Archive for category: Education

When Psychiatric Medications Are Abruptly Discontinued, Withdrawal Symptoms May be Mistaken for Relapse UCLA research contributes to assessing the reliability of industry-funded drug trials

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By Stan Paul

Withdrawal symptoms following the practice of discontinuation, or abruptly “coming off,” of psychiatric drugs in randomized clinical trials may be mistaken for relapse and bolster the case for continued use of medication, according to two new studies by UCLA researchers published in the journal Psychotherapy and Psychosomatics.

Principal investigator David Cohen, professor of social welfare in the UCLA Luskin School of Public Affairs, said that clinical trials employing a drug discontinuation procedure had not previously been studied systematically.

“For years, observers have asked whether people getting more symptoms when they came off their medication was their disorder returning or the withdrawal effects from drugs that could be reduced by more gradual, patient-centered discontinuation,” Cohen said.

In light of the difficulties that people have in discontinuing psychiatric medications, Cohen sought to answer that question, joined by co-author Alexander Récalt, a doctoral student in social welfare at UCLA Luskin who is also pursuing a master’s degree at the UCLA Fielding School of Public Health.

They looked at how and why antidepressants, antipsychotics and stimulants were deliberately discontinued from trial subjects in more than 80 randomized controlled trials from 2000–2017. The study also included benzodiazepines, a class of drugs such as Valium, upon which long-term users may become dependent and experience withdrawal symptoms.

In the first study, the researchers found:

  • In 67 percent of studies, no justification was given for a particular discontinuation strategy, which was abrupt or lasted less than two weeks in most cases (60 percent).
  • In 44 percent of studies that related to antidepressants, stimulants and antipsychotics, researchers used mainly abrupt discontinuation to test whether the drugs prevented relapse. Yet, researchers in most studies did not indicate that misclassifying a withdrawal reaction could occur.
  • Most studies incorporating benzodiazepines used discontinuation differently. These studies recognized that withdrawal symptoms were common, and they employed longer drug-tapering periods (more than eight weeks in most cases) to help people successfully come off and stay off these drugs.

The pharmaceutical industry was involved in 70 percent of the 80 studies; in most of the relapse-prevention studies; but in few of the benzodiazepines studies with longer tapering periods, according to the researchers.

Cohen, who also serves as associate dean for research and faculty development at UCLA Luskin, observed across the 80 studies that, in addition to testing relapse prevention, drug discontinuation was employed to chart withdrawal effects and to compare different methods of managing older and frail residents in institutions, given the known damaging effects of drugs taken over the long term.

But only a single study out of the 80 actually employed the discontinuation procedure in order to distinguish clearly between “relapse” and “withdrawal symptoms,” the researchers noted.

“This suggests to us that sponsors or researchers of discontinuation studies are really uninterested in exploring this crucial question,” Cohen said.

“Distinguishing between them requires careful history taking, an open mindset from the clinician and a degree of suspicion that the discontinuation process itself may be contributing.”

In many first-person accounts, patients have complained that they were not warned about these effects or told how slowly they should come off, Cohen said. Instead, their prescriber told them that the effects confirmed that the patients were better off taking the medication and therefore should continue to take it.

“The disconnect continues to drive a wedge between patients and their prescribers and is increasingly discussed in the media, as about one in six adult Americans take — increasingly for years — psychiatric drugs,” Cohen said.

“Our findings, if confirmed by other researchers looking at this literature, contribute to helping decide whether industry-funded drug trials in psychiatry are — as critics have maintained for years — infomercials for drugs or credible scientific investigations,” he said.

In their second study, Cohen and Récalt focused on whether they could detect evidence in the relapse-prevention randomized control trials that an actual misclassification — a confound — of relapse with withdrawal was occurring.

“Most publications do not raise the issue openly, so they do not provide the data to examine this issue directly,” said Cohen, explaining that an indirect method to test their hunch was used. Because withdrawal symptoms are known to begin to occur within an interval of time after drug discontinuation, the researchers focused on the timing of symptoms for drug-continued vs. drug-discontinued participants. They looked for evidence that end-of-study symptoms might already have been present during the study at set discontinuation times. A 50 percent rate of occurrence was chosen to indicate a substantial, non-trivial possible misclassification, Cohen said.

Few studies provided the data to actually test the hypothesis, even indirectly. Among the 14 studies that did provide the necessary data, about three-quarters showed evidence that withdrawal may be mistaken for relapse.

Relapse prevention trials that use psychiatric drug discontinuation commonly conclude that drugs work because they help prevent relapse, Cohen pointed out.

In line with a stream of previous warnings in the literature, the two studies show that more justifications are needed for why and how these discontinuation trials are conducted. Clinicians and consumers should not accept conventional interpretations of what is actually occurring to deliberately drug-discontinued participants in the trials, Cohen said, “and what this could mean for long-term use of psychiatric medications by ordinary people around the world.”

National Civil Rights Leader Named 2019 Commencement Speaker Longtime UnidosUS President Janet Murguía has worked to amplify the Latino voice on issues such as education, health care, immigration, civil rights and the economy

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By Les Dunseith

Janet Murguía, president and CEO of the nation’s largest Latino civil rights and advocacy organization, has been named the 2019 Commencement speaker for the UCLA Luskin School of Public Affairs.

