VOLUME 2 • ISSUE 6 DECEMBER 2011

NEWS FROM THE DEPARTMENT OF EPIDEMIOLOGY MAILMAN SCHOOL OF PUBLIC HEALTH COLUMBIA UNIVERSITY 3 PUBLICATION HIGHLIGHTS 6 IN THE NEWS 7 BRIEF MENTIONS 8 AWARDS & GRANTS 9 PROFILES 12 MASTER’S PRACTICUM DAY Carotenoid 13 JOURNAL CLUB 14 PARTNER PROFILES supplements 18 PIONEERS AMONG US 21 FACULTY ARTICLE tied to increase BIBLIOGRAPHY in breast cancer deaths

While the benefits of vitamin supplement use for breast cancer patients are unclear, some supplements may actually be harmful, according to a new study published in Cancer by lead author Dr. Heather Greenlee, Assistant Professor of Epidemiology and Medical Oncology (in Medicine), and colleagues. The researchers analyzed data from the Life After Cancer Epidemiology (LACE) prospective cohort study of 2,300 women with early-stage breast cancer, finding that those who regularly took either vitamins C or E supplements had a lower risk of cancer recurrence over five years compared to those who didn’t take them. However, women who regularly con- sumed a mix of carotenoids like vitamin A, beta-carotene, and lutein, were at greater risk of dying from breast cancer, and at risk of dying from any cause, when compared radiation can interfere with treatments. This could occur because with those who didn’t take them. the supplements may protect tumor cells from the “pro-oxidant” Moreover, much of the benefit associated effects of cancer treatments. However, antioxidants cannot be with vitamins C and E could be explained assumed to uniformly act in a similar function, since they have by “healthy user bias,” which means that different physiological functions in the body, Dr. Greenlee stresses. women who use dietary supplements Although the study could not prove that carotenoids are harmful generally have healthier lifestyles, to cancer patients, the results heighten concern about carotenoids’ according to Dr. Greenlee. Healthy user health effects, following on previous randomized controlled trials bias did not explain the findings found with that found beta-carotene to increase mixed carotenoids. the risk of lung cancer among smokers. “Our paper adds to the growing body of literature suggesting that dietary supple- “Dietary supplements Greenlee H, Kwan ML, Kushi LH, Song J, Castillo A, ments containing high doses of carotenoids Weltzien E, Quesenberry CP Jr, Caan BJ. Antioxidant may be harmful, and people should think containing high doses supplement use after breast cancer diagnosis and twice before taking them,” Dr. Greenlee mortality in the Life After Cancer Epidemiology (LACE) cohort. Cancer. 2011 Sep 27. [Epub ahead of print] says. “Dietary supplement use is high of carotenoids may be among cancer patients and they need spe- cific guidance on what is safe and effective.” harmful, and people Concerns have been raised that taking supplements with antioxidant properties, should think twice like carotenoids, vitamin E, vitamin C, selenium and zinc, during chemotherapy or before taking them.”

1 MESSAGE FROM THE CHAIR

Dear colleagues,

Welcome to the December 2011 issue of Two by Two, the Epidemiology Department newsletter. Dr. Inge Goldstein, Special Lecturer in Epidemiology, is featured in this issue as a Pioneer Among Us for her groundbreaking early studies on air pollution and health. Our December faculty profile endeavors to capture the spirit of the prolific Dr. Lloyd Sederer, Adjunct Professor of Epidemiology and Medical Director of the New York State Office of Mental Health. And as always, we highlight the accomplishments of our faculty, staff, and students over the last two months. This issue also launches a new regular feature, Partner Profiles, in which we provide a closer look at the outstanding centers and institutes with which our faculty collaborate. These partner- ships are essential to the cutting-edge interdisciplinary research and training conducted in Epidemiology, and our first Partner Profile, the Centre for the AIDS Programme of Research in South Africa (CAPRISA) is a superb exemplar. As we move toward the close of 2011, we are also beginning to reflect on the past year and to look ahead. We have a wealth of accomplishments to look back upon and exciting plans underway for the coming year. Many of these have been featured in the pages of Two by Two over the course of 2011. We will provide a comprehensive summary in our Department annual report, which will be published in January 2012. I would like to take this opportunity to say thank you once again to the faculty, students, and staff who have made Two by Two possible over the past 12 months. As always, we welcome comments and ideas for future issues of Two by Two. SUBMIT TO TWO BY TWO Wishing everyone a joyful and safe holiday season,

If you have a study, news story, award, or other milestone you’d like to share in Two by Two, please email Elaine Meyer at [email protected] with your submission. CLUSTER SEMINARS DECEMBER — JANUARY

SOCIAL EPIDEMIOLOGY FRIDAY, DECEMBER 16 10:00-11:30 AM UPCOMING DECEMBER — JANUARY PSYCH / NEURO EPIDEMIOLOGY THURSDAY, DECEMBER 1 12:30-2:00 PM THURSDAY, JANUARY 26 12:30-2:00 PM friday, december 2 staff meeting: pizza friday LIFECOURSE EPIDEMIOLOGY Wednesday, DECEMBER 7 CUEGR: Paolo vineis, md, mph, ffph TUESDAY, DECEMBER 13 1:00-2:30 PM Wednesday, DECEMBER 7 master’s students journal club TUESDAY, JANUARY 17 1:00-2:30 PM thursday, december 15 epi social: holiday party friday, december 16 faculty meeting EPIDEMIOLOGY INNOVATION wednesday, december 21 special lecture: Sarinnapha Vasunilashorn, phd WEDNESDAY, DECEMBER 21 8:30-10:00 AM wednesday, january 5 special lecture: theresa osypuk, sd, sm CHRONIC DISEASE EPIDEMIOLOGY monday, january 17 special lecture: dana march, phd FRIDAY, DECEMBER 9 12:00-1:00 PM friday, january 20 faculty meeting INFECTIOUS DISEASE monday, january 23 special lecture: siliva martins, md, phd EPIDEMIOLOGY wednesday, january 25 cuegr: deborah winn, phd FRIDAY, DECEMBER 9 3:00-4:30 PM FRIDAY, JANUARY 27 3:00-4:30 PM

DECEMBER 2011 2 PUBLICATION HIGHLIGHTS

Cancer treatment responsiveness varies by genetic mutation

Dr. Victor Grann co-authored an editorial in JAMA about the association between genetics and treatment outcomes for those with breast and ovarian cancer. Dr. Grann, Clinical Professor of Medicine, Epidemiology, and Health Policy and Management, commented on an accompanying study by researchers at the University of Texas who investigated women’s responsiveness to chemotherapy related to mutations in one of the 2 genes associated with breast cancer. Women with mutations in either the BRCA1 or BRCA2 gene have an elevated lifetime risk of developing breast or ovarian cancer. However, the Texas study found that women with BRCA2 mutations have an improved chance of survival compared to women with BRCA1 mutations or without mutations in either gene. This discrepancy “should encourage attention to the differences in treatment between the 2 groups, particularly among women with ovarian cancer,” says the editorial. “Further refinement in the understanding of the differ- ences in the DNA repair deficits due to BRCA1 versus BRCA2 mutations could lead to therapy that is better targeted.”

Grann VR, Parsons RE. Defining variations in survival of BRCA1 and BRCA2 mutation carriers. JAMA. 2011; 306(14): 1597-8.

Prenatal use of folic acid supplements may reduce risk of severe language delay in children

A large pregnancy cohort study in Norway has found that maternal use of folic acid supplements during the period around conception could reduce the risk for severe language delay in offspring at age 3. Published in JAMA by senior author Dr. Ezra Susser, Professor of Epidemiology and Psychiatry, and lead author Ms. Christine Roth, a visiting researcher, the study adds to what is known about the use of folic acid supplements, which are commonly recommended for pregnancy. The researchers found that the risk for devel- oping severe language delay among 3-year-olds was reduced twofold among women who took folic acid supplements during the period four weeks before conception and eight weeks after. The study was carried out from 1999-2008 and had a cohort of 38,954 children. Significantly, it is the first to look into the relation between folic acid and language development in infants. The researchers will follow up again with the children at age 5.

