Thursday, December 31, 2009

See You Next Year

New Voices is off for the rest of the week as we celebrate the coming of a new decade.

Best wishes for a safe and enjoyable conclusion to 2009, whether it's at home, abroad, or classic 80's movie style.

Happy New Year everyone!

Wednesday, December 30, 2009

Regulations for Animal Research

Yesterday, we started talking about animal-based research, and the importance of healthy, non-stressed animals for all concerned. Today, I want to focus on the regulations that address humane care.

Even if researchers didn’t have a vested interest in keeping their animals healthy, there are federal laws in place to protect the animals, as well as personnel at every research institution to enforce these laws. If researchers break the rules, their funding gets pulled and their lab gets shut down. Not exactly a career-maker.

A researcher can’t just start experimenting. The research process is set up in a way that requires researchers to receive approval before using animals for research. There are a number of steps in place to make sure that the proposed research is:
  1. useful to public health, and
  2. has the proper steps to ensure that the animals are used humanely, and only as necessary.
Before researchers can begin an experiment, they propose their research project to obtain funding. This is where reviewers will assess the validity of the project. Then, they must also receive permission to carry out the experiments on their chosen subjects. For basic researchers using animal models, this permission is granted by the Institutional Animal Care and Use Committee (IACUC). They make sure that the animal use is appropriate, the protocols are humane, and that, once approved, the protocols are followed.

Having applied for IACUC permission myself, I can tell you they are extremely thorough and beyond simply approving protocol, may also propose alternate protocols that improve the experimental design and the welfare of the experimental animals. Once the protocols are approved, the research can begin.

There are a few other things to keep in mind throughout this whole process:
  1. The term animal model doesn’t refer only to the whole animal. Researchers can also use tissues or cells from an animal rather than the whole animal. I promise you, when researchers can do that, they do. This is easier, cheaper, and many researchers prefer to not use live animals. But in some instances, they need the whole animal. This is especially important when you’re considering how a treatment might affect the entire system (i.e. the cardiovascular system), and not just an organ (i.e. the heart).

  2. I also want to point out that these experiments are not just for human health, but also for animals. Many developed therapies are used to keep pets and farm animals healthy as well. Just recently I read about an experimental cancer treatment that is being tested in dogs that have cancer. These dogs have no other options for treatment, and so they have been enrolled in the study to test this treatment. If successful, researchers will have developed a cancer therapy for dogs - saving some dogs’ lives in the process - and gotten one step closer to treating cancer in humans as well.
Speaking of humans, it's probably about time we started talking about how all of this basic research and animal research applies to human health. The series will be back next Tuesday, when we'll discuss the next step in the process - clinical research trials.


This is Part 5 of 13 in our From Ideas to Treatments series.
Part 1 - From Ideas to Treatments
Part 2 - Basic Research: It Starts with an Idea
Part 3 - You're an Animal!
Part 4 - Can I care about animals and do research too?
Part 5 - Regulations for Animal Research
Part 6 - Clinical Research Trials
Part 7 - Patient Safety in Clinical Trials: IRB Approval
Part 8 - Recruitment
Part 9 - Health Disparities in Clinical Research
Part 10 - A Brief History of Inclusion Policies
Part 11 - Breaking News: Women and Men are Different
Part 12 - Including Minorities in Clinical Trial Research
Part 13 - Bringing From Ideas to Treatments Home

Tuesday, December 29, 2009

Can I care about animals and do research too?

My dog Dinah at agility.

As a junior in college, I was at a turning point: should I pursue veterinary medicine or a career in research? I loved animals and was very compassionate towards their well-being. I wasn’t sure how I felt about animal-based research. I understood the necessity, both from a research and a legal standpoint. Most people don't realize this, but it is mandated that researchers prove the efficacy of a new drug or therapy using animals (as models for humans) before testing the treatment on people. So, without animal research, we wouldn’t have medical advances. But, could I really devote my career to research if it meant involving animals?

I began talking to a number of people about my concerns. It was a friend of mine that finally convinced me. She pointed out that perhaps I was the perfect person to pursue a career in research, because I genuinely cared about the animals. Taking her point and trying to keep an open mind, during my senior year in college, and for two years after, I worked in a research laboratory to really get a feel for what it was all about.

Well, I was in for quite a surprise. Rather than the dank, dreary lab that I had envisioned, I found that these research labs were quite the opposite. I quickly learned that researchers have a vested interest in keeping their animal populations happy and healthy.

Imagine if you will, a college student, whose biology final is approaching. This student absolutely needs an A in order to graduate, and has yet to begin preparing. In a brilliant move, the student decides to lock himself in his room for the next 48 hours, with nothing but coffee, snacks, and the fear a flunking to keep him going. The stress of the exam, lack of sleep, and the isolation will probably all work against him, and in the end he’ll perform no better than if he hadn’t studied at all.

Option 2 is one that most college students never consider, but time and again has been shown to provide the best results. It is to study in groups, in short sessions, being sure to eat, sleep, and take some breaks in between study rounds. Option 2 works, because it keeps stress down. Stress is a tricky thing. When experienced for over a long time, it breaks down your immune system, making you more vulnerable to illnesses, and generally affecting your body in a negative way.

The same is true of animals. If you put them in an environment that causes stress, they’ll become more anxious and prone to illness. In general their behaviors change. As a result, as a researcher you can't include them in your research trials because they’ll likely give you skewed results. If they get sick, then you absolutely can't use them in your research trials. So, if you don’t care for them properly, you’ve basically spent a whole lot of time and money on an animal that you can’t use. Not ideal!

So, not only did I find that there were actually a large number of researchers like me, who really care about their animals, all researchers have a vested interest in insuring their animals stay healthy.

For now, I'll leave you with that, and tomorrow, I'll talk about the laws in place that mandate humane treatment for research animals.


This is Part 4 of 13 in our From Ideas to Treatments series.
Part 1 - From Ideas to Treatments
Part 2 - Basic Research: It Starts with an Idea
Part 3 - You're an Animal!
Part 4 - Can I care about animals and do research too?
Part 5 - Regulations for Animal Research
Part 6 - Clinical Research Trials
Part 7 - Patient Safety in Clinical Trials: IRB Approval
Part 8 - Recruitment
Part 9 - Health Disparities in Clinical Research
Part 10 - A Brief History of Inclusion Policies
Part 11 - Breaking News: Women and Men are Different
Part 12 - Including Minorities in Clinical Trial Research
Part 13 - Bringing From Ideas to Treatments Home

Monday, December 28, 2009

You're an Animal!


The Muppet Show Season 2

Did you ever look around at your family and think, "I canNOT believe I'm related to these people"? Even if you really love your family, sometimes the vast differences between you and your nearest and dearest can make you question your genetic gene pool.

