Medical research goes global

36dsc_1304_ucsandiegopublications_erikjepsenBy Marg Stark

For more than 30 years, Dr. David Shapiro has had a front-row seat to watch the growth and evolution of San Diego’s booming biotech community and its increasing impact on the world. Shapiro, who is the chief medical officer at Intercept Pharmaceuticals, a company focused on developing treatments for nonviral liver disease said the engine that drives the growth of the life sciences is clinical trials, which help to prove—or disprove—the efficacy of possible treatments. Over the years, he said, as biotech companies around the globe have raced to find treatments for a wide range of diseases, clinical trials have become more crucial and more rigorous than ever.

“The primary and secondary research endpoints have to be more defined at the outset; there’s more uniform coordination across the Food and Drug Administration (FDA), the European Medicines Agency (EMA), and others, and less margin for error across the board,” Shapiro said. “Of course, even amid higher regulatory standards, we are always trying to make the pathway shorter. And drugs are now being tested globally much earlier in the development process, with patients being recruited for trials on multiple continents.”

To manage these intricacies, professionals need instruction that keeps up with a staggering pace of change and offers them global research insights. Because of the critical importance of having a talent pool with this expertise, Shapiro serves as an advisor to UC San Diego Extension’s clinical trials programs. He said the courses and certificates Extension offers in clinical trials and drug development allow professionals the opportunities to stay current and ensure San Diego continues as a leading hub in biotech and life science.

“Extension provides ideal training for professionals,” Shapiro said. “I’m extremely impressed with the energy and expertise of the program and the way it prepares students and rewards prospective employers.”

Robyn Leary is one of those professionals who has benefitted from Extension’s training. She had spent 14 years working in various roles in clinical research labs, but she yearned to see the results of her work in patients. Although Leary has a PhD, she said her lack of an MD thwarted her efforts to shift from “bench science to human work.”
So, while pursuing her second “postdoc” fellowship, Leary embarked on clinical trials administration studies at UC San Diego Extension. Within a year, she landed her dream job at Teva Pharmaceuticals, serving as a medical science liaison between the company and the outside community.

For Leary, learning the practicalities of how clinical trials are run and becoming versed in pharmaceutical industry lingo in the Extension certificate program proved essential to her career transition.

“Medical science liaison has become a hot job in the industry, and I would not otherwise have had enough insider knowledge to make the jump into it,” she said.

Shapiro said UC San Diego Extension works extremely hard to design programs that anticipate the constantly changing nature of research and clinical trials.

“Extension attends to innovations with a very fast-wheeling commitment to change and improvement,” Shapiro said.

To stay ahead of the curve, Grace Miller and Donna Stern, who oversee Extension’s clinical trials programs, travel the globe, attending international conferences and forging international partnerships. They also recruit instructors who are leaders in the field, refine curriculum, and add courses to keep the Extension program and its students at the forefront of the industry.

As an example, Miller recently noticed an uptick in interest in project management in clinical trials and attended a session on this topic at a conference in Montreal. Miller promptly recruited the instructor, who will soon teach the course for Extension. Similarly, Stern said, initial coursework in the Clinical Trials Administration Certificate Program will feature more information on the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) and other regulatory bodies, not just the FDA and EMA. Clinical trials studies are also offered in Spanish to accommodate the emergence of clinical trials in Latin America.

At Intercept Pharmaceuticals, where Shapiro is overseeing the development of an agonist in bile acid chemistry to treat liver disease, among other therapies, clinical trials are underway in 20 countries.

“That’s an amazing global reach for a small company,” he said. “But that is typical today in drug development.”

International trial recruitment comes earlier in the research process, and global trials are no longer pursued just by field giants such as Merck and Pfizer, both of which Shapiro worked for.

100dsc_1400_ucsandiegopublications_erikjepsenTrained in the United Kingdom, Shapiro said San Diego is the perfect training post for this fast-moving industry. Some of the seminal work on the nuclear receptor FXR, which Shapiro’s company is advancing, was performed two decades ago by UC San Diego professor Alan Hofmann and his team of scientists. UC San Diego’s intense study of this complex molecule, including examining bile samples from animals from the San Diego Zoo, paved the way for the practical-applications work Intercept is forging. If all goes well, patients across the world with liver disease will soon benefit from therapies created in San Diego.

“So often this is the case,” Shapiro said. “Biotechs here are building on the extraordinary basic science performed at UC San Diego and San Diego’s robust nonprofit research organizations.”

