Nutrition
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About the talk: This presentation will discuss the centrality and challenges of health-specific technological progress in global health improvement. It will describe a research agenda and provide examples of specific empirical studies and findings that are part of the agenda.

About the speaker: Grant Miller is an Associate Professor of Medicine at the Stanford University School of Medicine, a Core Faculty Member at the Center for Health Policy/Primary Care and Outcomes Research, a Senior Fellow at the Freeman Spogli Institute for International Studies, and a Research Associate at the National Bureau of Economic Research (NBER). His primary interests are health economics, development economics, and economic demography.

Professor Miller’s primary focus is research and teaching aimed at developing more effective health improvement strategies for developing countries. His agenda addresses three major interrelated themes: (1) The major causes of population health improvement around the world and over time (2) Behavioral underpinnings of the major determinants of population health improvement - which factors have contributed most to population health gains, and why? (3) From insights to policy relevance: how can programs and policies use these behavioral insights to improve population health more effectively? 

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Grant Miller Associate Professor of Medicine; Senior Fellow, FSI Speaker
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Africa (Proceedings of the National Academy of Sciences 2013): USAID and the UN's World Food Program have proposed strategies for allocating ready-to-use (therapeutic and supplementary) foods to children in developing countries. Analysis is needed to investigate whether there are better alternatives. We use a longitudinal data set of 5657 children from Bwamanda to construct a statistical model that tracks each child's height and weight  throughout the first five years of life. We embed this model into an optimization framework that chooses which individual children should receive food based on a child's sex, age, height and weight, to minimize the mean number of disability-adjusted life years per child subject to a budget constraint. Our proposed policy compares favorably to those proposed by the aid groups. Time permitting, we will also discuss a recent analysis of a nutrition program in Guatemala that quantifies the age dependence in the impact of supplementary food, and develops a food allocation policy that exploits this age dependence and reduces child stunting.

India: Motivated by India's nationwide biometric program for social inclusion, we analyze verification (i.e., one-to-one matching) in the case where we possess 12 similarity scores (for 10 fingerprints and two irises) between a resident's biometric images at enrollment and his biometric images during his first verification. At subsequent verifications, we allow individualized strategies based on these 12 scores: we acquire a subset of the 12 images, get new scores for this subset that quantify the similarity to the corresponding enrollment images, and use the likelihood ratio to decide whether a resident is genuine or an imposter. Compared to the policy currently used in India, our proposed policy provides a five-log (i.e., 100,000-fold) reduction in the false reject rate while only increasing the mean delay from 31 to 38 seconds.

A full speaker bio is available on CISAC's website. 

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Graduate School of Business
Stanford University
Stanford, CA 94305-5015

(650) 724-1676 (650) 725-0468
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Jeffrey S. Skoll Professor of Management Science
CISAC Affiliated Faculty Member
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Lawrence Wein is the Jeffrey S. Skoll Professor of Management Science at the Graduate School of Business, Stanford University, and an affiliated faculty member at CISAC. After getting a PhD in Operations Research from Stanford University in 1988, he spent 14 years at the Sloan School of Management at MIT, where he was the DEC Leaders for Manufacturing Professor of Management Science. His research interests include mathematical models in operations management, medicine and biology.

Since 2001, he has analyzed a variety of homeland security problems. His homeland security work includes four papers in Proceedings of the National Academy of Sciences, on an emergency response to a smallpox attack, an emergency response to an anthrax attack, a biometric analysis of the US-VISIT Program, and an analysis of a bioterror attack on the milk supply. He has also published the Washington Post op-ed "Unready for Anthrax" (2003) and the New York Times op-ed "Got Toxic Milk?", and has written papers on port security, indoor remediation after an anthrax attack, and the detention and removal of illegal aliens.

