September 2018 - The Epidemiology Monitor

Blue Chip Panel Of Epidemiologists And Other Experts Report On Mortality Associated With Hurricane Maria In Puerto Rico Collaborative Group Estimates 2,975 Excess Deaths Over A Six-Month Period

-3Epidemiologists React to Monsanto Decision

Loss Of Life Is Nearly Identical To 9/11 Attacks Excess Deaths

An independent assessment of the deaths caused by Hurricane Maria in Puerto Rico last year has been conducted and reported by the George Washington University School of Public Health. To establish the baseline or expected mortality prior to the hurricane, investigators examined mortality data from July 2010 to August 2017 and developed a series of generalized linear models.

In This Issue

Researchers estimated that 2,975 more deaths occurred during the six-month period September 2017-February 2018 after the hurricane than would have taken place without the storm. The excess number is almost identical to the loss of life associated with September 11 attacks. Overall the

-5STDs Skyrocketing -7E-Cigs Epidemic

- Maria cont'd on page 2

-11Notes on People

Announcement

2018 National Survey of Faculty Salaries in Academic Epidemiology Being Launched This Month Readers---Please Check Mailing List To Make Sure Your Department or School Will Be Participating The Epidemiology Monitor in collaboration with the University of Pennsylvania, Perelman School of Medicine is sending, later this month, a link to complete the 2018 salary survey of academic epidemiology salaries for the latest academic year 2017-2018. The survey sent to about 80 September 2018

departments of epidemiology and preventive medicine has previously been conducted exclusively by the University of Pennsylvania in an effort to identify and promote competitive compensation for faculty members.

- Survey cont'd on page 6 •

Volume Thirty Nine

•

Number Nine

-13Near Term Epidemiology Event Calendar -15Marketplace

-Maria cont'd from page 1 The Epidemiology Monitor ISSN (0744-0898) is published monthly

by Roger Bernier, Ph.D., MPH at 33 Indigo Plantation Rd, Okatie, SC, 29909, USA.

Editorial Contributors Roger Bernier, PhD, MPH Editor and Publisher Operations Linda Bernier, PhD, MS Operations Manager Advertising Sales Linda Bernier, PhD, MS Director of Advertising 770.670.1946 linda@epimonitor.net 2018 Advertising Rates All ads listed below also include a banner ad on our website and in our EpiGram emails.

Full Page $1,195 7.5”w x 10” h Half Page $895 7.5”w x 5” h Quarter Page $695 3.75”w x 5” h Website Ad $495 / mo.

Includes a banner ad in our EpiGram emails Multi-month discounts available upon request.

study documented 16,608 deaths during the study period.

The excess number of deaths represents a 22% increase over the number of deaths that would have occurred without the storm. Initial estimates were that 64 people had died, but this number appeared from preliminary investigations to be an underestimate. These discrepancies prompted the Governor of Puerto Rico to request an independent study

by George Washington University.

Risk Factors According to the report, the impact of the storm differed by municipality, age and socioeconomic status. Some 40% of municipalities were affected with significantly higher mortality. It was 60% higher in lower socioeconomic areas and 35% higher for males aged 65 or older. In a press release from GWU, Carlos SantosBurgoa who was the principal investigator for the project said “The results of our epidemiological study suggest that, tragically, Hurricane Maria led to a large number of excess deaths throughout the island.”

The team noted that the elevated risk they found persisted beyond the sixmonth observation period and may thus still be an underestimate.

Other Studies The research group conducted multiple interviews and analyses of death certificate data to identify flaws in mortality surveillance and communications activities during the storm period.

The report provides a number of key recommendations: 

All jurisdictions, not only Puerto Rico and other parts of the U.S. but also globally, should develop methods to rapidly assess total excess mortality after natural disasters and to provide that information to the public.

Monitoring should look not only at overall rates of death but also for spikes in death rates in certain areas and within subpopulations, such as the elderly.



Puerto Rico specifically needs to fully staff these public health functions within the Department of Health, including the Vital Statistics Registry and the Bureau of Forensic Sciences.



In addition, the island must strengthen the coordination between the Vital Statistics Registry and the Bureau of Forensic Sciences with the goal of creating a timely and accurate surveillance system.

Shifting Denominator Contact Us The Epidemiology Monitor 33 Indigo Plantation Rd, Okatie, SC, 29909 USA 678.361.5170 epimon@aol.com

2

Interestingly, the research group estimated there were 297,744 fewer persons on the island in February 2018 compared to when the storm hit in September 2017. This represents a migration of 8% and the mortality rates were calculated taking this displacement into consideration.





Outside disaster assistance agencies, including the U.S. Centers for Disease Control and - Maria continues on page 8

Epidemiologists React Quickly To Jury Decision About Monsanto’s Roundup Herbicide And Cancer A jury in San Francisco last month awarded $289 million dollars to a man who claimed his cancer was caused by exposure to glyphosate, a widely available herbicide sold by Monsanto under the Roundup brand name. Because the trial considered evidence from the International Agency for Research on Cancer (IARC) which has classified glyphosate as “probably carcinogenic”, epidemiologists who have criticized or defended the IARC were quick to publish their reactions.

