Spring 2006


National Institutes of Health

Race and ethnicity play a significant role in a woman’s symptoms and health as she goes through menopause, according to researchers in the Study of Women’s Health Across the Nation (SWAN). In 1996, SWAN researchers enrolled and began following 3,150 women between the ages of 42 and 52 as they approached and entered the menopause transition. Each of the seven SWAN centers includes a group of white women and a second group of women who identify themselves as African-American, Hispanic, Chinese or Japanese. Members of racial and ethnic groups experience symptoms differently during perimenopause, the period when a woman’s body is in transition to menopause. Among AfricanAmerican women, 46 percent reported hot flashes and night sweats, while 30 percent of Hispanics and white women experienced similar symptoms. Only 20 percent of Chinese and Japanese women were bothered by these symptoms. More needs to be learned about the effects of race/ethnicity on risk factors for heart disease, such as hypertension. The diversity among SWAN’s participants is yielding helpful insights. SWAN investigators have identified differences in hypertension between racial and ethnic study groups, according to a study, “Ethnic Variation in Hypertension Among Premenopausal and Perimenopausal Women,” by Donald M. LloydJones, M.D., and others in the October 2005 issue of Hypertension.

Minority Research & Training

Menopause: Race or Ethnicity Can Make a Difference
The researchers found that, compared to white women participating in SWAN, Hispanic participants were twice as likely to have hypertension and African-American women were three times as likely. The researchers further reported that Chinese and Japanese women had rates of hypertension comparable to white women. photo by Fermilab Some important risk factors for developing hypertension also varied by race or ethnicity. Current smoking was strongly associated with hypertension in African-American women. Bodymass index (BMI) was for Chinese women in the study and waist-hip ratio was for Japanese participants. But, when the group was looked at as a whole, those women with the highest BMI and waisthip ratio were nearly seven times more likely to develop hypertension as participants with the lowest BMI. IN THIS The investigators also looked at how successfully the participants’ hypertension was treated and controlled. Chinese, Japanese and ● Cuervo Builds Bridges white women receiving treatment Between Labs, Scientists for high blood pressure had similar (page 2) rates of successful control of their ● Master Mentor Kelty Retires condition. African-American women from the NIA (page 4) were significantly less likely to have

Minorities Willing to Participate in Clinical Trials (page 6)

controlled blood pressure than white women although they were the ethnic group with the highest (continued on page 3)

Cuervo Builds Bridges Between Labs and Scientists
pathophysiology. We want to know When Ana Maria Cuervo answers and we don’t care who finds graduated from Spain’s University of out. And we publish together,” Valencia medical school in 1990, Cuervo said. research wasn’t a wildly popular After a two-year, post-doctoral career choice. Out of 400 students, training fellowship with Dice, Cuervo only three wanted to go into research: became a research assistant professor Cuervo, Cuervo’s husband and in the same department at Tufts. In Cuervo’s best friend. 2001, she relocated her laboratory to “My friends were getting ready the Albert Einstein College of to do their residencies after six years Medicine, where she continues her of medical school. They asked me, study of the role of protein‘Do you really want to study for four degradation in neurodegenerative more years to be a researcher? You Ana Maria Cuervo, M.D., Ph.D. diseases and aging. know, you are never going to make a “One of the reasons I moved from Boston to the lot of money,’” laughs Cuervo, who graduated with a Bronx was to establish myself as an independent Ph.D. in biochemistry and molecular biology from researcher. It was very hard to leave, but it’s difficult the same university. for reviewers to see who has the ideas if you stay in Today, Cuervo is an associate professor in the the same lab where you did your post-doctoral work.” Albert Einstein College of Medicine departments of It is a common, but bad practice for a mentor to Anatomy and Structural Biology and of Medicine in train a post-doc and retain them without regard to the Bronx, N.Y., and a member of its Marion Bassin the post-doc’s aspirations, she said. When you’re Liver Research Center. Her ongoing research focus, through with your post-doctoral work, you are which was also the focus of her thesis and trained but you don’t know everything, she said. postdoctoral work, is how to improve the removal of Dice taught Cuervo how to direct people in the lab altered proteins that occurs in certain diseases and without being intrusive and how to deal with as part of the aging process. administrative duties. During her pre-doctoral fellowship, Cuervo was Dice also taught Cuervo how to review and mentored by Erwin Knecht, Ph.D., then with the evaluate papers. “Instead of trashing a paper and Instituto de Investigaciones Citológicas in Valencia, pointing out what it didn’t have, Fred would say, Spain. In Knecht’s lab, Cuervo began to investigate ‘What would be the experiments that would make why certain cells lose the ability to eliminate toxic the paper even better?’” she said. Cuervo said her products, which lead to various age-related diseases. first grants complemented the research that Dice “In Spain, I was working on identifying a was doing. “It is wrong for the mentor to see the pathway for the clearance of proteins in lysosomes, young researcher as competition,” she said. also known as chaperone-mediated autophagy, and At one point, Dice became ill and asked Cuervo Fred (J. Fred Dice, Ph.D., at Tufts University in to take over interviewing new students to work in Boston) was studying the same pathway. This was the lab. He instructed her to select people who are very nice because it brought the two labs together,” nice and considerate and who she would like said Cuervo, who spent two pre-doctoral summers working with 14 hours a day. “When I would go to a working in Dice’s lab. meeting, I would always hear that Fred was such a The Spanish and American labs continue to nice guy. This is so important because we spend so work closely together. “We discuss our projects, many hours in the lab.” which is nice because usually scientists are so Today, pleasant people from seven countries competitive. We divide up the questions to be populate Cuervo’s lab. “We have great parties with answered – Boston is more mechanistic, Spain is more protein-related and I am interested in (continued on page 3)


