The arduous art of the chocolate taster

First study the colour, then the nose, the structure and taste: as for any good wine, tasting chocolate is both a treat and a serious art, requiring regular practice to fine-tune the senses.
And who better to offer a lesson in chocolate tasting than Pierre Herme, the French master pastry chef?
"You start by looking at the texture," he explained at a recent tasting organised in Paris by the "Chocolate Crunchers' Club" -- a 150-strong fellowship created three decades ago to celebrate a common passion for the cocoa bean.
"I rough it up a bit first -- crushing it to test its resistance," Herme said, pressing a blade onto various parts of the chocolate bonbon on his plate.
Then comes the time to taste, paying close heed to "intensity, acidity, the lightness of the texture, the finish" -- how the flavour lingers after each mouthful -- "and for flavoured chocolates the balance between the chosen aroma and the chocolate itself."
Without forgetting the most important of all: "pleasure."
Five times a year the club's members gather around some of France's top artisans to taste all manner of cocoa-based treats -- from truffle bars to mousses, biscuits, patisseries and ice creams.
The ritual is always the same: each taster needs a small knife, a glass of water and some bread to cleanse the palate.
"The knife is essential, especially for chocolate bonbons," explained Claude Lebey, the doyen of French food critics and one of the founders of the club, gathered for the occasion in a Paris mansion.
"You have to slice the sweets in two, to see the thickness of the coating. It should offer resistance, but should not be too thick either, or it stops you from tasting what is inside."
Lebey confesses to keeping chocolate stashed away in various corners of his apartment so he can indulge in a quick nibble at any moment.
"Hmm, the coffee in this one is dosed just right," he mused approvingly, sucking on a bonbon named "Brasilia", created by Jean-Paul Hevin -- a star Parisian chocolatier with his own stores in Japan and Hong Kong.
"It's a dark chocolate ganache, but I added a bit of milk to bring out the scent of the coffee," explained Hevin, who uses ground coffee from Colombia and Brazil -- rather than instant as is often the case.
The club's expert crunchers sample another bonbon, this one flavoured with Earl Grey tea.
"The bergamot could be a little more pronounced," reckoned one taster. "Yes -- but that's risky, bergamot will easily crush any other flavour," tempered another.
For Hevin, "getting the right dose between different flavours is particularly difficult, it takes months of work."
"Most often I will put the accent on the chocolate, above any other flavour."
But sometimes, on a smoked tea bonbon for instance, he does the opposite: "I am a big tea fan, so on this one I pulled out the stops so you can really taste it. I wanted something more powerful, more virile.

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One Big Reason Not to Rush into Early Retirement

You might want to think twice about retiring early.  That’s because, new research has shown a link between early retirement and premature death.
Research by Andreas Kuhn, Jean-Philippe Wuellrich and Josef Zweimüller found that men, in particular, had an increased risk of death before age 67 when they retired early. To prove this, the researchers looked at a group of blue-collar workers from Austria, born between 1929 and 1941.
"We find that a reduction in the retirement age causes a significant increase in the risk of premature death for males, but not for females," the research said. "The effect for males is not only statistically significant but also quantitatively important. According to our estimates, one additional year of early retirement causes an increase in the risk of premature death of 2.4 percentage points (a relative increase of about 13.4 percent, or 1.8 months in terms of years of life lost)."
[10 Easy Paths to Self Destruction]
According to the research, this can be attributed to negative health habits of people during retirement.  These habits, which include smoking, drinking, unhealthy diet and limited exercise, contribute to 78 percent of casual retirement deaths, while smoking and drinking alone result in 32 percent of casual retirement deaths.
"Our results also suggest that preventive health policies should be targeted to (early) retirees," the research said. "Policies that induce individuals to adopt healthy (or avoid unhealthy) behaviors may have disproportionately positive health consequences for workers who (are about to) permanently withdraw from the labor market.

