Emily Carlson's Health website

ELIOT STIFFS ETHICS IN STEM-CELL TIFF - Emily Carlson

2008-01-22T11:43:00.000-08:00

Spitzer: Ignoring the advice of the state's own bioethics committee.

By DANIEL P. SULMASY, The New York Post

New York's new Empire State Stem-Cell Board has opted to ignore the advice of its own ethics committee. Those of us on the committee are left wondering if the state requested our service merely to make it look as if the enormous moral questions at stake would be given careful consideration. If so, New York's citizens have been deceived.

Other states have had vigorous debates about the ethics of stem-cell research. In New Jersey, a recent referendum on stem-cell research stirred hot debate and eventually went down in flames.

By contrast, New York's law allotting $600 million in taxpayer money to stem-cell research over the next 10 years passed in the middle of the night on April Fools Day 2007, tucked away inside the Albany budget.

To consider the issues that have made the topic so controversial, the governor and Legislature set up an ethics committee - but gave it the power only to make non-binding recommendations. And the first round of grants will go out without waiting for our recommendations.

No one doubts that stem-cell research holds great promise. But there's no consensus about what kinds of research should be funded by taxpayer money.

New York's law doesn't specify any limits, beyond prohibiting attempts to bring a cloned human to birth. Presumably, legislators thought the ethics committee would decide the ethical questions about which kinds of research should get funds.

The issues are weighty. Some obvious questions: Is it ethical for scientists to create cloned human embryos and then destroy them to "harvest" embryonic stem cells? May they create chimeras - part-human, part-animal creatures? Create human embryos via in vitro fertilization purely for research? Attempt parthenogenesis - creating human embryos with only the woman's egg, forgoing fertilization with sperm?

Yet the state Health Department went full-steam ahead, presenting draft research proposals to the first stem-cell board meeting on Oct. 22.

At the first ethics-committee gathering on Nov. 30, we were given just two hours to suggest "interim ethical guidelines."
Despite this pressure, we developed a reasonable plan: Delay funding for controversial practices to allow time for ethical review, while awarding grants for non-controversial practices (such as research on stem cells from adults and from umbilical-cord blood, as well as on stem-cell lines already derived from embryos).

Ethics-committee members hold diverse views on the controversial kinds of stem-cell research. Nonetheless, the committee unanimously recommended that the board hold off on funding these practices for six months so that the committee could examine these thorny ethical issues carefully and recommend guidelines.

The ethics committee thought that ethics mattered.

But perhaps ethics doesn't matter much in New York. The board's funding committee, composed almost exclusively of scientists and advocates for embryonic-stem-cell research, agreed on ambiguous guidelines that permit all the controversial practices noted above: cloning, chimeras, parthenogenesis and creating human embryos solely for research.

The ethics committee's sensible plan of ethical due diligence proved intolerable to the funding committee. It argued that even temporary limits would "send the wrong message to scientists."

On Jan. 7, Gov. Spitzer held a press conference to announce that the first round of funding had been awarded: $14.5 million.

This precipitous funding decision sends the wrong message - namely, that the discussion of research ethics should never encumber scientists' work. That's a dangerous premise for any society to hold. Was a six-month delay to allow ethical review really too much to ask? It's preposterous to propose that this would've had a "chilling effect" on science.

New York citizens deserve a serious ethical review of how $600 million of taxpayer money will be spent on a potentially valuable but extraordinarily controversial field of research. If the ethics committee had been permitted to do its job seriously, the whole nation might have benefited from a rigorous, public, dispassionate debate of the weighty ethical issues at stake.

Instead, ethics has been steam-rolled. The Spitzer administration can ill-afford to give the impression that this is how things work in New York.

Dr. Daniel P. Sulmasy directs the ethics programs at New York Medical College and St. Vincent's Hospital and serves on the Empire State Stem-Cell Board's ethics committee.

Key Health Issues Divide Dems, Reps - Emily Carlson

2008-01-20T14:20:00.000-08:00

By KEVIN FREKING, Associated Press

WASHINGTON (AP) — The Bush administration's health agenda this year will consist largely of fending off Democratic lawmakers until a new president and Congress take charge.

In a preview of what is ahead, Health and Human Services Secretary Mike Leavitt says the administration will work to limit the government's role in the delivery of health care. That goal is at odds with several Democratic proposals, such as giving the health chief the power to negotiate drug prices and greatly increasing enrollment in federally sponsored health insurance for children.

Leavitt sees the philosophical divide playing out in numerous ways before the November elections. The year, he predicted, "will be replete with the kind of conflict this town is famous for."

Most policy analysts see little chance for compromise on almost all the major health issues before Congress — a view shared by the top Republican on the House Energy and Commerce Committee, which oversees most health issues.

Based on last year's experience in the first year of Democratic control, "I'm not expecting too much cooperation or bipartisanship," Texas Rep. Joe Barton said. "I would assume that all that gets done will be the things that absolutely have to get done."

