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15 UC scholars elected to National Academy of Sciences

New members from six UC campuses.

Fifteen scholars from the University of California have been newly elected to the National Academy of Sciences. They are among 84 new members named to the prestigious organization.

They bring UC’s total number of members to 584.

Established by congressional order and signed into existence by Abraham Lincoln in 1863, the academy acts as an official science and technology adviser to the federal government. Election to the academy is considered one of the highest honors that can be accorded to a U.S. scientist.

New members, by campus, include:

UC Berkeley

  • Martin Head-Gordon, Kenneth S. Pitzer Distinguished Professor of Chemistry, department of chemistry
  • Jitendra Malik, Arthur J. Chick Professor of Electrical Engineering and Computer Sciences, department of electrical engineering and computer sciences
  • Daniel M. Neumark, chair and Joel Hildebrand Distinguished Professor of Chemistry, department of chemistry
  • Eva Nogales, investigator, Howard Hughes Medical Institute; and professor of biochemistry and molecular biology
  • Jeremy Thorner, professor, division of biochemistry and molecular biology

UC Davis

  • Alan Hastings, distinguished professor, department of environmental science and policy

UC Irvine

  • Shaul Mukamel, distinguished professor of chemistry, department of chemistry

UCLA

  • James C. Liao, Ralph M. Parsons Foundation Professor and chair, chemical and biomolecular engineering department
  • Glen M. MacDonald, UC Presidential Chair and distinguished professor, departments of geography and of ecology and evolutionary biology, Institute of the Environment and Sustainability
  • Jeffery F. Miller, M. Philip Davis Chair in Microbiology and Immunology and chair, department of microbiology, immunology, and molecular genetics

UC San Diego

  • Harvey J. Karten, professor of neurosciences and psychiatry
  • Julian I. Schroeder, full professor and Novartis Chair in Plant Sciences, division of biological sciences
  • Jeffrey P. Severinghaus, professor, Scripps Institution of Oceanography
  • Lisa Tauxe, distinguished professor of geophysics, Scripps Institution of Oceanography

UC Santa Barbara

  • Joseph Incandela, professor, department of physics

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Cal-BRAIN selects 16 California research projects for seed grants

Projects will speed development of new brain technologies.

By Jeff Gattas and Inga Kiderra, UC San Diego

Cal-BRAIN, a California research grants program that aims to revolutionize our understanding of the brain, has selected 16 projects to receive inaugural seed grants of $120,000 each. The projects represent efforts around the state to create new technologies capable of measuring brain activity in greater depth, breadth and detail than is currently possible.

An initiative led jointly by UC San Diego and the Lawrence Berkeley National Laboratory, Cal-BRAIN is short for California Blueprint for Research to Advance Innovations in Neuroscience. The program was signed into law in June 2014 and is the California complement to the federal BRAIN Initiative announced by President Barack Obama in 2013.

“State investment is critical to the advancement of important research in California,” said UC San Diego Chancellor Pradeep K. Khosla. “This funding will enable some of our nation’s most talented and innovative researchers to make discoveries that will transform lives and benefit society for years to come.”

Scientists from all California nonprofit research institutions were eligible to apply for Cal-BRAIN grants. And 126 interdisciplinary teams submitted their proposals.

The 16 funded projects will be carried out at 10 UC campuses as well as Caltech, Stanford and the University of Southern California.

“Interdisciplinary, and multi-institutional, research brings many insights and skills to this vital and urgent area of inquiry,” said Sandra A. Brown, vice chancellor for research at UC San Diego. “Support for our work in neurotechnologies will pay dividends in understanding, and healing, the brain.”

The projects will seek to measure four different aspects of the brain’s activity: electrical activity, neurochemical activity, metabolic activity and gene activity. The technological strategies include advances in microscopy, brain imaging, sensors based on nanotechnology and neural prosthetics, explained UC San Diego’s Ralph Greenspan, who co-directs Cal-BRAIN with Paul Alivisatos of the Lawrence Berkeley National Laboratory.

All of the projects aim at innovations that will be applicable to the full spectrum of brain disorders, Greenspan said, and several are specifically keyed to traumatic brain injury, paralysis, epilepsy and Alzheimer’s.

“We are tremendously excited by the quality and originality of the proposals. Getting these innovative projects launched is an essential step in realizing Cal-BRAIN’s goals,” said Greenspan, who, in addition to co-directing Cal-BRAIN, is also director of the Center for Brain Activity Mapping of the Kavli Institute for Brain and Mind at UC San Diego.

The proposals were reviewed by experts outside of California, to reduce the possibility of conflicts of interest. They were first assessed by Cal-BRAIN’s out-of-state scientific advisory board which then made recommendations on relevant subject experts, also out-of-state, to conduct detailed reviews. The review criteria included scientific quality, significance, innovation and scalability. The Cal-BRAIN directors made the final selections based on the reviews and also on relevance to the Cal-BRAIN mission.

