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.

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.

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

Thanksgiving Recipes

Every year for Thanksgiving, families gather together to enjoy one another's company over a feast of turkey, stuffing, various sides, and of course, dessert. However, for those with diet restrictions, the holidays can be a tough time of year.

For the past three weeks, we’ve featured posts on diabetes to recognize diabetes awareness month. This month is also Celiac Awareness Month.

Celiac disease is a digestive disease. Those with celiac disease cannot eat any gluten products because gluten causes the immune system to attack the structures in the small intestine that absorb food nutrients. Thus, people with celiac disease can suffer from malnourishment if they eat gluten in their diets.

Often celiac disease is referred to as a gluten allergy, but it is not. There are those that have wheat allergies, and there are those with celiac disease. People with wheat allergies also have an immune response, but it does not result in an attack of the small intestine.

Since the holidays can be so difficult for diabetics and celiacs, we will be featuring holiday recipes that are specifically designed for these diets. Today, we will focus on appetizers and the main course. Tomorrow, we will offer some dessert options. Enjoy!!!


APPETIZERS

Marinated Vegetables

Use artichokes, mushrooms, asparagus, or any vegetable that you really love
Add 1/4 tsp oregano for every 8 oz. of vegetable
Add a few tbsp. of Olive Oil and Canola Oil
Salt to taste
Toss gently and store in the refrigerator until ready to serve.

Spinach Dip

1 package of large cap mushrooms
1 package chopped spinach (drained, uncooked)
1 cup sour cream
1 can water chestnuts
1 package Knorrs Vegetable Soup (this is gluten free, other mixes may not be)
1 package Lipton Onion Soup Mix (this is gluten-free, others may not be)

Mix the day before and refrigerate. Hollow out a round loaf of pumpernickel bread, fill with dip and use the extra pieces of bread for dipping.

Gluten-free substitutions: Place dip in a bowl. Use rice crackers or tortilla chips for dipping. Gluten free cornbread (below) or gluten free bread made from a store-bought mix or local bakery may also be used.

Stuffed Mushrooms

1 package large cap mushrooms
1/4 of an onion, chopped
Bread crumbs, (~ 1/4 cup or added for your preferred breading consistency)
1/2 tsp. Paprika
1 tbsp. butter

Chop onion and stem mushrooms. Saute the onion and stems in butter. Add bread crumbs for a thick consistency. Stuff mushroom caps, sprinke with paprika. Bake at 350 degrees for 10-15 minutes.

Gluten-free alternatives: Use wild rice or Quinoa as a substitute for bread crumbs.

MAIN COURSE

Pumpkin Soup
2 tbsp. maragarine
1/4 cup finely chopped onion
1 tbsp. flour
1 tsp. curry powder
1 qt chicken broth
2 cups pureed or canned pumpkin
1 tsp. brown sugar
1/4 tsp. ground ginger
1/4 tsp. ground mace
1 tsp. salt
1 cup cream or milk

Saute onions in margarine. Stir in flour and curry; cook umtil bubbly. Remove from the heat and stir in chicken brother. Add pumpkin, sugar, ginger, mace, and salt. Cook on medium heat, stirring until mixture begins to simmer. Stir in cream or milk and heat to serving temperature. Do not boil. Serve hot sprinkled with chives or parsley; or chill and serve with a dollup of whipped or sour cream.
Gluten-free alternative: Use cornstarch or rice flour rather than wheat flour. Be sure chicken broth is gluten free.

Corn Bread (gluten free)

4 eggs
4 cups buttermilk
2 tbsp. olive oil(or butter if preferred)
4 cups yellow corn meal
2 tbsp. baking soda (gluten free)
2 tsp. sage, rubbed
2 tsp. Poultry Seasoning
1 tsp. salt
1 tbsp. sugar
dash of freshly ground black pepper

Grease 13 x 9 x 2-inch pan. Preheat oven to 425 degrees. In large mixing bowl, beat eggs, buttermilk and olive oil with a fork to blend. In another bowl, mix all dry ingredients until blended. Stir into buttermilk mixture and stir, pour into greased 9 x 13-inch pan. Bake on lowest rack in oven for 20 minutes. Reduce heat to 350 degrees and bake 10 minutes more, or until bread just begins to pull away from sides of pan; turn out onto wire rack. Cool thoroughly.

