Using a dynamic microsimulation model, a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston, shows that there are differentially positive health gains of smoking reduction among subgroups of smokers in South Korea, Singapore, and the United States.

Tobacco use is responsible for the death of approximately eight million people worldwide, estimates the World Health Organization, and countries are increasingly making tobacco control a priority. Indeed the relationship between smoking and the burden of chronic diseases such as cancer, lung disease, and heart disease, and, in turn, premature mortality, is well documented. Yet little is known about the health effects of smoking interventions among subgroups of smokers.

Do interventions targeted at heavy smokers relative to light smokers lead to disproportionately larger improvements in life expectancy and prevalence of chronic diseases? And how do these effects vary across populations? In today’s rapidly aging world, it is crucial to understand the potential health gains resulting from interventions to reduce smoking, a leading preventable risk factor for healthy aging.

That’s why a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston as well as Stanford Health Policy faculty member Jay Bhattacharya, set out to examine the health effects of smoking reduction. To do so, the team simulated an elimination of smoking among subgroups of smokers in South Korea, Singapore, and the United States.

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The team’s findings, discussed in a new paper published by the journal Health Economics, show that smoking reduction can achieve significant improvements in lifetime health as measured by survival while also reducing the prevalence of major chronic diseases, though the effects are heterogeneous. Whereas interventions in both subgroups and in all three countries led to an increased life expectancy and decreased prevalence of chronic diseases, the life-extension benefits were greatest – 2.5 to 3.7 years – for those who would otherwise have been heavy smokers, compared with gains of 0.2 to 1.5 years among light smokers.

The team developed a dynamic microsimulation model to estimate the health gains of reducing smoking among heavy smokers and light smokers. Microsimulation models are powerful tools for assessing the value of health promotion: they model individual health trajectories while accounting for competing risks, thus providing valuable information about the impact of interventions and how they may interact with the changing demographics and socioeconomic profile of a population to determine future health. The team’s study applied microsimulation models tailored to the demographic and epidemiological context in the three countries, then compared the gains in survival and reduction in chronic disease prevalence from a given reduction in smoking and how these impacts vary depending on initial smoking intensity.

The team’s findings indicate that there are differentially positive health effects from smoking reduction. The life‐year gain among heavy smokers quitting well exceeds that of light smokers quitting in each country, but the magnitudes differ substantially: 11.2 times for South Korea, 6.8 times for Singapore, and 1.7 times for the United States. The lower life expectancy among Americans is related to the greater extent in which they suffer from risk factors, such as obesity, relative to the Asian counterparts in the study.

The findings illustrate how smoking interventions may have significant economic and social benefits, especially for life extension, that vary across countries. They are particularly important for aging societies that are concerned about the sustainability of their health insurance systems in the face of increasing burden of chronic disease.

As of December 2019, at least 245 primary and secondary schools in the United States have experienced a shooting, killing 146 people and injuring 310, since the first major school shooting at Columbine in April 1999.

Now, new Stanford-led research sounds an alarm to what was once a silent reckoning: the mental health impact to tens of thousands of surviving students who were attending schools where gunshots rang out.

A study has found that local exposure to fatal school shootings increased antidepressant use among youths.

Specifically, the average rate of antidepressant use among youths under age 20 rose by 21%in the local communities where fatal school shootings occurred, according to the study. And the rate increase – based on comparisons two years before the incident and two years after – persisted even in the third year out.

“There are articles that suggest school shootings are the new norm – they’re happening so frequently that we’re getting desensitized to them – and that maybe for the people who survive, they just go back to normal life because this is just life in America. But what our study shows is that does not appear to be the case,” said Maya Rossin-Slater, a core faculty member at Stanford Health Policy and faculty fellow at the Stanford Institute for Economic Policy Research(SIEPR). “There are real consequences on an important marker of mental health.”

The study is detailed in a working paper published Monday by the National Bureau of Economic Research. It was co-authored by Rossin-Slater, an assistant professor of health policy in the Stanford School of Medicine; Molly Schnell, a former postdoctoral fellow at SIEPR now an assistant professor at Northwestern University; Hannes Schwandt, an assistant professor at Northwestern and former visiting fellow at SIEPR; Sam Trejo, a Stanford doctoral candidate in economics and education; and Lindsey Uniat, a former predoctoral research fellow at SIEPR now a PhD student at Yale University.

