Hofstra Horizons - Spring 2014

H o f s t r a

horizons Spring 2014

Sewage Epidemiology: Municipal Sewage as a Resource for Law Enforcement and Public Health See page 8.

Research and Scholarship Promoting Excellence in Teaching at Hofstra University

president’s COLUMN Thanks to the contributions of countless members of our community, 2013-2014 has been another excellent year for Hofstra University. In the past year, we received important support from alumni, friends and philanthropic organizations. In October we hosted a convocation celebrating the naming of The Lawrence Herbert School of Communication in honor of Hofstra alumnus Dr. Lawrence Herbert’s many years of service and a multimillion-dollar gift to benefit the school. Just a few months later, it was announced that the Hofstra North Shore-LIJ School of Medicine would receive $10 million for scholarships from the Louis Feil Charitable Lead Annuity Trust. The Feil Trust has supported many health-related facilities and programs in our region, and this gift to the School of Medicine will ensure the success of many medical students.

There are many other examples of meaningful gifts at all levels, such as a $250,000 grant from alumnus Dr. Bruce Lister and Doris Lister, to support summer research fellowships for students of chemistry, which will strengthen opportunities for students and faculty alike to further their research goals.

Hofstrahorizons Research and Scholarship at Hofstra University

table of contents

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The Wise King

But at the heart of the Hofstra experience is scholarship and teaching, and at the center of our community is our faculty, who are equally dedicated to our students and to research in their academic fields. As you read through the spring issue of Hofstra Horizons, I invite you to learn more about the contributions of our faculty.

Professor Simon Doubleday previews his upcoming book, The Wise King, and in doing so tells us how a 13th-century king affected European history through the Renaissance. Professor Kevin Bisceglia explains how the analysis of sewage has valuable applications for public health and law enforcement. How Khmer youth use transnational literacies to express and articulate complex social identifications is the subject of Professor Theresa McGinnis’ article, and in the article by Debra Rand and Saori Wendy Herman, we learn what the Hofstra North Shore-LIJ School of Medicine’s Health Sciences Library and students are doing to enhance health education and to mentor local high school students interested in careers in the health sciences.

I am very proud of the work that goes on at Hofstra and in our community, and I hope you will join me in congratulating the faculty whose valuable work is featured in this issue.

Sincerely,

Stuart Rabinowitz President

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Sewage Epidemiology: Municipal Sewage as a Resource for Law Enforcement and Public Health Cover photo courtesy of thinkstockphotos.com.

Stuart Rabinowitz, JD President

Herman A. Berliner, PhD Provost and Senior Vice President for Academic Affairs

Sofia Kakoulidis, MBA Associate Provost for Research and Sponsored Programs

Alice Diaz-Bonhomme, BA Assistant Provost for Research and Sponsored Programs

provost’s COLUMN With this spring issue of Hofstra Horizons, I invite you to take a moment to consider subjects as diverse as the legacy of a 13th-century philosopher-king, the merits of municipal wastewater treatment, the hidden meanings in tattoos and rap lyrics, and the future of patient and youth health education. The authors featured in this issue contemplate these unique subjects in the articles that follow.

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“The Wise King” tells the story of King Alfonso X of Castile and León, the fascinating subject of Dr. Simon R. Doubleday’s historical research and forthcoming book. Dr. Doubleday describes how the court of this “Wise King” was as foundational to the Renaissance movement as those later Italian artists and cities that we typically associate with the Renaissance’s explosion in philosophy and art.

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In the article by Dr. Kevin J. Bisceglia, the assistant professor of chemistry and new member of our faculty lays out how existing sewage networks, combined with current technologies, lead to powerful data about our cities’ habits — or, as Dr. Bisceglia puts it, “We can drug test a city!” His article, “Sewage Epidemiology: Municipal Sewage as a Resource for Law Enforcement and Public Health,” indicates the possible applications of wastewater analysis to collect evidence of prescriptive, as well as illicit, drug use, and encourages Long Island health and law agents to take notice of, and engage with, this promising field of research.

“ Khmer Pride”: Transborder Literacy Practices of Cambodian American Youth

School Projects and Web Tools to Enhance Health Education and Health Literacy

Dr. Theresa McGinnis of our Literacy Studies program explores the process of identity-construction for the children and descendants of Cambodian immigrants by interpreting, through new theories of visual and online literacies, the tattoos, raps, and dances they employ. “Khmer Pride: Transborder Literacy Practices of Cambodian American Youth” looks at how this youth subculture in Philadelphia has learned to express class, race, and gender roles through both traditional and nontraditional art forms, connecting a local urban youth culture with a transnational family heritage.

HOFSTRA HORIZONS is published annually by the Office for Research and Sponsored Programs, 144 Hofstra University, Hempstead, New York 11549-1440.

Each issue describes in lay language some of the many research and creative activities conducted at Hofstra.

The conclusions and opinions expressed by the investigators and writers are their own and do not necessarily reflect University policy. ©2014 by Hofstra University in the United States. All rights reserved. No part of this publication may be reproduced without the consent of Hofstra University.

Inquiries and requests for permission to reprint material should be addressed to: Editor, HOFSTRA HORIZONS, Office for Research and Sponsored Programs, 144 Hofstra University, Hempstead, New York 11549-1440.

Telephone: 516-463-6810.

Debra Rand and Saori Wendy Herman collaborated on “School Projects and Web Tools to Enhance Health Education and Health Literacy” to share some of the ways that the Hofstra North Shore-LIJ School of Medicine’s Health Sciences Library works toward positive community health education. Their article explains, for example, how consumers and patients can use the National Library of Medicine’s online MedlinePlus database to access professional health information and how the School of Medicine’s students are in turn helping to educate the communities around us.

These articles represent just a few examples of the inspiring research and programs taking place on and off campus every day. Please enjoy this opportunity to learn about the work of some of our illustrious faculty; in the meantime, I look forward to another year of scholarly excellence here at Hofstra University.

Sincerely,

Herman A. Berliner, PhD Provost and Senior Vice President for Academic Affairs

The Wise King Figure 1. Alfonso X, depicted in the Book of Games.

Simon R. Doubleday, PhD, Professor of History, Hofstra University

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ometime in or around the year 1237, a young Spanish prince, approaching the age of 16, opened a book of advice and began to read. The text was titled the Book of the Twelve Wise Men, and it had been commissioned by his father, Fernando III, ruler of the realms of Castile and León. “We, the twelve wise men whom you ordered to appear at your court,” the prince read, “have written down everything that a ruler should know, so that you might gaze into our book and study its pages.

Although it is small, its judgments are good. We ask that you ensure that each of your children receive a copy, for the sake of their bodies and souls.” Wishing good health to the king and his loved ones, and reminding him discreetly of the three

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traveling magi of the Christian gospels, these fictional wise men would serve as guides through the manual that would teach the young prince how to live.

The book could not have fallen into the hands of a better reader. The prince – whose name was Alfonso – was a sharp and curious student. A manuscript illustration from the Book of Games, which Alfonso himself would compose much later in life, shows a young man (quite possibly our prince) playing chess with an older opponent dressed as a scholar, probably his tutor. As Alfonso X, king of Castile and León, ruling from 1252 to 1284 (Fig. 1), the prince would prove to be the most intellectually voracious of all medieval rulers. Heir

to a tradition of kingship that had generally been more militaristic than cultured, he would oversee a farreaching artistic outpouring in his kingdom, foreshadowing the cultural rebirth that would seize Italy in the following century.

My current research aims to shed new light on this ruler, a man who, within a generation, would be celebrated as el Sabio, “the Wise King,” and who drank deeply from the wellsprings of many cultures – Muslim and Jewish, as well as Christian – that flourished and intermingled in medieval Spain. A decade after he opened the advice book, Prince Alfonso would stand awestruck before the walls of Ishbilya – Seville, the

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Figure 2. The Giralda (12th-century Almohad minaret), later tower of the Cathedral of Seville.

glittering capital of the Muslim realms of southern Spain – as his father, Fernando III, prepared his final assault on the city.

As he stood in the vast Christian encampment, a virtual city of tents, he would marvel at the architecture before him: among them, the Tower of Gold, perched on the banks of the Guadalquivir River, and above all at the Giralda, the svelte minaret that mirrored its twin in Marrakesh (Fig. 2). Even after the city fell to his father’s armies, Alfonso so deeply valued the Giralda that he later threatened to put to death anyone who dared destroy a single brick of its facade.

My study of The Wise King (which is scheduled to be published by Basic Books in 2015) will trace the many sides of Alfonso, a ruler whose brilliant vision paved the way for the European Renaissance. A prolific author of works on astronomy, gambling, hunting, and the properties of stones, he would infuse his limitless personal energy into the compilation of an astonishing spectrum of histories, law codes, and other literary forms. For centuries after his death, the Alfonsine Tables – providing data for calculating the relative positions of the sun, moon, and stars – would ensure his immortality; Copernicus would still rely

upon them in the 1490s, as a student at the University of Cracow, and his personal copy still survives. Today, Alfonso is best known for the Cantigas de Santa María (Songs to Holy Mary), a cycle of 400 lyric songs – windows into medieval Spanish life – whose words and music continue to envelop modern listeners in the fabric of 13th-century culture. In his cultural production, the imprint of the king’s pursuit of individual and collective happiness is visible everywhere. My book will trace his deep concern – both in his life and in his writing – with issues such as parenting; anger; greed; laughter; games (Fig. 3) and exercise, especially hunting; and friendship, a subject on which I will begin a separate NEH teaching project this year.