Cornbread Stuffing (gluten-free)

1.5 lbs Dark meat chicken- cooked and shredded
1.5 sticks butter, softened
1 lb yellow onions, coarsely chopped
1 cup celery, diced
1/2 cup parsley, chopped fresh
Gluten Free Corn Bread (above)
Small loaf Gluten Free Sourdough bread (optional)
1/4 cup gluten-free chicken broth

Melt 4 tbsp. butter in heavy skillet and sauté onions slowly until soft- about 15 minutes. Add 1 tbsp. butter and the celery, and sauté 10 more minutes. Add parsley. Remove from heat.

Bring chicken and all stuffing ingredients to room temperature. Trim and discard any dark brown crust from the corn bread; crumble into a large mixing bowl. Add crumbled sourdough and mix. Stir in onion/­celery mixture. Melt remaining 4 Tablespoons butter and drizzle over stuffing, tossing lightly. Add chicken. Sprinkle with just enough broth to moisten and mix lightly again. Press into prepared 9 X 13-inch pan. Bake in 375 degree oven for 1 hour. Serves 8 - 12.

Spinach Casserole

2 - 10 oz. packages of frozen spinach or equivalent
1/2 stick butter, melted
1 cup milk
1 cup self-rising flour
3 eggs, beaten
1 cup shredded cheddar cheese

Mix and pour into a buttered casserole dish. Bake for 25-30 minutes at 350 degrees.

Gluten-free option: Substitute gluten free flour for self-rising flour.

Cranberry Sauce

4 cups cranberries
1 cup rasberries
1 cup sugar
1 cup water
zest from 1 orange

Bring water to rolling boil in a saucepan and add sugar, stirring to dissolve. Add cranberries and raspberries, return to a boil. Reduce heat; simmer until cranberries burst (about 10 minutes). Add orange zest. Remove from heat. Cool completely at room temperature and then chill in refrigerator. Cranberry sauce will thicken as it cools.

Acorn Squash

1 Acorn squash, halved
salt, to taste
2 tbsp. butter
2-3 tbsp. brown sugar
Pure maple syrup

Cut acorn squash in half, remove seeds, and add a pinch of salt to each. Put 1 tbsp. butter in the center of each half. Sprinkle with brown sugar and lightly cover with maple syrup. Place in a bake pan with 1-inch of water at the bottom, cover with aluminum foil and cook at 400 degrees for 30 minutes. Remove the foil; bake another 30 minutes. Broil for the final few minutes.

Tomorrow we'll take a look at desserts and some alternatives for those with allergies.

Honoring Survivors of Suicide

An American dies by suicide about every 16 minutes, with an attempt being made every minute. Further, suicide is the leading cause of death among adults (18-65), the third leading cause of death among 15-24 year olds, and the elderly show an alarmingly high rate. Suicide rates have also reached an all-time high among the military in 2008, and are expected to rise further this year.

But these figures do not begin to capture all who are affected by suicide. For each victim, there are many survivors… family and friends left behind to try and make sense of the loss of their loved one.

Tomorrow (November 21, 2009) is the 10th Anniversary of National Survivors of Suicide Day. The result of a U.S. Senate resolution, this day is an opportunity for survivors to gather in support of one another, and to heal.

As survivors prepare to gather to remember their loved ones, my thoughts focus on the importance of the research that has, and will continue, to decrease suicide rates. Over 90% of those that die from suicide have a mental illness at the time of their death (including depression, the most common mental illness leading to suicide). Drugs and other therapeutic treatments have been, and continue to be, developed to help those that suffer from these conditions. Cognitive therapy has been shown to reduce repeat suicide attempts by 50%; community-based prevention programs were successful at decreasing the suicide rate in the U.S. Air Force by 1/3; and participation in teen awareness programs, such as Signs of Suicide, resulted in a 40% drop in suicide attempts.

The hardest part of preventing suicide is recognizing the signs. So, to honor those survivors gathering this weekend, spend some time researching the signs preceding suicide. Research continues to provide us with the treatments, but we need to make the effort to recognize the conditions.

Resources:
American Foundation for Suicide Prevention
Suicide.org
Suicide Prevention at NIMH
Survivors of Suicide

Making Cigarettes History

For the last three weeks, I’ve been writing entries about the history of public health. I started by giving you an overview of the history of public health, then wrote about public health in ancient times and cholera's connection to epidemiology. Today I’m going to write about a more recent public health topic: smoking. It is an especially timely topic because today is the Great American Smokeout.