Their collaborative research – accelerated by their simultaneous stints at SIEPR – is the largest study to date on the effects of school shootings on youth mental health.

The study comes as the issue of gun safety continues to stoke political wrangling and public debate. And the researchers say their findings suggest policymakers should take a wide lens to their decision-making process.

“When we think about the cost of school shootings, they’re often quantified in terms of the cost to the individuals who die or are injured, and their families,” Rossin-Slater noted. “Those costs are unfathomable and undeniable. But the reality is that there are many more students exposed to school shootings who survive. And the broad implication is to think about the cost not just to the direct victims but to those who are indirectly affected.”

A Driver for Antidepressant Use

More than 240,000 students have been exposed to school shootings in America since the mass shooting in Columbine in April 1999, according to data used in the study. And the number of school shootings per year has been trending up since 2015.

Yet despite this “uniquely American phenomenon” – since 2009, over 50 times more school shootings have occurred in the U.S. than in Canada, Japan, Germany, Italy, France and the United Kingdom combined – little is known about the effects of such gun violence on the mental health of the nation’s youth, the study stated.

“We know that poor mental health in childhood can have negative consequences throughout life,” Schwandt said. “At the same time, children are known to show significant levels of resilience, so it really wasn’t clear what we would find as we started this project.”

The researchers examined 44 shootings at schools across the country between January 2008 and April 2013. They used a database that covered the near universe of prescriptions filled at U.S. retail pharmacies along with information on the address of the medical provider who prescribed each drug. They compared the antidepressant prescription rates of providers practicing in areas within a 5-mile radius of a school shooting to those practicing in areas 10-to-15 miles away, looking at two years prior and two to three years after the incident.

Of those 44 school shootings, 15 of them involved at least one death. The 44 shootings occurred in 10 states: Alabama, California, Connecticut, Florida, Nebraska, North Carolina, Ohio, South Carolina, Tennessee and Texas.

Researchers found a marked increase in the rate of antidepressant prescriptions for youths nearby, but only for the shootings that were fatal. They did not see a significant effect on prescriptions for youths exposed to non-fatal school shootings.

“The immediate impact on antidepressant use that we find, and its remarkable persistence over two, and even three years, certainly constitutes a stronger effect pattern than what we would have expected,” Schwandt said.

Meanwhile, adult antidepressant use did not appear to be significantly impacted by local exposure to school shootings.

Layers of Costs, More Unknowns

The researchers also analyzed whether the concentration of child mental health providers in areas affected by fatal school shootings made a difference in the antidepressant rates, and they drilled a further comparison between the prevalence of those who can prescribe drugs, such as psychiatrists and other medical doctors, and those who cannot prescribe drugs, such as psychologists and licensed social workers.

Increases in antidepressant rates were the same across areas with both high and low concentrations of prescribing doctors, the researchers found. But in areas with higher concentrations of non-prescribing mental health providers, the increases in antidepressant use were significantly smaller – indicating perhaps a greater reliance on non-pharmacological treatments or therapy for shooting-related trauma.

The researchers also found no evidence that the rise in antidepressant usage stemmed from mental health conditions that were previously undiagnosed prior to the shootings.

In totality, the researchers say the results in the study clearly pointed to an adverse impact from a fatal shooting on the mental health of youths in the local community. Furthermore, the results capture only a portion of the mental health consequences: Non-drug related treatments could have been undertaken as well.

“Increased incidence of poor mental health is at least part of the story,” Schnell said.

Though their analysis included only 44 schools and 15 fatal school shootings, Rossin-Slater noted how the trend of school shootings is growing. She believes the mental health impact found on the local communities they studied “can be generalizable to other communities’ experiences.”

That’s all the more reason why policymakers should consider the overall negative effects of school shootings, and how further research will be needed to gauge other societal consequences, the researchers said.

“Think of it as layers of costs,” Rossin-Slater said. And when it comes to evaluating gun violence at schools, “we think our numbers say, ‘Hey, these are costly things, and it’s costlier than we previously thought.’”

The Elgin Heinz Outstanding Teacher Award recognizes exceptional teachers who further mutual understanding between Americans and Japanese. EngageAsia administers the Elgin Heinz Outstanding Teacher Award, which is funded by the United States-Japan Foundation. The 2019 Award focused on the humanities and the 2020 Award will focus on Japanese language. It is named in honor of Elgin Heinz for his commitment to educating students about Asia as well as for the inspiration he has provided to the field of pre-collegiate education.

