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Background: Sodium consumption raises blood pressure, increasing the risk for heart attack and stroke. Several countries, including the United States, are considering strategies to decrease population sodium intake.

Objective: To assess the cost-effectiveness of 2 population strategies to reduce sodium intake: government collaboration with food manufacturers to voluntarily cut sodium in processed foods, modeled on the United Kingdom experience, and a sodium tax.

Design: A Markov model was constructed with 4 health states: well, acute myocardial infarction (MI), acute stroke, and history of MI or stroke.

Data Sources: Medical Panel Expenditure Survey (2006), Framingham Heart Study (1980 to 2003), Dietary Approaches to Stop Hypertension trial, and other published data.

Target Population: U.S. adults aged 40 to 85 years.

Time Horizon: Lifetime.

Perspective: Societal.

Outcome Measures: Incremental costs (2008 U.S. dollars), quality-adjusted life-years (QALYs), and MIs and strokes averted.

Results of Base-case Analysis: Collaboration with industry that decreases mean population sodium intake by 9.5% averts 513 885 strokes and 480 358 MIs over the lifetime of adults aged 40 to 85 years who are alive today compared with the status quo, increasing QALYs by 2.1 million and saving $32.1 billion in medical costs. A tax on sodium that decreases population sodium intake by 6% increases QALYs by 1.3 million and saves $22.4 billion over the same period.

Results of Sensitivity Analysis: Results are sensitive to the assumption that consumers have no disutility with modest reductions in sodium intake.

Limitation: Efforts to reduce population sodium intake could result in other dietary changes that are difficult to predict.

Conclusion: Strategies to reduce sodium intake on a population level in the United States are likely to substantially reduce stroke and MI incidence, which would save billions of dollars in medical expenses.

Primary Funding Source: Department of Veterans Affairs, Stanford University, and the National Science Foundation.

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Annals of Internal Medicine
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Douglas K. Owens
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Background: Sodium consumption raises blood pressure, increasing the risk for heart attack and stroke. Several countries, including the United States, are considering strategies to decrease population sodium intake.

Objective: To assess the cost-effectiveness of 2 population strategies to reduce sodium intake: government collaboration with food manufacturers to voluntarily cut sodium in processed foods, modeled on the United Kingdom experience, and a sodium tax.

Design: A Markov model was constructed with 4 health states: well, acute myocardial infarction (MI), acute stroke, and history of MI or stroke.

Data Sources: Medical Panel Expenditure Survey (2006), Framingham Heart Study (1980 to 2003), Dietary Approaches to Stop Hypertension trial, and other published data.

Target Population: U.S. adults aged 40 to 85 years.

Time Horizon: Lifetime.

Perspective: Societal.

Outcome Measures: Incremental costs (2008 U.S. dollars), quality-adjusted life-years (QALYs), and MIs and strokes averted.

Results of Base-case Analysis: Collaboration with industry that decreases mean population sodium intake by 9.5% averts 513 885 strokes and 480 358 MIs over the lifetime of adults aged 40 to 85 years who are alive today compared with the status quo, increasing QALYs by 2.1 million and saving $32.1 billion in medical costs. A tax on sodium that decreases population sodium intake by 6% increases QALYs by 1.3 million and saves $22.4 billion over the same period.

Results of Sensitivity Analysis: Results are sensitive to the assumption that consumers have no disutility with modest reductions in sodium intake.

Limitation: Efforts to reduce population sodium intake could result in other dietary changes that are difficult to predict.

Conclusion: Strategies to reduce sodium intake on a population level in the United States are likely to substantially reduce stroke and MI incidence, which would save billions of dollars in medical expenses.

Primary Funding Source: Department of Veterans Affairs, Stanford University, and the National Science Foundation.