Read the Q&A with Neil Pearce on pages 5-6

Neil Pearce, professor of epidemiology at the London School of Hygiene and Tropical Medicine and a leading defender of the IARC, published a commentary on the School’s “Expert Opinion” section. https://bit.ly/2D3A5nS Geoffrey Kabat, cancer epidemiologist formerly at Albert Einstein College of Medicine, responded to the Pearce article with his own perspective on the IARC published on the website of the American Council on Science and Health. https://bit.ly/2peHd77 In an attempt to better understand the main reasons for the controversy, we asked each to clarify key points made in their articles. We begin this month with our questions to Pearce and his responses. For the convenience of our readers, we are reprinting Pearce’s commentary followed by our questions and his answers.

We invited Kabat to do the same by responding to questions of clarification about his commentary. He told the Monitor “I have already written what I have to say on the issue of glyphosate.”

Reprint Wednesday 15 August 2018 by Professor Neil Pearce Independent, Rigorous, Vilified—Why Attacks On The IARC Are Unfair.

Glyphosate (Roundup) is one of the most commonly used herbicides in the world, and in most countries is available to the general public – you can buy it in the UK at your local garden centre. More court cases are pending in the USA, and similar cases in other countries are likely to follow.

The recent decision of a Californian court to award compensation of $289 million to a man who claimed that herbicides containing glyphosate had caused his cancer (a non-Hodgkin’s lymphoma) has potentially profound implications.

A key piece of evidence in the trial was that the International Agency for Research on Cancer (IARC), an agency of the World Health Organisation (WHO), has classified glyphosate as ‘probably carcinogenic’. This classification has been followed by major controversies, particularly in light of the recent relicensing of glyphosate by the European Commission, hundreds of litigation cases in the USA brought by cancer patients against Monsanto and the decision of the California Environmental Protection Agency to label glyphosate as a carcinogen.

“The recent decision of a Californian court... has potentially profound implications."

Disappointingly, but perhaps not surprisingly, this controversy has led to attacks not only on the IARC decision, but also on some of those involved in the IARC - Monsanto cont'd on page 4

3

-Monsanto cont'd from page 3

"These events are not happening in a vacuum."

"IARC is under attack because it is objective, effective, and sometimes produces inconvenient findings."

4

Monograph meeting which made the decision, and on IARC itself. These events are not happening in a vacuum. There have been attacks on previous IARC decisions on potential causes of cancer such as formaldehyde, diesel fumes and radiofrequency electromagnetic elds. More ominously, there are moves by some governments to threaten to cut the funding of IARC, in response to these recent ‘inconvenient’ decisions.

So how do the IARC Monographs work?

IARC, by far the most authoritative agency in this field, is supported by funding from 26 countries, including the UK. There are independent Governing Councils and Scientific Councils, and also Advisory Groups that recommend which chemicals and other exposures should be considered for evaluation of their carcinogenicity. Monograph Work Groups are then assembled, each of which evaluates the human, animal and mechanistic evidence for carcinogenicity.

On this basis, the agents being reviewed are classified as carcinogenic (group 1), probably carcinogenic (group 2A, which includes glyphosate), possibly carcinogenic (group 2B), not classifiable (group 3), and probably not carcinogenic (group 4). The voting members of the Working Groups are not employed by IARC, and receive no financial compensation; observers from industry and other interested parties can attend the Working Group meetings but not vote. There are clear and strict rules about what evidence can be included in IARC Monographs, with clear rules for searching all of the published literature, and also clear rules that literature that is not publicly available cannot be considered.

I recently reviewed the IARC processes, and some of the criticisms that have been made of them from industry, in a scientific

paper with more than 120 co-authors, a group which includes most of the leading researchers in occupational and environmental cancer epidemiology. Some of us disagreed with individual Monograph decisions, which is normal and healthy in science. However, we concluded that, although there is always room for evolution and improvement, that the IARC processes are sound, and that recent industry-funded criticisms have been unfair and unconstructive.

We all look up to IARC and see it as a beacon of independence and objectivity in a world which is becoming increasingly partisan and polarised, and in which scientific evidence is increasingly disparaged and ignored. Facts matter, science matters, and in this field, there is no other agency which even comes close to IARC in terms of independence, objectivity, and transparency.

A few of the myths about IARC that are currently being propagated include “IARC finds that everything causes cancer, “IARC does no research, it only has opinions” and “IARC has been found to be corrupted” – I could go on. The facts are that IARC is under attack because it is objective, effective, and sometimes produces inconvenient findings. We need, and rely on, a court system which is independent, fair, and not subject to political, corporate, or community pressure. We also need independent scientific bodies such as IARC which can review the scientific evidence objectively, and without conflicts of interest, even if this leads to conclusions that some may find inconvenient.

- Q&A with Neil Pearce on page 5

-Monsanto cont'd from page 4

Interview With Neil Pearce About IARC Commentary EM: Can you be more clear about what you mean in your article by stating that the California court decision has “potentially profound implications”? These are not really spelled out as I read the article.