Cal-BRAIN has an initial budget allocation of $2 million. The seed grants account for 96 percent, or $1.92 million, of the monies. The remaining $80,000 is going to administrative costs and for conferences with researchers and various California stakeholder groups.

California Assembly Speaker Toni Atkins (D-San Diego), State Sen. Marty Block (D-San Diego), Gov. Jerry Brown and former California Senate President Pro Tem Darrell Steinberg (D-Sacramento) were strong champions of Cal-BRAIN.

“This inter-institutional initiative would not have been possible without the support of the governor and our state legislative leaders who saw the value of Cal-BRAIN’s ability to focus research teams throughout California on the next medical frontier – the brain,” Khosla said. “We are grateful for their resolve to keep California at the forefront of brain research.”

For a full list of the funded projects, including principal investigators and abstracts, see the Cal-BRAIN website.

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UC Davis ranked best in world for agriculture, veterinary sciences

First time subject area of veterinary sciences included in QS World University Rankings.

The University of California, Davis, ranks No. 1 in the world for teaching and research in agriculture and forestry as well as veterinary sciences, according to data released today (April 28) by QS World University Rankings. This is the third consecutive year that UC Davis has been ranked first in agriculture and forestry by QS.

The organization ranked UC Davis in 27 of the 36 subjects covered. This was the first time the subject area of veterinary sciences was included in QS rankings. UC Davis is the only University of California campus this year that was ranked first in any of the disciplines ranked by QS.

UC Davis among top 50 universities in many subjects

The organization ranked UC Davis among the top 50 universities in various subjects, including environmental sciences (15), biological sciences (29), earth and marine sciences (41), history (42), and statistics and operational research (50).

QS rankings are based on reputational surveys and research citations. The full report is available online.

“These rankings reconfirm that our faculty and researchers are respected the world over and that their work is making an impact throughout the globe,” said UC Davis Chancellor Linda P.B. Katehi. “This is a proud day for UC Davis and for all our faculty, staff, students and alumni.”

College of Ag and Environmental Sciences founded in 1905

The UC Davis College of Agricultural and Environmental Sciences was founded in 1905 as the University of California’s University Farm. Today, it has more than 6,200 undergraduate students in 27 majors and more than 1,000 graduate students in 45 graduate groups and programs. Its programs have characteristically received top-tier rankings from the Chronicle of Higher Education, U.S. News & World Report and ISI Essential Science Indicators.

More than 3,000 acres of UC Davis’ 5,000-acre campus are devoted to agricultural research.

UC Davis also is home to the World Food Center, established in 2013 to increase the economic benefits from research across campus; influence national and international policy; and convene teams of scientists and innovators from industry, academia, government and nongovernmental organizations to tackle food-related challenges in California and around the world.

“UC Davis researchers are at the forefront of addressing regional and global issues related to food, the environment, health, and families,” said Helene Dillard, dean of the College of Agricultural and Environmental Sciences at UC Davis. “At the same time, our students graduate to become leaders in science, education, business and decision-making, from the community to the international level.”

Vet Med runs teaching hospital, clinics throughout California

The UC Davis School of Veterinary Medicine annually cares for more than 48,000 animal patients and is educating more than 500 veterinary students plus residents and grad students. The school runs a veterinary medical teaching hospital at UC Davis and satellite clinics in San Diego and the San Joaquin Valley community of Tulare.

Veterinary faculty members work to solve society’s most pressing health issues by collaborating with colleagues from human medicine and other disciplines. An example of its “one health” approach is a recent $100 million grant to the veterinary school to coordinate surveillance for disease-causing microbes, discovering new viruses and strengthening global health capacity in more than 20 countries.

“The UC Davis School of Veterinary Medicine has a rich history of educating leaders in veterinary medicine, public health, biomedical sciences and specialty disciplines,” said Dean Michael Lairmore. “Our recognition by the QS World Rankings demonstrates our global impact in advancing the health of animals, people and the environment. While leading veterinary medicine, we use a One Health approach, bringing together multiple disciplines to translate basic and applied knowledge to address societal needs. I am very proud of our people and programs that have worked hard to earn this new recognition for our school and UC Davis.”

UC Davis, overall, was ranked ninth last fall among the nation’s public universities by U.S. News & World Report. The magazine ranked the UC Davis School of Veterinary Medicine No. 1 in the nation in its rankings on graduate programs and professional schools released in March.