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Spring/Summer hair trends: five new looks to try

Spring/Summer hair doesn't just have to mean tousled waves or blonde highlights, so take inspiration from the Spring/Summer 2012 catwalk shows and experiment with candy color or victory rolls.
Slicked back
Get the hair gel at the ready because slicked-back styles were all over the Spring/Summer 2012 runways, with everyone from Victoria Beckham to Mugler embracing the mullet-influenced style. Labels including Giambattista Valli, Rebecca Taylor, BCBG Max Azria and Viktor & Rolf also kept tresses smoothed off the forehead for a streamlined and almost futuristic look.
Candy color
Hair color has got bold for this season, with candy colors including purple and pink replacing classic springtime looks such as ombré tresses or beachy blondes. During the Spring/Summer 2012 shows labels including Issey Miyake, Narciso Rodriguez and Thakoon showcased the trend, with the latter painting models locks blue, orange, purple or pink. Models at DSquared2 had pink streaks in their hair, while Peter Som livened up blonde locks with orange strands. Celebrities have taken to the trend too, with Katy Perry and January Jones just some of the big names reaching for the dye.
Retro quiffs
Having already made an impact during the Fall/Winter season, the quiff has confirmed its staying power and will be back for Spring/Summer 2012 after showing up at shows from the likes of Limi Feu and Rochas. While a retro aesthetic dominated at many presentations, Haider Ackerman showcased punkier varieties and Ohne Titel worked the trend for shorter styles. Meanwhile, Jean Paul Gaultier championed the victory roll for a perfect pin-up look.
Futuristic up dos
Cone-shaped chignons offered an interesting new silhouette at the Spring/Summer 2012 shows, with Rochas, Narciso Rodriguez and Issey Miyake all sculpting long locks into the most streamlined of shapes which had a science fiction feel. Meanwhile, exaggerated silhouettes were seen at Fendi with its "fobs" (faux bobs), and Diane von Furstenberg embraced dramatic beehives. Be warned: these styles require plenty of hairspray and close attention to detail.
Experimental braids
Braids were one of the most popular up-do styles on the Spring/Summer 2012 runways, whether in messy fishtail form at Michael Kors or sleek at Peter Pilotto and Danielle Scutt. Low slung braids were seen at Ashish, while romantic plaits were wrapped around the head at Moschino and Valentino. Stars including Dianna Agron have been seen working the fishtail headband trend on the red carpet recently, while Jennifer Lawrence's The Hunger Games alter ego Katniss Everdeen's side French braid has become the subject of numerous YouTube tutorials.

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US late-night host Conan O'Brien shares his workout playlist

This week, famed American late-night talk show host Conan O'Brien shared his favorite music for staying motivated in the gym.
While not known for his rock-hard gym body, O'Brien is a fitness fan and music lover, and he released his top 16 playlist of gym-friendly tunes as part of his weekly series for streaming service Rdio's Guest DJ.

Here is Conan's playlist or in certain countries, stream it here at Rdio.

1. Vampire Weekend, "A-Punk"
2. The Dovells, "You Can't Sit Down"
3. Cheap Trick, "Dream Police"
4. The Raconteurs, "Steady, As She Goes"
5. Jay-Z, "99 Problems"
6. The Police, "So Lonely"
7. Kings of Leon, "Use Somebody"
8. Ronnie Hawkins, "Forty Days"
9. The Who, "The Real Me"
10. Naughty by Nature, "Everything's Gonna Be Alright"
11. Thin Lizzy, "The Boys Are Back in Town"
12. The Brian Setzer Orchestra, "Jump Jive An' Wail"
13. Electric Six, "Danger! High Voltage (Soulchild Radio Mix)"
14. Green Day, "Basket Case"
15. Boz Scaggs, "Lido Shuffle"
16. Elvis Presley, "Promised Land"

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The Challenges of Launching an Encore Career

