There have been many women who are leaders in ground-breaking scientific research across the globe and have had a significant role in humanity’s scientific advancement. Even though they are so significant in the scientific community, women only represent about 33.3% of scientific researchers globally. Despite their smaller numbers, history is full of women who made historical contributions to science.

Today, we are going to take a moment to look at some of the powerhouses in the scientific community and highlight their amazing achievements.

Marie-Anne Paulze Lavoisier
(January 20, 1758 – February 10, 1836)

Regarded as the mother of modern chemistry, she got her start as the wife of a chemist and nobleman and served as his assistant, and contributed to his work. She was fluent in Latin, English, and French and helped translate several scientific works. Her translations led to the discovery of oxygen gas and were instrumental in the standardization of the scientific method.

Sophia Louisa Jex-Blake
(January 21, 1840 – January 7, 1912)

An English physician, teacher, and feminist who helped lead the campaign to secure women’s access to a college education as a part of the “Edinburgh Seven”. She began studying medicine at the University of Edinburgh in 1869 and devoted her life to the advancement of women’s rights in the field of medicine. After a riot at Surgeon’s Hall in 1870, several petitions were sent to the medical institutions and the government which led to the Medical Act of 1876, which allowed medical institutions in Britain to license qualified applications regardless of gender.

Marie Curie
(November 7, 1867 – July 4, 1934)

A Polish and naturalized-French physicist and chemist who conductioned critical research on radioactivity and discovered Radium and Polonium. She was the first woman to win a Nobel Prize, and the first woman and only person to receive it twice in two scientific fields: physics and chemistry. She also headed the Curie Institution which is a leading medical research in France that is focused on cancer research and radiation therapy.

The Scientific Powerhouses of 2023

Brilliant women in science have been around since the beginning of science and they are not slowing down anytime soon. Research.com just released its list of the top 10 female scientists across the globe who are making notable achievements in the scientific community.

1. JoAnn E. Manson (Harvard Medical School) – an American physician and professor who is known for her pioneering research, public leadership, and for advocacy in the fields of epidemiology and women’s health.
2. Virginia M.-Y. Lee (University of Pennsylvania) – a Chinese-born American biochemist and neuroscientist who specializes in progressing the research of Alzheimer’s disease.
3. Aviv Regev (Broad Institute) – a computational biologist and systems biologist and Executive Vice President and Head of Genentech Research and Early Development in Genentech/Roche. In addition, she is a key member of the Broad Institute of MIT and Harvard and a professor at the Department of Biology of the Massachusetts Institute of Technology.
4. Tamara B. Harris (National Institutes of Health) – a key researcher in the role of the Interdisciplinary Studies of Aging Section is to integrate molecular and genetic epidemiology with interdisciplinary studies of functional outcomes, disease endpoints, and mortality in older persons.
5. Unnur Thorsteinsdottir (deCODE Genetics Iceland) – currently dean, School of Health Sciences, University of Iceland and is best known for her fields of study of genes, internal medicine, and genetics.
6. Brenda W.J.H. Penninx (Vrije Universiteit Amsterdam) – a professor at the department of psychiatry and her current research examines the etiology, treatment, and consequences of depressive and anxiety disorders.
7. Terrie E. Moffitt (Duke University) – an American clinical psychologist who is best known for her research on the development of antisocial behavior and also for her collaboration in research on gene-environment interactions in mental disorders.
8. Gail Hanson (University of California Riverside) – an American experimental particle physicist who participated in the discovery of the J/psi meson and tau lepton. Her work led to the first evidence of jet production in electron-positron annihilation.
9. Julie E. Buring (Brigham and Women’s Hospital) – currently her research is in the epidemiology of chronic diseases, particularly cardiovascular disease and cancer, and especially among women.
10. Nora D. Volkow (National Institute on Drug Abuse) – a Mexican-American psychiatrist who is currently the director of the National Institute on Drug Abuse, which is part of the National Institutes of Health.

“Research is formalized curiosity. It is poking and prying with a purpose.” – Zora Neale Hurston

Whole body donation plays a huge role in medical research and education. Cadavers offer a type of hands-on experience that cannot be recreated through technology and are used by medical students, physicians, researchers, and scientists to study things such as anatomy, identify disease sites, or determine causes of death. Typically, medical research can be broken up into three main categories.

1. Basic Research
2. Clinical Research
3. Epidemiological Research

In medical research, there are two classified types – primary and secondary research. Secondary research is a summary of available studies in the form of reviews and analysis. Primary research is where the actual studies happen. Basic, Clinical, and Epidemiological research are classified as three types of primary research.

The flow chart above provides a basic overview of what exactly happens in each category of medical research. Now that we have a quick overview, we can break down each category further.

Basic Research

Basic research is technically fundamental research or the study of life processes that are universal in their application to scientific knowledge. David Frank, MD, Associate of Medicine, Medical Oncology at the Dana Farber Cancer Institute quoted basic research as:

“If you think of it in terms of construction, you can’t put up a beautiful, elegant house without first putting in a foundation. In science, if you don’t first understand the basic research, then you can’t move on to advanced applications.”

Basic medical research includes animal experiments, cell studies, biochemical, genetic, physiological investigations, and studies on the properties of drugs and materials in fields such as biology and chemistry. These studies are the study of the core building blocks of life including DNA, cells, proteins, and molecules to help answer the questions about their structures and how they work.

Typically, in these experiments there is at least one independent variable that is varied, and those effects are what are investigated. The variable could be the population, number of groups, case numbers, treatments, or dosages. Also in these experiments, the confounding factors should be controlled or reduced, specific hypotheses are investigated, and causal statements are made.