For his homeland security research, Wein has received several awards from the International Federation of Operations Research and Management Science (INFORMS), including the Koopman Prize for the best paper in military operations research, the INFORMS Expository Writing Award, the INFORMS President’s Award for contributions to society, the Philip McCord Morse Lectureship, the Frederick W. Lanchester Prize for best research publication, and the George E. Kimball Medal. He was Editor-in-Chief of Operations Research from 2000 to 2005, and was elected to the National Academy of Engineering in 2009.   

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Lawrence Wein Jeffrey S. Skoll Professor of Management Science; CISAC Affiliated Faculty Member Speaker
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Abstract:

Because of the health and economic costs of childhood obesity, coupled with studies suggesting the benefits of comprehensive (dietary, physical activity, and behavioral counseling) intervention, the U.S. Preventive Services Task Force recently recommended childhood screening and intervention for obesity beginning at age 6. Using a longitudinal data set consisting of the body mass index of 3,164 children up to age 18 and another
longitudinal data set containing the body mass index at ages 18 and 40 and the presence or absence of disease (hypertension and diabetes) at age 40 for 747 people, we formulate and numerically solve—separately for boys and girls—a dynamic programming problem for the optimal biennial (i.e., at ages 2,4,...16) obesity screening thresholds. Unlike most screening problem formulations, we take a societal viewpoint, where the state of the system at each age is the population-wide probability density function of the body mass index. Compared to the biennial version of the task force’s recommendation, the screening thresholds derived from the dynamic program achieve a relative reduction in disease prevalence of 3% at the same screening (and treatment) cost, or—because of the flatness of the disease versus screening trade-off curve—achieves the same disease prevalence at a 28% relative reduction in cost. Compared to the task force’s policy, which uses the 95th percentile of body mass index (from cross-sectional growth charts tabulated by the Centers for Disease Control and Prevention) as the screening threshold for each age, the dynamic programming policy treats mostly 16-year-olds (including many who are not obese) and very few males under 14 years old. Although our results suggest that adult hypertension and diabetes are minimized by focusing childhood obesity screening and treatment on older adolescents, the shortcomings in the available data and the narrowness of the medical outcomes considered prevent us from making a recommendation about childhood obesity screening policies.

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Management Science
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Yan Yang
Jeremy D. Goldhaber-Fiebert
Lawrence M. Wein
Lawrence M. Wein
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Abstract:

Several aid groups have proposed strategies for allocating ready-touse (therapeutic and supplementary) foods to children in developing countries. Analysis is needed to investigate whether there are better alternatives. We use a longitudinal dataset of 5,657 children from Bwamanda to construct a bivariate time-series model that tracks each child’s height-for-age z score (HAZ) and weight-forheight z score (WHZ) throughout the first 5 y of life. Our optimization model chooses which individual children should receive readyto-use  therapeutic or supplementary food based on a child’s sex, age, HAZ, and WHZ, to minimize the mean number of disabilityadjusted life years (DALYs) per child during 6–60 mo of age [which includes childhood mortality calculated from a logistic regression and the lifelong effects of stunting (i.e., low HAZ)] subject to a budget constraint. Compared with the strategies proposed by the aid groups, which do not use HAZ information, the simple strategy arising from our analysis [which prioritizes children according to low values of a linear combination of HAZ, WHZ, and age and allocates the entire budget to therapeutic (i.e., 500 kcal/d) food for the prioritized children] reduces the number of DALYs by 9% (for the same budget) or alternatively incurs the same number of DALYs with a 61% reduction in cost. Whereas our qualitative conclusions appear to be robust, the quantitative results derived from our analysis should be treated with caution because of the lack of reliable data on the impact of supplementary food on HAZ and WHZ, the application of our model to a single cohort of children and the inclusion and exclusion errors related to imperfect food targeting.
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Proceedings of the National Academy of Sciences
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Yan Yang
Jan Van den Broeck
Lawrence M. Wein
Lawrence Wein
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Kelly Moore is Associate Professor of Sociology and Affiliate of Women's Studies at the University of Cincinnati.  She is the author of Disrupting Science: Social Movements, American Scientists, and the Politics of the Military, 1945-1975 (Princeton University Press, 2008), and the co-editor of The New Political Sociology of Science: Institutions, Networks, and Power (University of Wisconsin Press, 2006).   Her articles have appeared in Research in Organizational Sociology, American Journal of Sociology and other journals.  She currently serves as Chair of the American Sociological Association section on Science, Knowledge and Technology, and is writing a book about neoliberalism, food, and nutrition in U.S. from 1980 to 2005. 