The QS World University Rankings by Subject this year evaluated 3,467 universities and ranked 971 institutions. The rankings are prepared by Quacquarelli Symonds (QS), a British firm that previously was the data provider for the annual Times Higher Education rankings. The firm is widely considered to be one of the most influential international university rankings providers.

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Mark Bittman, UC team to launch California food video series

10-part series launches May 11.

By Alec Rosenberg

What happens when a renowned New York food writer comes to California to soak in the Golden State’s agricultural and food scene?

Find out in “Mark Bittman: California Matters,” a 10-part video series launching May 11, produced by the University of California and Berkeley Food Institute.

Bittman, a widely admired food writer, best-selling cookbook author and New York Times columnist, is in California this spring as a distinguished visiting fellow at the Berkeley Food Institute.

For the series, he hits the road, traveling from oyster farms off the Northern California coast to Chinese restaurants in Los Angeles to immigrant farmers in the Central Valley, exploring leading-edge UC research in food, sustainable agriculture, policy and health.

“While I’m here, I want to find out as much as I can about the agriculture and food research surrounding it,” Bittman said. “There’s a lot going on out here.”

Urban foraging

The first episode will explore urban foraging with UC Berkeley’s Tom Carlson and Philip Stark, who are studying the prevalence, nutritional value and possible toxicity of wild edibles in urban food deserts as well as barriers to widespread use of these foods. New stories will run online every two weeks with bonus footage in between.

UC is producing the video series in collaboration with the Berkeley Food Institute as part of the UC Global Food Initiative. UC President Janet Napolitano, together with UC’s 10 chancellors, launched the initiative in July in an effort to help put UC’s campuses, the state and world on a pathway to sustainably and nutritiously feed themselves.

“We’re excited about this video series because it will help elevate public attention to important innovative research projects at UC Berkeley and other UC campuses that address compelling issues in food and agriculture systems in California and beyond,” said Ann Thrupp, executive director of the Berkeley Food Institute. “The videos will give the public a taste of remarkable discoveries and findings from studies of a diversity of critical topics that touch our everyday lives.”

In the series, Bittman visits an oyster farm and discusses why ocean acidification matters with Tessa Hill of UC Davis. He checks out efforts to improve school meals and prevent childhood obesity with Kristine Madsen of UC Berkeley and UC San Francisco, and digs into sustainable food systems with Martha Brown and Daniel Press of UC Santa Cruz.

What role do pollinators play in crop production? Find out in an episode with Claire Kremen of UC Berkeley. Other episodes will cover lessons about pesticide exposure among mothers and children in the Salinas Valley with Brenda Eskenazi of UC Berkeley, and the changing face of California agriculture, highlighting Hmong and Mien farmers, with Jennifer Sowerwine of UC Berkeley and UC Agriculture and Natural Resources.

Food as culture and industry

In addition, Bittman will dive into the history of Chinese-American food and culture with Yong Chen of UC Irvine and take a look behind the kitchen door with restaurant worker advocate Saru Jayaraman of UC Berkeley.

For the last story, Bittman caps the series with a roundup of his experiences in California.

Don’t miss an episode. Subscribe to California Matters on YouTube and watch the series.

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Women’s health: A critical update across the lifespan

UCTV explores women’s health issues.

Women’s health needs are unique and cover a wide spectrum over the course of a woman’s life. This UCTV series explores a broad range of topics including stress management, sexual health, exercise and the athlete in each of us, osteoporosis, breast cancer in the Bay Area and fibroid treatment options. Presented by UC San Francisco faculty from the Women’s Health Center, Osher Center for Integrative Medicine and the Department of Orthopaedic Surgery (all of which are recognized internationally for their expertise in providing comprehensive care), these programs address both comprehensive and integrative approaches in women’s health.

Programs include:

Not All Roads Point to Hysterectomy: Treatment Options for Fibroids
First air date: April 27

Breast Cancer in Marin: The Myths, The Facts & The Science
First air date: April 20

Outsmarting Stress One Breath at a Time
First air date: April 13

Breast Cancer Screening and Prevention: A Clinician’s Perspective
First air date: April 6

What’s New in Management of the Menopause?
First air date: March 30

Every Patient is an Athlete: Using Exercise as Medicine
First air date: March 23

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Request for proposals released for new California precision medicine initiative

Concept proposals due May 22 for statewide effort hosted by UCSF, through UC Health.

A request for proposals for demonstration projects has been released to UC campuses for the new California Initiative to Advance Precision Medicine (CIAPM). Concept proposals are due May 22.

Gov. Jerry Brown and UC announced the initiative April 14. The initiative is a collaboration of public and private academic and industry partners that will start to build infrastructure and assemble resources necessary to advance precision medicine-oriented data, tools and applications. The goal is to integrate clinical data with genomic, environmental, socioeconomic, mobile and other data from patients so scientists can understand diseases better and develop more precise therapies.

