Inside UnityPoint - Winter 2015

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WINTER 2015 Employee magazine for UnityPoint Clinic® & UnityPoint at HomeSM

WINTER WEATHER FITNESS

VIRTUAL CARE: The Convenient Option for Care… Anytime, Anywhere

Step by Step: Gerald’s Story of Care Coordination & Recovery


TABLE OF CONTENTS 3

Did You Know?

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Unity Begins With You

SUCCEED

6 Cover Story — Step by Step: Gerald’s Story of Care Coordination & Recovery

8 Discover the Power of Hospice Volunteering

CARE

10 Virtual Care: The Convenient Option for Care… Anytime, Anywhere

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Medical Home: Unscripted

HEALTHY U

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Winter Weather Fitness

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Healthy Recipes


CEDAR RAPIDS, IA

MADISON, WI

SIOUX CITY, IA

Madison is one of only two U.S. cities built on an isthmus.

Mays Island is a small island in the Cedar River. Cedar Rapids is one of the few cities in the world with government offices on a municipal island.

Madison has five area lakes, over 260 parks and over 200 miles of shared-use trails and paths.

Sioux City is home to Palmer Candy Company, creator of the Bing candy bar.

Cedar Rapids is the largest corn-processing city in the world.

Madison was named after James Madison, the former U.S. president.

The Sergeant Floyd Monument in Sioux City honors Charles Floyd, a member of the Lewis and Clark Expedition, who died on the upstream voyage in 1804 and was buried there.

PEORIA, IL

The Cedar Rapids Museum of Art houses the largest collection of Grant Wood artwork.

Des Moines’ Downtown Farmers’ Market showcases more than 300 vendors from all areas of Iowa and surrounding states and attracts nearly 20,000 visitors on any given Saturday.

Peoria is the oldest European settlement in Illinois, and is named after the Peoria tribe.

Peoria has been awarded the All-America City Award four times (1953, 1966, 1989 and 2013).

Peoria is the largest city on the Illinois River.

Des Moines is the thirdlargest international insurance center after London, England and Hartford, Connecticut.

QUAD CITIES, IA & IL

DES MOINES, IA •

The Drake Relays in Des Moines have the longest streak of sellouts in U.S. track history.

The Quad Cities region is nestled on the only section of the Mississippi River that runs east to west.

Buffalo Bill Cody was born in LeClaire, Iowa. The original Buffalo Bill Cody homestead still stands today.

The John Deere world headquarters is located in Moline, Illinois.

Find Inside UnityPoint Magazine online on the intranet home page. Select the “newsletters” quick link in the left navigation and scroll to the “magazines” section. CONTACT US Inside UnityPoint Magazine is produced by the UnityPoint Clinic and UnityPoint at Home Marketing Communications Department. If you have questions about the magazine or ideas for future stories, email Allison McGrew at Allison.McGrew@unitypoint.org.

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DID YOU KNOW?

WATERLOO, IA •

Waterloo is home to the Sullivan Brothers Iowa Veterans Museum, a museum honoring the five Sullivan brothers of Waterloo who were killed in action while serving as World War II sailors.

The city took its name from the battle that occurred near Waterloo in presentday Belgium where British soldiers were victorious over Napoleon.

Dan Gable, Waterloo native and Olympic wrestler, was the 1972 gold medalist at the Olympic Games in Munich, Germany.

Managing Editor: Heather Nahas

Graphic Designer: Scott Rhone

Editor: Allison McGrew

Photographer: ZLR Ignition

Editorial Contributors: Erin Austin Alexis Hennig Allison McGrew Kelsie Zomermaand

Copyright ® 2015 UnityPoint Health. All Rights Reserved. ® SM trademarks of UnityPoint Health.

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Strong brands are built from the inside out. As staff and providers, you bring our brand to life every day through the work you do and the lives you touch. The success of our brand depends on all of us working together to deliver the kind of care our patients expect and deserve – providing the best outcome for every patient, every time. See how your colleagues are living out our brand promise:

“Hospice is a passion. Passion for hospice means caring, listening and portraying confidence at the end of life. You have to have passion to meet patients wherever they’re at.”