In fact, your cousin Wilfred's* behavior at the dinner table might make it easier to believe that we share quite a large number of genes with other animals - about 97% of our genes match those of primates and approximately 94% match those found in rats and mice.

Don't believe me? Look at the structures that make up an animal body, and those that make up our human parts. We all have kidneys, stomach, livers, etc., and these organs all do the same thing across species. It may be hard to imagine, but it's true. Trust me.

Our similarities to other mammals means we can ask a lot of questions about human health, using animals as models. The vast majority of research (~95%) is done in rodents (rats or mice). The remaining 5% of research animals includes primates, sheep, pigs, cats, dogs, and invertebrates. Each of these models is carefully selected for the research question at hand. All of these animals have similarities, and differences, with humans that make them an ideal model to use in asking different health-related questions.

For example, let's revisit Dr. Jay and his interest in studying heart disease. Having realized that there is previous research showing that a certain protein in the body is higher in people who suffer from heart disease, he can increase or decrease the levels of this protein in an animal model and see if it affects the animal's heart. If it does, then he can begin to work on a way to control the levels of this protein, and in doing so, he might have found a new protein to target to decrease heart disease in humans.

Using an animal model that has the same cardiovascular system, Dr. Jay is one step closer to discovering a new therapy for humans.

Since we’ve started talking about animal research, I’d like to pause for a minute because I understand the concerns that some of you may have about using animals in research. Actually, I almost chose an alternate career because I wasn’t sure that I agreed with animal-based research. Tomorrow I'll share my story on the topic, and what I’ve learned over the years as a research scientist.


*Another unfortunate imaginary direct relation of Great Uncle Milton and Great Aunt Mildred.

This is Part 3 of 13 in our From Ideas to Treatments series.
Part 1 - From Ideas to Treatments
Part 2 - Basic Research: It Starts with an Idea
Part 3 - You're an Animal!
Part 4 - Can I care about animals and do research too?
Part 5 - Regulations for Animal Research
Part 6 - Clinical Research Trials
Part 7 - Patient Safety in Clinical Trials: IRB Approval
Part 8 - Recruitment
Part 9 - Health Disparities in Clinical Research
Part 10 - A Brief History of Inclusion Policies
Part 11 - Breaking News: Women and Men are Different
Part 12 - Including Minorities in Clinical Trial Research
Part 13 - Bringing From Ideas to Treatments Home

Thursday, December 24, 2009

Christmas Party Science Tricks

New Voices is off for the rest of the week, but we’ll be back on Monday with more fun and exciting posts.

In the meantime, we wish you and yours a Merry Christmas.

Oh, and just in case you want to add a little science to your holiday gatherings, try some of these cool party tricks to impress your friends and family.

Wednesday, December 23, 2009

Basic Research: It Starts With an Idea

Basic research comes from the idea that in order to treat a human condition - like pain, diabetes, or heart disease - we need to learn about that condition first. That's where I come in. Hi, I'm Jackie, and I'm a basic researcher.

As a basic researcher, I look at what we already know about a condition and the treatments that work, and then come up with new ideas to enhance both our understanding of the condition and how best to treat it.

How did we find out that ibuprofen soothes headaches, or that anti-histamines calm an allergic reaction? There was a process involved, and the process began with basic research.

We make hypotheses (educated guesses) to advance our field. Now that sounds all science-y and difficult, but we do our jobs using the same methods that most professionals use.

Take a small business owner; we’ll call her Sarah. Sarah sells sports equipment. As winter approaches, due to changing weather patterns and past history, she knows that she needs to order more ski equipment. But she can’t just order any old skis. She needs to consider what will sell. So she looks back at last year’s inventory, and finds that one company was more popular than any of the others she had carried, and there was a certain type of ski that constantly sold out. Of course, she’s going to use this information to inform her order for this year. She doesn’t just open up her catalog, sing eeny-meeny-miny-mo, and order wherever her finger lands. She hypothesizes that based on the data already available, skis X, Y, and Z will sell best.

To use a more researcher-friendly example, let's assume Dr. Jay's research focus is on heart disease. Like Sarah the business owner, Dr. Jay heads to the books to get started. He reviews already published literature on the disease, and notices that previous research shows an increase in the level of a certain protein in the blood for people who have just suffered a heart attack. Naturally, he wonders if this protein plays a role in the occurrence of that heart attack, and so goes on to figure out what it is, what controls its levels, and what happens when he blocks its production. By asking these questions, he's really wondering can this protein be a target that we can use to decrease instances of heart attack. As a basic researcher, Dr. Jay discovers all of this before applying it to humans, but his research is driven by the intention to use his findings to eventually improve upon public health.

You might not head to Dr. Jay when you have a cold, but his role in trying to keep people healthy is an important one. He starts with an idea, and then research continues from there.*


*Much like this series, which you can read more of next Monday!

Library image courtesy of Wrote.

This is Part 2 of 13 in our From Ideas to Treatments series.
Part 1 - From Ideas to Treatments
Part 2 - Basic Research: It Starts with an Idea
Part 3 - You're an Animal!
Part 4 - Can I care about animals and do research too?
Part 5 - Regulations for Animal Research
Part 6 - Clinical Research Trials
Part 7 - Patient Safety in Clinical Trials: IRB Approval
Part 8 - Recruitment
Part 9 - Health Disparities in Clinical Research
Part 10 - A Brief History of Inclusion Policies
Part 11 - Breaking News: Women and Men are Different
Part 12 - Including Minorities in Clinical Trial Research
Part 13 - Bringing From Ideas to Treatments Home

Tuesday, December 22, 2009

From Ideas to Treatments

Over the next few weeks, I am going to be writing a series that gets into the deep, dark secrets of the research world. Actually, it’s really just a chance for me to put my science researcher hat on one last time as a contributor to New Voices, and talk about an area to which I devoted better part of my adult life.

We use drugs every day to cure that headache, calm that cough, or even soothe that poison ivy rash that resulted from a weekend of gardening. But do you ever stop to think how that medicine came to be? Research goes beyond drugs. Your Great Aunt Mildred* couldn’t have gotten that coronary bypass surgery if not for research trials that tested, and then perfected, the technique.
So given that the results of research can be seen in everything that we do, let’s talk about how this process works. How does an idea become a life-saving therapy?

I'd love to give you a two sentence answer, but unfortunately, the process isn't that easy. Throughout the series, I'm going to do my best to explain the idea to treatment process in the hopes that by the end, we can all better appreciate the amount of time and effort that goes into this process that we call scientific research.


*She's married to Great Uncle Milton.