Basic research will also include the development and improvement of analytics procedures. These procedures can include but are not limited to:
Analytical determination of

• Enzymes, markers, or genes

Imaging procedures

• Computed tomography
• Magnetic resonance imaging

Gene Sequencing

Development of Biometric procedures

• Statistical test procedures
• Modeling and statistical evaluation strategies

Clinical Research

Clinical research is a step above basic and addresses important questions of normal function and disease by using human subjects. This type of research is geared more toward exploring whether new treatments, medications and diagnostics techniques are not only safe but effective as well.

Clinical trials are extremely rigorous and controlled so that they can accurately monitor progress and evaluate the treatment’s efficacy and benefits. Clinical research can be broken down into several distinct categories of study. Some of those include but are not limited to:

Treatment Research that involves the intervention of medicine, psychotherapy, new devices and innovative approaches to surgery or therapy.

Prevention Research which aims to better the prevention of disorders from developing or returning using medicine, vitamins, vaccines, minerals, or lifestyle changes.

Diagnostic Research is the practice of looking for better ways to identify a particular disorder or condition.

Screening Research aims to find the best ways to detect certain disorders or health conditions.

Quality of Life Research finds new ways to improve comfort and quality of life for patients with chronic illnesses.

Genetic Studies are implemented to improve the prediction of disorders by identifying and understanding how genes and illnesses may be related.

Research includes discovering why a person’s genes make them more or less likely to develop certain disorders.

While clinical research is commonly associated with new medications or devices, some studies include healthy volunteers that are needed to compare to results of patients with illnesses. These types of studies include:

• Long-term studies that involve psychological tests or brain scans
• Genetic studies that involve blood tests
• Studies of family history

Epidemiological Research

This specific branch of medical research investigated all the factors that determine the presence or absence of disease and disorders to help understand how many people have a disease or disorder, if those numbers are fluctuating and how it affects our society and economy.

With epidemiology, the patient is the community and individuals that are viewed collectively. Epidemiology is the study (scientific, systematic and data drive) of the distribution (pattern and frequency) and determinants (causes and risk factors) of health related states and events in specific populations (neighborhoods, schools, states, cities, global).

When it comes to epidemiological studies there are some key terms you need to know:

1. Incidence: number of new cases in the population over a set period

2. Prevalence: number of exciting cases

3. Cost of illness: expenditures of medical care

4. Burden of disease: total significance of disease for society

• Measured in years of life lost to ill health
• Difference in total life expectancy and disability-adjusted life expectancy (DALY)

5. DALY – summary measure of health of a population. One DALY is one lost year of health and is used to estimate the gap between the current health of the world and an ideal situation.

There are several health problems or events that Epidemiological researchers are studying. These include environmental exposures like lead, heavy metals, air pollutants or asthma triggers. Infectious diseases such as foodborne illness, influenza, pneumonia. Injuries including increased homicides in a specific community or a national surge of DV. Non-infectious diseases that can include localized or widespread rise of a particular type of cancer or an increase in a major birth defect.

Diabetes mellitus (diabetes for short) is a health condition where your body has difficulty converting sugar to energy. Diabetes has been documented since 1552 B.C, when Hesy-Ra, an Egyptian physician, documented the symptom of frequent urination as a symptom of a mystery disease that also caused emaciation.

As of today, there are more than 37 million Americans that have diabetes which is about one in ten people with more than 90% having type 2. Diabetes is one of the most prominent diseases with 1.4 million more people being diagnosed each year and being the cause of blindness, kidney failure, heart attack, strokes, and limb amputation. Diabetes also has several different symptoms including:

• Frequent urination especially at night
• Extreme thirst
• Weight loss
• Increased hunger
• Blurry vision
• Numb or tingling hands or feet
• Increased exhaustion
• Dry skin
• Sores that heal slowly
• More infections than usual
• Irritability or other mood changes
• Presence of ketones in urine

When it comes to diagnosing diabetes, there are three distinct kinds that all have the commonality of high blood sugar levels. The three recognized types of diabetes are:

Type 1 Diabetes (T1DM) which is when your body’s endocrine part of pancreas does not produce enough hormone insulin and your blood sugar levels become too high

Type 2 Diabetes (T2DM) is when your body develops resistance to insulin and your blood sugar level increases as a result.

Gestational Diabetes (GDM) specifically occurs during pregnancy and blood sugar level is too high during pregnancy.

“Even slight elevations in blood sugar have been shown to increase the risk of Alzheimer’s disease.” – David Perlmutter

To further support the evidence that diabetes is one of the prominent, devastating but common diseases of our time, check out these gathered statistics below:

• It is estimated that by 2045 the global diabetes prevalence will surpass 12%. (Statista, 2021)
• It is expected that the number of people with the condition will increase by 134% in Africa, 68% in South-East Asia, and 13% in Europe. (Statista, 2021)
• 283,000 Americans under the age of 20 are estimated to have the disease. (ADA, 2022)
• 29.2% or 15.9 million American seniors aged 65+ have diabetes. (ADA, 2022)
• 23% or 8.5 million American adults with diabetes are undiagnosed. (CDC, 2020)
• One person dies every five seconds due to this condition. This accumulates to 6.7 million deaths. (IDF Diabetes Atlas, 2021)
• Diabetes type 1 statistics show that around 10% of people that have the disease have type 1. (IDF Diabetes Atlas, 2021)
• 90 to 95% or around 33 to 35 million diabetic Americans have type 2. (CDC, 2020)
• The number of people in the U.S. is expected to rise to 38 million by 2025. (Statista, 2021)
• The U.S.’s average cost per patient is the highest at $12,000. (Statista, 2021)

The Discovery of Type 3

While not recognized as a health condition officially and considered a research term over medical, type 3 diabetes is a condition that is linked with Alzheimer’s disease, a form of vascular dementia the most common form of dementia in the United States.

