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The elderly share of China’s population is projected to grow well beyond the capacity of the nation’s social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This paper examines the short-, mid-, and long-term effects of family support on elderly well-being in rural China, using four-wave panel data on 1,456 persons aged 60 and above in the Chaohu region of China. Findings showed that compared with living alone, being coresident with others lowered the mortality risk of several chronic diseases; but being coresident with adult children increased the mortality risk of cardiovascular diseases, though it was associated with a higher quality of life in the short and middle term. Children’s educational attainment and financial support increased the quality of life except for an increased risk of new incidence of cardiovascular disease in the middle term.

Published: Liu, Huijun, et al. "The Quality of Life and Mortality Risk of Elderly People in Rural China The Role of Family Support." Asia-Pacific Journal of Public Health (2013): 1010539512472362.

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Working Papers
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Asia Health Policy Program working paper # 30
Authors
Huijun Liu
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We offer the first large scale, multiple source analysis of the outcome of what may be the most extensive effort to selectively censor human expression ever implemented. To do this, we have devised a system to locate, download, and analyze the content of millions of social media posts originating from nearly 1,400 different social media services all over China before the Chinese government is able to find, evaluate, and censor (i.e., remove from the Internet) the large subset they deem objectionable. Using modern computer-assisted text analytic methods that we adapt and validate in the Chinese language, we compare the substantive content of posts censored to those not censored over time in each of 95 issue areas. Contrary to previous understandings, posts with negative, even vitriolic, criticism of the state, its leaders, and its policies are not more likely to be censored. Instead, we show that the censorship program is aimed at curtailing collective action by silencing comments that represent, reinforce, or spur social mobilization, regardless of content. Censorship is oriented toward attempting to forestall collective activities that are occurring now or may occur in the future -- and, as such, seem to clearly expose government intent, such as examples we offer where sharp increases in censorship presage government action outside the Internet. This is joint work with Jennifer Pan and Molly Roberts.

Gary King is the Albert J. Weatherhead III University Professor at Harvard University -- one of 24 with the title of University Professor, Harvard's most distinguished faculty position. He is based in the Department of Government (in the Faculty of Arts and Sciences) and serves as director of the Institute for Quantitative Social Science. King develops and applies empirical methods in many areas of social science research, focusing on innovations that span the range from statistical theory to practical application.

King received a B.A. from SUNY New Paltz (1980) and a Ph.D. from the University of Wisconsin-Madison (1984). His research has been supported by the National Science Foundation, the Centers for Disease Control and Prevention, the World Health Organization, the National Institute of Aging, the Global Forum for Health Research, and centers, corporations, foundations, and other federal agencies.

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Gary King Albert J. Weatherhead III University Professor Speaker Department of Government, Harvard University
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In this session of the Shorenstein APARC Corporate Affiliate Visiting Fellows Research Presentations, the following will be presented:

 

Minoru Aosaki, "Banking System and Sovereign Risk in Japan"

After the financial crisis of 2008, European financial markets have experienced sharp increases of sovereign risk. This adversely affected the solvency of banking institutions as they suffered losses from their sovereign holdings and deterioration in their funding conditions. Meanwhile, Japan's sovereign market remained stable, but market participants were cautious as the country’s debt-to-GDP ratio is the highest in the world, and its banking sector holds as much as 44% of domestic sovereign debt. The question is how Japanese policy makers should address the sovereign risk in the banking system. In pursuit of this question, Aosaki compares the market environment in Japan and the Euro Area, examining the reasons banks hold sovereign bonds and the channels that connect sovereign risk with the banking system.

Prashant Pandya, "Cell-based Therapies -- Current Trends and Future Prospects"

Stem cells have been the subject of considerable excitement and debate over the last decade. Stem cell therapy is emerging as a potentially revolutionary new way to treat disease and injury, with wide-ranging medical benefits. Stem cell research provides the opportunity to advance our understanding of human biology and treatment of various diseases. In Pandya’s research, he shares his experience about major challenges related to the commercial development of stem cell therapies and key technology drivers. This research is based on consultations with several prestigious regulatory agencies—including the U.S. Food and Drug Administration, European Medicines Agency, and Therapeutic Goods Administration of Australia—as well as interviews with 45 CEOs and senior scientists of large and small biotech companies and professors from leading universities across five countries. Pandya’s research reveals that there are many intriguing aspects of stem cells still remaining to be elucidated. Stem cells have the potential to treat an enormous range of diseases and conditions that plague millions of people and offer exciting promise for future therapies. But significant technical hurdles remain that will only be overcome through years of intensive research, and successful commercialization of cell-based therapies requires more than proving safety and efficacy to regulators. Ultimately the therapy must be commercially viable.