Many people dream about launching a second career in a field they have always wanted to try. But the transition into an encore career can be a long and costly process.
Most people earn a significantly lower amount of money (43 percent) or no money at all (24 percent) during the transition from one job to the next, according to a recent MetLife Foundation and Civic Ventures survey conducted by Penn Schoen Berland. The online survey of 253 adults between ages 44 and 70 who are currently in encore careers found that over half (57 percent) of these older workers had to tap their personal savings to make ends meet during the transition.
"That transition is not necessarily a very easy or a sure thing," says Jim Emerman, executive vice president of Civic Ventures. "The financial hardship of the transition, while not really surprising, really jumped out at us as one of the big challenges."
It often takes a significant amount of time for older workers to launch second careers. Three quarters of the survey respondents currently in encore careers experienced an employment gap of longer than 6 months. And a third (34 percent) of these older workers were unemployed for two or more years before they found another job. Some people used that time to volunteer (23 percent) or retrain by taking college courses (20 percent).
When Lisa Roger, 53, a former software engineering project director, was laid off in 2009, she faced a substantial reduction in income for about 14 months. She had to use her savings, collect unemployment benefits, and sign up for COBRA continuing health coverage to make ends meet. During the transition she participated in the Encore Hartford program in Storrs, Conn., a fellowship that helps experienced professionals transition to the nonprofit sector. She eventually found a new job as a family self-sufficiency services manager for the Norwalk Housing Authority. "Today I don't make nearly the salary that I did as a software engineer and I am ok with that," Roger says. "The work is incredibility rewarding. I know I am making a difference." The new job has caused her to reevaluate her retirement plans. "I used to feel that I was going to retire at a really early age, before 65," Roger says. "The career that I am in now, I see myself going beyond that because it is so rewarding."
Older workers are motivated to make a career change by a variety of financial and personal reasons. Insufficient income (28 percent) and inadequate savings (25 percent) were among the top reasons for making the switch. But realizing that some lifetime goals have yet to be fulfilled (28 percent) and a desire to make a bigger difference in the world (21 percent) also play a large role in decisions to move on to something new. Sometimes the transition is sparked by health problems (15 percent), an empty nest (11 percent), or hitting a specific age such as 50 (12 percent). Some people also speak of a spiritual calling into a new line of work (12 percent).
Most people switched into new jobs at for-profit businesses (22 percent) or nonprofit organizations (20 percent). Education (19 Percent), health care (15 percent), and government agencies (6 percent) are also popular second career choices. "Some people will work longer in their current jobs, whatever they are, and other people will want a change," says Emerman. Often the new job comes with shorter hours and a more flexible schedule. People in encore careers work an average of 30.5 hours per week, the Civic Ventures survey found.
Almost half of people who made a career change (47 percent) did so between ages 50 and 59. Only 3 percent of those surveyed changed careers at age 60 or older. The typical person in an encore career expects to continue working for an average of another 11 years and eventually retire at an average age of 69. They have an average of 24 years of work experience.
Many individuals need to keep working for the income (69 percent) and benefits (30 percent). Other people launch second careers to stay active and productive (58 percent), pursue a new challenge (6 percent), and because they simply enjoy the work (31 percent). Some older workers also want to give something back by helping others in the community (35 percent) and staying involved with other people (19 percent).
"People are living much longer and they are healthier, and so they want to stay engaged. People need and want and are able to work longer," says Emerman. "If people are out of work now or worried about their current job, the idea of a next career that combines continued financial security with personal satisfaction and something that they are passionate about is very strong."

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How Aggressive Hyena Moms Give Their Kids a Boost

Early one morning I caught sight of Morpheus, silhouetted against a pink African dawn. Her long, sloping neck was stretched out as she loped away from me, disappearing over a hill. I followed her to a nearby plain and was met with the unmistakable sound of a group of hyenas squabbling over a carcass. Morpheus entered the fray, first lunging at a smaller male on her right. A moment later, she looked up briefly, her nose and mouth covered in blood, then turned and snapped at a hyena feeding nearby.

I'm intimately acquainted with Morpheus and these other hyenas because they have been studied for more than twenty years by various members of the lab where I did my Ph.D. research; I've staked these hyenas out at dens for hours on end and followed them as they raced across open plains. From watching these animals, we've learned about hyenas' social system, their physiology, and the conservation challenges they face.