“Waka walks in the footsteps of Elgin Heinz as a key leader in educating the next generation about the U.S.–Japan relationship,” stated David Janes, Chair of the Board, EngageAsia. Heinz was born in China in 1913 and taught in the San Francisco Unified School District for 40 years. Challenging Americans’ lack of knowledge about Asia was central to Elgin’s life’s work. Janes has overseen the Elgin Heinz Outstanding Teacher Award since its inception in 2001. Daniel Tani, Director of Foundation Grants at the U.S.-Japan Foundation, and Janes formally presented the award to Brown.

In addition to teaching Stanford e-Japan for the last five years, Brown previously served as instructor for SPICE’s Reischauer Scholars Program (RSP). The RSP is an online course that introduces Japanese society and culture and U.S.–Japan relations to high school students in the United States. Current RSP Instructor and Manager Naomi Funahashi is a 2017 Elgin Heinz Outstanding Teacher Award recipient.

Waka Brown, Professor Daniel Okimoto, and Miles Brown (husband of Waka)

Prior to joining SPICE, Brown taught Japanese language at Silver Creek High School in San Jose and served as a Coordinator for International Relations (CIR) on the Japan Exchange and Teaching (JET) Program. Brown obtained both her undergraduate and graduate degrees from Stanford University.

In her acceptance speech, Waka noted: “As a Japanese American growing up in Kansas in the 1970s and 80s, and then as a Japanese American woman working in Japan, I’ve felt the need and immediacy for fostering cross-cultural understanding for my entire life. I feel extremely fortunate that I am able to work toward this goal through my professional work. My students and their knowledge and passion humble me. I am constantly in awe of them and their accomplishments. It is a true honor to receive the Elgin Heinz Award, and I am grateful for the opportunity to use these funds to foster connections between the future leaders in U.S.–Japan relations.”

Through Stanford e-Japan, Brown has engaged Japanese high school students from throughout Japan in an intensive study of U.S. society and culture. Since its first session in 2015, over 200 Japanese students have successfully completed the course. Some of her students have matriculated to universities in the United States.

In a very meaningful moment of the ceremony, Ryoga Umezawa, one of Brown’s former Stanford e-Japan students and now a university student at the Minerva Schools at KGI in San Francisco, expressed his gratitude to Brown, noting that the online format of Stanford e-Japan eased his transition to the online format of his university studies and also noted that the knowledge he gained from Stanford e-Japan has been invaluable to his transition to life in the United States.

The ceremony ended with a duet by Norman Masuda, an inaugural recipient of the Elgin Heinz Outstanding Teacher Award in 2002 (Japanese language category), and Irene Nakasone, instructor of kutu (Okinawan koto). Nakasone played the kutu and Masuda, the sanshin (Okinawan shamisen). They performed “Akanma Bushi” (red horse folk song), which was symbolic to the occasion as it is a congratulatory classical piece from the Yaeyama Islands, Okinawa Prefecture.

Irene Nakasone and Norman Masuda play a duet at the 2019 Elgin Heinz Outstanding Teacher Award ceremony.

For more information on the Stanford e-Japan Program, visit stanfordejapan.org. The Spring 2020 application period is open now until January 8, 2020. To be notified when the next Stanford e-Japan application period opens, join our email list or follow us on Facebook, Twitter, and Instagram.

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• The Yanai Tadashi Foundation and Stanford e-Japan: Cultivating Future Leaders in Japan
• Honoring High School Students from Japan and the United States: A Glow for Global Peace
• SPICE’s Waka Takahashi Brown Receives 2019 Elgin Heinz Outstanding Teacher Award

“Let’s bring all the planes down”—Secretary of Transportation Norman Mineta’s words to ground all U.S. planes on 9/11—elicited a moment of riveted silence in the audience of educators attending the National Council for the Social Studies (NCSS) annual conference in Austin, Texas, as they listened to Secretary Mineta’s keynote address on November 23, 2019. Upon hearing those words, many were transported back to a time when most people probably remember exactly where and what they were doing at the time that they heard of the events unfolding on September 11, 2001. However, most of their current students were not alive in 2001 and Mineta underscored the importance of teaching them about the lessons of 9/11 so that it is never forgotten.