Murguía has led UnidosUS since 2005. She will deliver the keynote address during the UCLA Luskin ceremony at 9 a.m. on June 14 at Royce Hall on the UCLA campus.

“Janet Murguía is an inspiration as a woman, a Latina, and a thoughtful and passionate advocate for social justice,” Luskin School Dean Gary Segura said. “In this very difficult time for the Latino population, I am excited to hear her share her insights and determination — developed and refined over decades of advocacy — with our graduating class.”

‘Janet Murguía is an inspiration as a woman, a Latina, and a thoughtful and passionate advocate for social justice.’

— Dean Gary Segura

During her tenure at the organization, which changed its name from the National Council of La Raza in 2017, Murguía has sought to strengthen the work of UnidosUS and enhance its record of impact as a vital American institution. Murguía has also sought to amplify the Latino voice on issues such as education, health care, immigration, civil rights and the economy.

A native of Kansas City, Kansas, Murguía earned bachelor’s degrees in journalism and Spanish, and a juris doctorate, from the University of Kansas. She has also received honorary degrees from Cal State Dominguez Hills, Wake Forest University and Williams College.

Murguía began her career in Washington, D.C., as legislative counsel to former U.S. Rep. Jim Slattery from her home state. She worked with the congressman for seven years before joining the Clinton administration, where she served for six years as a deputy assistant to President Bill Clinton, including deputy director of legislative affairs.

Murguía went on to serve as deputy campaign manager and director of constituency outreach for the 2000 presidential campaign of Democrat Al Gore, during which she was the primary liaison between former Vice President Gore and national constituency groups.

In 2001, Murguía returned to the University of Kansas as executive vice chancellor for university relations, where she oversaw KU’s internal and external relations with the public. She is credited with coordinating the university’s strategic planning and marketing efforts at KU’s four campuses.

Over the course of her career, Murguía has been featured in various magazines and newspapers for her work and leadership. This includes being highlighted on Hispanic Business Magazine’s “100 Top Latinas” and “100 Most Influential Hispanics” lists, Washingtonian magazine’s “100 Most Powerful Women in Washington,” the NonProfit Times’ list of top 50 leaders of “Power and Influence,” People En Español’s “100 Most Influential Hispanics,” Newsweek’s third annual women and leadership issue, Poder magazine’s “The Poderosos 100,” Latino Leaders magazine’s “101 Top Leaders of the Hispanic Community” and Hispanic magazine’s “Powerful Latinos.”

Murguía was the first Latino to give the keynote speech at the annual Martin Luther King, Jr. Unity Breakfast in Birmingham, Alabama. And she received Alpha Phi’s Frances E. Willard Award in 2018.

Murguía is currently a board member of Achieve, an independent and nonpartisan education reform nonprofit organization, and the Hispanic Association for Corporate Responsibility. She also serves as a member of diversity advisory councils for Bank of America, Charter Communications, Comcast/NBC Universal and Wells Fargo.

Learn more about the 2019 Commencement at UCLA Luskin.

 

UCLA and Human Rights Campaign to Host 2020 Presidential Candidates Forum Democratic contenders will be on UCLA campus to discuss LGBTQ platforms and plans for equality on eve of National Coming Out Day

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UPDATE, Sept. 5, 2019: The venue for the Oct. 10 presidential candidate forum has been changed to the Novo, an entertainment venue in downtown Los Angeles, in order to accommodate broadcast coverage. For further information, please contact Lucas Acosta of the Human Rights Campaign Foundation at lucas.acosta@hrc.org or 347-834-5063. The foundation will be the forum’s sole sponsor.  

 

The UCLA Luskin School of Public Affairs and the Human Rights Campaign Foundation, the educational arm of the nation’s largest lesbian, gay, bisexual, transgender and queer civil rights organization, will co-host a forum for 2020 Democratic presidential candidates this fall.

The conversation will take place on Oct. 10, 2019, — the eve of National Coming Out Day — at UCLA, and it will give candidates an opportunity to speak about their policy platforms and plans to move LGBTQ equality forward.

The forum will be part of UCLA’s Luskin Lecture Series, which enhances public discourse on topics relevant to the betterment of society. The series demonstrates UCLA Luskin’s commitment to encouraging innovative breakthroughs and creative solutions to formidable public policy challenges. Details regarding the RSVP process will be made available later on the UCLA Luskin website.

As in other presidential candidate forums, Democratic candidates can qualify for the event by receiving 1 percent or more of the vote in three separate national polls or by receiving donations from 65,000 different people in 20 different states.

Today, in 30 states, LGBTQ people remain at risk of being fired, evicted or denied services because of who they are. Thirty-five states have yet to outlaw the dangerous and debunked practice known as “conversion therapy.” LGBTQ youth continue to face elevated levels of bullying and rejection, and many associated physical and mental health challenges. According to FBI hate crimes statistics from 2017, the most recently available data, the bureau reported a surge in hate crimes disproportionately affecting LGBTQ people, black people and religious minorities, especially those living at the intersection of multiple identities. And at least 100 transgender people — most of whom are transgender women of color — have been murdered in the United States since the beginning of 2015.

