and approximately 200 patients are followed up and treated daily in the hospital. We try to ensure that each consultant ID team includes a clinical pharmacy student or graduate clinical pharmacist. Still, we can reserve 3-4 clinical pharmacists (including myself) for this place simultaneously in order to organize everyone’s rotations. I take part in the WhatsApp communication groups of the ward round teams that do not have a pharmacist, and I try to answer the questions asked in this group by calling.

As clinical pharmacists, our most significant contribution to antimicrobial doses in Hacettepe University Hospitals has been in the administration of loading doses and the administration of the first 24 hours dose for beta-lactams independently of renal function in critically ill patients with renal dysfunction (intensive care, sepsis, septic shock).

Although my workload has increased considerably due to my duties as a lecturer, researcher and other associations, a day as an infectious diseases clinic pharmacist is typically as follows:

  • Reviewing the laboratory findings, clinical status and treatments of the patients followed and writing notes on the treatment process updates
  • Participation in the clinical ward rounds
    • Notifying the ward round team of my recommendations about the patients
    • Answering questions of the team
    • Recommendations usually include:
    • Adjusting drug doses according to renal, liver functions and patient weight
    • Managing adverse effects of drugs
    • Managing drug-drug interactions
    • Therapeutic drug level monitoring and adjustment of drug doses according to TDM results
    • Duration of treatment
    • Drug selection according to guidelines
    • De-escalation
    • Switch to oral therapy

4. What is the most important lesson you have learned when it comes to antimicrobial stewardship? 

The most important thing I have learned from antimicrobial stewardship is that it helps me understand the importance and value of working with healthcare professionals from different disciplines. In the team, each stakeholder is a piece of the puzzle. I learned that we can handle things we cannot handle alone when we join our forces and resources. Each stakeholder involved in antimicrobial stewardship is truly a complement to the other, and the team would be incomplete without one.

Also, continuous self-development is an important part of this program because it is necessary to keep up with the very rapid changes in antimicrobial treatments and microorganisms. The war between microorganisms and humans, which has been going on for hundreds of years, continues without losing its warmth. As we develop new weapons against them, they continue to increase their defensive measures against these weapons. It is necessary to learn and remember the pharmacological properties, indications, adverse effects and other important characteristics of each new drug and transfer it to clinical practice. 

Most of the pharmacists in our department do not work directly on infectious diseases, but almost all of them are involved in a study on infection. In other words, antimicrobial management touches all pharmacists and even all health professionals at some point, even if they do not work primarily on infectious diseases.

5. What is the most pressing antimicrobial stewardship issue in Turkey today? 

I think the most pressing antimicrobial stewardship issue, including in our institution, is the inappropriate use of antimicrobials for surgical prophylaxis. The use of antimicrobials for surgeries that do not require prophylaxis, the wrong choice of antimicrobial drugs (unnecessary broad spectrum), the inappropriate dosage of antimicrobials, and the prolonged continuation of prophylaxis after surgery (sometimes even after the patient is discharged) are among the leading problems. 

Excessive use of carbapenems is another major problem because we have carbapenem-resistant Acinetobacter spp. and Enterobacterales in our hospitals. Antimicrobial agents that we can use to treat carbapenem-resistant microorganisms are very limited.

In addition, the lack of adherence to national and international guidelines/rules in selecting empirical treatment and the lack of an approach supported by local susceptibility data in selecting treatment are among our essential problems.

6. What do you predict the future holds for antimicrobial stewardship in Turkey? 

I am very hopeful about where our country is heading regarding antimicrobial stewardship in the future. There are several reasons for this hope. Awareness and knowledge levels of both health professionals and the community on antimicrobial resistance and rational drug use have increased considerably across the country. Now we’re going to start collecting the fruits of that. I believe that more concrete and strong steps can be taken hereafter. Participation in the meetings and training organized by ESCMID (European Society of Clinical Microbiology and Infectious Diseases) is relatively high in our country, and antimicrobial governance constitutes a large part of these meetings.

Similarly, the societies in our country have begun to devote more space to this issue. Experiences gained in international meetings are now being demanded and applied in our country as well. At least one session has been reserved for antimicrobial stewardship in our national congresses. In other words, preliminary information was provided, methods were determined, and even implementations started. We will start to get the results as soon as possible and discuss these results both nationally and internationally. 

