Issuu

Oregon County Epidemiologist Proves The Value Of Shoe-Leather Epidemiology In Combating Suicide

In This Issue

Wins 2018 Public Health Impact Award “Go out in the field! Do the hard, ugly fieldwork and you will find a data goldmine.” That’s the message elicited from Kimberly Repp, Washington county Oregon epidemiologist and winner of the 2018 Public Health Impact Award from the National Association of Medical Examiners. Repp competed for the prize with a manuscript and oral presentation at the annual National Association of Medical Examiners conference describing her work to reduce the

approximately 100 annual suicide deaths in Washington county. Her manuscript is entitled “Evaluation of a novel medico-legal death investigator based suicide surveillance system.” Start Up Her decision to tackle the suicide problem followed from the results of a community health needs assessment - Oregon cont'd on page 2

-3New Physical Activity Guidelines

-5Public Health Concerns & Priorities

-8Epi News Briefs

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Cause Of Limb Paralysis Outbreak In Young Children Still A Mystery CDC released its latest report on the 2018 outbreak of Acute Flaccid Myelitis (AFM) in mid-November in the Morbidity and Mortality Weekly Report describing 80 confirmed cases so far this year. This number represents a threefold increase over the 33 confirmed cases in 2017, but a number below the cases reported in 2014 and 2016.

outbreaks every two years since 2014 between August and October: Year 2014 2015 2016 2017 2018

*(An updated report not included in the MMWR article reveals 116 cases from 31 states as of late November.)

The US has experienced AFM November 2018

Cases 120 22 149 33 80*

- Paralysis cont'd on page 7 •

Volume Thirty Nine •

Number Eleven

-9Notes on People

-11Near Term Epidemiology Event Calendar

-12Marketplace

-Oregon 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.

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which identified suicide prevention as a priority need. Oregon was one of the first states to participate in the National Violent Death Reporting System (NVDRS) which collected data on five risk factors for suicide. However, the data were 3-4 years old when released and it was difficult to get county level data. “I wasn’t comfortable guiding local prevention efforts using 4 year old state data,” Repp told the Monitor. Unique Situation A relatively unique feature of the medical examiner death investigators in Washington County is that they are housed in the Public Health unit rather than with the district attorney or law enforcement agencies. This made it easier for Repp to interact with investigators in her agency, earn their respect and trust, and arrange to collect additional data on each possible suicide. She accompanied the county’s deputy medical examiners to collect new data on more than 200 investigations over a two year period. Payoff A feature of the data collection instrument she devised was a blank section where investigators could note any additional information of possible interest. In analyzing the information, investigators noticed that a number of cases were dropping off their pets at the animal shelter in the days before the suicide. This was weird, said Repp, because the pets were healthy and not abused or unloved. She called such an event a “touchpoint” where interventions might be introduced to help prevent some of the suicides.

Interventions Her group trained veterinarians and animal shelter staff and volunteers to recognize these situations as missed opportunities for prevention and encouraged them to ask clients if they were thinking of hurting themselves. Over a six-month period, 7 persons answered yes when asked by shelter staff if they were thinking about hurting themselves, and were put in contact with the local suicide crisis line. More Touchpoints Other actionable touchpoints uncovered with the new surveillance data include the finding that 40% of the suicide victims had been in a health care provider’s office in the two weeks prior to death, that evictions had taken place for 20% of cases, and that several suicides occurred at a specific budget motel. Repp and her group used these findings to work with the sheriff’s office responsible for implementing evictions to put potential cases in touch with the suicide crisis line and ensuring a trained mental health professional was present when eviction notices were served. Also, they trained staff at the motel in Question, Persuade, Refer (QPR) prevention technique. Armed with the new information, individual entities which have been identified as touchpoints are making their own changes to help potential victims. Impact The overall suicide rate in Washington county has declined but Repp told the Monitor it is too early to attribute any changes to the interventions they have implemented. Her plans call for collecting data from specific sites so that the effectiveness of interventions before - Oregon cont'd on page 6