UC San Francisco is hosting the two-year initiative, through UC Health, which includes UC’s five medical centers, with $3 million in startup funds from the state. The public-private initiative aims to leverage these funds with contributions from other academic and industry partners.

CIAPM will develop two demonstration projects in disease areas where UC and its external partners have deep expertise. The initiative also will inventory the public and private precision medicine assets now available in the state, and convene experts in medicine, technology, privacy, bioethics and intellectual property to ensure the secure, fair and respectful exchange of data and knowledge.

For more information, contact ciapm@ucsf.edu.

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President Napolitano joins American Academy of Arts and Sciences

New class includes 22 UC scholars.

Twenty-two scholars from across the University of California — including UC President Janet Napolitano — have been elected to the American Academy of Arts and Sciences’ class of 2015. They are among 197 new members spanning academia, the arts, business and philanthropy.

“We are honored to elect a new class of extraordinary women and men to join our distinguished membership,” said Don Randel, chair of the academy’s board of directors. “Each new member is a leader in his or her field and has made a distinct contribution to the nation and the world. We look forward to engaging them in the intellectual life of this vibrant institution.”

This year’s new members bring UC’s total membership to 511. By campus and classification, they include:

  • UC Berkeley: Carlos J. Bustamante, interclass; John Clarke, physics; Alexei V. Filippenko, astronomy; John F. Harwig, chemistry; Enrique Iglesia, engineering sciences and technologies; and John MacFarlane, philosophy
  • UC Davis: Sharon Y. Strauss and Peter C. Wainwright, evolutionary and population biology and ecology
  • UC Irvine: Rubén G. Rumbaut, archaeology, anthropology, sociology, geography and demography
  • UCLA: Ivan T. Berend, history; Barbara Kruger, visual arts – criticism and practice; Michael Mann, archaeology, anthropology, sociology, geography and demography; and Gregory R. Schopen, religious studies
  • UC San Diego: Patricia Smith Churchland and David Kleinfeld, neurosciences, cognitive sciences and behavioral biology
  • UC San Francisco: Joseph L. DeRisi, biochemistry and molecular biology; Frank P. McCormick, biological sciences; Robert L. Nussbaum, medical sciences, clinical medicine and public health; and James A. Wells, biological sciences
  • UC Santa Barbara: David R. Morrison, mathematical and physical sciences
  • UC Santa Cruz: Gail Hershatter, history
  • Systemwide: Janet A. Napolitano, educational, scientific, cultural and philanthropic administration

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Is that pill really what the label says it is?

Report calls for improved detection, data collection, analysis to combat ‘pandemic.’

Credit: iStock

By Scott LaFee, UC San Diego

When you take a medication for, say, high cholesterol, do you know that pill is really what the label says it is? Depending upon the type of medicine and where you live, the threat of falsified medications (also referred to as counterfeit, fraudulent and substandard) can be quite real, yet the full scope and prevalence of the problem is poorly understood, say researchers at the UC San Diego School of Medicine in a new report published today (April 20) in the American Journal of Tropical Medicine and Hygiene.

Counterfeit medicines have traditionally been defined as those for which the identity or source is mislabeled in a way that makes them appear to be a genuine product when they are not, though definitions of the problem itself are the subject of international debate.

The UC San Diego report is part of a special journal supplement featuring a variety of studies examining aspects of the “global pandemic of falsified medicines.” Produced by diverse universities and institutions across the country and world, the supplement investigates the quality of vital, broadly sold drugs, such as anti-malarials and antibiotics; new tests and assays to detect counterfeit drugs; and proposed policy changes and laws to reduce the distribution and sale of falsified medications.

Global problem

The UC San Diego study looked at the depth of counterfeit drug penetration in global legitimate medicine supply chains.

“Our study was based on data from the Pharmaceutical Security Institute (PSI), a nonprofit organization with members from the pharmaceutical security community,” said lead author Tim K. Mackey, M.A.S, Ph.D., assistant professor of anesthesiology and global public health, director of the Global Health Policy Institute and associate director of the joint masters program in health policy and law. “PSI data is collected from its industry members, law enforcement, drug regulators, the pharmaceutical industry and media reports, and confirmed by a team of multilingual investigators. It’s the only study of its kind with global statistics on counterfeit medications. We limited the scope to legitimate supply chains, places where you expect to get legitimate medicines, such as hospitals and pharmacies.”

The primary finding and “surprise,” said Mackey, is how little is known about the precise scope of the problem and how few mechanisms exist to monitor it despite the availability of some data. During the period studied, 2009 through 2011, there were 1,510 total counterfeit incidence reports tabulated by the PSI. But “nobody has a good idea how big the problem really is,” said Mackey. “There are guesses, but it’s hard to get accurate statistics on a criminal activity of this magnitude.”

