Oct 2015 - The Epidemiology Monitor

Ana Diez Roux Gives Milbank Lecture On Social Determinants Of Health At Yale Centennial Speakers are lauded in many ways when being introduced to an audience. An unique one preceded Ana Diez Roux, professor of epidemiology and Dean of the Drexel School of Public Health, when she delivered the Milbank Lecture at Yale in October as part of its centennial celebrations. Called “a walking School of Public Health” as a testament to her background and experience, Diez Roux rose to speak on “Population Health and Social Determinants of Health: Evidence and Future Directions”.

Lecture Topics She began her presentation by highlighting a handful of key facts about social determinants, followed up with mention of three important gaps or unanswered questions relating to social determinants, and finished the lecture by discussing areas where she believes additional research could be most helpful.

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CDC investigators detected a cluster

-3On Science Communication -5Communication Myths -7Ebola Epidemic Enters Phase III -9Asbestos Controversy -10-

Listeria Outbreak Solved After Five Years Through ShoeLeather Epidemiology A unique retroactive combination of laboratory and epidemiologic investigations have identified the source of a five year old multi-state Listeria outbreak, according to the Centers for Disease Control and Prevention. According to a report first posted in September 2015, 24 persons infected with one or the other of five closely related strains of Listeriamonocytogenes have been reported from 9 states since 2010.

In This Issue

of these cases in August 2015 when an increase in the number of isolates from one of these rare strains occurred. Four other rare strains in the specimens collected since 2010 were found to be closely related to the cluster strain. All the illnesses going back to 2010 were then seen as connected and counted as part of a single multi-state Listeria outbreak. A remarkably high percentage of these cases, 91%, were hospitalized and there has been one death.

- Listeria continues on page 8

NEW FEATURE What We're Reading -11Marketplace Jobs, Books & Events October 2015 Volume Thirty Six Number Ten

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Key Facts Among the things we know about social determinants is that social position is a powerful predictor of health. It acts in a dose response manner to create graded relationships for many health processes. Social position is generally very persistent over time, produces similar effects across societies, across age groups, and across many diseases and causes of disease. Some heterogenerities in the social patterning do exist and may provide clues about the drivers of patterns or to possible interventions.

There are multiple dimensions or components that make up social circumstances and these may interact with each other. Examples include income, education, and race/ethnicity. These elements may operate at different times over the lifecourse and how they act early in life can influence events at later ages.

There are multiple pathways by which social position exerts its influence. Social determinants manifest themselves at multiple levels, for example, at both the level of the individual as well as the neighborhood level.

Gaps in Knowledge There are important questions still unanswered noted Diez Roux. The first of these she described is a question many observers will ask, namely, how much variation in health do social determinants explain? Efforts have been made in pie chart or other forms to parcel out the contributions

of social determinants, however these parcels have really not been quantified, and the question remains unanswered. The reasons for this, Diez Roux stated, are the difficulties of measuring the components themselves, the fact that they are inter-correlated, and not knowing the causal ordering of the different components. Diez Roux wondered whether the question is one that should be asked, or if it is really a right question.

Mediating Processes A second gap in knowledge has to do with the mediating processes which explain the social determinants of health. It turns out that known risk factors for certain diseases do not always explain a large part of the variance and investigators have sought to determine if behavioral, psychosocial, or material resources could fill in the gap. These efforts have not yet succeeded, said Diez Roux, because social position appears to operate through complex causal chains. Such complex systems “remains a tricky problem” she said.

Policies and Strategies A third area with gaps in knowledge pertains to what policies and strategies should be implemented to address social position or social circumstances. Here Diez Roux introduced the concept of “fundamental social causes” and pointed out that to reduce the gradient in outcomes due to social position, the fundamental elements of social position such as power, - Social continues on page 6

National Research Council Group Develops “Take Home Messages” For Scientists Interfacing With The Public Societal debates about scientific matters are an ongoing occurrence.

Examples includes those on climate change, stem cell research, genetically modified foods, synthetic biology, and nanotechnology. In public health, these debates have revolved around vaccines and autism, tobacco control, cell phones and brain cancer, gun control, asbestos, screening guidelines, and many other topics where epidemiologic data have been central to the discussions.