Tobacco has a long history in the Americas. Long before Europeans arrived, native populations had been using it for ritualistic and spiritual purposes. And for centuries after the Europeans arrived, smoking was a popular social activity and tobacco an important economic commodity. It was important as a cash crop in the South during the 1700 and 1800s. And many older, grand houses had separate “smoking rooms” where men would go to smoke and socialize during parties.

This popularity continued into the 20th century. Smoking was allowed in restaurants, planes, and elsewhere. Cigarettes were often seen in movies, and celebrities, such as Lucille Ball and Frank Sinatra, helped popularize it through their personal use and appearances in tobacco advertisements. With this greater visibility and the political and social climates came new smokers. Many women adopted the habit, and companies even developed “Kiddy packs” for minors.

In the second half of the century, however, the tide began to turn. Growing concerns about the health effects of tobacco use led to public campaigns including the Great American Smokeout, which began in 1977 and is celebrated with rallies, parades, and the distribution of information (and again, is today).

New regulations were also put into effect to stem the use of tobacco in American society. In 1977, Berkeley, CA became the first city to limit smoking in restaurants and other public places. Other cities followed suit and also banned smoking in the workplace. Federal bans came on smoking on public transit came into effect in the 1990s.

More recently, city- and state-wide bans have been a major topic of debate. Although smoking regulations vary widely by state, increasing numbers of cities and states are adopting bans on smoking in restaurants, bars, and workplaces. As of October 2009, an estimated 71% of Americans are “covered by a 100% smoke-free provision in workplaces, and/or restaurants, and/or bars, by either a state, commonwealth, or local law.”

Although there have been concerns about the economic effects they have on small businesses by deterring smokers from going to restaurants and other places, they have an undeniably positive impact on the general public’s health and quality of life: a recently released report from the Institute of Medicine concluded that smoking bans reduce cases of heart attacks and heart disease, and that the difference begins to show pretty quickly after bans take effect.

Advertising has also changed dramatically. The Family Smoking Prevention and Tobacco Control Act of 2009 requires that cigarette warning labels cover 50 percent of the front and rear of each pack, with the word warning in capital letters, something that has been common in Europe for a long time.

We have come a long way toward clearing smoke from our air over the past few decades, and this is significant. Yet there is—as always—more than can be done. An estimated 46 million adults in the United States today are still smokers, and their actions are continuing to affect not only their own health but also those around them. The consequences of smoking are staggering: approximately half of the US smokers will die prematurely from smoking, and it causes one in five deaths from all causes. It’s also an extremely expensive habit.

Many resources and programs exist to help people quit and if you or someone you knows smokes, they’re worth looking into. Here are a few places to start:

• According to the American Cancer Society, smokers are most successful in quitting when they have some means of support, such as: nicotine replacement products, counseling, stop-smoking groups, telephone smoking cessation hotlines, prescription medicine to lessen cravings, guide books, encouragement and support from friends and family members.
• Telephone hotlines available in all fifty states. To find counseling or support in your area, you can call 1-800-ACS-2345 (1-800-227-2345).
• Some states have specific resources available, such as QUITPLAN, a free personalized approach available to all Minnesotans (financed by funds from the Minnesota Tobacco Settlement). Try searching online to find out what is offered in your area.
• Some insurance companies such as BlueCross BlueShield (MN) also have plans to help clients with quitting.

This is the final post in a series on the history of public health which I am writing in anticipation of Public Health Thank You Day, a time when Research!America and other leading health organizations recognize public health heroes whose work helps keep our drinking water safe, air clean and children healthy. My hope is that these posts will help illustrate how far we've come, and how much more remains to be done.

To read the first post, which gives an overview of the history of public health history, click here.

To read the second post, about public health in Ancient Greece and Rome, click here.

To read the third post, about cholera and the birth of epidemiology, click here.

Thank President Obama for Reprioritizing Science and Health

Urge President Obama to Fulfill His Commitment to Research

During this season of thanks, join advocates nationwide to express your gratitude for the recent revitalization of research. The American Recovery and Reinvestment Act has invigorated the research community after years of diminishing budgets for the National Institutes of Health.

Please contact President Obama now to thank him for his recommitment to science and urge him to continue to make research a priority in Fiscal Year 2011. It is critical to strengthen the scientific and economic momentum generated by ARRA by making NIH's new research capacity permanent.