Lives at risk

The falsified drug problem is not new, just bigger than ever, say experts. It covers widely used drugs, notably anti-malarials and more high-value, high-demand drugs, such as medications to treat HIV/AIDS, serious cardiovascular disease and cancer. According to a 2000 World Health Organization report, almost one-third of identified counterfeit drugs contained no active ingredient; and more than 20 percent either had incorrect quantities of active ingredients or contained the wrong ingredients. Other fraudulent practices included false packaging and high levels of impurities.

Each year, it’s estimated between 100,000 and 1 million people die from using counterfeit drugs.

“The most important takeaway of our study is that we don’t have the necessary data or surveillance to effectuate meaningful public health interventions or policy change,” Mackey said. “As an example, more than half of our dataset was from four countries, not necessarily because these countries have the most counterfeits, but possibly because they are countries of transit or are the ones actively looking for them.”

The researchers also noted that scores of countries filed no counterfeit incidence reports during the study period.

“We hope this study will prompt key opinion leaders and policymakers to make necessary changes to surveillance, security and improvements to pharmaceutical governance of drug supply chains in order to prevent future falsified medicine incidents and protect patients worldwide,” said Mackey.

Study co-authors include Bryan A. Liang, Global Health Policy Institute; Peter York and Thomas Kubic, Pharmaceutical Security Institute.

This research was funded, in part, by the Partnership for Safe Medicines and the Pharmaceutical Security Institute.

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Berkeley’s Jennifer Doudna among Time magazine’s 100 most influential people

List of most influential in world range from President Barack Obama to rapper Kanye West.

UC Berkeley professor Jennifer Doudna, left, has been named among Time magazine's 100 most influential people

By Robert Sanders, UC Berkeley

Time magazine has named Jennifer Doudna, a professor of molecular and cell biology, to its 2015 list of the 100 most influential people in the world.

The list, now in its 12th year, recognizes the activism, innovation and achievement of the world’s most influential individuals.

Doudna is in the company of honorees such as President Barack Obama, Supreme Court Justice Ruth Bader Ginsburg, Russian President Vladimir Putin, German Chancellor Angela Merkel, Democratic presidential hopeful Hillary Clinton, author Haruki Murakami, Apple CEO Tom Cook and rapper Kanye West.

A Howard Hughes Medical Institute investigator at UC Berkeley, Doudna has received numerous honors and awards for her discovery of a revolutionary DNA-editing technique that has upended the world of genetics. The technique, called CRISPR-Cas9, exploits precisely targeted DNA-cutting enzymes from bacteria to snip and edit human and animal DNA, making it much easier to create animal models of disease and possibly correct human genetic disease via gene therapy.

Her colleague and co-discoverer, Emmanuelle Charpentier of the Helmholtz Center for Infection Research and Umeå University, was also named to Time‘s 100 list.

“Their technique, CRISPR-Cas9, gives scientists the power to remove or add genetic material at will,” wrote geneticist Mary-Claire King in a summary of their work. “Working with cells in a lab, geneticists have used this technology to cut out HIV, to correct sickle-cell anemia and to alter cancer cells to make them more susceptible to chemotherapy. With CRISPR-Cas9, a scientist could, in theory, alter any human gene. This is a true breakthrough, the implications of which we are just beginning to imagine.”

King discovered the BRCA1 breast cancer gene while a professor at UC Berkeley in the 1990s, before moving to the University of Washington, Seattle.

Time editor Nancy Gibbs several years ago explained that “The Time 100 is a list of the world’s most influential men and women, not its most powerful, though those are not mutually exclusive terms …. While power is certain, influence is subtle…. As much as this exercise chronicles the achievements of the past year, we also focus on figures whose influence is likely to grow, so we can look around the corner to see what is coming.”

The full list and related tributes to the Time 100 appear in the April 27 issue of the magazine, available online today (April 16) and at newsstands and for tablets on Friday, April 17.

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States’ policies put health of undocumented immigrants at risk

Ohio rules create greatest health risk for undocumented residents; California the fewest.

By Gwendolyn Driscoll, UCLA

California scored the highest in a new ranking of U.S. states’ public policies and laws that support the health and well-being of undocumented immigrants.

The report, by the UCLA Center for Health Policy Research and the UCLA Blum Center on Poverty and Health in Latin America, with support from the UC Global Health Institute, also found that Ohio had policies that were more exclusionary than those of any other state.

The report focuses on state policies as of 2014 in nine categories across five areas: public health and welfare, higher education, labor and employment, access to driver licensing and government ID card programs, and enforcement of the federal Secure Communities program — all of which influence the health of immigrants and their families.