As an important and pleasing development for clinical pharmacy, the Ministry of Health started to assign clinical pharmacy specialists to hospitals this year. One clinical pharmacist for every 100 hospital beds will be obligatory. I think that both clinical pharmacy services and antimicrobial management will improve in hospitals with new clinical pharmacists in hospitals.

References & Readings

ABOUT THE INTERVIEWEE

Emre Kara, MSc., Ph.D.

Dr. Kara graduated from the Inonu University, Faculty of Pharmacy and received his MSc. degree in 2016 and a Ph.D. degree in 2022 in Clinical Pharmacy at the Hacettepe University-Ankara. He has been working as a committee member in the Antimicrobial Stewardship Team at the Hacettepe University Hospitals. His main research interests are implementing clinical pharmacy/pharmaceutical care in infectious disease, intensive care and internal medicine. He has more than 30 articles published in SCI-e and ESCI indexed journals. He is currently an executive committee member of the TUKED (The Society of Turkish Hospital and Institutional Pharmacists), and member of the Turkish Society of Clinical Pharmacy (KED), European Society of Clinical Pharmacy (ESCP), International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT), The International Pharmaceutical Federation (FIP), Society of Turkish Hospital Infections and Control (HİDER), Turkish Society of Intensive Care Specialists (TUYUD) and Society of Turkish Infectious Diseases and Clinical Microbiology Specialization (EKMUD), Drug Researchers And Applicants Society. In addition, he serves as a working group member in the Turkish Society of Clinical Microbiology and Infectious Diseases (KLİMİK) Antibiotic Resistance Working Group and Society for the Clinical Microbiologists of Turkey (KLİMUD) Antimicrobial Stewardship Working Group.

RECOMMENDED TO YOU



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Ho Ho Cake | The Recipe Critic

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Ho Ho Cake | The Recipe Critic


This website may contain affiliate links and advertising so that we can provide recipes to you. Read my disclosure policy.

Transform your favorite childhood snack cake into a decadent ho ho cake. Inspired by a Hostess ho hos, this dark chocolate cake is topped with cream filling and fudgy ganache frosting. Every bite takes you back to feeling like a kid again!

Chocolate cake lovers listen up because you’re in the right place! I have so many delicious chocolate cake recipes on the blog for you to make. Try this easy wacky cake, my favorite chocolate zucchini cake, or this fun whoopie pie cake!

Close view of a spatula lifting up a slice of ho ho cake.

What is Ho Ho cake?

If you grew up eating Hostess ho hos like me, you’re about to relive your childhood. This luscious, moist chocolate cake is tender and rich with every bite. Ho hos have a sweet layer of cream filling on top of the cake, followed by a layer of chocolate ganache. And this ho ho cake is the perfect “grown-up” version of the store-bought snack cake. This giant ho ho cake is a chocolate lover’s dream dessert! The creamy filling is made with my dreamy ermine frosting recipe and it takes this cake to the next level. And to finish it off, it gets a homemade chocolate ganache that is fudgy and decadent! Trust me, once you’ve had a taste, you won’t want to stop. It’s irresistible!

I love to recreate a store-bought dessert! It’s just fun to be inspired by favorite treats from growing up. But the best part is making them even BETTER by using better ingredients. Check out some of my other favorite copycat cakes. Make this fun ding dong cake, this Swiss roll cake, or my almond joy poke cake!

Ho Ho Cake Ingredients

Here is a list of everything you will need to make this giant-sized ho ho cake! It’s three layers of rich yummy goodness. You can make it even easier by using a boxed cake mix if you’re short on time. This homemade cake recipe is definitely better, but you do you! Find the exact measurements in the recipe card below.

Ho Ho Cake

  • Vegetable Oil: Keeps the cake super moist and tender!
  • Warm Coffee: Gives the chocolate a serious flavor boost, making it extra rich and irresistible.
  • Large Eggs: Holds everything together and keeps the cake nice and fluffy.
  • Vanilla Extract: Adds that yummy aroma and makes the cake even more tasty.
  • All-Purpose Flour: Acts as the base of the ho ho cake.
  • Granulated Sugar: Sweetness to the max, making each bite a treat.
  • Unsweetened Cocoa Powder (not Dutch process): This star ingredient creates rich and intense chocolate goodness.
  • Baking Powder and Soda: So the cake has a perfect rise.
  • Salt: A pinch of flavor enhancer, balancing the sweetness.

