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This is a CDDRL's Special Research Seminar within our Democracy in Taiwan Program.

Chang-Ling Huang is an associate professor of political science at the National Taiwan University. She received her Ph. D. from the University of Chicago. Her research interests are gender politics and labor politics. She has published in various journals including Developing Economies, Anthropology of Work Review, American Journal of Public Health and Issues & Studies. Her current research project is a comparative study on state feminism in South Korea and Taiwan. She examines how the newly democratized states in these two countries have been actively promoting gender equality.

Professor Huang received the Outstanding Teaching Award in 2007 at the National Taiwan University. In addition to her academic career, since 2000 she has been a board member of the Awakening Foundation, the earliest established feminist organization in post-war Taiwan. Between 2004 and 2007, she was the president of the foundation. She has also been a civilian member of various government committees and commissions in Taiwan.

Professor Huang is a visiting scholar at Stanford's Political Science Department in the academic year of 2007-2008.

Philippines Conference Room

Chang-Ling Huang Associate Professor of Political Science Speaker National Taiwan University
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OBJECTIVES: We sought to determine the prevalence of HIV in both inpatient and outpatient settings in 6 Department of Veterans Affairs (VA) health care sites. METHODS: We collected demographic data and data on comorbid conditions and then conducted blinded, anonymous HIV testing. We conducted a multivariate analysis to determine predictors of HIV infection. RESULTS: We tested 4500 outpatient blood specimens and 4205 inpatient blood specimens; 326 (3.7%) patients tested positive for HIV. Inpatient HIV prevalence ranged from 1.2% to 6.9%; outpatient HIV prevalence ranged from 0.9% to 8.9%. Having a history of hepatitis B or C infection, a sexually transmitted disease, or pneumonia also predicted HIV infection. The prevalence of previously undocumented HIV infection varied from 0.1% to 2.8% among outpatients and from 0.0% to 1.7% among inpatients. CONCLUSIONS: The prevalence of undocumented HIV infection was sufficiently high for routine voluntary screening to be cost effective in each of the 6 sites we evaluated. Many VA health care systems should consider expanded routine voluntary HIV screening.

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Am J Public Health
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Douglas K. Owens
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Migration and health are two areas that have each received significant amounts of attention in sociology. However, only recently have researchers begun to examine the links between these two population processes. There is growing yet incomplete evidence that migration and the health are intertwined in complex ways. Health itself can impact the decision to move, and migration may affect the health of those who move, those who stay, and those who host migrants. Using high quality longitudinal data from Indonesia, Lu's research makes a serious attempt to tackle important questions about the association between migration and health in the Indonesian context. In particular, she examines both how health may affect migration decisions, and how changing socioeconomic conditions associated with migration may have implications for the health of various populations involved, including not only migrants but also people left behind in sending communities. Lu will also discuss research underway on migration and health in China, including a new national survey with data to study that topic in the Chinese context.

Yao Lu is a Ph.D. candidate of Sociology, M.S. candidate of Public Health, and student affiliate at the California Center for Population Research at UCLA. She has a BS from Fudan University in China. Her research focuses on studying the causes and consequences of internal migration in developing countries, and modeling socioeconomic and behavioral factors as determinants of health. Her papers include studies based on data from China, Indonesia, and South Africa. She has a paper forthcoming in the American Sociological Review, and has received dissertation fellowships from the AAUW foundation and the Asia Institute at UCLA. She is currently completing her dissertation on the relationship between labor migration and health in Indonesia, while working on a national survey project on internal migration and health in China.

Daniel and Nancy Okimoto Conference Room

Yao Lu PhD candidate in Sociology Speaker University of California-Los Angeles
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Objectives: We examined the utility of the Veterans Health Administration (VHA) universal screening program for military sexual violence.

Methods: We analyzed VHA administrative data for 185 880 women and 4139888 men who were veteran outpatients and were treated in VHA health care settings nationwide during 2003.

Results: Screening was completed for 70% of patients. Positive screens were associated with greater odds of virtually all categories of mental health comorbidities, including posttraumatic stress disorder (adjusted odds ratio [AOR]=8.83; 99% confidence interval [CI] = 8.34, 9.35 for women; AOR = 3.00; 99% CI = 2.89, 3.12 for men). Associations with medical comorbidities (e.g., chronic pulmonary disease, liver disease, and for women, weight conditions) were also observed. Significant gender differences emerged.

