Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

Paragraphs

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.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Management Science
Authors
Lawrence M. Wein
-

From the 1950s through the 1970s, the success of antibiotics and vaccines in controlling or eradicating infectious diseases (ID) worldwide resulted in decreased emphasis on development of ID therapeutics. The emergence in the past three decades of HIV, SARS, West Nile, avian flu, swine flu, Ebola, and the potential for bioterrorist attacks has reversed this trend and renewed interest in treatment and prophylaxis of ID. Unfortunately, because many diseases are prevalent primarily in developing nations (e.g., malaria, TB, Chagas), potential sales of bioterrorist pathogens are limited mainly to orders for government stockpiles (e.g., anthrax, smallpox, botulinum toxin), and the cost of anti-infective clinical trials is high, traditional large pharmaceutical companies have cut back R&D resources in this arena. To combat this investment shortfall, a new paradigm has emerged where public-private partnerships between the NIH, World Health Organization, private foundations, academia, and non-profits, are beginning to function like pharmaceutical companies to advance the development of promising ID drugs, even when there is little opportunity for profit. This talk will discuss the growing need for ID therapeutics, present some new models for discovering and developing them, and provide examples of public-private partnerships that have advanced therapeutics for specific infectious diseases.


About the speaker: Dr. Jon C. Mirsalis is Managing Director of the Biosciences Division and Executive Director of Preclinical Development at SRI International in Menlo Park, CA. Dr. Mirsalis is an internationally recognized expert in the development of drugs for infectious diseases. He manages two large programs for the National Institute of Allergy and Infectious Diseases (NIAID) for the development of promising therapeutics for the prevention and treatment of a broad range of infectious diseases including TB, malaria, influenza, polio, anthrax, plague, and Ebola. He has personally been involved in the development of over 50 therapeutics that have entered clinical trials and several have already reached the market. Before joining SRI in 1981, Dr. Mirsalis was a postdoctoral fellow at the Chemical Industry Institute of Toxicology, where he developed the in vivo-in vitro hepatocyte DNA repair assay, which is now widely used as a screen for potential carcinogens by government and industry. He is the author of over 140 publications and abstracts. Dr. Mirsalis received his B.S. degree in zoology/molecular biology from Kent State University, his M.S. degree in genetics from North Carolina State University, and holds Ph.D. degrees in toxicology and genetics from North Carolina State University. Dr. Mirsalis has an adjunct faculty appointment with the University of California-Santa Cruz, where he lectures regularly on genetic toxicology and carcinogenesis. He has recently served on the Board of Scientific Councilors for the National Toxicology Program, the Advisory Board for the Critical Path Institute, and is a past member of the FDA’s Over-the-Country Product Review Committee. Dr. Mirsalis has been certified by the American Board of Toxicology since 1983.

CISAC Conference Room

Jon Mirsalis Managing Director, Biosciences Division Speaker SRI International
Seminars
Paragraphs

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.
All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Proceedings of the National Academy of Sciences
Authors
Lawrence M. Wein
Paragraphs

First paragraph of article:

Many of my colleagues and fellow investigators in the life sciences were surprised in late 2011 to hear about the deliberate laboratory manipulation of highly pathogenic avian influenza viruses for the purpose of creating derivative strains with enhanced capacity for respiratory transmission among mammals— strains with pandemic potential and serious global consequence. More importantly, few were prepared to undertake a reasoned and dispassionate assessment of the risks and benefits of such research and of its publication. This is unfortunate, not only because the resulting paucity of scientific leadership on this topic led to emotional and often unproductive discourse, but because new  instances of concerning research will be increasingly frequent and ever more consequential as the ongoing revolution in the life sciences unfolds.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Hastings Center Report
Authors
David Relman
Authors
News Type
News
Date
Paragraphs

Nearly $370,000 has been awarded to Stanford researchers trying to improve conditions in some of the world’s poorest places.

The money comes from the Global Underdevelopment Action Fund, which was established four years ago by the Freeman Spogli Institute for International Studies to provide seed grants to faculty designing interdisciplinary research experiments.

“It’s money that we can deploy quickly and that we can use in a very flexible way,” says Stephen D. Krasner, deputy director of FSI and chair of the Action Fund awards committee. “We can target specific kinds of activity that we’re interested in — not just because we think the activities themselves are worthwhile, but because we think they can really contribute to the interdisciplinary community that we’re building at FSI.”