Research states that type 3 diabetes occurs when the neurons in the brain become unable to respond to insulin, which is essential for basic tasks such as memory and learning. Researchers believe that this insulin deficiency is directly connected to the cognitive decline of Alzheimer’s disease.

Alzheimer’s disease is a prevalent, incurable disease that affects over 55 million people with 10 million new cases every year. Alzheimer’s disease also carries a hefty price tag with a global cost of $1.3 trillion and is expected to rise to $2.8 trillion by 2030. Beyond that check out these eye-opening statistics provided by alz.org just to see how prevalent Alzheimer’s is:

• 1 in 3 seniors die of Alzheimer’s or another dementia. It kills more than breast cancer and prostate cancer combined.
• Deaths from Alzheimer’s have more than doubled between 2000 and 2019
• People living with Alzheimer’s or other dementias have twice as many hospital stays per year as other older people.
• A person is diagnosed with dementia once every 64 seconds
• After the age of 65, 1 in 10 adults has dementia
• One in every eleven men will develop dementia
• One in every six women will develop dementia

While research is still happening with type 3 diabetes, there are some hypotheses that suggest that insulin-degrading enzymes may shift type 2 diabetes to type 3 by altering the metabolic pathways which has the possibility to result in oxidative stress and beta-amyloid in the brain – both prominent characteristic of Alzheimer’s disease.

Doctors do not currently use type 3 diabetes as a diagnostic term, they can diagnose Alzheimer’s disease using a combination of physical and mental tests, neurological exams, and brain imaging. They also have had the ability to narrow down risks and symptoms to try and help individuals and their loved one’s spot type 3 diabetes and ALzherimer’s disease as early as possible.

Treatment is possible but there are separate treatment options for people who have pre-type 2 diabetes, type 2 diabetes and Alzheimers. These treatments include making lifestyle changes, beginning exercising, a diet low in fat and rich in fruits and vegetables and quitting smoking.

If you have both type 2 diabetes and Alzheimer’s, treatment for the diabetes is important in slowing down the progression of dementia. Patients can also use anti-diabestes drugs such as metformin and insulin to reduce the risk of developing diabetes-induced brain damage.

In addition, acetylcholinesterase inhibitors like donepezil, galantamine or rivastigmine can be prescribed to help your body’s cells communicate with one another while memantine and NMDA-receptor antagonist can help reduce symptoms and low the progression of Alzheimer’s disease. Another option is psychotropic drugs such as antidepressants and anti-anxiety medications to help with dementia symptoms like depression and mood swings, some people require a light dose of antipsychotic therapy as well.

Hope For The Future

While not an official medical diagnosis yet, the link between Type 3 diabetes and Alzheimer’s disease is being closely researched and becoming more legitimate as more information is uncovered. With no cure for diabetes or Alzheimer’s, discovering this connection is a huge milestone as we advance into an age of medicine that hopefully can cure one or both these damaging diseases one day in the future. wings, some people require a light dose of antipsychotic therapy as well.

The Growth of Wound Care

Wound care has been around since the beginning of humankind and the basic principles of wound care have been around since as early as 2000 B.C. The oldest medical manuscript, a clay tablet from 2200 B.C, is the first documented writing that has the three basic healing principles:

1. Washing the wound
2. Making the plasters
3. Bandaging

Including the findings within this clay tablet, there are plenty of other approaches that helped shape the wound care we know and practice today that include:

• Ancient Egyptians applied a paste of honey, grease, and lint into an open wound to remove the skin and pus and encourage wound healing.
• Ancient Greeks who focused more on the cleanliness and washing of wounds with clean water, vinegar, and wine.
• Ancient Romans who were the first describe the four cardinal signs of inflammation which “rubor, tumor, calor, et dolar” which translates to “redness, swelling, heat and pain”.
• In the middle ages, the customary practices were to allow a wound to rot a bit and most wound care was carried about by nuns.
• Dominique Jean Larrey, was the first physician to document the necessity for early amputation of any limb injury where the limb would not be saved. He noted that early amputation would create a clean, viable wound.
• In 1854, Florence Nightingale, the founder of modern nursing, believed that cleanliness, fresh air, quietness, good nutrition and effectively performed treatments would improve the care of not only the wound but the patient as well.
• In the 1800s, textbooks that focused on wound care began to address the importance of skin cleaning and removal of foreign matter.
• In 1861, Louis Pasteur discovered Germ Theory. This introduced simple practices such as hand washing, sterilizing surgical equipment, and wound dressings which lead to significantly faster healing times.
• Joseph Lister is credited with the development of the first wet-to-dry dressing that used a clean cotton batting soaked in carbolic acid to pack wounds.
• In 1890, the founder of Johnson & Johnson, began using the Lister Antiseptic System, the treatment of compound fractures with carbolic acid, to develop gauze and wound dressing that are sterilized with dry heat, steam, and pressure.
• During 1909 to 1918, it was common practice to apply dry gauze packed with salt to the wound bed by the end of WW1, the Carrel-Dakin method that consists of continuously infusing hypochlorite solution directly into gauze to pack the wound became standard.
• Throughout the 19th century, metallic antiseptics were developed. These along with the introduction of antibiotics helped decrease mortality rates while also controlling infections. Silver ceramic powder was introduced in 1928, silver sulfadiazine was introduced in 1958 and they were both used to treat Pseudomonas infection in burn victims. In 1974, it was discovered that the application of zinc to wounds helped promote healing in zinc-deficient individuals which in turn led to the development of Unna’s zinc sulfate paste, a paste still used in treatment today.
• Wound nursing was officially established as a specialty in 1958 but the certification was NOT available until 1980.
• The moist wound healing technique was backed by George Winter, Cameron Hinman and Horward Maibach in the 1960’s which focused on creating and maintaining a moist wound healing environment vs a dry one.