Cuervo Builds Bridges (continued from page 2)

food from all over the world,” she said. “Working with an international group teaches us to be more tolerant. Everyone is a foreigner at some point. It is interesting to be continuously learning from someone from another country.” Cuervo stays in touch with her thesis and post-doctoral mentors and encourages scientists in her lab to do the same so they have connections to many labs. Cuervo, who has been running her own lab for four years, is beginning to see her students publish their first papers. “It’s very rewarding and exciting. One of my third-year students went to a meeting recently and his poster was chosen out of hundreds for oral presentation. Seeing how happy he was made me very, very happy,” she said. Einstein has a reputation for offering support and opportunities to international and minority students, she said. “A minority student, who worked in my lab for two years, wanted to go to grad school. She applied to 10 schools – including Johns Hopkins and Harvard — to do her Ph.D. and was accepted into every one. The senior advisor for minorities in

our school told her that she should inquire about how minorities do in those programs and look for the most supportive environment. This is very important.” There are a lot of opportunities for minorities and minority researchers should take Ana Maria Cuervo, M.D., Ph.D. advantage of them, Cuervo said. “We all need help. It is not a weakness if it’s going to fill a gap. For example, if you’re going to a meeting, always ask if there are any minority travel awards, because that will give you the opportunity to attend more meetings and to learn more. You have to believe in yourself. Most people are out there to help you. I’m very trusting and in the long run, it pays off.” ❖

SWAN (continued from page 1) level of treatment. Hispanic women were the least likely of all to have their hypertension treated or controlled. Because many women underestimate their risk of cardiovascular disease, and hypertension is a powerful risk factor for cardiovascular disease, these findings have important public health implications. The researchers suggest that urgent attention should be paid to public health and clinical efforts aimed at increasing awareness of the importance of hypertension prevention, treatment and control among all middle-aged women, but particularly among black and Hispanic women. “When SWAN began, we knew little about what actually happens to a woman’s health and her sense of well-being during her 40s and 50s or how the experience of menopause differs between racial or ethnic groups,” says Sherry Sherman, Ph.D., program director of Clinical Aging and Reproductive Hormone Research at the National Institute on Aging (NIA), and project officer for the study. “This research is answering questions about the physiological, psychosocial and lifestyle changes that occur as different groups of women go through menopause,” Sherman says. “It should teach us a lot about the factors that determine which women remain healthy as they enter later life and why the transition through the middle years is easy for some and difficult for others.” SWAN was started by the NIA, the National Institute of Nursing Research and the NIH Office of Research on Women’s Health. SWAN currently has clinical field sites at these seven centers:

● ● ● ●

The Massachusetts General Hospital, Boston. Rush Presbyterian-St. Luke’s Medical Center, Chicago. University of California, Los Angeles. University of California, Davis. University of Michigan, Ann Arbor. University of Medicine and Dentistry of New Jersey, Newark. University of Pittsburgh, Pennsylvania. ❖


Ai Appointed to Washington State Council on Aging
Gerontologist Amy L. Ai, Ph.D., an alumna of NIA’s Summer Institute on Aging Research (1997) and Technical Assistance Workshop on Aging, was recently appointed to the Washington State Council on Aging (SCOA), an advisory council to the governor, the Secretary of Social and Health Services and the Office of Aging. Ai, who received her post-doctoral training at the NIA, is the only at-large SCOA member who is Asian American. She served as the gerontologist representative of academic settings at the 2005 White House Conference on Aging. Ai is an associate professor of University of Washington (UW, Seattle) and an affiliated researcher, Section of Cardiac Surgery/Integrative Medicine, University of Michigan (UM) Health System in Ann Arbor. Prior to her current position, Ai received three master degrees and a Ph.D. from the UM, and then

WA Governor Christine Gregoire and Amy L. Ai, Ph.D.

held a research faculty position at the Section of Cardiac Surgery, UM, where she worked primarily on topics related to spirituality, cardiac rehabilitation and mental health co-morbidity of older and middle-aged patients. Ai has been the principal investigator for six research projects funded by NIH and the John Templeton, the John A. Hartford and the Niwano Foundations. Ai also has been a grant reviewer for the U.S. Department of State, the Economic and Social Research Council in the United Kingdom, the John Templeton Foundation and the Institute for Research on Unlimited Love. ❖

Master Mentor Miriam Kelty Retires from the NIA
Chances are that if you know Miriam Kelty, Ph.D., she has made a positive impact on your career. Throughout her professional life —the past 20 years of which she spent as director of extramural activities for the National Institute on Aging (NIA)— she has mentored many young scientists from elementary Judith Salerno, M.D., NIA deputy director school through (right) pays tribute to retiring Miriam Kelty, post-graduate Ph.D., associate director of NIA extramural stages and activities beyond. She is now preparing to end her 34-year federal career and recently reflected on her role as a mentor. “I have a long history of mentoring,” she says. “As a psychologist, I have a commitment to human potential. Both the individual and the field benefit. I think it’s very important because there seem to be a lot of people who don’t know how to achieve what they want.” Kelty’s position has been a natural venue for offering good counsel and sage advice to both extramural and intramural scientists. Her impact, as a scientific administrator at NIA, will be greatly missed, but retirement from the government will not mark the end of her work as a mentor. “Her contributions have been immeasurable,” says Richard J. Hodes, M.D., NIA director, who paid tribute to Kelty at the January meeting of the National Advisory Council on Aging, the group that advises NIA on the conduct and support of biomedical, social and behavioral research and training on the diseases and conditions associated with aging. Kelty has been a fellow of the American Association for the Advancement for Science since (continued on page 5)


Kelty Retires (continued from page 4)

1986 and a fellow of the American Psychological Association since 1976. Early in her career, she conducted research on brain and behavior interactions, specifically on hormones and reproductive behavior in birds and research on sleep in animals and humans. She was also involved in developing standards for the provision of mental health services in the late 1960s at the National Institute of Mental Health. In the 1970s, she worked for a congressional commission on bioethics and protections for human research subjects and contributed to reports on ethical principles (the Belmont Report), the mentally disabled, research with fetuses, children, prisoners and other vulnerable populations. Busy as her scientific and administrative responsibilities kept her, she always found time to mentor people in whom she saw potential or who sought her advice. In her community, Montgomery County, Md., she has volunteered as a science advisor to elementary school students working on science fair projects. She has also judged science fairs from elementary school level to the prestigious Intel Science Talent Search, America’s oldest pre-college science competition. Once, she recalls, she took advantage of a flight delay to get to know the winner of the Intel science fair. She introduced this young student to other scientists who could help her develop her interest in aging. “It’s very rewarding, especially when people have goals you can help them achieve. Some of it is guidance; some of it is being a sounding board,” she says. Kelty has also been an adviser to students from minority and disadvantaged backgrounds. She once paid the fee for a talented girl to take an entrance exam that enabled her to get scholarship money for college. Simple connections and chance meetings sometimes have led to mentoring relationships too. Once at a meeting, she met the father of a young American Indian woman who was coming to work in Washington. The young woman ended up staying with Kelty and her family during her employment and before going to law school. “It works both ways,” she says. Such experiences influenced Kelty’s children. “I’ve always encouraged my own kids to take advantage of where they are.” Her son, when a park ranger in Montana,