Democrats will try to keep attention on a proposed expansion of the State Children's Health Insurance Program. The party sees this program as the most practical way to increase coverage to 4 million children, said Democratic Rep. Frank Pallone of New Jersey, who heads the health subcommittee.

Under the program, the government and states subsidize insurance for children in low-income families that do not qualify for Medicaid. Leavitt often refers to the children's insurance program as government-run health care. Pallone, however, notes that private insurers routinely contract with states to administer the benefit.

The administration is "into this ideological labeling of everything, even when there's no basis for it," Pallone said. "That makes it difficult. But look, we're going to be practical and we're going to see if we can come to an agreement with them."

Democrats, with some Republican support, will try on Wednesday to override President Bush's veto of a bill that would basically double spending on the program, to $12 billion annually. A similar vote last year fell 13 votes shy.

Democrats also are focused on trimming payments to private health insurers that serve older people and the disabled. Democratic Sen. Max Baucus of Montana, who heads the Senate Finance Committee, has said a hard look at the payments and the marketing practices of insurers is long overdue.

The insurance companies provide coverage to about 9 million people through a program known as Medicare Advantage. The government, on average, spends about 12 percent more for beneficiaries treated through Medicare Advantage than it does for those in traditional Medicare. Under regular Medicare, the government simply reimburses a provider a set rate for a particular service.

But Leavitt said the administration will not support cutting money for Medicare Advantage.

"We want to protect it, enhance it and expand it as a tactical approach to entitlements in general," Leavitt said.

Agreement could come on a separate health-related issue, food safety. Barton said Rep. John Dingell, chairman of the House Energy and Commerce Committee, has told him he would like to work with Republicans on the issue.

"I think we would support more inspectors," Barton said. "I think we would support foreign inspections where we go into processing plants overseas like the FDA (Food and Drug Administration) has the right to do here."

Democrats will try to allow more poor people with Medicare coverage to qualify for extra financial help, and they are promising continued reviews of insurers' marketing practices.

About the only legislation that both Democrats and Republicans view as having to pass would eliminate a pay cut for doctors who treat the elderly and disabled. The doctors were scheduled to take a 10-percent rate cut beginning Jan. 1 until Congress granted a six-month reprieve.

As part of that expected bill, the administration wants to require that doctors adopt electronic record keeping. Those who do not buy such technology would get paid less than the doctors who do.

Such records can help coordinate patient care, potentially reducing health costs. The widespread adoption of electronic records furthers the administration's priority of creating a marketplace that gives people more information about the quality and price of the care they receive, Leavitt said.

Pallone said Democrats back the idea of electronic records, but he will not support requiring doctors to go along with the technology as a basis for their Medicare payments.

"It just becomes an excuse to reduce their rates," Pallone said.

Leavitt hinted that Bush will continue to recommend a slowdown in Medicare and Medicaid spending, but he declined to get specific.

Also at issue is an anticipated Democratic effort to allow the FDA to regulate tobacco. Leavitt said he opposes giving the agency that responsibility because some people could get a false sense of security about the safety of tobacco products.

Health Care Could Sway Nevadans - Emily Carlson

2008-01-17T19:33:00.000-08:00

By JENNIFER STEINHAUER, The New York Times

LAS VEGAS — Voters in Nevada fret about the economy. Many are disquieted by the war. They worry about taxes, the federal threat of a nuclear waste site in their midst, immigration and gun rights.

But with the Nevada caucuses coming Saturday, little seems to concern people here as much as health care. The state has an unusually high number of people with no insurance, doctors are hard to come by, Medicaid reimbursements are low and health care safety nets are eroding.

“I used to be able to go to the V.A. and they’d take care of us,” said Anthony DiMaria, 84, who served in the Marine Corps. “Now they send you a letter saying you have what they call ‘means,’ and they aren’t going to take you in anymore. Is that the kind of life we fought for?”

Just as the presidential nominating contests in other states have been defined in part by national issues with local poignancy — immigration in Iowa, unemployment in Michigan — Nevada’s caucuses could turn on how well the candidates address the United States’ growing health care crisis.

Older voters — and the children who help care for them — worry about Medicare benefits, young people in jobs without coverage say they cannot afford to pay for their own and most everyone knows or has cared for someone with too little insurance.

In interviews with 30 registered voters around this city — in a retirement community, a middle-class neighborhood and downtown on the steps of a courthouse — almost half said that health care was the most compelling and worrisome problem the candidates needed to solve.

“I have a daughter who had a major car accident three years ago and she can’t get health insurance,” said Terrence M. Jackson, 61, a lawyer. “I pay $15,000 a year for her medical coverage. And there are millions of people who can’t get coverage.”

Among Democrats — whose caucuses are the main event on Saturday because Republican candidates have largely sidestepped the state — voters were particularly outspoken in identifying health care over the mortgage foreclosure crisis, the national economy or the war in Iraq as their principal concern.