Conclusions: The VHA policies regarding military sexual trauma represent a uniquely comprehensive health care response to sexual trauma. Results attest to the feasibility of universal screening, which yields clinically significant information with particular relevance to mental health and behavioral health treatment. Women’s health literature regarding sexual trauma will be particularly important to inform health care services for both male and female veterans.

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American Journal of Public Health
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Mark W. Smith
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China's Harmonious Society colloquium series

co-sponsored by the Stanford China Program and the Center for East Asian Studies

Since 2006, the official doctrine of China's Communist Party calls for the creation of a "harmonious society" (HeXieSheHui). This policy, identified with the Hu Jintao leadership, acknowledges the new problems that have emerged as China continues its amazing economic growth. The economy is booming but so are tensions from rising inequality, environmental damage, health problems, diverse ethnicities, and attempts to break the "iron rice bowl." In this series of colloquia, leading authorities will discuss the causes of these tensions, their seriousness, and China's ability to solve these challenges.


Nancy Shulman's talk topic will be posted soon.

Nancy Shulman conducts laboratory and clinical research in the area of HIV therapeutics, with focus on antiretroviral resistance and treatment strategies of experienced patients, the impact of antiretroviral treatment on HIV co-receptor utilization, and HIV in China. she received her MD from Kansas University Medical School and holds a BA in biochemistry from University of Texas, Austin. She is a doctor specializing in internal medicine, pediatrics, and infectious diseases.

"Healthcare Coverage for 1.3 Billion: China's Odyssey"

Karen Eggleston

Media coverage as well as the academic literature give conflicting appraisals of China's reality: Is China's healthcare system on the verge of collapse? Why is healthcare so expensive and difficult to access in contemporary China? Have reforms 'marketizing' healthcare drastically undermined progress in assuring affordable access for all? Or do hospitals and other providers constitute a last bastion of state control and bureaucratized monopoly in the name of equal access? Chinese analysts and policy advisers have engaged in a sometimes acrimonious debate; some champion a government-led, National Health Service-like model, while others passionately argue that market forces should play a greater role. In this talk, Karen Eggleston will present a brief overview of China's health system reforms and current developments.

Karen Eggleston focuses her research on comparative healthcare systems during economic development and transition from central planning to market-based economies. Her interests include the impact of payment incentives on healthcare insurer and provider behavior; chronic disease management; and incentives surrounding health behaviors such as the spread of HIV/AIDS and tuberculosis, overuse of antibiotics, and smoking. She earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii.

Philippines Conference Room

Shorenstein APARC
Stanford University
Encina Hall E301
Stanford, CA 94305-6055

(650) 723-9072 (650) 723-6530
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Senior Fellow at the Freeman Spogli Institute for International Studies
Center Fellow at the Center for Health Policy and the Center for Primary Care and Outcomes Research
Faculty Research Fellow of the National Bureau of Economic Research
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
karen-0320_cropprd.jpg PhD

Karen Eggleston is a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University and Director of the Stanford Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center at FSI. She is also a Fellow with the Center for Innovation in Global Health at Stanford University School of Medicine, and a Faculty Research Fellow of the National Bureau of Economic Research (NBER). Her research focuses on government and market roles in the health sector and Asia health policy, especially in China, India, Japan, and Korea; healthcare productivity; and the economics of the demographic transition.

Eggleston earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii and a BA in Asian studies summa cum laude (valedictorian) from Dartmouth College. Eggleston studied in China for two years and was a Fulbright scholar in Korea. She served on the Strategic Technical Advisory Committee for the Asia Pacific Observatory on Health Systems and Policies and has been a consultant to the World Bank, the Asian Development Bank, and the WHO regarding health system reforms in the PRC.

Director of the Asia Health Policy Program, Shorenstein Asia-Pacific Research Center
Stanford Health Policy Associate
Faculty Fellow at the Stanford Center at Peking University, June and August of 2016
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Karen Eggleston Shorenstein Asia-Pacific Research Center Fellow Speaker Stanford University
Nancy Shulman Assistant Professor of Medicine (Infectious Diseases) Speaker School of Medicine, Stanford University
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Background: Effective strategies for managing patients with solitary pulmonary nodules (SPN) depend critically on the pre-test probability of malignancy.