Mary Horstman , Hospice Admiss ions Coordinator | U nityPoint Hospi ce

“My goal is for the patient to be in the middle of everything. It’s not about getting a paycheck; it’s about helping the patient. When we keep that goal in mind, we find fulfillment in our jobs.”

er, MD gel-Brow Hanna En int Clinic UnityPo

“Unity starts from within. My attitude and my drive towards helping an individual begins there, then I am able to pass that attitude along to my patients.” 4

Jen Kirstein, Care Coord inator UnityPoint Clinic


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“Every member of our team has a special role. Whether it’s a person that straightens up the room, the physical therapist, the nurse or the physician, no role is more important than another. We all work together to play a part in our patients attaining better health.”

Nurse nnes, Parish ity Cathy The rin T Health – UnityPoint

“What motivates me is the quality and integrity of the people I work with every day. Everyone from our generous donors, to our dedicated clinical and administrative staff and even our UnityPoint Health Affiliates, all of us working together helps me feel motivated and that I’m a part of something for the greater good.”

Amy Recob, Director of De velopment UnityPoint Health - Me riter

“What I admire about my coworkers is that we’re in it together. When we see the struggles that our coworkers are going through, we help each other in both our work and personal lives. Being part of that family doesn’t just stop at the door. ”

acist Stephanie Lasko, Pharm ke’s Lu St. UnityPoint Health –

HOW DOES UNITY BEGIN WITH YOU? Because you contribute to our brand in a unique way, tell us your story about how Unity Begins with You by submitting your story at brandcentral.unitypoint.org.

VIDEO

Visit Brand Central to watch the video of our employees living out our brand promise as a team.

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SUCCEED

STEP by STEP: Gerald’s Story of

Care Coordination Recovery

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Last August, Gerald Stuart didn’t know if he would ever show his horses at the Iowa State Fair again. He suffered a massive stroke at his home in New Virginia, a rural community 40 miles south of Des Moines. Because of his critical condition, he was taken by LifeFlight to UnityPoint Health® – Methodist for emergency care. He was stabilized, but his initial prognosis was poor. He lost function on the entire right side of his body, required a feeding tube, and was in need of extensive therapy and rehabilitation. However, due to the coordination of his hospital care team and UnityPoint Clinic – Physical Medicine and Rehabilitation at Methodist Plaza, Gerald steadily improved and transitioned to Younker Rehabilitation Center. After spending a total of 74 days in the hospital and receiving care from physicians,


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nurses and therapists, Gerald was discharged into home care. UnityPoint at Home then cared for Gerald beginning in mid-November 2014 and continuing until mid-March of this year. During this time, he made even more progress. While Gerald could walk, he required significant help and assistance. Communicating was still very difficult, as his speech and writing skills were very limited. His care included nursing visits, some speech therapy, and several occupational and physical therapy visits. Now Gerald can independently walk and manage the stairs in his home, has regained most of his speech, and can sign his name again. He continues working on strengthening his fine motor skills. His care team says that his recovery is remarkable and attributable to his wife, Bea, and her work with him. Gerald wasn’t quite done yet. He still had one more important milestone to reach on his road to recovery. Gerald and his son Jim are farmers, and they raise Belgian Draft horses. These are large, working horses traditionally used to pull wagons and other farm equipment. They have entered many draft horse events over the years, and Gerald’s goal was to participate in a show, specifically the Iowa State Fair. Gerald had not missed the fair in many years, and this one was no exception. In August, while being cheered by family, friends, and members of his UnityPoint at Home care team, he was able to drive his team of horses, Judy and Ginger, in

VIDEO

the Iowa State Fair, almost exactly a year since he suffered his stroke. Gerald’s story is inspiring, and illustrates how important coordinated care is to producing the best outcomes for our patients. Everyone involved played an important role in helping him recover. From LifeFlight, which saved critical time, to the extensive care and rehabilitation at Methodist Hospital and Younker Rehabilitation Center, all prepared Gerald for being discharged in his home. His home care team continued, providing seamless nursing and therapy, and working with his family to ensure that he was at the center of their care. Bea Stuart wrote a letter thanking each and every UnityPoint Health care team member who had a part in caring for Gerald stating, “My husband is making wonderful progress. We will be forever grateful to all who have given us this opportunity for a more fulfilling life.”

Watch the video about Gerald’s care coordination by visiting unitypoint.org/homecare/coordinated-care-approach.aspx 7


Discover the Power of Hospice Volunteering

From left to right: Linda Alexandres, volunteer coordinator; Terry Hertges, volunteer; Jillian Van Donselaar, volunteer coordinator; Pat Morton, volunteer; Mary Larson, volunteer coordinator; Jerry Beck (back), volunteer; Kay Jipp, volunteer; Cindy Smith, volunteer.