What Does Proper Wound Care Look Like Today?

There are different things to do and look out for with different types of wounds. In this section, we are going to cover cuts/scrapes, surgical wounds, and minor burns.

For cuts and scrapes, you will need to clean and soothe the injury with cool water and remove any foreign object with sterilized tweezers. Avoid irritating soap, iodine, alcohol, or hydrogen peroxide. Next would be an antibiotic cream or ointment that can help reduce infection and keep the wound moist. Apply a thin layer on the wound. Then, cover with a band-aid if your injury will be rubbed by clothing to avoid risk of reopening or infection, be sure to change the bandage daily.

Finally, notice signs of healing. Your body begins healing quickly with white blood cells attacking the infection-causing bacteria and soon you will form protective scabs that you want to avoid touching or removing.

For minor burns, cool the area immediately with a cold cloth or cool running water. This will stop the skin from holding the heat and continuing to burn. Next, wash the burn with non-irritating soap and water. Then, dress the burn lightly and leave any blisters that form alone because they help protect the skin.

For surgical wounds, protect your incision with a bandage for a few days and then change the dressing. Be sure to follow the care your doctor left for you for taking care of stitches or staples. It is important to keep the area dry and report any increase in redness or bleeding immediately to your doctor.

Look out for infections that can show signs such as swelling, green/yellow fluid, increased warmth, and tenderness in the incision. Other signs include swollen lymph nodes, body aches, chills, or fever. Contact a doctor if you have any of the previously stated symptoms and also if you have a wound that won’t stop bleeding after 10 minutes of pressure, is deeper than half-inch, near the eye, is ragged, caused by something rusty, has dirt or gravel in it, is very painful or is caused by an animal or human bite.

A New Approach To Treating Chronic Skin Wounds

Chronic skin wounds are a growing threat to public health and according to the National Institutes of Health, treating these wounds costs the United States $25 billion annually and affects 1 in 100 people. These wounds can come from aging and diseases such as diabetes, obesity and heart disease that can lead to ulcers and skin wounds.

One common way wounds are treated is using cadaver skin. Treating wounds with cadaver skin is not a new concept though, in fact cadavers’ skin was first used in 1881 for covering burn wounds. While this case failed due to graft rejection, it laid down the foundation for this technique by 1953 cadaveric skin was established as common management for burns.

Cadaver skin donated for medical use is typically referred to as allograft, homograft, or cadaver skin. To use cadaver skin, scientists created “dellurized skin” which use antibiotics to first decontaminate the skin and a combination of detergents, enzymes, and other chemicals to remove cells from the skin. This grew into delleuraized body body parts such as windpipes and scientists hope to use it for the heart and other organs.

“Imagine a house with all the furniture and people taken out — you’re left with an empty shell that is easier to populate than just building a house from scratch. In the same way, decellularized dermis provides a scaffold that the body can try to populate with its own cells. The good thing about decellularized dermis is that it has a structure and composition that the human body is already used to — the body responds more favorably to what it is used to than what it isn’t.”

– Ardeshir Bayat, a bioengineer and clinician-scientist at the University of Manchester in England

After some research and development, Bayat and his colleagues found that decellularized skin was efficient for not only chronic wounds, but acute wounds as well such as wounds from a burn. In their newest study, they removed 4 disks of skin about 5 millimeters wide from 50 healthy volunteers, for each volunteer, one wound site was left untreated and the next had the removed skin re-inserted, another was treated with an artificial skin substitute and the last was treated with decellularized skin.

The findings of this study concluded that the dellurized skin was the best for triggering growth of new blood vessels and had comparable strength to normal skin. Their next study is planned to be testing decellularized skin on a larger number of volunteers and adding electric stimulation with the hope of accelerating the integration of skin substitutes into the body.

While the use of cadaver skin has had slow progress, its progress is not foreseen to stop anytime. As researchers like Bayat continue to improve on how professionals treat wounds to chronic wounds, decellularized skin will continue to be improved upon and used in treatment. With around 100,000 skin grafts performed annually and 20,000 annual whole body donations, progress can seem slow and steady, but its outcomes can help generations to come.

End of life discussions and planning can be overwhelming regardless of who is involved or how it is managed. From decisions about what will happen to your body after death, what memorial arrangements you want or selecting the right, legal next of kin – there are plenty of factors to decide on.

What happens though when the individual is no longer capable of making decisions? This is when the legal next of kin or power of attorney would come into play. This previously decided on, individual can make decisions about treatment, arrangement and after death plans in place of the incapacitated individual. It is important for the decision maker to know the basics such as:

• The nature of the illness of the individual
• The purpose of treatment
• The risks and advantages to treatments
• Long-term planning such as housing (at home, in hospital, hospice, nursing home)
• The end of life wishes of the individual

The most important thing the next of kin can do is to HONOR the wishes of the individual who does not have capacity to make decisions to the best of their ability. While some things are unforeseen and out of their hands, knowing exactly what they want out of the remainder of their life and after death is a crucial part in being the legal next of kin.

The Convenience of Pre-Registration

Now, if you know that your loved one wants to choose whole body donation there are two options. Pre-registration is always best and if able should be completed before death. This can be done by the individual themselves or their legal authorizing agent, but individuals also can register after death.