“If any LGBTQ person were to take a cross-country drive from HRC headquarters in Washington, D.C., to UCLA’s campus, their rights and protections under the law would change dozens of times at every city line and state border,” said HRC President Chad Griffin. “That’s why we’ve fought to elect a pro-equality majority in Congress that would pass the Equality Act — and it’s why we’ve got to make sure the next president will fight for our community and establish full federal equality once and for all. HRC’s 3 million members and millions of LGBTQ voters across America will be key to victory in the 2020 election, and we’re excited to create an opportunity to hear candidates’ agendas for moving equality forward.”

The forum will be held in the midst of UCLA’s centennial year, when the campus will recognize its many contributions to Los Angeles, the nation and the world since its founding in 1919, as well as looking ahead to another century of discovery and achievement.

“The Luskin School of Public Affairs is dedicated to enhancing the well-being of all Americans through an informed electorate and educated social leaders,” said Gary Segura, dean of UCLA Luskin. “We are beyond excited to partner with the Human Rights Campaign in raising LBGTQ issues and the policy stances of candidates to greater public attention in this cycle. UCLA is the perfect host for this conversation.”

HRC worked to mobilize the powerful LGBTQ voting bloc in the 2018 midterms, endorsing more than 480 pro-equality candidates nationwide, and deploying 150 staff to organize and mobilize voters in more than 70 congressional, targeted U.S. Senate and other key races across 23 states. On Election Day, exit polling showed that more than 7 million LGBTQ voters — 6 percent of total turnout — cast ballots, making the difference in key races from coast to coast. Electing a pro-equality majority in the U.S. House of Representatives has already made a huge impact; Speaker Nancy Pelosi has made it a top priority to pass the Equality Act, a federal LGBTQ civil rights bill that will provide consistent and explicit non-discrimination protections for LGBTQ people from coast to coast. This legislation is expected to be introduced soon amid an unprecedented level of support from members of Congress, national advocacy organizations and leading U.S. companies.

HRC last hosted presidential forums in 2004 and 2007. In 2004, HRC’s forum included Sen. John Kerry, Rep. Dennis Kucinich, Sen. Carol Moseley Braun, Gov. Howard Dean, Sen. Joe Lieberman, Rev. Al Sharpton and Rep. Richard Gephardt. In 2007, HRC’s forum included then-Senator Hillary Clinton, then-Senator Barack Obama, Sen. Mike Gravel, Rep. Dennis Kucinich, former Sen. John Edwards and Gov. Bill Richardson.

Visiting Professors Encourage Careers in Government With a dysfunctional government and Election 2020 firing up interest in politics, faculty stress importance of getting involved

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By Stan Paul

“If government is so dysfunctional, why should I work there?”

That question guided a noontime discussion hosted by Visiting Professor of Public Policy Steven Nemerovski on Feb. 20, 2019, at the UCLA Luskin School of Public Affairs.

One answer, Nemerovski said, is that when nothing is getting done — at the federal level in particular — “that’s the time when you need talented people the most.”

Nemerovski is one of three visiting professors — all with decades of experience — at UCLA Luskin in the winter quarter. Citing his own unique career path, which has spanned politics, government, business and law, the adjunct professor at Columbia University’s School of International and Public Affairs encouraged the gathered students to consider government as a starting point for developing a successful and multifaceted career.

“There is no right way” into politics, said Nemerovski, who is teaching an undergraduate and graduate-level course in advocacy and legislation. He said government experience should be looked at as an extension of education, an early step in a student’s career process. “You have to go into it thinking that way,” he said.

Another teaching visitor this quarter is Gary Orren, the V.O. Key, Jr., Professor of Politics and Leadership at Harvard University, who is again teaching a graduate course “Persuasion: Science and Art of Effective Influence,” which he says “lies at the heart of our personal and professional lives.”

Orren, who has taught at the East Coast institution for nearly half a century, is also able to share his experience as a political advisor in local, state, national and international election campaigns.

Michael Dukakis, former Massachusetts governor and 1988 Democratic presidential nominee, has also returned to campus this winter, as he has for more than two decades. Dukakis is co-teaching a course on California policy issues in the School’s new undergraduate major as well as his graduate course on institutional leadership.

Visiting Professor Michael DukakisVisiting Professor Michael Dukakis speaks to undergraduates at a “Learn-at-Lunch” event. Photo by Mary Braswell
Visiting Professor Michael Dukakis Visiting Professor Gary Orren Visiting Professor Steven Nemerovski Visiting Professor Steven Nemerovski

In January, Dukakis led a Learn-at-Lunch discussion with UCLA undergrad students on the 2020 campaign. He noted that, since the 2016 election, young people’s interest in politics has increased dramatically and current events have only fired them up.

“They are streaming into my office asking about public service,” he said.

That sentiment was heard at the lunchtime conversation with Nemerovski, who offered a number of career lessons and insider tips.

Nemerovski, who has served as an attorney in government service, a campaign manager and lobbyist, and now president of a consulting firm specializing in advocacy at the state and federal levels, explained that his own career path did not start in a straightforward way or as early as he recommends to students.

He highlighted the importance of “picking a team” and “finding a cause” — of connecting passion with expertise. Admittedly, he said, he did not have a particular calling from the start in his home state of Illinois, but by becoming involved in lobbying, he developed a true career-long passion for health care issues.