President Obama will decide what funding to recommend for NIH before the end of the year. Patients, scientists and other research advocates across the U.S. must demonstrate our collective support for his innovation strategy by sending a strong call to robustly invest in NIH. Write to President Obama today!

An Education for Our Educators

Recently, my mom and I were reminiscing about my childhood teachers. Whenever I think about the teachers that most influenced me, I immediately recall my 7th grade science teacher, Ms. Krueger. You see, I wouldn’t be a scientist if not for Ms. Krueger. She was my first mentor and the person who first sparked my interest in science.

I was never much interested in science as a kid. I loved English… I read, I wrote, and I dreamed of being a writer when I grew up. Ms. Krueger changed that. She turned my attention to science, showing me not only that it was fun, but convincing me that I was good at it. She encouraged me to explore, ask questions, and praised me for a job well done. She made me feel proud of what I could do. In short, she empowered me.

Science was and is a challenging discipline for me; it never came easy. It’s this challenge that I love. There’s nothing like the feeling of success at finally decoding a concept that you’ve been working to understand for minutes, hours, or maybe even days. I got my first taste of this feeling in Ms. Krueger’s class. And now, twenty years later, I have a Ph.D. in neuroscience and a career in science policy.

As I was relating this to my mom, she mentioned my 5th grade math teacher, another favorite of mine. Although I never knew it, she revealed that during a parent-teacher conference years ago, he told her that I was not destined for a career in science. I’ve thought about that conversation a lot since then.

What would have happened if I had never had a Ms. Krueger in my life to encourage me to develop my interest in science? What if my fate had rested with those like my 5th grade teacher, who decided that because science was a difficult subject for me, it was not in my future, so best not to encourage it? Would I be a scientist still? I doubt it.

These thoughts then turned to myself, and my teaching career. Had I pre-judged my students, and in doing so, kept doors closed to them that should have been opened?

It is a strong part of human nature to observe and make judgments. I wonder how often those in a position of authority, such as teachers, role models, and mentors, have done just that, and in doing so suppressed rather than exposed opportunities. So, to those of you in these positions, remember my story the next time you are facing a student who may not excel in a subject, who might even struggle a bit, but looks to you all the same for inspiration and guidance. As shapers of the next generation of scientists, mathematicians, engineers, and writers, remember to always strive to open new doors, and never close them. You never know where a little bit of enthusiasm and encouragement will lead.

Type 2 Diabetes: No Longer Just for Adults

For more on Bryan's story and facts about diabetes, check out this fact sheet on how investment in research saves lives and money.

This is Part 3 in our National Diabetes Awareness Month series.
Part 1 - November is Diabetes Awareness Month
Part 2 - Living with Type 1 Diabetes

Does Recycling Matter?

Last week, my roommate and I attended a talk on climate change. After the program, she asked me how I could possibly walk out of that room and not feel hopeless about our environment. She couldn’t help but wonder if it was just too late; could her small contribution really make a difference? Her question to me was, “Does my recycling effort even matter?”

So, given that this Sunday, November 15th is America Recycles Day, I decided to conduct an experiment. I can spout statistics all day, but I prefer to do the work for myself. So, let’s examine how much one recycling household contributes to decreasing energy use and waste.

Question

Does the amount of materials that one household recycles really make a difference in the larger scheme of energy consumption and waste production?

Hypothesis

Yes.

Method
1. Assess the contents of a recycle bin that has been collecting recyclables for 4 days in a household with three adults by cataloging and weighing all items in the bin.
2. Use the EPA iWARM program to estimate the energy saved by recycling these items.

Results
1. Contents of recycle bin:

• 2 glass bottles (12 fl. oz.)
• 1 glass bottle (0.75L)
• 50 plastic bags
• 108 oz. paper (~4-inch stack)
• 7 plastic containers
• 1 gallon plastic container
• 1 non-corrugated cardboard box

Total weight of materials & bin (8 lbs.) – Total weight of bin only (3 lbs.) = Total weight of recycled materials (5 lbs.)

2. iWARM results
Net energy saved is equivalent to 12.8 kiloWatt hours (kWh)


Discussion:
Overall, the amount of recyclables collected in a four day period saved 12.8 kWh of energy. This is equivalent to the amount of energy needed to run: a room air condition for 8.6 hours, a ceiling fan for 107.1 hours, a hairdryer for 8.4 hours, a clothes washer for 30.2 hours, a dishwasher for 5.4 hours, a laptop computer for 257 hours, or a 60W fluorescent light bulb for 988.4 hours. That's a lot of energy saved over the course of a year!

