I Am Now a Bionic Woman

written by Sarah Howard
Coordinator of the Diabetes-Obesity Spectrum Working Group

Sarah HowardJust in time for World Diabetes Day (#WDD, November 14th), I have started wearing an artificial pancreas to help manage my type 1 diabetes. Normally I wear an insulin pump along with a continuous glucose monitor (cgm), but the two gadgets do not actually talk to each other. That means I still have to manage my diabetes manually 24/7, like everyone else with diabetes. While manufactured artificial pancreases are being developed and are now performing well in clinical trials, they are not yet available to the public.

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Shangri-la Goes Up in Smoke (mostly PM2.5s)

written by Elise Miller, EdM
Director

According to the Yale Environmental Performance Score in 2014, Nepal ranked 177 out of 178 countries in terms of poor air quality—stunningly, worse than China (ranked 176th). This would seem an abstract observation if it weren’t for the fact that my family and I will be in Kathmandu in about 10 days. My husband and I adopted our son (now 10 years old) from Nepal, and we are returning to his birth country for the first time since he was a baby. We’ll see his early caretakers and help with rebuilding a school and a milk shed in a village devastated by last spring’s earthquakes.

Not that long ago Nepal was seen to Westerners as a kind of Shangri-la, an earthly paradise. The term “Shangri-la” was coined in James Hilton’s 1933 novel Lost Horizon as a place where people were almost immortal, aging slowly and living years beyond the normal lifespan. Currently, almost the opposite seems true. Many look far older than their years given the pollution and poverty that permeate their lives. As we’ve been preparing to go, we have been repeatedly told to bring filter masks and spend as little time in Kathmandu as possible because of the terrible air quality. If it gets really bad, we’re of course the fortunate ones: Unlike the vast majority of residents, we can also simply leave.

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CHE Partner Forum: Call for Ideas and Comments

Dear CHE Partners,

We want your ideas! We’re in the process of evaluating various aspects of CHE’s services and initiatives and generating potential new ones. Given we are indeed a collaborative partnership, your innovative suggestions as to what CHE might do (within our mission, below) to address gaps or needs you see in the environmental health field would be genuinely welcome.

To facilitate this, we’re opening this Partner Idea Forum, a platform where you can offer your ideas. This one is interactive in that you can see, respond to and build on other partners’ suggestions.

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Breast Cancer Prevention Begins in the Womb

TedSchettlerwritten by Ted Schettler, MD, MPH
Science Director

As breast cancer awareness month ends with its primary emphasis on early detection I’ve been more interested in what we’ve learned about opportunities for prevention. Amidst all the pink ribbons and disagreements about optimal mammography scheduling an important theme seems to be finally taking hold. Although opportunities abound throughout life, breast cancer prevention begins in the womb.

This idea is not new. Twenty-five years ago Dimitri Trichopoulos proposed that breast cancer risk could originate in utero, influenced by maternal hormone levels.[1] Later studies linked hormone and growth factor levels with populations of breast stem cells in umbilical cord blood—a plausible mechanistic connection to cancer risk. A 2011 analysis reported a nearly two-fold increased risk of breast cancer in daughters of women who took estrogenic diethylstilbestrol (DES) during pregnancy before 1971.[2] This year, Barbara Cohn and colleagues reported that the highest maternal levels of the hormone-disrupting pesticide DDT during pregnancy were associated with a nearly four-fold increased risk of breast cancer in their daughters.[3]

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