Roth C, Magnus P, Schjølberg S, Stoltenberg C, Surén P, McKeague IW, Davey Smith G, Reichborn- Kjennerud T, Susser E. Folic acid supplements in pregnancy and severe language delay in children. JAMA. 2011; 306(14): 1566-73.

DECEMBER 2011 TOP PHOTO: ANNIE CAVANAGH, WELLCOME IMAGES 3 New evidence sheds light on timing co-treatment of HIV and TB

A new finding in the ongoing Starting Antiretroviral Therapy at Three Points in Tuberculosis (SAPit) study has been published in the New England Journal of Medicine by Drs. Salim and Quarraisha Abdool Karim (Professor of Clinical Epidemiology and Associate Professor of Clinical Epidemiology, respectively), and co-authors Dr. Wafaa El-Sadr, Professor of Medicine and Epidemiology and director of ICAP, and Dr. Gerald Friedland, Adjunct Professor of Epidemiology and Professor of Medicine at Yale University. The study investigates how to time the treatment of individuals infected both with tuberculosis (TB) and HIV in sub-Saharan Africa. It is a critical issue for a region in which 70% of individuals with TB are also HIV-positive. Overlapping anti-retroviral therapy (ART) with treatment for TB poses the risk of increased side effects and other hazards. The timing, according to the study results, should depend on the state of the patient’s immune system. While those with stronger immune conditions could start ART treatment 3-months into TB treatment, individuals with a low T-cell count—a sign of an immune system that has been severely weakened by HIV HIVTB —were better off if they began ART within the first four weeks of TB treatment. The latter group showed a two-thirds decline in the death rate, compared to those with severely weakened immune systems who had started ART later. For more on the history of SAPit, see page 17.

Abdool Karim SS, Naidoo K, Grobler A, Padayatchi N, Baxter C, Gray AL, Gengiah T, Gengiah S, Naidoo A, Jithoo N, Nair G, El-Sadr WM, Friedland G, Abdool Karim Q. Integration of antiretroviral therapy with tuberculosis treatment. N Engl J Med. 2011; 365(16): 1492-501.

Off-label use of female condoms poses health question

A new study provides the first documented evidence that the female condom is being used for heterosexual anal intercourse, adding to ques- tions about the vaginal contraceptive’s efficacy for off-label uses. The study in the American Journal of Public Health was first authored by Dr. Elizabeth Kelvin, a PhD graduate from the Department of Epidemiology, with co- authors Dr. Zena Stein, Professor Emerita of Epidemiology and Psychiatry, and Dr. Susie Hoffman, Assistant Professor of Clinical Epidemiology (in Psychiatry), along with other colleagues at the HIV Center for Clinical and Behavioral Research at the New York Psychiatric Institute / Columbia University and collaborators at Gay Men’s Health Crisis. The researchers surveyed 111 clients of an HIV/AIDS service organization in New York City finding that 17% had used a female condom for anal sex. Among that group, 21.4% used the condoms for anal sex with female partners. The female condom has been approved for vaginal use by the US Food and Drug Administration but not for anal use, highlighting “the urgent need to evaluate the safety and efficacy of the female condom in anal intercourse,” the study says.

Kelvin EA, Mantell JE, Cendelario N, Hoffman S, Exner TM, Stackhouse W, Stein ZA. Off-Label Use of the Female Condom for Anal Intercourse Among Men in New York City. Am J Public Health. 2011 Oct 20. [Epub ahead of print]

DECEMBER 2011 4 Marijuana use may double risk of driving accidents

Drivers who test positive for marijuana or who report marijuana use are more than twice as likely as other drivers to be involved in motor vehicle crashes, according to the results of a meta-analysis senior authored by Dr. Guohua Li, Professor of Epidemiology, with co-authors Dr. Charles DiMaggio, Associate Clinical Professor of Epidemiology; Ms. Joanne Brady, a PhD candidate; and Mr. Keane Tzong, an MPH candidate. The analysis, which pooled data from 9 epidemiologic studies conducted in 6 different countries, also indicates that 28% of fatally injured drivers and more than 11% of the general driver population tested positive for non-alcohol drugs, with marijuana being the most commonly detected substance. Dr. Li cautions against inferring from the epidemiologic data that marijuana use causes car accidents. However, “if the crash risk associated with marijuana use is confirmed by further research, this is likely to have major implications for driving safety and public policy,” he says.

Li MC, Brady JE, Dimaggio CJ, Lusardi AR, Tzong KY, Li G. Marijuana Use and Motor Vehicle Crashes. Epidemiol Rev. 2011 Oct 4. [Epub ahead of print]

The Early Determinants of Adult Health Study: A milestone

The first set of articles emanating from the Early Determinants of Adult Health (EDAH) and related studies have been published as a theme issue in the December Journal of Developmental Origins of Health and Disease. The seven papers include six on which MSPH faculty are first or senior author (Drs. Pam Factor-Litvak, L.H. Lumey, Ian McKeague, Ezra Susser, and Mary Beth Terry). The project is historically significant, as well as important for having developed a promising new resource. The core EDAH study, led by principal investigator Dr. Susser, combined two major US pregnancy cohorts born 1959-1966 to provide a large enough sample to study prenatal exposures and midlife health among same sex sibling pairs. Related grants by principal investigators Dr. Marybeth Terry and Dr. Pam Factor-Litvak extended the core study to other outcomes and other designs. Dr. Howard Andrews provided vital data management sup- port, and Ms. Kim Fader was a superb project director of this complex study. The EDAH study was based in the Imprints Center for Genetic and Environmental Lifecourse Studies.

DECEMBER 2011 TOP PHOTO: BRIAN BUCKMAN, BOTTOM PHOTO: DAVID FLAM 5 IN THE NEWS

Dr. Neugut comments In a Huffington Post column, Dr. Al Neugut offers some perspective on a widely-reported medical study that showed Vitamin E seemed to increase the risk of prostate cancer. Dr. Neugut, who is on studies of vitamin the Myron M. Studner Professor of Cancer Research (in Medicine) and Professor of Epidemiology, supplements and cancer points out that nearly all of the randomized trials that have looked at an association between vitamin supplements and cancer have shown that, for people who are not vitamin deficient, there is no benefit in taking supplements to prevent cancer. “If anything, as the studies are starting to suggest, it may be more harmful than beneficial,” he says.

Dr. Schluger quoted in Dr. Neil Schluger, Professor of Medicine, Environmental Health Sciences, and Epidemiology at NYPH/CUMC, is quoted in an article on PBS’s “News Hour” website about the adverse health story about respiratory effects of stoves used in fast-developing nations like India. The makeshift stoves, which families hazards of indoor stoves typically power by burning wood, dung, or other biomass fuels, emit smoke and pollutants that contribute to an estimated 2 million deaths a year, according to new figures by NIH. “This creates levels of air pollution in homes that are astronomical, hundreds of times more than what you might breathe in New York, for example,” says Dr. Schluger, who is also chief scientific officer at the World Lung Foundation. The United Nations Foundation is currently working on an initiative to create a demand for cleaner electric or solar-powered stoves.

Dr. Salim Abdool In 2010, the CAPRISA trial of tenofovir vaginal gel found that it not only lowered the likelihood of HIV transmission in women but did an even better job of protecting them against genital herpes. At Karim comments on the time, it was not clear why. Now, a follow-up study by researchers from the National Institutes tenofovir’s effectiveness of Health (NIH), Gilead Sciences Inc., and universities in Belgium and Italy, reported on in October by the New York Times, has biologically confirmed tenofovir’s preventative effect on herpes trans- against herpes mission using lab experiments. “We were very pleasantly surprised to see such a potent effect. However, until now, we had only a hypothesis for the mechanism of action—no clear-cut data,” says Dr. Salim Abdool Karim, director of the 2010 CAPRISA trial.

