Chiehwen Ed Hsu

Facing the fear factor in Taiwan election

Chiehwen Ed Hsu — Fri, 20 Jan 2012 00:13:18 PST

After observing recent legislative and presidential elections in Taiwan, members of the independent International Election Observation Mission have concluded that the elections were largely “free, yet partially unfair” (“Elections ‘free, partly unfair,’ watchdog says,” Jan. 16, page 1), citing several structural problems (eg, vote-buying, misuse of government power, and substantial disparities in party wealth) and extraneous fear factors (ie, undue influence exerted by the US and China under the myth of arguably fictional stability) that posed concerns for and pressures on Taiwan’s democracy, particularly on the freedom and fairness of the choices that Taiwanese voters must take. A case in point is the fear factor that runs against the universal values of a democratic election.

Identifying Shared Decision-Making Elements in Medical Encounters Dealing with Uncertainty

Roxana M. Maffei et al. — Sun, 25 Sep 2011 15:09:06 PDT

Understanding Behavioral Intent to Participate in Shared Decision-Making in Medically Uncertain Situations

Roxana Marie Maffei et al. — Fri, 23 Sep 2011 13:45:28 PDT

Evaluation of a tele-education programme in Brazil

Ashish Joshi et al. — Thu, 22 Sep 2011 00:44:40 PDT

We evaluated a tele-education programme for primary care staff in Pernambuco State, Brazil. During 2008 and 2009, tele-education sessions occurred four times each week for one hour per day. The topics included public health, child and adolescent health, mental health and nursing. After each session, participants completed an evaluation questionnaire. A total of 73 municipalities and 141 health centres participated in the programme. There were 254 tele-education sessions scheduled during the 20-month study period; of these, 224 sessions were successfully performed and 30 were cancelled. We collected 3504 responses from the satisfaction survey. There was high acceptance of the programme: 97% rated it as excellent or good.

台灣媒體變成了緊張大師. 台北中國時報論壇

Chiehwen Ed Hsu — Sun, 28 Aug 2011 14:48:01 PDT

What free election is meant for Taiwan. Taipei Times

Chiehwen Ed Hsu — Sun, 28 Aug 2011 14:46:10 PDT

Declaration on Talent Recruitment of Skilled Expatriates from Taiwan: Opportunities & Challenges 吸引海外華人產學研究者的人才宣言:有效政策,或可能失策?