Lacking the tact and political skill of his wife, Queen Yolant (a queen whose full history remains to be written), the Wise King would not always prove to be successful in his dogged pursuit of happiness. His middle and later years unfold beneath a gathering storm of disasters, including the expensive and humiliating failure to impose his claims to the title of Holy Roman Emperor (once held by Charlemagne) and the civil war that engulfed him in the closing years of his reign, when his son Sancho usurped power in Castile. A 16th-century Jesuit historian would famously declare that Alfonso lost the earth because he was too busy gazing at the stars. It is easy to read the story of Alfonso’s life, as has often been done, as a pragmatic parable: a warning against an excess of intellectual enthusiasm. But this would be to distort historical reality. The Wise King’s political failures, and even the rupture of close family bonds, have more to do with the changing structures of power in 13th-century Spain than they do with his undoubted moments of misjudgment.

Wisdom is not, in any case, to be measured merely in terms of political achievement. Alfonso’s response to a

“ My study of The Wise King ... will trace the many sides of Alfonso, a ruler whose brilliant vision paved the way for the European Renaissance.”

mounting sequence of troubles and catastrophes was an outpouring of some of the most sophisticated and beautiful works to have graced the Middle Ages.

His efforts to wrestle with these crises – both inward and external – sometimes got the better of him. In the last dozen years of life, above all, he would stumble, fall, and often lose his battles with personal demons and political enemies.

But throughout the reign, his struggle would be transformed and distilled, in his writing, into something sublime that speaks to us powerfully across the centuries.

Figure 3. A medieval game of baseball (Cantigas de Santa María).

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Almost a century ago, the great American medievalist Charles Homer Haskins – sometime advisor to President Woodrow Wilson – rightly observed that the Italian Renaissance was not the bolt from the blue that had long been imagined. “The continuity of history,” he wrote, “rejects such sharp and violent contrasts between successive periods ...

Modern research shows us the Middle Ages less dark and less static, the Renaissance less bright and less sudden, than was once supposed.” Haskins’ magisterial study of what he subversively called the “Renaissance of the Twelfth Century” brought to light a different reality: the century into which Prince Alfonso’s parents were born had been a period of intense vitality, characterized by new prosperity, cultural energy, and a new concern for the inner life of man.

The invasions that had menaced and reshaped Western Europe in an earlier period – among them, the great waves of Viking incursions – had come to a close; the consolidation of feudal kingdoms such as England and France allowed relative peace and prosperity; and the Mediterranean was reborn as a commercial hub for the first time since the “fall” (or better, the reconfiguration) of the Roman Empire.

Stimulated by the economic power of Byzantium – the eastern, Greekspeaking, torchbearer of the Roman legacy – Italian cities such as Genoa and Venice were already taking the lead, profiting from an increasing trade in luxury goods from the East. A renascent Church, asserting its claims powerfully against the secular kings and princes of Europe, became a great patron of learning. Cathedral schools and, from the later 12th century, the first universities – Bologna, Oxford, Palencia – stimulated a thirst for learning. Sadly, this was also a period that witnessed the birth of a persecuting society, intolerant toward internal dissidents as well as external 6

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threats, and hostile toward belief systems or practices that could not be reconciled with official doctrine. The crusading movement, which had first taken shape in the 1090s and which continued to shape the contours of the medieval imagination long after the fall of the kingdom of Jerusalem to Saladin’s armies in 1187, can itself be seen as an expression of these accumulated energies. The consciousness of living in a new age had not yet crystallized: the great minds of the 12th century world were keenly aware of how much they owed to an ancient but still living, indeed towering, past. Yet many of those qualities traditionally associated with Renaissance Italy (such as the ”discovery of the individual,” and the “rediscovery of antiquity”), and many of the social changes – including the rise of an urban middle class – can be traced back to the very heart of the Middle Ages.

Not everyone celebrated this transformation. New commercial prosperity, new confidence, and a newly elaborate code of courtly conduct clashed with older Christian sensibilities and moral principles; contemporary observers sensed a gulf between ideals and practice.

One such author, the French abbot Guibert de Nogent, left a particularly memorable tirade against what he saw as the moral corruption of his day, which he associated particularly with the wiles of women: “In all their behavior nothing can be noted but unseemly mirth, wherein are no sounds but of jest, with winking eyes and babbling tongues, and wanton gait and all that is ridiculous in manners.

The quality of their garments is so unlike that of the frugality of the past that the widening of their sleeves, the tightening of their bodices, their shoes of Cordoban morocco with twisted beaks – nay, in their whole person we may see how shame is cast aside.” It was the shoes that were for Guibert the very

Figure 4. Santa María la Blanca, Toledo: a Jewish synagogue built in Almohad style, later consecrated as a Christian church (12th-14th century).

embodiment of human vanity and moral decline. Fashioned of Spanish leather and manufactured in the Muslim metropolis of Córdoba, in southern Spain, which at its height had some quarter of a million inhabitants and was by far the largest city in the west of Europe, they would have been transported north across the Pyrenees. But from our modern vantage point we can detect something more familiar: a pointed critique of the culture of consumerism and the thriving market in luxury goods, supplied in this case by long-distance trade routes connecting Morocco with France. And at the very core of this commercial network was Spain.

While recent historians have suggested that the roots of the Renaissance can be found in the close contact between Italy and the Islamic world – particularly the Ottoman Empire – which emerged in the 14th and 15th centuries, these links had existed for more than half a millennium in the Christian and Muslim realms of Iberia, which the sixth-century bishop Isidore of Seville had termed “the Ornament of the World.” It was to the monastery of Ripoll, in northeastern Spain, that the “Scientist Pope” Gerbert of Aurillac had traveled at the end of the 10th century in search of mathematical and astronomical knowledge. It was in

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the spiritual capital of Spain – Toledo – that an intellectual revolution unfolded in the 12th century (Fig. 4). Here, in a city that embodied the complex coexistence of Muslims, Jews, and Christians, translators brought to light a world of ancient wisdom, preserved in Arabic, as well as the work of recent Muslim thinkers, setting aflame the imagination of Christendom. The long road to the re-emergence of Western Europe as a cultural powerhouse had been paved on the streets of Cordoba, Seville, Saragossa, Toledo, and a dozen other Spanish cities.

Prince Alfonso – Alfonso the Wise – was both the inheritor of this slow-burning revolution, and its greatest architect. *** Christian Spaniards of the 13th century often saw Muslims in general, and the rival Almohad empire – based in Morocco – not merely as enemies and certainly not as barbarians, but as patrons of a sophisticated civilization that was, in many respects, superior to their own. Alfonso himself was dazzled by the Almohads: this was a surprisingly bookish regime, living by the word as much as the sword. The central mosque in their capital, Marrakech, was called the Kutubiyya – a name deriving from the Arabic for “books” – precisely because of the large book market that thrived in the shadow of the minaret.

Some of the greatest philosophical works in the history of medieval Spain would be composed under the patronage of the Almohad movement. This wave of cultural energy could not be stopped, even by battle. In July 1212, nine years before the birth of Prince Alfonso, a coalition of Christian forces had met the Almohad army on the plateau just north of the olive-growing city of Jaén, and had won a resounding victory. Yet even as much of southern Spain was overrun

by Christian troops, the spirit of the place seemed to have conquered the hearts and minds of the conquerors.

Dozens of churches in the Christian realms were constructed in an Arabized architectural style, now emptied of Islamic significance; wooden ceilings replete with bilingual symbols were designed in accordance with Islamic patterns. New forms of pottery, inspired

by Islamic models, begin to proliferate, suggesting that ordinary Castilians were more frequently consuming foods whose Arabic origin is betrayed by their name: among them, eggplant (berenjena), artichoke (alcachofa), and sugar (azúcar). Meanwhile, in the sphere of elite literary culture, a tsunami of translations from Arabic into Latin washed over the Iberian Peninsula.

On a grander scale than in any other corner of Western Europe, the multiple

realms comprising the modern territories of Spain and Portugal were the arena for a kaleidoscopic interaction among peoples, religions, and cultures: an arena in which conflict was the handmaiden of cultural rebirth. It was this world into which Alfonso was born. Far more than his intellectual predecessors, and far more than his military-minded father, he would be seduced and mesmerized by the glories of al-Andalus: the sector of Iberia that had been ruled by Muslims.

In the years to come, Alfonso would draw on both Christian and Muslim forms in a series of works that would elaborate upon his deeply humane vision of the world. The Wise King was intensely, and personally, involved in the conception of these works, and while we cannot envisage him as if he were a modern author, single-handedly composing these texts, his spirit infuses them all. In the words of the Universal History composed under his aegis: “The king makes a book, not because he writes it with his own hands, but because he sets forth the reasons for it, and he amends and corrects and directs them, and shows how they should be done.”

Across his realms, after his accession to the throne in 1252, he would rebuild a new Christian culture in the image of its supposed adversaries, and rewrite the history of Europe.

Simon Doubleday, professor of history at Hofstra University, teaches a range of courses in the history of medieval and Renaissance Europe. He holds a BA in history (First Class Hons.) from Pembroke College, University of Cambridge (1988), and a PhD in medieval history from Harvard University (1996).