Objective: To validate two previously developed models that estimate the probability that an indeterminate solitary pulmonary nodule (SPN) is malignant, based on clinical characteristics and radiographic findings.

Methods: We retrospectively collected data on age, smoking and cancer history, nodule size, location, and spiculation from the medical records of 151 veterans (145 men, 6 women; range 39 to 87 years) with an SPN measuring 7 to 30 mm (inclusive) and a final diagnosis established by histopathology or 2-year follow-up. We compared each patient's final diagnosis to the probability of malignancy predicted by two models: one developed by investigators at the Mayo Clinic and another that we developed from patients enrolled in a VA Cooperative Study. We assessed model accuracy by calculating areas under the receiver operating characteristic (ROC) curve and model calibration by comparing predicted and observed rates of malignancy.

Results: The area under the ROC curve for the Mayo Clinic model (0.80; 95% CI 0.72-0.88) was higher than that of the VA model (0.73; 95% CI 0.64-0.82), but this difference was not statistically significant (Delta=0.07; 95% CI -0.03 to 0.16). Calibration curves showed that the probability of malignancy was underestimated by the Mayo Clinic model and overestimated by the VA model.

Conclusions: Two existing prediction models are sufficiently accurate to guide decisions about the selection and interpretation of subsequent diagnostic tests in patients with SPNs, although clinicians should also consider the prevalence of malignancy in their practice setting when choosing a model.

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Thorax
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Douglas K. Owens
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Jeanne Mager Stellman (speaker) has just recently joined the Department of Preventive Medicine and Community Health at SUNY-Downstate Medical Center in Brooklyn N.Y as Professor and Director of the Division of Environmental Health Sciences. She had been a member of the faculty of the School of Public Health at Columbia University since 1981 and directed the General Public Health track. Stellman is actively engaged in research on herbicides in Vietnam and was director of a multimillion dollar study for the National Academy of Science to develop exposure methodologies for epidemiological studies of military herbicides. She and her husband, Steven D. Stellman, are collaborating on several follow-up studies and, with National Library of Medicine support, she is now creating a website on Vietnam that uses the geographic information system they developed to make it accessible to researchers around the world. The Stellmans are the recipient of The American Legion's Distinguished Service Medal because of their ongoing research and assistance to veterans. In addition, Stellman is now heavily engaged in research and policy in the aftermath of the World Trade Center terrorist attacks. She served on the EPA's Technical Advisory Panel for WTC Cleanup and is a consultant to the Mt. Sinai WTC Medical Monitoring program, where she is co-directing research on the mental health and well-being of the first responders. Stellman served as Editor-in-Chief of the Encyclopedia of Occupational Health and Safety, 4th edition (1998). She is the recipient of a Guggenheim fellowship and was named one of Ms. Magazine's "80 women to watch in the 80's." She has written several books, many monographs and chapters and peer-reviewed publications.

Lynn Eden (discussant) is associate director for research/senior research scholar at the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Eden received her Ph.D. in sociology from the University of Michigan, held several pre- and post-doctoral fellowships, and taught in the history department at Carnegie Mellon before coming to Stanford. In the area of international security, Eden has focused on U.S. foreign and military policy, arms control, the social construction of science and technology, and organizational issues regarding nuclear policy and homeland security.

Reuben W. Hills Conference Room

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Lynn Eden is a Senior Research Scholar Emeritus. She was a Senior Research Scholar at Stanford University's Center for International Security and Cooperation until January 2016, as well as was Associate Director for Research. Eden received her Ph.D. in sociology from the University of Michigan, held several pre- and post-doctoral fellowships, and taught in the history department at Carnegie Mellon before coming to Stanford.

In the area of international security, Eden has focused on U.S. foreign and military policy, arms control, the social construction of science and technology, and organizational issues regarding nuclear policy and homeland security. She co-edited, with Steven E. Miller, Nuclear Arguments: Understanding the Strategic Nuclear Arms and Arms Control Debates (Ithaca, N.Y.: Cornell University Press, 1989). She was an editor of The Oxford Companion to American Military History (New York: Oxford University Press, 2000), which takes a social and cultural perspective on war and peace in U.S. history. That volume was chosen as a Main Selection of the History Book Club.