Pearce: My main concern is about the attacks on IARC, not about the court decision (I never get involved in court cases about these issues, on either side). There is a long history of attacks by industry on IARC decisions and processes; the glyphosate controversy is just the most recent.

However, in the introduction to my blog, I noted that the decision has ‘potentially profound implications’ just in terms of the ‘high stakes’ involved, because of the size of the compensation, and the number of people in the population who might consider that they have similar claims.

EM: By citing the Court decision’s reliance on the IARC work and on the decision by the Califronia EPA, you give the impression that glyphosate is an established cause of cancer. Is that your view?

Pearce: I didn’t say that at all – I simply note that the court relied in part on the IARC classification as ‘probably carcinogenic’; ‘probably’ (IARC category 2A) and ‘established’ (which more or less corresponds to IARC category 1 (sufficient evidence)) are not the same thing at all.

EM: Your main focus in the article appears to be a defense of the IARC and its monograph process. While no agency is perfect, do you think there are any fair and/or constructive criticisms that have been made about

the IARC report on glyphosate and/or the IARC process itself? Is it all really a smokescreen being used by interests adversely affected by IARC decisions?

Pearce: In my opinion it is a smokescreen; I recently reviewed the IARC processes, and some of the criticisms that have been made of them from industry, in a scientific paper with more than 120 co-authors, a group which includes most of the leading researchers in occupational and environmental cancer epidemiology.

Some of us disagreed with individual Monograph decisions, which is normal and healthy in science. However, we concluded that, although there is always room for evolution and improvement, that the IARC processes are sound, and that recent industryfunded criticisms have been unfair and unconstructive. No person or Agency is perfect, but when an Agency is doing a good job, and is under attack as a result of this, then we should say so. To give another example, no climate change scientist, report or agency is perfect, but when climate change reports and scientists are unfairly attacked by industry, then it is reasonable to defend them.

“In my opinion it is a smokescreen..."

"...but when an Agency is doing a good job, and is under attack as a result of this, then we should say so."

EM: You seem to have used a gentle word by calling some IARC decisions “inconvenient”. Aren’t they a lot more than that for Monsanto and other businesses or services that might be negatively impacted by IARC findings?

Pearce: Probably, but that is not my concern; my concern is that decisions about whether or not a chemical causes (or probably causes) cancer should be based on scientific evidence, - Monsanto cont'd on page 6

5

-Monsanto cont'd from page 5

“IARC is basically doing a good job of providing independent and objective scientific evaluation of these issues."

"I didn’t say anything for or against the court decision..."

irrespective of whether the findings have financial implications; what we then do with those decisions is up to policy makers and companies, etc, but we shouldn’t try and change the science because we don’t like the outcome EM: I think we can all agree on the need for an agency such as IARC that can serve as a kind of independent science court to evaluate evidence.

Also, that such groups must be vigorously defended when subjected to obviously self-interested attacks by various groups. But part of that vigorous defense is addressing valid or reasonable criticisms. Do you think IARC and its supporters have done or are doing an adequate job of addressing valid substantive and procedural criticisms if there are any?

Pearce: I agree completely, but IARC is being unfairly criticized; of course, there are always ways in which such organisations and processes could be improved, but IARC is basically doing a good job of providing independent and objective scientific evaluation of these issues.

EM: Following your article, Geoffrey Kabat has written an article attacking your apparent approval of the Court decision and defense of the IARC. Kabat seems most interested in making criticisms of the IARC findings on glyphosate and questions why these were not addressed by you. Can you speak to that?

6

Pearce: I didn’t say anything for or against the court decision; for that matter, I haven’t commented on the glyphosate decision – I was making a more general defence of IARC and the Monograph process. ■

-Survey cont'd from page 2 This year, the University of Pennsylvania is partnering with The Epidemiology Monitor to conduct a new, expanded survey in both schools of medicine and public health, to better publicize the survey and its results and increase the response rate. The University will perform the analysis of de-identified data, but will be blinded from all identifying institutional information.

One institutional representative from each participating institution should provide all anonymized faculty salaries within their division or department of epidemiology. To perform the analysis, the University of Pennsylvania will have access to the information only after it has been stripped of any institutional identifiers.

Responses will be due by Monday, November 5, 2018, allowing respondents adequate time to collect the information for analysis and publication by early 2019.

The names of the departments to be surveyed are listed here with the name(s) of the contact person being asked for the salary information. If your group is not listed, or the incorrect person is named, please contact us and we will add your institution or seek to identify a representative who can fill out the survey on behalf of your group. Please contact Lisbeth Dennis dennisls@pennmedicine.upenn.edu from the University of Pennsylvania if you have specific questions regarding the survey. For other questions, please contact The Epidemiology Monitor at epimon@aol.com. ■

Sexually Transmitted Diseases Are Skyrocketing Out Of Control Diseases Called A “Persistent Enemy Outpacing Our Ability To Respond” “The United States continues to have the highest STD [sexually transmitted disease] rates in the industrialized world”, and “We are in the midst of an absolute STD public health crisis in this country”.