He has co-edited three volumes of essays concerned with the contemporary relevance of the distant past and the intersection of historical inquiry with ethical issues and social justice: Why the Middle Ages Matter: Medieval Light on Modern Injustice (Routledge, 2011); In the Light of Medieval Spain: Islam, the West, and the Relevance of the Past (Palgrave Macmillan, 2008); and Border Interrogations: Crossing Spanish Frontiers (Berghahn, 2008). He is also the author of The Lara Family: Crown and Nobility in Medieval Spain (Harvard University Press, 2001) and editor-in-chief of the Journal of Medieval Iberian Studies. His book The Wise King is scheduled to be published by Basic Books in 2015.

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Sewage Epidemiology:

Municipal Sewage as a Resource for Law Enforcement and Public Health Kevin J. Bisceglia, PhD, Assistant Professor of Chemistry, Hofstra University Introduction

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ewers are mostly invisible, and we like it that way. No one likes to think about what goes on in one, or more accurately, what flows through one. Instead, sewers discretely carry away our waste to be treated, allowing many of us to remain in general ignorance of their very existence. This is a shame, as the proper collection, separation, and treatment of water and wastewater is almost certainly the single most effective thing humanity has done to reduce mortality from infectious disease (Cutler & Miller, 2005). Perhaps even more than modern medicine, it may be the reason you’re alive and healthy

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enough to read this article today.

Don’t fret if you’ve never had warm thoughts about your sewer system, however. Good water sanitation practices have been in place for most of the United States since the 1930s (Cutler & Miller, 2005) – odds are that you probably can’t even remember life before them. You might also be one of more than 30 percent of Americans who drink bottled water exclusively (HuertaSaenz et al., 2012), and might think that public sanitation is of less concern for you. Finally, and let’s be honest here, sewers remind us of their presence in pretty awful ways – backed-up toilets, contaminated waterways, and that distinctive, awful smell. Given all that,

it’s only natural to think, “Sure, sewers have protected my family’s health for the past 90 years, but what can they do for me now?” The answer may be more than you’d expect.

The Challenge of Obtaining Community-Level Health and Lifestyle Data Most of what we know about the health and lifestyle choices of our communities comes from oral and written population surveys (Daughton, 2011). Additional knowledge about drug abuse and medical conditions is also gleaned from arrest statistics and hospital visits, but essentially, current practices rely on our willingness to share sensitive,

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potentially incriminating information with perfect strangers who are (often) acting as agents of the government.

Self-reporting errors and sampling biases are just two acknowledged concerns with this approach. Studies that are able to independently verify self-reported data consistently find that it underestimates the prevalence of actual behavior, often by more than 50 percent (Magura, 2010). Biases arising from participant selection, nonresponses, and even the format of survey questions have been well-documented (Bowling, 2009).

Even when error and bias can be adequately characterized, survey-based monitoring of community-level public health requires significant investments of time, manpower, and money (SAMHSA, 2013). These barriers make it extremely difficult to collect, interpret, and disseminate results in short time frames (e.g., less than one month), and limit both the quantity and spatial resolution at which data can be collected. In short, real-time, continuous collection of public health data is just not possible with surveys alone.

Another potential approach to monitoring health and lifestyle choices at the community level relies on a discomforting fact: If you live in a city or densely populated suburb (such as Nassau County), your sewer system acts as a repository for countless chemical and biological agents excreted by you and your neighbors. Examples include drugs consumed for medicine or recreation, infectious viruses and bacteria, hormones and other endogenously-produced (bio)chemicals.

Many of these agents are used in the medical community as biomarkers of specific activities (e.g., drug abuse), as well as aspects of physiological and

emotional health (e.g., certain types of cancer, levels of oxidative stress).

I belong to a growing community of scientists investigating whether sewerbased monitoring of health and lifestyle biomarkers can complement traditional surveys in monitoring community-level public health. Compared to surveys, sewer-based monitoring is likely to be less intrusive, more quantitative, and more anonymous (in a sewer, your biomarkers mix with everyone else’s and most contain no personally identifiable features). Moreover, sewer-based monitoring could be done in near real-time, on a continual basis, and at the neighborhood level. Increasingly, this approach is being called sewage epidemiology.

“ ... If you live in a city or densely populated suburb (such as Nassau County), your sewer system acts as a repository for countless chemical and biological agents excreted by you and your neighbors.�

Using Sewage to Drug Pharmaceuticals are a major subclass of Test a City human-derived micropollutants that, Techniques already exist to monitor for over time, has grown to include drugs of chemical biomarkers in municipal abuse as well (Daughton, 2011). All that sewage in near real-time and with greater was required was a shift in perspective, spatial resolution than oral and written from viewing such chemicals as surveys (Castiglioni et al., 2013). They environmental contaminants, to viewing were developed by chemists and engineers to evaluate municipal wastewater as a Figure 1. Concept of Sewage Epidemiology source of human-derived micropollutants (e.g., plasticizers, hormones, personal care products, flame retardants, antibacterial agents) in the environment.

Widespread, low-level contamination by such chemicals has been identified as one of the principal environmental challenges of our time (Schwarzenbach et al., 2006), and environmental chemists (myself included) have spent countless hours in an ongoing effort to identify and characterize those that are of the most concern.

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Figure 2. Measuring biomarkers in sewage samples involves three basic steps: 1. Cleanup and pre-concentration, where we remove unwanted materials and accumulate enough of our target biomarkers for analysis.

(Figure 2). Finally, measurements of biomarker occurrence are converted into estimates of drug consumption by adjusting for factors such as metabolism (ƒex, if the biomarker is a metabolite), molecular weight (MW), wastewater flow (Qw), and the number of people within the sewer catchment (P):

For comparison, representative data for the occurrence of prescription and over-the-counter drugs (Bisceglia et al., 2010b) are presented in Figure 3B. From left to right are: acetaminophen (aka, Tylenol, an anti-inflammatory agent); metoprolol (aka Toprol, used to treat hypertension); carbamazepine (aka Tegretol, used to treat seizures and bipolar disorder); brompheniramine (aka Bromfed, Dimetapp, an antihistamine); diazepam (aka Valium, used to treat anxiety); and terbinafine (aka Lamisil, an antifungal agent).

Since 2005, the sewage epidemiology approach has been employed to estimate community-level consumption of more than 20 drugs of abuse, in more than two dozen cities (Castiglioni et al., 2013).

Consumption estimates have generally agreed with results obtained via conventional means (including surveys).

Equally important, the approach has been demonstrated to have sufficient spatial and temporal resolution to catch

Both figures plot occurrence on a logarithmic scale, as nanograms of drug per liter of sewage (ng/L). For perspective, 1 ng/L is equivalent to one molecule of drug in one trillion “molecules” of sewage, or one postage stamp in an area the size of New York City – all five boroughs. These concentrations may seem miniscule, but modern analytical instrumentation is sensitive, so much so that we were able to measure cocaine and other drugs presented above without preconcentration. Moreover, low concentrations add up to moderate

2. A separation step that sorts the biomarkers so we can study each one individually.

3. An identification step where we take a chemical fingerprint of each biomarker and compare it to a reference standard.

them as a source of information about human activity (Figure 1).

The first researchers to make this shift did so with cocaine (Zuccato et al., 2005); their approach has become standard for converting sewage-based measurements of occurrence into estimates of drug abuse.

Essentially, a sewage sample is processed to remove unwanted material (you can guess what this material is) and concentrate biomarkers of interest. For cocaine, the most common biomarker is benzoylecgonine (BE), its major metabolite. After processing, each biomarker is separated based on its physicochemical properties using a technique called chromatography. Then, both the abundance and identity of each biomarker are determined by mass spectrometry, which is in some ways akin to taking a chemical “fingerprint”

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changes in consumption that occur during weekend festivals and local sporting events (Castiglioni et al., 2013).

One of the most striking findings to come from sewage epidemiology is that drugs of abuse are just as abundant as prescription and over-the-counter (OTC) drugs. Figure 3A contains representative data for the occurrence of drugs of abuse in municipal sewage from Baltimore, MD (Bisceglia et al., 2010a).

Plotted from left to right are: cocaine and its principal metabolite, benzoylecgonine; methamphetamine (aka meth); MDMA (aka ecstasy); morphine, the principal metabolite of heroin; oxycodone (aka Oxycontin); and cotinine, the principal metabolite of nicotine.

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Figure 3. Typical occurrence (nanograms of drug per liter of sewage; one nanogram = 10 -9 grams) of (A) drugs of abuse and (B) over-the-counter/prescription drugs in Baltimore, MD, sewage.

(A) Drugs of Abuse

estimates of consumption in large sewer catchments, as is demonstrated for Baltimore, MD, in Figure 4. As with occurrence, sewer-derived estimates of cocaine consumption are roughly one-tenth that of heavily used OTC drugs like acetaminophen, and well within the range of common OTC and prescription drugs.

A caveat: Data in Figures 3 and 4 are means of composite daily samples, and are not necessarily representative of long-term drug use in Baltimore.

Nonetheless, our estimate of cocaine consumption for Baltimore agrees with values from detailed sampling campaigns in Europe, which range from 2 to 3 mg/inhab-d (Castiglioni et al., 2013). Unfortunately, there is very little sewage-derived data on drug consumption in the United States. At the time of its publication, ours was only the second sewage epidemiology investigation conducted in the United States. As of 2013, there are still only a handful of U.S. investigations; ours

(B) Over-the-Counter/Prescription Drugs

remains the most comprehensive in terms of the number of drugs of abuse and drug metabolites monitored – 23 in total (Bisceglia et al., 2010a).