This is Part 1 of 13 in our From Ideas to Treatments series.
Part 1 - From Ideas to Treatments
Part 2 - Basic Research: It Starts with an Idea
Part 3 - You're an Animal!
Part 4 - Can I care about animals and do research too?
Part 5 - Regulations for Animal Research
Part 6 - Clinical Research Trials
Part 7 - Patient Safety in Clinical Trials: IRB Approval
Part 8 - Recruitment
Part 9 - Health Disparities in Clinical Research
Part 10 - A Brief History of Inclusion Policies
Part 11 - Breaking News: Women and Men are Different
Part 12 - Including Minorities in Clinical Trial Research
Part 13 - Bringing From Ideas to Treatments Home

Monday, December 21, 2009

A Final Farewell

Well folks, it seems that three months has gone by since I first started as a science policy fellow. That means my tenure here is up. It’s been a lot of fun, and I’ll miss writing for New Voices, but it’s time for me to move on.

Since one of the major focuses of the New Voices blog is to become effective advocates for science, and really, you can’t be an effective advocate without being an effective communicator, I wanted to focus on the that I’ve learned about science communication. In truth, while I’ve grown quite a lot during my time here, my take home lesson is that there are always more ways to improve, and the most difficult thing is recognizing where the gaps are and working on those.

I have had a career where my focus has always been in academics. Coming to Research!America, I held the view that academic and non-academic communication were very different. However, I’ve come to realize that the overall goal for both of these styles is to educate, and so really, they can’t be that different. The big difference is in the style.

Writing
When I was younger, I used to write fiction all of the time. For a time, I even dreamed of being a fiction writer. Once I chose science, I left fiction writing behind, and adopted a writing style expected in academia-one with a very serious, formal tone. The problem is in giving up one style for another. I didn’t consider that even as an academic, there would be times that I wasn’t writing for my colleagues; and truly, times that I shouldn’t be writing for them, but rather for the public as a whole.

Over the past three months, my focus has been to try and recapture the story-telling quality of my abandoned fiction writing days and intermingle it with my science writing. This is the only way to reach an audience that is not one of academics. Not only that, it’s made science much more fun for me. Rather than remain emotionless, I now focus on conveying my excitement while I’m writing.

I’m not saying that the formal style that I often used in academia is not useful. It has its place, but it shouldn’t be the only style in use.

Example: I recently submitted a job application, and the employer requested a writing sample. I sent them three, with a note explaining that each sample had a particular purpose: a technical writing style, a narrative style, and an in-between (for those times when you need to sound formal without using jargon). All of those styles have their place depending on the audience that you’re targeting.

The toughest part for me was figuring out how to develop a more narrative style of writing. So, I thought I’d share a few tips that I’ve come up with to guide myself in that endeavor:
  1. Write as though you’re having a conversation with your best friend, and their training is in some field unrelated to science (I like to think of my friend Carrie, who is a theatre major).
  2. Think of stories or analogies that can demonstrate the point and turn the concept that you’re explaining into more of a reality for your intended audience.
  3. Avoid jargon at all costs.
  4. Use pictures to illustrate your ideas.
  5. Be concise, but not technical - there’s a difference and sometimes it’s hard to determine.
Presenting
Giving presentations is the other part of this communications equation. I hadn’t realized until academia how technical my presentations had become. And let’s face it, technical means boring.
As a fellow, I had to reexamine my presentation style, and really make an effort to expand it for a non-academic audience. I’ve always been a good presenter, but now I realize I wasn’t an engaging presenter. There’s an important difference. So, here are my presentation tips:
  1. Don’t hide behind the slides. Limit your use of a laser pointer so that you’re only emphasizing distinct points. The more you look at the audience, the more they connect with you.
  2. Bring personal interest stories into your presentation. Don’t just tell your audience the punch-line. Tell them why they should care about it too. How does it relate to them?
  3. Keep slides simple and use pictures rather than words to highlight the main point.
  4. The only way the audience will be excited about your topic is if you are, so use your voice and your body language to convey your excitement. Don’t try to hide it.
So that’s it for me, my final words of wisdom. I hope you’ve enjoyed reading my posts as much as I’ve enjoyed writing them.

Au revoir.

Friday, December 18, 2009

Where Are They Now?

New Voices for Research would not have such an incredible archive of posts if it wasn't for the talented writers who have lent us their voices. As part of our blogoversary celebration, we're taking a look at where this year's contributors are now.

(alphabetically by last name)

Matt Hanzlik is back at the University of Minnesota for his senior year, and working as the conference manager for the Minnesota Parkinson’s Disease Forum. He’s still engaged with the Student Society for Stem Cell Research and being an advocate.

Rasika Kalamegham joined Friends of Cancer Research as a science policy analyst, and is based in the DC metro area.

Hillary Lewis
is working for the district attorney’s office in Brownsville, Texas.

Jackie Maffucci's last day is today, and you can read her sign-off post on Monday.

Susan Maya
is a clinical research coordinator at MGH Neurology in Boston, Massachusetts and is in the process of applying to medical schools.

Emily Norton stayed in the DC area and is a research analyst in the environmental health solutions group at The Cadmus Group, Inc., an environmental consulting firm that works primarily with the EPA. She’s focusing mainly on indoor air quality and its effects on health, such as asthma and lung cancer from radon. Not far from her series on climate change and health!

Ilse Peterson is continuing down the science policy road and is starting a job that will deal with a wide range of policy issues. She is excited to be staying in DC and plans to stay connected to New Voices.

Takao Yamada is in his second year of law school at Georgetown University in Washington, DC.


Emily Connelly and I will be continuing on, and we look forward to working with another amazing group of New Voices in 2010. If you're interested in being part of the New Voices team or a guest blogging opportunity, please let us know!

Thursday, December 17, 2009

Our First Blogoversary


268 posts later, New Voices for Research has made one revolution around the sun.

Over the next year, we hope to continue sharing useful and fun information to all our readers. We've always said that the best way to communicate with your audience is to understand them, so today we're asking you to tell us what you'd like to hear about over the next year.
On the last weekday of every month in 2010, we'll incorporate the first 12 topics* suggested via comment into a post.
If you absolutely love everything we write about New Voices, and can't think of anything better than reading what we dream up each weekday (you know you can't!), then you're in luck. As a special treat for those of you celebrating with us, we're offering a blogoversary gift to the first three commenters who leave us a note today mentioning (or linking) to your favorite post on New Voices this past year. (Be sure to link back to your blog or send us contact information so we can mail you your book!)

Heck, go crazy and leave us a suggested topic and a link to your favorite post!

We really love doing what we do and appreciate your readership and support. Thanks for making this a great year for all of us.

~The New Voices for Research team


*We can't include topics of questionable appropriateness or are promotional in nature, sorry. However, we're happy to figure out a way to include completely obscure or random topics in an interesting and fun way - so be creative!