Ermine Frosting (Cream Filling)

  • Granulated Sugar: The sweet stuff that makes ermine frosting taste just right, not too sugary but perfectly delicious.
  • Flour: The secret ingredient that, when mixed with milk, creates the smooth and creamy base of ermine frosting.
  • Milk: The liquid magic that combines with flour to give ermine frosting its velvety texture.
  • Unsalted Butter: Adds richness and creaminess to the frosting.
  • Vanilla Extract: A splash of flavor that makes ermine frosting extra sweet.
  • Salt: Just a pinch to balance the sweetness and bring out all the tasty flavors.

Ganache

  • Semi-Sweet Chocolate: For that deep chocolatey flavor. Either semi-sweet chocolate chips or a baking bar will work. You can also use dark chocolate if you prefer!
  • Heavy Cream: Makes the ganache nice and smooth. It’s like a creamy fudge layer on top of the ho ho cake and SO irresistible.

Ho Ho Cake Recipe

Now that your ingredients are ready to go, let’s make this delicious ho ho cake! I’ve separated the instructions into a few different groups so that it’s easier to follow along and make the recipe. Let’s do this!

Ho Ho Cake

  1. Preheat Oven/ Prepare the Pan: Preheat the oven to 350 degrees Fahrenheit. Spray a 19×13-inch cake pan with cooking spray and set aside.
  2. Wet Ingredients: In a large bowl whisk together the vegetable oil, warm coffee, eggs, and vanilla until combined.
  3. Add Dry Ingredients to Wet Ingredients: In a medium bowl sift together the flour, sugar, unsweetened cocoa powder, baking soda, baking powder, and salt. Add the dry ingredients to the wet ingredients and gently whisk together until fully combined.
  4. Bake: Fill the prepared pan with the batter and bake for 35-40 minutes, until the center of the cake springs back lightly when pressed on, or a toothpick comes out clean. Allow the cake to cool completely before frosting.

Ermine Frosting (Cream Filling)

  1. Milk Mixture: Add the flour, sugar, and milk to a saucepan. Cool over medium heat while whisking constantly until thick like pudding, about 10 minutes.
  2. Chill: Remove from the heat and add to a heat-proof bowl or quarter sheet pan. Cover with plastic wrap so the plastic touches the top of the mixture and prevents a film from forming. Chill in the fridge for 40 minutes to allow it to finish thickening into a thick paste.
  3. Whip: Add the room-temperature butter to a stand mixer and whip with the whisk attachment for about 8 minutes, until the butter is light and fluffy. Scrape down the sides and bottom of the bowl as needed to ensure all the butter gets whipped.
  4. Add in Flour: Add the chilled flour paste to the butter one scoop at a time until it is all incorporated
  5. Add Vanilla and Beat: Scrape down the sides and bottom of the bowl and switch to the paddle attachment. Add the vanilla and salt and beat on medium-high for 10-13 minutes, until smooth and fluffy.

Ganache

  1. Heat the Cream: Place the chocolate in a small bowl. Heat the cream in the microwave until steaming but not boiling, about 1 minute.
  2. Pour Over Chocolate and Stir: Pour the hot cream over the chocolate and let it sit for a few minutes. Use a whisk to combine the chocolate and cream until smooth. If needed, heat the chocolate mixture for 10 seconds more to help melt the rest of the chocolate, but only if there are still little chunks of chocolate remaining after whisking well. Set aside to cool to room temperature.

Assembly

  1. Spread on the Cream Frosting: Use an offset spatula to spread the frosting evenly over the top of the cooled cake, getting it as smooth as you can.
  2. Pour on and Spread the Ganache: Carefully pour the cooled ganache on top of the frosting and use a spatula or offset spatula to spread it evenly.
  3. Chill and Enjoy: Let the cake chill in the fridge for an hour or so before serving.
First photo of cake batter pouring into a pan. Second photo of the cake being frosting with the cream filling. Third photo of the ganache spreading on the cake.

Make it a Ho Ho Sheet Cake

Covert this cake recipe into a sheet cake by using a large baking sheet pan. The cake layer won’t be as thick, but it will feed a bigger crowd. You will LOVE the cake-to-cream ratio! This cake is my favorite cake to transform into a sheet cake. The only difference will be the baking time. The cake will bake faster, so the baking time will be reduced. Use the toothpick method and check the cake around the 20-minute mark. Cool and frost the cake following the recipe card below.

Ho Ho Cake Tips

Let me help you make the ho ho cake of your dreams! Follow my tips and tricks below to give you the most success. I can’t wait for you to try it!