Minimizing Uncertainty, Moving Toward Routine Analysis The purpose of sewer systems is simple.

Frustratingly, the conditions that exist inside sewers are anything but. It is no

surprise, then, that proponents of sewage epidemiology have devoted most of their recent efforts toward identifying and minimizing uncertainties associated with the approach.

While the magnitudes of uncertainties are biomarkerspecific, many sources of uncertainty are likely to be universal. They include variations in sewer flow and biomarker loading, analytical uncertainty, biomarker stability (i.e., transformation and/or partitioning that occurs in sewers), estimation of population size and, for metabolites, variability in metabolic excretion.

Castiglioni et al. (2013) have summarized efforts to characterize these sources of uncertainty for drugs of abuse. As long as a biomarker is stable in sewage and not subject to metabolic variability (i.e., not a metabolite), overall error can usually be kept below 10 percent for estimates within the same sewer catchment. This makes routine sewer monitoring a distinct possibility for

Sewer-Derived Estimates for the Utilization of Cocaine and Selected Legal Drugs

Figure 4. Sewer-derived estimates for the utilization (milligrams of drug per inhabitant per day) of cocaine and certain legal drugs, in Baltimore, MD.

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methamphetamine, cannabinoids, oxycodone and hydrocodone, antiepileptic drugs, certain antibiotics, and a great many other legal and illegal drugs. Comparisons between catchments are also possible, provided that one can suitably estimate real-time population size in each sewer system (for additional details, see Brewer et al., 2012).

Even when biomarker stability is an issue, accurately and routinely estimating usage may still be possible.

For example, cocaine rapidly degrades in wastewater to form benzoylecgonine (Figure 5). While benzoylecgonine is stable, in-sewer production from cocaine can cause over-bias consumption estimates by up to 50 percent, depending on conditions (Plósz et al., 2013). Even worse, benzoylecgonine is a metabolite of cocaine. Its occurrence in sewage is also affected by interpersonal variations in cocaine metabolism, which depend on genetics, lifestyle choices, route of administration, and other factors.

This variability in excretion can also introduce uncertainties of up to 50 percent (Castiglioni et al., 2013).

Recently, colleagues at Johns Hopkins University and the National Institute of Standards and Technology (NIST) and I have developed an approach for minimizing these uncertainties that takes advantage of cocaine’s proclivity to break down in sewage (Bisceglia et al., 2012). By heating sewage samples under basic pH (thus encouraging a chemical process called hydrolysis), we are able to collapse cocaine and all of its major metabolites to ecgonine, the cocaine molecule’s “backbone” (Figure 5). This backbone appears to be stable in sewage; monitoring cocaine utilization via its presence in posthydrolysis samples reduces uncertainty from both in-sewer transformations and

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metabolic variability to about 10 percent – in keeping with sources of uncertainty that do not depend on biomarker identity (Bisceglia & Lippa, 2013).

Finally, as a bonus, the hydrolysis procedure dramatically streamlines cocaine analysis by eliminating the need to pre-concentrate samples.

Looking Toward the Future: Applications of Sewage Epidemiology in Law Enforcement and Public Health Feedback on Policies and Practices Sewage epidemiology has substantial, largely untapped, potential to address the efficacy of a variety of important public health, law enforcement, and legislative strategies. It is currently being used to monitor trends in the use (and potential abuse) of attention deficit disorder (ADD) drugs on a college campus (Burgard et al., 2013). Realtime, quantitative data on drug utilization might prove useful in answering a variety of other important questions.

For example: • Do needle exchange programs encourage drug abuse?

• Will legalizing medical marijuana, as New York state is considering, increase illegal marijuana use as well?

• What impact did New York City’s controversial “stop and frisk” program have on drug abuse?

• Are large drug seizures publicized by law enforcement effective in reducing levels of abuse? If so, does the abuse of another drug increase in compensation?

More generally, sewer-based monitoring could be systematically employed to evaluate the efficacy of drug treatment and control strategies on a continual basis.

Public Health Surveillance David Satcher, U.S. surgeon general from 1998 to 2002, said “[i]n public health, we can’t do anything without surveillance. That’s where public health begins” (Buehler, 2012). Sewage epidemiology seems like a natural extension for government programs designed to monitor the prevalence of infectious disease and other metrics of public health. Currently, such programs collect information from hospitals, electronic health records, even sales of cold medicines (Heffernan et al., 2004).

A primary objective – as yet unobtained – is to monitor the prevalence of infectious disease in real time. This is challenging to do by tracking sales of cold and diarrheal meds, but it might be possible by monitoring for spikes in the occurrence of these and other products (especially antibiotic and antiviral agents) in sewer systems (Singer et al., 2013).

Another approach for monitoring outbreaks is to conduct sewer-based monitoring for infectious agents themselves. Techniques to monitor for the presence of specific classes of viruses and bacteria in sewage are well developed, but generally more resource and time intensive than techniques for monitoring chemical biomarkers.

Recent efforts have been made to track the prevalence of adenoviruses (Bibby & Peccia, 2013) and parechoviruses (Lodder et al., 2013), which can cause diarrhea and flu-like symptoms, in European sewage. Unlike many chemical biomarkers, however, the abundance of such viruses may not necessarily correlate with disease prevalence (Bibby & Peccia, 2013).

Sewage epidemiology may also prove useful for monitoring general metrics of lifestyle and wellness at the community level. Trends in hormone levels and

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other endogenously produced biochemicals (such as isoprostanes) might provide indications of community-level stress (Daughton, 2011). Composite measurements of anti-inflammatory agents or antibiotics might be used to similar effect. Sewerbased monitoring can also be used to monitor for emerging drugs of abuse before they become problematic.

Cathinone-derived “bath salts�

(Gunderson et al., 2013) and synthetic cannabinoids (Huang, 2012) are just two classes of drugs whose rising popularity was detected too late for some.

Source Tracking Illegal Activity A final, admittedly more speculative, application of sewer-based monitoring involves source tracking of illegal activity. Using a hydraulic model of the sewer system and knowledge of how the relevant chemical signature(s) behave in sewer environments, it may be possible to identify the location of drug processing and terrorist-related

activities by the strategic placement of passive sampling devices.

Passive sampling techniques suitable for municipal sewers have only recently been developed (Birch et al., 2013). The devices require no external power source, and could be innocuously placed at sewer access points (i.e., man holes).

They could later be removed, analyzed for the presence of chemical signature, and placed in new locations until the source of activity has been pinpointed.

Success in such an effort would depend on the signal-to-noise ratio of the chemicals being monitored, but unlike most epidemiological applications, a simple yes/no for its presence may be sufficient. To my knowledge, source tracking of drug processing or terrorist activity has not been attempted.

However, a model for the approach might be the New Jersey Department of Environmental Protection’s efforts to identify sewer-based sources of PCB pollution (Belton et al., 2005).

Conclusion Sewage epidemiology holds great promise for providing near real-time, quantitative data on human activity at the community level. The idea is young, but sewer-derived estimates of drug abuse consistently agree with survey findings whenever such comparisons can be made (Castiglioni et al., 2013).

To provide just one more example of agreement, my colleagues and I used the occurrence of cotinine in Baltimore wastewater to estimate the number of cigarettes consumed per smoker per day in the city. Our sewer-derived result is in good agreement with the most recent survey-based estimate, which, I might add, is from 2002 (Table 1).

It is important to note that there are currently no technological impediments to the routine analysis of chemical biomarkers in sewage. Online, automated procedures already exist (Daughton, 2011), making it a simple matter of cost. The approach is gaining

Figure 5: Time courses for the hydrolysis of cocaine into its three principal metabolites in municipal sewage.

Concentration is in units of nanomoles of molecule per liter of wastewater. Mass balance = sum of cocaine and its metabolites at each sampling point.

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Cigarettes/smoker-d Sewer-derived1: Survey-based2:

18 ± 5.2 17 ± 1.2

1 Mean WW concentration of cotinine: 2050 ± 84 ng/L Urinary fraction of nicotine excreted as cotinine: 10-15% Deliverable dose of nicotine per cigarette: 1-1.5 mg Prevalene of smoking in Baltimore: 28% 2 Obtained from phone interviews in 2002.

Source: Centers for Disease Control and Prevention.

State Tobacco Activities Tracking and Evaluation (STATE) System. Tobacco Use Supplement to the Current Population Survey (2002).

Data from: Bisceglia, K.J. et al, Anal. Bioanal. Chem. 2010, 398(6): 2701-2712.

Image courtesy of iStockphoto.com.

Table 1. Sewer- and Survey-Based Estimates of Cigarette Consumption Among Smokers in Baltimore, MD.

momentum in the European Union and Australia. The EU has even devoted a special branch of its center for drug abuse (EMCDDA) to refining sewage epidemiology techniques. Interest in the United States, in contrast, has been quite limited.

My hope and suspicion is that the relative silence on our side of the Atlantic can be attributed mostly to a lack of awareness about this disgusting yet promising concept. Therefore, I’m ending this article with an invitation to start a dialog among law enforcement and public health officials in and around Hofstra University. Can sewer-based monitoring of health biomarkers help you with a research or professional question you have? What are the shortcomings, and how can they be fixed? You see, we environmental chemists have been developing this approach for a few years now, but the intended users have always been you.

So, what do you want out of it?