He cautioned that becoming an expert can only get a person so far and stressed the importance of establishing relationships. He said he still has important connections from more than four decades of work in his various roles, and he has invited many in his network to speak to his classes. This quarter, Nemerovski’s students had the opportunity to hear from several current and former legislators from Illinois and California.

One of the many benefits of maintaining relationships with people throughout a career, he said, is that “you will grow with them.”

Nemerovski also shared a few enduring political rules of thumb: “In the world of government and politics, you have to be from somewhere” and “We don’t want anybody that nobody sent.”

And in launching and nurturing a career involving work in and out of government, Nemerovski said, “There’s nothing wrong with a little luck.”

A New Network for Urbanists From Across the Americas Ciudades, as the Latin American Cities Initiative is known, brings urban planning students, educators and practitioners into a multinational conversation

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By Mary Braswell

A new initiative at the UCLA Luskin School of Public Affairs is strengthening connections among urban planning students, educators and practitioners from across the Americas.

Ciudades, as the Latin American Cities Initiative is known, taps into the expertise of scholars and professionals whose cultural, historical and geographical ties run deep, said Paavo Monkkonen, director of the venture and associate professor of urban planning and public policy.

“Los Angeles shares an early history of urbanization with many cities across the Americas,” said Monkkonen, whose research into housing, land use and sprawl in Mexico and other countries inspired him to establish Ciudades, with support from UCLA Luskin Dean Gary Segura.

“Academia and professional practice can benefit a lot from greater levels of communication,” and that interplay creates a spirited teaching environment, Monkkonen said. “Planners in Los Angeles and across California’s cities can learn a lot from the urbanism of Latin America.”

The mission of Ciudades is expansive, Monkkonen said.

“Urbanists can learn from one another’s experiences with issues ranging from public space, mobility, historical preservation and redevelopment to indigeneity, local democracy, integration and local public finance,” he said.

Since its launch in January, Ciudades has pursued an ambitious agenda: a weekly speaker series; a binational workshop bringing together city, state and federal leaders from California and Mexico; creation of an inclusive website, with translations in Spanish and Portuguese; and an effort to fund student research and internships.

Monkkonen is also exploring partnerships with Latin American universities, to augment the international opportunities Urban Planning already offers in Germany, France and China. And he envisions annual field visits to Latin American cities, with faculty from all three Luskin School graduate departments — Public Policy, Social Welfare and Urban Planning — invited to participate.

The connections that Ciudades is forging will make UCLA Luskin a draw for graduate students, planners and policymakers from across the region, Monkkonen said.

“We hope that this initiative is the beginning of something larger that deepens connections and intellectual exchange with students, educators and professionals across South, Central and North America,” he said.

‘Unequal Cities’ Conference Highlights Housing Research The multiday event in Los Angeles launches a global research network supported by the National Science Foundation that will unite scholars concerned with housing justice

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By Les Dunseith

UCLA Luskin’s Ananya Roy opened a multiple-day conference convened by the Institute on Inequality and Democracy at UCLA Luskin by stressing a desire to shift people’s thinking beyond the pragmatic concerns of a “housing crisis” to the broader theme of “housing justice” and what that means to society on a global scale.

“Our present historical conjuncture is marked by visible manifestations of the obscene social inequality that is today’s housing crisis, the juxtaposition of the $238-million New York penthouse recently purchased by a hedge fund manager for occasional use, to the tent cities in which the houseless must find durable shelter,” said Roy, a professor of urban planning, social welfare and geography who also serves as director of the Institute.

The setting for those remarks on Jan. 31, 2019, was particularly poignant — just outside, homeless people huddled on a cold and damp evening in tents lining the Skid Row streets surrounding the headquarters of the Los Angeles Community Action Network (LA CAN). Inside, a standing-room-only crowd of about 150 students, scholars, community organizers, housing experts and other stakeholders gathered to hear Roy and other speakers talk about the inadequate supply of affordable housing in California and around the world, and the cultural, political and economic barriers that undermine solutions.

“The fault lines have shifted,” Pete White, executive director and founder of LA CAN, told the audience. “We are now fighting the wholesale financialization of housing.”

Professor Ananya Roy opens the multiple-day conference on behalf of the Institute on Inequality and Democracy at UCLA Luskin by stressing the need for housing justice. Photo by Les Dunseith

The event in downtown Los Angeles and a full day of presentations that followed the next day on the UCLA campus was titled “Housing Justice in Unequal Cities,” and it signified the launch of a global research network of the same name supported by the National Science Foundation. With partners from India, Brazil, South Africa, Spain and across the United States, the network aims to bring together organizations, individuals and ideas around the creation of housing access and housing justice through legal frameworks, cooperative models of land and housing, and community organizing.

Roy said the Institute on Inequality and Democracy views the network as “exemplifying our commitment to address the displacements and dispossessions — what we call the urban color-lines — of our times.”

By partnering with community-based organizations such as LA CAN, “we situate housing justice in the long struggle for freedom on occupied, colonized, stolen land,” Roy told attendees.

The Housing Justice in Unequal Cities Network will bring together research and curriculum collaborations, data working groups, summer institutes, publishing projects and more. Roy said the network will unite movement-based and university-based scholars concerned with housing justice.

The effort also will build upon “an extraordinary proliferation of housing movements, policy experiments and alternative housing models,” Roy said. “This energy crackles all around us here in Los Angeles and it animates the work of the speakers at this conference.”