New Guidelines Call For Regular Physical Activity That’s Easier To Carry Out So Many Benefits It Appears To Be A “Cure All” Over 30 years ago epidemiologist Jerry Morris said physical activity is “the best buy in public health”. According to the latest guidelines from the US Department of Health and Human Services published in the Journal of the American Medical Association, that judgment is still valid today because “being physically active is one of the best investments individuals and communities can make in their health and welfare.” Consequences In the US, failure to perform adequate physical activity is posing a heavy burden costing hundreds of thousands of lives and is estimated to add $117 billion in annual health care costs. There are multiple reasons for concern. About 10% of premature mortality is associated with inadequate physical activity not meeting the existing aerobic physical activity guideline. In 2016, only 26% of men, 19% of women, and 20% of adolescents report performing sufficient activity. According to the new guidelines, there are moderate and vigorous levels of activity and healthy adults should exercise at a moderate level of intensity for 150-300 minutes per week or at a vigorous level for 75-150 minutes. Additionally, muscle strengthening exercises should be done on 2 or more days per week. Older adults should include balance training as well as aerobic and muscle strengthening work. The recommendations vary for other groups in the population such as children and pregnant women. In all

cases, moving more and sitting less will bring benefit. Ease of Exercise To help stimulate increases physical activity, the new guidelines emphasize the ease of doing more exercise and the long list of documented benefits. For example, it is not necessary to exercise in bouts of at least 10 minutes. That restriction has been lifted. There is no threshold. A single episode of moderate to vigorous activity can improve sleep, reduce anxiety symptoms, improve cognition, reduce blood pressure, and improve insulin sensitivity on the day of exercise. Also, it is possible to perform all of the activities on 1 or 2 days per week since the benefits are the same as for people who exercise 3-4 days per week. Another misconception clarified in the guidelines is that people do not need to get into shape to benefit from exercise. More exercise does increase positive effects over time.

“...being physically active is one of the best investments individuals and communities can make in their health and welfare.”

Cure All Benefits In an accompanying JAMA editorial, investigators note it is difficult not to convey the benefits of exercise as a “cure all”. They include more than two dozen positive benefits which far outweigh the risks of injury. And exercise can even reduce the risk of injury over time. Overall, the editorial notes that individuals who meet the new recommendations could lower their risk of premature death by 33% compared to those who are not physically active. - Activity cont'd on page 4

"... individuals who meet the new recommendations could lower their risk of premature death by 33%..."

-Activity cont'd from page 3 Children and Adolescent Benefits ♦ Improved bone health (ages 3 through 17 years) ♦ Improved weight status (ages 3 through 17 years)

♦ Prevention of weight regain after initial weight loss ♦ Improved bone health

♦ Improved cardiometabolic health (ages 6 through 17 years)

♦ Lower risk of falls (older adults)

♦ Reduced risk of depression (ages 6 to 13 years)

♦ Improved physical function

♦ Lower risk of fall-related injuries (older adults) To access the full text of the physical activity guidelines, visit: https://bit.ly/2z8RLKi ■

♦ Lower risk of all-cause mortality ♦ Lower risk of cardiovascular disease mortality ♦ Lower risk of cardiovascular disease (including heart disease and stroke) ♦ Lower risk of hypertension ♦ Lower risk of type 2 diabetes ♦ Lower risk of adverse blood lipid profile ♦ Lower risk of cancers of the bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach ♦ Improved cognition ♦ Reduced risk of dementia (including Alzheimer disease) ♦ Improved quality of life ♦ Reduced anxiety ♦ Reduced risk of depression

♦ Weight loss, particularly when combined with reduced calorie intake

♦ Improved cardiorespiratory and muscular fitness (ages 6 through 17 years)

♦ Improved cognition (ages 6 to 13 years)

"...people don’t care what you know until they know you care."

♦ Slowed or reduced weight gain

♦ Improved sleep

Quotable Quote The US Surgeon General Jerome Adams speaking in Wisconsin giving a frank talk about what works and doesn’t work in public health. “And by going to that community and showing that we cared about them, suddenly they cared about what we knew…We were able to get them to be advocates and institute a syringe service program and, I’m proud to say halt the spread of HIV in that community.” [Ed. His comments reminded us of the saying—“people don’t care what you know until they know you care.”]

Public Health Concerns And Priorities Reflected In Latest Policy Statements From The American Public Health Association The Governing Council of the American Public Health Association adopted 12 new policy statements at its recent 2018 Annual Meeting and Expo in San Diego. These statements provide a window on the current thinking of public health professionals about public health priorities in the US and beyond. Edited excerpts from APHA’s short descriptions of these priorities are presented below along with the reason(s) cited for selecting these issues as priorities for policy statements in 2018. Several recommendations are made in the policy statements that could help to address these problems. To read the recommendations, visit: https://bit.ly/2zn6SzU

Reducing gun-related suicides — Because U.S. suicide rates increased by nearly one-third over the last 20 years and guns are involved in more than half of U.S. suicide deaths. Understanding, treating violence as a public health issue — Because national data show an increase in violent deaths, such as gun-related homicides and suicides, as well as longterm health effects from childhood exposures to violence. Regulating electronic nicotine delivery products — Because the use of electronic nicotine delivery systems is increasing among all U.S. demographic groups and little is known about their long-term safety or efficacy in helping people quit cigarettes.