Indeed, UC San Diego Extension has partnerships that expose students to international research leaders, such as the University Medical Center Utrecht in the Netherlands.

“Our students spent a week at Utrecht as part of our summer intensive workshop,” Miller explained. “But more and more, students interested in our program want to come to San Diego for their classroom work, both for our weather and for the introduction to our international biotech hub.”

Having made her jump from basic to translation research, Leary said she keeps the binder from her Extension studies in her office at Teva and still calls upon it occasionally.

“Teva is an Israeli company with a very global perspective. For my work, I must know what the EMA does and keep up with the research in Europe and elsewhere,” she said. “I knew this day one because of the Extension program: all the agencies, how they differ, and how to look up all their regulations, not to mention the host of pharmaceutical abbreviations and terminology, which are not things you just Google and find.”

Having transitioned from academia to the private sector, Leary said she marvels at the considerable salary and benefits bumps she enjoys and the facets of her personality and interests she now indulges. “In the lab, my work was focused on going very deep. It was tough to find time to read the journals and get the big picture in medicine,” Leary said. “Today, I’m paid to do that—to read about scientific and medical developments and attend conferences to stay abreast of innovation. I consult and troubleshoot about clinical trials. I fly across the region, counseling doctors and answering questions for insurers and payers about the applications of Teva’s therapies. And I’m getting to see the results: the impact we are making around the world on the lives of patients who benefit.”

The Pulse: Continuing Childhood Obesity Crisis Requires Population Health Approach

San Diego expert shares collective impact results and community partnership wins

The number of overweight and obese children in the United States has doubled – and quadrupled among adolescents – in the last 30 years. San Diego County is making some strides in combating the epidemic but the rates remain alarming, especially among Hispanic children and those in disadvantaged communities, says Cheryl Moder, founding director of the Childhood Obesity Initiative. Moder shares the latest statistics from San Diego County and the broad-based collaborations she directs in this month’s Pulse podcast.

Employed by the non-profit Community Health Improvement Partners, Moder shares disturbing health consequences – nearly half of children of color born after the year 2000 will develop diabetes in their lifetimes – and the societal costs of the epidemic. “Besides quality of life, the sheer cost is staggering, from direct medical costs to lost productivity.” Forging partnerships to address the epidemic is the most rewarding aspect of her work, Moder says, pointing to seven domains, from healthcare and schools to businesses and community organizations, in which the Initiative is active, educating and promoting programs and policies to reverse the trend.

“If we had planned our neighborhoods in Southern California to promote obesity, we couldn’t have planned them better,” Moder shares, bemoaning abundant access to fast food and sugar-sweetened sodas, a tremendous reliance on automobiles, and a lack of access to healthy, fresh food and to safe exercise opportunities in many San Diego neighborhoods. Moder is encouraged to see cities implementing a tax on soda and other sugar-sweetened drinks, a move she likens to the tobacco control advocacy she did early in her career. For those passionate about ending the obesity epidemic, Moder says, “there are many roles to play, from city planners and decision makers to school administrators and community advocates, not just medical careers.”

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New partnership brings Extension’s clinical trials expertise to Mexican students

shutterstock_162106943Investment in clinical research in Mexico is predicted to triple in upcoming years, with a potential to reach $500 million USD, according to the Mexican Association of Pharmaceutical Research Industries. To prepare professionals for the rigors of global scientific studies and the growth in this industry, UC San Diego Extension is partnering anew with a private university in central Mexico, Universidad de las Américas Puebla (UDLAP).

The new partnership will enable UDLAP students to pursue UC San Diego Extension’s Clinical Trials in Latin America Certificate, taught by experts from San Diego, a worldwide hub for the pharmaceutical and biotech industry. The certificate is designed to expose principal investigators, nurses, study coordinators, and others to the guidelines and protocols that promote safe, successful clinical research, as dictated by international regulatory bodies.

UC San Diego Extension has engaged in clinical trials education for nearly 20 years and has offered Spanish courses for the last six years. “More and more, companies are pursuing clinical research in Latin America, both to control costs and to recruit more diverse patient populations. We are excited to expand the professional education available in Mexico and to contribute to the rising standard of clinical research being conducted globally,” said program director Dr. Leonel Villa-Caballero, MD, PhD.