Regardless of who is applying, pre-registration for whole body donation can be completed by filling out the qualification questionnaire and the registration packet. There will also be decisions made such as how the individual wishes their body to be used for whole body donation and what to do with the cremated ashes. When done at the earliest convenience, pre-registration also gives the organization time to answer any outstanding questions or concerns and be able to honor all end of life requests and wishes.

Next of Kin vs Power of Attorney

Just because someone has a good relationship with the passing individual, does not mean that they are automatically your next of kin or power of attorney. First, it needs to be decided which is appropriate for the situation at hand.

Let us start with next of kin, this is typically your closest relationship by marriage or blood meaning either your spouse or your child and is typically named by the passing individual in their medical paperwork or pre-planning for burials, cremations, donations, and other end of life arrangements but there are a few requirements. Next of kin needs to be at least 18 years old and deemed mentally competent to make decisions in place of the individual and can be a:

• Spouse
• Children (stepchildren included)
• Parents (stepparents included)
• Siblings (half or step siblings included)
• Legal Guardian
• Grandchildren/Great Grandchildren (half or step grandchildren included)
• Nephew (grandnephew included)
• Niece (grandniece included)
• Grandparents
• Uncle
• Aunt
• First/Second Cousins
• A Legally Appointed Trustee

Some states will include close friends but check for your states requirements and restrictions when selecting next of kin. Typically, next of kin is a relationship designation, but power of attorney is a legal designation and any adult can be chosen to be an individual’s POA. Another difference is that naming someone as your POA does not mean that necessarily can act on your designation, but common reasons people choose POA include:

• Ensure someone has the authority to make end of life decisions and honor an individual’s wishes
• Authorize someone to assist with personal finance management
• Have someone who will talk to medical providers on an individual’s behalf
• Designate someone to make all legal decisions

Registration After Death

If a legal next of kin and POA is declared but the individual planned for but never registered for whole body donation, they can step in and register them after death. While this process is a little different from pre-registration, they are the same.

The legal next of kin will first contact the organization to report the death. Just like pre-registration they will then complete the qualification questionnaire and authorization packet. Then the body will be transported to the organization’s facility.

After the body is received, the organization will reach out to the legal next of kin or POA for any additional information that is missing or any additional forms that may be needed. It is important to remember what your state requires for death. For example, Arizona needs a Death Registration Worksheet while California can confirm the death certificate information via phone.

Finally, the body is processed in the organization’s facility and cremated remains will be returned within 4-6 weeks to the legal next of kin or POA. If you do not want the remains, our organization personally offers options such as burials at sea or simply a no return option.

If your loved one or yourself is ready to pre-register with Research For Life, click here to begin the process. Do not hesitate to ask any questions or bring up any concerns. We appreciate your decision to donate a gift to the medical and research fields for generations to come.

End of life discussions are important to ensure that one’s personal wishes and preferences are known, making sure that their loves ones know what they want in their final days as well as after their death. These discussions are difficult but crucial, while some come to terms quickly with death others have a harder time dealing with it and during times of emotional crisis making critical decisions in the moment can add more stress and emotional turmoil for everyone.

Initiating end of life planning can be upsetting for some to the point where they end up completely avoiding it but there are a few ways to help ease into the beginning arrangements. The first way is gathering the important documents needed, figuring out where money or assets will go, and who is involved. This step includes preparation such as gathering end of life planning documents, making a list of all important assets (including what will happen to these assets), deciding on end of life housing plans, and settling on final wishes for funeral and burial arrangements.

One of the most natural catalysts for this discussion is admission to hospitals or hospice care which lead to open discussions between patients, family members and healthcare professionals about what the next steps are. While this might not be how everyone begins their end of life discussions, it is one of the most common. Doctors also can offer thorough insight to a patient’s condition, short or long term treatment, and end of life options per patient request. When a doctor (or patient) opens discussion for end of life options there are some key questions a patient should discuss with their doctor including:

• How much do you personally want to know about your condition? Would you rather know the basics, or would you like to know in more in depth detail? If you have a terminal illness, would you like to know how quickly it is progressing?
• How much information about your condition can the doctor share with their family?
• Which family members can know more important information? Who is the primary decision maker?
• Do you want to spend your last days in the hospital, nursing facility or at home? Do you have a preference or are you okay with any option?
• Is quality or quantity of life more important to you? Would you like to receive treatment indifferently?
• What is palliative care and is it right for me?
• Would you like a DNR (do not resuscitate) order?

Another way that end of life discussion can happen is an open, honest conversation with family. End of life planning can happen at home at any time and realistically any age. While it is not easy to discuss death and planning for after death, it makes it easier on families during the grieving process. When planning at home there are several questions one should ask themselves such as:

• Do I need a will?
• If I already have a will, does it need to be updated?
• Who will make decisions for me if I cannot make them myself?
• Do I have life insurance?
• What type of healthcare arrangements if I end up going to the hospital or hospice care?
• Do I have money set aside for funeral arrangements?
• What are my preferences for my body after death? (Burial, cremation, whole body donation, etc.)
• Do my family members know where my important documents are?
• Which family members do I share my end of life plan with? Who will honor my preferences?
• What type of memorial do I want? (traditional funeral or something more modern)

Talking to family about death can be more difficult without a healthcare provider as support in answering questions and receiving information. There are a few tips and tricks thought to keep the conversation on the right track, open and honest.

Be Engaged with them and make direct eye contact and answer any questions they have. Be firm in decisions, tell family members important information they should know but remain compassionate.

Give Them Time dealing with the death of a loved one, even just in discussion and pre-planning phases is not a happy topic. Just as the individual who initiates the planning, family members must come to terms with the future. If they need time to process or are not ready to continue the conversation, give them time and come back to it.