The researchers rated each state’s policies as “inclusive” (supporting health and well-being) or “exclusive” (harming health and well-being). Scores, which ranged from +1 to -1 for each category, were then tallied for an overall rating for each state. The average total score was -2.5 points.

California scored a total of +9; liberal-leaning New York scored +1. Only six other states and Washington, D.C., had overall scores greater than 0. Other surprises: Texas, frequently in the news for its conservative policies, scored +2 overall, making it one of the five most inclusive states. And Florida, which has a large population of recent immigrants, earned a -3. In all, 41 states were in negative territory.

See the results in a sortable, state-by-state list.

States with the top five and bottom six overall scores:

Top 5
1. California +9
2. Illinois +7
3. Washington +4
4. (tie) Colorado +2
4. (tie) Texas  +2

Bottom 6
51. Ohio -7
50. (tie) Alabama -6
50. (tie) Arizona -6
50. (tie) Indiana -6
50. (tie) Mississippi -6
50. (tie) West Virginia -6

“It is frustrating that so many states have policies that ignore or exclude a group of people who work hard and contribute so much to our society,” said Steven P. Wallace, associate director of the UCLA Center for Health Policy Research and co-author of the report. “The neglect or outright discrimination of the undocumented does not just hurt workers and their families; it hurts the communities that rely on them for the basic labor that makes our society function.”

Policies affect millions

The states’ public policies — and how each responds to flexibility in federal laws — affect the estimated 11.2 million undocumented immigrants living in the country, according to the report. The policies evaluated in the study also affect about 4 million U.S.-born children who live in “mixed-status” families, in which at least one parent is undocumented.

Laws in Arizona — including its immigration status check provision — and in other states have attracted federal court challenges and much media attention. Yet many state laws that can either promote or complicate the health of undocumented immigrants receive little attention.

Examples of beneficial or harmful policy outcomes, by program area:

Public health and welfare. Some states offer child health insurance or similar benefits regardless of immigration status, and some offer full Medicaid to pregnant undocumented women, but many do not. Most states determine eligibility for food stamps (now known as Supplemental Nutrition Assistance Program, or SNAP) by factoring in the family’s income and the number of all family members, regardless of their immigration status. But five states, including Arizona and Ohio, calculate eligibility for assistance using the income of all family members, but determine “family size” based only on those who are citizens or lawful permanent residents. This makes it more difficult for families with undocumented members to qualify.

Higher education. Twenty states, including California, Illinois, Florida, New York and Texas, allow undocumented students who attended secondary school in the state to pay in-state tuition for colleges and universities. Five of those, including California and Texas, also offer scholarship funding for those students. The rest require undocumented college students to pay out-of-state tuition, even if they attended K-12 in-state. Among the most exclusive is Georgia, which bars undocumented students from attending many of its public colleges and universities — even if they graduated from high schools in the state.

Labor and employment. Ten states’ workers’ compensation laws classify undocumented workers as “employees,” which qualifies them for workers’ compensation if they are injured on the job. But many states encourage public and private employers making hiring decisions to use the federal employment tool, E-verify, to check if an immigrant is authorized to work. Twenty states require state agencies, state contractors and/or private employers to use E-Verify; only two — California and Illinois — limit its use.

Access to driver’s licenses and government IDs. While some undocumented people can obtain identifications cards from their consular offices, cities such as Chicago, Oakland and San Francisco offer municipal IDs, which allow more access to public and private services. As of 2014, six states — California, Colorado, Illinois, Oregon, Utah and Washington — have laws that provide driver’s licenses to undocumented residents. But a federal law, REAL ID, puts restrictions on states that grant driver’s licenses or other IDs to the undocumented. Half of the states have passed resolutions or statute opposing the law.

Secure Communities. This enforcement program required that local police share information with federal immigration authorities, and it has contributed to the deportation of roughly 400,000 people per year, according to Pew Research. This has separated families and put stress on immigrants’ finances and health, the authors write. California, Connecticut and Colorado have adopted policies that prevent some undocumented immigrants charged with low-level, nonviolent offenses from being turned over to federal immigration authorities. Secure Communities was replaced by the Priority Enforcement Program, which does not require local law enforcement agencies to share information gathered in an arrest with the federal government.

Even high-scoring states can improve

Even the states that earned positive scores have room for improvement. The authors recommend actions all states can take to create a better environment for undocumented immigrants:

• Strengthen laws that secure undocumented immigrants’ rights in the five areas reviewed in the report.
• Buffer federal laws that restrict undocumented immigrants’ rights or access to resources.
• Focus on passing laws that are inclusive, rather than laws that explicitly exclude residents based on their legal status.
• More closely examine public policies for their ultimate impact on undocumented immigrants’ health.