This amount also equates to 260 lbs. of trash kept out of landfills in one year, or ~22,000 lbs. kept out in an average (86 year) lifetime.

Conclusion:

The numbers clearly show that recycling does matter. So on Sunday, celebrate America Recycles Day by making a pact to be a better recycler. Below are some resources and tips to help you on your way.

Additional Resources:
America Recycles Day
Earth911

Recycling tips:

• If you're cleaning out used items, don't thrown them away, Freecycle them.
• If you're upgrading your electronics or appliances, stores often provide exchange programs and will recycle your old model when you purchase the new. Be sure to ask.
• There are a number of products that can and should be recycled because of their chemical content. Below is the short list. Click on each product to find out how to recycle them.

Mercury light bulbs
Electronics
Batteries

Finally, to find out your local recycling guidelines, consult your local government's Solid Waste Department webpage.

The Birth of Epidemiology

Last week, I wrote about public health in Ancient Greece and Rome as part of my series on the history of public health. Today I’m bringing you the third installment in that series, about the 1854 cholera epidemic in London and the founding of the field of epidemiology.

Imagine that one day, while going about your life, you begin to “feel an odd sense of unease, accompanied by a slightly upset stomach. The initial symptoms themselves would be entirely indistinguishable from a mild case of food poisoning. But layered over those physical symptoms would be a deeper sense of foreboding. Imagine if every time you experienced a slight upset stomach you knew that there was an entirely reasonable chance you’d be dead in forty-eight hours. Remember, too, that the diet and sanitary conditions of the day... created a breeding ground for digestive ailments, even when they didn’t lead to cholera. Imagine living with that sword of Damocles hovering above your head—every stomach pain or watery stool a potential harbinger of imminent doom.”

–Steven Johnson, The Ghost Map, p. 32

In the summer of 1854, London was struck by a cholera epidemic. The disease took the city of more than 2 million by storm, sickening people overnight, causing large numbers to die, and compelling many more to evacuate their neighborhoods for fear of getting sick. No one seemed to know what would stop the disease: although many theories for the cause and spread of the disease had been proposed, they didn’t hold water, and most of the suggested remedies were ineffective.

One person who was particularly critical of the theories that had been proposed was a physician named John Snow, who practiced in the neighborhoods of London. Snow had for many years been interested in diseases, and was well known for his work in the field of anesthesiology. Although he was not confident about what was causing so many people to become ill, he had his own theories, and began making a careful record of cases of the disease as soon as it struck.

While visiting his patients, Snow made careful notes about who contracted the disease, and where these people lived. By marking the cases on a map, he soon discovered a pattern: he realized that the incidence of disease seemed to be related to where people got their water. He discovered that one pump in particular: the Broad Street pump, seemed to be causing a lot of people to become ill. In a letter to the Medical Times and Gazette, Snow wrote:

On proceeding to the spot, I found that nearly all the deaths had taken place within a short distance of the [Broad Street] pump. There were only ten deaths in houses situated decidedly nearer to another street-pump. In five of these cases the families of the deceased persons informed me that they always sent to the pump in Broad Street, as they preferred the water to that of the pumps which were nearer. In three other cases, the deceased were children who went to school near the pump in Broad Street...

Eventually, he came to believe that to stop the outbreak it was necessary to stop people from using water from the Broad Street pump. City officials were convinced to remove the handle of the pump, and this proved effective in stemming the spread of the disease. In the end, it was discovered that fecal bacteria had begun to leak into the well, and it became clear that the polluted water - caused by the abundance of fecal matter which spreads cholera - was the cause of the disease.

Snow's discovery of the role of polluted water in spreading disease demonstrates again the importance of sanitary measures, and the work of those who are instrumental in making our cities clean. Furthermore, Snow's work laid the foundation for our modern day understanding of how diseases spread, which continues to be important to ensuring the health of our communities.

For a fascinating, thorough account of this story I highly recommend reading The Ghost Map, by Steven Johnson. The book, which provided the information for this post, chronicles the outbreak and the efforts to solve the mystery and is an enjoyable read.

This is the part two in series on the history of public health which I am writing in anticipation of Public Health Thank You Day, a time when Research!America and other leading health organizations recognize public health heroes whose work helps keep our drinking water safe, air clean and children healthy. My hope is that these posts will help illustrate how far we've come, and how much more remains to be done.

