Stover J.,Avenir Health |
Brown T.,East-West Center |
Puckett R.,East-West Center |
Peerapatanapokin W.,East-West Center
AIDS | Year: 2017
Background: The Spectrum model is used by national programs and UNAIDS to prepare annual estimates of the status of the HIV epidemic in 160 countries. The model and assumptions are updated regularly under the guidance of the UNAIDS Reference Group on Estimates, Modelling and Projections in response to new data, studies, and program needs. This study describes the most recent updates for the 2016 round of estimates. Methods: Meetings of the UNAIDS Reference Group include individuals with extensive knowledge of HIV programs, research, statistics, and public policy. The Reference Group also collaborates with other institutions (such as the United Nations Population Division and the US Census Bureau) and projects (such as the ALPHA Network and IeDEA Consortium) to ensure that latest methods and data are used in the preparation of the annual estimates. In the past year new methods and data have been introduced for pediatric estimates, incidence fitting, and ART mortality (described elsewhere in this supplement). Results: The 2016 version of Spectrum includes a number of other enhancements, including updated demographic data from the United Nations Population Division, program options for treatment (treat all), and programs to prevent mother-to-child transmission (option B+), improved methods to aggregate uncertainty to regional and global levels, several options for generating incidence trends, adjustments to the Estimations and Projections Package model to better incorporate aging effects, adjustments to account for the changing bias in prevalence from antenatal clinic surveillance, and an option to fit incidence among all adults 15+ in addition to 15-49. Conclusion: The new methods and data implemented in the 2016 version of Spectrum allow national programs more flexibility in describing their programs and improve the estimates of key indicators and their uncertainty. © 2017 The Author(s). Published by Wolters Kluwer Health, Inc.
News Article | May 23, 2017
Growing up in Hawaii, the only disaster I was taught to prepare for was a catastrophic tsunami. If you asked me what to do, say, during a nuclear missile attack, I'd be utterly useless. It wasn't necessarily my fault, though. Decades had elapsed since residents worried about "the bomb." Hawaii's most recent community shelter plan, a set of instructions for surviving nuclear fallout, dates to 1985, when Cold War paranoia was still palpable. But as unproven fears of a North Korean nuclear strike grow louder, so too has the need for public reassurance. For this reason, Hawaii is massively overhauling its archaic nuclear contingency plans—an effort one state official described to me as "formidable and critical to the survival of our 1.4 million residents and visitors in the unlikely event of a nuclear detonation." I submitted a Freedom of Information Act request to the Hawaii Department of Defense last month for its nuclear evacuation plans and preparedness guidelines. The agency told me that no current materials exist, and that extremely outdated plans had been rescinded. Hawaii stopped planning for an attack in the 1980s, due to the low risk of an attack, although it did simulate a half-kiloton nuclear explosion near Oahu's Honolulu Harbor in 2006. Instead, I was provided with a Plan of Action and Milestones (PoAM) for a new ballistic missile defense initiative, two lists of talking points about the initiative, a Department of Defense disaster briefing, and a description of how the agency is actively responding to the North Korea threat. In response to the current threat from North Korea (DPRK), we are engaged in the following activities: Researching current knowledge and techniques for population protection. This activity includes surveying all 50 states and US territories (underway), obtaining and reviewing the latest scientific evidence (weapons effects, sheltering strategies, etc.) and modeling weapon impact on the island of Oahu. Developing the content for a public information campaign for near and long-term public education focused on an all-hazards approach. This information is not yet in draft form and will be available the first week of June. Reviewing existing emergency notification and warning protocols between the US Pacific Command (USPACOM) and our State Warning Point. Conducting briefings for congressional and state legislative leaders. Maintaining a set of 'talking points' for media inquiries. Reconfiguring siren systems statewide to allow for two distinct warning sounds; Attention-Alert (currently in use) and Attack-Warning (used up until the 1980's for attack scenarios - being restored) Exploring the use of the Wireless Emergency Alert (Cell phones) system to augment the existing Emergency Alert System (broadcast radio and television) and siren system (outdoor warning). Conducting in-service training for key staff and leadership regarding weapons effects, response protocols and related. Reviewing existing procedures for mass casualty and fatality management with the US Department of Health & Human Services Conducting a Functional Exercise to assure full integration of response activities and protocols. Going forward, we will be engaging with Hawaii's four county governments, the federal government and all state agencies to bring about meaningful plans and public guidance. The work ahead is formidable and critical to the survival of our 1.4 million residents and visitors in the unlikely event of a nuclear detonation. Our work is being conducted in a deliberate, transparent and scientifically-supported basis. Part of the agency's response is to a group of Hawaii lawmakers who urged the state to update its nuclear contingency plans. State representatives, led by Rep. Matt LoPresti, a Democrat, introduced a resolution this month to modernize Hawaii's nuclear response