“State and national lawmakers must recognize the value undocumented immigrants have in our country,” said Dr. Michael Rodriguez, co-author of the report, of the Blum Center and a faculty associate at the UCLA Center for Health Policy Research. “States must understand the critical role their policies play in promoting or hindering the well-being of undocumented immigrants who are an important part of the economic, political and social fabric of our nation.”

A report launch seminar with the authors, “The Healthiest (and Most Unhealthy) States to Be an Undocumented Immigrant: A Review of State Health Policies,” will be held from 12-1 p.m. today (April 16) at 10960 Wilshire Boulevard, Suite 1550, Los Angeles.

A special plenary session, “No Federal Immigration Reform? What States Can Do to Improve the Health of Undocumented Workers,” will be held from 11:30 a.m.-12:15 p.m. Saturday, April 18, during UC Global Health Day at UCLA, Covel Commons, 200 De Neve Drive, Los Angeles. Registration for UC Global Health Day is required for admission. Onsite: general $75, student $50.

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Seeing through Alzheimer’s disease

UC Berkeley’s William Jagust uses imaging to help find insights into Alzheimer’s.

William Jagust’s Alzheimer’s research has found evidence of neuron networks breaking down. (Photo by Peg Skorpinski, UC Berkeley)

By Wallace Ravven

A jury would have to acquit. Two tough guys are caught at the scene of a brutal beating, but no one witnessed the crime. No video cameras or cell phone captured the assault. Maybe both men arrived after the attack. Or one might have acted alone. They’re suspicious, but not guilty beyond a reasonable doubt.

The same might be said about our current understanding of how Alzheimer’s disease develops. Two proteins — called beta-amyloid and tau — definitely muck up neurons in Alzheimer’s victims.  Amyloid clumps into plaques that interfere with cell-to-cell communication. Tau proteins contort into tangled fibers inside the cells.

But until recently, neuroscientists have not been able to track the course of Alzheimer’s in the brain. Amyloid and tau might not destroy neurons directly, or perhaps amyloid works alone, wrecking the delicate integrity of neural networks and degrading memory.

Researchers have been limited to a single snapshot of the brain — one view of the battlefield provided by an autopsy. The course and chronology of the damage that steals memory are still up for grabs.

“We’ve been scratching our heads about how these two proteins are related to each other and to the cause of Alzheimer’s for literally 100 years,” says Berkeley neuroscientist William Jagust. “We don’t know the difference between ‘normal’ memory loss and the likely pathology associated with tau. We don’t know whether amyloid or tau is most important in Alzheimers, or if amyloid plaques between neurons affect the tau tangles inside cells.”

But there’s a sense of anticipation in the air, buoyed by researchers’ increasing ability to peer into the brains of people struggling with Alzheimer’s as well as  seniors free of its grip. In the past decade, PET scans and other powerful new imaging tools have begun to fill in the story of how healthy and damaged brains change throughout life.

“We still have many questions and few answers,” Jagust says. “But brain PET scanning in both diseased and healthy people is sort of blowing that wide open. We now have the tools to study the progression of plaque formation from its earliest stages and to determine how amyloid and tau affect cognitive decline over time.

Before PET scanning, Jagust says, researchers already knew from autopsies that about a third of older people with amyloid plaques had no symptoms of cognitive decline.

“This created the argument: ‘If they have no symptoms, how can it be that amyloid causes Alzheimer’s?’ You can’t answer that with an autopsy.” But if periodic PET scans show increasing plaque deposition over time as cognitive loss becomes severe, then the plaque argument becomes much stronger.

Research in his lab supports the hypotheses that plaques interfere with the formation or maintenance of synaptic connections. Using the metabolic imaging technique of functional MRI, he focused on plaque-ridden brains of healthy older people, and found indirect, but strong evidence that connections within networks of neurons were breaking down.

“Parts of the brain that should be connected strongly are becoming weakly connected, and parts that are normally not strongly connected become so. It’s almost like the brain is becoming rewired.”

But the rewiring evidence cuts both ways. In another study, Jagust found that some people with amyloid plaques performed as well on memory tests as those who were plaque-free. In some of them, novel connections appeared between neurons in their brains, suggesting new networks were in play.

“There is evidence of ‘rewiring’ that appears to be detrimental, but also evidence of ‘rewiring’ that may serve a compensatory role  — providing a cognitive reserve,” he says. “The balance between these in individuals may explain why some decline and others do not.” The research was published in 2013 in the Journal of Neuroscience and in 2014 in Nature Neuroscience.

Several large clinical trials have shown that experimental immunotherapeutic drugs can at least moderately slow Alzheimer’s amyloid plaque deposition. So far, the decline in plaque buildup has not slowed memory loss. But Jagust is confident that the tremendous boost in brain imaging will lead to effective therapies.