Chiehwen Ed Hsu — Sun, 28 Aug 2011 14:28:13 PDT

據報載,日前(8/14)中研院長及十餘位各界賢達表示,鄰近國家近來積極對國內產業及研究界挖角人才.他們聯合發表"人才宣言",憂心忡忡建議改善政策,修法和薪資結構來減少人才外流,吸引國外學者企業家回國服務.政府於次日立即回應以兩年內撥款台幣六百億元來改善.對此因應,有學者著文認為"用人無私,才能留才",批判撥款幫助外來學者坐領高薪,是個煙幕彈及障眼法. 筆者於國外教學研究十餘年,謹就研究數據和主觀經驗來討論金錢/高薪是否能是吸引海外學人回國的誘因,以及其他在"人才宣言"裡沒有處理到,但可能相對是重要的誘因和挑戰,並討論一個可行的方案供國內做參考. 首先,文獻顯示高薪並不一定是吸引海外學人回國的主要誘因.兩個分別在台灣和澳洲完成的研究顯示那些返國服務的僑胞表示對他們最大的誘因, 按照重要的順序分別是:生活方式,家庭或親人,對來自國家的認同/使命感及工作環境.另一方面,那些澳洲僑胞選擇不返回澳洲, 選擇留在僑居地的表示對他們選擇留在海外最大的誘因,按照重要的順序分別是:升遷機會多,工作機會好,已在僑居地建立基礎,接下來才是薪資高.這兩個研究結果說明了,加強吸引海外學人返國主要的誘因並不在用高薪,而在於改善生活的便利性,撫養家庭成長的客觀條件(如就學就醫的可近性,平價住宅等),對來自國家的使命感,及工作環境,例如友善支持的研究環境和升遷機會.由於台灣和西方國家經濟發展和薪資結構不同,根據美國大學協會 AAUP 的年度收入調查數據顯示,一般同級別的美大學教授和研究者薪資與台灣國內同等級的職位差別常在三四倍以上(業界薪資相差更大),在國外工作繳納賦稅較高,待遇也較好這是事實.據此可以合理地假設,那些考慮回國發展的海外學人,多少已經調整了回國後待遇的期望. 也因此,為了吸引海外人才,應該把重點加強上面討論的非薪資的誘因,如健保的就醫帶來的可近性,高鐵便捷的南北一日生活圈,雙語教學環境及平價住宅等為強項誘因其它吸引國外人才結構性的挑戰,在人才宣言裡沒有處理到的包括研究工作,健保和家庭. 比起其他國家大學教授每學期教一到兩門課(教研究所每周只上一門課),國內學者做研究以外要上課教學的份量很重.許多國內大學每周要教九到十二學分(約三到五門課).另外,國內著重研究投稿於特定刊物重排名(如SCI或SSCI)和影響係數,在美國申請聯邦研究經費只要檢附著作有PubMed索引的刊物即可.在生活上,全民健保法復籍者規定要在台居留四個月才能復保因而造成保險空窗期,以及國內房價高得和所得不成合理的比例等,這些都是招攬國外人才的潛在挑戰. 最後,考慮海外舉才千頭萬緒,為幫助釐清以上的誘因和挑戰,僑胞在實務上需要像在西班牙和中國大陸成功實施的讓僑胞短期返國合作 (diaspora’ option) 的專案.這種短期過度式的安排可以幫助僑胞了解回台工作定居的可行性.政府不仿考慮多實施. Opportunities and Challenges of Going Back Home to Serve: On the “Declaration on Talent Recruitment” of Skilled Expatriates from Taiwan Ed Hsu Houston, Texas Citing declining competitive edge against proactive talent recruitment campaigns launched by neighboring countries, President Wong of Taiwanese Academia Sinica, joined by 18 local leaders, proposed a ‘Declaration of Talent Recruitment’ aiming at retaining talent professionals, reversing brain drain and improving quality workforce in Taiwan. The proposition recommended major policy and legislative changes to address education, research, administrative systems and overall supporting infrastructure, such as removal of salary caps for highly skilled public servants and researchers, to make Taiwan more attractive in competing for the world’s top quality professionals. The Government quickly responded by setting aside USD$ 2.07 billion seeking to train personnel for emerging and priority industries, globalize the country’s workforce, and enhance the capabilities of public servants and strengthen alliances between the academic and industrial sectors. The sizable earmark at a time of economic downturn quickly drew strong reactions from both politicians and academia alike. At issues are 1) whether money along a major incentive to reverse brain drain, and 2) proposed policy changes on the right track, and inclusive enough to attract skilled Taiwan expatriate to move back to serve their homeland? Having worked in the U.S. for 10 plus years I would like to share my perspectives on these critical issues. First, the literature suggests that monetary incentive, although intuitively appealing, is not necessarily the most important incentive for attracting expatriates, including researchers. Two studies conducted independently in both Taiwan and Australia confirmed that reasons of those expatriates who chose to return to their own home countries to serve after overseas studies were (in the order of importance): lifestyle, family, commitment to native countries and work environment. The latter study further indicated that reasons given by expatriate researchers for not returning to Australia were ‘career and promotion opportunities’, (more) ‘employment opportunities’, ‘established in current location’, and followed by ‘higher income’ which ranked the 4th. The results suggest that monetary incentives alone may not either be main incentive or deterrent for returning to their homeland. However, skilled expatriates would otherwise return to their home countries for better lifestyle choices, more family friendly infrastructure (e.g., a better educational system and universal health insurance, the UHI) and commitment to native country, such as a mission relevant to self fulfillment. Second, several areas critical to a career decision, such as conduct research (teaching load) and raise a family (barriers of health insurance and home purchase) discussed in the studies remain left out in the Declaration. For instance, for researchers better work environment entails less teaching load. The high teaching load of a regular university faculty (that usually carries ranging from 9-12 credits/semester) and restrictive scholarly outlets - such as heavy preference of SCI-ranked journal publications for promotion review – could be disincentives. In terms of enrolling in UHI, the 4-month residency requirement for expatriates is likely to create a gap in insurance coverage and should be re-visited. In addition, although monetary rewards may not be a primary incentive, the diminished purchasing power of absolute incomes for home purchase and arguably, raising a family, could pose a potential challenge for talent recruitment. Lastly, giving the nature of major challenges and decisions surrounding talent recruitment and relocation, it may warrant consideration of the ‘diaspora’ option that encourages international short-term visit and collaboration. The Program, widely implemented by Spain and China, has met with great success in enabling skilled overseas expatriates to visit home countries in short time periods across several years, thus affording both parties to evaluate the association before the expatriates commit to moving back. The Program warrants consideration of the government and private sector alike.