DECEMBER 2011 6 BRIEF MENTIONS

MPH alum receives APHA abstract award MPH alum receives APHA best paper award Dr. El-Sadr honored by Infectious Diseases Society of America Laura Stadelmann, MPH ’11, received Dustin Carpenter, MPH ’11, has been the American Public Health Association’s awarded the 2011 Best Paper Award for Dr. Wafaa El-Sadr, director of ICAP and (APHA) Epidemiology Section Student the Injury Control and Emergency Health Professor of Epidemiology and Medicine, Award, for her abstract “Comparing models Services Section of APHA. His winning paper has been selected by the Infectious of HIV transmission risk on concurrent HIV/ was adapted from his thesis on road safety, Diseases Society of America (IDSA) to AIDS diagnosis using multiple imputation titled “Graduated driver license night-time receive the 2011 Society Citation Award for and other methods for handling missing risk compliance in US teen drivers involved in her outstanding contributions to the field of data, New York City 2008.” Ms. Stadelmann fatal motor vehicle crashes.” infectious disease. First presented in 1977, is currently a Council of State and Territorial the Society Citation is a prestigious award Epidemiologists Applied Epidemiology that recognizes exemplary contribution to Fellow at the New York City Department of IDSA and outstanding achievements in the Health and Mental Hygiene. field of infectious diseases in research, clinical investigation, or clinical practice.

Dr. Lumey joins University of Chicago’s Dr. Genkinger and Dr. Hall awarded Dr. Greenlee receives leadership award Health Inequality Network Calderone Junior Faculty prize from the Society of Integrative Oncology

Dr. L.H. Lumey, Associate Clinical Professor Dr. Jeanine Genkinger, Assistant Professor Dr. Heather Greenlee was honored with the of Epidemiology, was invited to become a of Epidemiology, and Dr. Megan Hall, Outstanding Service Award in Leadership at member of the Health Inequality Network, Associate Research Scientist, have each the Society for Integrative Oncology’s annual a multidisciplinary research network at been awarded one of this year’s 3 Calderone international meeting. the University of Chicago. The aim of the Junior Faculty Awards. The prestigious group is to combine insights from several award supports the research efforts disciplines into a unified approach, in order initiated by junior faculty at the Mailman to build up a comprehensive framework for School. We are proud that Epi won 2 out of 3 the emergence and the evolution of health of this year’s Calderone awards. disparities over the lifecycle and across generations.

DECEMBER 2011 7 AWARDS & GRANTS

Dean Fried honored Dr. Ottman Drs. Hornig, Lipkin, at Bipartisan awarded grants to and Hammer awarded Congressional research epilepsy chronic fatigue grant Awards Gala Dr. Ruth Ottman, Drs. Mady Hornig and In a ceremony attended Professor of Ian Lipkin of the Center by approximately 300 Epidemiology (in for Infection (CII) and members of Congress Neurology and the Immunity have been and key Executive Branch figures, the Sergievsky Center), was awarded R01 awarded a substantial grant from the Alliance for Aging Research honored funding from the National Institute of Chronic Fatigue Initiative to investigate the Mailman School Dean Linda P. Fried at its Neurological Disorders and Stroke funding role of pathogens in causing chronic fatigue 25th Anniversary Bipartisan Congressional program, called Centers without Walls for syndrome. Dr. Hornig, an Associate Professor Awards Gala held in Washington, D.C. Collaborative Research in the Epilepsies. of Epidemiology and Director of Translational Dean Fried, who is also the DeLamar The project, entitled “Epi4K: Gene Discovery Research at CII, will direct research on Professor of Public Health and Professor of in 4,000 Epilepsy Genomes,” is designed to biomarkers and pathogen discovery. Epidemiology and Medicine, was presented identify genetic variations that contribute The Initiative was established by the with the organization’s inaugural Silver to risk for specific forms of epilepsy using Hutchins Family Foundation with a donation Innovator Award for her work as a scientist whole genome or whole exome sequencing of more than $10 million in order to study who has been an exemplary leading in 4,000 affected individuals. chronic fatigue syndrome. The initial phase of innovative researcher in improving the It includes six linked R01 grants (three funding also supports New York-Presbyterian health and well-being of aging Americans. cores and three scientific projects), each of Hospital/Columbia University Medical Center, which has multiple principal investigators where the Hutchins Family Fellowship in from an international team. Dr. Ottman Infectious Disease will be established under is principal investigator on two of these the direction of Dr. Scott Hammer, Professor grants, worth a total of $3.1 million. of Medicine and Epidemiology. “This is a truly exciting opportunity to understand the causes of this often neglected disorder,” said Dr. Hornig. “We hope our findings will lead to better diagnoses and the development of an effective treatment.”

SUBMITTED GRANTS DEPARTMENT OF EPIDEMIOLOGY, JANUARY–NOVEMBER 2011

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DECEMBER 2011 8 FACULTY PROFILES Lloyd Sederer

Today Dr. Sederer serves as a medical New York’s chief editor of mental health for the Huffington Post. His work has also appeared in the psychiatrist International Herald Tribune/New York Times, the WSJ.com and Washington Post, and he ventures into runs a website called Ask Dr. Lloyd (askdrl- loyd.com), which is dedicated to helping public writing people figure out how to get care for a mental illness or addiction. His writing combines story-telling with In 2009, after nearly 35 years facts, figures, and an insider’s insights about practicing as a psychiatrist, mental health care in America. Several of his columns have used journalistic techniques to and with a CV full of academic highlight the story of a troubled patient or a journal publications and family member in despair. “A literary friend of mine told me this is textbooks, Dr. Lloyd Sederer, called ‘narrative non-fiction,’ another said it was memoir,” he says of an October 5 piece the chief medical officer of he wrote for Psychiatric Times. “All I know is the New York State Office that it is a true story.” In that article, Dr. Sederer recounts his of Mental Health (OMH), experience as a young intern in a Veterans began writing for a different Administration hospital. He is assigned to evaluate Billy, a 19-year-old Vietnam War FACULTY audience. veteran for a pre-trial evaluation pending APPOINTMENTS a court martial for robbing dead American AND PROMOTIONS He had always enjoyed writing, having soldiers. Dr. Sederer must decide whether published his first medical articles in the Billy is suffering from a psychotic disorder or American Journal of Psychiatry when he was is a criminal. Grace Hillyer appointed Associate a resident. “I was pretentious back then,” he After meeting daily, Dr. Sederer comes to Research Scientist in the chronic says, scoffing a bit at the punny title of some believe Billy has a mental illness that has disease epidemiology cluster of his early articles: “Moral Therapy and the been made worse by a difficult childhood, Problem of Morale” and “Second-Hand Rose”. drug abuse, and the war. Dr. Sederer makes Megan Horton appointed Associate But Dr. Sederer, who in addition to being a convincing case in a grand rounds session Research Scientist in the lifecourse New York’s chief psychiatrist is an Adjunct that Billy should not be treated as a menace epidemiology cluster Professor of Epidemiology, didn’t think his to society. “Billy taught me more about academic publications were getting him any mental illness than any book or paper I had Peter Stastny appointed Lecturer in closer to patients and their families—the read or seminar I had attended that year,” he the lifecourse epidemiology cluster groups he truly wanted to reach. says in the article. “I was trying to speak to the people who re- Despite being chief medical officer of the ceived services,” he says. “They are the ones largest mental health care system in the who need to understand medical care. They country, he is not shy about calling out the are yearning for someone to help them and mental health care system’s inadequacies. in a personal way, to answer questions like, “Mental health care in the U.S. is broken, ‘Why’s it so impossible to get an appointment? as you have or soon will see,” Dr. Sederer Why does my loved one not get better? Where says in a Huffington Post article that gives do I turn when that happens? Why does the advice for those who have family with a doctor not answer my calls?’ mental illness. “Like it or not, you will need “I started to realize, answers to those to become a vocal spokesperson for what questions are not what’s in journals.” your loved one needs in a system that is So Dr. Sederer approached the world of fragmented, not organized to be accountable, online media. A professional writer friend not funded to incentivize effective care, and of his introduced him to an editor at The very uneven in its quality, despite good people Huffington Post who quickly responded that trying to do the right thing,” he continues. the website wanted to publish an article he It is an insight gleaned firsthand from had sent in. Soon, his pieces were appearing his many years in hospital administration regularly in the The Huffington Post. positions, including as medical director and