Rebecca Slayton is a lecturer in the Science, Technology and Society Program at Stanford University and a CISAC affiliate. In 2004-2005 she was a CISAC science fellow. Her research examines how technical judgments are generated, taken up, and given significance in international security contexts. She is currently working on a book which uses the history of the U.S. ballistic missile defense program to study the relationships between and among technology, expertise, and the media. Portions of this work have been published in journals such as History and Technology and have been presented at academic conferences. As a postdoctoral fellow in the Science, Technology, and Society Program at the Massachusetts Institute of Technology, in 2004 she completed an NSF-funded project entitled Public Science: Discourse about the Strategic Defense Initiative, 1983-1988.

As a physical chemist, she developed ultrafast laser experiments in condensed matter systems and published several articles in physics journals. She also received the AAAS Mass Media Science and Engineering Fellowship in 2000, and has worked as a science journalist for a daily paper and for Physical Review Focus. She earned her doctorate in chemistry from Harvard University in 2002.

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Kelly Moore Associate Professor of Sociology, University of Cincinnati Speaker
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Slayton’s research and teaching examine the relationships between and among risk, governance, and expertise, with a focus on international security and cooperation since World War II. Slayton’s current book project, Shadowing Cybersecurity, examines the historical emergence of cybersecurity expertise. Shadowing Cybersecurity shows how efforts to establish credible expertise in corporate, governmental, and non-governmental contexts have produced varying and sometimes conflicting expert practices. Nonetheless, all cybersecurity experts wrestle with the irreducible uncertainties that characterize intelligent adversaries, and the fundamental inability to prove that systems are secure. The book shows how cybersecurity experts have paradoxically gained credibility by making threats and vulnerabilities visible, while acknowledging that more always remain in the shadows.

Slayton’s first book, Arguments that Count: Physics, Computing, and Missile Defense, 1949-2012 (MIT Press, 2013), shows how the rise of a new field of expertise in computing reshaped public policies and perceptions about the risks of missile defense in the United States. In 2015, Arguments that Count won the Computer History Museum Prize. In 2016, Slayton was awarded a National Science Foundation CAREER grant for her project “Enacting Cybersecurity Expertise.” In 2019, Slayton was also a recipient of the United States Presidential Early Career Award for Scientists and Engineers, for her NSF CAREER project.

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Rebecca Slayton CISAC Affiliated Faculty; Lecturer, Science, Technology, and Society Program, Stanford University Commentator
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We developed a mathematical model of a cows-to-consumers supply chain associated with a single milk-processing facility that is the victim of a deliberate release of botulinum toxin. Because centralized storage and processing lead to substantial dilution of the toxin, a minimum amount of toxin is required for the release to do damage. Irreducible uncertainties regarding the dose-response curve prevent us from quantifying the minimum effective release. However, if terrorists can obtain enough toxin, and this may well be possible, then rapid distribution and consumption result in several hundred thousand poisoned individuals if detection from early symptomatics is not timely. Timely and specific in-process testing has the potential to eliminate the threat of this scenario at a cost of less than 1 cent per gallon and should be pursued aggressively. Investigation of improving the toxin inactivation rate of heat pasteurization without sacrificing taste or nutrition is warranted.

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Proceedings of the National Academy of Sciences
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Lawrence M. Wein
Lawrence M. Wein
Yifan Liu
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