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What’s Next in Etiquette?

Emily Post’s EtiquetteThe queen of good manners, Emily Post, died in 1960, but great-great grandson Daniel Post Senning ’99—one of the editors of the 19th edition of Emily Post’s Etiquette—is helping to carry forward the family business.

And it’s not all about forks, knives and seating arrangements.

In the world of etiquette, Senning says, the only constant is that there’s always something new to grapple with. The advent of the home telephone brought with it a fear of the end of family life. The explosion of social media raised questions about navigating online spaces. A globalized world has brought with it cultural quandaries in international business meetings.

So what’s next?

For one thing, big shifts are coming with increased questions about gender and gender identity, Senning says. Traditional gender courtesies will need to be adjusted.

The smartphone is also challenging social norms. “People are going to take more and more seriously how we show respect to each other and are able to shut off from the digital world, from the information that’s flowing around us all the time, and connect with each other as people,” he says.

Senning also predicts that the legalization of cannabis in California and other states will affect how we entertain at home. Do you offer an after-dinner joint? How do you navigate a guest who is high? Or a relative who was raised to believe that cannabis was criminal and immoral?

But for Senning, no matter how much things change, the organizing principles of etiquette always stay the same: respect and flexibility.

“Change is something we’ve survived before as a society, as individuals, as cultures all over, and things will continue to change. Changing with them, frankly, is something that we’ve done before.”

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What’s Next in Maternity Care?

MaternityWhich nation in the “developed world” spends the most on maternity care? You guessed it—the United States. And which has the highest maternal mortality rate? Same answer, and the numbers aren’t even close.

“We are spending the most and getting the least,” says Melissa Hanna ’09, founder and CEO of Mahmee (pronounced “mommy”) “And even though we have a slowly but surely declining infant mortality rate, it’s still too high.”

That’s why Hanna founded Mahmee, a secure online platform designed to bring together a network of education and support services that expecting and new mothers and their babies need in order to thrive—from early pregnancy through the first year of an infant’s life. Hanna calls it “bundling care,” and she notes that the same model has been used successfully to manage other health-related conditions that require attentive, long-term maintenance, such as diabetes and chronic heart failure.

“Being pregnant is not considered being sick,” she says. “But I like to say having a baby is like a hormonal boomerang. Your body is prioritizing the baby over you, and so, if you think of the experience of childbirth as being this acute, physical trauma on the body, on the hormones, on the brain, why don’t we treat that as something that a person should be recovering from? If we did, it would totally change our approach to health care for women.”

Part of the problem, Hanna says, is our disconnected health care system. “One doctor, the pediatrician, is responsible for the baby, and a completely different doctor in a completely different office, using a completely different system of tools and software, is keeping track of the mother’s health. Mother and baby are connected in the womb and then outside of the womb for months after, and yet the way that we take care of them is so separated.”

In addition, most Americans don’t have the family support systems that mothers rely on in more traditional cultures. “We’re all transplants,” Hanna says. “We move around the country, away from our parents, away from our grandparents, so we end up having children in environments where we’re very isolated.”

When systemic change finally comes, Hanna believes, it’s probably going to look a lot like what other countries have done for years. “I think when we look to the future, we can look to other countries like France, like England, having a model of sort of nurse-midwifery and in-home health care,” she says. As an example, she points to the growing demand for doulas. “We end up creating a whole new industry—the industry of being a doula, which is basically being a home health assistant after delivery. That has become part of the market share in the United States, and I think that’s going to continue.”

Online services like Mahmee, which connect expecting mothers with networks of other mothers and health care experts, are also an important part of the future, Hanna believes.

“In the next few years, we’re going to see a big shift, where people start to take their Lamaze classes online, where mothers join video chat support groups,” she says. “Our company is starting to offer those, as an example, and I know that we’re not the only ones. I think that’s going to be a big way for women to connect and support each other online.”

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What’s Next in Health Care Apps?

Health Care AppsRising costs and access to health care are issues that weigh heavily on Americans and their families. These issues deepen when it comes to mental health. Common mental illnesses can be extraordinarily disabling, and yet, many patients do not receive treatment.

Stephen Smith ’17 believes technology will be part of the solution.

After winning his own battle with obsessive compulsive disorder (OCD), the economics grad has used his experience to help others by creating a smart-phone app that provides on-the-go treatment to fight the condition.