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DECEMBER 2011 9 FACULTY PROFILES Lloyd Sederer

CONTINUED FROM PAGE 9

executive vice President of McLean Hospital in be a life sentence. Belmont, Mass., a Harvard teaching hospital. Although he intends to keep his day job— A selection of After 11 years at McLean and most of the Huffington Post gig is unpaid—Dr. Sederer his adult life spent in Boston, he moved to has taken on increased writing and editorial Dr. Sederer’s New York City to become executive deputy responsibility for a number of publications. commissioner for mental hygiene services He is also frequently called on to review articles in at the Department of Health and Mental movies and books, focusing in particular on Hygiene. those that say something about the human Not long after beginning his tenure at OMH condition. “Crime in the Military: in 2007, he implemented sweeping reforms These days, he is finding himself get- Madness, Badness, and in licensing of mental health clinics in the ting pretty comfortable in his new role. At a state—basing the process on clinical care fundraising dinner for autism, he was seated Survival” in Psychiatric rather than paperwork and “exit signs.” The at the same table as New Yorker editor David Times (October 5, 2011) effort came about in 2009 after several grue- Remnick, who complimented Dr. Sederer some murders might have been prevented, Dr. on his work as a public servant. When they Sederer found, had the people involved gotten exchanged contact information, Dr. Sederer “Advice for Those with a good mental health treatment. He reported opted for slipping Mr. Remnick his Huffington on this story with his boss, Commissioner Post card instead of the OMH card. Loved One With Mental Michael Hogan, in Health Affairs in 2009. Illness” in The Huffington The new licensing requirements mandate Post (March 14, 2011) communication between caregivers, screen- ing for drug and alcohol use, and having someone on call and available to patients “Ink-Stained for Life” in and families after 5 pm, all previously not expected by the state’s licensing procedures. The International Herald Public writing, Dr. Sederer likes to say, is Tribune/New York Times very reinforcing. Articles are published days (December 23, 2010) after they are written and readers can get in touch with him directly—and do—when they have a question or comment about his article. “Pay for Health Reform While Dr. Sederer says he cannot give medical advice to those who contact him by email, with an Alcohol Tax” he wants to serve as a public, human face of with Eric Gopelrud in mental health, a doctor who can at the very least encourage people to seek treatment and The Washington Post assure them that mental disorders need not (September 28, 2009)

“Mental Health Crises and Public Policy” with Michael Hogan in Health Affairs (Vol 28, No 3, 2009)

DECEMBER 2011 10 STAFF PROFILES Kathleen Flandrick

As the Senior Cluster In New York, she has worked as a develop- ment associate at Regis High School on the Administrator (SCA) Upper East Side, where she managed the for the chronic disease daily operations of the annual fund, edited and designed the monthly magazine, and epidemiology cluster, Kathleen produced the annual report. She also worked as a grants coordinator at the CUMC Dental Flandrick’s intelligence and College, where she focused on pre-award professionalism is well known grant administration. Kathleen hails from Stillwater, Minnesota. to faculty and fellow staff. Her parents have a small organic farm where they raise free range chickens, sheep, pigs, “Kathleen is so good at her administrative and bees. A number of animals keep watch and organizational activities that I have to over the farm, including a llama, several make up reasons to go in to talk to her,” Chinese geese, and two large dogs. says chronic epidemiology cluster leader Currently, she and her husband, an Dr. Al Neugut. emergency medical resident at Stony Brook Her duties include handling the cluster’s University Medical Center, live in Great Neck, pre- and post-award grant administration and Long Island, the halfway point between their management, along with many other projects. jobs. Her commute to Columbia gives her She also serves as a liaison between chronic ample time to read fiction. A recent favorite disease epidemiology faculty and staff and the of hers was Jennifer Egan’s A Visit from the Department’s central administration. Goon Squad. “She supports an extremely productive In her free time, Kathleen enjoys catching STAFF live indie or punk rock shows, visiting her group of the Department’s faculty, and she’s APPOINTMENTS done a fantastic job of becoming fluent in friends in Brooklyn, and taking in modern AND PROMOTIONS their various activities and research projects and contemporary art. Some of her favorite in a very short period of time,” says Christina artists are Richard Serra, Anselm Kiefer, McCarthy, interim Department Administrator. Gordon Matta-Clark, and Zoe Strauss. Both Emil Fraija appointed Financial Kathleen appreciates how being an SCA travel enthusiasts, Kathleen and her husband Coordinator in the social keeps her involved with both public health and recently visited Iceland and are planning a epidemiology cluster grant making. “The chronic disease cluster vacation to Istanbul in the spring. has a diverse set of research activities and Scott Skversky appointed Senior IT funding sources, and they always keep me on User Support Technician in the office my toes,” she says. of the Department Chair Arriving here this past June, Kathleen came with a wealth of education and Melissa White appointed Project experience in public health and administra- Coordinator in the chronic disease tion, including an MPH from University of epidemiology cluster Pennsylvania. While there, she worked as a research program development manager, project managing large institutional grant proposals and editing and producing an annual grant writing manual. She has also worked as a financial admin- istrator in London at South Bank University’s business school, and as an administra- tive specialist at the Amherst H. Wilder Foundation in St. Paul, where she edited and designed a collaborative newsletter, orga- nized large events, and worked closely with grantees on reporting.

DECEMBER 2011 11 Master’s Student Day

Practicum Day awards Best abstracts

First place Patrick Dawson, Infectious disease epidemiology, for “The epidemiology of tuberculosis among New Yorkers living in public housing, 2001-2009”

Second Place Ashleigh McGirr, Epidemiology innovation, for “Assessing the effects of human behavior in distributing post exposure prophylaxis: A computer simulation approach”

Third place (tie) Rhea Powell, Chronic disease epidemiology, for “Does genetic ancestry modify the relationship of smoking to lung function? The MESA Lung Study”