Key Quotes “I want to assure you that the public is not irrational”, “There is no unframed information”, “Sometimes science plays a very small role in the decisions that we make involving scientific topics” “Where there is respectful discourse, it is my experience that we get betterquality outcomes in the public interest.”

These are some of the quotes used by rapporteurs of a workshop on science communication sponsored by the National Research Council earlier this year. The workshop was focused on the topic of genetically modified organisms and the challenges and lessons learned from interfacing with the public on this issue, however much of the content of the report and the conclusions reached are applicable across many scientific disciplines, especially epidemiology.

The “science of science communication” has learned a great

deal about how people process information, make decisions, and engage with the world, according to the report, and these lessons apply to scientists as well as laypersons.

Key Conceptual Points Some of the key conceptual points presented at the workshop included:  The deficit model is the idea that if people had more information, they would agree with scientists and make better decisions. But that is not how people make decisions. Better explanation by scientists and better listening by the public is not the answer to the science communication problem.  People use mental shortcuts to make sense of excessive and complex information.  Bringing people with diverse viewpoints together is one way to resist confirmation bias , the tendency to look for information that supports what people already believe and to dismiss disconfirming information.  All information is framed, regardless of intent to frame.  Scientists can assume various roles in a policy discussion— pure scientist, science arbiter, issue advocate, and honest broker—and all the roles are needed in a robust society.  The pure science communicator, uninvolved in politics, does not exist.

"I want to assure you that the public is not irrational”

" All information is framed, regardless of intent to frame"

- Messages continues on page 4

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-Messages continued from page 3 Take Away Ideas

“…recognizing that bias is part of the human condition rather than a shortcoming can advance how we engage with others about science in a rational way.”

“...the quality of the fight is better when we can acknowledge some shared commitments before we begin the really difficult conversation.”

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Flowing from these findings, participants at the two day workshop also developed actions to help scientists and their supporting institutions to prepare for and conduct public engagement.

Among the “take away” ideas were the following: 1. Understand the controversy. By this participants mean that scientists should take the time to study and identify the true issues and to develop a strategy. This is a better approach than automatically assuming that simply getting out more information to the public is the right approach.

Scientists were encouraged to foster a science communication environment that supports basing decisions on diverse values and interests while gaining access to the best information available.

2. Manage the communication process. As one member explained, “if you don’t just try to impose something on people, if you enter into their lives in a way that shows that you are respectful of and solicitous about their stake in what you are doing, you will have a community that is less likely to be vulnerable to being misinformed.”

3. Draw from social science evidence to inform public engagement practice.

The idea here is to help scientists to avoid missteps and to avoid reinventing the wheel by ignoring what has been and is being learned about how people come to know what they know.

4. Get communication training.

5. Examine your biases. As one member clarified, “…recognizing that bias is part of the human condition rather than a shortcoming can advance how we engage with others about science in a rational way.”

6. Public engagement is not the same as persuasion. Simply stated, one member noted that you need to be able to put yourself at intellectual risk to have true engagement with other parties. Stated another way, this suggests you need to be prepared to change your mind.

7. Common ground encourages respectful discourse.

This was expressed as follows—“the quality of the fight is better when we can acknowledge some shared commitments before we begin the really difficult conversation.” ■

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Myths About Public Perceptions Of Science The National Research Council workshop group addressing science communication with the public debunked some popular myths about the public.

Myth 1 Knowledge deficits are responsible for the lack of public support of science.

Truth is, says the group, more scientific information or knowledge about an issue does not lead to greater public support of particular scientific findings, and may even produce the opposite effect.

Myth 2 Useful public debate requires citizens that think like scientists.

All people, scientists included, are cognitive misers who use mental shortcuts such as beliefs and values to process information. These are healthy human responses to the multitude of decisions that need to be made.

Myth 3 The public does not trust scientists.

According to one member, people trust scientists but they are motivated to see that what science says is consistent with what their group says. ■

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-Social continued from page 2 knowledge, and resources must be tackled.

Why Study

"...while we may know fundamental social causes, it is not always obvious what intervention to carry out."

"...she called for a tighter or more iterative connection between research and action..."

Some have asked why bother to study social determinants at all since we know the fundamental causes already.

Diez Roux gave several reasons why it is important to continue to study social determinants.