Reduce global child mortality rates — Because one child younger than 5 worldwide dies of diarrhea every minute and oral rehydration salts and zinc treatment can prevent many such deaths.

Preventing tuberculosis among health workers — Because tuberculosis is causing nearly 2 million deaths worldwide in 2016 and health care workers are at higher risk of infection than the general population.

Address potential health impacts of fracking — Because unconventional oil and gas extraction — often known as fracking — poses a range of known and unknown risks to public health and the environment, including risks to drinking water, air quality and worker health.

Advancing the health of refugees — Because global instability is contributing to historic levels of displaced people and refugees face significant health challenges.

Ensure a healthy energy future — Because communities are moving toward to non-fossil fuel and alternative energy sources

Achieving health equity in the U.S. — Because research documents clear disparities in morbidity and mortality, particularly among racial and ethnic minority groups.

- APHA cont'd on page 6

“These statements provide a window on the current thinking of public health professionals about public health priorities in the US and beyond. "

"research documents clear disparities in morbidity and mortality, particularly among racial and ethnic minority groups."

-APHA cont'd from page 5 Supporting global food security — Because hunger is still a daily challenge for more than 815 million people worldwide.

“Two regular people talking— that was what saved a life.”

Addressing police violence as a public health issue — Because law enforcement violence — including death, injury, trauma and stress — often disproportionately affects marginalized populations. Opposing family-child separations at the U.S. border — Because the separation of immigrant children and families at the U.S.Mexico border is a public health crisis with the potential for long-lasting negative health impacts. ■ -Oregon cont'd from page 2 and after the new efforts will be ascertainable. Challenges

"...people who are at risk for suicide will answer questions truthfully."

Repp told the Monitor that convincing public health professionals to undertake some of the interventions has been relatively easy while convincing death investigators to do so has been more challenging. However, winning the award from the Medical Examiners Association has been useful and “it is exciting to see buy-in at the national level from that group”. Reactions Asked about her reactions to participating in over 200 death investigations, Repp told the Monitor that on the professional side there are real parallels between how epidemiologists go about investigating the possible causes of an outbreak and

how medical examiners investigate and rule out different potential causes of death. On the personal side, she said one cannot prepare for how you are going to deal with being present at a death scene. She had to undergo a 4 hour psychological evaluation before being allowed to shadow the investigators. She told the Monitor that the only correct answer that is acceptable to the question of how are you going to deal with a violent death scene is “I don’t know.” She had to get over her fear of what she would do in that situation. She has been very impressed by the cultural competencies exhibited by the medical examiners as they have to respect a very wide and rich range of death rituals carried out by different ethnic and cultural groups in her county. Closing Comments As Repp told her local newspaper, people who are at risk for suicide will answer questions truthfully. “The take-home from this is that anyone can save a life. You just have to have the courage to ask the question—Are you thinking about hurting yourself? You do not have to be a doctor or a psychologist. Anybody can ask and then get that person on the phone with a crisis line. All this research has shown that at the end, what saved a life was the person at the animal shelter asking a question. Two regular people talking—that was what saved a life.” Repp closed her interview with the Epi Monitor by noting that “The biggest touchpoint is the health care provider where prevention opportunities are being handed out on a silver platter.” ■

-Paralysis cont'd from page 1 Beginnings The following report was compiled from the MMWR article as well as other documents made available by CDC, including a transcript of a telebriefing given by Nancy Messonnier, Director of the National Center for Immunizations and Respiratory Diseases. The 120 cases in 2014 were reported in conjunction with a national outbreak of severe respiratory illness caused by enterovirus-D68. Since enteroviruses are known to cause paralysis, this virus has been a prime suspect. However, viral isolates from cerebrospinal fluid which can be considered etiologic have been limited since only 4 viral isolates have been made from the 404 confirmed cases since 2014. These were coxsackievirus A16, enterovirus A71, and enterovirus D68. Findings Since 2014, more than 90% of the cases have had a mild respiratory illness or fever consistent with a viral infection before they developed AFM. About half of the cases with respiratory or stool specimens tested in 2018 were positive for enterovirus or rhinovirus. However, the significance of the positive findings in respiratory specimens is unclear. Because many viruses circulate at the same time of the year, the viruses found will be temporally even if not causally associated with AFM. While the evidence to date suggests a viral association, as noted by CDC, â€œthe absence of a pathogen in most AFM cases means we havenâ€™t found the definitive cause yet.â€?