Sarah Reber, Epidemiology innovation, “Child protection systems First annual Master’s and outcomes in Northern Uganda CPC Learning Network” Student Day showcases student work Best posters Chronic disease epidemiology (tie) Jennifer Brite, “Height and the risk of gestational diabetes: Does maternal On October 28, the Department of wrace make a difference?” Epidemiology held its first annual “Epi Stephen Mooney, “Using Google Street View to assess physical Master’s Student Day.” The event was characteristics of neighborhoods” created to give master’s students an Epidemiology innovation Alexandra Kravitt, “Birth outcomes experience similar to that of presenters at among pregnant women exposed to the World Trade Center attacks professional conferences. on September 11, 2001” Infectious disease epidemiology (three-way tie) Stephanie Shiau, The event kicked off with an hour-long session in which master’s “Body composition and metabolic abnormalities of perinatally HIV- students in all six Department clusters presented posters about infected children in South Africa on long-term ARV treatment” their practicum research and experience. The diversity of practi- cum sites offered by the Department was well represented, from Man Kai (Alyssa) Wong, “Strengthening active case finding of the New York City Department of Health and Mental Hygiene tuberculosis among deported migrants in Cambodia” to UNICEF Ghana, from the National Institutes of Health to the Shanghai Centers for Disease Control. Faculty and students also Frank Zadravecz, “Spectral decomposition of the viral gathered to listen to presentations by our 3 abstract winners and meteorological seasonal forcing reactivated tuberculosis incidence to ask questions, which allowed our students to demonstrate in urban Brazil” their command of complex epidemiologic principles. The win- ners also received cash prizes. Lifecourse epidemiology Colette Friedenson, “Do offspring of Special acknowledgements go out to Dr. Joyce Pressley, who mothers exposed to constant, low levels of organochlorine com- heads up the practicum program and brought this impressive pounds have increased risk of autoimmune thyroid disease?” event together. Ebony King, Anthony Diaz, Erin Gilbert, Liliane Zaretsky, and Elizabeth Ferrari were critical in making sure the Psych/neuro epidemiology Seema Kara, “Socioeconomic event happened smoothly. Dr. Ruby Senie, Dr. Parisa Tehranifar, disparities and modifiable risk factors amongst people with and Dr. Megan Hall reviewed and submitted abstracts and judged serious mental illness” posters. PhD students Carolyn Herzig and Catherine Richards and master’s students Diane Addison, and Patrick Dawson also Social epidemiology Niloufer Taber, “Castle Gardens: Affordable helped with all stages of the event. and supportive green housing for low-income New Yorkers” We look forward to this becoming a long-term tradition in the Department, showcasing the best of our students’ work. Following is a list of the winners of our practicum awards, in the best abstracts category and in the best posters category, which was broken down by cluster:

DECEMBER 2011 12 A new journal club for master’s students

On a recent Wednesday afternoon, 15 master’s students went around a table, each describing his or her “neighborhood food environment.” They weren’t there to discuss restaurant recommendations, however, but to analyze a journal article published in 2009 called “Neighborhood food environment and walkability predict obesity in New York City” for the second meeting of the Master’s Student Journal Club.

The club was started this fall by Patrick Dawson, MPH ’12, with Catherine Richards and Carolyn Herzig, doctoral students and the doctoral liaisons to master’s students. Its purpose is to allow master’s students to discuss important papers in epidemiology and to practice critically evaluating epidemiological literature. The group typically meets every other Wednesday from 2-3 pm in the classified but didn’t have the resources or available data at the time Environmental Health Sciences conference room. At each meeting, to better understand that category. (Since the paper was published, a different student comes prepared to lead a discussion on an article the BEH group received funding to hire high school interns to walk of his or her choosing. around NYC neighborhoods using validated food questionnaires to On this particular Wednesday, MPH ’12 student Spruha Joshi was audit various food establishments). leading the discussion of the neighborhood food environment paper, According to Mr. Dawson, most of the students who came to that which was authored by Dr. Andrew Rundle, Dr. Gina Lovasi, Ms. meeting of journal club were interested in chronic disease topics, Richards, and colleagues and published in the journal Environmental while the students at the first meeting of the year, which took up an Health Perspectives. infectious disease epidemiology article, tended to be interested in Ms. Joshi, whose research interest is in chronic disease epide- that area. “It’s helpful for me,” said Dawson, who himself is inter- miology, says she chose the article in part because it was authored ested in infectious disease epidemiology, “because I’m constantly by researchers affiliated with the Department with whom she is being exposed to different topics and approaches.” involved at the Built Environment and Health (BEH) research group. Among the subjects discussed were how the researchers defined Next journal club meeting: several variables like neighborhood food environment, neighbor- Wednesday, December 7, 2-3 pm in the Environmental Health hood walkability, and healthy options available at a food establish- Sciences Conference Room (1101) ment. They use three categories to classify food establishments: “BMI (body mass index)-healthy,” “BMI intermediate,” or “BMI unhealthy.” This led some students to question the classification of certain stores as uniformly healthy or unhealthy. “Any given store has both healthy and unhealthy options,” one student said. Adding that the data was 10 years old, another participant First EPIC Epidemiology and Population Health suggested that an analysis of more current data should include Fund Cycle awards Summer Institute at Columbia University establishments like farmers markets and food carts, which weren’t factored in to the original study. In October, six trainees were awarded funds in our first EPIC At the end of the hour, Ms. Joshi teased out the rationale for Fund cycle from a total of 13 applicants. The EPIC Fund was critiquing journal articles. “Critiquing research isn’t bad form,” established by the Department to provide our trainees with she said, “it is important to help the researchers know what gaps an opportunity to access resources beyond those covered by still exist.” their standard tuition. Drawn from revenue generated by our Ms. Richards added that it is important for scientists to publish annual summer institute, EPIC, trainees apply for funding for findings, even if they don’t have all the data they would like to have such things as travel; purchase of datasets or samples for a in an ideal world, in order to circulate results and get funded for study; and expenses for short workshops, software packages, future studies. For instance, the BEH group was aware at the time or training in lab techniques. The next funding cycle will be in of publication that the BMI-intermediate group wasn’t perfectly January 2012.

DECEMBER 2011 13 PARTNER PROFILES

This is the first of our “Partner Profiles.” Over the coming year, Two by Two will feature some of the many innovative centers across the University with which the Department of Epidemiology partners.

14 PARTNER PROFILES

DR. Quarraisha ABDOOL KARIM explains the tenofovir gel trial to Mr. Michel Sidibé, the executive director of UNAIDS, with Dr. Salim Abdool Karim looking on.

A cross- continental partnership for AIDS and For the Department of Epidemiology, where both Abdool Karims have faculty appointments, the tenofovir trial was emblematic of a commitment to public health research and interventions that are shaped by social realities. It also highlighted the long history the tuberculosis Abdool Karims have with the Department, dating back to their time as graduate students here in the late 1980s, when they studied and experienced the public health response to the HIV epidemic in research New York City. While the collaboration between Columbia and CAPRISA was made official nearly one decade ago, when the latter was founded, CAPRISA and the Department of the relationship between the Abdool Karims and the Department of Epidemiology has endured for nearly 25 years. Epidemiology “It is a cross-Atlantic partnership that has deep roots going back the fight against apartheid and the struggle for human rights, social n 2010, the Centre for the AIDS Programme of Research in South justice and health for all,” Slim says. Africa (CAPRISA) announced at the International AIDS Conference in Vienna that the vaginal gel containing 1% of Gilead Sciences’ Education in Epi Iantiretroviral agent, tenofovir, had been effective in reducing HIV infection among women by 39% overall and by 54% in women who used the gel consistently. The announcement was based on a clinical The couple came to New York in 1987 so Slim, a physician, could trial carried out at two sites in South Africa led by Dr. Salim (often begin a new fellowship started at the Gertrude H. Sergievsky Center known as Slim) Abdool Karim and Dr. Quarraisha Abdool Karim, by Dr. Mervyn Susser to train South Africans in public health. Slim respectively the director and associate scientific director of CAPRISA. enrolled in the MS in epidemiology program at Columbia in 1987 The results of the CAPRISA 004 trial, which made front page and Quarraisha joined him at the beginning of 1988, doing research headlines across the world including The New York Times, Wall in the Microbiology laboratory while studying epidemiology and Street Journal, and Washington Post, were celebrated in the HIV/AIDS parasitic diseases at Columbia. research community and by women in Africa, both groups who had During their year in New York, the newly married couple became become accustomed to the stream of disappointing news that came involved with the public health debates about AIDS. Quarraisha out of most HIV prevention trials. was mentored by Dr. Zena Stein who would, in 1990, publish a

DECEMBER 2011 15 PARTNER PROFILES

Dr. Quarraisha Abdool Karim explains how to use an applicator.