The holiday season is a good time to give back and recognize the great work that UnityPoint Hospice does in our communities. One of the unique aspects of hospice care is that it utilizes the help of volunteers to provide comfort and compassion to patients and their families.

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Recently, four UnityPoint Hospice volunteers were honored at the Hospice and Palliative Care Association of Iowa’s annual Volunteer Recognition Event. The honorees are nominated for their service and commitment. They are: •

Jerry Beck, Fort Dodge

Terry Hertges, Waterloo

Kay Jipp, Storm Lake

Pat Morton, Des Moines


Pat Morton began volunteering in 2014 with UnityPoint Hospice and has served patients and families in many different ways at Taylor House in Des Moines, bereavement services, NODA (No One Dies Alone) and We Honor Veterans.

experiences. I always ask if they would like to talk to me about where they served and if they want to share their story.

What drew you to volunteering?

Explore your own feelings, especially if you have experience with someone dying or dealing with a terminal condition. Know what you are able to give, and know that you are giving comfort to the patient and family.

In 2003 I lost a sister, two good friends, my father-in-law and my husband. I always felt that I had a good support system to help me through that time, and I knew that when I was ready, I wanted to give back.

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BECOMING A HOSPICE VOLUNTEER:

What would you say to someone considering becoming a hospice volunteer?

What do you witness as a volunteer? Everyone is different as they go through the process of dying, so you learn to feel what they each need. Sometimes it’s reading to patients, or just sitting beside them and patting their hand. And sometimes a hug is worth a thousand words. Describe about a meaningful moment you had as a volunteer. I visited with a World War II veteran, who was in the same area of the South Pacific that my father served in. We were able to share a connection that way. As a military veteran, and the widow of one, I know that I can relate to fellow veterans and their

VIDEO

Pat Morton, volunteer

Learn more about hospice volunteering and how you can get involved by visiting unitypoint.org/homecare/hospice-stories.aspx 9


CARE

Virtual Care Anytime, Anywhere, Any Device

In June, UnityPoint Clinic introduced a new way to get care for common illnesses – from the convenience of your smartphone, tablet or computer. Virtual care offers medical appointments with board-certified providers by phone or secure online video. And UnityPoint Health employees are realizing just how convenient it can be to get care anytime, anywhere – from home, at work or on the go. When Kim French, senior administrative assistant at UnityPoint Health, noticed her son was coming down with a sudden case of hives the night before his end-of-season baseball tournament, she needed convenient care fast. “Gavin had red, raised, itchy hives all over and needed to see a doctor, but we had to be on the road by 8 a.m. the next morning.” Kim knew that virtual care was a new service and decided to give it a try. She found that activating an account was easy. After completing her son’s profile she got help uploading photos of his hives so the provider could see them. “She was able to give us a diagnosis by looking at the photos of Gavin and she even sent a prescription to our local pharmacy.” “In this situation, virtual care was the best option for our family,” Kim said. “We didn’t have time to see our regular doctor or get to an urgent care clinic and risk being late for the tournament. Instead, we were able to have a provider call us without ever leaving home.” Kim was impressed with the virtual care provider and the overall experience. “Our provider was very thorough, asked lots of questions and the process was easy to understand. We will definitely use virtual care again!”

>>>>

Here’s what other UnityPoint Health employees are saying about virtual care:

“Virtual care worked so well for my family I created an account for my older son so he could use it while he’s away at college.” – Pam Samuelson, UnityPoint Health – Quad Cities

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“My son had a bad case of poison ivy that was starting to spread, but with virtual care we got what he needed to take care of it fast. It was great!” – Todd Richard, UnityPoint at Home

“My two-year-old son had pink eye, we were out of town and it was 8 o’clock at night. Virtual care was the perfect solution. The hardest part was getting him to hold still so we could send a photo to the provider!” – Jessica Meisner, UnityPoint Clinic