Wednesday, December 16, 2009

One more day ...


... until the New Voices blogoversary!

Stop by tomorrow for the big celebration!

Tuesday, December 15, 2009

It's All About You

This is a map of readership over the past 12 months

Counting down to the big blogoversary, we thought we'd take a look back at who we've been writing for all year - YOU!

New Voices has had more than 16,300 visitors from 131 countries and every U.S. state and territory.

Our strongest international followings are in the UK, Canada, Germany, India, Australia, the Philipines, France, Brazil and the Netherlands. Here at home, our top ten states/districts are: Virginia, California, New York, Maryland, Texas, Pennsylvania, Florida, DC, Massachusetts, and Illinois.

You've commented, on average, once every third day; sharing resources and thoughts on everything from health reform to animal research to votes on the Coolest Scientist Ever.

Some of you are scientists, others communicators. Some just people who were looking for an image or a keyword and found us.

As we head into our second year, we hope to continue to draw people in and provide useful and entertaining posts. How did you discover New Voices? What kept you reading?

Monday, December 14, 2009

12 Months of New Voices

Thursday is the blogoversary of New Voices! We'll be celebrating all week and today we're joining in this meme (read: Internet game that has lots of people do the same thing so you can learn about each other).

The rules for this blog meme are simple.
Post the link and first sentence from the first blog entry for each month of the past year.
I encourage all of you to do the same, and leave us a note in the comments so we can come by and check out a year (or maybe less) of your blogging.

January 5, 2009
How to: Give a Tour of Your Lab
So, you have a 6-color FACS machine, an industrial-size centrifuge, and three hundred cages of morbidly obese mice.

February 3, 2009
Getting Started as an Advocate for Research
Profile: Dr. Robert Wells, PhD
Robert A. Welch Endowed Professor of Chemistry
Director, Center for Genome Research at the Institute of Bioscience and Technology, Texas A&M Health Science Center, Houston, Texas

March 2, 2009
Being a Spokesperson
Last week, we commented a little on being a spokesperson for science. Being a spokesperson for science is great, but being a good spokesperson for science is even better.

April 1, 2009
Research on Cherry Blossom Trees
Last week I wrote about research going on at the National Arboretum and asked if anyone knew more about it.

May 1, 2009
Climate Change and Health: Mental Health
Over the past two weeks you've read about a number of health implications of climate change, from cardiovascular and respiratory issues exacerbated by heat to vector-borne diseases like malaria and Lyme disease.

June 1, 2009
TV Science is Not Real Science
I don't watch a lot of popular shows, but after some prodding by a colleague here at New Voices, I watched an episode of House.

July 1, 2009
Speak out for Research Funding Now
Urge your members of Congress to support robust funding for NIH, CDC, AHRQ and NSF in FY 2010.

August 3, 2009
August is ____ Month
As we roll merrily into August, there are lots of special health issues to highlight.

September 1, 2009
Science and Entrepreneurship: An Introduction
Which of these statements is true?
Science = Mmm . . . this frozen pizza sure tastes good. *Sigh.* Wish I could afford something else for dinner.
Science = I'm glad I spent a gagillion hours on that research project, just to put someone else's name on it. *Sigh.* I wish I were my own boss.
Science = A business opportunity to create high paying jobs, keep what you earn, and be your own boss.
October 1, 2009
The Quest for Cures: Horizons in Cancer Research
Today Research!America hosted “The Quest for Cures: Horizons in Cancer Research” on Capitol Hill.

November 2, 2009
November is Diabetes Awareness Month
With obesity and type 2 diabetes on the rise in the United States, it is especially important to acknowledge National Diabetes Awareness month.

December 1, 2009
World AIDS Day 2009
The AIDS Memorial Quilt was established in 1987 as a telling symbol of the way HIV and AIDS effects people - it is one disease that manifests itself differently in each person.


Thanks to all of my fellow New Voices bloggers for their contributions over the past year. We wouldn't have 12 months of blogging without you!

Friday, December 11, 2009

Lessons from Great Uncle Milton

According to Great Uncle Milton, this child is a "carrier monkey."

December is a time for holiday cheer: family get-togethers, office parties, decorations, general merriment, and Great Uncle Milton* refusing to eat at a table with “carrier monkey” younger relatives.

Now, my niece and nephew are constantly exposed to germs at daycare, and because of this, they get sick. It’s not their fault and it certainly isn’t fun for them, but by getting sick their immune system builds up antibodies (proteins in body that attack diseases), so they can STOP being carrier monkeys.

However, my ear-hair-sprouting great uncle doesn’t really seem interested in that argument. So this year – just for him – we’re starting our holiday celebrations at New Voices (and maybe with the family?) with a lesson on hand washing.

There's an excess of research proving just how effective hand washing is at keeping illness away. We also know that throughout the day, we touch all kinds of things that hold unknown germs. In the past thirty seconds, I’ve taken a sip of water from my mug on my desk, typed on my keyboard, used my mouse, and in a moment of thought, rested my head on my hand. How many germs did I just transfer from all of those surfaces to my face?

An even scarier thought: money changes hands on a daily basis. Have you ever considered where that five dollar bill that the lunch lady just returned with your change (after you washed your hands) has been?

Oh gosh, I’m turning into Great Uncle Milton. Back to the lesson.

Hands should be washed anytime you’ve increased your exposure to germs: after you’ve touched raw food or used the bathroom, and before eating – for starters.

At this point, you’re thinking that this is ridiculous. You’re an adult and you know how to wash your hands. But if you were totally honest with yourself, you’d have to admit to maybe just running your hands under the faucet for a quick rinse from time to time?

Here’s what you should be doing:
  1. Remove any jewelry and wet your hands with warm water
  2. Rub your hands together with soap for 20-30 seconds (many suggest singing “Happy Birthday” or “Twinkle, Twinkle Little Star”)
  3. Be sure to wash between your fingers and under your nails and you're rubbing.
  4. Rinse you hands with warm water
  5. Dry thoroughly with a towel



The above routine removes 99% of germs. The soap is the most important factor, breaking the bonds that hold germs to your skin. Water alone just isn’t going to do it.

Remember, germs are on every surface (not just on the shorter members of the family), so keeping your oft-used electronics (think cell phone or laptop) and other surfaces clean can help decrease your daily exposure to illness.

We all want to stay healthy over the holidays; if for no other reason than eggnog doesn’t taste as good when you’re all stuffed up. And trust me, you’re going to need that eggnog if Great Uncle Milton is coming.


*No one here at New Voices has any family member named Milton, and we feel awfully bad for anyone named Milton, since they are always getting picked on in fictional stories about great-uncles.