groundbreaking article about HIV prevention in the American Journal Rosenfield, Dr. Alan Berkman, Dr. Ron Bayer, and Dr. Anke Ehrhard. of Public Health that highlighted the importance of HIV prevention In 1995, Quarraisha was appointed by Nelson Mandela’s govern- methods that women could control. ment to lead the country’s AIDS control program, where she faced the “She really imprinted on me the importance of looking at every- daunting task of converting evidence into policy and policy into action. thing through a gendered lens,” Quarraisha says. During this time, Slim was the director of the South African Medical After the Abdool Karims returned to South Africa at the end of Research Council’s Center for Epidemiologic Research in South Africa 1988, Slim started his 3-year residency in public health medicine at (CERSA) and in 2001 took up the position of Deputy Vice-Chancellor the Nelson R. Mandela School of Medicine. for Research at the University of KwaZulu-Natal in Durban. Meanwhile, Quarraisha began her career in public health research at the South African Medical Research Council. As she was working to establish research priorities, she thought of her experi- Founding of CAPRISA ence in New York, having seen the HIV epidemic’s effects on communities like Greenwich Village, Harlem, and the Bronx. CAPRISA was established in 2002 through a groundbreaking It inspired her to conduct one of Africa’s first population-based stud- agreement that brought five partner institutions together, made ies on AIDS in rural districts of the province of KwaZulu-Natal. possible by a National Institutes of Health (NIH) grant. The various The study results showed that a disproportionate impact of the legal and other requirements of each partner institution, and the HIV burden was born by young women, and that transmission was trans-continental relationships between Columbia and the four intertwined with population migration. Furthermore, women on South Africa institutions (University of KwaZulu-Natal, University of average were 5 to 7 years younger when they acquired the virus Cape Town, University of Western Cape, and the National Institute than men, suggesting that female-targeted prevention had to begin for Communicable Diseases in Johannesburg) made the agreement at an early age. both a challenge and a great achievement, Slim says. “This study was one of the first reasons why we started focusing At the outset CAPRISA became an official research center at on women,” Quarraisha says. both Columbia and the University of KwaZulu-Nata, one of only two The study also suggested that the worst was yet to come, that organizations that received funding in the first cycle of the NIH’s new “we were only at the very early stage of the epidemic.” Comprehensive International Program of Research on AIDS (CIPRA) to fund international centers of excellence in AIDS research. CAPRISA today has a strong collaborative relationship with Joining the epi faculty several senior faculty members of the Department of Epidemiology. Drs. Zena Stein, Mervyn Susser, Wafaa El-Sadr, Scott Hammer, In 1994, the couple returned to New York for a semester, this time Sharon Schwartz, Al Neugut, Ian Lipkin, Seth Berkley, and Ezra as faculty. They taught infectious disease epidemiology in the Susser all work with CAPRISA scientists. Department, worked with Dr. Zena Stein to set up the Fogarty AIDS With several collaborating research laboratories across the International Training and Research Program, and established country, the organization has a significant presence in Durban, Cape several collaborations to build their AIDS research efforts in South Town, and Johannesburg. CAPRISA has clinics that are accessible Africa. Since then, they have continued as faculty in Epidemiology, for walk-in patients in the Durban city center and rural Vulindlela, including in their Mailman collaborations with Dean Allan about 90 minutes from Durban.

DECEMBER 2011 16 PARTNER PROFILES

The year 2010 was a triumphal one for the organization. In February, CAPRISA came out with the results of the seminal Starting Antiretroviral Therapy at Three Points in Tuberculosis Dr. Salim Abdool Karim Therapy trial (known as “SAPiT”), which made recommendations on treating concurrent TB and HIV. (Treatment of a patient with both diseases can often cause serious side effects, which has made it difficult for doctors to decide when to start antiretroviral therapy during TB treatment). The World Health Organization and the US Department of Health and Human Services subsequently used SAPiT as the basis for their guidelines for the treatment of TB-HIV co-infected patients. When fully implemented, the findings of SAPiT could save thousands of lives a year, Slim says. Then there was the announcement of the CAPRISA 004 find- ings, which was ranked in the “Top Ten Scientific Breakthroughs of 2010”by the journal Science. The Abdool Karims had begun their first microbicide trial in 1993. They first investigated the feasibility of a vaginal microbicide by interviewing the sex workers who frequent- ed truck stops in South Africa—a population that was considered significantly at-risk for HIV transmission. Although their early trials met repeated failure, the exigencies of the time made it impossible to stop working on the technology; an HIV prevention method for women was desperately needed. “In many ways, you have to be somewhat pig-headed to persist in the presence of all of this failure,” Slim says. “When the going got tough, our friends and colleagues in Epi were always sympathetic and actively supported us in our efforts to stay the course.” By the late 1990s, the HIV epidemic in South Africa was no longer asymptomatic—that is, people had moved past the early stages of infection and were now showing telltale AIDS symptoms and dying, much like the US experience in the mid-to-late 1980s. The trend of “The idea is to make women being infected with HIV at a higher rate than men continued to bear out in the higher number of young women presenting to enough gel to supply hospital with AIDS. “We were constantly being reminded about the needs for meth- the whole of Africa ods that women could initiate and use,” Quarraisha says. “As we continued to do our prevention work and tried to identify uninfected on a straight not-for- women, we started to find more women who were infected than un- infected. It was a dire response to a real situation. It wasn’t whether profit basis.” we wanted to do it. We had to do it.”

The future of CAPRISA

Despite the good news of the tenofovir trials, the Abdool Karims’ the FACTS001 study that is like an expanded CAPRISA 004 study. agenda for CAPRISA has not slowed. They are now conducting a TB If these are successful and the gel becomes an approved medi- prevention study that looks at HIV patients who get infected for a cine, the gap between evidence, policy, and implementation will be second time with TB. substantially reduced owing to an early entreaty CAPRISA made with Quarraisha is also heading up a study that focuses on preventing Gilead headquarters in California to secure a royalty-free license, HIV by incentivizing certain behaviors in adolescents. The 2,500 which has now enabled a joint government—private partnership to school children enrolled will receive a financial incentive every manufacture and distribute the gel. time they engage in certain preventative behaviors, such as getting “The idea is to make enough gel to supply the whole of Africa on HIV testing. They also will receive money as an incentive if they do a straight not-for-profit basis,” Slim says. well academically, based on findings that the longer children are in It is a remarkable prospect, considering most pharmaceuticals school, the less likely they are to contract HIV. take years to make it to a mass market in Africa. It signifies the way A trial of a new AIDS vaccine—thus far an elusive goal for AIDS in which CAPRISA bridges science and implementation, as well as researchers—is also being planned for 2012 with a research group evidence and public health. from Harvard. Says Slim: “We’ve never seen ourselves in any other way than As for tenofovir gel, it is currently going through what are called being scientists of the world.” confirmatory trials, including the VOICE study of 5,000 women and