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References Belton, T., Stevenson, E., Lippincott, L., et al. (2005). Trackdown of Polychlorinated Biphenyls (PCBs) in a Municipal Sewer System: Pilot Study at the Camden County Municipal Utility Authority (CCMUA). Proceedings of the Water Environment Federation 2005:212-229.

Bibby, K., & Peccia, J. (2013). Prevalence of respiratory adenovirus species B and C in sewage sludge. Environ Sci: Processes Impacts 15:336-338. doi:10.1039/C2EM30831B Birch, H., Sharma, A. K., Vezzaro, L., et al. (2013). Velocity dependent passive sampling for monitoring of micropollutants in dynamic stormwater discharges. Environ Sci Technol 47:12958-12965. doi: 10.1021/es403129j Bisceglia, K. J., & Lippa, K. A. (2013).

Stability of cocaine and its metabolites in municipal wastewater – The case for using metabolite consolidation to monitor cocaine utilization. Environ Sci Pollut Res Advance online publication. doi 10.1007/s11356-0132403-5

Bisceglia, K. J., Roberts, A. L., & Lippa, K. A. (2012). A hydrolysis procedure for the analysis of total cocaine residues in wastewater. Anal Bioanal Chem 402: 1277-1287. doi: 10.1007/s00216-0115553-7 Bisceglia, K.J ., Roberts, A. L., Schantz, M. M., & Lippa, K. A. (2010a).

Quantification of drugs of abuse in municipal wastewater via SPE and direct injection liquid chromatography mass spectrometry. Anal Bioanal Chem 398: 2701-2712. doi: 10.1007/s00216-0104191-9 Bisceglia, K. J., Yu, J. T., Coelhan, M., et al. (2010b). Trace determination of pharmaceuticals and other wastewaterderived micropollutants by solid phase extraction and gas chromatography/mass spectrometry. J Chromatogr A 1217:558564. doi: 10.1016/j.chroma.2009.11.062 Bowling, A. (2009). Research methods in health: Investigating health and health services. McGraw Hill/Open University Press, Maidenhead, Berkshire, England; New York, NY Brewer, A. J., Ort, C., Banta-Green, C. J., et al. (2012). Normalized diurnal and between-day trends in illicit and legal drug loads that account for changes in population. Environ Sci Technol 46: 8305-8314. doi: 10.1021/es202447r Buehler, J. W., Centers for Disease Control and Prevention. (2012). CDC’s vision for public health surveillance in the 21st century. Introduction. MMWR Surveill Summ 61 Suppl:1-2.

Burgard, D. A., Fuller, R., Becker, B., et al. (2013). Potential trends in Attention Deficit Hyperactivity Disorder (ADHD) drug use on a college campus: Wastewater analysis of amphetamine and ritalinic acid. Sci Tot Environ 450-451: 242-249. doi: 10.1016/j. scitotenv.2013.02.020 Castiglioni, S., Bijlsma, L., Covaci, A., et al. (2013). Evaluation of uncertainties associated with the determination of community drug use through the measurement of sewage drug biomarkers. Environ Sci Technol 7:1452-1460. doi: 10.1021/es302722f

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Cutler, D., & Miller, G. (2005). The role of public health improvements in health advances: The twentieth-century United States. Demography 42:1-22. doi: 10.1353/dem.2005.0002 Daughton, C. G. (2011). Illicit drugs: Contaminants in the environment and utility in forensic epidemiology.

In Whitacre, D. M. (Ed.), Reviews of Environmental Contamination and Toxicology, Volume 210. Springer, New York, pp. 59-110.

Gunderson, E. W., Kirkpatrick, M. G., Willing, L. M., & Holstege, C. P. (2013).

Substituted cathinone products: A new trend in “bath salts” and other designer stimulant drug use. J Addict Med 7: 153-162. doi: 10.1097/ ADM.0b013e31829084b7 Heffernan, R., Mostashari, F., Das, D., et al. (2004). Syndromic surveillance in public health practice, New York City.

Emerg Infect Dis 10:858-864. doi: 10.3201/eid1005.030646 Huang, L. (2012, Spring). “Spice” tales: Good chemists vs. evil. Hofstra Horizons, pp. 28-34.

Huerta-Saenz, L., Irigoyen, M., Benavides, J., & Mendoza, M. (2012). Tap or bottled water: Drinking preferences among urban minority children and adolescents.

J Community Health 37:54-58. doi: 10.1007/s10900-011-9415-1 Lodder, W. J., Wuite, M., de Roda Husman, A. M., & Rutjes, S. A. (2013).

Environmental surveillance of human parechoviruses in sewage in the Netherlands. Appl Environ Microbiol 79: 6423-6428. doi: 10.1128/AEM.01917-13 Magura, S. (2010). Validating self-reports of illegal drug use to evaluate National Drug Control Policy: A reanalysis and critique. J Eval Prog Plan 33:234-237. doi: 10.1016/j.evalprogplan.2009.08.004 Plósz, B. G., Reid, M. J., Borup, M., et al.

(2013). Biotransformation kinetics and sorption of cocaine and its metabolites and the factors influencing their estimation in wastewater. Water Research 47:2129-2140. doi: 10.1016/j. watres.2012.12.034

Singer, A. C., Järhult, J. D., Grabic, R., et al. (2013). Compliance to oseltamivir among two populations in Oxfordshire, United Kingdom affected by influenza A(H1N1)pdm09, November 2009 – A waste water epidemiology study. PLoS One 8:e60221. doi: 10.1371/journal. pone.0060221 Substance Abuse and Mental Health Services Administration. (2013). Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. R. Zuccato, E., Chiabrando, C., Castiglioni, S., et al. (2005). Cocaine in surface waters: A new evidence-based tool to monitor community drug abuse.

Environmental Health 4:14. doi: 10.1186/1476-069X-4-14

Schwarzenbach, R. P., Escher, B. I., Fenner, K., et al. (2006). The challenge of micropollutants in aquatic systems.

Science 313:1072-1077. doi: 10.1126/ science.1127291

Kevin Bisceglia is an assistant professor of chemistry at Hofstra University. Prior to joining Hofstra in fall 2013, Dr. Bisceglia founded the Chemistry Department at Bard High School Early College Queens, a satellite campus of Bard College that grants AA degrees to socioeconomically diverse New York City public school students; he also worked in the Chemical Sciences Division of the National Institute of Standards and Technology (NIST). He holds a BS and ME in environmental engineering from Manhattan College and a PhD in environmental engineering and chemistry from Johns Hopkins University.

In addition to refining techniques for sewage epidemiology, Dr. Bisceglia’s research focuses on understanding how suburban lifestyle and land use practices influence water quality and chemical cycling on Long Island. His long-term goal is to find ways to modify these practices to increase the sustainability of suburban living. At Hofstra, he teaches courses in general chemistry, environmental chemistry, and instrumental analysis. In his spare time, he enjoys hiking and exploring Long Island’s coastal ecosystems with his wife and two young children.

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Dancers are performing in Khmer dance.

“Khmer Pride”: Transborder Literacy Practices of Cambodian American Youth Theresa McGinnis, EdD, Associate Professor of Teaching, Literacy and Leadership, Hofstra University

R

ithy posts a message on an Internet site, “putting both of my hands high to the sky saying ‘Khmer Pride.’” Samaly watches a YouTube video of a professional Cambodian dance troupe performing “The Coconut Dance,” and Panat1 creates his own video game character based on the Japanese anime Dragonball Z. Today’s generation of Cambodian American youth are growing up in communities with more transnational connections than in the past. Newer technologies and communication devices allow the youth to remain active in their heritage language and culture, 1All names are pseudonyms.

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and – through social networks – to interact with globalized youth culture.

transnational literacies to express and articulate complex social identifications.

My research seeks to address questions about the role of multimodal and/or digital literacies in Cambodian (Ethnic Khmer) youth’s production and maintenance of these transnational connections across space and over time, particularly with regard to identity construction, performance, and transformation. I examine the ways that their literacy practices reveal local, national, and global relationships and processes. Overall, in this article, I explore how Khmer youth use

New Literacy Studies Thirty years ago, a movement occurred within the field of literacy studies.

Scholars such as Heath (1983), Scribner and Cole (1981), and Street (1984) challenged previous autonomous models of literacy by suggesting that literacy is not merely the decontextualized ability to read and write, but also the ability to socially construct meaning. Their research revealed that literacy is an ideological act, and cannot be separated from social factors, culture, and a

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group’s political and economic conditions. Literacy research within this paradigm, known as the “new literacy studies,” has moved beyond classroombased practices into local contexts where literacy operates in social groups.

Within the “new literacy studies” perspective, the intensive intertwining of text and life was foregrounded (Baynham & Prinsloo, 2009). Though initially print-based texts were privileged, newer theories of visual and online literacies have posed interesting questions of what we mean by text (Baynham, 2007).

Scholars have focused on the literacies of immigrant populations to understand how textual designs are influenced by global society, cultural affiliations, and the transnational flow of goods and products (Warriner, 2009). For example, Sanchez (2007) describes how a group of Mexican American young women produced a picture book telling the story of immigrant families and their movement across the U.S.-Mexican border. For these bilingual young women the narrative they produced was a countertext to the unfavorable image of the border crosser as criminal. Pahl (2007) examines the text construction of a young Turkish immigrant who draws upon Turkish prayer beads to design a map illustrating his grandparents’ journey from Turkey to England. The boy used the materials he found in his home to portray how the lives of his family were shaped dramatically by large-scale global processes. The work of these scholars and others shows the proactive ways in which marginalized youth use informal literacies to explore possible worlds, claim space, and make their voices heard.