“We had to go to one of those plans that are Medicare-driven and they tell you what you’re going to do and not going to do,” said Carol Wilken, 62, who said at a retirement community here that the candidates’ health care plans would drive her vote. “It’s the pits. Don’t ever get old.”

While insurance difficulties plague nearly every state, Nevada has come to its problems in some unique ways. The fastest-growing state for most of the last two decades, it has a largely mobile employee base — particularly in Las Vegas — with residents who move from job to job, often never gaining insurance. The state’s large Hispanic population — which tends to lead the numbers of uninsured — further contributes to the high numbers.

Finding doctors who will accept Medicaid is difficult in the state, especially in rural areas, and the state’s income eligibility requirements are high and the paperwork required to enroll is excessive and inaccessible compared with other states, health care experts say.

A recent poll of 500 likely Democratic voters in Nevada found health care to be “the single most important issue in determining” a presidential vote among 20 percent of those polled. Only the economy, with 21 percent, was mentioned by more respondents. (The poll, conducted by Research 2000 for The Reno Gazette-Journal, has a margin of sampling error of plus or minus four percentage points.)

The percentage of people without insurance in Nevada is among the highest in the nation, significantly higher than in Iowa, New Hampshire or Michigan — the states that have already voted. According to the Census Bureau, an average of 18.3 percent of Nevadans did not have health insurance from 2004 to 2006, compared with 9.3 percent in Iowa.

The Democratic and Republican candidates concur that affordable health care eludes many Americans, but they are deeply divided on how to remedy the problem and insure the 47 million people without health insurance.

The Democrats, whose plans would cost $65 billion to $100 billion annually, believe that the federal government should play a role, in part through the elimination of the Bush administration’s tax cuts for the wealthy.

Senator Hillary Rodham Clinton of New York and John Edwards, the former North Carolina senator, say they would require all Americans to get coverage and would provide subsidies to that end, while Senator Barack Obama of Illinois would require only children to have coverage. Mr. Obama’s plan would require employers to provide coverage or contribute to a new public program. They have all mulled expanding the Federal Employees Health Benefits Program.

Republicans prefer plans that rely on the marketplace over government, and they generally eschew mandated coverage.

Rudolph W. Giuliani, the former mayor of New York City, has called for a voluntary move from the employer-based system to one granting tax benefits to those who buy their own insurance.

Mitt Romney, who signed a universal coverage plan into law when he was governor of Massachusetts, would give states the flexibility to come up with their own answers, with federal assistance. Senator John McCain of Arizona is focused on containing health care spending, and has said that essentially high-cost diseases, like diabetes and heart disease, should get more attention. Mr. McCain proposes that hospital and doctor compensation be linked to performance measures.

Among the voters interviewed here, few were particularly informed about what any of the candidates have proposed. While no candidate was overwhelmingly supported by those interviewed, Mrs. Clinton’s association with health care registered with some voters.

“I know it was a major issue when she was a first lady,” said Jeffrey Eskin, 55. “And my feeling is that it was started and not completed.”

The issue cuts both ways for Mrs. Clinton, whose health care plan in the Clinton administration failed spectacularly.

“I think with Senator Clinton, she’s trying to bring in a socialistic health care system which would probably bankrupt the country,” said Marlene Lansdell, a registered nurse and a Democrat. “Health care is my No. 1 issue, but they are going to make changes that are going to be extremely costly and the taxpayer will foot the bill. I don’t want a free-for-all.”

So for the next few days, most everyone here seems to be listening intently — and hoping for inspiration. Cheryl Reber, who at 26 was recently removed from her parent’s coverage, has no insurance in her job as a legal secretary, but says she tries not to think about that.

“I haven’t had to face any health care problems yet,” Ms. Reber said, adding that the possibility haunts her. “I don’t want to go as far as Canada, but we need something more affordable.”

U of M researchers grow a beating heart in a jar - Emily Carlson

2008-01-14T10:52:00.000-08:00

By Josephine Marcotty, Star Tribune

MINNEAPOLIS -- Researchers at the University of Minnesota have grown a beating heart in a jar.

They used detergents to strip a rat heart of its own cells, leaving behind a white, three-dimensional scaffolding of connective tissue. They then infused it with living cardiac cells from newborn rats, which multiplied and grew into a fully functional heart -- a first in the field of tissue engineering.

"We've figured out how to use nature's own matrix -- chambers, valves, blood vessels," said Dr. Doris Taylor, the lead researcher and director of the university's Center for Cardiovascular Repair. She said that the technique holds promise for growing human tissue to repair not only hearts, but many other parts of the body. It might be possible, she said, to grow whole organs for patients who need a transplant.

Other tissue engineering scientists around the country said there are enormous obstacles to using the technique for people, but described the work as exciting and a landmark.

"It's gutsy. I am very impressed with her going right for the meat of it ... and showing remarkable results," said Dr. Buddy Ratner, a University of Washington bio-engineer.