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MEET THE UNITYPOINT CLINIC VIRTUAL CARE PROVIDERS Erica Parrish, ARNP, remembers reading articles about virtual care when she was working toward her graduate degree. “It seemed really futuristic then,” she explains. Erica didn’t know that just a few years down the road she would be providing medical exams electronically as a virtual care provider with UnityPoint Clinic. Erica was trained on the virtual care platform by MDLIVE, the telehealth company UnityPoint Clinic partners with to provide the new service. The online, face-to-face education resembles a virtual care video visit. Providers learn to use the MDLIVE system, chart patient information and diagnosis by phone or video. Erica explains that while the technology was new, the rest of the experience is very familiar. “The virtual care practice itself – the care protocols – are the same as in the clinic setting.” Having its own employed providers as part of the virtual care team was important to UnityPoint Clinic to ensure quality and continuity of care. Erica and Cynthia Kildare, ARNP, helped launch the new service on June 1, 2015. The two cover daytime shifts on weekdays and weekends, when the majority of virtual care visits occur. The telehealth physician network from MDLIVE covers late evening and overnight appointments. Cynthia is also impressed with the evolution of telehealth during her career. “I first experienced virtual care when I was caring for patients in the prison system. We used a similar method for psychiatric counseling and it worked beautifully.” With experience in urgent care, family medicine and emergency medicine, Cynthia appreciates how telehealth improves convenience and expands access to quality care. “At first, I wondered if on the phone I would be able to get the whole story,” she says. “I quickly

Erica Parrish

Cynthia Kildare

learned that even if you don’t see the patient, it’s amazing what you hear. You tune in to what they’re saying, how they’re saying it and ask questions to understand what you can’t see. Using care protocols for telehealth, you make sure you get the same picture of your patient’s health as you would sitting in a room with them.” As innovative as virtual care is, most people who use it opt for a phone visit over the video option, but Erica expects that will change in time as people become more comfortable with virtual care in general. “More people are beginning to opt for video, which is really handy with visual symptoms like rashes,” she says. “Having a good picture of things helps make a good diagnosis.” In December, UnityPoint Clinic will welcome its third virtual care provider to the team, Shelbie Curry, ARNP. You can choose Erica, Cynthia or Shelbie for your virtual care visit from the provider directory when you are scheduling an appointment. Just look for the UnityPoint Clinic logo near their names and photos. Virtual care is available to all UnityPoint Health employees, patients and the general public. If you are enrolled in a UnityPoint Health employee health plan, go to mdlive.com/uphemployees or call (888) 727-7150 to activate an account or schedule a visit. Others may go to unitypoint. mdlive.com or call (888) 727-7339.

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CARE

Medical Home:

UNSCRIPTED

“I am so impressed by my team here at Urbandale on their grace through this transition. They have persevered through Epic, an entire clinic remodel, Lawson and to PCMH in just a few months’ time. Each day there are smiles and laughter, amazing team work between providers and staff and they continue to make each day fun. PCMH has been a successful and seamless transition for us thus far.” — Bekah Johnson, Clinic Administrator Family Medicine – Urbandale

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INSIDE UNITYPOINT

Staff and providers of UnityPoint Clinic – Family Medicine | Urgent Care – Urbandale

FOLLOW A CLINIC TEAM AS THEY BECOME A MEDICAL HOME! UnityPoint Health believes that better coordinated care leads to a better care experience, better health and lower costs. So across the health system, we are making changes to how we coordinate care by working together as a team — with each other and with our patients. At UnityPoint Clinic, providers and staff are improving primary care by transforming their practices into medical homes. Patient-Centered Medical Home is a primary care model designed to improve patient care through teamwork, access and technology. After piloting the model in several clinics in 2012, UnityPoint Clinic began the process of implementing it in its family medicine, internal medicine and pediatrics clinics across multiple regions. Today there are 73 primary care clinics designated as medical homes and more to come. Becoming a medical home is a 10-month process that involves a lot of hard work — and a lot of change. Providers and staff alike are challenged to do things differently, change familiar workflows, even co-locate with each other in pods. Most clinics admit it was rough in the beginning, but well worth all the effort. Now you can experience a medical home deployment yourself from start to finish, whether or not you work in a clinic. Medical