During his address, Secretary Mineta highlighted the importance of conference themes such as informed action and decision making as he reflected upon lessons from his life, and the important role that teachers have in shaping critical attitudes of their students. In a touching moment, he shared his experience as a 10-year-old boy in 1942 who was forced from his home in San Jose, California, and incarcerated with his family in Heart Mountain, Wyoming, the location of one of the 10 major incarceration camps for people of Japanese descent during World War II. He vividly recalled his cherished baseball bat being confiscated by the Military Police as it was deemed a weapon. Mineta also shared how his experience during World War II informed one of President George W. Bush’s comments immediately following 9/11, that is, “We know what happened to Norm Mineta in the 1940s, and we’re not going to let that happen again.” A son of immigrants from Japan, Norman Mineta became the first Asian American mayor of a major city (San Jose, California). This led to a distinguished 20-year career in Congress and the first Asian American Cabinet member, having served two U.S. Presidents, a Democrat (Bill Clinton) and Republican (George W. Bush).

As Secretary Mineta spoke, one could sense that he never forgot his roots or the shame and humiliation that he and his family felt during World War II; as a congressman, he led the way for an apology from the U.S. government and redress for Japanese Americans who were interned. As U.S. Secretary of Transportation during and after 9/11, he made critical decisions that would ensure that what happened to Japanese Americans during World War II did not happen to any other group based on ethnicity or religion. His burning desire for all people to be treated equally is at the heart of a film, Norman Mineta and His Legacy: An American Story, that was co-produced by Dianne Fukami and Debra Nakatomi, who were also in the audience. The film premiered on PBS earlier this year.

Following Secretary Mineta’s keynote to an audience of hundreds who gave him a standing ovation, SPICE’s Rylan Sekiguchi and Jonas Edman led a more intimate discussion with Secretary Mineta and 70 educators that also included an overview of a SPICE-produced web-based curriculum unit that is titled, “What Does It Mean to Be American?” As its main author, Sekiguchi explained that the curriculum unit consists of six lessons with readings, videos, and assignments to examine key themes from Secretary Mineta’s life and career: immigration, civil liberties & equity, civic engagement, justice & reconciliation, leadership, and U.S.–Japan relations.

Sekiguchi also noted that the curriculum meets national standards for history, social studies, civics and government courses, and topics are brought to life and connected to students’ own lives through primary source documents, interactive classroom activities, and custom-created video vignettes (produced by Fukami) showcasing a diverse range of American voices—from high school youth to former U.S. Presidents George W. Bush and Bill Clinton. Each lesson provides a different lens through which students can examine the curriculum’s central question: What does it mean to be an American? The curriculum unit will be released in spring 2020.

Sekiguchi’s overview was followed by a discussion between Mineta and the 70 educators that was moderated by Edman. Questions from the audience ranged from Mineta’s legendary lifelong friendship with Republican Senator Alan Simpson of Wyoming to issues concerning immigrant families today. Many of the questions and Secretary Mineta’s responses touched upon the political divisiveness in U.S. society today and prompted educators to think of ways to use “What Does It Mean to Be An American?” and Norman Mineta and His Legacy: An American Story in their classrooms. Compliments from the audience like “this was the best session of the conference” and “this was the best workshop I’ve been to” could be heard following the session.

During their work with Secretary Mineta, Sekiguchi, Fukami, and Nakatomi were especially touched when they heard why Secretary Norman Mineta wears an American flag on his lapel. Mineta has noted, “When you’re in close quarters… people will sort of give you the once over. And so, I always wear this [flag pin]. It’s something you feel when you’re doing things. Am I really being fully accepted as an American citizen? I want to make sure everyone knows I am one.”

Question & Answer session with Secretary Norman Mineta with Jonas Edman moderating

Related articles:

• Secretary Norman Mineta and SPICE’s Rylan Sekiguchi Speak at the Ronald Reagan Library
• Secretary Norman Mineta and SPICE’s Rylan Sekiguchi Highlight National Council of History Education Conference in Washington, DC
• Presidents Bill Clinton and George W. Bush Interviewed for the Mineta Legacy Project

"What if we had a better way to select presidential nominees, one that didn’t reward appeals to the most ideologically committed voters and donors in each party? What if we weren’t trying to excite the already convinced — to vote, to contribute and to volunteer on campaigns? This pulls each party toward more militant postures and deepens polarization. What if we prized substantive dialogue across the partisan divides over intense mobilization within them? Would it make a difference?" Read HERE to learn more about Larry Diamond's and James Fishkin's experiment within the project "America in One Room".