These are two of the statements made by public health officials participating in a press briefing held in connection with the 2018 STD Prevention Conference in Washington in late August. Preliminary data reported from CDC indicate that 2.3 million cases of syphilis, gonorrhea, and chlamydia were diagnosed in 2017, a total which surpasses the 2016 total by more than 200,000 cases.

Chlamydia accounted for the largest share of these at 1.7 million cases, followed by 555,608 cases of gonorrhea, and 30,644 cases of primary and secondary syphilis, and more than 1,000 cases of congenital syphilis. Up to 40% of the babies are stillborn or die shortly thereafter, and survivors have a range of problems. Since 2013, STD cases showed a “steep and sustained” increase.

CDC Infographic

CDC’s Jonathan Mermin told the media “It is evident the systems that identify, treat, and ultimaltely prevent STD’s are strained to near the breaking point.”

Several reasons for the increases were discussed at the press briefing, the most important included the following:

“Since 2013, STD cases showed a 'steep and sustained' increase."

1. Lack of awareness and education about STD’s and sexual health.

2. Failure to screen and test for STD’s 3. Stigma related to STD’s in America.

4. Decrease in federal and state public health funding.

According to Michael Fraser, Executive Director of the Association of State and Territorial Health Officials, “ We know what works with STD prevention. We just don’t necessarily want to pay for all of it. And so we really have to ask ourselves if we are to take this seriously and we want to get on top of this, are we willing to make that investment.”

■

"We know what works with STD prevention."

7

-Maria cont'd from page 2 

Prevention, need to provide aid and assistance to professional staff involved in natural disasters.



Puerto Rico needs to conduct after-action reviews and use those, along with the results of the study, to create a new crisis and emergency risk communication plan, one that is integrated with government agency and municipal plans, has community and stakeholder involvement, and is aligned with the possibility of catastrophic disasters.

“Additional research must be done to understand how the hurricane was involved in the excess deaths..."

Additional research must be done to understand how the hurricane was involved in the excess deaths identified in this study. This would involve interviews of family members and others, as well as in-depth statistical analyses, to learn about the circumstances leading up to individual deaths. Such a study can provide clues that will aid in protecting vulnerable groups in the future.



Investigators And Staff The blue chip panel of investigators and staff who carried out the study are listed below, including their titles and/or diverse areas of expertise. 





8

 

Dr. Elizabeth Andrade, Dr.P.H., M.P.H. Behavioral Scientist, Project Researcher Nicole Barrett, M.P.H. Senior Research Associate, Project Research Assistant Dr. Uriyoan Colon-Ramos, Sc.D., M.P.A. Nutritionist, Project Researcher Dr. Mark Edberg, Ph.D., M.A. Anthropologist, Project Researcher

 



  





       

  

 

Alejandra Garcia-Meza, M.P.H. Consultant, Project Researcher Dr. Ann Goldman, Ph.D., M.P.H, M.A. Epidemiologist, Economist, Project Coordinator Dr. Lynn Goldman, M.D., M.S., M.P.H. Dean of the Milken Institute School of Public Health, Environmental Health Specialist, Project Researcher Dr. Amira Roess, Ph.D., M.P.H. Epidemiologist, Project Researcher Dr. John Sandberg, Ph.D., M.A. Demographer, Project Researcher Dr. Carlos Santos-Burgoa, M.D., Ph.D., M.P.H. Epidemiologist, Principal Investigator Dr. Scott Zeger, Ph.D., M.S. (Johns Hopkins University, Bloomberg School of Public Health) Biostatistician, Project Researcher and Expert Panel Member Noel Estrada Merly, M.S. Graduate Research Assistant, Project Research Assistant Dr. Cruz María Nazario, Ph.D. Epidemiologist, Project Researcher Dr. Cynthia Pérez, Ph.D. Epidemiologist, Project Researcher Dr. Erick Suarez Pérez, Ph.D., M.A. Biostatistician, Project Researcher Ljubica Latinovic, M.D., M.H.A. Communications Expert, Consultant Ivonne Rivera, M.P.H. Expert in Qualitative Analysis, Consultant Samuel Clark, Ph.D., M.A. Demographer Debarati Guha Sapir, Ph.D. Epidemiologist Bernardo Hernández Prado, DSc., M.S. Epidemiologist, Mortality Estimation Expert Matthew Seeger, Ph.D. Communications Expert Daniel Hoffman, Ph.D., M.P.H., Epidemiologist Pietro Marghella, DHSc, MSc, MA, CEM, FACCP Complex humanitarian emergencies expert Sam Simmens, Ph.D., M.A Biostatistician Ronald Waldman, M.D., M.P.H. Complex humanitarian emergencies expert ■

FDA Says Use Of E-Cigarettes Is Epidemic Among Young People Stricter Measures Being Taken and More Are Anticipated Saying the agency believes that ecigarette use among youth has hit epidemic proportions, the Food and Drug Administration has announced the agency “intends to take new and significant steps to address this challenge”. While FDA presented no new or updated data in support of its view, FDA Commissioner Scott Gottlieb said that he sees an epidemic of e-cigs among teens, and “deeply disturbing trends that show no sign of abating.” He added, “The FDA is closely watching the trends in youth use. And if, as we expect, preliminary data that’s in our possession and will be finalized and released in the coming months confirm our present observations that the youth use of ecigs is rising very sharply, we’ll swiftly change course.”