The research was published online Sunday by Nature Medicine, a journal known for publishing cutting edge science.

Growing human tissue outside the body has been a medical Holy Grail for decades. Progress accelerated in recent years with the use of stem cells, special cells in embryos and adults that can be manipulated to grow into many kinds of tissue. The National Institutes of Health has provided millions of dollars for tissue engineering, but so far researchers have had success with only a few types of human tissue -- primarily bladders, skin, and blood vessels.

Though growing heart tissue holds the greatest therapeutic promise of all, it has also proven the most difficult. The heart is a complex structure of chambers, valves, and thick muscled walls fed by an intricate system of blood vessels. And it doesn't just contract, it twists, as if the muscle was wringing the blood out of the chambers and into the body.

Researchers have tried to grow cardiac patches in the lab to use repairing damaged hearts. But in order to work, tissue patches must be quite thick and researchers have not found a way to provide the growing tissue with enough oxygen. Hearts are also three dimensional -- the cells need a scaffold to grow on that allows the cells to contract and do the mechanical work of a heart.

"Scaffolding is the challenge where we are doing most of our work," said Ratner, who is trying to build an artificial structure with the same kind of material used for contact lenses.

Taylor said that one of the rules in her laboratory is "to give nature the tools and get out of the way." That's how she and her co-researchers came up with the idea of adopting a strategy that's been used elsewhere for smaller parts of the body. They stripped a heart of its cells -- or de-cellularized it -- leaving behind what's called the extracellular matrix.

"When you think about a steak, it's the gristle," she said. It provides both the blood vessel system to deliver oxygen and the three-dimensional structure. The researchers provided the right medium by placing it in a glass chamber and giving it oxygen, nutrients and fluids to pump.

"The cells know they are in a heart and that they should act like a heart," she said.

She has done the same thing with a pig heart and believes it could also be done with kidneys, livers, and lungs. She is looking into which kinds of cells -- heart, bone marrow or embryonic stem cell -- could be used.

Some experts said that for transplantation, the technique could prove most useful for organs other than the heart.

"Long term, a transplant of the heart is not necessarily going to be the preferred therapy," said Dr. Robert Nerem, director of the bioengineering institute at Georgia Institute of Technology in Atlanta. "I think there may be more interest in repair of the heart."

The first adaptation for cardiac patients might be for infants born with congenital heart deformities.

Those heart problems are usually identified before the child is born. Stem cells from the baby's umbilical cord and the mother's amniotic fluids hold potential to grow the heart parts the baby needs.

"The biggest hurdle is cell type," said Dr. William Wagner, professor of bioengineering at the University of Pittsburgh. Since Taylor is an expert in stem cell biology, "I bet she is well equipped to try that," he said.

It could also be used to make patches for adults who have lost heart muscle from heart attacks.

But one major barrier to advancing the technique to people is getting body parts to strip. "You have to take a heart to make a heart," Ratner said.

Taylor said it might be possible to use human cadaver organs or pig organs. Pig organs are similar to those from humans and could be adapted, though it might be difficult to get the human body to accept such foreign tissue. That's why Ratner is working with artificial material that would biodegrade within the body, he said.

But most importantly, said Dr. Tim Henry, a cardiologist and researcher with the Minneapolis Heart Institute, Taylor has brought a startlingly new approach to an area of medicine with vast but largely unproven potential.

"The problem with science is that you need to take big steps," he said. "Some things we think are not possible, and someone has to think outside the box and prove that they are."

Putting Obama to Work for Health-Care Reform - Emily Carlson

2008-01-11T09:59:00.000-08:00

The Nation -- Barack Obama is not yet focusing his presidential campaign on the delegate-rich state of California. California's primary is one of February 5 "tsunami Tuesday" contests that will likely settle the race for the Democratic nomination. But to get to California, Obama must first win Nevada, South Carolina and several other states.

Yet, the Illinois senator's voice is all over the airwaves in the Golden state.

It's not an early-strike Obama ad campaign, nor even an independent initiative by Obama friends or foes.

Rather, the surging senator's voice is being borrowed by the California Nurses Association to help explain what's wrong with a health-care "reform" plan backed by Republican Governor Arnold Schwarzenegger and Democratic Assembly Speaker Fabian Nunez and California's most powerful insurance corporations.

The Schwarzenegger-Nunez plan would -- like a similarly-flawed proposal from Obama's rival, New York Senator Hillary Clinton -- address the health-care crisis by forcing individuals to buy insurance. That's a very popular approach with insurance companies, but not one that can or should appeal to people who are serious about providing health care for all.

Obama has said as much on the campaign trail. And the California Nurses Association -- a savvy, activist union that represents health care workers and advocates for real reform through the adoption of a single-payer plan -- has added Obama's voice to a media campaign that declares: "Don't let the politicians force you to buy insurance you can't afford and which won't help you when you're sick."

The radio ads being aired by CNA announce that, "The nurses of California agree with Senator Barack Obama: the government shouldn't punish people who can't afford health insurance."