By monitoring crops through machine learning and satellite data, Stanford scientists have found farms that till the soil less can increase yields of corn and soybeans and improve the health of the soil – a win-win for meeting growing food needs worldwide.

Agriculture degrades over 24 million acres of fertile soil every year, raising concerns about meeting the rising global demand for food. But a simple farming practice born from the 1930’s Dust Bowl could provide a solution, according to new Stanford research. The study, published Dec. 6 in Environmental Research Letters, shows that Midwest farmers who reduced how much they overturned the soil – known as tilling – increased corn and soybean yields while also nurturing healthier soils and lowering production costs.

“Reduced tillage is a win-win for agriculture across the Corn Belt,” said study lead author Jillian Deines, a postdoctoral scholar at Stanford’s Center on Food Security and the Environment. “Worries that it can hurt crop yields have prevented some farmers from switching practices, but we found it typically leads to increased yields.”

The U.S. – the largest producer of corn and soybeans worldwide – grows a majority of these two crops in the Midwest. Farmers plucked about 367 million metric tons of corn and 108 million metric tons of soybeans from American soil this past growing season, providing key food, oil, feedstock, ethanol and export value.

Monitoring farming from space

Farmers generally till the soil prior to planting corn or soybeans – a practice known to control weeds, mix nutrients, break up compacted dirt and ultimately increase food production over the short term. However, over time this method degrades soil. A 2015 report from the Food and Agriculture Organization of the United Nations found that in the past 40 years the world has lost a third of food-producing land to diminished soil. The demise of once fertile land poses a serious challenge for food production, especially with mounting pressures on agriculture to feed a growing global population.

In contrast, reduced tillage – also known as conservation tillage – promotes healthier soil management, reduces erosion and runoff and improves water retention and drainage. It involves leaving the previous year’s crop residue (such as corn stalks) on the ground when planting the next crop, with little or no mechanical tillage. The practice is used globally on over 370 million acres, mostly in South America, Oceania and North America. However, many farmers fear the method could reduce yields and profits. Past studies of yield effects have been limited to local experiments, often at research stations, that don’t fully reflect production-scale practices.

The Stanford team turned to machine learning and satellite datasets to address this knowledge gap. First, they identified areas of reduced and conventional tilling from previously published data outlining annual U.S. practices for 2005 to 2016. Using satellite-based crop yield models – which take into account variables such as climate and crop life-cycles – they also reviewed corn and soybean yields during this time. To quantify the impact of reduced tillage on crop yields, the researchers trained a comput

Average impacts on corn yields from conservation tillage across the U.S. Corn Belt from 2008 to 2017. Red colors indicate increased yields under conservation tillage, blue colors indicate yield declines.

Improved yields

The researchers calculated corn yields improved an average of 3.3 percent and soybeans by 0.74 percent across fields managed with long-term conservation tillage practices in the nine states sampled. Yields from the additional tonnage rank in the top 15 worldwide for both crops. For corn, this totals approximately 11 million additional metric tons matching the 2018 country output of South Africa, Indonesia, Russia or Nigeria. For soybeans, the added 800,000 metric tons ranks in between Indonesia and South Africa’s country totals.

Some areas experienced up to an 8.1 percent increase for corn and 5.8 percent for soybeans. In other fields, negative yields of 1.3 percent for corn and 4.7 for soybeans occurred. Water within the soil and seasonal temperatures were the most influential factors in yield differences, especially in drier, warmer regions. Wet conditions were also found favorable to crops except during the early season where water-logged soils benefit from conventional tillage that in turn dries and aerates.

“Figuring out when and where reduced tillage works best could help maximize the benefits of the technology and guide farmers into the future,” said study senior author David Lobell, a professor of Earth system science in the School of Earth, Energy & Environmental Sciences and the Gloria and Richard Kushel Director of the Center on Food Security and the Environment.