Encourage Respect and Ensure Understanding even if this means not involving family members who might not respect certain wishes or preferences, let the family members who will know what is expected. Be thorough about planning and expectations so everyone fully understands what is being asked. If they need reassurance that all decisions are made in sound mind, give them that. Keep the conversation at a high level and fact-based to help with peace of mind.

Remember, change is okay, having the initial conversation is hard enough, so if changes come up to any planning, family members could become worried. Just remember that change is natural and if preferences about burial arrangements, healthcare options, or even how assets will get split up that it is okay to change them and discuss them with family. Any family member who is decided to be involved with end of life planning should be kept up to date with them.

Keep Them Involved by not only letting them know of any change in preferences but also taking them to doctors’ appointments or any end of life planning appointments, if necessary. Let them ask the professionals questions to help them feel at ease and get a better understanding of what is going on.

Put It In Writing while this might seem obvious it can be often overlooked but patients should have an advance directive which falls into three categories: a living will, a power of attorney or a healthcare proxy. This written statement of a person’s wishes regarding medical treatment and end of life plans helps ensure those wishes are carried out especially if the person is unable to communicate them.

With keeping these tips in mind, the conversation about end of life can be easier. While it is always going to be difficult to initiate and family members might struggle to accept these decisions or the future, beginning the conversation and being prepared can only help ease the transition. While it might seem easier to put it off until the time comes, early planning helps ensure that an individual’s preferences and wishes are honored regardless of the future outcomes.

“Our simple aim is to make scholars, strong, bright, useful, and true.”
Daniel Coit Gilman, JHU’s first President

Johns Hopkins University, founded in 1876 takes its name from 19th-century Maryland philanthropist and entrepreneur Johns Hopkins. With the help of the first president, Daniel Coit Gilamn, Johns Hopkins, the nation’s first research university, opened not only the university but other institutions such as the university press, the hospital and the schools of nursing and medicine.

Located in Baltimore, Maryland this private university has just an 11% acceptance rate and is consistently ranked in the top twenty schools in the US. Admissions officers. While acceptance can be difficult, once accepted, students can choose from over fifty-one majors and forty-three minors, many that are nationally ranked. Additionally, a few core values Johns Hopkins looks for when recruiting students are an excitement to learn, strong ties to the community, leadership, courage, innovation, curiosity, and ambition.

Fascinating Facts about Johns Hopkins

• The Johns Hopkins University Press, founded in 1878, is the oldest continuously-operating university press in the United States.
• The university’s graduate programs in public health, nursing, biomedical engineering, medicine, and education are considered among the best in the country, according to U.S. News & World Report.
• Johns Hopkins claims 29 Nobel laureates past and present.
• Claiming he did not deserve the salary he was offered, Albert Einstein turned down an invitation to join the Johns Hopkins faculty in 1927.

The Leader In Research

Since conception, Johns Hopkins has focused its efforts on research and the pursuit of discovery in fields such as humanities, social sciences, natural sciences, engineering, international studies, education, business, health, and medicine.

Over 140 years with research being the core of what this university thrives in has led to incredible advancements including:

The Global Impact

Beyond these incredible discoveries and advancements, another thing Johns Hopkins prides themselves on is their global reach. Johns Hopkins typically has 6,000 graduate and undergraduate students that hail from 111 countries each year and more than five hundred undergraduate students have the opportunity to study abroad in forty countries with campuses in locations such as Bologna, Italy, and Nanjing, China. On top of that, there are more than 12,000 alumni that are currently living outside the country that help make up the sixty-three international alumni clubs.

Moving past just their students and alumni, the Johns Hopkins Health System currently treats over almost 4,000 patients from over 145 countries. There are also international research and training sites and programs in more than one hundred countries. Some of their most notable global impacts include:

Johns Hopkins Bloomberg School of Public Health – a leader in public health research and education with practices in more than one hundred countries. This program specifically has had major advancements against health threats such as polio, road traffic injuries, malnutrition, gun violence, HIV/AIDs, and addiction.

Jhpiego – a nonprofit health organization affiliated with the university that has spent more than 40 years in 155 developing countries aiming to improve the health of women and families.

Johns Hopkins Alliance For a Healthier World – an initiative that brings together experts from a range of disciplines to address global health challenges and advance global health equity.

Johns Hopkins Medicine International – a program that offers personalized care for patients traveling to Hopkins from outside of the United States and works closely with affiliates from around the world to help improve global health care.

Johns Hopkins University has made its mark with its research, incredible advancements, groundbreaking discoveries, and global impact with no indication of slowing down. From multiple Nobel Prize recipients, over 2,000 inventions awaiting patents, scientific revelations, and famous alumni – JHU proves to not only be a leader but ahead of the pack when it comes to research, discovery, and global leadership.

A mighty wind blew night and day
It stole the oak tree’s leaves away
Then snapped its boughs and pulled its bark
Until the oak was tired and stark

But still the oak tree held its ground
While other trees fell all around
The weary wind gave up and spoke,
“How can you still be standing Oak?”

The oak tree said, “I know that you
Can break each branch of mine in two
Carry every leaf away
Shake my limbs and make me sway.

But I have roots stretched in the earth
Growing stronger since my birth
You’ll never touch them, for you see
They are the deepest part of me.

Until today, I wasn’t sure
Of just how much I could endure
But now I’ve found, with thanks to you
I’m stronger than I ever knew.”
– Johnny Ray Ryder Jr.

Humble Beginnings

For centuries, trees have been associated with unmovable strength, wisdom, power, protection, and most recently, a new way to be buried and honored after death. Tree pod burials are a very straightforward concept which involve putting human remains into biodegradable pods rather than traditional caskets.