But to me, it's the aggression that is the most fascinating thing about hyenas. It's rule-based and constrained by specific social norms, but at the same time, it's incredibly primal and ruthless. Studying aggression has helped us understand what makes hyenas tick, offering us a glimpse into the evolutionary pressures that have made them one of the most unusual and misunderstood species in the animal kingdom.

Formidable females

For more than 1000 years, people believed that hyenas were hermaphrodites, since female hyenas have long, fully-erectile pseudopenises that mimic male genitalia. Seeing a hyena play the role of mom while sporting what looks like a penis would bewilder even an astute naturalist. Not only do female hyenas look like males, they are also the more aggressive and socially dominant sex, exhibiting aggression more than three times more often than male hyenas do.

For many animals, too much aggression is detrimental, at least in terms of reproductive success; in baboons, aggressive females have reduced fertility and increased rates of miscarriage , and in western bluebirds, overly-aggressive males tend to fledge fewer offspring than other males. But in these species, males are generally more aggressive than females; how is aggressiveness related to fitness in a species where females are the more aggressive sex?

Life in the clan

Hyenas live in huge social groups called clans that are structured by a "linear dominance hierarchy." That's the scientific way of saying that in these societies, a high-ranking individual is dominant to every lower-ranking animal in the clan: Morpheus is dominant to Scrabble, who is dominant to Hendrix, and so on. For hyenas, social rank isn't just a title or a badge of honor. Rank determines access to food, so a high-ranking hyena like Morpheus can drive a lower-ranking hyena off a kill at any time, no matter who hunted or scavenged the meat.

Social rank also plays an important role in aggressive behavior among hyenas, since dominance determines who can exhibit aggression toward whom. Aggression is nearly always directed down the hierarchy, toward lower-ranking hyenas (and if a hyena disregards this rule, it's not taken lightly by other clan members). This means that the highest-ranking hyenas have a lot of opportunities for aggression - they can attack nearly any other hyena in the clan - whereas lower-ranking hyenas have far fewer possible targets. Aggression can occur over food, in defense of cubs, or to reprimand a pesky suitor.

But unlike many species, aggression doesn't dictate social rank among hyenas; instead, social rank is inherited. Hyenas are stuck with their lot in life, unable to move up the hierarchy. So does all this aggression actually benefit hyenas, and if so, how?

The implications of aggression

Aggressiveness, it turns out, varies drastically among hyenas; some hyenas tend to threaten - or outright attack - group members more frequently than others do. There is more than a five-fold difference in the aggression rates of the least aggressive and the most aggressive females, even after controlling for social rank and the number of opportunities for aggression.

This type of consistent variation in behavior, called "animal personality," is being found in several traits, such as sociability, boldness, and docility, across many species. And aggressiveness, like other personality traits, can have major implications for fitness. However, for hyenas, aggression doesn't affect fitness by improving a hyena's own survival; aggressive females don't live longer or survive at higher rates than others that attack less often.

Instead, the benefits of aggressiveness are seen later down the line, in the survival of offspring. Female hyenas that are particularly aggressive over food successfully rear a larger proportion of their cubs to adulthood than do females that aggress less often over food. But interestingly, the benefits of aggressiveness depend on social rank. For high-ranking hyenas, aggressiveness doesn't matter much in terms of reproductive success; the offspring of dominant females do well no matter how aggressive their mom is. However, for hyenas low on the totem pole, aggression plays an important role in reproductive success, greatly improving their offspring's odds of surviving until adulthood. But how?

Competition and reputations

It all comes down to acquiring resources for your offspring. High-ranking hyenas already have prime access to food, so being super-aggressive at a kill or carcass isn't a huge advantage. However, for hyenas low on the totem pole, being able to secure a little extra food for a cub could mean the difference between its survival and starvation.

When cubs begin eating meat at around 4 months of age, they start visiting kills with their moms. But as these cubs attempt to eat, they are often harassed by older hyenas and chased off the carcass. Additionally, these young hyenas have another disadvantage when it comes to feeding: their skulls haven't finished developing yet. Although being able to crush bone is a big benefit for hyenas evolutionarily, it's a huge morphological handicap for cubs. It takes up to 35 months for a hyena's skull to develop the integrity and strength to crack bone, so until about three years of age, young hyenas feed more slowly and less efficiently than adults. Combine this physical disadvantage with the incredible feeding competition seen at kills, and cubs - especially low-ranking ones - often don't get much to eat during these communal feeding situations.