One ambitious study, just launched at Harvard and UC San Diego neuroscientists, combines refined imaging and drug trial, focusing on 1,000 people in their 70s and 80s. Study participants do not have Alzheimer’s, though some have amyloid plaques. Researchers hope that by intervening early enough with drugs to slow plaque accumulation, they can prevent or at least delay severe cognitive loss. If early intervention is key, then so is the ability to detect even the slightest sign of neurological damage. The Jagust Lab is using statistical and computational approaches to refine PET scan sensitivity.

In images of people’s brains with significant amyloid deposits, the protein shows up clearly as fiery orange bands across the cerebral cortex, or gray matter areas of the brain. Jagust suspects that improved scanning will allow researchers to spot mere traces that hint at possible trouble to come. The lab is also beginning studies that will image accumulations of tau, allowing the researchers to understand the relationships between tau and amyloid, and provide another target for drug development.

“If the images can tease apart the different roles of beta-amyloid and tau, and if we can detect damage in its very earliest stages, we would have strong reason to hope that new drugs can spare or significantly slow cognitive damage. I don’t think this is being overly optimistic.”

In recognition of his research on brain aging and dementia, Jagust received the 2013 Potamkin Prize for Research in Pick’s, Alzheimer’s and Related Diseases by the American Academy of Neurology and the American Brain Foundation.

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Surgery for terminal cancer patients still common

Surgeons increasingly selective in deciding whether to operate.

By Dorsey Griffith, UC Davis

The number of surgeries performed on terminally ill cancer patients has not dropped in recent years­, despite more attention to the importance of less invasive care for these patients to relieve symptoms and improve quality of life. But new research from UC Davis also finds that the morbidity and mortality among patients with terminal cancer has declined because surgeons are selecting to operate on healthier patients.

The study, “Current Perioperative Outcomes for Patients with Disseminated Care Undergoing Surgery” was published online this week in the Journal of Surgical Research.

“Surgeons are becoming wiser,” said study lead author Sarah Bateni, a UC Davis resident surgeon. “Our research suggests that surgeons may be operating on healthier patients who are more likely to recover well from an operation. These are patients who can perform activities of daily living without assistance, for example.”

Bateni’s interest in the appropriate surgical care of people with late-stage cancer grew from observing terminally ill patients whose acute problems were addressed through surgery, and who then suffered complications resulting in lengthy stays in intensive care units, and even in death.

“It is common that patients end up dying in the intensive care unit instead of being managed with medication with hopes of returning home with their families, including with hospice care,” she said.

For the study, Bateni used the American College of Surgeons National Surgical Quality Improvement Program between 2006 and 2010 to identify 21,755 patients with stage IV cancer, meaning that the disease had metastasized, or spread, beyond the primary tumor site.

Over the five years in the study period, surgical interventions declined just slightly, from 1.9 percent to 1.6 percent of all procedures. The most frequent operations were surgeries to alleviate bowel obstructions among cancer patients with metastatic disease.

Also over time, the patients undergoing surgery were more independent and fewer had experienced dramatic weight loss or sepsis, a serious blood infection. These characteristics are generally associated with poorer surgical outcomes.

The patients’ rate of morbidity, a measure of illness, significantly decreased, from 33.7 percent in 2006 to 26.6 percent in 2010. Mortality declined as well, although more modestly, from 10. 4 percent to 9.3 percent over the study period.

Why surgeons continue to operate on patients at such high risk for complications and death is due to several factors, Bateni said.

“Some of it has to do with the patients and families,” she said. “If the patient is uncomfortable, the family wants a solution. In some cases, the surgeon also may be too optimistic about what the surgical outcome will be.”

What Bateni also found was that just 3 percent of the patients with terminal cancer had Do Not Resuscitate (DNR) directives in place at the time of their surgery. DNRs, part of advanced directives used in end-of-life planning, direct physicians to withhold advanced life support if the patient stops breathing or their heart stops beating.

Bateni said the study results imply that patients, families and care providers, including surgeons, are often delaying discussions about the goals of the care and the priorities at the end of life.

She cautioned that delaying end-of-life discussions can have serious consequences because it can lead to delayed referrals for palliative care and hospice. In addition, the patient risks undergoing multiple invasive, uncomfortable procedures in an attempt to prolong life, despite being against the patient’s goals of care and how they wish to spend their final days of life.

“It’s really important that the doctor has an end-of-life, goals-of-care discussion prior to the time that the patient comes into the hospital with an acute illness,” she said. ”Patients should be referred to a palliative care counselor or  have a comprehensive end-of-life discussion to ensure that their goals are respected as soon as they are diagnosed with cancer, especially those with cancers that have a high mortality rate.”

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