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Medical researchers must work together across disciplines to provide better health care to those who need it most, according to panelists at Stanford Medicine’s Annual Population Health Sciences Colloquium.

The symposium, hosted by the Stanford Center for Population Health Sciences, brought together working groups from across the Stanford campus to showcase the latest findings in population health research.

“Population health science at Stanford is likely to make the most important contributions when we cross traditional intellectual expertise disciplines,” said Paul H. Wise, a core faculty member at the Center for Health Policy/Center for Primary Care and Outcomes Research (CHP/PCOR).

Many of the scholars at the daylong conference on Tuesday stressed that an interdisciplinary approach to health care is crucial to understanding and aiding underserved populations.

“To deal with life-course questions we need to create-life course observational windows,” said Mark Cullen, chief of the Division of General Medical Disciplines and director of the Stanford Center for Population Health Sciences.

Instead of trying to create an all-encompassing care plan for the human population as a whole, panelists demonstrated that studying the needs of particular groups, or smaller populations, can better serve individuals within populations that may not receive the best care.

Douglas K. Owens, director of CHP/PCOR, said the U.S.  Preventive Services Task Force, of which he is a member, has “often faced a real paucity of data trying to develop prediction guidelines for both the very young and the old.”

The Task Force, a panel of experts that makes recommendations for medical prevention services, is generally able to make guidelines for large populations like adults, but suggestions for specialized groups like children and the elderly are more challenging. Though Stanford researchers like Wise are working to improve care for particular sectors like children, more study is needed.

Several speakers at the conference said the underserved population of poor children could benefit from research targeted toward their population group.

“We don’t really understand the biology of the life-course, why things taking place in gestation and early life actually affect healthy aging and adult onset disease,” said Wise, adding, “We have a very poor understanding of how to translate this understanding into effective interventions for communities in need.”

Panelists agreed that big data can help them understand smaller, poorly served populations, such as young children in impoverished communities. By collecting large amounts of data from the general population, researchers will increase the amount of data available for more specific groups. This allows researchers to study these populations more closely and help create better outcomes.

Abby King, a professor of health research and policy and of medicine, and Jason Wang, director of the Center for Policy, Outcomes and Prevention (CPOP) and a CHP/PCOR core faculty member, believe life-course digital applications can provide individualized care while collecting data on a large-scale.

According to King, a life-course app, or a device to track health and provide care throughout one’s life, would grow with the user and help them through important developmental stages.

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Wang has taken a first step toward creating such an app with PLAQUEMONSTER.  Intended for children eager for Halloween candy, the PLAQUEMONSTER app provides kids with a “tooth pet” they must keep safe from “plaquemonsters” and the so-called evil candy corporation. By flossing and brushing their teeth each day, kids earn points, and Wang’s team hopes the game will encourage good dental hygiene.

Health-care techniques using mobile devices, known as mHealth, could be particularly useful in underserved populations. King notes that even low-income populations have cell phones, so using phones as health-care tools could help decrease the gap between higher- and lower-income populations.

“I think for us one of the major challenges of the century is to really close that health-disparities gap and mHealth can help.”

However, each app must be tailored to the user.

“There’s no reason to believe that an African-American 16-year-old is going to be motivated the same way as a 45-year-old white man,” said Wang. “You need to involve patients in the design of the app.” When the app fits the specific patient’s needs, they are more likely to use it regularly, and knowing the needs of their population helps determine their preferences.

As the world continues to become more connected, the panelists said that reaching across disciplines and incorporating technology may hold the key to effective health care in the 21st century.

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The Freeman Spogli Institute for International Studies has welcomed five new senior military fellows, including three active duty lieutenant colonels from the U.S. Air Force and two from the U.S. Army, who will spend the next academic year at Stanford pursuing self-directed study of important national issues.

Former U.S. Secretary of Defense and CISAC faculty member Bill Perry created the program to give military officers the opportunity to take a deep dive into an area of strategic interest.