The 12 Action Fund grants range from projects with immediate social impact to those designed to build an academic foundation for future work. The seed grants provided by the fund often are the first steps toward a sustainable research project funded by other sources, as well. Krasner says the grants are also awarded in part to impact policy and help solve problems that benefit from a multifaceted approach.

One such project comes from Stephen P. Luby, a professor of medicine and new senior fellow at FSI and the Stanford Woods Institute for the Environment. His project aims to curb pollution from Bangladeshi brick kilns, which may seem like a strange topic for Luby, who studies infectious diseases. But by broadening the viewpoint, the issue is more complex than only replacing the kilns with more efficient models. Solving the problem requires an understanding of social pressures and government regulations as well.

“I’m interested in working with people who want to solve real problems,” Luby says, explaining what brought him to Stanford. “FSI collaboration can really convene the group.” The “intensely interdisciplinary” nature of the project made it perfect for FSI, he says.

“That kind of project can have a real impact on health,” says Krasner, who adds that interdisciplinary research is key. “It typifies the kind of work that we like to support with the Action Fund.”

Another project will study electricity in East Africa, headed by economics professor and FSI Senior Fellow Frank Wolak. Households powered by solar batteries are found throughout the region, but until recently it has been difficult to determine how the power is being used within the home. Wolak’s team will use iPad tools to track household appliance usage and investigate how households are making decisions about power consumption. The double-faceted approach will answer crucial questions related to the distribution and use of power in the developing area.

Mariano-Florentino Cuéllar, co-director of FSI’s Center on International Security and Cooperation (CISAC) and incoming director of FSI, was awarded an Action Fund grant to study refugee communities around the world. Cuéllar, a law professor, will focus on a renewed approach to refugee camps for the United Nations High Commissioner for Refugees (UNHCR), at the U.N.’s request. In addition to Cuéllar’s background in law, the project will also employ students to help rethink camp logistics, architects focused on improving camp design and CISAC’s expertise in maintaining a collaboration with UNHCR.

In three previous rounds of funding since the Action Fund was established in 2010, $694,000 has been awarded to support 19 research projects.

Throughout the spring, past projects will be featured during Action Fund Fridays in Encina Hall. Topics will range from medical technology in India to poverty concerns in rural Africa. Events will be held at noon on March 22, April 26, May 10, May 24 and June 7. 

For more information, visit http://fsi.stanford.edu/events/series/2900 or contact Elena Cryst at 650.723.3369.

 

All News button
1
-

Peter will discuss work at SRI and the University of Cambridge under two projects currently funded by DARPA, relating to clean-slate architectures for hardware, software, networking, and clouds, aimed at higher-assurance security, resilience, evolvability, and other critical requirements.

Two papers provide some early views of the ongoing work:

http://www.csl.sri.com/neumann/law10.pdf 
http://www.csl.sri.com/neumann/2012resolve-cheri.pdf


Peter G. Neumann (Neumann@CSL.sri.com) has doctorates from Harvard and Darmstadt. After 10 years at Bell Labs in Murray Hill, New Jersey, in the 1960s, during which he was heavily involved in the Multics development jointly with MIT and Honeywell, he has been in SRI's Computer Science Lab since September 1971. He is concerned with computer systems and networks, trustworthiness/dependability, high assurance, security, reliability, survivability, safety, and many risks-related issues such as election-system integrity, crypto applications and policies, health care, social implications, and human needs -- especially those including privacy. He is currently PI on two DARPA projects: clean-slate trustworthy hosts for the CRASH program with new hardware and new software, and clean-slate networking for the Mission-oriented Resilient Clouds program. He moderates the ACM Risks Forum, has been responsible for CACM's Inside Risks columns monthly from 1990 to 2007, tri-annually since then, chairs the ACM Committee on Computers and Public Policy, and chairs the National Committee for Voting Integrity (http://www.votingintegrity.org). He created ACM SIGSOFT's Software Engineering Notes in 1976, was its editor for 19 years, and still contributes the RISKS section. He is on the editorial board of IEEE Security and Privacy. He has participated in four studies for the National Academies of Science: Multilevel Data Management Security (1982), Computers at Risk (1991), Cryptography's Role in Securing the Information Society (1996), and Improving Cybersecurity for the 21st Century: Rationalizing the Agenda (2007). His 1995 book, Computer-Related Risks, is still timely. He is a Fellow of the ACM, IEEE, and AAAS, and is also an SRI Fellow. He received the National Computer System Security Award in 2002 and the ACM SIGSAC Outstanding Contributions Award in 2005. He is a member of the U.S. Government Accountability Office Executive Council on Information Management and Technology, and the California Office of Privacy Protection advisory council. In 2012, he was elected to the newly created National Cybersecurity Hall of Fame as one of the first set of inductees. He co-founded People For Internet Responsibility. He has taught courses at Darmstadt, Stanford, U.C. Berkeley, and the University of Maryland. See his website (http://www.csl.sri.com/neumann) for testimonies for the U.S. Senate and House and California state Senate and Legislature, papers, bibliography, further background, etc.