“A good foundation in clinical trials management will enable practitioners to optimally incorporate scientific advances and state-of-the-art health technologies,” said Dr. Lucila

Castro-Pastrana, a professor at UDLAP. Castro-Pastrana says the market for clinical studies is extremely competitive in Latin America and that the training is critical. The partnership also comes at a time when UDLAP is improving its research realm and adding a PhD program in molecular biomedicine among other strategic initiatives.

udlap-consultores1The program will offer UDLAP students clinical trials courses online and in Spanish – at an affordable rate and via a Mexican invoice, which many employers require for tuition reimbursement. Candidates can also obtain grants and make payment plan arrangements through UDLAP. Students graduate with a diploma from UDLAP and with a Clinical Trials Administration certificate from UC San Diego, offering them the prestige of both organizations.

Both Drs. Villa-Caballero and Castro-Pastrana hope the forging of the partnership is just the first step in the relationship. “We look forward to UDLAP students joining us in San Diego for our intensive workshop in May 2017, for example, where even more advanced instruction is offered and networking is facilitated,” said Villa-Caballero. “We hope eventually to have our instructors teach courses alongside UC San Diego’s,” said Castro-Pastrana, citing a “new bridge” between scholars and students across the Americas.

Leading amidst chaos: 5 life lessons from an emergency department nurse

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As an emergency room nurse, Cathy McJannet has learned to make life-saving decisions in an instant. But with a career that relies on skills, judgment and compassion, she understands that emergency department nursing is not for everyone.

“It is a highly specialized type of nursing in which only a select number of nurses are suited to work in that type of environment,” McJannet said.

McJannet, who works at Sharp Coronado Hospital, got her start in nursing as a teenage volunteer at the Moncton Hospital in New Brunswick, Canada, where she realized her love for helping others.

“I became a nurse because I wanted to care for people and help them through challenging times as it relates to their health status,” said McJannet.

She then discovered a passion for teaching as a nursing officer in the military where she had the ability to work with people and help them understand different concepts and achieve their goals.

“Nothing makes me happier than to teach someone and watch that ‘light bulb’ go off as they really start to comprehend that difficult concept,” she said.

Following her passion for education, McJannet partnered with UC San Diego Extension to develop the Emergency Department Nursing Certificate program, which offers focused education in emergency nursing skills and knowledge to licensed nurses.

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Cathy McJannet

“Being a nurse is about being committed to lifelong learning as healthcare is a dynamic state that is ever changing,” she said. “You don’t go to school, become a nurse and that’s it. You go to nursing school, become a nurse and continue your education for the rest of your working life.”

Making a difference in patients’ lives and the challenge of continuously learning in the emergency department is what pushes McJannet to continue her work. It’s not just a full-time job; it’s a calling – one that requires commitment and nerve. Here are some of the attributes McJannet says are necessary to be successful as an emergency department nurse:

  1. Learn to be uncomfortable and overcome it. Emergency department nurses need to learn how to deal with all sorts of patient situations. “You need to have the patience to handle those who verbally and physically abuse medical staff and be able to create calm out of chaos,” she said.
  2. Be able to prioritize. The ideal emergency department nurse has highly developed clinical judgment skills and is able to make decisions quickly. “To the outsider, the emergency department may appear to be chaotic and confusing,” McJannet said. “But emergency department nurses thrive on the challenge of providing care and compassion to their patients and families while performing life-saving interventions.”
  1. Stay healthy. It’s not enough to be mentally sharp but you also have to be physically fit as well. “To work in an emergency department, you have to be able to sustain 12 hours of a fast-paced, high stress environment,” she said.
  1. Expect the unexpected and be flexible. Emergency department nurses need to be able to go from a calm, quiet environment to maximum speed in a nano-second. “You could be working with a two-month-old baby that is critically ill and your next patient will be a trauma from a car accident or family crisis,” she said. “Just when you think you have seen it all, there is a new adventure just around the corner.”
  1. Have a sense of humor. Apparently even for emergency room nurses laughter is the best medicine. “That is just one method used to combat the constant stress that comes with working in that high acuity medical environment,” McJannet said.

“Nurses are taught from the beginning of their career to understand that a commitment to lifelong learning is a part of belonging to the profession,” she said. “My favorite saying is that you can be a nurse who works in the ED or you can be an ED nurse. I choose to be an ED nurse.”

Interested in becoming an emergency department nurse? Learn more about UC San Diego Extension’s Emergency Department Nursing certificate.