Images of "Great Uncle Milton" (not his real name) are courtesy of hiro008.

Thursday, December 10, 2009

Adventures in Cuba

I was excited about the opportunity to go to Cuba since so few Americans get the chance. However, getting there is not easy, and although the U.S. and Cuba are less than 100 miles apart the distance between the two countries is almost immeasurable.

Our adventure - I was traveling with Karen Goraleski, who leads our Paul G. Rogers Society for Global Health Research - began in Miami, where there was mass confusion about checking-in and our charter left over an hour late. We would soon learn that this was pretty much par for the course on this trip. After 12 hours of traveling, including about an hour standing in a sea of blue plastic-wrapped bags (to prevent pilfering) waiting for our luggage, we made it to the hotel to find that it was overbooked. The hotel eventually came up with a solution, but this was not the way we wanted to start our trip.

We made our way to the Palacio de Convenciones the next morning for our meeting on tracking resources for health research. The Global Forum for Health Research officially started that evening with an opening ceremony planned by our Cuban hosts.

Cuba's Minister of Public Health, Jose Ramon Balaguer Cabrera (right) and Vice President Jose Ramon Fernandez Alvarez (center) both addressed the Forum. Together they spoke for more than an hour and a half about the Revolution and their health system. Interesting at first and then very, very tedious. Cuba does produce a large number of doctors and have some very good stats on measures such as infant mortality and vaccination rates, but their public health message is watered-down when the toilets in the convention center didn't have seats and then you were lucky to find soap in the bathroom (I don't usually rely on hand sanitizer, but I was really happy to have a small bottle in my purse!).

Although we spent most of our time at the Global Forum, we had a free afternoon to explore Havana. We opted to take a guided tour since our time was so limited. It, like most things in Cuba, started very late.

Our first stop on the tour was Plaza de la Revolucion where many political rallies take place and many government offices are located. The Ministry of Interior building features the image of Che Guevara, with the slogan "Hasta la Victoria Siempre" or "Forever Onwards Towards Victory." Guevara was a major figure in the Cuban Revolution and the first Minister of the Interior appointed by Fidel Castro.

This billboard commemorating the 50th anniversary of the Revolution when Fidel Castro claimed control of Cuba was on the perimeter of Plaza de la Revolucion - just one of many examples of propaganda supporting the regime that we saw.

Our next stop was a cigar shop, but we took the opportunity to look around the area rather than risk being stopped in the Miami airport. This photo captures a lot of what we saw in what seemed to be a neighborhood where average Habaneros live, work and go to school.

The tour made its way to El Capitolio, where the Cuba legislature met from the 1930s-1950s. Today, it houses the Cuban Academy of Sciences. This stop provided some of the starkest contrasts for us. The beautiful El Capitolio building and surrounding parks were on one side of the street.
While this building was directly opposite on the other side of the street. As evidenced by the laundry hanging from the balconies, people live in this building. We could tell that it was once very beautiful, but years of neglect and hurricanes have taken their toll.

However, Cuba, with the help of UNESCO, slowly has been restoring La Habana Vieja or Old Havana. The Castillo de la Real Fuerza borders the Plaza de Armas. The sculpture on the watchtower is called La Giraldilla and is the symbol of the city of Havana.
The ceiba tree in the picture above marks where Havana, then called Villa de San Cristobal, was founded on November 16, 1519. We were in Havana on the 490th anniversary, although we did not get to see the annual gathering where residents walk around the tree three times, dropping coins in the hope that their wishes will come true.


The Hotel Santa Isobel is a great example of one of the restored buildings in La Habana Vieja.

As the sun began to set, we stopped at some of Ernest Hemingway's haunts, including La Bodeguita del Medio and the Hotel Ambos Mundos. I used the last few moments of daylight to capture the photo above from the roof of the hotel.

Overall, my trip to Havana was fascinating, and I really enjoyed meeting many Cubans who were very friendly and always willing to chat. It will be an experience to remember that gave me a tremendous appreciation for so many things that as an American I took for granted before my trip.

Wednesday, December 9, 2009

Our Woman in Havana

Presenting at the Global Forum for Health Research held at the Palacio de Convenciones in Havana, Cuba.

So I'm not a spy, but I did have what will likely be a once in a lifetime opportunity to go to Havana, Cuba. I recently attended the Global Forum for Health Research, which I was able to do as a U.S. citizen under a general license to attend a professional meeting organized by an international organization.

Because of the work that Research!America does tracking the U.S. investment in health research, we were invited to participate in a day-long meeting that brought together other experts in the field of tracking resources for health research. I have been studying the U.S. investment in health research for more than five years now, so it was interesting to meet others from around the world doing similar work. The participants came from a variety of backgrounds with a range of perspectives about tracking health research resources. Some—like Research!America—focused on country-level spending, others looked at disease-specific research and still others took a more global view.

I think one thing that all of the meeting attendees could agree on is that tracking investments in health research, and specifically research for global health, is a challenge and that more information about what is being spent on research for health around the world is needed. As is often the case in meetings like this, more questions than answers were generated. Some of the key questions include:
  • What is the definition of research? Should infrastructure, salaries, capital investments and other research enabling activities be included?
  • Is there a difference between “health research” and “research for health?”
  • Which countries/organizations are tracking health research investments?
  • How can we establish guidelines for cross-country comparisons of their investments in health research?
  • How can this data be most effectively used for advocacy?
  • Should methodology differ when the data will be used in advocacy?

In addition to this meeting, I also had the opportunity to participate in a panel discussion titled “Who’s Investing and Who Cares?” that was moderated by New England Journal of Medicine Editor-in-Chief, Jeffrey Drazen, MD. I shared our data on the U.S. investments in health research and global health research, some of our public opinion polling that shows that Americans do care about the issue and information about Research!America’s Paul G. Rogers Society for Global Health Research.

Attending the Global Forum for Health Research also allowed me to meet an interesting array of people from around the world, all working in some way on global health, and to learn more about topics outside the realm of my day-to-day work, such as product development partnerships, incentives for global health research and the Cuban health system. Much more to come in my post tomorrow about the travel experience, Cuba and photos from a brief tour of Havana.

Tuesday, December 8, 2009

A Literal Look into H.M.'s Mind

Discoveries take time, and scientists must be meticulous in the steps leading to these discoveries. I like to think of science as building a house. First you lay the foundation, the most important part of the process. Then you add to the foundation piece by piece, following a carefully laid out plan.

As you put the plan to action, and the house begins to take shape, you might need to make a few adjustments to make sure that the kitchen or family room is just right. Over time, the result is the house of your dreams, and while it might have taken a bit longer than you expected, all of the waiting suddenly becomes worthwhile.