Then an audio clip from Obama is heard. "I know that there have been some folks who said that it's not possible to provide universal health care coverage unless there's a mandate," says the senator. "Their essential argument is the only way to get everybody covered is if the government forces you to buy health insurance. If you don't buy it, then you'll be penalized in some way. And the reason people don't have health insurance is because they can't afford it."

While CNA is using Obama's comment to make the case against the Schwarzenegger-Nunez plan, the union has also been blunt in suggesting that the Illinois senator needs a better plan of his own. California Nurses Association/National Nurses Organizing Committee Rresident Deborah Burger, RN, argued last year that Obama's proposed reform plan "fails to rein in the health-care industry pricing practices that have put so many American families at financial and health risk."

CNA is borrowing Obama's words for its California campaign -- because Obama's stance is indeed better than that of the state's Republican governor, and because the senator's voice is suddenly one of the most recognized and well-regarded in the nation. But the union actually aired a commercial in Iowa that told Obama, "It's not good enough just to be better than the Republicans on this."

CNA is using the politicians, rather than being used by them. And in this campaign season, there are not many unions that are this smart, this edgy or this committed to holding everyone to account.

Stem Cell Technique Wins U.S. Funding, Fuels Debate - Emily Carlson

2008-01-09T00:09:00.000-08:00

By Tom Randall

Scientists have begun competing for the first U.S. government grants to investigate a stem cell breakthrough that may lead to new treatments for diabetes, heart disease and brain disorders and avoids destroying human embryos.

The National Institutes of Health, the government's medical research financing unit, began accepting grant applications Jan. 5 from scientists studying an advance reported in November. Japanese and U.S. researchers had transformed ordinary skin into stem cells that, in theory, could be grown in the laboratory into tissue to repair organs damaged by disease or trauma.

The new approach may compete with research under way at Geron Inc. and Advanced Cell Technology Inc. to regenerate nerves and cure blindness, even though scientists say it may be years before they know whether the advance will yield useful treatments. Advocates of extracting stem cells from embryos say exaggerated claims for the new method could derail research programs backed by California and New York, the biggest biomedical projects undertaken by states.

``Misrepresentations of this research are leading people into believing that embryonic stem cell research is not necessary anymore,'' said Robert Klein, chairman of the California Institute for Regenerative Medicine, which is responsible for giving out $3 billion in state grants over the next decade. ``That is a tragic distortion of these very new, very tentative discoveries. Patients' lives are at stake.''

The U.S. restricts funding for stem cells harvested from unused embryos created during fertility treatments. President George W. Bush hailed the November breakthrough because it doesn't destroy human embryos and preserves ``the high aims of science'' and the ``sanctity of human life,'' Dana Perino, a White House spokeswoman said in a statement. Bush has twice vetoed legislation that would have increased funding for embryonic stem cell research.

`Tens of Millions'

NIH is ready to give ``tens of millions of dollars'' in annual funding for three years, said Story Landis, chief of the U.S. research agency's Stem Cell Task Force. The state of California, the world leader in funding embryonic stem cell research, also will begin offering grants to study the new technique after the Jan. 10 application deadline.

The U.S. spent about $640 million on stem cell research in 2007. Because of the U.S. restrictions on embryonic research funding, 10 states developed their own programs, budgeting about $400 million in 2008 for embryonic stem cell studies and about $4 billion more over the next decade. Private donors have given at least $1.7 billion, according to the Rockefeller Institute, an independent research group in Albany, New York.

No Substitute

Companies already using embryonic cells for research say they think the funding to investigate the new technique may divert money from existing embryonic cell research that's closer to treating diseases, said William M. Caldwell, chief executive officer of Advanced Cell Technology.

The new technology ``is not a substitute for what we're doing now,'' said Caldwell in a telephone interview. His Alameda, California-based company is about to start human testing on an embryonic cell treatment to reverse vision loss in aging people. The company has transplanted embryonic stem cells into the retinas of blind mice, restoring their vision.

Therapies like that could be on the market in a few years, Caldwell said. It could take that long just to prove whether the new technique's cells are viable, according to the NIH's Landis.

New Nerves

Geron Corp., based in Menlo Park, California, hopes to begin the first human tests of embryonic stem cells this year to treat damaged spinal cords. The company uses the cells to produce proteins that encourage the growth of new nerves.

Chief Executive Officer Thomas Okarma said Geron, one of the largest embryonic stem cell companies in the U.S. by market size, won't invest in the non-embryonic method because it's ``too complicated and too expensive.''

Geron rose 19 cents, or 3.8 percent, to $5.26 at 4 p.m. New York time in Nasdaq Stock Market composite trading. Advanced Cell Technologies climbed one cent, or 6.9 percent, to 16 cents in over-the-counter trading. Before today, Geron had fallen 20 percent since the Nov. 20 breakthrough announcement and Advanced Cell Technologies had plunged 42 percent.