Here's where a mom's aggressiveness comes in: we found that the cubs of aggressive females are tolerated better, and are able to feed longer, at these kills than the cubs of less aggressive females are. By being super-aggressive, moms secure extra feeding time and valuable calories for their cubs during this particularly handicapped period in their lives. Although we don't completely understand the process yet, aggressive females appear to develop a type of "mean girl" reputation within the clan that gives their offspring a boost early in life. This effect is incredibly strong and persists even when the mom isn't present at the kill, allowing cubs to benefit from their mom's aggressiveness even in her absence. This increased access to resources benefits low-ranking hyenas disproportionately, since they generally have very limited access to food.

A combination of behavioral, morphological, and ecological research has helped us begin to understand why these highly aggressive and masculinized females have been favored evolutionarily. But even after 20 years of intensive research, there's so much more to learn; we still aren't sure what the functions and implications of male aggression are, and it's possible that there are consequences of aggression in females that we haven't yet discovered.

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After parent's cancer death, one in five kids self-injure

NEW YORK (Reuters Health) - One in five teens who lost one of their parents to cancer cut or burn themselves, compared to one in ten teens with two living parents, according to a new Swedish study.

"We were very surprised to find that so many did it," said lead researcher Tove Grenklo, a behavioral scientist at the Karolinska Institutet in Stockholm.

Cutting and burning is thought to be how some troubled teens express their emotions, according to the American Academy of Child and Adolescent Psychiatry. Those teens may hurt themselves if they can't talk about their feelings, are upset or have low self esteem.

Earlier this year, a study found that children start harming themselves as early as third grade. (see Reuters Health article of June 11, 2012. http://reut.rs/Kveo8v)

The study's researchers write in the Archives of Pediatrics and Adolescent Medicine that past research showed children with one dead parent are already more likely to have - among other things - psychiatric problems, depression, drug and alcohol abuse and anxiety.

Grenklo and her colleagues wanted to see if they were also more likely to hurt themselves.

For the study, they used Sweden's national death databases to find and survey teens who lost one of their parents to cancer between 2000 and 2003, when they were between 13 and 16.

They then found teens who still had two living parents for a comparison group.

Of the 851 teens who lost a parent, 622 returned their survey, as did 330 of the 451 teens in the comparison group.

Overall, about 20 percent of the teens with only one surviving parent said they hurt themselves, compared to about 10 percent of teens with both parents living.

'WE SHOULD TALK WITH EACH OTHER'

"This study is one of the first to establish that (losing a parent to cancer) might be a unique risk factor for this behavior," said Stephen Lewis, who was not involved with the new study but has studied self-injury at the University of Guelph in Ontario, Canada.

Lewis added that the study's findings seem to be in line with other estimates of how many teens injure themselves.

The researchers say teens may be driven to self-injure after their parents' deaths by an increased sense of emotional distress and numbness.

Another possible explanation for the increase is that the teens lost a caretaker who would notice their emotional suffering and prevent self-injury, they add.

As for prevention, both Grenklo and Lewis emphasized communication.

"I'm a strong believer that we should talk with each other," said Grenklo. "Children need to know the facts of what happened and why. And that it's OK to be sad and talk about the diseased parent."

"We know one of the reasons people self injure is that they use injuring as a way to release their emotions," said Lewis, who added that it's important for parents, family members and teachers to know how to talk about self-injury and how to prevent it.

Lewis said information on preventing and handling self injury can be found at SIOutreach.org - a Web site where he is co-director.

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Disability expected to rise as more premature babies survive

LONDON (Reuters) - Little progress has been made in improving the long-term health of extremely premature babies, and with pre-term births on the rise across Europe, rates of serious disability are likely to increase, doctors said on Wednesday.