procedures, citing geopolitical tensions and North Korea's developing intercontinental ballistic missile (ICBM) technology. "This is uncomfortable to think about, but we have a whole generation of people growing up that haven't ever really thought about these things, and they need to be educated about the reality and survivability and what we can do," Rep. LoPresti told Governing. A North Korean ICBM could reach Hawaii in 20 minutes, the state estimates. And since fallout shelters are not blast shelters, the likelihood of injury is grim—an outcome the agency acknowledges in its prepared remarks. (During the Cold War, students in Hawaii often practiced "duck and cover" drills, which were part of a Federal Civil Defense Administration public awareness campaign.) It's clear, however, that Hawaii is trying to avoid an outbreak of mass hysteria. The Department of Defense notes that no imminent threat exists, and that, contrary to some media reports, "the sky is not falling." "If North Korea fires a missile with the intent of hitting a US city, they do that knowing that the game is over in the most profound sense," Denny Roy, a senior fellow and Asia Pacific security expert at the East-West Center, told me. They don't "want to use nukes against the US because it means North Korea will be extinguished as a separate country." Still, the fear of an attack feels different this time, some locals say. President Trump's disregard for foreign policy is a national concern. In April, he called North Korean dictator Kim Jong Un "a pretty smart cookie," and has recklessly tweeted about the possibility of war with the country. Rep. LoPresti hopes that Trump and Congress will fund Hawaii's nuclear contingency preparations, much like the federal government did during the Cold War. "Despite whom you talk to," the Department of Defense notes, "or whom you believe, as far as the nuclear delivery capabilities of North Korea, hoping for the best, but preparing for the worst is the burden of our government."
News Article | December 20, 2016
HONG KONG, Dec. 20, 2016 /PRNewswire/ -- The American Chamber of Commerce in Hong Kong (AmCham) Board of Governors announced today that Ms. Tara Joseph will join the Chamber as its new president, taking office on February 6, 2017. Ms. Joseph, currently the Chief Asia Correspondent, Reuters TV, has 25 years' experience in broadcast media in New York, London, and Hong Kong. For more than a decade, she has been reporting and presenting for TV based in Hong Kong for Asia, including Chief Correspondent for Asia, TV (2015-16) and Executive Producer, TV (2008-14) at Reuters. She has moderated numerous webcasts and panel events including shows hosted at the World Economic Forum in Davos. Prior to working in Hong Kong, Ms. Joseph was the Global Editor and main presenter of Reuters Financial Television based in London. Ms. Joseph is a graduate of the Columbia University School of Journalism and Smith College in the United States. She is also currently the president of the Foreign Correspondents' Club in Hong Kong and has lived in Hong Kong for nearly 14 years. "On behalf of the Board of Governors, we are pleased to welcome Tara as the new President of AmCham Hong Kong," says Walter Dias, 2016 -- 2017 AmCham Chairman. "Tara's exceptional communication skills and deep knowledge of issues impacting Hong Kong and Asia will help drive AmCham's efforts to further build and promote relationships and commerce between Hong Kong, the United States and the greater Asia region. Her positive outlook and energetic leadership will drive excellence for our membership. I would like to thank the search committee for their efforts in executing an exhaustive search with such successful results." "I also want to thank Richard Vuylsteke for his exemplary leadership during the past nine years at the helm of AmCham Hong Kong. Richard's tireless leadership and passion helped fuel AmCham's thought leadership and success in the community." Outgoing AmCham President Richard Vuylsteke will depart Hong Kong at the end of December to embark on his new role as president of the East-West Center in Honolulu, Hawaii. With close to 1,600 members, the American Chamber of Commerce in Hong Kong (AmCham) is one of the largest American Chambers outside the United States, the largest international chamber in Hong Kong, and one of the most dynamic and influential international business organizations in the Asia-Pacific region. AmCham's mission is to foster commerce among the United States, Hong Kong, and Mainland China; and to enhance Hong Kong's stature as an international business center. THE AMERICAN CHAMBER OF COMMERCE IN HONG KONG
Marshall K.R.,East-West Center
Military medicine | Year: 2012
The majority of combat-related traumatic brain injury (TBI) within the U.S. Armed Forces is mild TBI (mTBI). This article focuses specifically on the screening, diagnosis, and treatment aspects of mTBI within the military community. Aggressive screening measures were instituted in 2006 to ensure that the mTBI population is identified and treated. Screenings occur in-theater, outside the contiguous United States, and in-garrison. We discuss specific screening procedures at each screening setting. Current diagnosis of mTBI is based upon self-report or through witnesses to the event. TBI severity is determined by specific Department of Defense criteria. Abundant clinician resources are available for mTBI in the military health care setting. Education resources for both the patient and the clinician are discussed in detail. An evidence-based clinical practice guideline for the care of mTBI was created through collaborative efforts of the DoD and the U.S. Department of Veterans Affairs. Although symptoms following mTBI generally resolve with time, active treatment is centered on symptom management, supervised rest, recovery, and patient education. Medical specialty care, ancillary services, and other therapeutic services may be required.