To read the first post, which gives an overview of the history of public health history, click here.

To read the second post, about public health in Ancient Greece and Rome, click here.

A Veteran's Best Friend

Today, millions of people are celebrating and honoring the bravest of our citizens – the men and women that serve in our armed forces. As I began thinking of how I wanted to mark Veteran’s Day, immediately my mind wandered to a story I had heard a few months ago on National Public Radio. It focused on prison inmates, a young veteran, and his dog, Samba.

You see, Paul Bang-Knudsen is one of the 111,000+ veterans of the wars in Iraq and Afghanistan that has been diagnosed with post-traumatic stress disorder (PTSD). While this number seems staggering, keep in mind that these are only the reported cases. Studies estimate that this number is likely closer to 200,000, and growing daily.

PTSD is an extreme anxiety disorder that is usually caused by some traumatic event. This trauma, and the feelings that accompany it, are then relived repeatedly (through dreams, hallucinations, or other events); usually due to some trigger in the person’s surroundings.

These triggers can be small and unexpected. In his interview, Paul Bang-Knudsen stated that simply walking around the corner in a grocery store and coming face to face with another shopper could act as a trigger for him. What are triggers to these veterans are often every day non-events to us. These can be so painful to experience that the affected veterans begin to actively avoid them, in some cases that can mean avoiding the outside world.

This is where Samba comes in. Samba is one of the many service dogs trained to help veterans with PTSD assimilate back into civilian life. These dogs act as barriers to the triggers that would normally set off an attack. Beyond this, the companionship that they offer can be a first step towards this re-acclimation.

Now, how do prison inmates work into this? Samba was a Puppies Behind Bars graduate. This program, and others like it, pairs inmates with future therapy dogs. The inmates take responsibility for their care for the first sixteen months. While certainly there are other programs that do not involve inmates that also provide this service, Puppies Behind Bars is worth special mention because often these dogs provide therapy not only to their owners, but to the inmates with whom they interact as they learn their trade.

Historically, mental illnesses, whether in the military or civilian population, have been under-recognized and under-treated, partly because they can’t be seen with the naked eye like a wound can. However, the newly appointed head of the Department of Veterans Affairs, Eric Shinseki, is changing this. He has made PTSD a priority for the VA, initiating programs that both seek out and treat veterans with the disorder.

As more soldiers come home to their families and communities, we hope research into PTSD and dogs like Samba can make the transition easier. On this Veteran’s Day, we want to remember and thank all of our brave soldiers and their families for the sacrifices that they've made for our country. They deserve so much more than just one day.

I Want to Change the World

When I was a kid I wanted to be an astronaut. Maybe it was because I grew up in Florida and could see shuttle launches from my backyard. Or maybe it was because my family was addicted to science fiction like Star Wars and Star Trek. Getting to be the first woman to set foot on another terrestrial body was my entire mission in life. I even pretended astronaut ice cream tasted good (hint: if you eat it dry, it doesn't).

It turns out that because of a medical issue, I'll probably never get to go to space. For years I hoped that, like my hero Alan Shepard, I would outgrow it. But I've since resigned myself to a life here on Earth. It used to disappoint me, but my best friend told me something once that it took me a long time to believe: you don't have to be the president or an astronaut or have some powerfully huge job to make a difference in the world.

I imagine that many of you readers want to change the world, too. We can:

• Arm our legislators with facts so they can make good policy decisions.
• Speak out against injustice. Silence is the enemy.
• Provide the next generation with the tools to do amazing things.
  

What else should be on our list?


Hat tip to Ed Yong for the link to today's image.

Living with Type 1 Diabetes

As part of our month long series on diabetes, today we're taking a look at Type 1 diabetes.

One of my aunts was diagnosed with Type 1 diabetes at the age of twelve. Over the course of her life she had two kidney transplants and a series of amputations that eventually took both of her feet. She was one of the first to use an insulin pump, delivered two healthy (though premature) babies, had special gears put in her car so she could drive footless, and was maybe one of the every hundred people who had a Furby who actually figured out how to make the thing talk.

I mention that last part, because although I always knew my aunt had diabetes, aside from the funky slippers she wore and the occasional wire you saw running to her pocket, you might never have known that she was sick. At least from a distance. Because diabetes is a manageable, and oft-overlooked disease. But it’s still a disease.