Japanese and American scientists on Nov. 20 described how they had inserted genes into skin cells to trigger a process that makes the cells similar to embryonic stem cells. The converted cells were then grown into heart, brain, muscle, fat and cartilage cells, using techniques similar to ones Geron and Advanced Cell use for creating specific tissue cells to treat disease.

Next Step

The next scientific step is to compare the properties of the two types of cells, said Shinya Yamanaka, the Japanese scientist who wrote one of the two breakthrough articles.

Scientists will have to rely on state and private funding for that research because the NIH, under a 2001 presidential mandate, restricts funding for research on cells taken from embryos.

``All of the people who have always been interested in saying we should not do embryonic stem cell research unfortunately will now have another arrow in their quiver,'' said Susan Solomon, chief executive officer of the New York Stem Cell Foundation. ``The subtleties of very complicated work are something they are all too happy to disregard.''

New York City

2008-01-01T22:17:00.000-08:00

Wow. That's all I could muster up and think when I stepped off the subway right in downtown Manhattan, on the 44th St. subway stop. Wow. Pictures really can't do New York City any kind of justice. My friends, who are native New Yorkers, of course thought my reaction was halarious, but their Midwestern friend did NOT grow up in the Big Apple. New York City is overwhelming and fascinating. I loved exploring the city for the week I was there, but don't know if I could ever live there. I do know that the one thing I loved was that there were shops open all night long! There was so much to do! NYC really is the city that never sleeps. While I could never do even a fraction of the sights in a week, what I did walk away with was the diversity of such a big city. One of my friends lived near Harlem, while another lived in a very Greek neighborhood. One night we went to a party at what looked like an industrial neighborhood which held a huge club, another night we went to a bar near NYU with a lot of students. Everything was very expensive, but I had a great time. NYC is charming, and full of life. I would visit anytime.

Vail

2007-12-29T16:17:00.000-08:00

Vail is one of the most charming U.S cities I have ever been to. Vail reminds me of a rural European cities, it could be somewhere in Switzerland or Germany. I used to go to Vail every summer for skating competitions. Held at Dobson Arena, I would warm up with some of the most beautiful scenery to get me ready for my short and long programs. After the competition was over, my family and I would hike up the mountains, and enjoy the breath taking views. The shops in the center of town were very cute, a tourist destination for sure. I bet Vail is rockin during ski season, I am not much of a skiier, and have not been to Vail in the winter, but I hope to someday. Marriot has a great resort in Vail right along the stream, I highly reccomend staying there, and relaxing at their spa. Vail is THE ultimate Colorado resort town, with Beaver Creek coming in a close second.

2007-12-26T12:33:00.000-08:00

It's a city in the middle of California, so not it's not going to be as popular as San Francisco or Los Angeles or San Diego, but Fresno is a great place to visit. It's very warm, pleasant with lots of parks. I really enjoyed Fresno. It's a medium sized city, great suburbs and lots of Starbucks! It was really funny. I saw Starbucks everywhere, and I got to try the great fare of Jack in the Box. Tacos, burgers, sandwiches, Jack in the Box was very, um, interesting. There was a very pretty park, huge with lots of playgrounds and even a Japenese garden. Fresno is very agricultural, with Fresno State. It's not by the ocean, but Fresno is a great town.

Liverpool

2007-12-19T15:29:00.000-08:00

It was Valentine's weekend and my friend Nicole and I didn't really want to sit in London and watch all our friends go out with their dates. What was the other last minute option? Go on our school sponsored trip to Liverpool, England and see the Beatles museum. Sure, why not? After a train, a bus, and a very long walk, we arrived at the Holiday Inn. We were crabby, but we got a free dinner, which is a VERY big plus, almost worth the trip if you've been living in London with a very strong pound and a weak dollar. On Valentine's Day, we went on a lame walking tour.. and then, the ever famous Beatles museum. That night? I swear, Liverpool has every themed bar you would ever want to go to. Right down the road they have...the 20's, the 30's the 40's.. I think you get the idea... they even have a futuristic bar with themed music for every one! It was interesting. Liverpool was interesting. A must if you like the Beatles, or are trying to avoid a romantic Valentine's Day!

Seattle

2007-12-16T15:40:00.000-08:00

Seattle. Home of Starbucks and rain. A vibrant, fun city with lots of great shopping and eating. Seattle is a seafood haven with amazing restaurants with every kind of fish you would ever want to try. Seattle has 8 million coffee shops (well, not really) but at least three on every street. I remember standing at a Starbucks downtown, and I could see 3 other Starbucks, and 2 Seattle's Best's. Seattle is one caffinated city. I really enjoyed Fisherman's Warf, where one of the fishmongers randomly threw a fish right at me, which a caught with one hand (don't worry, it wasn't a real fish, it was a stuffed animal!) While I only spent a few days in Seattle, I had a fun time shopping (home of Nordstroms and a wicked Nordstrom's Rack. Seattle is a must see city, and would be a great place to live.