Taiwanese American Identity in the U.S. Census. Taipei times.

Chiehwen Ed Hsu — Sun, 28 Aug 2011 14:25:49 PDT

The U.S. Census announced that close to a quarter million Taiwan expatriates self identified as 'Taiwanese' in the Census 2010, nearly doubling the figure from a decade ago, with most Taiwanese community so identified in the state of California, New York and Texas. Both politically and substantively significant, the statistic does not only suggest a concerted self identity of Taiwanese expatriates, but also signals an expanded health and social service needs of this growing community to be met. The growing number of self-identifying Taiwanese in the U.S. is politically important, as the increased constituents of Taiwanese Americans representing an even bigger picture of the U.S. political landscape that gradually becomes too salient to ignore. The concerted voice of Taiwanese Americans could result in a stronger impact in political and financial decisions, both at home and abroad. It also warrants notice that, although some Taiwanese Americans who chose to identify so may be ideologically sympathetic to Taiwanese independence movement back home, yet many more did so indicating an emotional endorsement, identifying with Taiwan’s common values close to their adopted country - America - in terms of free expressions of spiritual and political beliefs, free press, and multi-culture diversity that Taiwan society embraces so near and dear, especially after lifting its longest Martial Law in the world, 25 years ago. The sizable self-identified Taiwanese Americans also present an opportunity for addressing the expressed needs of their health and wellbeing. On this note, a U.S. county government supported health needs-assessment study of Taiwanese community in Maryland by our research team demonstrated that many (new) immigrants from Taiwan were concerned with many chronic and infectious diseases affecting this community, including cancer, hepatitis, diabetes, mental health, and culturally appropriate senior care services, just to name a few. In the era of evidence-based allocation of scarce health resources, and given the influx of U.S. federal resources allocated to address health disparities among racial and ethnic groups, it is imperative that more Taiwanese expatriates self identify as Taiwanese to be incorporated into U.S. Census, so that research and formula funding - usually allocated in proportion to head counts - could be appropriated accordingly to address the increased social and health needs of this growing community. Ed Hsu Houston, Texas

Surveillance of Hepatitis B Infection and Vaccination Status of Vietnamese Americans in Texas, Manuscript under revision, Unpublished

Chiehwen Ed Hsu — Tue, 16 Aug 2011 21:39:23 PDT

Communicating H1N1 risk to college students: a cross-sectional survey study

Francisco G. Soto Mas et al. — Sat, 06 Aug 2011 13:04:20 PDT

Objective: To assess the H1N1 risk communication needs of college students. Participants: Students at a major university in the southwestern U.S. Method: Data were collected in early spring 2010 through a 24-item, self-administered survey. Outcome variables included knowledge, behavior and intention. Results: A total of 483 students participated. Most reported trying to prevent H1N1 influenza though specific behaviors. Many lacked knowledge about symptoms and treatment, a few (10%) had been vaccinated, and half had no intention to get vaccinated or practice self-isolation. Gender and age were significantly associated with the three outcome variables. Intention was the most significant contributor of behavior [t (1) = 3.34, p < 0.001]. Conclusions: The results suggested that H1N1 influenza campaigns directed toward university students in the U.S. should focus on undergraduate, male students, and place greater emphasis on vaccination and self-isolation, rather than hygiene, as well as on differences between regular and H1N1 influenza and facts about symptoms.

Do EHR Investments Lead to Lower Staffing Levels?

Jeff Helton et al. — Wed, 27 Jul 2011 11:58:40 PDT

Whether to get an H1N1 vaccination or not?

Chiehwen Ed Hsu — Sun, 17 Jul 2011 14:34:19 PDT

In this interview Dr. Hsu provided public health informatics expertise to answer why or why not to receive H1N1 vaccination.