Ramnath Ramanathan, "Designing Toxicology Studies for Small Interfering Ribo Nucleic Acid"

The field of medicine has improved drastically over the period of time. Medical treatment has evolved from using plant extracts to chemical drugs to stem cell and gene therapies. Discovery of small interfering Ribo Nucleic Acid (siRNA) was one of the most important recent breakthroughs in the field of medicine. This was due to siRNA’s capability of posttranscriptional gene silencing by destruction of mRNA and thereby reducing the protein synthesis. Though the efficacy studies conducted in vitro and in animal models are promising, there have also been circumstances where there were adverse effects including mortality of animals treated with siRNA. Since RNA interference is a relatively new technique, it is very important to understand the toxicity involved before using it as a therapy. For this purpose, toxicology studies have to be designed in order to address all questions on the safety aspects of siRNA. In addition to the traditional toxicity studies, several other tests will have to be conducted. These additional studies will have to address issues specific to siRNA therapy such as immune activation, formation of tetraplex DNA, down regulation of non-target mRNA, interaction with cellular proteins, etc. Through Ramanathan’s work, he has designed a battery of toxicology studies to understand the side effects so that only relatively safe therapy is tried on humans during clinical trials. Ramanathan will present his findings.

 


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Corporate Affiliate Visiting Fellow
Minoru_Aosaki_2.jpg MA

Minoru Aosaki is a corporate affiliate visiting fellow at the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) for 2010–11 and 2011–12. Prior to joining Shorenstein APARC, he was deputy director for international banking regulations at the Government of Japan's Financial Services Agency, where he was responsible for developing bank regulatory standards as a member of groups of the Basel Committee on Banking Supervision. Before 2008, he worked for Japan's Ministry of Finance and drafted the ministry's policy-position papers on the International Monetary Fund and also participated in the communiqué drafting processes at the G7 and G20 meetings.

During his time at Shorenstein APARC, Aosaki researches policy responses to the recent financial crisis with the support of Dr. Michael Armacost, and discussed at seminars and conferences at Stanford University, Cornell University, and Harvard University.  He received a bachelor of law degree (LL.B.) from Hitotsubashi University in 2001, a master of public administration degree (MPA) from Syracuse University in 2004, and a master of law degree (LL.M.) from Cornell Law School in 2005.
 

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Minoru Aosaki Speaker Ministry of Finance, Japan
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Corporate Affiliate Visiting Fellow
Prashant_Pandya.jpg PhD

Prashant Pandya is a corporate affiliate visiting fellow at Shorenstein APARC for 2011-12.  Prior to joining Shorenstein APARC, he has worked for Reliance Life Sciences at Navi Mumbai (India) as a Deputy General Manager.

He has over 12 years of experience in various fields such as first in human studies, stem cell research, phase-II-IV, bioequivalence and QTC studies. He has monitored and conducted more then 100 national and global studies and has hands-on experience in the complete drug development process. He is a qualified Pharmacist, certified Project Manager & clinical research professional with post-graduate work in pharmaceutical & business management. Prior to joining Reliance Life Sciences, he was associated with India’s leading pharmaceutical and Contract Research Organizations such as Ranbaxy & Cadila.

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Prashant Pandya Speaker Reliance Life Sciences
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Corporate Affiliate Visiting Fellow
Ramnath_Ramanathan.jpg MS

Ramnath Ramanathan is a corporate affiliate visiting fellow at Shorenstein APARC for 2011-12. He works for Reliance Life Sciences Pvt. Ltd. (India). For more than 6 years with Reliance, he has been working on various branches of laboratory animal research. He started his carrier with monitoring quality of laboratory animals. Currently, his major field of work is toxicology. His interests include creation and research on animal models of human diseases.  

Ramanathan received his Masters degree in biotechnology from the Univeristy of Madras and is currently pursuing his Ph.D. in biochemistry at Mumbai University.

 

Date Label
Ramnath Ramanathan Speaker Reliance Life Sciences
Seminars
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Life expectancy at aged 65 is remarkably similar in the three Chinese cities of Hong Kong, Shanghai, and Taipei, even though the cities differ in levels of socioeconomic development, health systems, and other factors. Edward Jow-Ching Tu will discuss research that aims to understand this phenomenon. Despite unprecedented increases in life expectancy and attainment of similar current levels of life expectancy, the cities differ in the contributions of changes in major causes of death to the improvements in life expectancy among the elderly. Tu and colleagues have explored several possible determinants of these different patterns and trends in the three cities, including socioeconomic development, health service delivery systems, cause-of-death classification systems, and competing risks from cardiovascular disease and other diseases. Their analysis suggests that the effect of equity of health service delivery has become more important over time.