  • Use a Cake Mix: You may use a Devil’s Food cake mix or other rich chocolate mix instead for a quicker, easier recipe. 
  • Keep the Oven Door Closed: Try to avoid opening the oven early to check the cake. This can cause a drop in temperature, which in turn can cause the center of the cake to sink. 
  • Coffee: The coffee enhances the chocolate flavor of the cake, but if you don’t want to use coffee go ahead and replace it with buttermilk.
  • Ganache: For the ganache, you may use whatever semi-sweet chocolate you prefer! Mini chocolate chips will melt the quickest, but regular chocolate chips or chopped baking chocolate would be delicious.
  • Glass Pan: If you have a glass baking pan, this allows you to see the beautiful layers of cake, frosting, and ganache!

Close view of the cake layers showing in the pan.

Storing Leftover Cake

If you have leftover ho ho cake then it won’t last long! I’ve been known to sneak into the kitchen for a slice after the kids go to bed because it’s too good to resist! Follow my tips below for storing leftover cake in the refrigerator and freezer.

  • In the Refrigerator: This cake is best stored in the fridge for up to 5 days. Store in an airtight cake container or wrapped in plastic wrap.
  • In the Freezer: Wrap individual slices in plastic wrap and then place them in a ziplock bag. Freeze for up to 3 months. Let the slices thaw overnight in the fridge before unwrapping them. Being a sheet cake, I do not recommend freezing it whole.

Close view of a fork on a plate with a slice of ho ho cake.

More Decadent Chocolate Desserts

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Ermine Frosting (Cream Filling)

Cake

  • Preheat the oven to 350 degrees Fahrenheit. Spray a 19×13-inch cake pan with cooking spray and set aside.

  • In a large bowl whisk together the vegetable oil, warm coffee, eggs, and vanilla until combined.

  • In a medium bowl sift together the flour, sugar, unsweetened cocoa powder, baking soda, baking powder, and salt. Add the dry ingredients to the wet ingredients and gently whisk together until fully combined.

  • Fill the prepared pan with the batter and bake for 35-40 minutes, until the center of the cake springs back lightly when pressed on, or a toothpick comes out clean. Allow the cake to cool completely before frosting.

Ermine Frosting

  • Add the flour, sugar, and milk to a saucepan. Cool over medium heat while whisking constantly until thick like pudding, about 10 minutes.

  • Remove from the heat and add to a heat-proof bowl or quarter sheet pan. Cover with plastic wrap so the plastic touches the top of the mixture and prevents a film from forming. Chill in the fridge for 40 minutes to allow it to finish thickening into a thick paste.

  • Add the room-temperature butter to a stand mixer and whip with the whisk attachment for about 8 minutes, until the butter is light and fluffy. Scrape down the sides and bottom of the bowl as needed to ensure all the butter gets whipped.

  • Add the chilled flour paste to the butter one scoop at a time until it is all incorporated

  • Scrape down the sides and bottom of the bowl and switch to the paddle attachment. Add the vanilla and salt and beat on medium-high for 10-13 minutes, until smooth and fluffy.

Ganache

  • Place the chocolate in a small bowl. Heat the cream in the microwave until steaming but not boiling, about 1 minute.

  • Pour the hot cream over the chocolate and let it sit for a few minutes. Use a whisk to combine the chocolate and cream until smooth. If needed, heat the chocolate mixture for 10 seconds more to help melt the rest of the chocolate, but only if there are still little chunks of chocolate remaining after whisking well. Set aside to cool to room temperature.

Assembly

  • Use an offset spatula to spread the frosting evenly over the top of the cooled cake, getting it as smooth as you can.

  • Carefully pour the cooled ganache on top of the frosting and use a spatula or offset spatula to spread it evenly.

  • Let the cake chill in the fridge for an hour or so before serving.

Calories: 509kcalCarbohydrates: 52gProtein: 5gFat: 33gSaturated Fat: 15gPolyunsaturated Fat: 7gMonounsaturated Fat: 8gTrans Fat: 1gCholesterol: 65mgSodium: 235mgPotassium: 228mgFiber: 3gSugar: 35gVitamin A: 562IUVitamin C: 0.1mgCalcium: 55mgIron: 2mg

Nutrition information is automatically calculated, so should only be used as an approximation.





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When a Loved One is Incarcerated

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When a Loved One is Incarcerated


Few people talk about it, but the numbers tell the story.