Today, I'm going to follow up on a story I began to tell you last week, that truly embodies the discovery process. As you may remember, we were discussing the contribution that H.M. made to science during his lifetime. On December 2, 2008, H.M. died, and in his death he continues to contribute to science. He donated his brain so that researchers could continue to learn from his life.

By donating his brain, researchers can now examine the structures of his brain and relate it to observational data that they have collected over the past 50 years. They can look at the distribution of different components of these regions, and relate these structural observations to their behavioral notes. The possibility for advancing our understanding of the brain, damage to the brain, and the formation of memories is immeasurable.

The process of obtaining and preparing his brain for research has been a long, hard task. Researchers only get one shot at processing the tissue correctly. It began a year ago, where upon his death, H.M.'s brain was scanned with magnetic resonance imaging (MRI) to provide one final set of brain images while it was still in the skull. The brain was then removed and the tissue preserved for two months in formalin. Once the body dies, the tissue does as well. By preserving it, we insure that the tissue won't break down over time, but remains intact in a state akin to suspended animation.

Once completed, the preserved brain was moved to the University of California at San Diego as the newest addition to the Brain Observatory. The Brain Observatory is a fairly young research institute that acts as a library of human brain tissue. It is collecting donated brains from both healthy and diseased individuals, and hopes to create an online digital library of these specimens. This library will be available to anyone interested in the brain. Thus, this library will allow researchers to ask countless questions about the brain while allowing access to the public as well, providing a resource to provide further education about the brain and the scientific discovery driving our knowledge of this complex organ.

On December 3, 2009, after a year of preparation, the Brain Observatory was able to finally slice H.M.’s brain into smaller sections, a 30-hour procedure. This event was video-streamed online. Each slice measured 70 microns in thickness, resulting in anywhere from 26,000 - 36,000 slices for a human brain.

Some of these slices have been selected for digitizing. This entails mounting each slice on a slide and then staining each tissue with a particular dye. Each dye labels a specific component of the brain, such as brain cells (neurons) or support cells for the neurons. The slides will then be digitized and made available online to all who are interested. (To see the slicing process, click here).

By selecting a sampling of slices, rather than using them all, researchers create a series of images akin to a child's flip book. Just like these books, which tell a sequential story as you flip through, these sequential slide images provide researchers with a complete series of H.M.'s brain. An added advantage to using only a sampling of the brain slices for imaging is that the remaining tissue can be preserved and used for other experiments. This is a common technique that researchers use to "get more bang for their buck," since tissue like H.M.'s can be difficult to obtain.

It took a year - almost to the day - to even begin slicing H.M.'s brain for analysis. Digitizing the images will take months, or maybe longer. That may seem like a long time, but the discovery process is just beginning. This is the foundation for a house of research that is yet to come.

Monday, December 7, 2009

He Said, She Said

I love quotes. Historical quotes, movie quotes, random things my friends blurt out, basically anything. I have collections of them in different places, most obviously in my daily movie quote "away" message and on the post-its stuck to the map above the desk in my office.

I collect quotes, because they come in handy for so many things in writing.

1. Quotes can say the thing you want to say but in a way you maybe never would have thought to say it; and isn't that nice, easy to read thing way the heck better than all my rambling to get to the same basic point?

2. Quotes from leaders (in your field or historically) can bolster a message.

3. Quotes can serve as a piece of evidence.

My library of quotes is pretty large at this point, and I do have quite a few favorites from Thomas Edison's "ways not to make a light bulb" to Star Wars' "Let the wookie win." But instead of just sharing those with you, I want to hear from you!

What are your favorite quotes? What do you find yourself using fairly regularly?

And as a bonus for today's post, the trailer for He Said, She Said.

Friday, December 4, 2009

Remembering the Man Who Forgot



If you’ve ever taken an intro psychology class, you’ve probably heard of patient H.M. For years H.M. suffered from epileptic seizures. They got so bad that in the 1950s, he opted to undergo an experimental surgery. This surgery removed a portion of his brain, and the theory was that in doing so, would cure his epileptic seizures.

The surgery was a success, as far as the seizures were concerned, but his doctors were surprised by the “side effects” of the surgery. H.M. became an anterograde amnesiac. Basically, he lost the ability to create new long-term memories.

However, H.M. was able to turn this misfortune into an opportunity for others. Rather than fade into obscurity, H.M. opted to continue working with doctors and researchers. Through this 50 year collaboration came a wealth of information that advanced our understanding of the brain and memory formation, ultimately informing neuroscience research and shaping health care today.

Before H.M., it was thought that memory was a generalized process of the brain. His case provided scientist with the first evidence that contradicted this thought. If memories were generalized, the removal of a portion of the brain should not have obliterated memory formation. The fact that for H.M., the direct result of his surgery was the loss of long-term memory showed conclusively that memories were a function of specific brain regions.

Beyond this, doctors were now able to identify that there were also categories of memory. H.M. retained his procedural memory and short-term memory capabilities, but lost long-term memory formation.

For example, while H.M. could remember how to ride a bike (a memory referred to as a muscle memory because it involves an action of the muscles), he couldn't remember HOW he learned to ride a bike. His procedural memory was intact, and he had a decent short-term memory, but he couldn't convert those short-term memories to long-term. If you asked him what he had for breakfast two hours after he ate, he wouldn't be able to answer you, and beyond that, he wouldn't even remember eating breakfast!

What is most interesting about H.M.'s case is that although it was generally accepted that he could not form long-term memories, there were exceptions to the rule. For example, he remembered the assassination of John F. Kennedy, something that given his condition, he shouldn't have remembered.

We know that the brain can be adaptable. For example, a person who is blind generally develops a more keen sense of hearing, and this happens because the area responsible for vision adapts, becoming sensitive to detecting sound. This finding with H.M. has researchers wondering if the same phenomenon occurs with memories. Can other brain regions "fill in" for lost or damaged memory regions; or was his limited ability to form long-term memories present because there were some memory-associated brain tissue left behind from the surgery?

H.M. died December 2, 2008, but his contribution to science lives on. This man spent 50 years of his life working with scientists and researchers so that we can better understand the brain, and in doing so, helped advance the means by which we treat patients with for those with brain injuries, impairments, and other neurological disorders.

But his story doesn't end here. He donated his brain to science, giving researchers the ability to physically examine the structures of his brain. We can now relate the years of observational data that H.M. contributed to the actual physical structures of his brain. This donation could potentially undercover an entirely new level of understanding as to how the brain and memory formation works.

Often when we hear of breakthroughs in medical research, we tend to forget that there are real people behind these advances; people who selflessly donate their time and their bodies to help discover medications like Aspirin, Prozac (for mental health), and Lipitor (for cholesterol).