Type 1 diabetes is a condition in which a person’s body cannot produce insulin. Insulin is a hormone - produced in the pancreas – that converts sugars and other food into energy for the body. Without it, we lose our ability to process food properly. There are a number of treatments, but there is no cure for a pancreas that won’t produce insulin; except for a new pancreas.

Sometime around New Year’s 2002, a doctor called my aunt and uncle and told them they were getting a late Christmas present for my aunt. After more than 30 years of living with diabetes, she was at the top of the donor list and would be getting a new pancreas. Her cure for diabetes had arrived.

Organ replacement surgery is a risky business. My aunt lived through the surgery, but died from post-operative complications without ever leaving the hospital. To have her survive so much and then to not get to go home and enjoy a life free from daily injections and worry was overwhelming.

But there is good news. Before insulin replacement therapy, survival rates for diabetics were weeks. My aunt lived with diabetes for more than three decades. Research has brought us so far in understanding the dynamics of diabetes:

• Replacements for islet cells in the pancreas are being tested as an alternative to total pancreas transplants.
• Today’s insulin pumps can detect changes in blood glucose levels and help prevent diabetic attacks.
• Advances in eye research have helped to decrease the incidence of diabetes-induced blindness.

There is still so much to learn about diabetes. I have confidence that one day research will help save the lives of people like my aunt. But,

“Without research, there is no hope.”

~The Honorable Paul G. Rogers

This is Part 2 in our National Diabetes Awareness Month series.
Part 1 - November is Diabetes Awareness Month

Are you a scientist? Good, take this survey.

We're trying to find out more about scientists' views on communicating science to the public and their perspectives on the policy process. We want to know what you think, and what experience you have with each. How can you tell us?

Take the survey.

Come on, you know you want to. We're less than a dozen responses from statistical significance (though obviously the more respondents, the more useful the data). The only thing standing between us and that reliable data is your response.

That's right, you have the power to help make this survey of scientists a success. All it takes is about 10 minutes of your time and access to the Internet. You've already got the Internet part down if you're reading this, so please give us just ten minutes of your time. You'll be glad you did.


More information about the survey is available here.

Air and Aqueducts: Health in the Greco-Roman World

“Whoever wishes to investigate medicine properly, should proceed thus... When one comes into a city to which he is a stranger, he ought to consider its situation, how it lies as to the winds and the rising of the sun… and concerning the waters which the inhabitants use, whether they be marshy and soft, or hard, and running from elevated and rocky situations, and then if saltish and unfit for cooking; and the ground, whether it be naked and deficient in water, or wooded and well watered, and whether it lies in a hollow, confined situation, or is elevated and cold; and the mode in which the inhabitants live, and what are their pursuits, whether they are fond of drinking and eating to excess, and given to indolence, or are fond of exercise and labor, and not given to excess in eating and drinking.”

-Hippocrates, On Airs, Waters, and Places, 400 B.C.E.

Although they lacked the knowledge and technology we have today, the Ancient Greeks and Romans had a definite concept of wellbeing and the factors that affected it. Through their awareness of environment and development of sanitary measures and medical resources, these Ancient societies made notable improvements in infrastructure and resources that helped keep their citizens healthy.

For the Greeks, environment, lifestyle, and health resources were all important to health. As the passage above demonstrates, the Greeks were concerned with the impact of seasons, air, water, and soil quality on quality of life: they believed that changes in all of these things could affect one’s health and used this awareness to inform their choices about where to live. They also recognized that one’s individual choices about how to live were important: the ideal life was one in which “nutrition and excretion, exercise and rest were perfectly balanced… For each individual, account had to be taken of age, sex, constitution, and the seasons.” (Rosen, 10) Furthermore, many cities also charged individuals with public health administration services such as drainage and water supply, and had municipal doctors.

The Romans built upon Greek achievements when they took control of the Mediterranean world, carrying on Greek medical practices and introducing several public health improvements. Among these were aqueducts and an organized water supply in many cities that increased access to water, the availability of public baths, and generally helped keep people clean. By the 3rd century C.E. (200s), these sources were delivering about 40 million gallons/day to the Romans, or about 40 gallons per person per day, which is no small achievement. (Rosen, 16) (For comparison, the average American uses 80-100 gallons per day.)

Not everyone in the Ancient world had access to these resources. Many lived in dirty, overcrowded slums without clean water. Nonetheless, over the years these resources became more widely available, with more complete sewerage systems and medical advancements. These changes significantly improved the lives of those in the Ancient world, and lay the foundation for our modern understanding of medicine and public health.