Why No Pathogen And the reasons for failing to find a pathogen may be because the virus has been eliminated by the time the specimens are taken at or near onset of paralysis, or the pathogen is difficult to detect, or testing for the right pathogen is not being carried out. All the stool specimens since 2014 have tested negative for poliovirus. Broader Thinking Also, the cases in 2018 have not been associated with an increase in EVD-68 or EVA-71 so CDC is broadening its thinking to consider not only specific viral etiologies but also to investigate what is triggering AFM in a small number of infected persons. It could be that one of the viruses detected so far or another yet to be found is triggering an autoimmune process. In that case, the implicated virus would be an indirect rather than a direct cause of AFM.

"Since enteroviruses are known to cause paralysis, this virus has been a prime suspect."

Hypotheses Given the wide distribution of AFM cases in multiple states, a toxic cause of AFM is not considered likely but has not been ruled out, according to Messonnier. Vaccines have been mentioned on social media as a possible cause and are going to be investigated but they have not been implicated and CDC continues to recommend that all children receive their vaccinations.

"Vaccines have been mentioned on social media as a possible cause and are going to be investigated but they have not been implicated..."

Risk AFM is considered a rare condition with CDC estimating that less than 1-2 in a million children will get AFM - Paralysis cont'd on page 8

Epi News Briefs Fine Particle Air Pollution Called A Public Health Emergency In Plain Sight

•

"...ambient air pollution...the largest environmental health problem..."

Two Boston area academics Tufts University’s Douglas Brugge and Boston University’s Kevin James Lane are sounding the alarm about the health consequences of ambient air pollution by calling it the largest environmental health problem worldwide causing over 4 million deaths. Not only that, fine particulate matter smaller than 2.5 millionths of a meter (PM 2.5) causes more deaths and illnesses than all other environmental exposures combined. Most of the deaths caused by PM2.5 are caused by heart attacks and strokes. A recent WHO conference on air pollution and health adopted a goal to reduce global deaths from air pollution by twothirds by 2030. To read more of the Brugge and Lane statement, visit: https://bit.ly/2TFSBXI

Survey Finds Biostatisticians Frequently Asked To Perform Inappropriate Analysis and Reporting "...inappropriate requests for assistance...are not infrequent."

A random sample of biostatisticians sent a survey questionnaire about inappropriate requests for assistance has found that such requests are not infrequent. Almost 400 biostatisticians surveyed state that the 4 most frequently reported inappropriate requests (rated as “most severe” by at least 20% of the respondents) were, in order of frequency, • removing or altering some data records to better support the research hypothesis; • interpreting the statistical findings on the basis of expectation, not actual results;

not reporting the presence of key missing data that might bias the results; and ignoring violations of assumptions that would change results from positive to negative.

These requests were reported most often by younger biostatisticians. https://bit.ly/2y9R7vL ■ -Paralysis cont'd from page 7 every year. Since virus circulation is common during the months of the outbreaks and many children are presumably being infected, what is most mysterious is why some children are developing AFM while others presumably infected are not. In short, there is intense focus on what this missing trigger might be. Descriptive Epidemiology from MMWR 11/16/18 • Most cases are in children with a median age of 4 years but ranging from 7 months to 32 years. • All confirmed cases have been hospitalized but no deaths reported • Cases have been reported from 25 states. • Males accounted for 59% of cases. • Whites accounted for 86% of cases with available race information. • Most cases (47.5%) had only upper limb involvement but 28.8% had both upper and lower limbs affected. At least half of the cases don’t recover.■

Notes on People Awardee: Donald Burke, Dean of the University of Pittsburgh Graduate School of Public Health, as recipient of the John Snow Award from the American Public Health Association at its annual meeting in San Diego. The award is given in recognition of enduring contributions to public health through epidemiologic methods and practice.