The app, which he dubbed nOCD, records real-time data, offers guided cognitive behavioral exercises and allows people with OCD to join in-app support communities at any hour of any day. With this technology, users get 24/7 clinically approved care and are connected to a community that understands them.

“People are always wondering how you’re going to treat mental illness, given the shortage of licensed mental health clinicians,” says Smith. “And the answer is through technology.”

Smith sees this technology trend not only for mental health but for healthcare overall.

“The healthcare industry today is going ‘more mobile’ and ‘more digital’ given that technology offers consumers an always-on, personalized treatment experience,” he says. “Since the majority ‘at-risk’ populations are already actively engaged in technology, utilizing digital solutions to deliver care can have both an immediate clinical as well as an economic impact for both the patient and provider.”

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What’s Next in Treating Mental Illness?

People in confusion. Concept of fusion of thoughtsWhat’s next in the treatment of mental illness will be a direct outcome of what’s now, according to Pomona College Professor of Psychology Sara Masland. Two developments in the field may, over time, transform treatment of psychological disorders.

The name of the first development sounds tricky to understand, but it’s really pretty straightforward. The National Institute of Mental Health started a framework called RDoC (Research Domain Criteria) that encourages researchers not to stick strictly to the textbook—or in psychological cases, standard diagnostic manuals—when studying disorders. Instead, they look more carefully at a person in all their complexities.

“We now have a good deal of information that suggests that the lines we draw are not always appropriate,” says Masland. “This framework seeks to take a step back and understand differences in the functioning of basic human processes across multiple levels and units of analysis.” By levels of analysis she means genes and behavior, and she’s talking about processes like reward processing and basic cognition.

More nuanced diagnoses dovetail with a second development: research that uses mathematical models to understand which symptoms and experiences are central and which may be caused by these primary symptoms.

“As a clinician, I might see a patient come in who reports five symptoms, and I can conclude that they co-occur,” says Masland. “But what is hard to get a good sense of is how these symptoms contribute to one another. Which came first? Does the presence of one cause or exacerbate the presence of another?”

If a psychologist can see a map of symptoms, she says, treatment can be more targeted.

These two developments offer a lot of promise for the future. Masland foresees the possibility of a move away from relying on flawed (yet still useful) diagnostic categories toward a more empirical approach. Over time, she hopes this will destigmatize psychological disorders and build compassion as well as clarity. With the new model of symptom mapping, Masland says targeted treatment will become more personalized and efficient.

Masland also believes both of these approaches will change how we understand the basic mechanisms of psychopathology. That change in understanding will, in turn, change the treatment landscape. Ultimately, her hope is that “they will lead to better understanding of human experience more broadly.”

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What’s Next in Big Data?

dataFor many of us, the words “big data” have taken on sinister connotations, evoking stories of data breaches, manipulation and abuse. But in medicine and pharmacology, Jan Lethen ’93 believes big data is already saving lives—and in the future, it’s going to get even bigger and save many more.

As director of statistical programming in observational research at the biopharmaceutical firm Amgen, Lethen works with a storehouse of anonymous data from over 100 million patients worldwide. Statistical research based on that data, he says, permits companies like Amgen “to support product safety, to profile diseases, to design more effective clinical trials and to forecast populations that would most benefit from our drugs.”

As a sign of the future, Lethen points to a new app that pairs with Apple’s iWatch, enabling patients to link their health records to their biometric data, potentially making that linked data available for researchers. “We’re seeing more and more types of data being brought together and linked together,” he says. “So that might include genetic data, which is critical in fields like oncology.”

He also points to an NIH-funded initiative called “All of Us,” which seeks to collect genetic data and other health data from a million Americans for research purposes. “These data sets are going to get ever more complex, ever more extensive, ever more complete in the history of the patient,” he says.

Indeed, the ability to tailor medicine to the patient may become so exact that drug companies may charge only for successful treatments. “That’s a move that a number of pharma companies are currently working on with payers,” Lethen says. “They can say, ‘Hey, if you give our drug to these patients with these characteristics and it doesn’t work, you don’t have to pay for the drug.’ That will be a new business model that will continue to expand.”

The ultimate goal, he says, will be medicines tailored to a single individual. “Especially with oncology, you could say, ‘Hey, if you use this therapy in conjunction with these two other things, we are confident it’s going to work for you. The level of detail that we have on each patient right now doesn’t allow us to do that, but as we build out those genetic profiles for each patient and they become more and more unique, we’ll be able to build profiles that actually do get down to very small patient cells, and perhaps, eventually, to a patient level of one.”