This is the part two in series on the history of public health which I am writing in anticipation of Public Health Thank You Day, a time when Research!America and other leading health organizations recognize public health heroes whose work helps keep our drinking water safe, air clean and children healthy. My hope is that these posts will help illustrate how far we've come, and how much more remains to be done.

To read the first post, which gives an overview of the history of public health history, click here.

To the Gentleman at Cafe Scientifique

Last night, I attended Café Scientifique, a free for the public monthly event that features diverse scientists and topics. Last night, the speaker was Nobel Laureate Mario J. Molina, PhD, and the topic was climate change. Dr. Molina (pictured at right) gave a great synopsis on climate change, the data supporting it, and the issues surrounding it. At the end of his talk, he opened the floor to questions and comments, and this is the reason for this post.

In this Q&A session, a gentleman asked a question that has had me thinking ever since. Although I cannot remember his exact words, the general idea was that Congressional leaders do not necessarily have the technical background and scientific training to truly understand climate change, particularly the science behind it and the solutions being offered. So, his question was basically should we be sitting back and letting them make the decisions when clearly they do not have the training.

While the speaker answered, I felt the question needed more discussion, but the conversation quickly changed before I could comment - so…

To the gentleman who asked this question:

First, I’d like to say that I don’t think that you’re alone. I get the impression that many people feel that once elected, the policy makers should be left to do their jobs. We entrust them to make the decisions on issues ranging from science and healthcare, to war and diplomacy while we go about our lives. Certainly, there are issues that spark public debates, but it seems that experts in the field often take a back seat to this.

Now, to be fair, I don’t know whether or not you’re a scientist, but I was a bit disappointed to hear this question posed in a room that I expect was full of scientists; and I was even more disappointed that there was less of a reaction to your question. Here’s the thing, as scientists, we are the experts, and we should be the ones speaking to our leaders.

Now certainly some of our Congressional members do have training in the sciences, but most do not. They certainly do not have specialized knowledge in every single area of upon which they make decisions. They would be superhuman if that were the case. This is why they hire staff. The staff specialize in particular areas, and their job is to make sure the Congressional member knows what they need to know for each of these issues. But should we even trust that each staff member has the expertise? Absolutely not!!!

If you, as a citizen, are an expert in a particular field then it is your responsibility to pass that knowledge on to our Congressional leaders. You absolutely should not be trusting that your elected officials, once in office, no longer need your support. How will they know what their constituency wants if you remain silent? How can they become well-informed when the experts in the fields won’t talk to them?

So let me re-emphasize, as an expert in your field, YOU ARE NEEDED. I think as scientists, we often forget that not everyone who needs to see our data is going to be actively seeking it out. We need to recognize that we need to be proactive in helping to affect policy decisions. We need to make sure that our leaders are seeing and understanding the data, and make data-driven recommendations on how best to have policy decisions reflect the data.

Take Dr. Molina, our speaker, as an example. He and his colleagues not only discovered that CFCs were causing a hole in the ozone layer, but he went one step further and took that information to our elected officials. He talked himself blue until policy changes were finally made. He knew that he had an obligation as a citizen and scientist to not only make the discovery, but to make it known.

So sir, I apologize for the length of this letter, but I have to say that I am tired of this idea that we are second-class citizens. The government is supposed to be working FOR us, not against us. In sitting back and “letting them do their jobs” without offering our expertise, we are hurting science, and ourselves. If you choose not to affect policy, then you absolutely cannot complain when you find it going away from the science. So, my simple answer to your question is, as the experts, we need to be talking to our policy-makers, and we should never accept a passive role in the policy process.

Thank you for listening.

Sincerely,

Jacqueline Maffucci, PhD

Go Vote!

It's Election Day here in the United States. As citizens, it is our duty to do our part and vote for our leaders. I hope everyone will take a few minutes today to review the candidates and head to the polls.

Happy voting!

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.

Each Monday this November, we’ll share information about different forms of diabetes, survivor stories, the cutting edge research in diabetes, and – because it is the start of the holiday season – recipes for enjoying the holidays while being conscious of what is going into your body.

We hope you’ll join us and participate in the comments section with your questions, thoughts, and personal stories. With diabetes effecting approximately 1 out of every 12 Americans, there’s no time like the present to help increase awareness of diabetes.