My research echoes these themes. The study presented here developed from a larger ethnographic research project

tracing the journey of a small group of Cambodian youth as they navigate the complexities of life in Philadelphia and simultaneously draw on a variety of cultural resources (from urban American culture, from global culture, and from their own Khmer cultural inheritance) in constructing layered identities. I became interested in how the choices of materials used for textual production by the Khmer youth, children of migrant farm workers, are culturally, socially and economically shaped, and how their meaning-making processes drew from the sociocultural contexts in which they lived. My research explored how their text productions were formed by their material conditions and expressed their aesthetic and humanistic perspectives as the children of immigrants at a particular moment in history (Bahktin, 1981; Holland, Lachicotte, Skinner, & Cain, 1998; Kress & van Leeuwen, 2001).

Cambodian American History

come to the United States with “interpretive frameworks of how they make sense of the world around them” (Smith, 1994).

The history of the Cambodian refugees includes the Khmer genocide under the Pol Pot regime. This traumatic experience continues to cause postmigration stress within the Cambodian community (Nou, 2006). Socioeconomic deprivations are another aspect affecting Cambodian refugees in the United Sates (Chan, 2004; Hein, 2006; Nou, 2006; Ong, 2003). Both Hein (2006) and Chan (2004) point to low levels of “human capital” upon arrival; that is, Cambodian refugees do not have high levels of

“ I examine the ways that their literacy practices

reveal local, national, and As waves of Southeast Asian refugees were produced by various political global relationships and upheavals, war and persecution, many migrants found themselves beginning a processes.” process of unplanned and rapid adjustment to a new life. In particular, Cambodian refugees were people who had fled their country, endured life in refugee camps, and resettled in a new country – the United States (Ledgerwood, Ebihara, & Mortland, 1994). Hein (2006) asserts that this process of resocialization not only involves the refugees’ history, politics and culture of their homeland, but also involves coping with new Figure 1. Vantha’s stencil for the Hanuman tattoo. identities and inequalities following migration.

Cambodian immigrants Hofstra horizons t Spring 2014

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education, transferable job skills, or knowledge of U.S. culture. Ong (2003) further elaborates and explains that for exploited Asian workers, like migrant agricultural workers, there is little room for improving one’s socioeconomic status within the United States’ neoliberal market economy.

The Khmer Youth I came to know the Khmer youth and their families through my work at a Migrant Education Program. They are too young to have been born during the reign of the Khmer Rouge or the Vietnamese invasion of Cambodia; however, the youth in this study have experienced the stressors of their parents, including cultural adjustments and socioeconomic deprivations. These youth find themselves negotiating complex U.S. communities, public schools, and cultural practices. “Seen – if they are seen at all – as perpetual victims, and as refugees, their social and economic struggles with gang activities and welfare dependency dominate the discourse about them, pointing out and blaming their recent history as the origins of their ‘plight’” (Lee, 2010, p. xiv).

There is no simple, static form of identity that develops among the Khmer youth; however, there is at the same time a collective “Khmerness” or subculture of what it means to be Cambodian in an urban context. Their individual identities and collective shared identities are a complex entanglement of different layers (Jenkins, 1996). In truth, the Khmer youth are cultivating multiple identities, which include the negotiation of class, race, religion, ethnicity, and gender. The Khmer youth’s multimodal and digital expressive acts afford a space for cultivating these multiple identities.

More specifically, drawing on Bakhtin’s (1981) notion of textual webs, or the idea

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that texts build upon other texts, I describe the “textual webs” that connect the Khmer youth across generations and geographical spaces, with artifacts and with practices in both the United States and Cambodia.

For example, Vantha learned the art of tattooing from his father, a Cambodian refugee. Magical tattoos believed to bring good luck, good fortune or protection against enemies have been popular among Cambodian men for generations. The tattoos usually feature images of supernatural creatures, Hindu gods, or characters from Pali and Sanskrit. Cambodian fighters were often adorned with intimidating images of a dragon, tiger or the monkey king Hanuman. Since Vantha was not a healer or a Buddhist monk, he did not have the spiritual abilities to create “magical tattoos,” but he used images like the monkey king Hanuman on tattoos he created for his peers (Figure 1).

In addition, Vantha created tattoos relating to urban gang culture and to his friends’ individual identifications,

including tattoos of the phrase “Khmer Pride.” This practice of tattooing reflects a web of Khmer generational and cultural traditions, both as a familial practice passed down to Vantha from his father, and as a historical Cambodian practice. Vantha’s designs of gang signs and symbols reflect how his textual webs are also interconnected to U.S. urban culture and to current cultural shifts among U.S. youth where tattoos are no longer viewed as “edgy” but have become a popular part of a larger “mainstream” American youth culture.

“Khmer Pride” “To be Khmer is to be born in Cambodia, to be descended from ancestors who were born in Cambodia” (Su, 2010, p. 357). The marking of items with the words “Khmer Pride” is a very obvious way that these youth communicate their Khmer group identity – their solidarity. They display their shared “Khmerness” through the words “Khmer Pride” or the letters K.P. These words show up sometimes in large bubble letters or in graffiti art in school on class folders, journals,

Figure 2. Rithy’s drawing of Khmer Pride.

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portfolios and white boards. The youth also mark their Khmer identity on T-shirts and baseball caps.

In examining this one multimodal textual production, made by Rithy (Figure 2), multiple textual webs are discovered. The style of lettering itself is a sign, since block lettering is similar to some of the urban gang affiliated tagging/writing and the word “pride” is a representation of the knowledge of the rap lyrics discussing “gangsta pride,” or one neighborhood gang, “Original Khmer Pride.” Thus, the sign marks the youth’s connection to, or membership in, urban youth culture. The word “pride” also expresses solidarity for a particular group of individuals, such as “Gay Pride,” or “Korean Pride.” This provides the other layer of the message – the demonstration of pride in the youth’s Khmer cultural heritage. This message is one that is also meant to distinguish them from other Asian youth, often in response to receiving derogatory comments from other youth in their communities such as: “You Chinese should go home.”

Thus, the textual production of Khmer Pride is multilayered. It serves as a way for the youth to form themselves in collective terms – to mark a collective Khmer identity representing shared cultural, linguistic and historical experiences. As a textual web, the marking of Khmer Pride connects Rithy to youth in his urban neighborhood and also to a larger affiliation to Cambodia.

This production also serves as an important response to social situations that young Cambodians experience in their schools and in their community.

Hence, through the Khmer youth’s multimodal practices there is a mediation of the self, and of the collective self, within their urban context.

New Technologies, New Spaces Rithy’s design was made with paper and pencil; however, as new technologies shift the materials, media and spaces afforded to these newer generations of Khmer youth, one can see their expressions of the Khmer experience, and their identifications as Khmer, circulate across time, space and cultures. For example, there are now websites where youth like Rithy discuss their “Khmer Pride” and build a virtual Khmer community with other Khmer youth living around the United States using digitally designed texts. Khmer youth watch YouTube videos of Khmer rappers who perform songs in their heritage language of Khmer and English, with lyrics such as, “I am proud to say, I am a Khmer with pride.”

These new technological spaces also provide avenues for the durability of Cambodian traditions, such as the “Coconut Dance” performed at Cambodian celebrations. As transnational cultural productions, traditional dances span time frames and geographical space. Samaly, whose interest in dance began at home through

“ The marking of items with the words “Khmer Pride” is a very obvious way that these youth communicate their Khmer group identity – their solidarity.

They display their shared “Khmerness” through the words ‘Khmer Pride’ or the letters K.P. ”

Figure 3. Cambodian young women practicing the Apsara.

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her mother, uses new technologies to study the movements of professional dancers to learn Cambodian dances, which in turn she teaches to younger girls in her community. In addition to the Coconut Dance, she learns the Apsara dance (Figure 3), a dance used

by Khmer in America to retain the importance attached to their original identification as “truly Khmer” (Ledgerwood et al., 1994).

be viewed as an

Embedded in the Apsara dance are Khmer notions of women, which include adjectives such as kind, gentle, graceful and refined. Khmer feminine comportment, speaking softly and moving slowly, are also symbolically represented through the Apsaras, celestial dancers whose figures decorate Angkorean temples in Cambodia.

Ultimately, the Apsara dance can be viewed as an intrinsic bond between Cambodian past and present.

intrinsic bond between

Conclusion

“... the Apsara dance can

Cambodian past and present.”

Though the preceding examples represent only a few tiny windows into the transnational literacy and cultural practices of the Khmer youth, I believe they serve to illustrate how, through the interweaving of textual webs made up of different modes and language forms, these youth express loyalties to youth cultural practices and home countries,

and they articulate pride in their cultural heritage. These youth examine multiple identifications that are a result of their positioning within a transnational context. These include not only multiple identities across ethnicity, race, gender, and socioeconomics but also a range of encounters with racism, stereotypes, and anti-immigration sentiments. Therefore, transnationalism plays an important role in understanding from a more broadened perspective how youth form identities within local social networks and across national boundaries.

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Baynham, M., & Prinsloo, M. (2009).

Introduction: The future of literacy studies. In M. Baynham & M. Prinsloo (Eds.), The future of literacy studies, (pp.