First, the gradient in outcomes is not invariant. This suggests that changes could also be brought about with interventions. What we learn about mechanisms which produce varying outcomes could teach something important about the causes of disease more generally.

Another reason to conduct social determinants research is that while we may know fundamental social causes, it is not always obvious what intervention to carry out. She cited the example of cash transfers, too rapid economic growth, and the mixed effects of neighborhood level interventions to illustrate the difficulties of designing effective interventions related to social circumstances.

According to Diez Roux, the policy implications of knowledge about social position are difficult to decipher because the causes are very distal, i.e., have a long latency, are context dependent, and randomized trials are not feasible to carry out.

Opportunities for Additional Work

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Given the challenges she articulated

Diez Roux was able to point out the need for more research in several categories.

1. Etiologic research in the broad sense Here she called for better methods to improve causal inference using the observational data we have, integrating new types of data such as those from electronic health records, and more systems thinking and modeling.

2. Mechanistic understanding and creating more plausible causal pathways 3. Policy development and evaluation She called for looking at more policies with possible health consequences such as those related to transportation, and for broadening the tools used by taking advantage of natural experiments or engaging in more systems thinking. Importantly, she called for a tighter or more iterative connection between research and action and using evaluation of interventions as feedback to better inform the next wave of research.

4. Dissemination and translation In this arena, Diez Roux argued for giving more thought to how dissemination and implementation research can be applied not just to translation of clinical findings but to population level interventions as well.

She also called for novel uses of data to help change perceptions about the social drivers of health. At present, she speculated that most people when asked about the causes of health would answer genes, behavior, and - Social continues on page 8

Ebola Enters A Third Phase Of The Epidemic New Control Strategies Articulated To Reach “Resilient Zero” From an overwhelming 950 cases per week at the height of the epidemic, the Ebola outbreak in West Africa has now remained at 5 or fewer confirmed cases for more than 10 weeks. Two consecutive weeks in late September and early October registered no cases.

between seven one quarter were still positive for to nine months after their illness. In early October, a case from the United Kingdom in December 2014 who later recovered was hospitalized after developing late complications from Ebola.

World Health Organization officials are now noting that the epidemic has entered its third phase in which the few cases are geographically confined and can be epidemiologically-linked to known chains of transmission.

Challenges in Phase 3

A recent WHO report on this third phase asserts that the control strategies used to date ( rapid scale-up of treatment beds, safe and dignified burial teams, behavior change, casefinding, contact-tracing, and community engagement) have worked.

New phase objectives articulated by WHO call for 1) accurately defining and rapidly interrupting all remaining chains of transmission, and 2) identifying, managing, and responding to any consequences of the remaining Ebola risks. The goal is to reach and sustain a “resilient zero” Risks in Phase 3 The risks at this stage are for Ebola to re-emerge because some chains of transmission have been missed or for Ebola to be re-introduced from nature or from virus persistence in survivors.

For example, a recent report in the NEJM examined 93 survivors from Sierra Leone who provided a semen sample and virus genetic material

According to WHO, the implementation of phase 3 activities will be made difficult due to the following threats:

"...the few cases are geographically confined and can be epidemiologically -linked..."

1. Decreased partner support. It is possible donors will not sign up for these longer term activities as they did for the more pressing needs which occurred earlier in the outbreak.

2. Insufficient coordination to manage the risks of re-emergence.

Coordination responsibilities may be transitioning from the emergency command centers back to the Ministries of Health. Without the same command infrastructure, there are concerns that the needed coordination could suffer.

3. Loss of technical experts. There is fear that experienced national and international Ebola responders may see their job as complete and leave.

Also, new expertise for new areas of work may be needed for this phase.

"...there are concerns that the needed coordination could suffer."

4. Complacency. The outbreak has lasted at least 18 months. As cases decline or reach zero, other priorities - Ebola continues on page 9

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-Listeria continued from page 1 Shoe-Leather Findings

“...a really astute epidemiologist in Texas thought to ask about caramel apples..."

Shoe-leather interviews and investigations have sought to obtain retrospective food histories for the month before illness among affected persons. This sleuthing has found that most ill persons ate soft cheese before becoming ill. Furthermore, investigations found that 63% of the ill persons were of Middle Eastern or Eastern European descent or shopped at Middle Eastern style markets. Four of the 7 ill people who specified the brand of cheese consumed reported eating brands distributed by Karoun Dairies of San Fernando, California.