Nearly half of all Americans have a loved one who has spent time in prison, with an estimated five million children having at least one parent incarcerated during their lifetime. In Pennsylvania, about 62,000 people are currently in custody, and nearly 80,000 children in the Commonwealth have a parent who is incarcerated.

“We hear from more than 100 family members on a weekly basis,” says Kirstin Cornnell, Family and Community Support Director for the Pennsylvania Prison Society. According to Cornnell, “Family members often have questions or concerns about loved ones in prison, and that’s where the Society comes in. Some want to learn how their loved ones can access health care. Others call to report allegations of abuse, neglect, or unsafe conditions such as lack of heat or running water. The Society advocates for these families. They follow up and physically check on loved ones by tapping into a network of more than 300 volunteers across the state.”

The Impact of Incarceration on Mental Health

Families can experience significant stress when a loved one is in prison. The Society offers advice on everything from making ends meet in the absence of a family member’s income to supporting children affected by a loved one’s incarceration.

“A lot of the anxiety is dealing with the lack of control,” Cornnell says. “The windows for when you can talk to or visit a loved one when they are incarcerated are limited. You can’t talk to them when you want to. That’s a big adjustment. The other piece is fear and worry for the loved one’s safety. There’s a limited amount we can do about the conditions, but we can give the family a safe space to talk.”

There is also a great need for additional family support. “We’re trying to fill that space by launching support groups,” says Cornnell. “You can’t do it alone. Due to the scale of mass incarceration, if you haven’t had a loved one incarcerated, you likely know somebody who knows somebody who has been involved in the system. Talking to people in a similar circumstance goes a long way.”

To reduce the family’s anxiety, the Society staff explain the processes for things like visitation and sending mail. They also teach family members how to become advocates for their loved ones. In addition, they help family members set up electronic accounts to arrange visitation, which is critical for everyone’s mental health.

Family Visits are Important

“We try to encourage people to take advantage of visits as much as possible, whether in person or on video,” Cornnell says. The more you can keep in touch, the better. Research shows that people in prison who receive frequent visitors are less likely to return to prison. They are also more likely to have relationships they can rely on when they are released.

And although some adults hesitate to bring children to a prison, research shows that in-person visits are important for children affected by incarceration. But children need to be prepared for what to expect during a visit.

“It’s important to remind loved ones that they’re still part of the family,” Cornnell says. “Physical separation can’t break the bonds of love. We’re all more than the worst thing we’ve done, and family is there for you.”

Resources for Families

If you have a loved one who is incarcerated, the following resources may be helpful:

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.



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Homemade Electrolyte Drink Recipe (With Flavor Options)

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Homemade Electrolyte Drink Recipe (With Flavor Options)


Drinking enough pure clean water is one of the most important things we can do for overall health. In most cases, water alone is wonderful. When there’s hot weather or we’re exercising and sweating though we lose minerals through our sweat. A homemade electrolyte drink can help replenish minerals and remedy electrolyte imbalances.

Do We Really Need Electrolytes?

You may have heard that our bodies are 80% water, but they’re actually 80% salt water.

Plain water doesn’t have high levels of electrolytes. And our body loses a lot of minerals during exercise and hot weather. Adding electrolytes and minerals helps with rehydration after times of high-intensity exercise or lots of sweating. They’re also useful during times of illness if someone has vomiting or diarrhea to maintain fluid balance.

We need electrolytes to maintain healthy blood pressure, for our nervous system, and to prevent muscle cramps. They help move waste through the body and are overall necessary for every function! In a perfect world, we wouldn’t need supplements but electrolyte water and drinks can be very helpful for some.

My Cautionary Tale

This post could also be titled “How to avoid a big hospital charge for IV fluids while on vacation.” Hopefully, you can learn from my mistake on this one.

Years ago I went on vacation and spent days on the beach snorkeling, sailing, and scuba diving.

Normally, if I’m out in the sun I have my own homemade electrolyte drink with me, but this time I’d forgotten some of the ingredients. I figured I would just drink enough water, which worked fine until I had wine for dinner that night, coffee the next morning, and not enough water.

At that point, I noticed I was getting a headache. I started drinking water but the headache got worse and I also started having a rapid pulse, dizziness, and nausea. Even after drinking lots of water I still had dehydration and heat exhaustion symptoms.

This resulted in a trip to the international hospital to get fluids. After the most painful IV of my life with a 12-gauge needle, the fluids were in and I started to feel better!