DECEMBER 2011 17 PIONEERS AMONG US

Inge F. Goldstein, Special Lecturer in Epidemiology, has spent nearly 45 years at the Mailman School of Public Health, researching the health effects of air pollution, air-borne allergens, and asthma. She was one of the earliest researchers to realize, as the late Dean Allan Rosenfield put it, that “asthmatics [might] be canaries in the mine shafts—a sensitive population whose health status might have implications for all of us.” INGE GOLDSTEIN

hrough her research, she “pioneered in thinking about how urban From a chance meeting with Dr. Jack Elinson, the environments contribute to the burden of asthma and developed new founder of the Mailman School’s Department of methods for studying air pollution and health,” says Dr. Jonathan Sociomedical Science, Dr. Goldstein learned about the TSamet, Director of the Institute for Global Health at University of field of epidemiology, which seemed to represent exactly Southern California. “She was among the first to notice that people who live this kind of research. Dr. Elinson suggested she talk to in northern urban environments spend more time indoors than outdoors and Dr. Mervyn Susser, the Chair of what was then known as to study the health effects of indoor environmental exposures. She was also the Division of Epidemiology. Under Dr. Susser’s supervi- among the first to use time-series approaches to investigating air pollution, sion, Dr. Goldstein in 1968 began studying health effects now a standard and informative methodology. She did this work in a typically of air pollution. quiet but determined fashion, and, in my opinion, she should have been more During this time, public awareness of air pollution had widely recognized for her early contributions.” led to acrimonious debates between affected communities and industry. Observing that these conflicts sorely needed From biophysics to epidemiology good science, Dr. Goldstein served as a scientific adviser to the New York City Department of Environmental Protection Dr. Goldstein came to the US in 1949 after serving in the Israeli army during (DEP) and testified as an expert witness for the New York the War of Independence. She earned a degree in chemistry at Wellesley City Department of Health in a dispute over Consolidated College and a master’s in biophysics from the University of Pittsburgh. She Edison Co.’s application for an exemption from fuel quality began PhD courses at the University of Michigan but interrupted her graduate standards. After the hearings ended, Mitchell E. Blum, the work to move to New York City in 1965 with her husband and their 3 children. Department of Health’s director of air pollution studies, There, her career plans changed as she became interested in the possibility of wrote her a grateful letter of praise for having “taken applying the scientific rigor of the physical and natural sciences in which she risks that others might have chosen to avoid; withstanding had been trained to studying health-related issues of communities. cross-examination in a legal proceeding that is not the

DECEMBER 2011 18 accustomed milieu of a research scientist and teacher.” Dr. Goldstein was also appointed as an epidemiologist on an expert Dr. Goldstein was committee assembled by DEP to evaluate a lawsuit filed by a group of Bronx parents over a landfill in their neighborhood where toxic chemi- the first researcher cals had been illegally dumped . The parents alleged that the dumping was responsible for excess leukemia cases in their children. During the trial, Dr. Goldstein also served as an interpreter of the scientific to go into inner city issues involved to the mostly lay audience at the hearings. homes to conduct Toward a rigorous measurement of air pollution measurements of Shortly after beginning her work and study for the MS in Epidemiology at the Mailman School, Dr. Goldstein authored indoor air pollutants, her first paper, which pointed out the weaknesses in the then- customary methods of correcting for weather variables in air pollution monitoring. Subsequent papers based on collaborative including emissions studies with Dr. Leon Landowitz of the City University of New York demonstrated the inadequacy of using a single, centrally-located from gas stoves monitoring station on a Manhattan rooftop to represent people’s exposure to air pollution across all five boroughs of New York City. The research also showed that the other 45 aerometric stations around the city did not provide a good representation of air pollution in their immediate neighborhoods. The papers attracted considerable attention in the field and led to better accuracy in show that allergens and chemical irritants in people’s homes, particu- future assessments of air pollution exposure. larly allergens emitted by cockroaches and mice, and pollutants from After earning her DrPH in 1975, Dr. Goldstein moved into develop- gas stoves and space heaters, could be significant triggers of asthma. ing new statistical methods to study the health effects of air pollution regulation, working with Dr. Jack Cuzick of Oxford University. In the Understanding asthma epidemics 1980s, Dr. Goldstein was the first researcher to go into inner city homes to conduct measurements of indoor air pollutants, including Although not a communicable disease, asthma occasionally emissions from gas stoves, which were often used by residents not occurs in “epidemics”—periods of a day or two in which attacks, only for cooking but also for supplemental heating in the winter. She as measured by daily emergency room visits, skyrocket to ten or recruited families in poor African American and Hispanic neighbor- twenty times the usual number. Such epidemics have occurred in hoods with high asthma prevalence to participate. The studies could be disparate parts of the world: New Orleans, Brisbane (Australia), trying, but the families were cooperative, allowing Dr. Goldstein’s study Barcelona, and to a lesser extent New York City. For decades these team to bring cumbersome equipment into their homes to measure events went unexplained. pollution levels, and agreeing to wear personal exposure monitors. Then, in the late 1980s, with the help of statistical methods Dr. Drawing on these studies, Dr. Goldstein, with Dr. Charles Reed of the Goldstein and colleagues had developed, Drs. Josep Anto and Jordi Mayo Clinic, pioneered indoor air monitoring of allergens. They helped Sunyer demonstrated that the Barcelona epidemics occurred only

DECEMBER 2011 LEFT PHOTO:UNITED NATIONS, RIGHT PHOTO: STEVEN DEPOLO 19 “One of Inge’s many inspirational qualities is her interest “Inge has been a mentor to many young scientists, like in and concern for everyone with whom she has worked. me. She encouraged and fostered the development of She encouraged me to get an MPH, to get up the courage novel and innovative research projects that helped me to apply to the doctoral program in epi, and was there for develop an independent research program.” me when I went back to asthma research after spending many years researching cancer.” Dr. Matthew Perzanowski

Dr. Judith Jacobson “Dr. Goldstein is one of the most dedicated professionals in the field of environmental epidemiology. As a former student of hers, I am continually impressed by her commitment to educating the public, her concern about environment justice, her dedication to helping students refine their interests in this field, and her adherence to rigorous scientific standards when investigating “She brings a lot of wisdom to the table, and she remains environmental hazards.” very careful in terms of reminding us how to ask and look at research questions as an experienced epidemiologist.” Dr. Andrew Goodman Dr. Rachel Miller

“Dr. Goldstein is a gifted and inspiring scientist, teacher, researcher, advocate and mentor, and I am grateful to have been touched by her wisdom, patience and leadership in the field of environmental epidemiology.”

Dr. Susan Klitzman

when cargoes of soybeans, whose dust contains allergens, were being unloaded 1993), which explains the concepts of energy and entropy. in the harbor. After the appropriate filters were installed, the epidemics disap- All are still in print. Dr. Goldstein is currently collaborating peared. Building on their findings, Dr. Goldstein and collaborators at the Center with colleagues in the Department of Environmental Health for Disease Control in Atlanta reviewed 25 years of data gathered from records Sciences (EHS) on studies that use novel biomarkers to of the emergency room of Charity Hospital in New Orleans as well as records of increase the accuracy and precision of exposure assess- what cargoes had been handled in the port and found that the soybean loading ment of agents that are suspected of playing a role both there had also been responsible for the long-unexplained and severe epidemics. in the high prevalence of asthma in the inner-city areas Dr Sunyer, currently Co-Director of the Centre for Research on Environmental of New York City and in the exacerbation of its symptoms. Epidemiology and Director of the Research Program on Environmental They are also seeking to detect the biological effects of such Epidemiology at the Municipal Institute for Medical Research—both research agents. Those who work with her fully appreciate how her centers in Europe—says, “Dr Goldstein was one of the first searching for the role earlier research has laid the groundwork for these studies. of the urban indoor and outdoor air in asthma.” Says Dr. Matthew Perzanowski, an Associate Professor in EHS who works on the NYC Neighborhood Asthma A researcher and an author and Allergy Study with Dr. Goldstein, “In many ways, we’re still investigating the risks of the things she was looking at Having worked in several fields of science, Dr. Goldstein has become aware 30 years ago.” that not only students and the general public but even many scientists need a better understanding of general scientific concepts. Together with her husband Dr. Martin Goldstein, a professor of chemistry, she has written 4 books with this purpose. They include How We Know: An Exploration of the Scientific Process and The Experience of Science: An Interdisciplinary Approach (Plenum Press 1978 and 1984) dealing with the methods and processes of science in general, How Much Risk (Oxford, 2002), which uses case studies to illustrate basic principles of environmental epidemiology, and The Refrigerator and the Universe (Harvard,

