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Explore our series of multimedia interviews and Q&As with the contributors to this volume: 


China's future will be determined by how its leaders manage its myriad interconnected challenges. In Fateful Decisions, leading experts from a wide range of disciplines eschew broad predictions of success or failure in favor of close analyses of today's most critical demographic, economic, social, political, and foreign policy challenges. They expertly outline the options and opportunity costs entailed, providing a cutting-edge analytic framework for understanding the decisions that will determine China's trajectory.

Xi Jinping has articulated ambitious goals, such as the Belt and Road Initiative and massive urbanization projects, but few priorities or policies to achieve them. These goals have thrown into relief the crises facing China as the economy slows and the population ages while the demand for and costs of education, healthcare, elder care, and other social benefits are increasing. Global ambitions and a more assertive military also compete for funding and policy priority. These challenges are compounded by the size of China's population, outdated institutions, and the reluctance of powerful elites to make reforms that might threaten their positions, prerogatives, and Communist Party legitimacy. In this volume, individual chapters provide in-depth analyses of key policies relating to these challenges. Contributors illuminate what is at stake, possible choices, and subsequent outcomes. This volume equips readers with everything they need to understand these complex developments in context.

Available May 2020.

This book is part of the Stanford University Press series, "Studies of the Walter H. Shorenstein Asia-Pacific Research Center"

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Jean C. Oi
Jean C. Oi
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Stanford University's Asian Liver Center (ALC) and the Global Business Group on Health jointly hosted the inaugural JoinJade for China Summit and Awards Ceremony at SCPKU on April 22, 2016.  29 major employers committed to a hepatitis B discrimination-free work environment were recognized at the event.  Lenovo, General Electric and IBM also participated in an employer panel to discuss key strategies for a discrimination-free work environment and next steps.

 

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employer panel

JoinJade for China is a joint initiative involving global organizations including the ALC in the U.S. and China, Global Business Group on Health, IBM, General Electric, Intel, Hewlett Packard Enterprise, and HP Inc.  The initiative focuses on building fully inclusive workplaces free from hepatitis B discrimination.  

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joinjade award

 

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joinjade award 2

 

The ALC at Stanford University is the first non-profit organization in the U.S. that addresses the disproportionately high rates of chronic hepatitis B infection and liver cancer in Asians and Asian Americans.  Founded in 1996, the center addresses the gap in the fight against hepatitis B through a four-pronged approach of collaboration, advocacy, research, and education and outreach (CARE).  The ultimate goal of the ALC is to eliminate the transmission and stigma of hepatitis B and reduce deaths from liver cancer and liver disease caused by chronic hepatitis B.

 

Photos courtesy of Stanford University's Asian Liver Center

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Anna Lembke, Assistant Professor of Psychiatry and Behavioral Sciences at the Stanford University Medical Center, visited SCPKU for two weeks as a faculty fellow in July 2014.  Below are the highlights of a conversation Professor Lembke had with SCPKU in which she shares more details about her research and how SCPKU helped to advance her work in China.

 

Q: Describe your research and its connection to China

My research focuses on improving the lives of those with addictive disorders. I am especially interested in the intersection between health care systems and culture, and how this intersection impacts addiction treatment. I became interested in studying drug use disorders in China for a number of reasons. First, I spent a year after college living in China (1989-1990) teaching English as part of the Yale China Program. I have followed events in China with keen interest ever since. Second, the total number of drug users in China may be as high as 7 million, with China predicted to have the most heroin users of any country in the world within 5 years. I was curious to find out how China is addressing its burgeoning drug problem, and didn’t just want the “party line.” I wanted to learn about how people addicted to drugs in China are seeking and getting help.

 

Q: What got you interested in the study of addiction?

When I first began practicing psychiatry, I was not interested in treating addiction. But over time, I came to realize that if I didn’t treat my patients’ drug and alcohol problems, their other mental health issues were unlikely to improve. I also realized that in targeting and treating addiction, I could help patients transform their lives for the better, as well as the lives of those who love them.

 

Q: Why did you decide to apply for an SCPKU Faculty Fellowship?

SCPKU gave me the financial and logistical support to pursue a research project in China, an opportunity that would not have been possible without their help.

 

Q: How valuable was SCPKU's team in supporting your fellowship at SCPKU?

The team here at Stanford was helpful with drafting the initial proposal, creating the budget, which was especially challenging, due to my lack of familiarity with what things cost in China, and making contact with the SCPKU staff in Beijing. The team in Beijing was helpful in setting up temporary housing and meals in Beijing, as well as providing maps, information on how to take the subway, and logistical support getting back to the airport.

 

Q: What were your fellowship objectives and were they met? 

My fellowship objective was to interview treatment-seeking heroin users in China to learn more about the state of addiction treatment in China. My research assistant, Dr. Niushen Zhang, and I planned to publish our findings in a peer-reviewed journal.

We learned that individuals in China addicted to drugs experience intense social stigma. They are reluctant to utilize government-sponsored treatment, because of fear of loss of anonymity and the ensuing social and economic consequences that follow when they are publicly identified as “addicts,” not to mention the potential loss of their personal freedom. (Addicted persons in China are sent against their will to forced detention centers, or “rehabilitation through labor camps.”) As a result, drug addicted persons in China are deeply mistrusting of government-sponsored treatment, and willing to sacrifice large sums of their own money for anonymous, confidential treatment.

Dr. Niushen Zhang and I recently published our findings in Addiction Science and Clinical Practice, 2015, “A qualitative study of treatment-seeking heroin users in contemporary China.” (To access the article online go to http://www.ascpjournal.org/content/10/1/23)


 

Q: Describe some highlights of your stay in China/SCPKU. 