Edward Jow-Ching Tu is a senior lecturer of demography in the Division of Social Science at Hong Kong University of Science and Technology. His work is focused on the impact of fertility, mortality, and migration on socio-economic changes in East Asia countries with special emphasis on nations experiencing a transition from planned economy to market economy; on causes and impacts of mortality changes and health transition on aging societies; and on the causes of lowest-low fertility in many East Asia countries. He has several active research projects ongoing in China, Japan, Taiwan, Hong Kong, and Singapore. He holds graduate degress from West Virginia University, the University of Pennsylvania, and the University of Tennessee (Knoxville). Tu has worked extensively in Asia, and has served as an adjunct professor and taught in many universities in China, including Peking University, Peoples University, Nankai Univerity, and Fudan University. He had served as a senior research scientist at the New York State Health Department and as a research fellow (full professor) at the Institute for Social Sciences and Philosophy at Academia Sinica. Tu has also taught at the State University of New York in Albany.

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Edward Jow-Ching Tu Senior Lecturer of Demography at the Division of Social Science Speaker Hong Kong University of Science and Technology
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Emerging infectious diseases (EIDs) pose international security threats because of their potential to inflict harm upon humans, crops, livestock, health infrastructure, and economies. The following questions stimulated the research described in this paper: What infrastructure is necessary to enable EID surveillance in developing countries? What cultural, political, and economic challenges stand in the way of setting up such infrastructure? And are there general principles that might guide engagement with developing countries and support EID surveillance infrastructure?

Using the U.S. Naval Area Medical Research Unit No. 2 as a common denominator, this paper compares barriers to EID surveillance in Cambodia and Indonesia and presents key factors—uncovered through extensive interviews—that constrain disease surveillance systems. In Cambodia, the key factors that emerged were low salaries; poor staff and human resources management; the effect of patronage networks; a culture of donor dependence; contrasting priorities between the government and international donors; and a lack of compensation for animal culling. The Cambodian military has also played a part. The government ceased a merit-based salary supplement scheme for civil servants after the military is alleged to have demanded similar pay incentives that donors had no interest in funding.

In Indonesia the key issues emerging as barriers to effective surveillance include poor host-donor relationships, including differing host-donor priorities and a misunderstanding of NAMRU-2 by Indonesian authorities; low salaries; a decline in the qualifications of personnel in the Ministry of Health; poor compensation for animal culling; and difficulties incentivizing local-level reporting in an era of decentralization.

As the interviews with in-country practitioners revealed, low levels of development in general are the main impediments to building EID surveillance infrastructure and are perhaps beyond the scope of health and scientific agencies at this point. Nevertheless, promoting greater understanding of these issues is a critical first step in mitigating negative outcomes.

Published: Ear, Sophal. "Emerging Infectious Disease Surveillance in Southeast Asia: Cambodia, Indonesia, and the US Naval Area Medical Research Unit 2." Asian Security 8.2 (2012): 164-187.

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Asia Health Policy Program working paper #27
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Aims:

We evaluated the factors associated with inpatient costs including total costs, pharmaceutical costs and laboratory costs for diabetes-related admissions.

Patients and Methods:

Using data for 960 adult patients admitted between May 2005 and April 2008 with a primary or secondary diagnosis of type 2 diabetes mellitus (DM) at Sir Run Run Shaw Hospital affiliated with Zhejiang University Medical School (SRRSH) in Hangzhou, China, we evaluate the association between patient characteristics and inpatient costs with multivariable regression analyses.

Results:

Total inpatient costs were positively associated with age, higher UKPDS stroke risk score, and presence of any complication. A regression that included patient socioeconomic and clinical characteristics explained 21.5% of the variation in total inpatient costs; regression estimates indicate that patients with coronary artery disease, retinopathy, nephropathy, neuropathy, and diabetic foot had inpatient costs that were respectively 93.7%, 14.0%, 17.5%, 11.5% and 89.0% higher than otherwise similar patients without those complications. Pharmaceutical costs did not differ by insurance coverage. Insured patients spent 7-16% more on laboratory tests than otherwise similar patients did.

Conclusions:

Clinical factors, especially presence of diabetes-related complications, appear to be the primary determinants of variation in inpatient costs for patients with type 2 DM in China. To mitigate the health costs increases associated with China's DM epidemic, policymakers should focus on cost-effective ways to manage patients in outpatient settings to prevent the complications associated with diabetes.

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Publication Type
Journal Articles
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Experimental and Clinical Endocrinology & Diabetes
Authors
Brian Chen
Karen Eggleston
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