These urns are meant to break down over time allowing the encapsulated remains to be broken down into the soil and become fertilizer which results in the tree growing in place of a headstone. As of now, it is most common for tree pod burials to be for cremated remains but have the potential for the entire body to be encapsulated as well. If a body is placed in a capsule, it cannot be embalmed or otherwise prepared and will be placed in the fetal position within the pod.

The tree pod burial concept was introduced in 2016 by two Italian designers, Francesco D’Angelo and Adriano Del Ferro. Their burial system, known as Capsula Mundi which is “world’s capsule” in Latin, consisted of human remains, typically cremated, wrapped in a natural fiber cloth that are then stored in an eco-friendly, egg-shaped pod.

Once the pod is implanted in the ground, a tree is planted directly above it, as time passes the egg will break down and the remains will undergo the process of decay. During the decaying process, nutrients and microbes from the remains will nourish the tree as it disintegrates, aiding extra aid allowing for the tree to grow and thrive.

Growing Green with Interest

As people start gravitating towards more green burial options and past traditional funeral services, we notice tree pod burials popping up more frequently. With worldwide issues stemming from climate change and individuals wanting to be more eco-conscious, traditional funerals that put nonbiodegradable materials such as hardwood, steel and toxic embalming chemicals into the earth are slowly losing traction and interest quickly as more alternatives make themselves available.

Beyond the need to be eco-friendly, tree pod burials are also significantly cheaper than traditional funeral services. Traditional services can cost up to $12,000 while tree pod burials can range from $1,000 to $4,000 depending on price of the urn and cremation services in your state. Typically, the biodegradable urn costs $457 but there are cheaper alternatives available as well. You will also need to plan out the cost of a tree but typically a sapling can cost around $55 but it truly depends on the tree chosen.

Other costs will lay in where exactly you want to plant your tree. If you have land or special permission to plant, you can save serious money on burial plots. If you go this route, be sure to check local laws because not every jurisdiction allows for human remains to be buried on private property. On the other hand, if you decide on a conservation burial land, burial fees are typically required to acquire land and protect the tree, these fees can be anywhere from $1,000 to $4,000 depending on the land.

While initially, burial pods seem costly, they are still significantly cheaper than traditional funerals offering budgetary relief, a smaller environmental impact while the tree will continually contribute by providing oxygen, improving air quality, climate amelioration, and wildlife support for years to come.

Choosing A New Life

While tree pod burials are still relatively new and can be off-putting to those who have not considered nontraditional burial practices, the popularity of creating a life after death has proven enticing enough to create a real need for it in the funeral industry. Tree pod burials are the answer for individuals who want to be eco-conscious with their after-life plans and ease the financial, environmental, and emotional burden that are typically associated with funerals. If you or a loved one is looking into tree pod burials, be sure to follow all state or jurisdiction guidelines and regulations before beginning the process.

Hospice is a specialized care program that is typically offered to people who have six or less months to live due to a terminal illness. There are some hospice programs that offer long term care if needed and can be offered in the home, nursing home, assisted living facility, hospital, or hospice house.

Fast Hospice Care Facts and Figures

Source: https://aginginplace.org/

• 1.43 million beneficiaries were enrolled in hospice care for at least one day.
• The average length of hospice care for Medicare beneficiaries was 71 days.
• The median length being 24 days for Medicare beneficiaries.
• 98% of hospice care was provided at the Routine Home Care level.
• There are currently 4,382 Medicare-certified hospices in operation with most hospices averaging less than 50 patients.
• Hospice care is not a permanent decision, there have been patients to move off hospice due health improvements.

Hospice care teams include, but are not limited to, doctors, nurses, social workers, and pharmacies, all with the focus of managing a patient’s illness and giving them the necessary emotional, spiritual, and physical support. Hospice also offers benefits such as:

1. Specialized Care – a hospice environment can meet the needs of individuals that require more in depth care, offering comfort and support during the final days.

2. Insurance – hospice care is covered by Medicare, which is the most common health insurance in the United States allowing it to be easily accessible to most people.

3. Personal Assistance – hospice can take care of daily tasks such as laundry, food prep, personal hygiene, and bedside care.

4. Bereavement Support – after death, most hospice centers provide bereavement support and grief counseling to families which include visits from trained grief counselors, grief support groups or remembrance services (level of support varies by hospice).

5. Team Approach – hospice knows that caring for an ill patient is exhausting on all levels which is why the hospice care team is available to patient and family to help provide comfort, support, and rest for tired family members.

The Family Approach

Now while turning to hospice can be an extremely difficult decision for family members, family remains the primary support for a hospice patient. Family members and loved ones being active in the patient’s life even during hospice care is incredibly important for emotional and spiritual support. While hospice takes care of pain and symptom management, has access to community resources, provides the necessary medical equipment and being able to connect with patients on a surface level – family members are there to provide reassurance, love and be an advocate for their loved one.

Being admitted to hospice is not just nerve wrecking for the family but for the patient as well, giving up a lifetime of freedom, being completely dependent on others and accepting the inevitable is not always easy on people, especially with independent individuals. Family members can support loved ones in hospice by:

Advocating For Their Loved One

By working closely with the hospice care time to create a personalized hospice plan, families can accurately reflect their loved one’s preferences. They can also make sure the hospice care team knows their last wishes including how they would like to be cared for, the level of intervention, their end-of-life options, and other related concerns.