 

50 Voices of the Future: Lori Alexander on the boom in research and medical writing

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In honor of UC San Diego Extension’s first 50 years, 50 Voices of the Future asks thought leaders about the trends, breakthroughs and social advances they foresee over the next 50 years.

Most kids don’t dream of a career as a medical writer. Instead, many fall into medical writing while following an alternate pathway. Some are scientists who prefer writing about medical research rather than conducting it while others start with a passion for writing and realize science is a topic they enjoy writing about. Lori Alexander, president of Editorial Rx, Inc., followed the latter path. “From as early as I can remember, I loved to write, and it didn’t matter what it was about. I then became fascinated with medicine when I started working in a community hospital. I had no idea there was a field out there where I could blend my two loves into one career.” Today, the field is more recognized, but still, medical communication is not a field that is well represented at school career fairs. Programs such as the one at UC San Diego Extension are helping to bring medical communication into the forefront.

 (1) Why is the work you do important?

My work—and the work of all medical communicators—is important because clear communication is essential to scientific research and to meaningful patient-physician interactions. My two primary areas of medical writing are continuing medical education for health care professionals and education for people with cancer. Continuing Medical Education is essential for improving the knowledge and skills of health care professionals and thus enhancing health outcomes for patients. The educational resources I develop help people better understand their disease and treatment options, which in turn helps them to make more informed health care decisions. Across medical writing settings, the goals are the same: to create clear medical communications that lead to better health and well being. In fact, this goal is the vision statement for the American Medical Writers Association (AMWA).

(2) What are the influential/exciting developments happening in your field now and why?

So many exciting things are happening right now in medical communication, and they’re related to unprecedented growth in medical research and publishing, changes in the stakeholders in the health care arena, and advances in technology. These developments are helping to create more and varied opportunities for medical communicators. The growth in medical research is reflected in the explosion in the number of clinical trials being conducted, which has increased from 25,858 in 2006 to more than 225,000 this year. Many medical writers are involved with developing the required documentation for the trials and the approvals of new drugs, as well as with writing reports on the trial results and implications. The number of scientific and medical journals is also increasing exponentially—about 2.5 million science, technology, and medicine articles are published each year. Medical writers and editors are needed to help prepare these manuscripts. Increasing discussions about the value and cost of medical products also is leading to new opportunities for medical writers in such areas as health economics and outcomes research, technology assessments and comparative effectiveness research.

Social media is also making its mark as it is changing how medical writers communicate with each other, how researchers communicate with each other, and how research is conveyed to various audiences. These developments not only increase the demand for medical writers but also call for medical writers and editors to enhance their knowledge in science and medicine as well as strengthen their writing skills. The Medical Writing Certificate Program at UC San Diego Extension is an excellent way for scientists to forge a pathway to these exciting opportunities.

(3) What’s the next big thing?

I think the next big thing is certification for medical writers because it provides a way for medical writers to legitimize what they do. American Medical Writers Association developed the first (and only) credentialing program for medical writers, and the examination is based on first-of-its-kind research into the key areas of knowledge, skills and abilities required of medical writers. Certification gives employers a way to feel confident in the credibility of medical writers who have earned this credential. Certification also raises the standard for medical writers and thus increases the need for educational programs to help scientists and others gain the core competencies needed for a career in medical writing.

(4) How big an impact will your field play in shaping the future of the San Diego region and beyond?

The San Diego region is home to hundreds of biotechnology and pharmaceutical companies and California has large health care systems and a strong commitment to medical research. Medical writers and editors can help these industries further advance their goals.

(5) Hop in to your time machine…what does the future look like for this field in 50 years? How can individuals/companies get prepared for what’s next?

Medical communication will ride into the future along with medicine and health care. Physicians predict that technology will dramatically affect how people are treated in the next 50 years and medical communicators will need to keep pace with ways to make data actionable. How do we gather and interpret massive amounts of health data and turn that into information that helps scientists and patients alike? Also, as researchers gain a better understanding of the underlying biology and molecular bases of diseases, the field of personalized medicine will continue to grow. These advances mean that medical communicators will need strong critical thinking and communication skills to translate complex concepts into easily understood content.

clinicaltrialsLori Alexander, president of Editorial Rx, Inc., teaches Introduction to Medical Writing at UC San Diego Extension, which is part of the Professional Certificate in Medical Writing.