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DECEMBER 2011 23 Riboli E, Franceschi S. Endogenous sex steroids and risk Schneier FR, Neria Y, Pavlicova M, Hembree E, Suh EJ, Tatemichi TK, Desmond DW, Mayeux R, Paik M, Stern Y, of cervical carcinoma: results from the EPIC study. Cancer Amsel L, Marshall RD. Combined Prolonged Exposure Sano M, Remien RH, Williams JB, Mohr JP, Hauser WA, Epidemiol Biomarkers Prev. 2011 Oct 12. [Epub ahead of Therapy and Paroxetine for PTSD Related to the World Figueroa M. Dementia after stroke: Baseline frequency, print]. PMID: 21994406 Trade Center Attack: A Randomized Controlled Trial. risks, and clinical features in a hospitalized cohort. Am J Psychiatry. 2011 Sep 9. [Epub ahead of print]. Neurology. 2011;77(17):1610. PMID: 22025458 Ripke S, Sanders AR, Kendler KS, Levinson DF, Sklar PMID: 21908494 P, Holmans PA, Lin DY, Duan J, Ophoff RA, Andreassen Terry MB, Knight JA. 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DECEMBER 2011 24 Wright JD, Lewin SN, Deutsch I, Burke WM, Sun X, Neugut Zeki Al Hazzouri A, Haan MN, Galea S, Aiello AE. Life- AI, Herzog TJ, Hershman DL. Defining the limits of radical course exposure to early socioeconomic environment, cytoreductive surgery for ovarian cancer. Gynecol Oncol. education in relation to late-life cognitive function among 2011 Sep 27. [Epub ahead of print]. PMID: 21958535 older mexicans and mexican americans. J Aging Health. 2011;23(7):1027-49. PMID: 21948769 Wu X, Scelo G, Purdue MP, Rothman N, Johansson M, Ye Y, Wang Z, Zelenika D, Moore LE, Wood CG, Prokhortchouk Zesiewicz TA, Elble RJ, Louis ED, Gronseth GS, Ondo WG, E, Gaborieau V, Jacobs KB, Chow WH, Toro JR, Zaridze Dewey RB, Okun MS, Sullivan KL, Weiner WJ. Evidence- D, Lin J, Lubinski J, Trubicka J, Szeszenia-Dabrowska N, based guideline update: Treatment of essential tremor: Lissowska J, Rudnai P, Fabianova E, Mates D, Jinga V, Report of the Quality Standards Subcommittee of the Bencko V, Slamova A, Holcatova I, Navratilova M, Janout American Academy of Neurology. Neurology. 2011 Oct 19. V, Boffetta P, Colt JS, Davis FG, Schwartz KL, Banks RE, [Epub ahead of print]. PMID: 22013182 Selby PJ, Harnden P, Berg CD, Hsing AW, Grubb RL, Boeing Xu X, Gammon MD, Jefferson E, Zhang Y, Cho YH, Wetmur H, Vineis P, Clavel-Chapelon F, Palli D, Tumino R, Krogh JG, Teitelbaum SL, Bradshaw PT, Terry MB, Garbowski V, Panico S, Duell EJ, Quirós JR, Sanchez MJ, Navarro C, G, Hibshoosh H, Neugut AI, Santella RM, Chen J. The Ardanaz E, Dorronsoro M, Khaw KT, Allen NE, Bueno-de- influence of one-carbon metabolism on gene promoter Mesquita HB, Peeters PH, Trichopoulos D, Linseisen J, methylation in a population-based breast cancer study. Ljungberg B, Overvad K, Tjønneland A, Romieu I, Riboli Epigenetics. 2011;6(11). PMID: 22048254 E, Stevens VL, Thun MJ, Diver WR, Gapstur SM, Pharoah PD, Easton DF, Albanes D, Virtamo J, Vatten L, Hveem Yaddanapudi K, De Miranda J, Hornig M, Lipkin WI. Toll-like K, Fletcher T, Koppova K, Cussenot O, Cancel-Tassin G, Receptor 3 Regulates Neural Stem Cell Proliferation Benhamou S, Hildebrandt MA, Pu X, Foglio M, Lechner D, by Modulating the Sonic Hedgehog Pathway. PLoS One. Hutchinson A, Yeager M, Fraumeni JF, Lathrop M, Skryabin 2011;6(10):e26766. PMID: 22046349 KG, McKay JD, Gu J, Brennan P, Chanock SJ. A genome- wide association study identifies a novel susceptibility locus Yang LH, Singla DR. Use of indigenous cultural idioms for renal cell carcinoma on 12p11.23. Hum Mol Genet. 2011 by chinese immigrant relatives for psychosis: impacts on Oct 18. [Epub ahead of print]. PMID: 22010048 stigma and psychoeducational approaches. J Nerv Ment Dis. 2011;199(11):872-8. PMID: 22048140 Xu Q, Paik MC, Rundek T, Elkind MS, Sacco RL. Reweighting estimators for Cox regression with missing Young Park J, Nicolas G, Freisling H, Biessy C, Scalbert A, covariate data: Analysis of insulin resistance and risk of Romieu I, Chajès V, Chuang SC, Ericson U, Wallström P, stroke in the Northern Manhattan Study. Stat Med. 2011 Oct Ros MM, Peeters PH, Mattiello A, Palli D, María Huerta J, 3. [Epub ahead of print]. PMID: 21965165 Amiano P, Halkjær J, Dahm CC, Trichopoulou A, Orfanos P, Teucher B, Feller S, Skeie G, Engeset D, Boutron-Ruault Xu X, Gammon MD, Jefferson E, Zhang Y, Cho YH, Wetmur MC, Clavel-Chapelon F, Crowe F, Khaw KT, Vineis P, JG, Teitelbaum SL, Bradshaw PT, Terry MB, Garbowski Slimani N. Comparison of standardised dietary folate G, Hibshoosh H, Neugut AI, Santella RM, Chen J. The intake across ten countries participating in the European influence of one-carbon metabolism on gene promoter Prospective Investigation into Cancer and Nutrition. Br J methylation in a population-based breast cancer study. Nutr. 2011;:1-18. PMID: 22040523 Epigenetics. 2011;6(11). PMID: 22048254 Zeki Al Hazzouri A, Haan MN, Galea S, Aiello AE. Life- Yaddanapudi K, De Miranda J, Hornig M, Lipkin WI. Toll-like course exposure to early socioeconomic environment, Receptor 3 Regulates Neural Stem Cell Proliferation education in relation to late-life cognitive function among by Modulating the Sonic Hedgehog Pathway. PLoS One. older mexicans and mexican americans. J Aging Health. 2011;6(10):e26766. PMID: 22046349 2011;23(7):1027-49. PMID: 21948769

Yang LH, Singla DR. Use of indigenous cultural idioms Zesiewicz TA, Elble RJ, Louis ED, Gronseth GS, Ondo WG, by chinese immigrant relatives for psychosis: impacts on Dewey RB, Okun MS, Sullivan KL, Weiner WJ. Evidence- stigma and psychoeducational approaches. J Nerv Ment based guideline update: Treatment of essential tremor: Dis. 2011;199(11):872-8. PMID: 22048140 Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2011 Oct 19. Young Park J, Nicolas G, Freisling H, Biessy C, Scalbert A, [Epub ahead of print]. PMID: 22013182 Romieu I, Chajès V, Chuang SC, Ericson U, Wallström P, Ros MM, Peeters PH, Mattiello A, Palli D, María Huerta J, Amiano P, Halkjær J, Dahm CC, Trichopoulou A, Orfanos P, Teucher B, Feller S, Skeie G, Engeset D, Boutron-Ruault MC, Clavel-Chapelon F, Crowe F, Khaw KT, Vineis P, Slimani N. Comparison of standardised dietary folate intake across ten countries participating in the European Prospective Investigation into Cancer and Nutrition. Br J Nutr. 2011;:1-18. PMID: 22040523 TWO BY TWO

Sandro Galea, MD, DrPH Gelman Professor and Chair Department of Epidemiology

Editor Barbara Aaron Administrative Director

ASSOCIATE Editor / WRITER Elaine Meyer Communications Coordinator

Designer Jon Kalish