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Douglas K. Owens
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Carolina for Kibera (CFK) inspires and nurtures youth leaders in the slum of Kibera, Kenya through a unique model of participatory development.  CFK recognizes the youth of Kibera as resilient, wise, innovative, and eager to lift their community above the poverty and violence that plagues it.  CFK's long-term initiatives provide youth opportunities to learn and serve while addressing a wide range of community needs including healthcare, education, waste recycling and reduction, HIV/AIDS testing and counseling, and girls' empowerment.  CFK's model of participatory to fight abject poverty, and prevent ethnic, gender and religious violence has been internationally recognized, earning awards as a Time Magazine and Gates Foundation "Hero of Global Health" and the 2008 Oklahoma City National Memorial Foundation's Reflections of Hope Award.  CFK is a major affiliated entity of UNC based at the Center for Global Initiatives.


Salim Mohamed Salim Mohamed co-founded and served as the Executive Director of Carolina for Kibera for eight years. At the age of 16, he was involved in the development of MYSA - the largest youth sports program in Africa based in the Mathare slum of Nairobi.  Salim has helped launch community based sports and development programs in Ghana, Gambia, and Nigeria and presented at the International AIDS Conference. He serves as a director for Shoe 4 Africa, an advisor to Global Education Fund and a YES! facilitator.  A TED Africa Fellow, he is currently pursuing a master's degree at the University of Manchester.

Rye Barcott  While an undergraduate on an NROTC scholarship at UNC-Chapel Hill in 2001, Barcott founded CFK with the late nurse Tabitha Atieno Festo and community organizer Salim Mohamed. Barcott served five years in the Marine Corps before earning a combined MBA and MPA at Harvard as a Reynolds Social Entrepreneurship Fellow and a member of the Harvard Endowment's Advisory Committee on Shareholder Responsibility.  In 2006, he was named an ABC World News Person of the Year.  A TED Fellow and member of the UNC Chancellor's Innovation Circle, Barcott is writing a book that juxtaposes community organizing and counter-insurgency (under contract, Bloomsbury Publishing).

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Rye Barcott Founder (l) Speaker Carolina for Kibera (CFK)
Salim Mohamed Co-Founder (r) Speaker Carolina for Kibera (CFK)
Conferences
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Daniel Markovits is Professor of Law at Yale Law School. He works in the philosophical foundations of private law, moral and political philosophy, and behavioral economics. He has written articles on contract, legal ethics, distributive justice, democratic theory, and other-regarding preferences. Professor Markovits concentrates, in each area, on the ways in which legal orderings engage the human instinct in favor of sociality to sustain cooperation even among persons who pursue conflicting interests and endorse competing moral ideals. He finds respectful relations in surprising places, for example in contracts between self-interested buyers and sellers, litigation between adversary disputants, and political competition between partisan parties. In each case, Markovits argues, seemingly competitive interactions contain, in their immanent logic, forms of reciprocal recognition and respect. After earning a B.A. in Mathematics, summa cum laude from Yale University, Markovits received a British Marshall Scholarship to study in England, where he was awarded an M.Sc. in Econometrics and Mathematical Economics from the L.S.E. and a B.Phil. and D.Phil. in Philosophy from the University of Oxford. Markovits then returned to Yale to study law and, after clerking for the Honorable Guido Calabresi, joined the faculty at Yale.

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Daniel Markovits Professor of Law Speaker Yale Law School
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The 9/11 terrorist attacks opened America's eyes to a frightening world of enemies surrounding us. But have our eyes opened wide enough to see how our experiences compare with other nations' efforts to confront and prevent terrorism? Other democracies have long histories of confronting both international and domestic terrorism. Some have undertaken progressively more stringent counterterrorist measures in the name of national security and the safety of citizens. But who wins and who loses? In The Consequences of Counterterrorism, editor Martha Crenshaw makes the compelling observation that "citizens of democracies may be paying a high price for policies that do not protect them from danger." The book examines the political costs and challenges democratic governments face in confronting terrorism.