CDC Data In a recent report on tobacco product use among students in the US between 2011-2017, CDC found that during this period prevalence of the current use of any tobacco product decreased from 24.2% to 19.6% among high school students and from 7.5% to 5.6% among middle school students. E-Cigarettes were the most commonly used tobacco product among high school students at 11.7% (rising from 1.5% in 2011 and peaking at 16% in 2015) and among middle school students at 3.3% in 2017.

E-cigarette use jumped dramatically higher in 2014 among these two groups of students and has remained high since then. It increased somewhat in high school students in 2017 and decreasing slightly in middle school students last year, according to the

CDC survey data.

Unintended Consequence In a statement to the press, the agency acknowledged that it did not predict or anticipate the increased use of ecigarettes among teenagers when it launched its new plan to regulate tobacco as part of the Tobacco Control Act and permitted the use of ecigarettes to help people quit.

According to Gottlieb, “The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine as a tradeoff for enabling adults to have unfettered access to these same products.”

“The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine..."

To accomplish this, the FDA has a three-pronged startegy: 1. Preventing youth access to tobacco products using enforcement.

FDA has announced a coordinated initiative against sales that violate the law. It is aimed at retail and online sales of e-cigarettes to minors. It is the largest compliance effort in FDA history.

2. Curbing the marketing of tobacco products aimed at youth

"It is the largest compliance effort in FDA history."

3. Educating teens about the dangers of using any tobacco products, including a national campaign beginning shortly to warn teenagers of the dangers of nicotine and e-cigarette use FDA is requesting that the - e-Cig cont'd on page 10

9

-e-Cig cont'd from page 9 manufacturers of these brands and products come back to the agency in 60 days with robust plans on how they will convincingly address the widespread use of their products by minors.

“This may require these brands to revise their sales and marketing..."

This may require these brands to revise their sales and marketing practices, including online sales; to stop distributing their products to retailers who sell to kids; and to remove some or all of their flavored ecig products from the market until they receive premarket authorization and otherwise meet applicable requirements.

Review of the Evidence A recent review of E-cigarettes by the European Public Health Association reached the following conclusions:

"The health risks associated with ecigarettes remain uncertain but they cannot be considered safe."

1. On Safety The health risks associated with ecigarettes remain uncertain but they cannot be considered safe. What is certain is that statements that they are some percentage safer than conventional cigarettes are so far unjustified.

2. On Effectiveness against Smoking Overall, e-cigarettes may help some smokers quit but, for most, e-cigarettes depress quitting.

3. On Gateway Role The net effect of making e-cigarettes widely available, at population level, seems likely to be an increase in sole and dual use of e-cigarettes and sole smoking unless there is very stringent regulation.

10

4. Role of tobacco industry E-cigarettes and “smoke not burn” products are portrayed publicly by the tobacco industry as a means to reduce smoking yet, at the same time, these companies are actively promoting their combustible products. https://bit.ly/2oWXwoT ■

Do you have news about yourself, a colleague, or a student?

Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at the address below for inclusion in our next issue. people@epimonitor.net

Notes on People Awarded: to Harvey Risch, the Ruth Leff Siegel Award for Excellence in Pancreatic Cancer Research. The award carries a $50,000 prize. The international award is open to all types of pancreatic cancer research and it is notable that Dr Risch was recognized for his work as an epidemiologist. He is Professor of

Epidemiology in the Department of Epidemiology and Public Health at the Yale School of Public Health and Yale School of Medicine.

Hired: Anne Marie Jukic, PhD, by the National Institute of Environmental Health Sciences, to lead the Fertility and Reproductive Health Group as a researcher in the Epidemiology Branch. Jukic was formerly assistant professor at the Yale School of Public Health.

Profiled: Miriam Al-Fardous, for preparing to become the first female to dive at both the North and South Poles. Fardous, 33, is a physician, epidemiologist and graduate of King Abdul Azis University. She was the first Arab woman to dive at the North Pole and is preparing to dive at the South Pole in February which could earn her the title “first female two-poles diver”.

Awarded: to Jo Freudenheim, a $359,024 grant from the New York State governor’s “Get Screened, No Excuses” initiative. Freudenheim was one of nine scientists selected. She also was one of seven researchers receiving a second grant to examine the role of the microbiome in breast cancer. She is the Distinguished Professor and Chair of Epidemiology and Environmental Health at the University of Buffalo.

Retired: Kathleen McKeen, 77, Director of the Iowa Cancer Registry after 59 years of service. “I like to refer to the registry people as detectives,” McKeen told Iowa’s Gazette. She has supervised a staff of 50 at the registry and has been very dedicated to cancer surveillance, according to Charles Lynch, University of Iowa professor and Principal Investigator for the federal contract that funds most of the Iowa registry.