Home: Unscripted follows the team at UnityPoint Clinic Family Medicine in Urbandale, Iowa through their journey to becoming a medical home. Follow them on the intranet, get to know the team members, and hear about their ups and downs as they work together to change health care for the better. Since their kick-off, they’ve been challenged with staff shortages, learning new roles and getting comfortable with Epic. “Overall they’re doing great,” said Holly Ashley, project manager. “They’re building trust and relationships with each other and with their patients. And the patients have noticed that their provider always works with the same team now. They feel reassured seeing that connection.” Medical Home: Unscripted will give clinics set to implement the medical home model in the future a preview of what’s to come. And it will help other employees better understand and appreciate what it’s like to work in a clinic — especially during a time when so much in health care in changing. Medical home is a great example of why change is worth the effort. Follow Medical Home: Unscripted to keep up with the Urbandale team throughout their medical home deployment. Read about their progress, see photos and watch video testimonials from providers and clinic staff. You’ll find a link to the site on the home page of the intranet under Quick Links. 13


HEALTHY U WINTER WEATHER FITNESS When winter weather hits, it’s easy to forget about our fitness goals. Spending an evening on the couch with a cup of hot cocoa almost always sounds better than bundling up and braving the icy roads to make it to the gym. And it’s not just the cold weather that deters us from staying in shape in the winter. Studies have shown that during winter months, our bodies naturally produce more ATLPL than usual. ATLPL is a chemical that promotes fat storage. That’s right: the odds are stacked against us when it comes to staying fit through the chilliest months! Fortunately, there are many ways to keep our waistlines under control throughout the holiday season, whether you prefer to stay inside or brave the outdoors. Check out these winter fitness ideas!

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STICK TO YOUR ROUTINE Snow and cold weather doesn’t mean you have to move your workout indoors. Think of the outdoor activities you did throughout the fall. Can you alter them slightly to get the same great fitness benefits while also staying safe? We think so! Getting outside for a run or brisk walk will be invigorating compared to your time cooped up inside. Just make sure you take the right precautions. Invest in a shoe with good traction, like a trail-running shoe that has deep treads. You’ll also want some good waterproof socks and gloves, as well as warm, layered gear. Start your winter jogs off slowly, and make sure you’re confident in your footing no matter where your run takes you. Perhaps most important of all: avoid hills! PLAY OUTSIDE Who says kids get to have all the fun when it comes to playing in the snow this winter? Bundle up and get outside for an old-fashioned snowball fight! Remember how exhausting it was to play outside for a few hours as a kid? Imagine how many calories you burn running through knee-high snow during a single snow fight? You can even get a good workout in by sledding, shoveling snow, ice skating and even building a fire. Who knew winter fitness could be so fun?

START A NEW HOBBY

INSIDE UNITYPOINT

OUTDOOR Let it snow… and learn something new! Find the nearest slopes and try your hand at skiing or snowboarding. If hills are nowhere to be found, try crosscountry skiing or snowshoeing. Tromping through the snow will give you an instant cardio burst. Swapping your bike’s regular tires for snow tires is another way to stay active. HELP YOUR NEIGHBORS Volunteer to help friends and neighbors in the winter months. Shoveling sidewalks and distributing snow melt will make a big difference to someone in need. Not to mention, it gets you outside of the house and moving. Carrying a heavy trash can down the driveway can get your heart rate up, and this small favor could keep an elderly neighbor off the ice.

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INDOOR WORK OUT AT HOME Exercise equipment can be a great investment for those who like to work out without leaving the house, but you don’t need a home gym to stay fit! Consider buying a yoga mat, small free weights or even just a good pair of tennis shoes. The internet can be a great resource for exercise routines: check out Blogilates, Body Positive Yoga or even YouTube to find a great (and often free!) video workout tutorial that’s right for you! Another option is to keep a set of resistance bands next to the couch. Even when you’re vegging out in front of the TV, you’ll have a reminder to get active during commercial breaks. KICK HOUSEHOLD CHORES UP A NOTCH Vacuuming, sweeping and dusting can keep you active… and keep your house tidy! Try listening to music while you clean. A speedy beat will keep you moving, burning a few calories while making your place spick and span.

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GET ACTIVE AT WORK If you sit at a desk all day, staying active from 8-to-5 isn’t easy during any season. Things probably get even worse during wintertime, when bundling up for a walk around the building doesn’t sound quite as nice without the Midwest summer sun. But whether you’re in an office or not, there are plenty of ways to increase your activity. Walk up and down stairs or take a lap around the office. Even if it’s only for a few minutes, walking can boost your cardio and mobility. Drink water throughout the day from a small glass – refilling it often gives you a great opportunity to squeeze in a brief walk.