It takes time to see the benefits from reduced tillage, as it works best under continuous implementation. According to the researchers’ calculations, corn farmers won’t see the full benefits for the first 11 years, and soybeans take twice as long for full yields to materialize. However, the approach also results in lower costs due to reduced need for labor, fuel and farming equipment while also sustaining fertile lands for continuous food production. The study does show a small positive gain even during the first year of implementation, with higher gains accruing over time as soil health improves. According to a 2017 Agricultural Censuses report, farmers appear to be getting on board with the long-term investment and close to 35 percent of cropland in the U.S. is now managed with reduced tillage.

“One of the big challenges in agriculture is achieving the best crop yields today without comprising future production. This research demonstrates that reduced tillage can be a solution for long-term crop productivity,” Deines said.

To read all stories about Stanford science, subscribe to the biweekly Stanford Science Digest.

David Lobell is also the William Wrigley Senior Fellow at the Stanford Woods Institute for the Environment, a senior fellow at the Freeman Spogli Institute for International Studies and the Stanford Institute for Economic Policy and Research. Graduate student Sherrie Wang is also a co-author. Research was funded by NASA Harvest.

“What saves citizens from the knock on the door in the dead of night, from the risk of being silenced or removed, is a constitution, a robust body of laws, an independent judiciary to enforce them, and a culture that insists on free elections, human rights, and human dignity,” says Larry Diamond for Stanford Magazine. Read here.

Stanford e-Tottori is a distance-learning course sponsored by the Tottori Prefectural Board of Education and the Stanford Program on International and Cross-Cultural Education (SPICE) at Stanford University. Tottori Governor Shinji Hirai and Superintendent Hitoshi Yamamoto of the Tottori Prefectural Board of Education were instrumental in its establishment. Offered for the first time in 2016, Stanford e-Tottori presents a creative and innovative approach to teaching Japanese high school students about U.S. society and culture. Stanford e-Tottori Instructor Jonas Edman recently wrote these reflections on his work with students in Tottori.

While visiting Tottori Prefecture during the summer, I came to realize that Tottori, which once seemed like a distant and isolated place in my mind, has become a central part of my life’s neighborhood. In early August, I attended the closing ceremony for the third-year course offering of Stanford e-Tottori. On the same day, I attended the opening ceremony for the fourth-year course offering of Stanford e-Tottori. During the ceremonies, student representatives from several high schools in Tottori—Seishokaichi High School, Tottori Nishi High School, and Yonago Higashi High School—offered very meaningful messages. While listening to them, I felt so fortunate to be living in a time when technology affords me the opportunity to work in real time with students on the other side of the Pacific.

We are now in the midst of the fourth-year course offering, and I am already noticing significant growth in the English abilities and critical thinking skills of my 30 students. We have discussed topics ranging from studying at universities in the United States to the popularity of Japanese manga (comics or graphic novels) in the United States. My colleagues Rylan Sekiguchi and Naomi Funahashi led a very engaging discussion on studying at universities in the United States, and my students shared thoughts on what they perceive to be similarities and differences in studying at universities in Japan. The discussion of manga led to feelings of pride among my students, having come to realize the prevalence of Japanese manga in the United States. Tottori is very famous for its manga artists.

Whenever I work with my students in online classes from Stanford on topics like manga, I feel like I have been transported back to Tottori as I see the 30 familiar faces of students whom I first met in Tottori. This inevitably prompts me to reflect upon several key observations that I have made during my several visits to Tottori. First, while traveling in Tottori, one can almost feel that Tottori is the least populated prefecture in Japan. Perhaps correlated with this fact is how I have always been struck by the attention the students receive from their teachers. This infectious dedication to educating the next generation of leaders has had a ripple effect across the Pacific to us at SPICE and my guest speakers for Stanford e-Tottori. For example, Silicon Valley entrepreneur Takeshi Homma, who hails from Tottori, puts his heart and soul into his talk on “Entrepreneurship and Silicon Valley” each year. Second, Tottori is known for its nature and agriculture, and the importance of preserving the environment seems foremost on people’s minds. This is a global mindset that I wish others in the United States and Japan would share. Our online class on the environment has always prompted spirited discussions. Third, since I spent 16 years of my youth in Tokyo, I cannot help but notice the slower pace of life in Tottori. Magically, the slower pace helps me to take notice of each valuable moment that I spend with my students not only in person but virtually as well. Topics like aging and population decline are ones that have drawn interest and critical attention not only in Tottori but across Japan.

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