Finucane M.L.,East-West Center |
Gullion C.M.,Kaiser Permanente
Psychology and Aging | Year: 2010
The authors evaluated the reliability and validity of a tool for measuring older adults' decision-making competence (DMC). A sample of 205 younger adults (25-45 years), 208 young-older adults (65-74 years), and 198 old-older adults (75-97 years) made judgments and decisions related to health, finance, and nutrition. Reliable indices of comprehension, dimension weighting, and cognitive reflection were developed. Comparison of the performance of old-older and young-older adults was possible in this study, unlike previous research. As hypothesized, old-older adults performed more poorly than young-older adults; both groups of older adults performed more poorly than younger adults. Hierarchical regression analyses showed that a large amount of variance in decision performance across age groups (including mean trends) could be accounted for by social variables, health measures, basic cognitive skills, attitudinal measures, and numeracy. Structural equation modeling revealed significant pathways from 3 exogenous latent factors (crystallized intelligence, other cognitive abilities, and age) to the endogenous DMC latent factor. Further research is needed to validate the meaning of performance on these tasks for real-life decision making. © 2010 American Psychological Association.
McGraw K.,East-West Center
Military Medicine | Year: 2016
The literature on gender differences related to psychological health among in-theater service members who are deployed in a combatant role is limited. Much focuses on retrospective reports of service members who have returned from deployment. Potential key factors that contribute to gender differences in psychological health among combatants are found in literature across several topic areas, but integration of findings across disciplines is lacking. A growing body of literature on gender differences related to psychological health of postdeployment military populations suggests males and females respond differently to perceived levels of social support pre-and postdeployment. One study on service members who were deployed suggested no significant gender differences related to reported psychological health symptoms, but did appear to find significant gender differences related to reported perception of unit morale. In another related area, research explores how ostracism impacts physical and psychological health of individuals and organizations, and can result in perceptions of physical pain, although research on gender differences related to the impact of ostracism is scarce. Research has also begun to focus on sex differences in pain responses, and has identified multiple biopsychosocial, genetic, and hormonal factors that may contribute as potential underlying mechanisms. In this brief review, we focus on and begin to integrate relevant findings related to the psychological health of females in combat roles, gender differences in the impact of perception of social support on psychological health, the psychological and physical impact of ostracism on individuals and organizations, and the current literature on sex differences in pain perception. We conclude with a synthesis and discussion of research gaps identified through this review, implications for clinical practice, and potential future research directions. In conclusion, there appear to be gender differences related to the presence or absence of social support, the impact of ostracism, and the perception of pain. These differences may play a critical role in the psychological health of female combatants. More research on this topic is needed. © 2016, Association of Military Surgeons of the US. All rights reserved.
West T.A.,East-West Center |
Marion D.W.,East-West Center
Journal of Neurotrauma | Year: 2014
Currently, there is considerable debate within the sports medicine community about the role of concussion and the risk of chronic neurological sequelae. This concern has led to significant confusion among primary care providers and athletic trainers about how to best identify those athletes at risk and how to treat those with concussion. During the first quarter of 2013, several new or updated clinical practice guidelines and position statements were published on the diagnosis, treatment, and management of mild traumatic brain injury/concussion in sports. Three of these guidelines were produced by the American Medical Society for Sports Medicine, The American Academy of Neurology, and the Zurich Consensus working group. The goal of each group was to clearly define current best practices for the definition, diagnosis, and acute and post-acute management of sports-related concussion, including specific recommendations for return to play. In this article, we compare the recommendations of each of the three groups, and highlight those topics for which there is consensus regarding the definition of concussion, diagnosis, and acute care of athletes suspected of having a concussion, as well as return-to-play recommendations. © Copyright 2014, Mary Ann Liebert, Inc.