Epidemiologist Reactions

“...causes are usually found, not in prior events, but in the structure and policies of the system.“

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When questioned about the delayed investigation by Food Safety News, CDC epidemiologist Brendan Jackson said “We saw there was a Middle East connection back then, but there was just too little information…

Nothing was really standing out back then, so we stopped following that cluster at that point." Jackson added that after detecting the latest cluster and seeing that it was related to earlier findings, “Suddenly, we went from just a few cases…to upwards of 20…Once we had those numbers, it was fairly easy to see that there was a signal for soft cheese.” Follow up interviews with some of the more recent cases identified a couple of cases who were able to remember the brand of cheese they had eaten--Karoun Diaries. The types of cheeses this company distributes fit the pattern identified in the investigation .

Proven Value The utility of epidemiologic investigations of lab-identified cases was proven again recently when an epidemiologist was able to identify caramel apples as a source of a more recent Listeria outbreak earlier in 2015. Jackson told Food Safety News that a really astute epidemiologist in Texas thought to ask about caramel apples because it had been mentioned by another patient earlier. It led to the source of the outbreak.

“There is a perception among some people out there that whole-genome sequencing will make epidemiology obsolete. Investigation after investigation shows that’s just not the case. They have to be used together to be most effective,” Jackson said. ■ -Social continued from page 6 medical care and not single out or include social circumstances.

Closing Remarks She ended her presentation by calling for a broadening of conceptual approaches and tools used to study social position. She acknowledged the successes of reductionist approaches to the study of phenomena but said that these models identify single factors and are not the most helpful in studying phenomena with many feedback dependencies. She called for more systems approaches and for learning through action.

She closed with a favorite quote from Jay Wright Forrester a pioneer computer engineer and systems scientist at MIT who said about complex systems “causes are usually found, not in prior events, but in the structure and policies of the system.“■

Cumulative, Not Just Recent Exposures To Asbestos, Said To Play A Causal Role In Mesothelioma Collegium Ramazzini, a group of experts in environmental and occupational health from 35 countries, has issued a press release in October rebutting what it calls the “false concept that recent exposures to asbestos do not contribute to causation of mesothelioma.

Referencing the large number of cases of mesothelioma that have been brought to the attention of the Italian courts as possible occupational diseases, the Collegium Ramazzini concludes that risk of malignant mesothelioma is related to cumulative exposure to asbestos in which all exposures - early as well as late - contribute to the totality of risk.”

Public Health Implications The Collegium goes on in its statement to paint a clear picture of the public health implications of false claims about prolonged exposure to asbestos. According to the statement,

the Collegium “rejects as false, mendacious, and scientifically unfounded the claim put forth by the Italian asbestos industry and its expert witnesses that in cases of prolonged exposures to asbestos only the earliest periods of exposure contribute to mesothelioma induction, while all subsequent exposures have no causal role. The Collegium Ramazzini is deeply concerned that acceptance of this false claim will contribute to the unjust denial of workers' compensation and civil damages to affected workers, that it will hinder efforts to diagnose and prevent malignant mesothelioma, and that ultimately it will undermine the health of the public in Italy and in countries around the world.”

“...the Collegium “rejects as false, mendacious, and scientifically unfounded the claim put forth by the Italian asbestos industry..."

Readers who wish to view the entire statement can do so at: https://tinyurl.com/oa8849a ■

-Ebola continued from page 7

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emerge and there is a risk that complacency will prevent achievement of true zero incidence.

All of these challenges are on top of recovery efforts in the affected health systems where the health workforce must be strengthened and essential health services must be provided.

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“...there is a risk that complacency will prevent achievement of true zero incidence."