Photo credit (Lori Alexander’s image): Cindy Cone Photography

Food safety program to provide much-needed training in wake of new food safety rules

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Each year one in six Americans become sick from consuming contaminated foods or beverages. That’s according to the Centers for Disease Control and Prevention, which also reports that annually 48 million people in the United States get sick from a foodborne illness. Of those, 128,000 people are hospitalized and 3,000 die. To prevent these outbreaks, new regulations have been put in place to reduce foodborne illness through preventative measures.

While the regulations went into effect in 2015, many in the food industry are unprepared to comply with the new rules, which require detailed food safety plans, said Michael and Charlie Kalish, twin brothers who have a consulting business that assists in developing food safety plans. To help address the need for training, the brothers will be leading a food safety workshop in partnership with UC San Diego Extension.

Cheese-makers by trade, the brothers gained valuable knowledge about food safety principles and new ways of approaching manufacturing and holding food while working on farms, manufacturing facilities and warehouses in Europe and the United States. Working as consultants to local creameries, they realized there was a need for more food safety training.

“When we started consulting, the opportunities that were popping up were food safety related,” said Michael. “Businesses really needed help developing food safety plans. What has made us successful is our ability to identify an opportunity. We gave it a shot and it has just exploded.”

In 2015, the Food and Drug Administration published the final rule for the Food Safety Modernization Act, requiring facilities that manufacture, process, pack or hold food for consumption in the United States, be required to have a Preventative Controls Qualified Individual (PCQI). The new rules are considered the most sweeping reform of food safety laws in more than 70 years.

“The paradigm shift is not only going toward inspecting on good manufacturing practices but also looking for a documented food safety plan,” Michael said. “Now we are seeing not just inspection, but an audit. That’s one of the biggest changes.”

The FDA estimates that the new regulations will affect more than 83,000 food facilities requiring them to institute a number of new safety requirements as well as keep detailed records of their compliance.

The brothers recognized the growing need for highly knowledgeable professionals who could develop food safety plans for businesses of all sizes.

“Food safety regulation can be extremely convoluted, which is why there is a real need for professionals who specialize in food safety – someone who takes the time to read the fine print and gives these businesses what they need to make informed decisions,” said Michael.

Michael and Charlie Kalish became two of the country’s first and youngest Food Safety Preventative Controls Alliance (FSPCA) lead Instructors and are now educating businesses around the country on how to comply with new federal regulations. They are partnering with UC San Diego Extension to put on a two-and-half day workshop from September 28 to September 30, 2016. This training, which the Food Safety Preventative Controls Alliance developed, is the only standardized curriculum that the FDA recognizes for the new Preventive Controls for Human Food rule. Attendees who successfully complete the course will meet the requirements to be considered a preventive controls qualified individual, also known as a PCQI.

The workshop will benefit employees from a wide diversity of food businesses of all sizes across the supply chain, including manufacturers, warehouses, distributors and retailers/restaurants. Since 2007, national job postings for food safety experts increased more than 300 percent.

Because of that, the Kalish twins said there are not just more job opportunities but also there’s good money to be made. As it stands now, demand is outstripping supply when it comes to food facilities being able to find well-trained quality assurance professionals who can implement the Food Safety Modernization Act’s new rules.

“I think the industry, as far as food safety experts are concerned, could really use a lot more competent people who are eager to learn,” said Charlie. “Training is critical and learning how to apply food safety principles is the first thing you need to do.”

To find out more about UC San Diego Extension’s food-safety workshop, visit http://extension.ucsd.edu/foodsafety.

The Pulse: Lung Health Advocate Debra Kelley Takes On Big Tobacco – Again – Through Prop 52

Debra Kelley steered San Diego through major changes in social norms about smoking

Fresh out of graduate school 30 years ago, Debra Kelley began work in San Diego for the American Lung Association. Her first assignment? To help pass a statewide initiative that would establish smoking and no-smoking areas within restaurants. In this month’s Pulse podcast, Kelley shares the results of three decades of advocacy and the remarkable changes she has helped bring about in California, as citizens and governing bodies have come to understand the detriments of smoking and second hand smoke.


“We’ve come a long way, and it is so gratifying to be a part of dramatically changing social norms and saving so many lives,” Kelley says. Today, her work is more apt to be focused on expanding and enforcing smoke-free areas and insuring that emerging tobacco use such as vaping and hookah lounges are subject to the same restrictions as smoking. Auto emissions and climate change are also concerns, as is a major California ballot initiative in November to raise the tax on cigarettes by $2 a pack. The revenue from the proposed initiative will fund prevention programs and medical research related to tobacco-disease as well as help “offset the abysmal rates of reimbursement in California for the 1 in 3 Californians who are on Medi-Cal.”