A decade of advances in medicine mean more babies born at between 22 and 26 weeks gestation manage to survive, but rates of severe health complications remain as high as they were in 1995, according to research by neonatal specialists in Britain.

The findings of two separate studies published in the British Medical Journal suggest the number of children and adults with disabilities caused by premature birth will rise in coming years.

Babies born before 27 weeks of gestation - 13 weeks before they would be considered full term - face a battle for survival. Many of those who do survive face problems such as lung conditions, learning difficulties and cerebral palsy.

Rates of premature birth are rising in many European countries and are particularly high in Britain and the United States.

"As the number of children that survive pre-term birth continues to rise, so will the number who experience disability throughout their lives," said Neil Marlow, of University College London's Institute for Women's Health, who worked on both studies and presented the results at a briefing in London.

He said this was "likely to have an impact on the demand for health, education and social care services."

The two studies, led by Marlow and Kate Costeloe of Queen Mary, University of London, compared a group of babies born in the UK between 22 and 26 weeks' gestation in 2006 with those born between 22 and 25 weeks over a 10-month period in 1995.

The first one looked at the immediate survival rates and the health - until they went home from hospital - of extremely premature babies born in 2006 and compared them with 1995 rates.

Researchers found the number of babies born at 22 to 25 weeks and admitted to intensive care increased by 44 percent during this period. The number of babies who survived long enough to go home from hospital increased by 13 percent.

There was no significant increase in survival of babies born before 24 weeks - the current legal limit for abortion in Britain - and the number of babies who had major health complications was unchanged over the decade.

Costeloe said what while survival rates for babies born at less than 27 weeks gestation were moving in the "right direction", there was still room for improvement.

"We can't be complacent, because the fact of the matter is, that in 2006 if at this gestation you were alive at the end of the first week, you had no greater chance of going home (from hospital) than you would have done had you managed to survive the first week of life in 1995."

The second study looked at the health of the 2006 babies when at three years old and compared this with 1995. It found that while 11 percent more babies survived to three without disabilities the proportion of survivors born between 22 and 25 weeks with severe disability was about the same - at 18 percent in 1995 and 19 percent in 2006.

The researchers also found a link between gestational age and the risk of disability, with babies born earlier more likely to have serious health complications at three years of age.

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Iron may prevent behavioral issues in small babies

NEW YORK (Reuters Health) - Iron supplements may help boost brain development and ward off behavioral problems in babies who are born a bit on the small side, a new study from Sweden suggests.

Low birth-weight babies are more likely to end up iron deficient, researchers said. They need more of the nutrient for catch-up growth and haven't stored as much as other babies if they're also born premature.

For that reason, very early-term and very small babies are often put on iron - but less research has looked at babies born just shy of normal weight, to see if they are also at risk.

"I think this further solidifies the evidence that it's a very good idea to give these (marginally low birth-weight) children iron supplements," said Dr. Magnus Domellof, from Umea University, who worked on the study.

The research was led by his colleague, Dr. Staffan Berglund. Their team followed 285 infants born between 4 pounds, 7 ounces and 5 pounds, 8 ounces.

When the babies were six weeks old, the researchers randomly assigned them to get iron drops - either one or two milligrams per kilogram of body weight - or iron-free placebo drops each day until their six-month birthday.

Then at age three and a half, Domellof's team brought the kids back for IQ tests and surveyed parents about their behavioral issues. The researchers compared kids in the iron- and placebo-drop study groups with another 95 children who were born at normal weight.

There were no IQ differences based on whether the smaller-than-average babies had been put on an iron regimen. All three low birth-weight groups had average scores between 104 and 105. ("Cognitive impairment" in this study was considered an IQ under 85.)

However, significantly more babies given placebo drops had behavioral problems, as reported by their parents. The issues included problems managing emotional reactions, anxiety and depression, as well as sleep and attention problems.

Almost 13 percent of the placebo-group babies scored above the cutoff for clinical behavior problems, versus about 3 percent of kids who'd taken iron drops and kids from the normal-weight comparison group.

That suggests iron deficiency in infancy may be a direct cause of behavioral problems later in childhood, the researchers wrote Monday in the journal Pediatrics.