11

Notes on People, continued from page 11 Arrested: Tom Frieden, fomer CDC Director, for groping a woman in his apartment in 2017. He was charged with forcible touching, sex abuse and harassment. His attorney entered a not guilty plea on his behalf. He was released without bail.

Newsmaker: Karin Michels, for her statements that "coconut oil is pure poison" and "is one of the worst foods you can eat." She made the comments during a lecture in Germany which was translated and has gone viral with almost a million views. The video appears to have been removed from Youtube. Michels is professor and chair of epidemiology at UCLA and an adjunct professor at Harvard School of Public Health.

Notes on People Do you have news about yourself, a colleague, or a student?

Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at the address below for inclusion in our next issue. people@epimonitor.net

12

Near Term Epidemiology Event Calendar Every December The Epidemiology Monitor dedicates that issue to a calendar of events for the upcoming year. However that often means we don't have full information for events later in the year.

Thus an online copy exists on our website that is updated regularly. This year we will print upcoming events in the Monitor monthly. To view the full year please go to: http://www.epimonitor.net/Events

October 2018 October 1-5 https://tinyurl.com/y8d23aq9 Conference: 8th Africa Nutritional Epidemiology Conference / International Union of Nutritional Sciences / Addis Abba, Ethiopia October 1-19 https://tinyurl.com/ybtkjpvw Short Course: Genetic Epidemiological Research Methods / Erasmus MC / Rotterdam, The Netherlands October 3-7 http://www.idweek.org/ Conference: IDWeek 2018 (Infectious Disease Week) / Multiple Sponsors / San Francisco, CA October 14-16 https://tinyurl.com/y7zr7273 Conference: IGES 2018 / International Genetic Epidemiology Society / San Diego, CA October 16-20 https://tinyurl.com/y8ykt67w Short Course: Clinical Translation of Epidemiology / Erasmus MC / Rotterdam, The Netherlands October 17-19 https://tinyurl.com/ybdykegs Conference: ECVPH Annual Conference / European College of Veterinary Public Health & University of Perugia October 22-24 https://aea.asn.au/ Conference: Annual Scientific Meeting / Australian Epidemiological Association / Freemantle, Australia Oct 26-Nov 7 https://tinyurl.com/ya8z6jbv Short Course: Clinical Epidemiology / Erasmus MC / Rotterdam, The Netherlands October-TBA https://tinyurl.com/zovbezj Conference: 2018 Northeast Epidemiology Conference / Multiple Sponsors / New England October-TBA https://tinyurl.com/ybtkjpvw Course: Genetic-Epidemiologic Research Methods / Erasmus MC / Rotterdam, The Netherlands October-TBA https://tinyurl.com/y8ykt67w Short Course: Clinical Translation of Epidemiology / Erasmus MC / Rotterdam, The Netherlands

November 2018 November 6-9 https://tinyurl.com/y7zc472l Conference: 14th International Conference on Molecular Epidemiology / Elsevier / Sitges, Spain November 10-12 https://tinyurl.com/yauuehoa Conference: APHA 2018 / American Public Health Association / San Diego, CA

13

Near Term Epidemiology Event Calendar November 2018 continued from page 13 November 12-16 https://tinyurl.com/ydytyole Symposium: 15th Annual Symposium of Veterinary Epidemiology & Economics / ISVEE / Chaing Mai, Thailand November 21-23 https://tinyurl.com/yd9zjjdc Conference: ESCAIDE 2018 / European Scientific Conference on Applied Infectious Disease Epidemiology / St. Julien, Malta Nov 28- Dec 1 https://ephconference.eu/ Conference: 11th European Public Health Conference / EPU (European Publich Health Association) and National Institute of Public Health / Ljubljna, Slovenia November-TBA https://tinyurl.com/ya6tzxbt Short Course: Causal Inference in Epidemiology / London School of Hygiene & Tropical Medicine / London, England November-TBA https://tinyurl.com/ya8z6jbv Short Course: Clinical Epidemiology / Erasmus MC / Rotterdam, The Netherlands

Your Ad Should Be Here Do you have a job, course, conference, book or other resource of interest to the epidemiology community? Advertise with The Epidemiology Monitor and reach 35,000 epidemiologists, biostatisticians, and public health professionals monthly.

Advertising opportunities exist in this digital publication, on our website and Facebook page, and in our Epi-Gram emails.

For more information please contact: Linda Bernier, Director of Advertising 770.670.1946 / linda@epimonitor.net

14

Assistant or Tenured Associate Professor Mental Health Epidemiology The UCLA Jonathan and Karin Fielding School of Public Health invites applications for a full-time, state-funded tenure-track Assistant or tenured Associate Professor of Epidemiology (https://epi.ph.ucla.edu). The ideal candidate will have a strong, emerging record of an innovative and productive research program in mental health epidemiology, including mental health, substance use, and/or psychiatric disorders, and a history of successful external funding, consistent with career stage. The successful candidate should also have a strong track record and dedication to teaching foundational and advanced epidemiology courses (e.g., introductory epidemiology, population health, measurement, research methods, and/or study design), as well as courses in the candidate’s specialty area. We are looking for a candidate with excellence in research and dedication to teaching and training the next generation of epidemiologists in areas such as, but not limited to, epidemiologi c studies of mental health and substance use, randomized clinical trials for psychiatric disorders, psychiatric genetics, psychopharmacology, mental health comorbidities with infectious or other chronic diseases, and/or mental health-related studies using “big data” (e.g., omics, electronic health records, administrative databases, internet-based data).