The tobacco industry spent more than $100 million to defeat the last such initiative, Kelley says. To take on this foe, as well as others she’s faced as director of advocacy at the nonprofit, Kelley describes drawing on a “deep understanding of the political system,” much-in-demand grant writing skills, a comfort with budgets and spreadsheets, as well as ease in public speaking she developed over time.

UC San Diego Extension announces “The Next Fifty” scholarship recipients

50thLogoCMYKUniversity of California San Diego Extension has announced the 10 recipients for “The Next Fifty” scholarships, which is part of its yearlong 50th anniversary celebration. The scholarship program is UC San Diego Extension’s way to give back to the community by helping people prepare for what’s next. Awardees can use the $5,000 scholarship toward Extension’s courses and certificates.

Extension selected the 10 recipients out of close to 500 applications and the recipients represent a wide variety of interests and backgrounds. The recipients and their areas of study are:

  1. David Beatty for Business Analysis Tools and Strategies
  2. Lala Forrest for Art and the Creative Process
  3. Rami Husseini for Datamining
  4. Norma Lopez for Teaching Adult Learners
  5. Patrick Mazza III for Occupational Health and Safety
  6. Alexandra Southard for Business Intelligence Analysis
  7. Kathleen Stadler for Fundraising and Development
  8. Abigail Wattierrez for Sustainable Business Practices
  9. Ryan Williams for Community Research and Program Evaluation
  10. Jordan Woolsey for Translation and Interpretation (Spanish/English)

The scholarships were open to those with at least a high school degree or equivalent and who saw UC San Diego Extension as a way to advance their career or pursue their passions. The applicants were required to write a 500-word essay on how Extension can help them prepare for the future, which will be shared on Extension’s blog in the coming weeks.

Ed Abeyta, assistant dean of community outreach and director of pre-college programs for UC San Diego Extension, said “The Next Fifty” scholarships deliver on Extension’s mission to offer the education and training needed to ensure the region is prepared for changes occurring in everything from the arts to technology to science.

“UC San Diego Extension wants to be a positive force for change. For more than 50 years, Extension has been evolving its programs and educational offerings to meet the needs of San Diego,” Abeyta said. “These scholarships will help individuals stay ahead of the curve and get ready for what’s next and underscore our commitment to lifelong learning.”

In addition to the scholarship program, Extension has been publishing a weekly blog feature called “Voices of the Future,” which showcases thought leaders including UC San Diego faculty, industry and civic leaders as well as Extension instructors on the technological and social advances envisioned in the next 50 years. These stories are designed to cover a wide variety of topics and highlight the life-changing advances happening on campus, in the San Diego region, and in the education sector itself.

UC San Diego Extension has also offered a variety of public lectures and programs to deliver on Extension’s anniversary celebration’s core mission and message, which is to prepare individuals and institutions for change. Upcoming events include a panel on the Election 2016 that Steve Clemons, Washington editor at large for The Atlantic, will moderate and that will feature, Thad Kousser, chair and professor of political science at UC San Diego; Scott Lewis, editor of the Voice of San Diego; and Laura Fink, professional political consultant.

To find out more about UC San Diego Extension’s anniversary scholarships, blog features and events, visit http://extension.ucsd.edu/.

50 Voices of the Future: Dr. Kimberly Brouwer on tracking disease worldwide

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In honor of UC San Diego Extension’s first 50 years, 50 Voices of the Future asks thought leaders about the trends, breakthroughs and social advances they foresee over the next 50 years.

Trying to reduce the spread of disease is an endeavor that can make a scientist pessimistic. There is always some new illness waiting to unleash itself on humanity. Dr. Kimberly Brouwer, a professor in the Epidemiology division of UC San Diego Family Medicine and Public Health and adjunct at UC San Diego Global Health, believes disease will remain a global problem for the foreseeable future. What’s encouraging, she says, is our ability to respond to these new threats far more rapidly than in the past. “With better surveillance and communications we can catch things much earlier than ever before,” she says. Decades from now, she predicts, we will be even more adept at mobilizing against whatever new diseases might pose the latest threat.

(1) Why is the work you do important?