Over the course of the first evening and the full day of programming that followed, conference participants heard from a variety of speakers from UCLA, across the country and around the world — several of whom traveled from their home countries to be in attendance. The opening night included talks by James DeFilippis of Rutgers University, Maria Kaïka of University of Amsterdam, Erin McElroy of the Anti-Eviction Mapping Project and Keisha-Khan Y. Perry of Brown University.

Kickoff event attendees also were treated to music, with UCLA Luskin’s urban planning student Caroline Calderon serving as DJ, and listened to a riveting spoken-word performance by poet Taalam Acey.

“A man is judged by what’s in his soul and what is in his heart … not just what is in his pocket,” Acey said.

The second day of the event attracted a crowd of about 250 people and focused primarily on current research related to housing justice. Speakers pointed out that housing equity goes well beyond the extremes of homeownership and homelessness to include the experience of renters as well.

“Renters are powerful contributors and creators of their communities,” noted Sarah Treuhaft of PolicyLink.

According to Tracy Jeanne Rosenthal of the Los Angeles Tenants Union, “We don’t have a housing crisis, we have a tenants’ rights crisis.”

Additional speakers at the conference included UCLA Luskin’s Michael Lens, associate professor of urban planning and public policy; UCLA Luskin graduate students Terra Graziani and Hilary Malson; Gautam Bhan of the Indian Institute for Human Settlements; Nicholas Blomley of Simon Fraser University; Nik Heynen of University of Georgia; Toussaint Losier of University of Massachusetts, Amherst; Sophie Oldfield of University of Cape Town; Laura Pulido of University of Oregon; Raquel Rolnik of University of São Paulo (via video); Tony Roshan Samara of Urban Habitat; Desiree Fields of University of Sheffield; and former UCLA Luskin Urban Planning faculty member Gilda Haas of LA Co-op Lab.

Those interested in finding out more and getting involved in the effort are encouraged to sign up to receive housing justice reports and updates about community action and events: join the network.

View additional photos from the conference on Flickr.

Institute on Inequality & Democracy - Housing Justice in #UnequalCities

Briefing Seeks Solutions to Latino Doctor Shortfall UCLA Latino Policy and Politics Initiative’s gathering of medical professionals, policy analysts and advocates looks at underlying causes and why the impact is keenly felt in California

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By Gabriela Solis

Although Latinos comprise the largest ethnic group in California, Latino doctors in the state are in short supply, according to recent research from the UCLA Latino Policy and Politics Initiative (LPPI).

On Jan. 15, 2019, the UCLA Luskin-based think tank co-hosted a discussion in Oakland that brought together doctors, medical practitioners, academics and advocates to discuss California’s Latino physician shortage.

“California has an alarmingly low rate of Latino doctors. There are 46 Latino doctors for every 100,000 Latino Californians,” said LPPI Executive Director Sonja Diaz, citing data derived from the U.S. Census Bureau’s 2015 American Community Survey. “In contrast, there are 405.7 non-Hispanic white physicians for every 100,000 non-Hispanic white Californians.”

Diaz led the discussion co-hosted by the Latino Coalition for a Healthy California (LCHC) and the Greenlining Institute, which is based in Oakland.

“We graduate about 110 Latino medical doctors every year. If we continue forward, it will take almost five centuries to close the gap,” noted Diaz. That data from the Association of American Medical Colleges is included in the LPPI report, “5 Centuries to Reach Parity: An Analysis of How Long It Will Take to Address California’s Latino Physician Shortage,” which was produced under the guidance of LPPI faculty expert David Hayes Bautista, a distinguished professor at the UCLA David Geffen School of Medicine.

Joining Diaz in debate and discussion were Jeffrey Reynoso, executive director, Latino Coalition for a Healthy California; Arturo Vargas Bustamante, associate professor of health policy and management at the UCLA Fielding School of Public Health and public policy at UCLA Luskin; Carmela Castellano-Garcia, president and chief executive officer, California Primary Care Association; Berenice Núñez Constant, vice president, government relations, AltaMed Health Services Corporation; and Carmen Estrada, MD candidate at the UC Davis School of Medicine.

The wide-reaching conversation focused on the shortage’s effects on California’s economy, the needs of medical providers and the shortcomings within higher education that contribute to the shortfall.

Medical student Carmen Estrada of UC Davis

Estrada spoke about her personal experience of being one of the limited number of Latinos currently pursuing a medical degree. Estrada’s first-hand experiences traced her personal journey to medical school from a California State University and the lack of outreach that she said created unnecessary challenges in her career choice.

Núñez Constant shared that although her organization, AltaMed, is constantly looking for Latino physicians, “The supply is just not there.” She also highlighted the difficulty of retaining a Latino physician in such a competitive job market.

Vargas Bustamante’s research supported Núñez Constant’s comments on workforce recruitment. Bustamante said he has found a substantial pipeline problem for Latinos in their transition from high school to college and their transition from college to medical school. Based on his interviews with Latino pre-med students, medical school applicants, Latino medical students and recently graduated Latino physicians, Vargas Bustamante said students who may have an interest in the field often feel discouraged by the lack of investment to recruit and retain Latino students. Many then choose another career.

The panel agreed that this complex issue requires a strategic collaboration of California policymakers, medical providers and academia to form solutions.