1-21). New York: Palgrave MacMillan.

Chan, S. (2004). Survivors: Cambodian refugees in the United States. Chicago: University of Illinois Press.

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New York: Russell Sage Foundation.

Holland, D., Lachicotte, W., Skinner, D., & Cain, C. (1998). Identity and agency in cultural worlds. Cambridge, MA: Harvard University Press.

Jenkins, R. (1996). Social identities.

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Kress, G., & van Leeuwen, T. (2001).

Multimodal discourse: The modes and media of contemporary communication.

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Pahl, K. (2007). Creativity in events and practices: A lens for understanding children’s multimodal texts. Literacy, 41(2), pp. 81-87.

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Su, C. M. (2010). Narratives of “Khmerness” and Cambodian American Identity. In J. Lee (Ed.), Cambodian American experiences: Histories, communities, cultures and identities (pp. 354-372). Dubuque, IA: Kendall Hunt Publishing.

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160-180). New York: Palgrave MacMillan.

Street, B. (1984). Literacy in theory and practice. Cambridge: Cambridge University Press.

Theresa McGinnis is an associate professor in the Teaching, Literacy and Leadership Department at Hofstra University. She holds a doctorate in reading, writing and literacy from the University of Pennsylvania. Her dissertation, Khmer Youth in a Migrant Education Program: Discourses, Literacies and Possible Selves, describes the literacy and discourse practices of Khmer children of migratory agricultural workers as they engage with their urban schools and communities. Her research interests include sociocultural theories of literacy, the transnational literacy practices of immigrant youth, and digital spaces as sites for identity construction. She has presented her work in these areas at national and international conferences sponsored by the American Anthropological Association, American Educational Research Association, National Council of Teachers of English, and International Sociological Association. Dr. McGinnis’ work has been published in several peer-reviewed journals, including Anthropology and Education Quarterly, Linguistics and Education, The Journal of Adolescent and Adult Literacy, and the Journal of Southeast Asian American Education and Advancement.

As a Hofstra faculty member, Dr. McGinnis has taught a wide variety of undergraduate, master’s and doctoral level courses. She has designed courses on digital literacies, and on the cultural and historical perspectives of literacy. In addition to her University teaching, Dr. McGinnis has spent more than 12 years teaching middle school students in the urban communities of Los Angeles and Philadelphia.

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School Projects and Web Tools to Enhance Health Education and Health Literacy Debra Rand, MS, AHIP, Associate Dean for Library Services, Assistant Professor of Science Education, Hofstra North Shore-LIJ School of Medicine at Hofstra University Saori Wendy Herman, MLIS, AHIP, Education and Liaison Librarian, Assistant Professor of Science Education, Hofstra North Shore-LIJ School of Medicine at Hofstra University

School of Medicine Project

T

he Health Sciences Library staff at the Hofstra North Shore-LIJ School of Medicine is committed to supporting health education, and in particular, effective searching for consumer health information on the Web. The library received an Outreach Award from the National Network of Libraries, National Library of Medicine in 2013 in which one of the goals is to disseminate information and teach workshops on consumer health education resources.

The Outreach Award is a partnership between the Health Sciences Library, the students in the community service club Healthy Habits Project at the School of Medicine, and the Plainview-Old Bethpage Central School District

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(POBCSD). The goals of the project include consumer health education and mentoring of school district students in potential health careers.

As part of the Outreach Award, the library staff, medical students and staff at the POBCSD planned and held a Health Education Fair at the Mattlin Middle School in Plainview. Librarians from both the School of Medicine and North Shore-LIJ Health System provided information about the National Library of Medicine databases MedlinePlus and the Genetics Home Reference. The medical students created activities and distributed information about a broad spectrum of health and wellness topics, including sun safety, nutrition labels and

healthy eating, signs of stroke and heart attack, adolescent health, sports-related concussion, and when to call for emergency services. The information tables were staffed by medical students representing their special interests, such as the Oncology Club, Internal Medicine Club, AMA (American Medical Association) Club, Neurology Club, Emergency Medicine Club, and Wilderness Club. One popular activity was an exercise with laparoscopic surgical tools and iPads that allowed students to practice their hand-eye coordination skills – a necessary skill for expert surgeons. This same exercise was an earlier course activity for the medical students and is also utilized by doctors in training at hospitals. Clinical staff from

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the North Shore-LIJ Health System also participated in the Health Education Fair.

Additional activities and support were provided by the ShopRite of Plainview and the Mid-Island Y JCC.

result in a lasting resource for both the medical school and the school district.

The subject guide is anticipated to become publicly available and will be continually updated.

In addition to the Health Education Fair, the School of Medicine librarians conducted workshops with the POBCSD school nurses, health education staff, and library staff. Topics covered during the workshops included MedlinePlus, Genetics Home Reference, Household Products Database, Tox Town, efficient searching of PubMed (the National Library of Medicine’s database of life science and biomedical literature), and how to locate the full text of articles retrieved in a literature search.

To further the goal of mentoring high school students for careers in health sciences professions, site visits are scheduled at the Center for Emergency Medical Services and the Center for Learning and Innovation at the North Shore-LIJ Health System. There are plans to expand on these educational activities as a model for future health education projects with other local school districts.

As a companion piece to the workshops and Health Education Fair, an online subject guide was created by the librarians to provide centralized access to trusted websites for consumer health education and health careers from the National Library of Medicine, other government agencies and professional medical organizations. The subject guide, still a work in progress, will include links to educational materials created by the medical students and will

The resources in the following section are a sample of what’s been covered by the School of Medicine librarians during the workshops with the POBCSD school nurses, health education staff, and library staff.

Finding Reliable Health Information on the Web

A close relative tells you that he has recently been diagnosed with Crohn’s disease. You’ve heard of the disease but don’t know much about it. As a result, you want to find a clear, accurate and reliable overview of the symptoms, treatments, nutritional issues, latest research and/or possible clinical trials, and coping mechanisms for the disease. You’re also interested to see if there are any hereditary concerns associated with Crohn’s disease. Where do you begin your search to find reliable health information that Hofstra North Shore-LIJ School of Medicine Internal addresses these topics Medicine Club. Pictured (L to R): James Eaton (MS2), and is easy to read and Frank Chin (MS2), Anna Marie Sonstegard (MS1) understand?

“ There are plans to expand on these educational activities as a model for future health education projects with other local school districts.”

A good place to begin your exploration is MedlinePlus, a website for trusted health information compiled by the U.S. National Library of Medicine. According to the site’s About page: MedlinePlus is the National Institutes of Health’s Web site for patients and their families and friends. Produced by the National Library of Medicine, it brings you information about diseases, conditions, and wellness issues in language you can understand.

MedlinePlus offers reliable, up-to-date health information, anytime, anywhere, for free.

You can use MedlinePlus to learn about the latest treatments, look up information on a drug or supplement, find out the meanings of words, or view medical videos or illustrations. You can also get links to the latest medical research on your topic or find out about clinical trials on a disease or condition. (MedlinePlus)

You can access MedlinePlus at http://www.nlm.nih.gov/medlineplus or http://medlineplus.gov.

The website is updated daily and doesn’t contain advertisements. You can toggle between the English and Spanish language sites. There are also links to content in a number of other languages.

Easy-to-read print sources and audiovisual tutorials are also available for those who are interested.

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Image 1: MedlinePlus search results page for the keyword “Crohn’s disease”

MedlinePlus is organized into three major groups: Health Topics, Drugs & Supplements, and Videos & Tools. The Health Topics pages are a compilation of links covering a specific topic and are from health-related government sites and national medical organizations, all in an efficient one-stop search. The website includes health calculators, a medical dictionary and encyclopedia, directories, and a source for press releases on the latest health news.

To locate a specific topic on the Health Topics pages, you can either enter a keyword into the MedlinePlus search box located on the top right corner of the homepage or you can click on the green Health Topics button located on the top left corner of the homepage.

For example, if you search for “Crohn’s disease” using the MedlinePlus search box, the results above appear (see Image 1), starting with the entry from the embedded medical encyclopedia.

On the left side of the screen are filters to refine your results by type of resource or

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Image 2: MedlinePlus page for Crohn’s disease

related keywords. The first result on the main screen is always the link to the MedlinePlus page for the topic. Clicking on that link leads to the full page on Crohn’s disease in a Web page design that is similar for all Health Topics pages (see Image 2). Links are organized into six major categories: Basics (e.g., overviews, latest news, diagnosis/symptoms, treatment), Learn More (e.g., alternative therapy, coping, etc.), Multimedia & Cool Tools, Research (e.g., genetics, journal articles, etc.), Reference Shelf (e.g., dictionaries/glossaries, etc.) and For You (i.e., information on specific population groups). Health Topics pages often include links to statistics or epidemiologic data.

In our example, many of the targeted links are to the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) or to the Crohn’s & Colitis Foundation of America. Scrolling down to the section on Genetics, there is a link to another very useful site from the U.S. National Library of Medicine called Genetics Home Reference, http:// ghr.nlm.nih.gov.

The Genetics Home Reference website provides information about genetic conditions and the genes or chromosomes related to those conditions (see Image 3).

Just like MedlinePlus, this site is written in consumer-friendly language, is updated frequently and does not contain any advertisements. The About page provides specific notes about content that is included in the following sections: Conditions; Genes; Gene Families; Chromosomes; the Handbook, Help Me Understand Genetics – an excellent concise textbook on genetics (downloadable as a PDF file); Glossary; and additional resources. The editors note that new research that has not been verified may be excluded.