St. Petersburg

2007-12-12T06:37:00.000-08:00

Florida is a warm, lovely state and St. Petersburg is a quaint, old jewel. The weather, the architecture, and especially the beaches. The sand at the Don Cesar at St. Pete beach is amazing. I could sit there all day and run my feet through the light sand. Then there's downtown and the Baywalk, the many galleries with lots of local artists' work, and the excellent food. There are so many unusual and interesting things to do in the city. Beach, shopping, old architecture and good eats... and we haven't even mentioned Tampa yet. Tampa is to Minneapolis as St. Pete is to St. Paul. The cities couldn't be more different, even though they are right next to each other. When I go to Tampa/St. Pete, I don't really even go into Tampa. I am totally content with staying over the bay. St. Pete has lovely old hotels, bed and breakfasts, and plenty of things to do. Next time you're there, have a cocktail at the Don Cesar hotel by the beach, go shopping at the galleries downtown, andhave dinner at Sushi Rock on Martin Luther King Dr. The perfect day!

Kansas City

2007-12-06T21:29:00.000-08:00

Take me to the Plaza anyday. Yes, it's no Paris, and it's certainly not like Rome, but don't knock it till you've been there... Kansas City is charming and unique. The city of fountains, you can find a bubbly delight on almost any block on any street. Kansas City is not just in Kansas, but in Missouri too. That's where you can find the best outdoor shopping mall around (this is coming from an expert... I live right by the Mall of America!) The Plaza has everything you could ever want, with charming surroundings. I like that you can walk around... get some exercise while you shop in the lap of luxury in stores like Dior, Ann Taylor and Halls. (Check out the holiday goods in Halls if you're never seen them... the Christmas trees will take your breath away!) Kansas City is a very metrosexual city for being in the Midwest. There are things to do and places to go. I enjoy staying there. My friends from the East coast say the Midwest is just a place to fly over on the was to the West coast. Think again! Kansas City is a happenin place!

San Francisco

2007-12-03T15:00:00.000-08:00

San Francisco is definetly Emily Carlson's favorite U.S. city. I was there just a few weeks ago, visiting my cousin. There is so much to do, you just can't see all of San Fran in a week! The Golden Gate bridge just takes my breath away. My cousin laughed at me because she drives over it every day, and doesn't even look at the spectacular view anymore, but I couldn't get enough. The massiveness, the structual beauty of the bridge is unbelievable. I would have loved to walk the bridge, but just didn't have the time. I could spend days and days in the city. Lombard Street, the Piers, Chinatown, the street cars...whew! And of course, being the chocolate lover that I am, Guiradelli was a must see. The chocolate sundae was excellent! I also had a Irish Coffee at the charming little pub right around the corner from the famous chocolate shop.. delish! The food, the shopping, San Francisco is definetly one unique city. It's not the land of strip malls of big box stores. Little off beat boutiques and interesting cafes are charming. How can you go wrong in San Franciso? The bay, the mild weather... I wish I could live in San Fran!

Rome

2007-12-01T18:10:00.001-08:00

Rome, ahh Rome. One of my favorite cities. Charming, old, romantic, lovely. Gelatto, the Vatican, Trevi fountain, and the Spanish steps. Amazing. The language is beautiful and the people are very friendly. I think all I did the whole time I was there was eat. Pizza, gelato, linguini and clams... yum. I had the best meals of my life in Italy. A week and so many things to do. Walk everywhere... mass at the Vatican, the Coliseum, there is charm everywhere you go in Rome. The only thing I didn't do while I was there was step inside a musem. There is no need! Just walk around the city and find the beauty. The buildings ARE art. Trevi fountain is one big sculpture! Make sure you sit and enjoy it... and toss in a coin. Oh... and my favorite gelatto is somewhere in that square. Wish I could remember the name of the place. Get pistachio. The best meal was just around the corner from the Spanish steps. Charming outdoor dining with lights everywhere... the wait was really really long... but SO worth it! Really good bread. How can you wrong in Rome? Make sure to go to the Sunday morning mass at the Vatican. The pope comes out on the balcony and speaks to the crowd... even if you're not religious... go. You feel something.. I don't know, moving when you're there. The whole city is amazing. A MUST on a Europe trip.

Edinburgh

2007-11-29T17:30:00.000-08:00

Scotland! Emily Carlson went to Scotland during her study abroad program. I LOVED Scotland. It was like stepping back into medieval times. Castles everywhere! I really enjoyed visiting Edinburgh Castle. You can't miss it! It's right on a hill in the middle of downtown, and the views are amazing. It's worth the entrance fee. The charm of Edinburgh is undeniable. From the men in kilts playing the bagpipes to the cozy pubs with excellent service, I loved this trip. There's even a Starbucks inside a very old Church! Make sure you go on the Scotch Wiskey experience. I was unable to go on the tour, because I arrived minutes before closing, wiskey is to Scotland as air is to humans. Like in Ireland, I went on a student bus tour. The highlands of Scotland are beautiful, and like in the movie Braveheart, we went and saw the land where William Wallace fought the British for independence. Stirring some controversy, we saw the statue dedicated to William Wallace (made after the move) that looked EXACTLY like Mel Gibson. Then it was off to Loch Ness! The lake is gorgeous... although no Nessie sightings!