After several hours of sitting in a hospital getting hydrated with IVs, I couldn’t help but think how much easier, cheaper, and less painful things would have been if I’d remembered my DIY electrolyte drink.

Why Not Regular Sports Electrolyte Drinks?

So why not just drink one of the many store-bought electrolyte drinks available (Gatorade, Powerade, etc.) these days?

Regular sports drinks contain lots of glucose, artificial flavors and colors, and not much nourishment.

I’m all for rehydrating, but are the preservatives, mystery flavors, and artificial dyes really necessary? I know from experience that these ingredients typically make me feel terrible and just aren’t worth it. Now when I need something more than water to hydrate I make my own version.

Natural Sports Electrolyte Drink Recipe

Coconut water is one of the simplest sports drink alternatives and can be used as is. It’s similar in structure to the fluid used in IV rehydration. For this reason, there are rumors it was used during the Pacific War as an IV electrolyte replacement. It makes a pretty good natural electrolyte drink on its own or with a splash of lime juice.

Coconut water is a great source of potassium and sodium and I even used it during labor. The only downside to coconut water is the price. If you want an inexpensive (yet still healthy and tasty) alternative, this recipe is the next best thing.

Homemade Electrolyte Drink Recipe

You can make this recipe in a variety of ways, but the ratios are the most important part. The base is any healthy liquid of choice and some good options are:

To turn the basic liquid into a sports drink, add some or all of these ingredients:

  • Salt – A high-quality salt adds sodium and other essential minerals. Table salt is pure sodium chloride and doesn’t have trace minerals, but Himalayan or sea salt are great options.
  • Calcium and Magnesium – Adding calcium magnesium powder helps replenish minerals.
  • Juice – Optional but adds sweetness and natural sugars if needed during exertion. Orange juice, lime juice, and fresh lemon juice are some of our favorites and add vitamin C and potassium.
  • Natural Flavors – Add natural flavors like fresh ginger, fresh herbs, or even natural-flavored stevia extracts

This recipe is naturally gluten-free and can easily be made low-carb by omitting the added juice.

Want to Buy it?

Looking for a quick way to have electrolytes on hand, especially during travel? These are my favorite no-junk electrolyte powder drinks.

  • LMNT – I’m a big fan of these flavored electrolyte powder that replaces vital electrolytes lost from sweating. They work amazingly on their own with just water and have different flavors like citrus, grapefruit, or watermelon.
  • Jigsaw Health Electrolyte Supreme – My favorite flavor is the Berry-licious.
homemade electrolyte drink

Homemade Electrolyte Drink Recipe

Save money and avoid artificial ingredients by making your own homemade natural sports drink recipe with electrolytes. There are endless options to make a flavor you love!

  • Brew tea if using, or slightly warm base liquid.

  • Add sea salt and calcium magnesium powder and mix.

  • Add juice and sweetener if using and mix or shake well. A mason jar works well for this.

  • Cool and store in the refrigerator until ready to use.

  • This will last up to four days in the refrigerator, but I prefer to make it as needed.

Nutrition Facts

Homemade Electrolyte Drink Recipe

Amount Per Serving (1 cup)

Calories 70
Calories from Fat 5

% Daily Value*

Fat 0.5g1%

Saturated Fat 0.4g3%

Polyunsaturated Fat 0.01g

Monounsaturated Fat 0.02g

Sodium 395mg17%

Potassium 620mg18%

Carbohydrates 15g5%

Fiber 3g13%

Sugar 13g14%

Protein 2g4%

Vitamin A 1IU0%

Vitamin C 28mg34%

Calcium 77mg8%

Iron 1mg6%

* Percent Daily Values are based on a 2000 calorie diet.

  • My normal recipe includes 1 quart of tea (brewed with red raspberry leaf, alfalfa, nettle, and stevia), ¼ tsp sea salt, 1 tsp calcium magnesium powder, and ¼ cup grape or apple juice.
  • Another easy alternative is mixing vitamin C powder with water, salt, and a little juice.
  • The magnesium in this recipe is 27 mg per serving. Nutrition data was calculated using raw honey, coconut water, and grape juice. The exact nutrients will depend on which ingredients you use. 