Knowledge of and efficient search skills on the resources of the National Library of Medicine and similar reliable websites can help to enhance health literacy and support health education. Several recent articles describe research or demonstration projects with school populations and patient care clinics that assess the relationships between

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awareness and usage of MedlinePlus or the Genetics Home Reference and subsequent improved health literacy or confidence in finding credible health information (Beaudoin, Longo, Logan, Jones, & Mitchell, 2011; Ghaddar, Valerio, Garcia, & Hansen, 2012; Olmstadt, Hansen, & Engeszer, 2012).

This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00003-C with the University of Pittsburgh, Health Sciences Library System.

References Beaudoin, D. E., Longo, N., Logan, R. A., Jones, J. P., & Mitchell, J. A. (2011). Using information prescriptions to refer patients with metabolic conditions to the Genetics Home Reference website.

Journal of the Medical Library Association, 99(1), 70-76. doi: 10.3163/1536-5050.99.1.012 Ghaddar, S. F., Valerio, M. A., Garcia, C. M.& Hansen, L. (2012).

Adolescent health literacy: The importance of credible sources for online health information. Journal of School Health, 82(1), 28-36. doi: 10.1111/j.1746-1561.2011.00664.x MedlinePlus. Retrieved Dec 9, 2013, from http://www.nlm.nih.gov/medlineplus/

Image 3: Genetics Home Reference homepage

Olmstadt, W., Hansen, J., & Engeszer, R. J. (2012). The Mobile School Health Information Initiative: Creating and sustaining a free curriculum for P-12 staff to find credible health information.

Journal of Consumer Health on the Internet, 16(4), 382-389. doi: 10.1080/15398285.2012.723546

Debra Rand is the associate dean for library services and assistant professor of science education at the Hofstra North Shore-LIJ School of Medicine. She earned a BA at the University of Michigan and an MS in library services at Columbia University. Prior to her position at the School of Medicine, Ms. Rand was the library director at Long Island Jewish Medical Center for more than 20 years.

She is currently the principal investigator on the 2013-2014 Outreach to Consumers Award from the National Network of Libraries of the National Library of Medicine. She was also the principal investigator on a three-year award from the National Library of Medicine (NLM) to create a centralized online library of e-journals, e-books, and databases for the North Shore-LIJ Health System. She has co-authored several articles in the Journal of Hospital Librarianship and the Journal of the Medical Library Association. Ms. Rand has been very active in professional associations, serving on many committees of the Medical Library Association, and as chair of the Hospital Libraries Section. She has a longtime interest in promoting consumer health education and health literacy. She was instrumental in the establishment of the Kohl’s Family Resource Center at the Cohen Children’s Medical Center and was active on the Patient Education Committee at LIJ. Currently she serves on committees of the Association of Academic Health Sciences Libraries (AAHSL) and is very involved in collaboration among the librarians of the new medical schools that have opened across the country over the last 10 years. She was awarded an NLM/AAHSL Leadership Fellowship in 2009-2010, parallel to her involvement in planning the new library at the School of Medicine.

Saori Wendy Herman is the education and liaison librarian and assistant professor of science education at the Hofstra North Shore-LIJ School of Medicine. She earned a BA from the University of California, Irvine, and an MLIS from Florida State University. Ms. Herman is a member of various professional library organizations, has served as the Connections Committee co-chair for the Medical Library Groups of Southern California and Arizona, and is currently the editor of the Health Sitings column for the Journal of Consumer Health on the Internet and the editor of the Section and SIG News column for MLA News.

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2013

In 2012 Hofstra University awarded the inaugural Mentor of the Year Award. For the first time, Hofstra students and faculty were invited to nominate a full-time faculty member who had supervised advanced undergraduate research and guided students, in both professional Justin DiAngelo and intellectual ways, toward developing their own ideas and 2013 Hofstra University Mentor of the Year pursuing their own research. This annual award acknowledges a faculty mentor who has had a significant impact on undergraduate research at the advanced level in his or her respective discipline.

ofsra tra niversity ofst niversity proudly pre sents the

2013 Mentor of the Year Award to

Justin DiA

ngelo, Ph.D

Assistant Prof

essor of Biol

ogy

his award reaff irms Hofstra recognition University’s of research and advanced undergraduat part of its comdedicated faculty supe e rvision mitment to teac hing excellenc as e.

Presented at

the Latin Hono rs Recognitio n Convocati Friday, May on 17, 2013

Stuart Rabinow itz President, Hofstra University

Herman A. Berliner Provost and Senior Vice Preside for Academ ic Affairs, Hofstra nt University

Justin DiAngelo • Biology Dr. DiAngelo teaches courses in cell biology and genetics, molecular biology, bioinformatics, and endocrinology. The research in his lab focuses on the ability of an animal to sense changes in its nutrient environment and adapt its behavior and metabolism accordingly.

“Dr. Justin DiAngelo has been a faculty member in the Department of Biology for [only] three years, and his influence and collaboration with student researchers has [already] become an invaluable asset to the department. Dr. DiAngelo has mentored 12 research students, a few of whom are now graduate students in prestigious cell and molecular biology programs, including Brandeis University and the University of Rochester.

Students are the driving force of his research program; they perform the experiments, analyze the results, and author scientific publications. Dr. DiAngelo carefully structures the students’ research experience in order for students to learn the entire process of research. Students gain experience asking research questions, designing experiments, analyzing data, and communicating their results to the public.”

— Professor Beverly Clendening, Biology Department

“Whether performing research in his lab or attending one of his classes, you will learn how to think like a scientist. Dr. Justin DiAngelo truly imparts his scientific experiences and knowledge to his students and encourages undergrads to pursue degrees of higher education within the sciences.”

— Jacqueline McDermott

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.

for outstand ing supervision undergradu of ate research Hofstra Coll ege of Liberal in biology in Arts and Scie nces

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Hofstra at a Glance Location Hempstead, Long Island, 25 miles east of New York City.

Telephone: 516-463-6600 Character A private, nonsectarian, coeducational university.

President Stuart Rabinowitz, JD Colleges and Schools Hofstra College of Liberal Arts and Sciences; Hofstra University Honors College; Frank G. Zarb School of Business; The Lawrence Herbert School of Communication; School of Education; School of Health Sciences and Human Services; School of Engineering and Applied Science; Maurice A. Deane School of Law at Hofstra University; Hofstra North Shore-LIJ School of Medicine at Hofstra University; School for University Studies; and Hofstra University Continuing Education.

Faculty There are 1,123 faculty members, of whom 495 are full-time. Ninety-two percent of full-time faculty hold the highest degree in their fields.

Student Body Undergraduate enrollment of 6,840. Total University enrollment, including graduate, School of Law and School of Medicine, is about 11,000. Male-female ratio is 47-to-53.

Degrees Bachelor’s degrees are offered in about 140 program options.

Graduate degrees, including PhD, EdD, PsyD, AuD, JD, and MD, advanced certificates and professional diplomas, are offered in about 150 program options.

The Hofstra Campus With 115 buildings and 240 acres, Hofstra is a member of the American Public Gardens Association.

Libraries The Hofstra libraries contain 1 million+ volumes and provide 24/7 online access to more than 75,000 full-text journals and 100,000 electronic books.

Accessibility Hofstra is 100 percent program accessible to persons with disabilities.

January and Summer Sessions Hofstra offers a January session and three summer sessions between May and August.

Trustees of Hofstra University As of January 2014 OFFICERS Janis M. Meyer,* Chair James E. Quinn,* Vice Chair Peter G. Schiff, Vice Chair David S. Mack,* Secretary Stuart Rabinowitz, President MEMBERS Alan J. Bernon* Tejinder Bindra Robert F. Dall* Steven J. Freiberg* Arno H. Fried Martin B. Greenberg* Leo A. Guthart Peter S. Kalikow* Arthur J. Kremer Diana E. Lake* Karen L. Lutz John D. Miller* Marilyn B. Monter* Martha S. Pope Julio A. Portalatin* Edwin C. Reed Robert D. Rosenthal* Debra A. Sandler* Thomas J. Sanzone* Leonard H. Shapiro Joseph Sparacio* Frank G. Zarb* DELEGATES Stuart L. Bass,* Chair, University Senate Executive Committee Tanya Levy-Odom,* President, Alumni Organization William F. Nirode, Speaker of the Faculty Andrea Standrowicz, President, Student Government Association Ron Singh, Vice President, Student Government Association Eugene Maccarrone,* Chair, University Senate Planning and Budget Committee

James M. Shuart,* President Emeritus Wilbur Breslin, Trustee Emeritus Emil V. Cianciulli,* Chair Emeritus John J. Conefry, Jr., Chair Emeritus Maurice A. Deane,* Chair Emeritus George G. Dempster,* Chair Emeritus Joseph L. Dionne,* Trustee Emeritus Helene Fortunoff, Chair Emerita Lawrence Herbert,* Trustee Emeritus Florence Kaufman, Trustee Emerita Walter B. Kissinger, Trustee Emeritus Ann M. Mallouk,* Chair Emerita Thomas H. O’Brien, Trustee Emeritus Norman R. Tengstrom,* Trustee Emeritus

*Hofstra alumni

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Non-Profit Org. U.S. Postage PAID Hofstra University

The Wise King See page 4.

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