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What’s Next for the Blind?

blindThe 1970s TV show The Six Million Dollar Man (which now seems quaintly underpriced in today’s dollars) brought the word “bionic” into general use, with sci-fi connotations that it has never completely shed. But one area of prosthetics where fact has begun to overtake fiction is in the world of bionic vision. In 2015, the Honolulu-based ophthalmologist Dr. Gregg Kokame ’78 was the first physician in the Asia-Pacific region to implant a bionic eye, giving a patient who had been blind from hereditary retinal disease the gift of sight.

The process involves inserting into the eye a 60-microelectrode implant, which transfers impulses from a tiny camera attached to a pair of glasses directly to the patient’s retina. “It does not allow people to recover reading vision,” he explains, “but they do recover the ability to ambulate, the ability to see figures, the ability to see somebody come into a room. They can even pick out patterns. So they can do a lot more than they could do before.”

Future bionic eyes, Kokame says, may permit patients to see in color or to read a book, but first researchers will have to break the brain’s code for color vision and develop even tinier and cooler microelectrodes so that more of them can be added to the matrix without overheating the eye. “Amazingly,” he adds, “for patients whose eyes or optic nerves are not working at all, they are trying to bypass the eye completely and implant electrodes directly on the brain.”

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What’s Next in Biodiversity?

extinctionWe are in the middle of a mass extinction event, says Professor of Biology Nina Karnovsky, and, this time, it’s our fault.

“It’s called the Anthropocene Era because it’s being caused by humans,” says Karnovsky, who specializes in the study of seabirds. “The warming of our planet, the destruction of habitat, pollution and other contaminants are causing widespread extinctions. It is really grim. I don’t think I would be able to cope if I didn’t try every day to do something to ameliorate this overwhelming thing that’s happening around us.”

Paying attention is one way to make a difference, says Karnovsky, who assigns her students to keep journals and record their observations.

“It’s extremely important to be a great naturalist and to keep track of what you’re seeing around you, and to notice and document that,” she says. “If you aren’t really noticing the change in the species, then you won’t notice when they’re gone.”

In fact, many species that we didn’t know about are already lost, says Karnovsky. It’s not just about climate change, but habitat destruction, harvesting, oil spills and other things that are causing a “vortex of extinction.” And when a population gets impacted and can’t recover, that affects other species, including humans.

“It’s not esoteric. It’s a social justice issue,” says Karnovsky. “There isn’t enough food to eat because the ice has changed; the marine mammals aren’t coming into the fjords where they used to come and people used to hunt them. So for these communities, this is life or death.”

Compounding the problems in identifying and studying endangered species are cuts to research made by the current administration, making it harder for researchers to keep up sustained studies, where they return to the same locations to test for changes that show a species has become more vulnerable.

For Karnovsky, the warnings are clear and call for some big decisions about what direction we’re going. “We need to tell our leaders, and it has to be a multi-pronged approach.” She says. “We have to be active on political fronts, but also in our daily lives.’

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What’s Next for the Sagehen?

SagehenPomona College’s mascot, the sagehen—the sage grouse in the real world—needs a “lek” up.

A rare collaboration between conservation and energy interests came together to protect the sage grouse’s mating habitat—known as leks. But the U.S. Interior Department led by Secretary Ryan Zinke is now re-examining the plan in order to prioritize energy development, leading to an uncertain future for our beloved mascot.

Jessica Blickley ’02, an ecologist at Pasadena City College, studied the sage grouse as a graduate student at UC Davis and lays out the history, present and potential future of Cecil’s brethren.

Historically, the sage grouse’s habitat spanned the western United States, but as grazing land overtook wild land, as invasive grasses crept over native sagebrush, as wildfires grew in ferocity and frequency, and as natural gas, oil and wind developments popped up, the sage grouse’s domain has shrunk. And with shrinking domains, explains Blickley, there’s less space for the sage grouse to puff up their chests and attract mates. That means shrinking populations.

That’s why, a few years ago, a diverse group of concerned stakeholders, from state governments to private landowners, came together to craft a large-scale sage grouse conservation plan focused on protecting the bird’s natural habitat. In 2015, this multi-state effort led the U.S. Fish and Wildlife Service to keep the sage grouse off the Endangered Species Act (ESA), a decision the Audubon Society saw as a nod to the ongoing success of the plan.