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What We’re Reading [Ed. Note: If it interested us it will interest you! That's the thinking of our epidemiologist mind in creating a new feature in this issue of the newsletter entitled "What We're Reading". The concept is to share with our readers some of the best articles we come across each month or give readers more opportunities to learn about topics we were not able to report on. We hope you will benefit from this new addition and send of some of your own "best articles" to share with readers. Send your suggestions and links to epimon@aol.com]

How To Debate Vaccine Skeptics - And Win "If you tell people that these are contagious diseases and that there are serious benefits to getting vaccines, you can get improvements in people with negative attitudes toward vaccines." https://tinyurl.com/phk8eun (From Vocativ.com)

Experts See Mass Killings as a Kind of Contagion The potential for cultural contagion, many experts say, demands a public health response, one focused as much on early detection and preventive measures as on politically charged campaigns for firearm restrictions. https://tinyurl.com/o763x8p (From NY Times)

A Breast Cancer Surgeon Who Keeps Challenging the Status Quo Dr. Esserman, 58, is one of the most vocal proponents of the idea that breast cancer screening brings with it overdiagnosis and overtreatment. https://tinyurl.com/nphssyf (From NY Times)

The Connection Between Cleaner Air and Longer Lives Numerous studies have found that the Clean Air Act has substantially improved air quality and averted tens of thousands of premature deaths from heart and respiratory disease. Here I offer new estimates of the gains in life expectancy due to the improvement in air quality since 1970. https://tinyurl.com/q2fm7xy (From NY Times)

Vanishing Canada: Why we're all losers in Ottawa's war on data A months long Maclean's investigation, which includes interviews with dozens of academics, scientists, statisticians, economists and librarians, has found that the federal government's "austerity" program, which resulted in staff cuts and library closures (16 libraries since 2012) - as well as arbitrary changes to policy, when it comes to data - has led to a systemic erosion of government records far deeper than most realize, with the data and data gather capability we do have severely compromised as a result. https://tinyurl.com/q2fawd7 (From Macleans.ca)

A New, Life-or-Death Approach to Funding Heart Research The result will be the financing of fewer, but deeper, studies, to focus resources on efforts with real world impact and life or death implications. https://tinyurl.com/ncuekpd (From NY Times)

Study Shows Spread of Cigarettes in China Chinese men now smoke one third of all the world's cigarettes, and a third of all young men in China are doomed to eventually die from the habit, scientists in China and Britain have concluded. https://tinyurl.com/nsts63k (From NY Times)

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Faculty Position in Epidemiology Wayne State University School of Medicine Wayne State University located in Detroit, Michigan is seeking to strengthen its Epidemiology Unit, which deals with the incidence, distribution, and possible control of diseases and other factors relating to health.

The Epidemiology Unit collaborates with Departments within the School of Medicine, and also with the Perinatology Research Branch of the Division of Intramural Research, NICHD, NIH, DHHS, which is housed at the Wayne State University campus.

As a key staff member in support of the PRB, this individual would help to accomplish the Branch’s mission by 1) developing statistical analysis, programming strategies and methodologies in support of research projects, 2) evaluating and analyzing data using accepted statistical and biostatistical techniques, 3) working closely with the scientific team and collaborators to provide operational parameters to ongoing research, 4) training the next generation of researchers, 5) translating the results of the research through publications and technology transfer.

The individual chosen for this position will become part of a highly successful, fast-paced research group that focuses on clinical and basic research in perinatal medicine and related disciplines. The goal of this internationally recognized research is to develop novel diagnostic, therapeutic and preventative strategies to reduce adverse pregnancy outcome, infant mortality and handicap. The research agenda involves novel discovery technologies in functional genomics, proteomics, metabolomics and DNA analysis.

To be considered for this position, it is recommended that candidates demonstrate the following: 1. Thorough knowledge of biostatical methodologies, procedures and testing 2. Expertise in issues pertaining to the conduction and analysis of longitudinal studies 3. Competence in the area of mathematical modeling 4. Knowledge of data coordination, collection and statistical analysis methods and research coordination principles 5. Knowledge of medical and research protocols 6. Knowledge of computer software design and multiple programming languages 7. Demonstrated broad knowledge of the understanding of scientific principles, theories and technologies applicable to biological sciences, in general, and perinatology in particular 8. A sound understanding of academic research and related issues together with extensive experience in complex, multi-disciplinary programs (administrative and scientific) 9. Ability to foster intellectual productivity 10. Strong oral and written communication skills 11. Ability to work independently and collaboratively 12. Basic knowledge of perinatology is desirable Academic and professional requirements: 1. Ph.D. in Epidemiology, Biostatistics, Statistics or related field 2. Minimum of five years of experience Interested individuals should send: a curriculum vitae, a separate statement summarizing their experience and professional contributions, and three references to:

Jennifer Turpin Wayne State University School of Medicine jturpin@med.wayne.edu

Epidemiology: Tenure-track or Tenured Faculty Positions in Epidemiology Vanderbilt Epidemiology Center at Vanderbilt University Medical Center is accepting applications for multiple faculty positions at Assistant, Associate or Full Professor rank. More than 60 epidemiologists at Vanderbilt conduct clinical and population-based studies, including three large cohort studies in the U.S. and abroad with survey data and biological samples from approximately 225,000 study participants. Areas of ongoing research include diet and nutrition, health behaviors, environmental exposures, reproductive epidemiology, genetic and other biomarkers for disease risk and progression, and racial disparities in health outcomes. The center is particularly interested in expanding its research and training programs in chronic disease epidemiology.

Successful candidates will have a doctorate in epidemiology or a related field with additional training or experience in epidemiologic research, with demonstrated ability to develop and sustain an independent research program in chronic disease epidemiology.

Vanderbilt fosters a rich environment of cross-disciplinary collaboration, providing exciting opportunities to work on cohort consortium projects and collaborate on ongoing research projects in epidemiology.

Vanderbilt University, is one of America’s premier private universities. Vanderbilt School of Medicine is ranked #14 (tied) on the US News and World Report 2016 list of top medical schools for research in the United States and in the Top 10 for NIH-funded research.

Vanderbilt University is an Equal Opportunity/Affirmative Action Employer.

Nashville, the state capital, is the largest metropolitan area in Tennessee, with temperate climate, low cost of living, affordable residential areas, vibrant cultural activities and abundant recreational opportunities.

To apply, email a cover letter, briefly describing research experience and interests, and curriculum vitae to kim.kreth@vanderbilt.edu.

Address the cover letter to: Dr. Wei Zheng, c/o Kim Kreth, Vanderbilt University Medical Center, 2525 West End Ave., 8th floor, Nashville TN 37203-1738.

Psychiatric Epidemiology Program Research Scientist I Investigator – Obesity Prevention at Kaiser Permanente Southern California

Interested candidates should submit their letter of interest, CV and references to: Dr. Steven J. Jacobsen (c/o Valerie.A.Papatsos@kp.org).

Please visit http://jobs.kp.org for job submission details, referencing job number 380315. Principals only.

Columbia University Psychiatric Epidemiology Training Program announces openings for pre- and postdoctoral fellows beginning September 2016. The program provides social scientists, epidemiologists, psychologists, and psychiatrists with research skills in psychiatric epidemiology. Training involves course work in substantive issues and research methods and participation in an affiliated research unit.

Postdoctoral stipends range from $42,840 to $56,376, depending on years of experience. Predoctoral stipends are $22,920.

Application deadline: December 01, 2015.

Contact PET Program Administrator Columbia University, School of Public Health 722 West 168th Street, Room 720-A New York, NY 10032 e-mail: bls85@cumc.columbia.edu

EEO/AA Employer.

Columbia University is an equal opportunity affirmative/action employer.

PRIMARY CARE AND DIABETES PRIMARY CARE RESEARCH FACULTY OHIO UNIVERSITY HERITAGE COLLEGE OF OSTEOPATHIC MEDICINE ATHENS, OHIO

Full, Associate or Assistant Professor of Primary Care or Diabetes Primary Care Research (Tenure-Track, full-time academic year) based in one of the departments of primary care (Family Medicine, Geriatrics, Osteopathic Manipulative Medicine, Pediatrics, and Social Medicine) depending on area of expertise Ohio University is located in Athens, OH, a historic college town with a modest cost of living in southeastern Ohio in the foothills of the Appalachian mountain range. It was founded in 1804, making it the oldest university in the Northwest Territory and ninth oldest public university in the United States. The Ohio University Heritage College of Osteopathic Medicine was founded in 1975, and our medical school educates physicians committed to practice in Ohio, emphasizes primary care, engages in focused research, and embraces both Appalachian and urban communities.