The fellows will be considering a diverse range of topics, from how to adapt Silicon Valley’s innovative work culture to the Army, to China’s actions in the South China Sea, and the effectiveness of U.S. economic sanctions against North Korea.

You can learn more about our fellows’ military backgrounds and the intended focus of their studies from the brief bios below.

John Cogbill and Scott Maytan will be assigned to the Center for International Security and Cooperation.

John Chu, Ryan Blake and Jose Sumangil will be based at the Walter H. Shorenstein Asia-Pacific Research Center.

 

LTC John Cogbill

LTC John Cogbill was commissioned as an Infantry officer from the United States Military Academy in 1994 and has held a variety of positions in both conventional and special operations units. John’s first assignment was as a Platoon Leader and Executive Officer in the 82nd Airborne Division. John then served two years in the 1st Battalion, 75th Ranger Regiment as a Platoon Leader and Civil-Military Affairs Officer. Next, John served three years in Alaska as an Airborne Rifle Company Commander and the Aide-de-Camp to the Commanding General. After earning his MPA from the Harvard Kennedy School, John taught Economics in the Social Sciences Department at West Point. Following the Command and General Staff College, he spent two years as a Combined Arms Battalion Executive Officer in the 1st Cavalry Division. He then served as the Strategic Plans and Requirements Officer for the 75th Ranger Regiment. Most recently, John commanded the Reconnaissance and Surveillance Squadron for the U.S. Army Third Corps. John has deployed on three combat and two peacekeeping missions, including two tours in Iraq, one tour in Afghanistan, one tour in Haiti, and a recent tour in Kosovo. He will be exploring how the Army can encourage innovation and use emerging technologies to achieve and maintain a competitive advantage on the battlefield.

 

lt col scott maytan 5x7 Lt Col Scott Maytan, U.S. Air Force

Lt Col Scott Maytan was the commander of a B-52H operational bomb squadron, responsible for ensuring combat mission readiness for any worldwide nuclear or conventional tasking. Lt Col Maytan is a navigator with over 2500 flying hours, primarily in the B-52H, and is a graduate of both the Command and General Staff College (U.S. Army) and the U.S. Air Force Weapons School. He has served four operational assignments, as an advanced tactics instructor, and also a tour at the Pentagon where he developed Air Force positions concerning long-range strike and aircraft nuclear requirements. Lt Col Maytan has served three combat deployments for Operations Desert Fox (Southern Watch), Allied Force and Iraqi Freedom and has also deployed four times supporting USPACOM’s Continuous Bomber Presence mission. Maytan will be studying the “red-lines” that shape Western deterrence posture, and how strategic action and deterrence posture in one region affects others.

 

LTC John Chu, U.S. Army

LTC John Chu is an active duty officer in the United States Army. Chu has held a variety of leadership and staff positions in his 20 year career. Most recently, he served as the Chief of Intelligence Training at the Department of the Army. Chu has twice been deployed to Iraq and once to Bosnia, with multiple assignments to South Korea, Germany and Turkey. Born in Seoul, he grew up in California and graduated from West Point in 1995. At Stanford, Chu is researching the Korean armistice agreement and the United Nations mission to South Korea. He will also examine U.S. policy toward North Korea, particularly analyzing the “brink of war” tension and developing strategic deterrence measures to reduce risk of unwanted military escalation on the Korean Peninsula. For both research streams, Chu aims to produce analyses and recommendations that could inform a policy audience.

 

Lt Col Ryan Blake, U.S. Air Force

Lt Col Ryan Blake is an active duty officer in the United States Air Force. Blake was the commander of a flight test squadron where he was responsible for the flight test of new Air Force programs. He has over 2,400 flying hours in over 40 types of aircraft, and has held two operational F-15E assignments, including combat deployments in support of Operations Southern Watch, Iraqi Freedom and Enduring Freedom. He had also been positioned at the Pentagon in defense acquisition and the Office of Security Cooperation in Baghdad. At Stanford, Blake is researching the U.S. policy toward China and its relation to Northeast Asia. He aims to discover areas of cooperation between the U.S. and Chinese militaries.