developed a better understanding of American Indian culture and architecture, especially the use of symbols in architecture, by taking courses at the local Miriam Kelty, Ph.D. community college where he met and worked with his own mentor. Her mentoring relationships in the research community run deep, too. At NIH, Kelty has counseled a variety of people both formally and informally. For example, she recalls talking to participants in the annual NIA Summer Institute, a program for young researchers embarking on their careers. Favorite topics included gaining credentials, scientific ideas and learning about resources to balance work and personal life. “I look for a thread. One has to establish a continuing relationship and to follow up and be a good listener and see where they want to go,” she says. “In the 70s, there were two people I mentored. One I told to finish her Ph.D. The other I hired and then encouraged to finish her Ph.D. Both have had significant careers. We’ve maintained contact and our long-term relationships.” Kelty also recalls working through existing NIH networks to be an effective mentor. She has participated in professional groups and classes for grants associates, extramural staff and the extramural staff training advisory committee as a speaker, seminar presenter and mentor. “We talk a lot about how to develop your career at NIH,” she says. Fortunately for those who have benefited by her guidance, leaving NIH will not mark the end of her role as mentor. In her post NIH-life, Kelty plans to continue mentoring relationships and hopes to work as a consultant to NIH. She is also looking forward to returning to an old interest—art. Prior to studying psychology and neuroscience, she was an art student. “I would like to do pottery or sculpture.” Among her other interests are hiking, scuba diving, skiing and travel. ❖


Pavon Wins AGS’ Edward Henderson Student Award
National Institutes of Health with cancer with guidance from (NIH) training opportunities have mentor Tamara B. Harris, M.D., paid off for Juliessa Pavon, a third senior investigator and chief of year medical student at the NIA’s Geriatric Epidemiology University of Florida, College of Section. Pavon’s interest in health Medicine (UF) in Gainesville. disparities led to a fellowship with Pavon is the 2006 recipient of the the NIH Academy. The NIH American Geriatrics Society’s Academy is a postbaccalaureate Edward Henderson Student Award program that provides in recognition of her strong interest opportunities for recent college in pursing a career in geriatrics. graduates to spend a year engaged Students who demonstrate in biomedical investigation at commitment to the field through NIH. leadership in initiating programs in As an undergraduate, Pavon geriatrics or scholarship through volunteered for Minority Juliessa Pavon original research or reviews are Community Outreach for the honored with this award at the Orlando Alzheimer’s Association and for Duke annual American Geriatrics Society conference being University Alzheimer’s Family Support Program held this year in Chicago, IL, May 3-7, 2006. directed by Lisa P. Gwyther. At Duke University’s As part of her pre-doctoral Intramural Research Center for the Study of Aging, Pavon investigated Training Award, Pavon worked in the National the impact of religious attendance of disabled Institute on Aging (NIA) Laboratory of elders on functional ability and the impact of Epidemiology, Demography and Biometry. She cognitive function and race on health service examined functional limitations of long- and shortutilization in the elderly. At UF, she is studying term cancer survivors and of people never diagnosed the effects of Parkinson’s disease in the elderly. ❖

Minorities Willing to Participate in Clinical Trials, Study Shows
New findings by researchers at the National Institutes of Health (NIH) show that minorities participate in health research studies at the same rate as non-Hispanic whites when they are made aware of the study and meet the medical requirements. The findings counter a widely held notion that minorities are less willing to participate and lead the researchers to suggest that minority involvement may be more a matter of access than attitude. “In order to improve the health of our population, we must make health research accessible to all groups,” says NIH Deputy Director Raynard Kington, M.D., Ph.D., M.B.A. “This NIH-supported study is a good example of research on how we do our research that can help us in making sure we have the best scientific knowledge base possible for eliminating health disparities.” Kington, whose research has focused on the relationship between social factors such as race and economic status and health, is one of the report’s authors. The study was led by researchers in the Department of Clinical Bioethics at the National Institutes of Health (continued on page 7)


Minorities (continued from page 6)

Clinical Center, the hospital at NIH. The work appeared online Dec. 6, 2005, in the medical journal PLoS Medicine, published by the Public Library of Science.