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Begin a culinary excursion that engages you: A Broad Mediterranean Having routine Supper Plan

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Begin a culinary excursion that engages you: A Broad Mediterranean Having routine Supper Plan

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The Mediterranean eating plan, mixed by the standard dietary cases of countries covering the Mediterranean Sea, has obtained all over appreciation for its different clinical benefits and astonishing flavors. Something beyond an assortment of recipes, this eating plan is more extensive; A way of life that focuses on overall health and is built on a foundation of new common foods, vegetables, whole grains, lean proteins, and olive oil. In this article, we will present a total Mediterranean Eating routine Festival Plan, offering seven days of supporting and excellent blowouts.

Day 1:

  1. ** Breakfast – Greek Yogurt Parfait:**
  • Greek yogurt with mixed berries, honey, and a sprinkle of almonds.
  1. ** Mediterranean Chickpea Salad for Lunch:**
  • Dressed with olive oil and lemon juice, with chickpeas, cherry tomatoes, cucumber, red onion, feta cheddar, and olives.
  1. ** Barbecued Mediterranean Chicken for Supper:**
  • Barbecued chicken chest marinated in lemon, garlic, oregano, and olive oil. joined by quinoa and cooked vegetables as an inconvenient thought.

Day 2:

  1. ** Breakfast: Avocado on Whole Grain Toast:**
  • Whole grain toast got done with beat avocado, tomato cuts, and a sprinkle of olive oil.
  1. ** Lunch – Mediterranean Quinoa Bowl:**
  • Quinoa bowl with spinach, cherry tomatoes, cucumber, feta cheddar, and a lemon-olive oil dressing.
  1. ** Warmed Eggplant Parmesan for dinner:**
  • Layers of cut-up and arranged eggplant topped with mozzarella, Parmesan, and pureed tomatoes presented with salad greens as a side.

Day 3:

  1. ** Breakfast – Mediterranean Omelette:**
  • Whisked eggs with spinach, tomatoes, feta cheddar, and a sprinkle of oregano.
  1. ** Lunch: Greek Serving of leafy greens Wrap:**
    A whole grain wrap contains Greek plate of leafy greens trimmings and hummus.
  2. ** Dinner:** Mediterranean-stuffed peppers
  • Faultlessly coordinated chile peppers stacked down with tomatoes, feta, quinoa, and chickpeas.

Day 4:

  1. ** Breakfast – Transient Chia Seed Pudding:**
  • Chia seeds were tipsy with almond milk, finished off with new berries and honey.
  1. ** Lunch – Mediterranean Lentil Soup:**
  • Liberal lentil soup with tomatoes, carrots, onions, and a sprinkle of Mediterranean flavors.
  1. ** Dinner – Shrimp Scampi with Whole Wheat Pasta:**
  • Scrumptious shrimp served over entire wheat pasta in a garlic and lemon-mixed sauce.

Day 5:

  1. ** Breakfast – New Typical thing Salad with Mint:**
  • Honey, new mint, and a blend of customary thing salad were added.
  1. ** Mediterranean Fish Salad for Lunch:**
  • Fish salad with mixed greens, cherry tomatoes, olives, and a lemon-olive oil dressing.
  1. ** Supper: Mediterranean Mix Fry in with Vegetables:**
  • Composed Mediterranean vegetables dish touched off with chickpeas and ready with olive oil and flavors.

Day 6:

  1. ** Breakfast – Mediterranean Smoothie Bowl:**
  • Greek yogurt, chia seeds, a banana, spinach, blended berries, and a smoothie bowl
  1. ** Lunch – Caprese Salad with a Twist:**
  • Tomato and new mozzarella salad with Kalamata olives, basil, and a balsamic covering.
  1. ** Dinner:** Mediterranean Cauliflower Rice Bowl
  • Cauliflower rice bowl with a lemon-olive oil dressing, spinach, cherry tomatoes, feta cheddar, and stewed chickpeas.

Day 7:

  1. ** Breakfast – Mediterranean Breakfast Burrito:**
  • Whole grain tortilla stacked up with cooked eggs, hummus, cherry tomatoes, and olives.
  1. ** Lunch: Dolma (stuffed grape leaves):**
  • Grape leaves stacked down with coordinated rice, pine nuts, and new flavors, gave a side of tzatziki.
  1. ** Dinner: Barbecued Chicken Chest with Lemon Herb:**
  • Grilled chicken chest marinated in lemon punch, new flavors, and olive oil. given vegetables stewed.