CISAC Conference Room

Peter Neumann Principal Scientist, SRI International Computer Science Lab Speaker
Seminars
Authors
News Type
News
Date
Paragraphs

Mariano-Florentino Cuéllar, a Stanford law professor and expert on administrative law and governance, public organizations, and transnational security, will lead the university’s Freeman Spogli Institute for International Studies.

The announcement was made in Feb. 11 by Provost John Etchemendy and Ann Arvin, Stanford’s vice provost and dean of research.

“Professor Cuéllar brings a remarkable breadth of experience to his new role as FSI director, which is reflected in his many achievements as a legal scholar and his work on diverse federal policy initiatives over the past decade,” Arvin said. “He is deeply committed to enhancing FSI’s academic programs and ensuring that it remains an intellectually rich environment where faculty and students can pursue important interdisciplinary and policy-relevant research.”

Known to colleagues as “Tino,” Cuéllar starts his role as FSI director on July 1.

Cuéllar has been co-director of FSI’s Center for International Security and Cooperation (CISAC) since 2011, and has served in the Clinton and Obama administrations. In his role as FSI director, he’ll oversee 11 research centers and programs – including CISAC – along with a variety of undergraduate and graduate education initiatives on international affairs.  His move to the institute's helm will be marked by a commitment to build on FSI’s interdisciplinary approach to solving some of the world’s biggest problems.

“I am deeply honored to have been asked to lead FSI. The institute is in a unique position to help address some of our most pressing international challenges, in areas such as governance and development, health, technology, and security,” Cuéllar said. “FSI’s culture embodies the best of Stanford – a commitment to rigorous research, training leaders and engaging with the world – and excels at bringing together accomplished scholars from different disciplines.”

Cuéllar, 40, is a senior fellow at FSI and the Stanley Morrison Professor of Law at the law school, where he will continue to teach and conduct research. He succeeds Gerhard Casper, Stanford’s ninth president and a senior fellow at FSI.

“We are deeply indebted to former President Casper for accomplishing so much as FSI director this year and for overseeing the transition to new leadership so effectively,” Arvin said.

Casper was appointed to direct the institute for one year following the departure of Coit D. Blacker, who led FSI from 2003 to 2012 and oversaw significant growth in faculty appointments and research.

Casper, who chaired the search for a new director, said Cuéllar has a “profound understanding of institutions and policy issues, both nationally and internationally.”

“Stanford is very fortunate to have persuaded Tino to become director of the Freeman Spogli Institute for International Studies,” Casper said. “He will not only be an outstanding fiduciary of the institute, but with his considerable imagination, energy, and tenacity will develop collaborative and multidisciplinary approaches to problem-solving.”

Cuéllar – who did undergraduate work at Harvard, earned his law degree from Yale and received his PhD in political science at Stanford in 2000 – has had an extensive public service record since he began teaching at Stanford Law School in 2001.

Taking a leave of absence from Stanford during 2009 and 2010, he worked as special assistant to the president for justice and regulatory policy at the White House, where his responsibilities included justice and public safety, public health policy, borders and immigration, and regulatory reform.  Earlier, he co-chaired the presidential transition team responsible for immigration.

After returning to Stanford, he accepted a presidential appointment to the Council of the Administrative Conference of the United States, a nonpartisan agency charged with recommending improvements in the efficiency and fairness of federal regulatory programs.

Cuéllar also worked in the Treasury Department during the Clinton administration, focusing on fighting financial crime, improving border coordination and enhancing anti-corruption measures.