“I think it’s going to surprise many people,” says Ezekiel Emanuel, M.D., Ph.D., chair of the Department of Clinical The researchers Bioethics at NIH and an author of found only small the report. According to the study, differences in the it is widely claimed that racial and willingness of minorities ethnic minorities are less willing to participate compared to participate in health research, to non-Hispanic whites. and many people attribute it to a But the researchers distrust traced to past research found big differences NIH Deputy DirectorRaynard Kington, abuses, the most notable being the when it came to who was M.D., Ph.D., M.B.A. 1932-1972 Tuskegee syphilis study. asked to participate. In In that study, which was funded by the U.S. seven of the 17 clinical and surgical intervention Public Health Service, hundreds of poor African studies, enrollment was discussed with relatively American men in Alabama were followed for few people from minority groups. decades without being told they had syphilis and The authors say efforts to increase minority were not given penicillin to treat their syphilis. enrollment in trials should focus on improving But the data from this new study find that access rather than changing minority attitudes. when minorities are given the opportunity to The researchers offer a number of suggestions. participate in health research, they do so at the They include: informing minority groups about same rate as non-Hispanic whites. specific trials; choosing study sites that minorities can easily access; partnering with “The big take home message here is that community health clinics and other sites where a the main barrier probably is not the attitudes of substantial number of minorities receive medical African Americans and other minorities,” care; addressing logistics that could undermine Emanuel says. “The main barriers are access, minority participation such as the need for child knowledge that these studies exist, eligibility care and reimbursement for travel expenses. criteria that ensure minorities can participate and overcoming logistical barriers that exist,” “Study participants should reflect our society such as the location of the study or the need for as a whole to ensure that findings benefit the child care. most people,” says John I. Gallin, M.D., director of the NIH Clinical Center. “Identifying more The research team did a comprehensive ways to reach out to people who are willing to search of the medical literature to identify take part in research can advance medical science published trials that reported consent rates by and improve the health of our nation.” race and/or ethnicity. The team identified and reviewed 20 studies that involved more than This research was done in collaboration with 70,000 patients. Most of the studies were researchers from the Office of Behavioral and conducted in the United States and most of the Social Sciences Research at NIH, the Centers for participants from minority groups were African Disease Control and Prevention and the Yale Americans or Hispanics. Given that research was University School of Medicine. ❖ based on the enrollment decisions of more than

70,000 people over two decades in a variety of different types of research studies, from epidemiology to drug to surgical studies, the authors say they believe their findings are robust.


Work Group on Minority Aging Office of the Director National Institutes of Health National Institute on Aging Building 31, Room 5C35 Bethesda, MD 20892-2292 Phone: 301-496-0765

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Remember! July 17 Deadline for Technical Assistance Workshop
On November 16-17, 2006, the National Institute on Aging (NIA) will hold the Technical Assistance Workshop for Minority and Emerging Scientists and Students, a two-day interactive forum where minority and emerging scientists and students receive feedback from NIA staff on their current or planned research as well as general information about applying for NIA grants. The workshop is will be held immediately prior to the annual scientific meeting of the Gerontological Society of America in Dallas, TX. Participation is by competitive application. NIA encourages applications from members of groups under-represented in aging research and investigators committed to research careers related to minority aging issues. Applicants should be pre- or post-doctoral students or recent recipients of Ph.D., M.D. or related doctoral degrees; new to the NIH application process and/or embarking on an independent program of research; investigators with less than five years of research experience; and U.S. citizens, non-citizen nationals or permanent residents. Applications are due by July 17, 2006. For information and application forms, please contact Jamie Gulin at 301-496-0765; gulinj@nia.nih.gov. ❖


Links: Minority Research and Training newsletter is published by the Work Group on Minority Aging, Office of the Director, National Institute on Aging, Building 31, Room 5C35, Bethesda, MD 20892, 301-496-0765. Thanks to Editor Jeannine Mjoseth. Thanks also to contributers Linda Joy and Karin Kolsky. This is an administrative document.