Using historical and comparative perspectives, The Consequences of Counterterrorism presents thematic analyses as well as case studies of Britain, France, Germany, Spain, Japan, and Israel. Contributor John Finn compares post-9/11 antiterrorism legislation in the United States, Europe, Canada, and India to demonstrate the effects of hastily drawn policies on civil liberties and constitutional norms. Chantal de Jonge Oudraat and Jean-Luc Marret assert that terrorist designation lists are more widespread internationally than ever before. The authors examine why governments and international organizations use such lists, how they work, and why they are ineffective tools. Gallya Lahav shows how immigration policy has become inextricably linked to security in the EU and compares the European fear of internal threats to the American fear of external ones.

A chapter by Dirk Haubrich explains variation in the British government's willingness to compromise democratic principles according to different threats. In his look at Spain and Northern Ireland, Rogelio Alonso asserts that restricting the rights of those who perpetrate ethnonationalist violence may be acceptable in order to protect the rights of citizens who are victims of such violence. Jeremy Shapiro considers how the French response to terrorist threats has become more coercive during the last fifty years. Israel's "war model" of counterterrorism has failed, Ami Pedahzur and Arie Perliger argue, and is largely the result of the military elite's influence on state institutions. Giovanni Cappocia explains how Germany has protected basic norms and institutions. In contrast, David Leheny stresses the significance of change in Japan's policies.

Preventing and countering terrorism is now a key policy priority for many liberal democratic states. As The Consequences of Counterterrorism makes clear, counterterrorist policies have the potential to undermine the democratic principles, institutions, and processes they seek to preserve.

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The exploration of visual archives related to Korean history has grown at an exponential rate over the past decade.  While photographs ostensibly hold the possibility of tranforming the captured ephemeral moments into the fixity of celluloid perpetuity, they can have profound effects on changing memories of the past, and collapsing time and space.  This lecture examines the history and the meanings of photography in modern Korean history through the two dual prisms of "wormholes" and "phantom zones."

Lynn is the AECL/KEPCO Chair in Korean Research at the Institute of Asian Research, University of British Columbia.  He is also the editor for the journal Pacific Affairs which has been published continuously since 1928.  His research covers a range of topics relating to modern and contemporary Korea (both South and North), and Japan.  His publications include Bipolar Orders: The Two Koreas Since 1989 (2007); "History of Gendered Migration in the Two Koreas," Harvard Asia Quarterly (2008); "Moving Pictures: Postcards of Colonial Korea," International Institute of Asian Studies Newsletter (2007); and "Vicarious Traumas: Television and Public Opinion in Japan's North Korea Policy," Pacific Affairs (2006).

Lynn received a B.A and an M.A from University of British Columbia, and a Ph.D. from Harvard University.

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Hyung Gu Lynn AECL/KEPCO Chair in Korean Research, University of British Columbia Speaker
Seminars
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Albie Sach’s career in human rights activism started at the age of seventeen, when as a second year law student at the University of Cape Town, he took part in the Defiance of Unjust Laws Campaign. Three years later, he attended the Congress of the People at Kliptown where the Freedom Charter was adopted. He started practice as an advocate at the Cape Bar at the age of 21. The bulk of his work involved defending people charged under racist statutes and repressive security laws.

In 1966, he was forced into exile. After spending eleven years studying and teaching law in England, he worked for a further eleven years in Mozambique as law professor and legal researcher. In 1988, he was blown up by a bomb placed in his car in Maputo by South African security agents, losing an arm and the sight in one eye. 

After recovering from the attack, Justice Sachs devoted himself full-time to preparations for a new democratic Constitution for South Africa. In 1990, he returned home and, as a member of the Constitutional Committee and the National Executive of the ANC, took an active part in the negotiations which led to South Africa becoming a constitutional democracy. After the first democratic election in 1994, he was appointed by President Nelson Mandela to serve on the newly established Constitutional Court. 

In addition to his work on the Court, Justice Sachs has travelled to many countries sharing South African experience in healing divided societies. He is a prolific author in law and philosophy and is engaged in art and architecture.