There are always emerging infections we’re looking for. We’re looking for a better understanding of what causes disease and its transmission. Even for diseases that are well-known, epidemiology is very useful in that it can help you understand why certain people are more at-risk than others, why certain people are having a harder time accessing care or working under a certain treatment regimen than others. So it’s a very useful way to make informed decisions and provide the data that policy makers and health care providers need.

(2) What are the influential/exciting developments happening in your field now and why?

It’s becoming more and more interdisciplinary. I started out focusing on infectious disease epidemiology and then I got additional training in spatial epidemiology, where I was incorporating geospatial calculations and techniques into my studies. Instead of just working with surveys to understand people, we’re mapping where they’re located. Sometimes we even follow them in real time with GPS. It gives you a much better idea of where diseases are clustered, where they might be heading in the future, and what neighborhood factors might affect transmission. This helps you better plan where services should be located. Now we’re often using both quantitative methods – surveying people, measuring biological markers – and also qualitative methods, where I get anthropologists involved as co-investigators. So we’re really taking advantage of multiple disciplines and trying to treat public-health problems in a new way than they have in the past.

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(3) What’s the next big thing?

We’re really running to catch up with technology and media trends. I feel like the marketing field tends to be ten years ahead of public health. For instance, they were doing geospatial calculations long before us to look at where to build the next Walmart. Now we’re finally applying this technology to where to build the next health center. They’re also doing social-media type advertising to get people to use their services and that is something that we in public health should also take advantage of. Maybe we can generate that type of popularity for beneficial behavioral changes or getting people more informed about public health issues. It’s a moving target, I’d say.

(4) How big an impact will your field play in shaping the future of the San Diego region and beyond?

Hopefully it will play a big role. With climate change new disease vectors, such as different mosquitos, are entering the county. We also have a lot of population mobility, so you’re constantly facing the potential for new infections. These and other health changes are impacting many cities, although luckily people are getting more and more interested in the idea of prevention and better connecting people to services, from a public health but also from an economic perspective.

(5) Hop into your time machine…what does the future look like for this field in 50 years?  How can individuals/companies get prepared for what’s next?

If you’d interviewed people in the 1950s, they likely would have predicted that most infectious diseases would be conquered 50 years in the future. But I think what we’ve learned in the past several decades is that infections adapt and mutate and there’s constant surprises arising. It really speaks to the need for constant surveillance and constant vigilance. Fifty years from now, it may not be HIV, it may not be malaria, but there will still be plenty of infections that we’ll be trying to solve and treat. I think one main difference is that the pace at which we develop responses to them will be much faster than in the past. For instance, with Zika they developed diagnostics and are looking into vaccine development much faster than they have for diseases in the past. I would imagine that aspect of infectious disease epidemiology will continue to improve into the future.

Dr. Kimberly Brouwer is a professor in the Epidemiology division of UC San Diego Family Medicine and Public Health and an adjunct at UC San Diego Global Health in the School of Medicine at UC San Diego. She teaches Epidemiology II for the UC San Diego Extension Master’s degree program in Clinical Research.

The Pulse: New wave consultants, Kalish brothers promote emphasis on U.S. food safety

About 48 million Americans, or one in six, get sick from food-borne illnesses each year, 128,000 of them requiring hospitalization, and 3,000 of them dying as a result. Twin brothers Michael and Charlie Kalish bring food-manufacturing, processing, packing, holding and farming experience to this cause, consulting to start-ups and leadership to food businesses to promote a safer food supply chain. Hear how they parlayed a background in cheese making into a thriving food safety consultancy in this month’s Pulse podcast.

Michael and Charlie’s professional experience began in a train tunnel in France, the site of one of Europe’s premier cheese aging facilities where they worked together handling 60 tons of fromage. “Working in these rustic environments, we gained not just a new language but new principles and ways of approaching the manufacturing and holding of safe food,” Michael says.

In 2012, the twins launched their Food Safety Guides consultancy in response to the growing need by industry for food safety expertise and the sweeping changes in U.S. food safety regulations resulting from the Food Safety Modernization Act. They now specialize in working with QA teams in businesses of all sizes to ensure safe food practices. Michael and Charlie have distinguished themselves globally in the food safety field with their innovative approach to food safety system development, engaging training styles, and FSMA expertise. Join them in September when they will offer a  2.5-day FSPCA Preventive Controls for Human Food Training at UC San Diego Extension.