 

Lt Col Jose “Ed” Sumangil, U.S. Air Force

Lt Col Jose “Ed” Sumangil is an active duty officer in the United States Air Force. During his career, Sumangil has served in a range of operational assignments, including joint staff officer at U.S. Strategic Command where he was a lead planner of the command’s space campaign. Before coming to Stanford, he was the commander of a B-1 squadron and led airmen through combat deployments in support of Operations Enduring Freedom, Inherent Resolve and Freedom’s Sentinel. At Stanford, Sumangil is examining China’s actions in the South China Sea and the Philippines arbitration case regarding Chinese actions there. He seeks to offer perspectives and policy and strategy options to maintain peace and stability in the South China Sea.

 

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Efforts to address the global healthcare workforce crisis focus heavily on traditional service providers such as physicians and nurses. Yet, improving health systems also necessitates involvement from a wide range of management and support workers. Global Health Corps (GHC) pairs a team of at least two skilled management and support fellows (one local and one non-local fellow) from sub-Saharan Africa and the United States to work in partnership with non-profit and government agencies focused on the implementation of health services in a setting of poor health outcomes in sub-Saharan Africa or the United States. This manuscripts presents a five-year evaluation of the program.  By filling the human resources gaps of global health organizations with management and support workers, GHC and similar approaches may help generate a new pipeline of local and global leaders in global health.

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U.S. Senator John McCain told a select group of Stanford undergraduate students that technological innovation had created both unparalleled opportunities for the United States as well as new national security risks, during a visit to Silicon Valley this week.

“This has changed the world,” Senator McCain told the students as he held up his smart phone.

“This is the biggest change in our ability to inform and educate than any invention since the printing press.”

However, McCain told students that he believed the United States needed to develop a clearer policy for responding to cyber attacks from foreign nations.

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“You’ve got to accept a fundamental premise, that cyber attacks are an act of war…but that doesn’t mean you’re going to war in a conventional fashion,” he said.

“The people who are doing these cyber attacks have to realize that the costs will be higher than the benefits of the attack. Everybody has to know that there will be a price to pay for it.”

McCain called on the students, who included several computer science majors, to step up and defend the United States in cyber space.

“I would call on the people here to help us develop defensive capabilities, and frankly, offensive capabilities,” McCain said.

In the wide-ranging conversation, McCain fielded questions from students and shared his views on the conflict in Syria, the Iran nuclear deal, Russia’s imperial ambitions and the pullout of U.S. troops from Afghanistan.

“I study international security, and I feel that his dedication to national security and to veterans have been fundamental, and it was an honor to meet him and hear him talk about these issues,” said Chelsea Green.

The forty students who met with McCain were selected for their special interest in international affairs and politics, and included representatives from the Center for International Security and Cooperation’s honors program, Hoover Institution National Security Mentees and Stanford in Government student group.

International relations major Kayla Bonstrom said she was excited to meet the Senator from her home state of Arizona.

“He was very easy to talk to,” she said.

Bonstrom said McCain’s casual style, which included the occasional joke, helped put the students at ease.

“It was nice to see him in a different setting.”

Mathematical and computation science major Varun Gupta said he was touched by the empathy McCain showed when he shared his experiences visiting refugee camps in war zones.

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“It was really great to see the more human side.”

Other students were also impressed by McCain’s sincerity.

“He seems to sincerely believe in all of his views,” said Alexa Andaya, a political science major.

“You can tell when he says something he’s genuine about it.”

Matt Nussbaum, another political science major, said that while he disagreed with many of McCain’s hawkish positions on national security, he welcomed the opportunity to hear the opinions of such a seasoned veteran of foreign policy.

“A lot of times, we’re looking at the academic side of things, and I think that’s very interesting, but Senator McCain and other policy makers use the theory to create policy, so it’s useful to see what they think, how they think and why they think that way,” Nussbaum said.

McCain ended his talk by urging the students to get more involved in politics, whether they were “Democrat or Republican, libertarian or vegetarian.”