But, said California State Assemblyman Robert “Rob” Bonta, expressing his support, “I think we have some wonderful opportunities.” Bonta, a Democrat whose California District 18 includes Oakland, Alameda and San Leandro, serves on a number of legislative committees, including the Health Committee. “Your timing couldn’t be better in terms of uplifting and raising the issue. This is something I’d be proud to work on, and I think it needs to be worked on.”

To learn about California’s Latino physician shortage, visit latino.ucla.edu/health.

View additional photos on Flickr.

Latino Physician Briefing

In the Weeds of Legalized Pot Recreational cannabis raises pressing questions for California officials, citizens and UCLA faculty experts seeking to devise common-sense policies

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By Mary Braswell

When Californians voted in 2016 to bring the cannabis industry out of the shadows, the aim was to create an environment where marijuana was safe, controlled and taxed. This has not been a simple undertaking.

Legalization of recreational pot has raised pressing questions from public health officials, local law enforcement, state regulators, city planners and citizens hungry for common-sense policies — not to mention the growers, retailers and users who drive California’s multibillion-dollar weed industry.

What will the city-by-city patchwork of laws look like? How can marijuana cultivators safely introduce pesticides into a neighborhood? When will communities see the benefits of tax revenues? How will lifting the stigma on pot use affect adolescents?

The need for facts, evidence and clear thinking has never been greater. Fortunately, UCLA Luskin researchers and policy experts are on the case, among them Public Policy lecturer Brad Rowe MPP ’13.

‘A REALLY TRICKY BUSINESS’

Proposition 64, the ballot measure that legalized recreational pot, gave each of California’s 482 cities and 58 counties the authority to license cultivation, manufacturing and sales. So far, most have declined to do so.

The more than 160 cities and unincorporated areas that decided to move forward face a labyrinth of policy questions, said Rowe, who launched his own research firm, Rowe Policy + Media, in 2017. He also serves on the faculty of UCLA’s Cannabis Research Initiative, teaches a Public Policy class on drugs and crime, and advises municipalities that are venturing into the marijuana fray.

“Cannabis is a really tricky business, and it’s one that is probably going to have more volatility than most of the other licensing areas,” Rowe said.

In many cases, he said, communities have overestimated the financial gains and underestimated the complications.

“Expectations have been set so high for tax revenues. Common claims from city representatives are, ‘We’re going to build libraries and parks and football programs for the kids,’ ” Rowe said. “The truth is that you’ve got to get your system up and running, and realistically expect that that store that you just licensed may only generate tens of thousands rather than hundreds of thousands in tax revenue for you this year. … It’s hard to pay for your new inspector and the new police officer you just hired, and your financial department has to figure out how to handle the cash.”

Cannabis commerce requires cities to create systems for licensing, taxation, financial compliance and the delicate matter of handling deposits from a largely cash business, Rowe said. They must keep up with evolving regulations from the state’s Bureau of Cannabis Control and shifting signals from the federal government, which strictly prohibits pot.

They will have to consider whether growing outdoors will create a nuisance and how to safeguard first responders against new threats. Firefighters arriving at a site that uses pesticides or volatile solvents for terpene extraction “shouldn’t be inhaling that stuff,” Rowe said.

Some of the policy debates veer toward the high end. Sonoma, he said, is considering whether to permit tastings of cannabis products, just as it does for viognier and pinot noir. “So then we’re getting into on-site consumption, event permits, more cannabis cops,” Rowe said.

On the whole, he said, “it can be a big hairy hassle for the cities, and that’s one of the reasons a lot of them have said we’re going to kick the can down the road and see how these other cities do.”

SEEKING JUSTICE, EQUITY AND FACTS

Rowe’s work with the UCLA Cannabis Research Initiative focuses on criminal and juvenile justice as drug offenses are reclassified.

“Are we even moving away from the war on drugs? That is the intent but in practice it’s a trickier thing, so we’re looking at equity considerations,” he said.

The health and well-being of young people must be a top policy priority, he argues.

“The one thing I am super concerned about is cannabis use disorder among adolescents,” Rowe said, citing brain research as well as recent studies measuring the toll that compulsive pot consumption takes on test scores and analytical skills.

“We just don’t know enough about the plant,” he said. “We don’t know enough about its addictive properties; we don’t really know what will happen as it becomes de-stigmatized and easily available.”

Legalization has led to new funding for research aimed at answering these questions. Proposition 64 earmarks $10 million a year for public universities to evaluate the impact of the law and make recommendations to the state.

Rowe has visited cities up and down the state as a consultant with MuniServices, which helps local governments manage their affairs. He has hosted forums for potential pot licensees, family and faith-based groups, and other stakeholders and says, “There have been some really heartfelt, interesting conversations. Some are opposed and some just want this to be done with caution.”

Many simply want reliable information, he said.

“There’s a lot of room for reasonable conversation; there’s a lot of room for public policy people to come into this area,” Rowe said. “It’s only going to get bigger. It’s going to be a very big industry.”

Getting a Handle on the Future Transportation experts join with policymakers and entrepreneurs to tackle the impact of disruptive technology on urban mobility

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By Will Livesley-O’Neill

Getting around Southern California has never been easy. But the infamously congested region has grown even more complicated with the arrival of new private services — including ridehail companies such as Lyft and Uber and electric scooter operators such as Bird and Lime — looking to disrupt how people travel.