Ohio University is a university committed to excellence in teaching, research and public service, with a rapidly growing health sciences research community. Candidates will be based at the Ohio University Heritage College of Osteopathic Medicine Athens campus. The Heritage College has recently expanded within the state by developing extension campuses in Dublin and Cleveland and by partnering with prominent academic health organizations. During this time of unprecedented growth, based in part on a recent $105 million transformational gift from the Osteopathic Heritage Foundations and a significant increase in federal funding, the primary care departments, in collaboration with the Diabetes Institute (http://www.ohio.edu/diabetes), seek to recruit up to five tenure-track faculty members to expand their primary care, health outcomes and diabetes research programs.

Ideal candidates will have advanced training in behavioral health, nutrition, epidemiology, health communications, public health or analytics.

Applicants interested in maternal, infant, and child health; diabetes and obesity; population health and health policy, quality improvement in medical practices; practice-based research networks; and medical education research, as evidenced by peer-reviewed scholarly works, are encouraged to apply. We are targeting at least two hires to specifically focus on diabetes- and/or obesity-related research. If hired, applicants will have access to a growing research infrastructure and a multitude of collaborators within Ohio University.

Primary Care Research has strong institutional support with the goal of improving overall health of rural and urban underserved communities. The mission is to provide a collaborative environment where faculty, students, residents and community members can:  Work together in translating science into practice of medicine  Evaluate innovations to provide the best healthcare to patients  Understand how to better organize healthcare to meet patient and population needs  Engage patients, communities, and practices to improve overall health The primary responsibilities will be to maintain an externally-funded research program that complements a team-based approach to science and to participate in collaborative, multidisciplinary research projects in partnership with other units at Heritage College, Ohio University, and with our national and international partners. The successful candidates will also be expected to deliver lectures on selected topics and/or facilitate small groups and to demonstrate service to the profession, university, college or department.

Minimum Qualifications: Candidates are required to have completed a DO, MD, PhD, or EdD. Minimum qualifications include a track record of scholarship or evidence of a clear plan for developing independent and/or collaborative research funding. For physician investigator candidates, practice opportunities are available—board certification is required.

Preferred Qualifications: Postdoctoral training or mentored research training beyond terminal degree is preferred.

The salary for this appointment covers 9 months of effort spread over a 12-month period. Academic base salary may be supplemented with additional grant support as allowed by granting agency. Additionally, Ohio University offers an excellent benefits and start-up package.

For full consideration, please complete the online application at www.ohiouniversityjobs.com/postings/15427 and attach the following documents: Resume/CV, Cover Letter, a statement of Research Interests which includes a plan for obtaining extramural funding for the next five years, and contact information for three professional references. Review of applications will begin immediately and continue until the positions are filled. We anticipate the positions to begin as early as November 1, 2015. Please contact either of the Search Committee Co-Chairs, Darlene Berryman (berrymad@ohio.edu) or Kelly Nottingham (nottingk@ohio.edu) for further information regarding this announcement.

Positions will remain open until filled; for full consideration, please apply by November 1, 2015.

Ohio University is an equal opportunity employer and is committed to increasing the diversity of its faculty. We welcome nominations of and applications from women and members of minority groups as well as others who would bring additional dimensions to Heritage College’s research, teaching and clinical missions.

Administrative Manager The Rutgers University Biostatistics and Epidemiology Service (“RUBIES”) Center Administrative Manager is responsible for the overall management of The Center, including: managing and prioritizing epidemiological / statistical requests and administering the financial and business aspects of The Center. He/she will provide basic epidemiological/statistical services, including the design and/or analysis of both observational and experimental studies, to investigators throughout Rutgers University; assist the RUBIES Faculty Director with developing RUBIES processes and procedures, a website and a marketing plan; and implementing “Total Quality Management.” Requires travel between Rutgers campuses and flexible hours to meet deadlines. This position is geographically located within the School of Public Health in Piscataway, NJ. REQUIRED EDUCATION AND EXPERIENCE: • Master’s or Doctoral Degree in Statistics, Epidemiology or a related field from an accredited college or university • 6 years of experience working in an administrative position, such as program coordinator, with proven organizational skills • A track record of communicating in a complex environment • Evidence of productivity working as an analyst in a team environment • Experience with basic MS Office software • Experience with data analysis software including SAS, SPSS, R, etc.