Since his appointment as co-director of CISAC, Cuéllar worked to expand the center’s agenda while continuing its strong focus on arms control, nuclear security and counterterrorism. During Cuéllar’s tenure, the center launched new projects on cybsersecurity, migration and refugees, as well as violence and governance in Latin America. CISAC also added six fellowships; recruited new faculty affiliates from engineering, medicine, and the social sciences; and forged ties with academic units across campus.

He said his focus as FSI’s director will be to strengthen the institute’s centers and programs and enhance its contributions to graduate education while fostering collaboration among faculty with varying academic backgrounds.

“FSI has much to contribute through its existing research centers and education programs,” he said. “But we will also need to forge new initiatives cutting across existing programs in order to understand more fully the complex risks and relationships shaping our world.”

In addition to Casper, the members of the search committee were Michael H. Armacost, Francis Fukuyama, Philip W. Halperin, David Holloway, Rosamond L. Naylor, Douglas K. Owens, and Elisabeth Paté-Cornell.

Hero Image
tino logo
Mariano-Florentino Cuéllar will take the helm of FSI in July.
Rod Searcey
All News button
1
News Type
News
Date
Paragraphs

David Relman, a Stanford microbiologist and professor of infectious diseases, has taken up the mantle as CISAC co-director alongside Stanford law professor Tino Cuéllar, both of whom intend to broaden the center’s research in biosecurity and the life sciences.

Relman, the Thomas C. and Joan M. Merigan Professor at Stanford’s School of Medicine and chief of infectious disease at the VA Palo Alto Healthcare System, has advised the U.S. government about pathogen diversity, dual-use technology and biosecurity. He also is the current president of the Infectious Diseases Society of America.

“The appointment of a life scientist who focuses on infectious diseases and biosecurity is an innovative step for our work in international security and cooperation,” said Gerhard Casper, president emeritus of Stanford University and director of CISAC’s umbrella organization, the Freeman Spogli Institute for International Studies.

Relman succeeds Siegfried S. Hecker, a nuclear scientist and director emeritus of the Los Alamos National Laboratory, who was the CISAC co-director since 2007. One of the world’s foremost experts on plutonium, nuclear weapons and nonproliferation, Hecker is on sabbatical in New Mexico and the Vienna Center for Disarmament and Non-Proliferation. He is working on a book about his historic efforts to foster collaboration between U.S. and Russian nuclear labs, as well as traveling to meet his nonproliferation counterparts in parts of Europe and Russia.

Hecker will return to CISAC this summer to resume his teaching in the Department of Management Science and Engineering, as well as his writing and research as a senior fellow at CISAC and FSI.

Read more

 

  

All News button
1

Y2E2
473 Via Ortega
Stanford, CA 94305

(650) 723-4129 (650) 725-3402
0
Faculty Lead, Center for Human and Planetary Health
Professor of Medicine (Infectious Diseases)
Professor of Epidemiology & Population Health (by courtesy)
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Woods Institute for the Environment
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
steve_luby_2023-2_vert.jpg MD

Prof. Stephen Luby studied philosophy and earned a Bachelor of Arts summa cum laude from Creighton University. He then earned his medical degree from the University of Texas Southwestern Medical School at Dallas and completed his residency in internal medicine at the University of Rochester-Strong Memorial Hospital. He studied epidemiology and preventive medicine at the Centers for Disease Control and Prevention.

Prof. Luby's former positions include leading the Epidemiology Unit of the Community Health Sciences Department at the Aga Khan University in Karachi, Pakistan, for five years and working as a Medical Epidemiologist in the Foodborne and Diarrheal Diseases Branch of the U.S. Centers for Disease Control and Prevention (CDC) exploring causes and prevention of diarrheal disease in settings where diarrhea is a leading cause of childhood death.  Immediately prior to joining the Stanford faculty, Prof. Luby served for eight years at the International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), where he directed the Centre for Communicable Diseases. He was also the Country Director for CDC in Bangladesh.

During his over 25 years of public health work in low-income countries, Prof. Luby frequently encountered political and governance difficulties undermining efforts to improve public health. His work within the Center on Democracy, Development, and the Rule of Law (CDDRL) connects him with a community of scholars who provide ideas and approaches to understand and address these critical barriers.

 

Director of Research, Stanford Center for Innovation in Global Health
Affiliated faculty at the Center on Democracy, Development and the Rule of Law
CV
Date Label
Subscribe to Health and Medicine