He told them that he believed the next presidential election was going to be the most important decision point for the country since 1980, when Republican Ronald Regan defeated Democratic incumbent Jimmy Carter.

“Pick the cause that you want to support, pick the candidate you want to support, and be engaged,” he said.

“It’s your future. You’re the ones that are going to live with the person that you choose to be president of the United States.”

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U.S. National Security Advisor Susan Rice '86 will give a special public lecture at the Freeman Spogli Institute on Climate Change and National Security.

Doors open at 4:00pm. Space is limited.

 

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Nearly nine years following the release of the Center for Global Development’s When Will We Ever Learn? Improving Lives Through Impact Evaluation report, and almost a decade into increased focus on evaluation among global donors, many in the research community are reflecting on the state of the impact evaluation field, whether the development community is learning what was hoped to from impact evaluations and where the future of impact evaluation leads. 

As part of this reflection, in this paper we will explore the recent past, current status and future of impact evaluation of development interventions. 

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This book evaluates the global status and prospects of democracy, with an emphasis on the quality of democratic institutions and the effectiveness of governance as key conditions for stable democracy. Bringing together a wide range of the author’s work over the past three decades, it advances a framework for assessing the quality of democracy and it analyzes alternative measures of democracy. Drawing on the most recent data from Freedom House, it assesses the global state of democracy and freedom, as of the beginning of 2015, and it explains why the world has been experiencing a mild but now deepening recession of democracy and freedom since 2005.

A major theme of the book across the three decades of the author’s work is the relationship between democratic quality and stability. Democracies break down, Diamond argues, not so much because of economic factors but because of corrupt, inept governance that violates individual rights and the rule of law. The best way to secure democracy is to ensure that democracy is accountable, transparent, genuinely competitive, respectful of individual rights, inclusive of diverse forms and sources of participation, and responsive to the needs and aspirations of ordinary citizens. Viable democracy requires not only a state that can mobilize power to achieve collective goals, but also one that can restrain and punish the abuse of power—a particularly steep challenge for poor countries and those with natural resource wealth.

The book examines these themes both in broad comparative perspective and with a deeper analysis of historical trends and future prospects in Africa and Asia,. Concluding with lessons for sustaining and reforming policies to promote democracy internationally, this book is essential reading for students and scholars interested in democracy, as well as politics and international relations more generally.

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In a recent piece in Stanford News, FSI Senior Fellow Larry Diamond expresses his thoughts on the ebbing of global democratic expansion, highlighting that not all countries have equal opportunities at achieving democracy and that democratic change should be approached multilaterally.

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Larry Diamond speaks on his new book "In Search of Democracy," at the National Endowment for Democracy (NED) in Washington, D.C.
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With the proliferation of online social media, political actors have a new means of reaching their constituents directly, circumventing the mainstream news media. Indian Prime Minister Narendra Modi has had a very significant presence on social media with almost 30 million “likes” on Facebook and 15 million followers on Twitter. Modi's rise on Twitter offers an important example on political brand management, in this talk we examine specific outreach strategies and how these have evolved over time. We examine the frequency, tenor, and popularity of messages, the evolution of thematic discussions, and the use of political metaphor in Modi's sharpening of a new populist discourse as leader of an aspirational, global India.

 

Speaker Bio:

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joyojeet pal

Joyojeet Pal is an assistant professor at the University of Michigan's School of Information where his work focuses on user experience and accessibility in low- and middle-income countries. His recent research looks at the use of social media in political communication in India, specifically on the role of political branding online in India. He is one of the technical collaborators on the Unfinished Sentences project examining oral histories of the El Salvador civil war, and leads the Colombia Digital Culture project at the University of Michigan. He researched and produced the award-winning documentary, "For the Love of a Man" based on the fan following of South Indian film star Rajnikanth.

Assistant Professor, University of Michigan's School of Information
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In an op-ed for The New York TimesLarry Diamond presents a timeline of democracy charting the spread, regression, and sometimes even collapse, of democracy in the last 40 years.

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