Successful candidates must have (or be on track to conclude before July 1, 2019) a doctoral degree (PhD, ScD, MD, DrPH or equivalent) in Epidemiology or related field, demonstrable expertise and interest in epidemiologic research, evidence of excellence in teaching and training of pre- and/or post-doctoral students, peer-reviewed publications, and a demonstrated commitment to public health. Faculty appointment level and salary will be commensurate with the candidate’s experience and qualifications.

The deadline for applications to be submitted is November 1, 2018 but the search remains open until the position is filled. The anticipated start date is July 1, 2019. Informal inquiries may be submitted to episearch@ph.ucla.edu Please submit your applications at: https://recruit.apo.ucla.edu/apply/JPF03945 The University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status. For the complete University of California nondiscrimination and affirmative action policy, see: UC Nondiscrimination & Affirmative Action Policy.

Chief and Senior Investigator Biostatistics and Bioinformatics Branch The Division of Intramural Population Health Research (DIPHR) of the Eunice Kennedy Shriver National Institute of Child Health and Human Development is recruiting a Senior Investigator to serve as Chief of the Biostatistics and Bioinformatics Branch (BBB). The BBB mission is to develop novel biostatistical and bioinformatics methods motivated by the Division’s population health research that spans human fecundity and fertility, pregnancy, child and adolescent development, and health-related behaviors. BBB currently has methodological research programs in the areas of analysis of biomarker data, analysis of time-to-event data, and analysis of longitudinal and correlated data. A description of the Branch may be found at https://www.nichd.nih.gov/about/org/diphr/officebranch/bbb.

The Branch Chief will shape the research direction of BBB and provide scientific, administrative and fiscal leadership of the Branch while maintaining his/her own original methodologic and collaborative research. The successful candidate will be a dynamic leader, an internationally recognized methodologist whose accomplishments are commensurate with the academic rank of a tenured full professor as demonstrated by a strong upward trajectory of high quality statistical publications, a trajectory of high impact collaborative publications, extramural funding (for academic candidates), and a clear vision of BBB’s essential role in population health research. The Chief is expected to lead in strengthening current research areas and in developing new areas of expertise to address increasingly challenging designs and analyses, including priorities such as bioinformatics and causal inference in areas central to the Institute’s mission.

APPLY The full position description and instructions for applying may be found at https://www.nichd.nih.gov/sites/default/files/201808/DIPHR_BBB_Chief_Position.pdf. For further information about the position please contact Dr. Stephen Gilman, Senior Investigator and Chief, Social and Behavioral Sciences Branch, DIPHR, NICHD; Phone: 301-435-3895; Email: stephen.gilman@nih.gov. Applications received by November 1, 2018 will be considered for a first round of interviews, but applications will be accepted until the position is filled.

HHS, NIH, and NICHD are Equal Opportunity Employers.

Faculty Position at the Memory Keepers Medical Discovery Team – Health Equity The Memory Keepers Medical Discovery Team on American Indian and Rural Health Equity (MK-MDT) is recruiting an epidemiologist or equivalent researcher to join our dynamic and growing core of faculty investigators and staff. Applicants’ intellectual perspectives should place high value on social and cultural contexts, social determinants of health, and the interconnected and interacting environmental, behavioral, social, and cultural complexities of chronic health conditions, with specific experience or interest in the linkages between diabetes and dementia. The MK-MDT investigates the synergistic occurrence of diabetes and dementia in Indigenous and rural populations using a social determinants of health lens. MK-MDT faculty investigators work in an interdisciplinary team science research environment.

This is a tenure-track academic appointment at the rank of Assistant Professor prepared for promotion in one to two years, Associate Professor, or Professor to the University of Minnesota Medical School, Duluth Campus. Rank and salary commensurate with experience. The successful candidate will be appointed as a faculty investigator and physically located with the MK-MDT, with academic home in the Department of Family Medicine and Biobehavioral Health.

Duties and responsibilities of the position include: Develop and implement applied research on Indigenous (e.g., American Indian/Alaska Native/First Nations) and rural health disparities in dementia and diabetes, as aligned with the strategic goals of the MK/MDT and the University of Minnesota Medical School, Duluth campus. In close collaboration with community partners, develop and conduct interdisciplinary dementia and diabetes health disparities research among rural populations, including rural Indigenous, other rural ethnic minority, and rural majority populations of all age groups. Participate in collaborative interdisciplinary team science with MK-MDT faculty, including active contributions to community engagement, workshops, and funding applications. Contribute to teaching and service in the Department of Family Medicine and Biobehavioral Health of the University of Minnesota Medical School, Duluth campus and to the Duluth campus mission in rural and Indigenous health.