Motorized scooters are often seen at UCLA.

As in any field impacted by technology-fueled disruption, transportation policymakers want to find ways to adapt. And that requires taking stock of what the transportation system is meant to do and, more importantly, whom it is meant to serve.

This was the focus of the 28th annual UCLA Lake Arrowhead Symposium, hosted by the Institute of Transportation Studies (UCLA ITS) and Lewis Center for Regional Policy Studies, in October. At the university’s retreat center in the San Bernardino Mountains, dozens of the nation’s leading experts on transportation and land use policy pondered the symposium’s theme, “From Public Transit to Public Mobility.”

The changing nature of travel means different things for elected officials, planners, academics, advocates and tech leaders. But everyone fundamentally agrees that, as LA Metro chief planning officer and symposium panelist Therese McMillan put it, “there’s a public interest in how private activity happens in a public space.” The modes may change, but the mission of a safe, effective, accessible transportation system remains the same.

John Zimmer, co-founder and president of Lyft, set the tone for a discussion of balance between tradition and innovation. Lyft has been actively expanding beyond ridehailing into other forms of mobility, including e-scooters and automated vehicles. The company’s stated goal of providing more options for consumers and reducing the number of people driving

alone benefits the environment — as well as those profiting from the service.

But the way that some tech companies roll out new products — a “move fast and break things” model — often leads to public backlash.

Southern California has been ground zero for arguments about the traffic tie-ups and sidewalk clutter allegedly caused by ridehailing and scooters. Public officials are being forced to make policy on the fly — although some such as Francie Stefan, chief mobility officer in Santa Monica, describe that as an opportunity. Santa Monica recently partnered with Lyft, Uber, Bird and Lime to introduce new regulations on the number of e-vehicles in the city while funding infrastructure improvements.

“[We] made a conscious choice to embrace new technology and work through some of the kinks that are inherent in change,” Stefan says.

Technology also gives cities the chance to innovate and to fulfill some hard-to-implement planning goals. Willa Ng, an associate director at Google’s Sidewalk Labs, presented an example at her panel on “coding  the curb.”

“If we need to do more stuff at the curb, and we need to have those spaces constantly turning over, we can’t have it managed by a static aluminum sign,” Ng explains, outlining how creating a flexible digital management system could allow the same section of curb to be used for parking, ridehail drop-offs, delivery unloading, or as a bike and scooter lane depending on the time of day. New transportation technology can crowd and complicate the use of public space, but it can also help make sure the space is better used to benefit the most people.

For example, Anastasia Loukaitou-Sideris, a professor of urban planning at UCLA Luskin, recently spoke to the University of California for a story and accompanying video about e-scooters titled, “What the battle over scooters gets wrong.”

Urban planners recently adopted a model known as “complete streets” that involves rethinking how shared space is divided between a street and a sidewalk, Loukaitou-Sideris says. This model abandons the assumption that streets are for cars and sidewalks are for pedestrians.

“The complete street perceives the street as a space where different transportation modes can coexist: not only cars, but also buses, and lanes for trams, bicycles and scooters,” according to Loukaitou-Sideris. “Nobody wants to compromise the safety of anyone by mixing these modes. So that’s where planning and design needs to come in.”

People-centered design — of services, systems and infrastructure — is at center stage in these policy discussions. Technology needs to be a tool to help improve transportation for people, not an end goal in itself.

“A lot of people are really annoyed with private capital coming into the mobility space without understanding people’s travel needs,” says Clarrissa Cabansagan of the Bay Area climate change nonprofit TransForm. But tech disruption will be worthwhile if it provides people with more options to get around besides driving their own car, she says.

Professor Brian Taylor of UCLA Luskin Urban Planning

Urban Planning Professor Brian D. Taylor, director of UCLA ITS, co-authored a groundbreaking 2018 study that found that Southern Californians are buying more cars than ever and turning away from public transit. That’s the exact opposite outcome of what policymakers had sought and shows the need to set new priorities for shared public spaces.

“We have to manage the automobile more intelligently. We can’t just allow people to drive anywhere they want, anytime they want,” Taylor says. “We need to create environments that are more conducive to travel by foot, by bike, by scooter or by public transit.”

New and old mobility services could work hand-in-hand to reduce private car travel. Ideally, technology should improve, not replace or eliminate, traditional transit, according to transportation experts.

“We should really focus on making the core strength of transit something we do incredibly well,” says Houston-based planner and author Christof Spieler, who spoke at the conference. With transit ridership falling across most of the country, new policies need to make riding the bus as easy as hailing a Lyft, he says, noting that public transit can move many more people much more effectively than any ridehail vehicle or scooter.

Bay Area transportation advocate Ratna Amin argues that focusing on riders as people, not cogs in a machine, is key.

“When we think about public transit as a utility, we focus on the bare minimum: We got the service out, it’s clean enough, the doors opened, the bus stop is there and it’s labeled,” Amin says. “We need to actually talk to people and find out what their experience is, and try different possibilities out to see if they improve the experience.”

Seattle is one of just a few American cities to see an increase in transit ridership in recent years. Terry White, the deputy general manager of Seattle’s transit operator, believes one factor has been key to success: an emphasis on making sure service is equitable.