Named: Steffanie Strathdee, Associate Dean of Global Health Sciences at the University of California San Diego, as one of Time magazineâ€™s 50 most influential people in health care for 2018. The honor identifies people who have changed the state of health care in America this year and bear watching for what they do next. In 2015, Strathdee, an infectious disease epidemiologist, urged doctors at UC San Diego to use phage therapy as a last resort to save her husband who was dying from a multidrug resistant bacterial infection. Since then, five patients at UC San Diego Health have been treated with phages, including a patient this year with a years-long chronic infection that was successfully cleared, allowing him to undergo life-saving heart transplant surgery. Died: Margaret Becklake, on Octorber 17 at age 96 in Montreal. Her obituary notes she grew up in South Africa, studied medicine in Johannesburg and after postgraduate training in London, worked at the University of the Witwatersrand and the Miners Silicosis Bureau where she studied the effects of dust inhalation on workers in the gold mines. In 1957 she immigrated with her family to Montreal and worked at McGill University in the Departments of Medicine and Epidemiology, the Montreal Chest Hospital and the Royal Victoria Hospital. Her widely published research brought her international recognition.

Died: Naomi Breslau, on October 23, 2018 in Pittsboro, North Carolina age 86. She was emeritus professor of epidemiology and biostatistics at Michigan State University. She was one of the first scientists to study how the experiences of everyday life can cause serious psychiatric syndromes like PTSD.

Awardee: Aaron Blair, National Cancer Institute, as recipient of the Wade Hampton Frost Lectureship Award from APHA. It recognizes a person who has made a significant contribution to addressing a public health issue of major importance by applying epidemiologic methods.

Notes on People, continued from page 9 Died: Wendy Atkin, on October 2, 2018, at age 71. She was an emeritus Professor of Gastroenterology at Imperial College London. Colleagues describe her as exceptional scientist who made remarkable and lasting contributions to the field of cancer screening and prevention. She led the UK Flexible Sigmoidoscopy Trial (UKFSST), a large randomised controlled trial of 170,000 men and women that would ultimately and unequivocally demonstrate the benefit of flexible sigmoidoscopy on colorectal cancer prevention. Awardee: Marianne Passannante, Professor of Epidemiology and Associate Dean for Educational Program Development at the Rutgers School of Public Health, as recipient of the Abraham Lilienfeld award from the American Public Health Association which recognizes excellence in teaching. In receiving her award, Dr Passannante said, “As anyone who knows me knows, aside from my family, teaching is my first love…What I love most about teaching is to see the excitement in my students as they learn a new concept that they can apply in their work…It’s really wonderful to receive an award for something that you love to do every day.”

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

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

December 2018 December 20-21 https://tinyurl.com/y9x6gtnk ICTID 2018 - International Conference on Tropical Infectious Diseases / World Academy of Science, Engineering and Technology (WASET) / Bangkok, Thailand

January 2019 January 7-18 https://bit.ly/2JIaIaT Winter Program / Johns Hopkins - Bloomberg School of Public Health / Baltimore, MD January 7-25 https://bit.ly/2PFhJyt Short Course / Research in Action - Qualitative Approach / University College / London, England January 9-11 https://bit.ly/2D3A8hU Short Course / Epidemiology for Clinicians / Univ. of Southampton / Southampton, England January 9-23 https://bit.ly/2JKo72k EpiM Winter Program 2019 / VU Medical Center - Dept of Epidemiology / Amsterdam & Soesterberg, The Netherlands January 15-17 https://bit.ly/2SLvDhj APHL 2019 - PulseNet - OutbreakNet / Joint Conference / Multiple Sponsors / Tampa, FL January 16-18 https://bit.ly/2zz8sxU 2nd ISIRV Epidemiology Group Conference / European Virus Bioinformatics Center / Solna, Sweden January 21-26 https://bit.ly/2QFwYp2 Swiss Epidemiology Winter School / Institute of Social & Preventive Medicine - Bern / Wengen, Switzerland January 21-25 https://bit.ly/2zz5EAS Winter School in Clinical Epidemiology / UMIT / Tirol, Austria Jan 28 - Feb 15 https://bit.ly/2JId5dN Short Course: Climate Change & Health / University College London / London, England Jan 29 - Feb 1 https://bit.ly/2RDiHsK 2019 Annual Conference / International Society for Disease Surveillance / San Diego, CA Jan 30 - Feb 1 https://bit.ly/2DnMCBW Short Course: Analysis of Repeated Measures / University of Bristol / Bristol, England