Required qualifications: PhD in Epidemiology or equivalent. Track record in high impact epidemiological or equivalent research with an emphasis on health equity. Background or interests in, and a willingness to adhere to principles of Indigenous data sovereignty. Knowledge and experience in one or more of the following areas: chronic disease, syndemics, multi-causative disease pathways, rural or Indigenous health. History of external funding from NIH or equivalent sources. Strong record of peer reviewed publication in one or more of the following areas: diabetes, dementia, rural, or Indigenous health. Experience with and/or valuing of quantitative, qualitative and mix-method research design. Preferred qualifications: Indigenous lived experience, as well as demonstrated experience working with Indigenous peoples, cultures and communities. Experience and demonstrated interest in work with interdisciplinary research teams. Experience with or interest in small populations research and small samples analyses.

Proven track record of success in NIH grant awards or equivalent in rural and/or Indigenous health. Strong biostatistics knowledge base and the ability to apply epidemiological tools and skills to programs of research that are collaboratively prioritized by the MK-MDT Investigator team. Proven track record in providing epidemiological and analytic expertise to team research efforts through successful team based grant applications, project implementation, and high impact publications.

Interest/proficiency in promising and state of the art techniques in small and hidden populations research and in small samples analyses (for example, respondent driven sampling or Bayesian analysis).

The mission of the Memory Keepers Medical Discovery Team is to support an environment of Team Science to conduct community-based participatory action research on diabetes and dementia in Native American and rural communities with the aim of achieving health equity. The vision is to advance the boundaries of health equity research to create innovative interventions to support healthy aging in Native American and Rural populations.

TO APPLY: Applications must be submitted online at https://humanresources.umn.edu/jobs. Follow the "External Faculty and Staff Applicants" link and search by job posting "326130." To be considered for this position, please click the Apply button and follow the instructions. You will have the opportunity to complete an online application for the position and attach a cover letter and curriculum vitae. Additional documents may be attached after application by accessing your "My Activities" page and uploading documents there. Completed applications will be evaluated starting November 1, 2018 and will continue until the position is filled. Top candidates will be invited for a seminar/interview as a component of the selection process. Questions concerning the online application process should be directed to Ms. Tracy Kemp at tkemp1@d.umn.edu.

To request an accommodation during the application process, please e-mail employ@umn.edu or call (612) 624-UOHR (8647).

Any offer of employment is contingent upon the successful completion of a background check. Our presumption is that prospective employees are eligible to work here. Criminal convictions do not automatically disqualify finalists from employment.

The University of Minnesota is an equal opportunity educator and employer.

Cancer Epidemiology: Assistant / Associate Faculty Member

Your Ad Should Be Here Do you have a job, course, conference, book or other resource of interest to the epidemiology community? Advertise with The Epidemiology Monitor and reach 35,000 epidemiologists, biostatisticians, and public health professionals monthly.

Advertising opportunities exist in this digital publication, on our website and Facebook page, and in our Epi-Gram emails.

For more information please contact: Linda Bernier, Director of Advertising 770.670.1946 / linda@epimonitor.net

The Division of Public Health Sciences at Fred Hutchinson Cancer Research Center invites applications for a faculty position at the Assistant or Associate Member (equivalent to Assistant or Associate Professor) level depending on qualifications. We seek candidates who share our goals to advance an understanding of the etiology of cancer and survivorship. Areas of particular interest include, but are not limited to molecular and genetic epidemiology, integrated tumor epidemiology, pharmacoepidemiology; use of electronic health records, mobile technology, and other novel biomedical data sources.

The successful candidate will develop a dynamic independent research program and will join in collaborative multidisciplinary and translational endeavors pertinent to our mission of reducing cancer incidence, progression, and sequelae through the identification of risk determinants and translation of discoveries into preventive strategies. Applicants should have a doctoral (PhD or MD with MPH/MS) degree or equivalent training in cancer epidemiology (or a related discipline) and relevant research experience.

Please submit all application materials including cover letter, curriculum vitae, a statement describing current and future research interests, and three references to https://apply.interfolio.com/53328. Please direct any questions related to this search to Teri Martinez (mailto:tmartine@fredhutch.org). The applicant review process begins as applications arrive, but any application received by Dec 1, 2018, will be guaranteed consideration for the position.

Applications that arrive after that date will be considered as long as the position remains open.

Fred Hutchinson Cancer Research Center is an equal opportunity/affirmative action employer. The institution is building culturally diverse faculty and strongly encourage applications from female and minority candidates.

The Epidemiology Monitor in a Digital Version is available FREE to subscribers The Epidemiology Monitor is available exclusively online in the same familiar print format subscribers are accustomed to, and they can read through the publication on their electronic devices in the same manner they did with the print version. In addition, you’ll be able to download and save copies of The Epidemiology Monitor for easy future access. Over the next year we’ll be exploring ways to make this publication available on additional mobile devices.

This publication format provides: ► ► ► ► ►

Easier access to information that is more timely Publication alerts via email Embedded hot links in articles Full color advertising Wider circulation for advertisers

SUBSCRIBE FOR FREE TODAY AT: http://epimonitor.net/Subscribe.htm