Aging
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Japan is at the forefront of the trend in developed nations to have an increasing proportion of the population represented by the elderly. By 2030, people over 65 years of age are expected to reach 30 % of Japan's population. Despite the significance of this demographic group, remarkably little is known about how the elderly adjust to the social changes that they experience with aging. The focus of this talk is on the issue of change as it impacts on the aging individual and how this change is discursively interpreted and negotiated. Recorded informal conversations of elderly Japanese women both with peers and with younger acquaintances will be used to illustrate the speaker's continuing adjustment of her established persona, identity and attitudes in recognition of the changing reality associated with age.

Co-sponsored by the Center for East Asian Studies.

Philippines Conference Room

Yoshiko Matsumoto Associate Professor Speaker Japanese Language and Linguistics, Stanford University
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Background

Human growth hormone (GH) is widely used as an antiaging therapy, although its use for this purpose has not been approved by the U.S. Food and Drug Administration and its distribution as an antiaging agent is illegal in the United States.

Purpose

To evaluate the safety and efficacy of GH therapy in the healthy elderly.

Data Sources

The authors searched MEDLINE and EMBASE databases for English-language studies published through 21 November 2005 by using such terms as growth hormone and aging.

Study Selection

The authors included randomized, controlled trials that compared GH therapy with no GH therapy or GH and lifestyle interventions (exercise with or without diet) with lifestyle interventions alone. Included trials provided GH for 2 weeks or more to community-dwelling participants with a mean age of 50 years or more and a body mass index of 35 kg/m2 or less. The authors excluded studies that evaluated GH as treatment for a specific illness.

Data Extraction

Two authors independently reviewed articles and abstracted data.

Data Synthesis

31 articles describing 18 unique study populations met the inclusion criteria. A total of 220 participants who received GH (107 person-years) completed their respective studies. Study participants were elderly (mean age, 69 years [SD, 6]) and overweight (mean body mass index, 28 kg/m^2 [SD, 2]). Initial daily GH dose (mean, 14 µg per kg of body weight [SD, 7]) and treatment duration (mean, 27 weeks [SD, 16]) varied. In participants treated with GH compared with those not treated with GH, overall fat mass decreased (change in fat mass, -2.1g [95% CI, -2.8 to -1.35] and overall lean body mass increased (change in lean body mass, 2.1 kg [CI, 1.3 to 2.9]) (P 0.001), and their weight did not change significantly (change in weight, 0.1 kg [CI, -0.7 to 0.8]; P = 0.87). Total cholesterol levels decreased (change in cholesterol, -0.29 mmol/L [-11.21 mg/dL]; P = 0.006), although not significantly after adjustment for body composition changes. Other outcomes, including bone density and other serum lipid levels, did not change. Persons treated with GH were significantly more likely to experience soft tissue edema, arthralgias, carpal tunnel syndrome, and gynecomastia and were somewhat more likely to experience the onset of diabetes mellitus and impaired fasting glucose.

Limitations

Some important outcomes were infrequently or heterogeneously measured and could not be synthesized. Most included studies had small sample sizes.

Conclusions

The literature published on randomized, controlled trials evaluating GH therapy in the healthy elderly is limited but suggests that it is associated with small changes in body composition and increased rates of adverse events. On the basis of this evidence, GH cannot be recommended as an antiaging therapy.

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State public employee health plans (PEHPs) provide health benefits for millions of state and local workers, retirees, and their dependents nationwide. This paper explores major issues and challenges that PEHP leaders and state policymakers are addressing. These include the perennial challenge of funding benefits for a diverse and aging workforce; new accounting standards affecting public employers; and the changing relationship between states, retired public employees, and the Medicare program. Interviews with PEHP executives explored whether these are incremental challenges to which states can effectively adapt, or whether these challenges will catalyze broader and lasting change in the public employee and retiree health benefits arena.

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"Ethnicity in Today's Europe" will commence with a Related Presidential Lecture featuring Partha Chatterjee.

Conference Statement

Headlines today blaze with stories about the fate of Europe. There is a sense, both in Europe and around the world, that a sort of "tipping point" has been reached. A recurrent theme is the question of demographics. For instance, how are European social welfare systems going to cope with an aging population? What role will immigrants from outside Europe's borders, both recent and less recent, play in European society? What will be the impact of immigration between the member states of the European Union? What place will Europe's growing population of Muslims have in twenty-first century Europe?

As the ongoing process of unification redraws Europe's borders, as the populations of major European cities become more and more diverse, the question of ethnicity is at the forefront of many of the most important debates on the continent. On the one hand the long history of European national and ethnic identities is at play, as is the legacy of colonialism. On the other, a significant recent upswing in the movement of peoples around the globe has changed the face of Europe, often literally. Movement, of course, from outside Europe's borders into European states. But also, and crucially, movement within the space between Portugal and the Urals. Such movement certainly responds to a number of economic and social needs. At the same time, European conceptions of citizenship, equity, and nationhood often exist in tension with the realities of changing ethnic populations.