List Your 2019 Epidemiology Event We are currently assembling our 2019 calendar issue. Don't be left off the list.Send us the details of your event: Linda Bernier linda@epimonitor.net 770.670.1946 http://epimonitor.net/Post-an-Event.htm

The University of Alabama at Birmingham

OPEN RANK FACULTY - Department of Epidemiology The University of Alabama at Birmingham (UAB), Department of Epidemiology in the School of Public Health is inviting applications from outstanding candidates for three full-time tenure-track faculty positions at the rank of Assistant Professor, Associate Professor, or Professor (12-month appointments with rank and tenure status commensurate with qualifications). Eligible candidates must have a PhD, MD, or equivalent doctoral degree with graduate-level training in epidemiology or a closely related field. Preferred qualifications include a record of peer-reviewed publications, experience in teaching graduate or undergraduate level epidemiology courses and demonstrated ability to work effectively in an interdisciplinary, collaborative academic setting. For the rank of Associate Professor or Professor, applicants should have evidence of securing extramural funding to support an independent research program. We are seeking applicants who have or can develop research programs in the substantive areas of infectious diseases (particularly HIV/AIDS), cancer, social determinants of health or climate change and population health. Applicants with an interest in global health are also welcome. Applicants with research programs that will enhance and build on the departmental strengths in cardiovascular diseases, genomics, and health disparities will also be considered. UAB pursues the frontiers of education, research, and health care and strives to be one of the most dynamic and productive universities of the 21st century. UAB ranked 15th in NIH research funding among public universities in fiscal year 2016 and has transformed the Birmingham metropolitan area into a nexus of research, medicine, business, and development. The successful applicant will have the opportunity to foster research collaborations across campus and leverage resources available through our University-Wide Interdisciplinary Research Centers (https://bit.ly/2PTsWfV) and core facilities (https://bit.ly/2TKsnU0) Birmingham has thriving outdoors, arts and cultural scenes (http://birminghamal.org/) and is one of the best places to live, work and play. Our restaurant scene is truly world-class, featuring national award winning restaurants and chefs. To apply, please submit: 1) a curriculum vitae, and 2) a cover letter describing your interest in the position online at http://uab.peopleadmin.com/postings/4397. Applications will be reviewed immediately and will continue until the positions are filled. UAB is an Equal Opportunity/Affirmative Action Employer committed to fostering a diverse, equitable and family-friendly environment in which all faculty and staff can excel and achieve work/life balance irrespective of race, national origin, age, genetic or family medical history, gender, faith, gender identity and expression as well as sexual orientation. UAB also encourages applications from individuals with disabilities and veterans. A pre-employment background investigation is performed on candidates selected for employment.

Faculty Position in Pharmacoepidemiology Department of Epidemiology The Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health invites applications for a tenure-track position as Assistant or Associate Professor with expertise in pharmacoepidemiology, including drug utilization, safety or comparative effectiveness research. Academic rank will be commensurate with experience. The successful candidate will contribute to the Departmentâ€™s expansion of research and educational initiatives in pharmacoepidemiology. The candidate will serve as core faculty in the Johns Hopkins Center for Drug Safety and Effectiveness which provides a nexus for individuals within the Schools of Medicine and Public Health who are committed to research, education, clinical programs and public service to improve prescription drug use and pharmaceutical policy in the United States and around the world. The candidate will be expected to develop an independent research agenda and establish collaboration with departmental faculty as well as social scientists and clinicians in an interdisciplinary setting. Applicants should hold a doctoral degree in epidemiology, a related scientific discipline, or a clinical degree with graduate training in epidemiology or biostatistics. Applicants should also have demonstrated original scholarship in clinical, population or methodological research with an emphasis in pharmacoepidemiology, possess excellent written and communication skills as evidenced by peer-reviewed publications, teaching, and/or presentations at professional meetings, and demonstrate the potential to establish and maintain external research funding. The Department of Epidemiology is one of the oldest and largest in the world, with over 170 doctoral and masterâ€™s students and a diverse research program directed by more than 100+ full-time faculty members. The Johns Hopkins Center for Drug Safety and Effectiveness was established in 2012 with a commitment to collaborative, transdisciplinary research with more than 30 affiliated faculty with a range of disciplinary expertise.

Interested applicants should send their curriculum vitae, research statement and the names of three references by March 31, 2019 to: apply.interfolio.com/57535

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.

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November 2018 - The Epidemiology Monitor