Providing Emotional Support

Providing emotional support to a loved one is one of the most important things friends and family can do. Be sure to speak calmly and offer reassurance while reminding your loved one how you value them, the impact that they had during their life, revisit treasured memories, and talk about their interests or hobbies. If you are not sure what to say to your loved one, simply lend them a listening ear or a shoulder to cry on. Providing physical acts, such as holding hands, is also incredibly soothing for patients during an emotional time.

Creating A Comforting Environment

If you can have any control over the environment, create a calming one. Avoid loud music and bright lights and opt for soft versions of both. It has been proven that this helps improve mood and alleviate stress for patients. Calming, familiar music is also proven to help evoke specific memories. Be sure to also keep the temperature comfortable, the bed dry and limit any distracting noises or chaos.

Arranging Visits (Virtual or In-Person)

Seeing a loved one ill is hard, but avoiding them does not help anyone, patients more than ever want to feel connected to their family and friends. Be sure to have regular in-person visits, have scheduled phone calls or do virtual visits via Skype or Zoom. Be sure to remind the patient that they are loved and that you will be in contact with them again.

Choosing Hospice

Though choosing hospice is never an easy choice for family members, it is important for them to not feel defeated over the decision. Hospice truly is a family affair that includes patients and loved ones into care. With family members and the hospice care team coordinating together, it can ensure that patients feel comfortable, valued, respected, loved and heard during this emotionally exhausting time.

Why People Are Seeking Alternatives To Traditional Funerals

It is no secret that the cost for a traditional funeral is increasing annually and has been for quite some time with the average funeral costing anywhere between $7,000 – $12,000. These prices clearly are not always easily affordable for all families which can make holding a funeral infinitely more stressful, all while grieving.

When the pandemic hit in 2019 hit, this did not help improve the funeral industry, with more deaths but also more restrictions on gatherings it was becoming increasingly difficult to even plan a traditional funeral. While we have already seen people move past traditional funeral services with cremation, the interest in alternatives has truly peaked in the past several years. Moving forward we see more concern about overall cost, reducing the stress placed on family members, and a need for more environmentally friendly options. Listed below we have covered six, increasingly common, alternatives to traditional funeral services that help meet these new growing concerns.

Virtual Services

With the pandemic, travel, family, conflicts, or any other issues that may arise when planning a funeral, virtual services have become increasingly popular. Virtual funerals allow loved ones to pay respects and grieve regardless of location or illness, saves money on certain traditional funeral costs, and brings the service to the comfort of home. It is important when holding a virtual service to choose accessible video platforms such as Zoom or Google Hangouts. If you are feeling overwhelmed with the thought of planning the service, funeral homes and other various companies can send a professional to help plan and make sure the service runs as smoothly as possible.

Hosting a Home Funeral

Home funerals are a tradition in many cultures that dates back centuries. With a home funeral, families can prepare the service and body themselves or hire a funeral home to prepare for them. Home funerals create an intimate experience with death but in a more relaxed atmosphere. It is important to remember that while home funerals are legal everywhere you should check with your state’s laws regarding things like if you need a funeral director to file the death certificate, transport the body or any other aspect your state requires a funeral director to be a part of.

Hold An Annual Anniversary Memorial

Not all families are comfortable with funerals and grieving death openly but just because you have decided to skip the funeral does not mean that annual memorials cannot be held. This could range from annual memorial dinners to a formal service. Anniversary memorials are going to be specific to families, do whatever works best for you and your loved ones.

Creating A Shrine

Shrine can be an intense word; but, done right, it can be an excellent way to remember your loved ones. If you want to skip the complexity of a traditional funeral but still want to pay respects to the deceased, a shrine is a good way to still be able to say goodbye to loved ones. Unlike a home funeral when creating a shrine, the body typically is not at the home. Instead, the process of putting this together is more meaningful and a place for all your loved ones to gather, share members, add items and honor passed loved ones.

Planting A Tree

While there are many eco-friendly funeral alternatives one of the most common is hosting a tree-planting ceremony in place of a funeral. This can be done at home or in the park (with permission) and it is a wonderful way to memorialize loved ones. If the deceased has been cremated, family members are able to mix their ashes in to grow with the tree. Typically, when choosing this route, you plan a ceremony as you break ground, plant the tree of your choice, and have friends and family participate by contributing soil or saying a few kind words. Another popular part of the tree-planting ceremony is placing a tree plaque that honors the deceased as a permanent memorial that will stay with the tree.

Other Eco-Friendly Funeral Alternatives

An eco-friendly burial is an environmentally-friendly alternative to the traditional funeral services with emphasis on earth preservation and carbon footprint reduction. There are plenty of aspects to consider when planning an eco-burial such as:

• Biodegradable Urns which are created out of material such as recycled paper, wool fiber, compacted peat, and coconut shells that end up having a positive impact on the environment.
• Eco-friendly Coffins which are coffins that do not impact tree life such as traditional wooden caskets do. The materials can be a variety of materials such as bamboo, banana leaf, willow pine or cardboard.
• Alternative Transportation is typically meant for loved ones and mourners and suggests finding ways to minimize the cars in the funeral procession and for using more eco-friendly car options for transporting the body.
• Woodland Burial Sites is an eco-friendlier option than being buried in a cemetery since that environment is 100% natural. Natural burial sites can include woodland areas, forests, meadows, and they rarely allow headstones or memorials.

Important Reminders

When planning the funeral service of a loved one, regardless of the route you take, it is important that it works for you and your family. When choosing alternatives, make sure they meet your concerns, needs, and loved ones wishes. Once you move past traditional funerals, the options are endless on creating a personalized memorial service to properly honor a passed loved one in a way that is special to them and the family. While most funeral alternatives’ costs will average significantly less than a traditional service, prices for all the listed alternatives will depend on size, location, and other various aspects.