They are continuing to monitor the same group of kids as they get older, to see if new cognitive or behavioral problems develop or old ones get better as the children head into grade school.

Domellof said he and his colleagues didn't see any extra stomach problems in kids or delayed growth linked to the use of iron drops. Some research has suggested giving excessive iron to young kids who aren't deficient may stunt their development.

But, "I would not be afraid of recommending this to all children (born) below 2,500 grams (5 pounds, 8 ounces) at this dose," Domellof told Reuters Health.

"Here's where an ounce of prevention is worth a pound of cure," said Dr. Michael Georgieff, a child development researcher at the University of Minnesota in Minneapolis who had reviewed the study as part of Berglund's dissertation committee.

He told Reuters Health that it's important for all parents to know their baby's iron requirements when they leave the hospital.

"The issue with these marginally low birth-weight infants is, people really haven't paid a lot of attention to them, but the evidence is accumulating that they are at risk for behavioral problems and less than ideal cognitive function," said Dr. Betsy Lozoff, who studies the effects of iron deficiency in infants at the University of Michigan in Ann Arbor.

For most babies in the United States, extra iron is recommended starting at four to six months, either through supplements if the mother is breastfeeding or through formula. Very small or premature babies typically have their iron monitored from birth.

But Lozoff, who wasn't involved in the new research, said that in many places, there are no recommendations for how to treat babies who are just below a normal birth weight.

"This would suggest that it should just be a routine supplementation, and it can be at a low level of iron," she told Reuters Health.

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C-Sections Save Kids and Moms in Tanzania

It never ceases to amaze me how much the world says it wants to save children's lives and how rarely it tries to do the one thing that has been proven to protect more youngsters than anything else--keeping their mothers alive. (Maybe if it was called "orphan prevention?") That is why I was so pleased to hear that Tanzania's efforts to expand skilled medical care to all women during labor and delivery have started to pay off.  Dying during childbirth--typically from bleeding, high blood pressure or infection--is one of the most common causes of mortality for women in the poorest regions of the world--despite the fact that death in these situations is largely preventable.

The president of Tanzania, Jakaya Kikwete, spoke on October 2 at the United Nations in New York about the encouraging results of a pilot program designed to safeguard the lives of pregnant women in the remotest parts of the country--far from any hospital or major medical center. He began, however, by reciting a few sobering statistics. Currently, about 454 pregnant women die for every 100,000 live births of children in Tanzania. That ratio translates to about 8,500 women dying during or shortly after childbirth each year in Tanzania (population 46 million). Or another way of looking at it, 23 women die during childbirth each and every day there. By contrast, the maternal death rate in the U.S. was 12.7 deaths per 100,000 live births in 2007, or 548 women across the country annually .

The main idea for improving the maternal death rate in Tanzania (or any other poor country) is simple to explain and supported by solid evidence--although the logistics for putting it into place can be daunting. However it takes some getting used to--and a bit of background information--for people who are used to living in the richest parts of the world.

First, the background information. Ideally, when a pregnant woman develops an infection, has a worrisome increase in blood pressure or starts bleeding excessively, you'd like to treat the cause--with antibiotics, antihypertensives or anti-clotting medication, as needed. But these medications or, more often, the people with the knowledge needed to administer them correctly during pregnancy are often not available in the poorest areas of the world. On the other hand, delivering the baby right away, via cesarean section, can frequently solve the immediate problem and save both the mom's and child's life or simplify their subsequent treatment.

Now, you might think that correctly giving medication is easier than performing surgery, but in fact, that is not always the case. It can actually be easier and safer to train nurses and clinical officers (individuals who are trained to give basic medical care in many poor countries but who are not medical doctors) to perform cesarean sections in many areas of the world where access to sophisticate medical care is simply unavailable.

And so that is what Tanzania did. With support from Bloomberg Philanthropy, the government's Ministry of Health expanded access to emergency obstetric care in a few health care districts by training non-physicians to perform cesarean sections and upgrading rural health centers so that the operations could be performed there.

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