Please apply online at: https://jobs.rutgers.edu/postings/13225 Rutgers, the State University of New Jersey, is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will be considered for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability status, genetic information, protected veteran status, military service or any other category protected by law. As an Institution, we value diversity of background and opinion, and prohibit discrimination or harassment on the basis of any legally protected class in the areas of hiring, recruitment, promotion, transfer, demotion, training, compensation, pay, fringe benefits, layoff, termination or any other terms and conditions of employment

Epidemiologists (Faculty Positions) The Department of Epidemiology at Rutgers School of Public Health invites applications for multiple open rank faculty positions. With a new Dean, Dr. Jasjit S. Ahluwalia, the School is undergoing a rapid expansion. The successful applicants will be expected to develop and sustain an extramurally funded research program, contribute to the teaching mission, and mentor MPH and doctoral students. The School is recruiting in the broad areas of global health, cancer, health disparities, environmental, social, infectious disease, maternal and child health, and nutritional epidemiology. Experience in molecular, biomarker, and/ or genetic methods are a plus.

Applicants will find a wide range of experts within the School of Public Health (sph.rutgers.edu) and Rutgers Biomedical and Health Sciences (RBHS; bhs.rutgers.edu).

The School of Public Health is located on the Rutgers University–New Brunswick and RBHS at Newark campuses, and is close to New York City and the beaches of the Atlantic Ocean. An attractive recruitment package will include a competitive salary and start-up funds. Successful applicants will have a doctoral degree (PhD or equivalent) and a demonstrated record of scholarship as appropriate to their faculty rank. Applications will be received and reviewed until the position is filled.

Please apply online at: http://jobs.rutgers.edu/postings/13952 Rutgers, the State University of New Jersey, is an Equal Opportunity/Affirmative Action Employer. Qualified applicants will be considered for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability status, genetic information, protected veteran status, military service or any other category protected by law. As an Institution, we value diversity of background and opinion, and prohibit discrimination or harassment on the basis of any legally protected class in the areas of hiring, recruitment, promotion, transfer, demotion, training, compensation, pay, fringe benefits, layoff, termination or any other terms and conditions of employment.

ASSOCIATE CHIEF OF RESEARCH Radiation Effects Research Foundation

The U.S. National Academies of Sciences, Engineering, and Medicine invites applications for its Associate Chief of Research position at the Radiation Effects Research Foundation (RERF) in Hiroshima, Japan. The successful candidate will work with RERF’s Chief of Research to provide scientific leadership of the Foundation’s research programs in clinical medicine, epidemiology, molecular biosciences, and statistics and will also participate directly in research collaborations with RERF scientists.

RERF is a bi-national foundation supported by the governments of Japan and the United States and is a global leader in the study of longterm effects of radiation exposure on human health and its interactions with genes, lifestyle, and environment. RERF investigates the health of Japanese atomic bomb survivors in three large cohort studies: Life Span Study, Adult Health Study, and a study of survivor offspring (F1 Study). The Academies have a long-standing cooperative agreement with the U.S. Department of Energy to recruit and employ U.S. scientists at RERF. Additional information about RERF and its research programs can be found on the RERF website (rerf.or.jp).

To qualify for this position you must be a U.S. citizen; possess an earned Ph.D., Sc.D., or M.D. degree in a relevant scientific discipline, preferably epidemiology; have a demonstrated record of scientific leadership and research productivity; and be willing to relocate to Japan.

The successful candidate will receive a joint Academies/RERF appointment for an initial period of two years with the potential for renewal.

Preference will be given to candidates who are interested in working at RERF for longer than two years.

Starting salary-140,000+ Status- Full Time Location- Hiroshima, Japan To apply directly to the following link online http://chk.tbe.taleo.net/chk02/ats/careers/requisition.jsp?org=NAS&cws=1&rid=8174 for this position. Submit a letter describing your interests and potential contributions and a current CV or contact Dr. Kevin Crowley, Director, Nuclear and Radiation Studies Board, The National Academies of Sciences, Engineering, and Medicine (kcrowley@nas.edu), or Dr. Robert Ullrich, Chief of Research, RERF (ullrich@rerf.or.jp). EOE, M/F/D/V

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