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JOIN A GYM OR INDOOR SPORTS LEAGUE Sure, we don’t like to leave the house any more than usual during the winter. Look for a gym that you drive past on your way home from work. That way, you don’t have to drive any further… and you can’t make a last-minute excuse not to go! Employees enrolled in a UnityPoint Health medical plan are eligible to receive a monthly gym reimbursement, so you could possibly have your gym membership paid for! If you prefer organized sports over lifting weights and exercise equipment, research winter sports leagues in your community. Many city recreation departments, churches and community groups organize indoor sports leagues in December and January. Get your friends together and start a basketball team!

Winter weather has a tendency to keep us indoors, but cold temperatures have been proven to raise metabolic rate. Keep that in mind when you’re planning your next winter workout! It’s also important to remember that working out isn’t the only part of staying fit in the winter. When the holiday season is among us, we tend to eat more carbs and more sweets than usual. To get inspired about eating healthy this season, check out some healthy recipes submitted by employees like you on page 19.

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HEALTHY RECIPES

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Peanut Sesame Slaw with Soba Noodles

Ingredients:

Ingredients:

• 5 pounds winter squash (such as butternut, buttercup, kabocha or hubbard), peeled, seeded and cut into 1-inch chunks (see Tip) • 2 tablespoons extra-virgin olive oil, divided • 1 1/2 teaspoons salt • 1/4 teaspoon freshly ground pepper, divided • 3 cloves garlic, minced • 2 tablespoons chopped Italian parsley Directions: 1.

Preheat oven to 375°F.

2. Toss squash with 4 teaspoons oil, salt and 1/4 teaspoon pepper. Spread evenly on a large baking sheet. Roast, stirring occasionally, until tender throughout and lightly browned, 30 to 45 minutes (depending on the variety of squash). 3. Heat the remaining 2 teaspoons oil in a small skillet over medium heat. Add garlic and cook, stirring, until fragrant but not brown, 30 seconds to 1 minute. Toss the roasted squash with the garlic and parsley. Taste, adjust the seasoning and serve. Make Ahead Tip: Cut squash up to one day ahead and store airtight in the refrigerator. Nutrition Information: Serving size: 3/4 cup; Serves 10 Calories: 104; Total Fat: 3g; Saturated Fat: 0g; Mono Fat: 2g; Cholesterol: 0mg; Total Carbohydrate: 21g; Dietary Fiber: 6g; Protein: 2g; Potassium: 555mg; Sodium: 375mg. Submitted by: Gloria Schulte Source: EatingWell.com

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Oven Roasted Squash with Garlic and Parsley

• 4 ounces soba noodles • 1 small purple or green cabbage, sliced into quarters and core removed • ½ pound (about 12) Brussels sprouts • 4 carrots, peeled • 1 bunch green onions, trimmed and sliced into thin rounds • ½ cup peanut butter (unsweetened works best) • 3 tablespoons white wine vinegar or rice vinegar • 3 tablespoons toasted sesame oil •3 tablespoons reduced-sodium tamari, soy sauce or Bragg liquid aminos • 2 tablespoons honey or agave nectar • 1 tablespoon finely grated fresh ginger • 2 garlic cloves, pressed or minced • Sprinkle of coarsely chopped peanuts • Handful of cilantro, coarsely torn • 1 lime, sliced into wedges Directions: 1.

Cook the soba noodles: Bring a large pot of water to boil and cook the noodles according to package directions. Drain and rinse with cold water before returning to pot.

2. Prepare the vegetables: This is easier in a food processor than by hand. If using a food processor, shred the cabbage and sprouts with the slicing disk, then grate the carrots using the grating disk. Or use a chef’s knife to chop the cabbage and sprouts into thin strips, and coarsely grate the carrots. 3. Prepare the dressing: In a small bowl, whisk together the dressing ingredients until smooth. 4. In a large serving bowl, combine the cooked soba noodles, shredded cabbage and sprouts, grated carrots, and chopped green onions. Pour dressing over the vegetables and toss to coat (you may or may not need all of the dressing). For best flavor, let the slaw marinate for 20 minutes before serving. 5. Serve slaw with a sprinkling of chopped peanuts, torn cilantro and a lime wedge. Submitted by: Jacob Shkolnick Source: CookieandKate.com

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8101 Birchwood Court, Suite N | Johnston, IA 50131

000970-2 10/15 CS

Visit the LiveWell online health information center: unitypoint.org/livewell

Health and wellness articles, infographics, videos, recipes and more, designed to help you live a healthier life.


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