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Albie Sachs Former Justice of the Constitutional Court of South Africa Speaker
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Rosamond L. Naylor
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In an Op-Ed featured on Huffington Post, aquaculture specialist and FSE director, Rosamond Naylor, supports a newly proposed House bill, the National Sustainable Offshore Aquaculture Act. The bill addresses the potential threats of poorly regulated, intensive fish farming in U.S. ocean waters, and ensures that U.S. aquaculture adopts a science-based, precautionary approach to protect our ocean ecosystems, fishing communities and seafood consumers.

With all eyes on the climate deliberations in Copenhagen, it is more important than ever to find innovative ways of reducing agriculture's contribution to global climate change. The livestock industry in particular has helped feed the world but at a significant cost to the environment, including generating large emissions of greenhouse gas.

One promising solution is to substitute fish production for meat production. But to do so we must ensure that the "blue revolution" in ocean fish farming does not lead to the same suite of environmental problems that have accompanied the "green revolution" for land-based agriculture. Americans' appetite for fish continues to grow and is increasingly met by a year-round supply of fresh fish imported into our marketplace. Yet few Americans know where their fish comes from or how it was produced. Just as most chickens, pigs and cows are raised in tightly confined, intensive operations, so too are many fish.

Right now in the United States we have an opportunity to help ensure that the emerging marine aquaculture sector meets both human and environmental needs. This week, Rep. Lois Capps (D-Calif.) will introduce in the House of Representatives a bill called the National Sustainable Offshore Aquaculture Act that addresses the potential threats of poorly regulated fish farming in U.S. ocean waters. These threats include spread of disease and parasites from farmed to wild fish; discharge of effluents into surrounding waters; misuse of antibiotics and other pharmaceuticals and chemicals; escape of farmed fish into wild fish habitat; killing of marine mammals and sharks that might prey on ocean farm cages; and reliance on use of wild-caught fish in aquaculture feeds, which could deplete food supplies for other marine life and the aquaculture industry itself over time.

These environmental impacts have been evident in many other countries with intensive marine fish farming. The recent collapse of salmon aquaculture in Chile, where industry expansion was prioritized over environmental protection, is the most glaring example. Salmon, one of Chile's leading exports, has suffered a major blow as a result of poor regulation and environmentally unsound management. Tens of thousands of people are now jobless in southern Chile, where the salmon farming industry once boomed.

There are three critical points to be made about the Capps bill. First, unlike previous attempts to legislate on fish farming at the national level, the bill would ensure that U.S. aquaculture adopts a science-based, precautionary approach that establishes a priority for the protection of wild fish and functional ecosystems. This approach is consistent with President Obama's recent call to develop a comprehensive and integrated plan to manage our ocean's many competing uses to ensure protection of vital ecosystem services in years to come.

Second, the Capps bill would preempt the emergence of ecologically risky, piecemeal regulation of ocean fish farming in different regions of the U.S. Efforts are already afoot in Hawaii, California, the Gulf of Mexico and New England to expand marine aquaculture without consistent standards to govern their environmental or social performance. If these piecemeal regional initiatives move forward, there will be little hope of creating a sustainable national policy for U.S. open-ocean aquaculture.

Finally, the Capps bill as currently written has a solid, long-term vision for the appropriate role of fish farming in sustainable ocean ecosystems and thus should win widespread support among environmental and fishing constituencies. It should also garner support from the more progressive end of the aquaculture industry that aspires to sustainable domestic fish production.

Previous federal bills introduced in 2005 and 2007 were fundamentally flawed -- and thus rightly criticized -- because they put the goal of aquaculture expansion far above that of environmental protection. Now, for the first time, a bill has been introduced that would demonstrably protect our ocean ecosystems, fishing communities and seafood consumers from the risks of poorly regulated open-ocean aquaculture.

Rep. Capps and her colleagues are to be commended. Now is the time for the new leadership in Washington -- at the White House and at the National Oceanic and Atmospheric Administration -- to embrace this more science-based and precautionary approach to ensure a sustainable future for U.S. ocean aquaculture.

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