As a researcher, I'm constantly thinking about how research findings translate to medical miracles for our diverse human population. This is something that I've been focused on during my time at Research!America, and a topic that I will revisit in later posts.

For now, I'd like to take a moment to thank all of those people who have enrolled in clinical research trials, and to encourage others to learn about these trials. H.M. is one example of the difference that one person can make by volunteering for clinical research.

Visit us Tuesday to learn more about how H.M. is contributing to the field even after his death.

Thursday, December 3, 2009

How To: Communicate with Food

For your next chemistry-themed party, an idea from BuzzFeed.

Whenever I’m trying to describe something that is new or difficult to understand, I try to relate it to something else that my audience already understands. In my family, one of the best metaphors is food.

In a lot of ways, cooking is similar to lab work. Some experiments require precise timing, while in others the specificity of ingredients (materials) is more important. In both instances, if you want to recreate the final product, you have to take measurements, record each step, and think of variables that could effect the outcome next time (what if I use a different pan or the produce isn’t as fresh?).

But metaphors are not the only way to communicate with food. Sharing meals is a great way to learn to talk about what you do in an informal way. Without the networking pressures of a conference or academic setting, you’ll more freely be yourself, and your passion for your work will be obvious in how you talk about it. (Just be careful not to gesticulate with food on the end of your fork.) Moreover, sharing details over meals gives everyone time to listen and absorb as well as participate in the discussion.

Just a little food for thought for those of you looking for ways to more effectively communicate your ideas.

Wednesday, December 2, 2009

You Can Help Make Research a Higher National Priority

Advocates nationwide are expressing their gratitude for the recent revitalization of research by writing letters of thanks to President Obama. If you haven’t, you can join them. As we urge the president to continue to make research a priority in Fiscal Year 2011, we must also reach out to our members of Congress.

Ask your members of Congress to get on the record about where they stand on supporting research online at Your Congress-Your Health and thank those who have already responded.

Patients, scientists and other research advocates across the U.S. must join together to urge Congress to support innovation and invest in research to improve health. Visit http://www.yourcongressyourhealth.org/ today and join the thousands of Americans each week who are helping make research a higher national priority.

Tuesday, December 1, 2009

World AIDS Day 2009

The AIDS Memorial Quilt was established in 1987 as a telling symbol of the way HIV and AIDS effects people - it is one disease that manifests itself differently in each person. Similarly, the quilt squares all teach, memorialize, or reflect the social ramifications of a virus that has embedded itself in the world's psyche and too many of its citizens.

According to the UNAIDS report released last week, 33.4 million people are living with HIV, and in 2008 alone, 2.7 million new infections were reported while 2 million people died of AIDS worldwide. However, there is hope. New HIV infections have been reduced worldwide by 17% over the past eight years.

HIV is unique as a disease because it is a retrovirus. Not retro like bell bottom jeans and disco music, but certainly backwards. For an initial infection, instead of the DNA coding for the RNA (which tells the proteins to be lethal to cells) like a normal virus; HIV uses a reverse process where the RNA tells the DNA what to do, and the DNA then creates the codes for the deadly proteins. If that sounds confusing, this more thorough explanation should help.



HIV was only the second known retrovirus at the time of its discovery, so we can thank quick thinking researchers for the origination of anti-retroviral drugs. The development of anti-retrovirals has made HIV a much more manageable disease.

Research has certainly made HIV much less of a death sentence to those who have access to anti-viral therapies, but it still is not a cure, and millions of people die each year from HIV/AIDS. While HIV prevention programs have made an impact on reducing the number of people infected, there is a need for a preventative treatment.

Current research is focusing on the development of a vaccine against HIV. There have been many challenges to finding a safe vaccine because of the nature of HIV.

HIV appears to be a master of change. Currently, there are many known strains of the virus, and possibly other unknown strains. This variability makes it difficult to develop a vaccine that will target all of these subcategories of the virus.

Development of vaccines is a timely process. From the first polio epidemic, it was 61 years until a vaccine was developed. It was 19 years from the first case of Hepatitis A to the implementation of a vaccine. So for researchers to report some promising data suggesting that they might have discovered a viable AIDS vaccine in just over 2 decades is amazingly fast for such a complex disease.

Researchers are cautiously optimistic, as there have been previous trials of other vaccines that showed promise, only to fail with more testing. However, regardless of if this newest vaccine fails or succeeds, researchers will have more information to use in developing therapies to combat this virus.

This World AIDS Day, we remember those who've been lost to this disease and look forward to a future post where we can definitively say that HIV/AIDS is no more.

Monday, November 30, 2009

Understanding Diabetes

On each Monday throughout November, we've discussed diabetes in recognition of Diabetes Awareness Month. We've focused on the personal stories of those diagnosed with type I and type II diabetes, and offered some recipe alternatives for the Thanksgiving holiday.

However, we have yet to talk about the differences between the types of diabetes. Just like the Thanksgiving turkeys that we all enjoyed over the holidays, either baked, smoked or even (bravely) fried, not every diabetes diagnosis is the same.

The terms type I and type II diabetes may be familiar to you, but do you know what they mean? I myself often forget. So today, I thought it might be time for a refresher, and while we're at it, let's discuss gestational diabetes as well.



Type I Diabetes
Type I diabetes, previously referred to as juvenile diabetes, results from your body being unable to produce insulin. Insulin is a hormone released in the body that allows the cells to take in glucose, which provides the cells with energy.

Historically, this type of diabetes is thought to appear in juveniles and young adults, but truly, it may be diagnosed at any age.

The most common treatment to manage type I diabetes is insulin injections. Although the body can't produce insulin itself, by injecting it into the body, cells can use this source of insulin to help to absorb glucose. Other methods of treatment include a pancreas transplant (since the pancreas is the organ that houses the insulin producting Islets of Langerhans cells), or a transplant of the Islets themselves.



Type II Diabetes
Type II diabetes is a metabolic disorder in which either the body doesn't produce enough insulin, or once produced, the body can't use the insulin properly. When insulin is released, it binds to proteins called receptors located on the cell. Once the receptors receive the insulin, the cell can then absorb glucose. In some patients with type II diabetes, the receptors that recognize the produced insulin don't work, so glucose can't enter the cell even though insulin is present.

In this case, the best therapy is attention to lifestyle. Exercise, a healthy diet, and weight loss are the best means by which to decrease the chance of onset of this disease and to control it once it is diagnosed. In doing so, blood sugar levels can be closely controlled.

Further, there are oral medications available that can help to control blood sugar in a variety of ways. This can be through increasing insulin production, making the cells more sensitive to the presence of insulin, or inhibiting the breakdown of starches into glucose.

Gestational Diabetes
Gestational diabetes is more rare, as it is a condition associated with pregnancy. It is diagnosed in ~135,000 pregnant women each year. It appears around gestational week 28 and continues through the pregnancy.