The highlight for me was hearing the life stories of heroin-addicted patients at New Hospital in Beijing, and attending an Alcoholics Anonymous meeting, conducted entirely in Chinese. The AA members we met told us their participation in this grass-roots 12-step movement literally saved their lives. I also met many wonderful doctors and nurses working with addicted patients in China. Finally, Dr. Zhang and I became good friends. We had hardly known each other before venturing off to do research in China.

 

Q: List at least THREE words or thoughts that come to mind which best describe your experience at SCPKU. 

Compassion, endurance, overcoming adversity
 

Q: Any future plans in China? 

I’m thinking about taking a group of Stanford residents and/or medical students to China for a total immersion 3-week course to learn about addiction in China.  But not right away.

 

 

 

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Noncommunicable diseases (NCDs) have become the leading causes of death worldwide and China's increased NCD prevalence is of growing concern. Randall Stafford, Professor of Medicine in the Stanford Center for Research in Disease Prevention and SCPKU Faculty Fellow, led a symposium at the center last fall.  Entitled "Tackling China's Noncommunicable Diseases: Shared Origins, Costly Consequences, and the Need for Action," the symposium focused on China's NCD threats to public health and the urgent need for solutions.  The symposium summary was published earlier this month in the Chinese Medical Journal.

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Speaker:  Robert Chang - Assistant Professor of Ophthalmology at Stanford University Medical Center

 

More patients are living longer and developing chronic diseases, often managed with increasingly expensive technology.  Both healthcare providers and hospital systems are struggling to keep up.  Modern smartphones can be converted into powerful, inexpensive portable medical devices to improve the delivery of healthcare, particularly in low- and middle-income countries.

Professor Chang will talk about his experience in developing a simple adapter to turn an iPhone into an “Eye-Phone” Camera. Chang is an ophthalmologist with a special interest in healthcare startups and online medical education. His clinical research focus revolves around understanding the association between high myopia and glaucoma. He is currently co-developing “EyeGo,” an iPhone imaging adapter system for remote eye care triage.

Stanford Center at Peking University
The Lee Jung Sen Building
Peking University
No.5 Yiheyuan Road Haidian District
Beijing, P.R.China 100871

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Robert Chang, Assistant Professor of Ophthalmology at Stanford University Medical Center and SCPKU Faculty Fellow, gave a public talk at the center earlier this month focused on mobile healthcare innovation and the growing adoption of smartphones as medical devices.

Life expectancy worldwide made huge gains in the last century alone which has created an increasingly heavier burden on our health systems.  The world has seen a rise in age-related chronic illnesses, unique challenges for less developed nations, an increased need for specialized health care workers, and alarming health care cost increases.  These challenges have created opportunities which have spurred innovation in mobile healthcare solutions and the use of smartphones as medical devices to improve the delivery and cost of healthcare.

Chang highlighted Apple’s plans to penetrate the mobile healthcare market including rumors that the company will be releasing a new “iWatch” in October.  At its Worldwide Developer Conference in early June, the company also announced a new iOS 8-based health app and HealthKit framework for tracking personal health and fitness data.  Chang believes these represent important steps in digital health, signaling strong interest in major high-tech players to develop digital healthcare “hubs” and solutions for effective disease monitoring and management.

The current trend within the healthcare technology space is the general population’s use of smartphone sensors to self-track health and fitness data including heart rate, sleeping patterns, activity level and calorie consumption.  Over time, Chang sees the industry moving towards more wearable devices that are more fashionable, invisible and intuitive. 

Within the field of ophthalmology, eye disease diagnoses have typically been done with expensive, bulky equipment.  This limits the ability to deliver effective and efficient eye care in remote patient situations and/or where eye specialists aren’t readily available.  Ophthalmology is well-suited for telehealth and the use of mobile devices to facilitate remote triage. As mobile medical devices, smartphones are ideal given their broad market adoption and processing power and the ubiquity of the Internet.  Currently,  however, cost-effective adapters are needed to accompany a smartphone solution as the smartphone alone is insufficient to capture enough detail inside the eye for effective diagnoses.  As an ophthalmologist with a special interest in healthcare startups, Chang is working with a Stanford-based team to develop the EyeGo, a custom iPhone attachment and adapter coupled with a HIPAA-secure app to facilitate taking pictures of both the front and back of the eye to support remote triage and more efficient physician to physician communication.  While his initial platform is iPhone-based due to the phone’s ubiquity in the Silicon Valley, he eventually plans to port his solution to an open systems platform.

Chang closed his talk by re-emphasizing his point about wearable mobile healthcare becoming more invisible and intuitive.  “The lines are blurring between man and machine,” he said. He cited the “Turing Test,” an experiment developed by famed mathematician Alan Turing to create an artificial intelligence (AI) design standard for the tech industry.  “Can you design an AI where the AI can talk to a person but you can’t tell the difference between the computer and the human?” he challenged.  In order to pass the test, one must fool at least 33% of the judgment panel into thinking the AI is the real person.  Chang believes that mobile health technology can be successfully integrated into the medical field and that we will get to the point where people are completely comfortable interacting with the technology   “This is the next level in the wearable healthcare revolution  -- it will be like you’re talking to your doctor and you won’t be able to tell the difference,” he said.

Chang is a clinician-scientist with an active surgical practice and an interest in early stage medical device development and healthcare IT startups. He has received numerous grants and fellowships In recognition of his focus on patient care, physician innovation, biodesign, and design thinking.  Chang’s clinical research revolves around understanding the association between myopia and glaucoma.  

 

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