“Transportation is a human right for everyone,” White says. “We’re trying to make sure everyone gets an opportunity to

be mobile.”

That’s ultimately what a better transportation system will mean — mobility for all, regardless of whether they take a bus or ride a scooter. Efficient use of public space lessens the need for gridlocked, polluting private vehicles.

The disruption of old transit methods is still in its early stages, with plenty of blind spots to be navigated. But as Juan Matute, deputy director of UCLA ITS, recently told LA Weekly, it’s important to remember that the disruption from new technology is likely to lessen over time.

“The safety hazards are comparable to those for automobile use,” Matute said of the new innovations, particularly e-scooters. “We’ve had over 100 years to figure out a lot of things.”

A New Wrinkle at UCLA Luskin — Undergrads Within months of official approval, the undergraduate degree in Public Affairs was already educating scores of pre-majors and providing them an avenue for activism

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By Mary Braswell

The rising excitement over UCLA Luskin’s new undergraduate program increased by at least a hundredfold as the first prospective Public Affairs majors stepped onto campus this fall.

Just weeks into the fall quarter, more than 100 students had formally opted in and dozens more had reached out to hear about the ambitious program, which combines critical thinking, social science methodology and deep engagement in the community.

In a year when young people are leading the charge for gun reform, transgender rights, climate change and more, the new major provides an avenue for activism.

“There will certainly be an infusion of energy that only undergraduates can bring,” said Dean Gary Segura.

Freshman Callie Nance was immediately attracted to the public service ethos at the heart of the major.

“I was undecided and feeling a little anxious about that, so I looked through all the majors on the UCLA website. When I came across Public Affairs, I realized it hit all of my passions,” said Nance, who spent time in high school working to create educational and employment opportunities for young people.

“This major doesn’t just expand knowledge,” she said. “It shows us how to do something with that knowledge, to make an impact.”

That sentiment is reflected in the undergraduate program’s motto: Developing Leaders Engaged in Social Change.

“Our students are developing knowledge and skills in the service of solving society’s most pressing problems, which is really what distinguishes this major from others,” said Undergraduate Affairs Chair Meredith Phillips, who is also an associate professor of public policy and sociology.

No other campus in the UC system offers a Public Affairs bachelor’s degree that draws from the three fields UCLA Luskin is known for: public policy, social welfare and urban planning.

This partnership has created an infectious energy that was on display during an undergraduate open house during the first week of school. Phillips led the welcoming committee, along with more than 20 faculty from across the School and Dean Segura, who noted that he too will teach an undergrad course this year, Foundations and Debates in Public Thought.

The event offered a glimpse of the resources available to students pursuing the B.A. in Public Affairs. Freshmen and sophomores freely mingled with professors who teach graduate-level courses and conduct cutting-edge research. And the undergraduate staff, who came together this summer to ensure the major was launched without a hitch, was out in force to answer questions and offer encouragement.

The networking continued the following evening at the Schoolwide Block Party, where the entire UCLA Luskin family — students, faculty, staff and alumni — came out to celebrate the new academic year.

“It was a good chance to talk to some alumni, to see what they are currently doing,” said freshman Navkaran Gurm, whose interests lie in law, politics, economics and public service.

Over the summer, another alumni connection led Gurm to the new major. He had enrolled in a Fresno City College economics class taught by Nelson Esparza MPP ’15, and ended up volunteering for Esparza’s campaign for Fresno City Council.

In the classroom and on the trail, Gurm spent hours talking to Esparza, who urged him to take a look at the Luskin School’s new bachelor’s degree. Gurm was sold. He plans to double-major in Economics and Public Affairs, with an eye toward attending law school.

“What I saw in the Public Affairs major was a way to show us how to make the world a better place, and that was something that really appealed to me,” said Gurm, who is keenly interested in battling disparities that put youth in rural communities, like his hometown, at a disadvantage.

A poll ahead of the November 2018 midterm elections found a remarkable level of civic engagement among young Californians. They talk politics, volunteer and allow political values to guide their purchases, the survey of 16- to 24-year-olds found. A full 80 percent said they considered themselves part of a social movement, according to the poll funded by the California Endowment.

Rising student demand led to creation of the Public Affairs major, which UCLA Luskin faculty unanimously endorsed in 2017. The university’s Academic Senate gave final approval in April 2018, and the first cohort was recruited over the summer.

Ricardo Aguilera switched to the pre-major as soon as it was announced. “For me, it was right on, concentrating on social advocacy within the community and just giving back,” he said.

Aguilera is one of several dozen sophomores who are working closely with the undergraduate staff to complete pre-major requirements in a single year. The School also continues to offer undergraduate minors in Public Affairs, Gerontology and Urban and Regional Studies.

Aguilera, Nance and Gurm have been struck by the personalized attention they receive in the relatively small Public Affairs program. Weekly emails share information about jobs, internships and campuswide events, and keep the cohort connected, they said.

Gurm said he attended informational sessions for other majors where students clamored to get their questions answered. At the Public Affairs workshop, “there were four of us and Brent, and it was as if we were having a one-on-one conversation,” he said, referring to undergraduate advisor Brent Showerman, who explained both the vision and the requirements of the program.

“I really like that whole support system, the feeling that they are guiding us in the right direction,” he said.