The conference "Ethnicity in Today's Europe" at Stanford will address this topic in an interdisciplinary manner. Participants will focus on the question: "What's new about the situation in Europe today?" Bringing together scholars from different disciplines, the conference will provide a historical perspective together with contributions addressing economic, social, cultural, and political issues. Some themes that may be discussed include: how the current situation mirrors or departs from the past; the role of the media in portraying the interaction between different groups; the different perspectives of specific populations within Europe; whether Europe's diversity is best described under the rubric of ethnicity, nationality, race, or some other term; similarities and differences between European nation-states with regard to diversity within their borders. Above all, participants will use their own disciplinary perspective to assess what is at stake in the interaction between peoples in Europe as the twenty-first century gets underway.

"Ethnicity in Today's Europe" is jointly presented by the Forum on Contemporary Europe and the Stanford Humanities Center.

November 7 - Related Presidential Lecture:
Bechtel Conference Center
Encina Hall
616 Serra Street

November 8-9 - Conference Panels:
Stanford Humanities Center
424 Santa Teresa Avenue
Stanford University

Rogers Brubaker Sociology, UCLA Panelist
Leslie Adelson German Studies, Cornell University Panelist
Partha Chatterjee Related Presidential Lecture; Director and Professor of Political Science, Centre for Studies in Social Sciences, Calcutta; Professor of Anthropology, Columbia University, New York Keynote Speaker
Salvador Cardús Ros Sociology, Universitat Autònoma de Barcelona Panelist
Carole Fink History, Ohio State University Panelist
Alec Hargreaves French, Florida State University Panelist
Kader Konuk Germanic Languages and Literatures, University of Michigan Panelist
Saskia Sassen Sociology, Columbia University Panelist
Bassam Tibi International Relations, University of Göttingen, Germany Panelist
Zelimir Zilnik filmmaker Speaker
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One aspect of globalization that is receiving increasing scholarly attention is international migration, especially the transnational migration of workers. Practically every country of the world is affected in one way or another as either a sending or a receiving country. There are reportedly more than 500,000 foreigners residing in South Korea, with unskilled transnational migrant workers accounting for about a half of these.

Although the country's reliance on imported foreign labor is likely to continue unabated, the Korean government and society as a whole have been generally intolerant of foreigners living in Korea.

This paper examines various social factors, including the country's record-low fertility rate and rapid aging of its population, that all point to the continuation of labor importation. Such immigration will contribute to the making of a multiethnic Korean society.

The paper then analyzes the cultural factors that account for Koreans' low receptivity to foreigners and argues that it is the cultural ideology of ethnic homogeneity, based on the "one ancestor myth," that fuels an intense pride and stake in cultural uniqueness, linguistic homogeneity, and historical collectivity-sensibilities that government policy reinforces.

Andrew Eungi Kim is an Associate Professor in the Division of International Studies at Korea University and is currently a Visiting Professor at the University of California, Berkeley. He received his Ph. D. in sociology from the University of Toronto in 1996. His primary research interests pertain to cultural studies, sociology of religion, social change, sociology of work, and comparative sociology.

Currently, he is revising two book-length manuscripts for publication: "The Rise of Protestant Christianity in South Korea: Religious and Non-Religious Factors in Conversion" and "Understanding Korean Culture: The Persistence of Shamanistic and Confucian Values in Contemporary Korea."

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Andrew Eungi Kim Associate Professor Speaker Korea University
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"Ambiguity aversion" occurs when people prefer making no choice at all to making an ambiguous risky choice, even if the ambiguous choice holds higher expected value. Behavioral evidence suggests that a majority of individuals show some degree of ambiguity aversion, and older adults may be especially prone to this bias, which could have specific consequences for healthcare decisions. In this study the investigators examine ambiguity aversion in young and old adults using a standard experimental "Ellsberg Paradox" task as well as a more generalizable healthcare decision-making task.

What accounts for differences in "ideal affect," or the affective states that people value and ideally want to feel? The investigators predict that ideal affect influences what people do to feel good and what decisions they make. Preliminary studies suggest that younger adults value excitement states more and calm states less than do older adults, with middle age adults falling in between the groups. Therefore, age differences in mood-producing behaviors and decision making may be mediated by ideal affect.

The perceptions of policy makers regarding the ability and desire of Medicare beneficiaries to make choices regarding their health insurance coverage has shaped the development of the Medicare program in fundamental, yet sometimes contradictory, ways. Yet relatively little is known about the factors that affect the decision making of older adults in this context.

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This issue of CHP/PCOR's quarterly newsletter, which covers news from the spring 2006 quarter, includes articles about:

  • a study led by CHP/PCOR trainee Hau Liu which found that teriparatide (Forteo) -- the first in a new class of osteoporosis drugs -- is not cost-effective compared with the most commonly prescribed osteoporosis drug, alendronate (Fosamax), due largely to teriparatide's much higher price;
  • an update on projects and priorities at CADMA (the Center on Advancing Decision Making in Aging) and CDEHA (the Center on the Demography and Economics of Health and Aging), two multidisciplinary research centers based at CHP/PCOR that support promising early-stage projects on health, economics and aging;
  • an April working trip by CHP/PCOR research assistants Meghan Fay and Raina Mahajan, in which they traveled to San Lucas Toliman, Guatemala, with faculty member Paul Wise, assisting him with various medical treatment and health promotion activities in the region; and
  • a meta-analysis led by CHP/PCOR trainee Smita Nayak which evaluated the accuracy of an emerging screening test for osteoporosis -- heel ultrasound -- compared with the standard test, known as DXA. The study found that there is not enough evidence to recommend heel ultrasound over DXA as an osteoporosis screening tool.
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