“The conservation plan seemed to be working well until 2017 when Zinke decided he was going to put this conservation plan under review and change it,” says Blickley. “In addition, there is currently a bill in Congress that would specifically prevent future listing of the sage grouse under ESA. Due to these federal actions, the future of the sage grouse is much less certain than just a few years ago.”

But Blickley hasn’t lost hope. “My hope comes from the state level. In the state of Wyoming, where 40 percent of the sage grouse are found, the Republican governor believes strongly in the collaborative conservation plan, so hopefully many of the state level regulations will go into place.”

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What’s Next for Science Museums?

Two kids looking at a science exhibit, back viewScience museums are not just science lessons for kids any more.

As president and CEO of the Science Museum of Minnesota, Alison Brown ’80 says science museums are becoming something more—more contemplative, more thought-provoking, more people-oriented. “I’m leading a team that is helping us move away from the idea that museums curate only the facts and tell you what’s what,” says Brown, who is also a vice chair of the Board of Trustees of Pomona College. “We will always do real science. We also want our museum to be the place where you’re having two-way conversations and contributing your experience to the collective understanding—all while you’re having fun.”

In the ‘70s, she says, science museums were noisy with hands-on interactives and gadgets. “As people start seeing science museums not just as places for pushing buttons and pulling levers, but as places where they’re engaged in conversation and joining us in creating experiences that are worth their time—that’s an exciting future.”

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What’s Next in Space Exploration?

space explorationAs we near the 50th anniversary of the first moonwalk, Colleen Hartman ’77 believes the next chapter in human space exploration is not far away. “When I talk to high-school and younger groups, I always tell them that I’ll be alive when the first human puts her foot down on Mars, and they always laugh,” she says.

But what brings Hartman to work each day as director of the Sciences and Exploration Directorate of NASA’s Goddard Space Flight Center is the extraordinary science that continues to be done through spacecraft with no astronauts aboard. As an example, she points to a couple of new spaceborne telescopes that are likely to kick the search for exoplanets—planets circling other stars—into high gear.

Although the number of confirmed exoplanets has exploded into the thousands since the launch of the Kepler spacecraft in 2009, we still know next to nothing about them. With the launch of TESS (the Transiting Exoplanet Survey Satellite) in April 2018 and the planned launch of the James Webb Space Telescope in 2020, NASA hopes to change that, Hartman says. “Whereas Kepler looked at only a tiny fraction of the sky,” she explains, “TESS will look for extrasolar planets all around our closer neighborhood, where hopefully, we can have follow-up observations with the James Webb Space Telescope.” Those observations, she says, should give us our first detailed analysis of the chemical makeup of an exoplanet’s atmosphere.

Other upcoming NASA missions of particular note include:

  • The Parker Solar Probe (Planned launch: August 2018)—This probe’s orbit will carry it to within 3.8 million miles of the sun, which is actually inside the sun’s corona. Able to withstand temperatures of up to 2,500 degrees Fahrenheit, the probe will study such things as the solar wind and mass ejections. “This mission will help us understand the relationship between the sun and the Earth in ways we never could before,” Hartman says.
  • The Wide Field infrared Survey Telescope or WFIRST (Planned launch: 2020)—WFIRST will join in the search for exoplanets, but it will also play a key role in the effort to solve the most baffling mystery in astrophysics today. “Approximately three quarters of the universe is made of something we call dark energy, because it doesn’t interact with anything and we don’t really understand what it is,” she says. “WFIRST will be looking for clues about dark energy as well.”
  • The Europa Clipper (Planned launch: sometime in the 2020s)—This probe will investigate the habitability of Jupiter’s icy moon Europa. “To me, this is one of the most exciting things at NASA,” Hartman says. “When we’re looking for life on other planets, we’re looking for water, but it turns out that here in our own solar system, you can have a frozen icy moon, and under the frozen surface, a liquid ocean. That’s Europa. I like to joke that if there’s life in that liquid ocean, they’re not going to be very good astronomers.”

One thing Hartman says she can’t predict is the practical benefits that will accrue from continued exploration of the solar system and beyond, but she’s sure there will be many of them. “There’s plenty to discover and investigate, and I do think there’ll be a lot of practical output from some of these investigations, but you don’t necessarily know beforehand what the spinoffs will be. It’s serendipitous, and that’s part of the joy.”

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