Eden's book Whole World on Fire: Organizations, Knowledge, and Nuclear Weapons Devastation (Ithaca: Cornell University Press, 2004; New Delhi: Manas Publications, 2004) explores how and why the U.S. government--from World War II to the present--has greatly underestimated the damage caused by nuclear weapons by failing to predict damage from firestorms. It shows how well-funded and highly professional organizations, by focusing on what they do well and systematically excluding what they don't, may build a poor representation of the world--a self-reinforcing fallacy that can have serious consequences, from the sinking of the Titanic to not predicting the vulnerability of the World Trade Center to burning jet fuel. Whole World on Fire won the American Sociological Association's 2004 Robert K. Merton Award for best book in science, knowledge, and technology.

Eden has also written on life in small-town America. Her first book, Crisis in Watertown (Ann Arbor: University of Michigan Press, 1972), was her college senior thesis; it was a finalist for a National Book Award in 1973. Her second book, Witness in Philadelphia, with Florence Mars (Baton Rouge: Louisiana State University Press, 1977), about the murders of civil rights workers Schwerner, Chaney, and Goodman in the summer of 1964, was a Book of the Month Club Alternate Selection.

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Lynn Eden Speaker
Jeanne Stellman Professor of Clinical Health Policy and Management, Mailman School of Public Health Speaker Columbia University
Seminars

Shorenstein APARC
Stanford University
Encina Hall E301
Stanford, CA 94305-6055

(650) 723-9072 (650) 723-6530
0
Senior Fellow at the Freeman Spogli Institute for International Studies
Center Fellow at the Center for Health Policy and the Center for Primary Care and Outcomes Research
Faculty Research Fellow of the National Bureau of Economic Research
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
karen-0320_cropprd.jpg PhD

Karen Eggleston is a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University and Director of the Stanford Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center at FSI. She is also a Fellow with the Center for Innovation in Global Health at Stanford University School of Medicine, and a Faculty Research Fellow of the National Bureau of Economic Research (NBER). Her research focuses on government and market roles in the health sector and Asia health policy, especially in China, India, Japan, and Korea; healthcare productivity; and the economics of the demographic transition.

Eggleston earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii and a BA in Asian studies summa cum laude (valedictorian) from Dartmouth College. Eggleston studied in China for two years and was a Fulbright scholar in Korea. She served on the Strategic Technical Advisory Committee for the Asia Pacific Observatory on Health Systems and Policies and has been a consultant to the World Bank, the Asian Development Bank, and the WHO regarding health system reforms in the PRC.

Director of the Asia Health Policy Program, Shorenstein Asia-Pacific Research Center
Stanford Health Policy Associate
Faculty Fellow at the Stanford Center at Peking University, June and August of 2016
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This issue of CHP/PCOR's Quarterly Update covers news from the Spring 2007 quarter and includes articles about:

  • the HIV/AIDS International Conference in St. Petersburg, Russia, that was attended by the CHP/PCOR National Institute on Drug Abuse project team;
  • a special international health section that highlights HIV/AIDS research in Zimbabwe, and two Payne lecturer talks, given by David Heymann and Peter Piot, speaking on infectious diseases and HIV/AIDS, respectively;
  • two Research in Brief selections -- one highlights health care financing structures in high-income countries, and the second covers an ongoing trial that incorporates a smoking cessation program into posttraumatic stress disorder treatment at the VA;
  • a Staff Spotlight feature on new CHP/PCOR core faculty member Sally Horwitz;
  • two conferences -- one hosted by the Stanford International Initiative and the other a National Summit on America's Children at the Capitol.
The newsletter also contains various other news items that may be of interest to our readers. Note to the reader: The newsletter is fully-navigational. Any text that is surrounded by a dashed box is clickable and will allow the reader to navigate the newsletter more efficiently. The end of each article contains a special symbol (§) that, when clicked, will take the reader back to the table of contents. Please feel free to contact Amber Hsiao with any questions.
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