Eini-Zinab H.,East-West Center
Population Studies | Year: 2013
This paper presents a new method for estimating the effect of child mortality on the total fertility rate (TFR). The method is based on discrete-time survival models of parity progression that allow construction of a multivariate multidimensional life table of fertility with four dimensions: woman's age, parity, duration in parity, and number of previous child deaths. Additional socio-economic variables are included in the set of predictor variables in the underlying survival models of parity progression. The life table yields a replacement rate, which measures the effect of one additional child death on the TFR. The method is illustrated by applying it to three Indian National Family Health Surveys. Major findings are that dead children are incompletely replaced, and that the replacement rate rises as the TFR falls, reflecting women's increasing ability to control their fertility. © 2013 Copyright Population Investigation Committee.
Brown T.,East-West Center
Sexually transmitted infections | Year: 2010
OBJECTIVE: The UNAIDS Estimation and Projection Package (EPP) is a tool for country-level estimation and short-term projection of HIV/AIDS epidemics based on fitting observed HIV surveillance data on prevalence. This paper describes the adaptations made in EPP 2009, the latest version of this tool, as new issues have arisen in the global response, in particular the global expansion of antiretroviral therapy (ART). RESULTS: By December 2008 over 4 million people globally were receiving ART, substantially improving their survival. EPP 2009 required modifications to correctly adjust for the effects of ART on incidence and the resulting increases in HIV prevalence in populations with high ART coverage. Because changing incidence is a better indicator of program impact, the 2009 series of UNAIDS tools also focuses on calculating incidence alongside prevalence. Other changes made in EPP 2009 include: an improved procedure, incremental mixture importance sampling, for efficiently generating more accurate uncertainty estimates; provisions to vary the urban/rural population ratios in generalised epidemics over time; introduction of a modified epidemic model that accommodates behaviour change in low incidence settings; and improved procedures for calibrating models. This paper describes these changes in detail, and discusses anticipated future changes in the next version of EPP.
News Article | April 16, 2015
U-T San Diego, the region’s most comprehensive source of news, sports, entertainment and information, proudly announced today that military affairs reporter Gretel C. Kovach has been selected to participate in the East-West Center’s (EWC) 2015 Jefferson Fellowships travel-study seminar. Founded in 1967, the Jefferson Fellowships are the EWC’s most widely recognized seminar program, with an illustrious network of more than 650 program alumni from leading news organizations across the U.S. and the Asia-Pacific region. As a result of the selection, Kovach will join 14 other highly accomplished international journalists on an excursion from May 2-23, 2015, to China, the Philippines, Singapore and Hawaii, to study pressing geopolitical issues in the South China Sea. Throughout her journey, Kovach will file reports that will be published in U-T San Diego. “We’re delighted with the diversity and experience of the group of accomplished journalists that will be traveling together to study crucial South China Sea issues,” said Ann Hartman, the EWC’s Jefferson Fellowships coordinator. “We’ll be looking at a broad range of strategic and security issues, as well as economic topics like oceans as a key source of food and resources, the importance of sea trade, and the need for regional cooperation to ensure freedom and safety of navigation.” Kovach, who has nearly two decades of journalistic experience, joined U-T San Diego in 2010 as a military affairs reporter, with a primary focus on Marine Corps operations. She has reported extensively from the front lines in Afghanistan and Iraq, including stints embedded with U.S. military units. She is also a four-time winner of national journalism awards from the Marine Corps Heritage Foundation, and was honored with the Marine Corps-Law Enforcement Foundation’s 2014 Semper Fidelis Award for her outstanding work in bringing the Marine Corps story from the war zone home to San Diego. “Gretel is a remarkable journalist and a dedicated student of our times. We all are proud to have her represent the U-T as a fellow,” said Jeff Light, U-T San Diego’s president and editor. “The rise of the Chinese military is reconfiguring the balance of power in the Asia-Pacific, making China both an ally of the U.S. and a rival for influence in the South China Sea. This generous fellowship from the East-West Center is a unique opportunity to examine a new era in Sino-American relations as the U.S. military steers its fleet toward an important region of the world,” said Kovach. For all other information, including media inquiries, contact Stephanie Brown, U-T San Diego’s senior director of marketing and public relations, at stephanie.brown(at)utsandiego(dot)com or 619-823-9794. The San Diego Union-Tribune, LLC, owner of the 146-year-old U-T San Diego, is San Diego’s leading media company and its most comprehensive source of news, entertainment and information in the region. Each week, products are delivered to more than 96 percent of all San Diego County households through its integrated media portfolio: the Pulitzer Prize-winning newspaper, U-T San Diego; the website, UTSanDiego.com; Sunday’s Best; The Night + Day, DiscoverSD and DiscoverSD.com weekly entertainment guides; Spanish-language products Enlace and Vida Latina-San Diego; U-T TV, an Emmy award-winning on-demand video news source; and hyper-local community papers, U-T Community Press. For more information visit http://www.utsandiego.com.