Dublin

2007-11-27T19:23:00.000-08:00

Another one of my stops on my study abroad trip. I loved this trip because we went on a student bus tour. Yes, hole in the wall hostels. Yes, bad showers. But... 200 percent fun! We had a really attractive looking leader, we sang songs on the bus, and we went to every little pub along the way! This picture is of Dublin castle, which is right in the middle of the city. The best part of out trip was that we were in Dublin ON St. Patrick's Day! We flew in in the morning, and people were already lining the streets outside the bars. We quickly put our bags in the hotels and hit the shops to get out GREEN GEAR~ I got a green hat with yellow braids. We all got beads, and painted our faces green. We had a blast! And... contrary to American tradition, there is NO green beer in Ireland! Everyone in Dublin was very, very nice and friendly. I had a great time at the Guiness factory learning how beer is made, although I don't actually like Guiness! When we were leaving, it started hailing... The weather wasn't the best, but I would reccomend a trip to Ireland anytime! Cheers!

Venice

2007-11-25T17:27:00.000-08:00

Emily Carlson also traveled to Venice, Italy on her study abroad program. She loved the city of canals, even though she was there in February, one of the coldest months! In fact, I was there on Valentines Day, which should have been really romantic with all the gondolas and the Italian men, right?:) Nope! My friends and I had fun there, though. We had really nice, cheap accomidations (even though we totally got lost and walked around Venice in the middle of the night for hours) We had good food, and went on one of those tourist trap gondolas. The Guggenheim museum was definetly worth the trip, if you get a chance there's lots of treasures there. The wine was amazing, and good... we had good meals the whole time we were there, even though my friend Nicole will argue they should have cut the head and tail off her fish before they served it to her! Venice is really pretty. Still an old school town.. the bars were really hard to find, and when we did find a jazz club, we were the only tourists there! We spent the whole night dancing with Italians! It was a blast. The only thing that we didn't get to was the Murano glass factory. I really wish we would have made it there... if you go, make sure you make the effort!

Barcelona

2007-11-20T19:51:00.000-08:00

Emily Carlson traveled to Barcelona on her 6 month study abroad overseas. Barcelona was amazing.. I loved the sangria, Picasso museum, and the quaint cobblestone streets. My friends and I were able to walk almost everywhere in Barcelona. Although some places were quite a hike, we managed to get everywhere by foot. My favorite part of the trip was the Gaudi architecture. In particular La Sagrada Familia was amazing... (we actually climbed to the top) Park Guell was art decco looking (I loved the lizards!) and of course Casa Batllo (which looks like a dragon on the roof). I absolutly fell in love with Gaudi's work, and had a fabulous time in Barcelona. The only bad part was the hostel we stayed in. There were about 16 of us to a room, one shower, and one computer. The espresso at breakfast was good, but there was a curfew at night! (So, you just have to stay out till morning:) The good thing is, Barcelona never sleeps. There are cafes open all night, and street performers begging for your money. Barcelona is a must see Eurpean city!

London

2007-11-18T19:47:00.000-08:00

London is where I lived for 6 months. I LOVE LONDON. It was a nice transition into Europe because obviously, the language is English in England! The best plus of London is the FREE museums. I went to one every week, and I still didn't get to all of them! I loved the ease of getting around on the Tube, but I especially loved HARROD'S. I had to cut myself off from going there, cause I was spending too much money. Not that I could afford 90% of the things there! The best meal I had in London was actually at Harrods. The best meal in the city I had right in the Food Hall at Harrods. (That was my LEAST favorite part of England, the food was horrible. I'm just not a big fan of beans and shepards pie.) Cherrio! I would love to love in London someday.

Emily Carlson's Travel Page

2007-11-16T13:04:00.001-08:00

One of Emily Carlson's passions is traveling. I love to go to new places and try new things. One of my favorite cities is Paris. When I was in college, I went to Paris twice, once for a month my sophomore year, and also my junior year, for a week with my mom.
Emily Carlson thinks Paris is magical. The museums, the language, the food.. everything is fantastic and beautiful. The d'Orsay would have to be my favorite museum.. the Degas and Monets are well worth the admission fee.. and don't forget one day a week you can get in for FREE. I don't speak French, but am enchanted when I hear it spoken on the street. But... my FAVORITE thing EVER about Paris would HAVE to be the CREPES. They are by far my favorite food in the whole world. I stayed at a little hotel near the San Michelle, and a few blocks away there was this little crepe stand that had the most amazing nutella and banana/nutella and coconut crepes. YUM! I also like the breakfast crepes, but nutella holds a special place in my heart!