Key Considerations for a Valuable Mediterranean Diet:

  1. ** Olive Oil Uses:**
    The essential wellspring of fat for both cooking and dressing is additional virgin olive oil.
  2. ** Area Management:**
  • Base on portion sizes to keep a congruity of macronutrients.
  1. ** Different Wellsprings of Protein:**
  • Incorporate different proteins, including dairy, fish, and lean meats.
  1. ** Mind blowing and New Ingredients:**
  • Stress clear food combinations made from the beginning, well as new flavors, for most imperative flavor and food.
  1. ** Complete Grains:**
  • For additional improvements and fiber, pick entire grains like quinoa, abrasive tinted rice, and entire wheat.

Conclusion:

Leave on a supporting culinary journey with this wide Mediterranean Having routine Supper Plan. By incorporating the zesty flavors and nutrient-dense components of the Mediterranean, you will enjoy grand galas and improve your overall health. Whether you’re searching for heart thriving, weight the trailblazers, or essentially a more delectable lifestyle, the Mediterranean eating routine offers a splendid and genuine method for supervising eating.

Measles Outbreak Continues to Grow, Affects Multiple States

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Measles Outbreak Continues to Grow, Affects Multiple States


This article originally appeared on our sister site, Contemporary Pediatrics.

Cases of measles continue to be reported in Delaware, New Jersey, Georgia, Pennsylvania, Virginia, and Washington State, according to an American Academy of Pediatrics (AAP) News report.1

Transmitted through contact of droplets or airborne spread via breathing, coughing, or sneezing from an infected individual, measles can remain in the air for up to 2 hours.1

“[These reports are] not really surprising given the decrease in vaccination rates that have been occurring since the pandemic,” said Tina Tan, MD, FAAP, FIDSA, FPIDS, editor-in-chief, Contemporary Pediatrics; professor of pediatrics, Feinberg School of Medicine, Northwestern University; pediatric infectious diseases attending, Ann & Robert H. Lurie Children’s Hospital of Chicago.

“This is not new and demonstrates what is known, in that if vaccination rates do not stay at a level that is protective, outbreaks of vaccine preventable diseases will occur,” said Tan.

The acute viral respiratory illness can be characterized by fever as high as 105 degrees Fahrenheit and malaise, coryza, cough, and conjunctivitis, a pathognomonic enanthema followed by a maculopapular rash, according to the Centers for Disease Control and Prevention (CDC).2

The CDC states that up to 9 out of 10 susceptible persons with close contact to an infected measles patient will develop the infectious disease. Infants and children aged younger than 5 years are at high-risk for severe illness and further complications from measles.2

Routine childhood immunization for the measles-mumps-rubella (MMR) vaccine is recommended at 12 to 15 months of age for the first dose, with the second coming at ages 4 through 6 years, or at least 28 days after first dose.2

The MMR-varicella (MMRV) vaccine is available to children 12 months through 12 years of age, with 3 months being the minimal interval between doses.2

“Clinicians need to understand that the United States—and multiple other countries around the world—are currently in an environment where vaccination rates have fallen below protective levels given the significant increase in vaccine hesitancy and major decrease in vaccination rates,” Tan said. “Measles and other vaccine preventable diseases need to be on the differential diagnoses of children presenting with signs and symptoms that may be associated with these diseases.”

According to the CDC, evidence of immunity for measles includes at least 1 of the following:2

  • One or more doses of a measles vaccine on or after the first birthday for preschool-aged children
  • Two doses of a measles vaccine for school-aged children, including college students, health care personnel, and international travelers.
  • Laboratory evidence of immunity
  • Laboratory confirmation of measles
  • Birth before 1957

The AAP report states a CDC study recently revealed that 93% of kindergartners were fully vaccinated against measles in the 2022 to 2023 school year, marking it the third consecutive year that vaccination rates were below the “Healthy People 2030 target of 95%.”1

“There has been a decrease in vaccination rates here in Chicago and other areas of the United States due to an increase in vaccine hesitancy,” added Tan. “There has also been an increase in parents seeking notes of medical and philosophical exemption so that they do not have to vaccinate their children.”

References:

  1. Jenco M. Measles reported in multiple states; be prepared to take infection-control steps. AAP News. January 24, 2024. Accessed January 25, 2024. https://publications.aap.org/aapnews/news/27983/Measles-reported-in-multiple-states-be-prepared-to?searchresult=1
  2. For Healthcare Providers. Centers for Disease Control and Prevention. Updated November 5, 2020. Accessed January 25, 2024. https://www.cdc.gov/measles/hcp/index.html



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