This condition occurs in pregnant women with no prior history of diabetes. During their pregnancy, they experience elevated glucose levels and other diabetic symptoms. It is thought that this is due to the release of hormones that accompany the pregnancy, which act to block the actions of insulin in the woman's body.

Although this condition does not cause birth defects, it can have health consequences for the baby, including an increased risk for type II diabetes later in life.

All of these types of diabetes has one thing in common, the need to control blood glucose (sugar) levels. The following video can explain better than I why sugar is so important to the body.



Final Thoughts
Although diabetes can be well controlled with attention to lifestyle and medication, there is still a need for understanding and acceptance of those diagnosed with this condition. For children, this can be especially important, as those diagnosed at an early age might feel that they are different because they can't have all of the treats that their friends eat, and need to have daily medication to manage their condition. But, those diagnosed are no different from a non-diabetic individual. While they do have certain medical precautions to take, they can still excel at sports, academics, or any other activity that they choose. In general, they can lead a very healthy, normal life.

Further, it is important to understand the hereditary nature of diabetes. Type I diabetes has a strong genetic component, with some environmental influence. Type II has the opposite; a strong environmental factor, but with genetic influence. Those with a family history of type II appear to be more at risk for developing it, given the proper environmental conditions.

According to the American Diabetes Association, nearly 27 million people have been diagnosed with some type of diabetes in the U.S. If not managed, this disease can lead to severe health complications, including loss of vision, amputation of limbs, and kidney failure.

To learn more about diabetes, please visit the American Diabetes Association website.




Wednesday, November 25, 2009

Happy Thanksgiving!

New Voices is off until next Monday. As we scatter around the country to our families and friends, we wish you all the best and hope you all have an excellent Thanksgiving weekend.

Travel safely, and we'll see you back here on Monday as we dive into the last month of 2009!

Happy Thanksgiving.

Tuesday, November 24, 2009

A Second Helping of Thanksgiving Recipes

Yesterday, we posted some great recipes with suggestions for those requiring a gluten-free Thanksgiving. However, these recipes were not all necessarily friendly for diabetics, nor did they take into account the many other food allergies out there.

Twelve million Americans suffer from some sort of food allergy and 90% of these are caused by nuts, eggs, milk, fish (including shellfish), wheat, and soy. These allergies affect children and adults alike, and can be life threatening.

Sticking to such strict diets can be difficult, but is necessary. So as Thanksgiving approaches, we hope that these recipes help to make your holiday both delicious and safe. Enjoy!

Turkey Stuffing
Orange
Apple
Yellow/Vidalia onion
Celery tops/carrots
Butter/olive oil
Spices

The stuffing inside the turkey can be delicious, but it's primary purpose is to keep the turkey moist and well-shaped during cooking. To avoid the starches and potential allergens in traditional stuffing:
Create a small bowl of spices that accentuate the other components of your meal. One suggestion: salt, pepper, parsley, sage, rosemary, and thyme (yup, just like the song).
After rinsing turkey, lightly coat the inside with butter or olive oil.
Rub spice mixture into the walls of the turkey as well as under any loose skin.
Stuff turkey with any combination of other ingredients, though an apple and onion are highly recommended.
Stitch 'er up and follow regular cooking instructions.

Mashed Potatoes
(for those with corn or wheat allergies)

Slice, boil, and mash your favorite potatoes with a little cream/milk and butter. Salt and pepper to taste. Margarine and soy milk products can be used to replace dairy ingredients for the lactose intolerant and other allergic to dairy.

Old-Fashioned Rice Pudding
(for those with corn or wheat allergies)

1 cup uncooked white rice
2 cups coconut milk
3 eggs, beaten
2 cups whole milk
1 cup granulated sugar
1 tbsp. vanilla extract
1/4 tsp. salt
1/3 cup sliced almonds (leave out if allergic to nuts)
pinch of cinnamon
pinch of nutmeg

Place uncooked rice in a saucepan. Add coconut milk. Bring to a boil and reduce heat to simmer for 25 mins.
Preheat oven to 325 degrees. Coat the sides and bottom of a 10x6x2-inch baking dish with butter or non-stick cooking spray.
In a large bowl, combine eggs, milk, sugar, vanilla, and salt. Pour into baking dish, add rice, mix well.
Bake covered for one hour, stir, and cook for another 30 minutes or until a knife inserted into the pudding comes out clean. Sprinkle with cinnamon, nutmeg, and almonds (optional).

Fruit Pie - Apple, Pear, Peach, Cherry, etc. (for diabetics and easily modify-able for others)

Fruit of choice (apples and pears mix well, but the others might be best alone)
Sugar-free applesauce or apple butter (for apple and pear pies)
Cinnamon
1-2 frozen or pre-made pie crusts suitable to your needs (sugar/gluten-free, etc.)
1 Tbsp lemon juice (for apple and pear pies)
Two pie pans

Preheat the oven to 350 degrees
Unroll one pie crust into pie pan. Place second pie pan on top of crust in pan. (This weighs it down.)
Place in oven during preheat/during prep.
Slice/pit about four cups of fruit, with or without skin, into centimeter or thinner slices. If using apples or pears, squeeze a little lemon juice over them to keep them from turning brown.

For peach or cherry pies...
Make sure crust in oven is lightly browned at edges before removing from the oven. Take off top pie pan.
Place fruit evenly over pre-baked bottom crust, cover with second crust in criss-cross pattern or just flat. Make sure to vent the upper crust by slicing a thin line or X in the center.
Return to oven and bake until tops are golden brown. Placing aluminum foil around the edges of the pies will prevent the crust edges from burning.

For apple and pear...
Remove crust from oven anytime. Remove top pie pan.
Spoon a thin layer of apple sauce or apple butter over the bottom of the pie crusts (retains moisture).
Place fruit evenly over the sauce in a circular pattern. Sprinkle with cinnamon.
Replace in oven and bake until bottom is golden brown.
*Note: not including a top crust decreases the amount of starch/sugar intake

Exercise

On a day that's often all about food it's easy to forget that one excellent way to manage our metabolisms (especially for diabetics) is to add in some exercise. Try to schedule in a walk, a game of touch football in the yard, or 15 minutes of yoga in your room (stress relief is also good for you!).

Resources
Thank you to BabyMamma who left excellent links for those searching for recipes on yesterday's post. Here are some other sites:

Recipes for wheat allergies and celiacs
The Gluten Free Pantry
Glutenfreeda

Diabetic recipes
Diabeticrecipes.com
Diabetic Gourmet Magazine

Food allergy recipes
The Food Allergy Kitchen
The Food Allergy Network
Cooking Allergy Free