Risk communication and college students: the 2009 H1N1 pandemic influenza

Francisco G. Soto Mas et al. — Sun, 10 Apr 2011 07:39:57 PDT

Popular People Help Experts Predict Flu Outbreak?

Chiehwen Ed Hsu — Thu, 16 Sep 2010 11:08:31 PDT

Popular people are the trendsetters of society, especially when it comes to the next flu outbreak, according to preliminary research from Harvard University. The hypochondriac effect may have also exaggerated how predictive the friend group was, says Ed Hsu, associate professor of Public Health Informatics at the University of Texas. Those in the friend group are more likely to know someone who has the flu and hence may be more likely to think (and report) that they are coming down with it themselves.

Controlling Influenza A (H1N1) in China: Bayesian or Frequentist Approach

Dejian Lai et al. — Tue, 16 Mar 2010 22:32:19 PDT

This article discusses two approaches to controlling the newly identified influenza A (H1N1): via Bayesian and frequentist statistical reasoning. This study reviewed the measures implemented in China as an example to illustrate these two approaches. Since May 2009, China has deployed strict controlling mechanisms based on the strong prior Bayesian assumption that the origin of influenza A (H1N1) was from outside China and as such strict border control would keep the virus from entering China. After more than 4 months of hard work by Chinese health professionals and officials, the number of confirmed influenza A (H1N1) has increased steadily against the expectations of the general public. Taking into account the great financial burden in maintaining strict measures, Chinese health authorities have slowly adjusted their policies of controlling influenza A (H1N1) in China according to frequentist reasoning since July 2009.

Assessing the Needs and Guiding the Future: Findings from the Health Needs Assessment in 13 Asian American Communities of Maryland in the United States

Sunmin Lee et al. — Mon, 14 Dec 2009 05:31:38 PST

There is lack of in depth data on health needs of diverse Asian American communities. We conducted 19 focus groups in 13 Asian American communities in Maryland in 2007. We developed a moderator’s guide to collect qualitative data on health needs from 174 participants, and used MAX QDA to analyze data and code emergent themes. Cardiovascular disease related conditions, diabetes, and mental health were the top three health concerns. Weight concerns, cancer, arthritis, smoking, osteoporosis, and hepatitis B followed next. Many participants were not receiving preventive health service such as cancer screening due to a lack of access to health care or lack of awareness of preventive care. Additionally, under-represented communities lacked adequate health resources and advocacy, potentially due to a relatively shorter history of immigration and a small population. The results render support for awareness education on importance of preventive care and mental health.

Keeping National Health Insurance (NHI) accessible for all. 許:論台灣健保局修法規定海外僑胞返臺需住四個月才能加(復)保的政策. 台北英文時報社論論壇

Chiehwen Ed Hsu — Sat, 21 Nov 2009 14:38:10 PST

Media reports say that Taiwan Health Insurance Bureau and the Department of Health are proposing an amendment to the health insurance laws to require every returned overseas Taiwanese who has been abroad for more than six months be resident in Taiwan for four months before he or she becomes eligible to re-enroll in the National Health Insurance (NHI) program. The proposed amendment arose from a small portion of overseas Taiwanese who are have allegedly played medical tourists, returning to Taiwan for medical treatments under the NHI plan.

The amendments’ proponents urged “restoring equality” in the NHI. However, the proposal could deny equal protection of access to care for the majority of non-opportunistic overseas Taiwanese who visit Taiwan on a short term basis. In addition, if the amendment passes, the actual financial contribution to the NHI deficit would be minimal, as it could only reduce 0.01 percent of the expenditure.

Swine flu central: No winter surge of H1N1 cases coming?

Chiehwen Ed Hsu — Sun, 11 Oct 2009 09:34:19 PDT

Everyone worries about how hard swine flu's going to hit when fall turns to winter, the traditional peak of the influenza season, but one expert says early indications are we might not see much wider spread of the H1N1 virus in January and February. Hsu says the "widespread" prevalence of swine flu in southern states and the "local" or "regional" spread in northern states suggests the virus' spread may not be influenced by cooler temperatures. He notes that that's not just been since temperatures turned colder in the United States' North, but in Northeast Asia as well.

Applying Informatics to Improve Vulnerable Population Registration for Emergency Preparedness in the Gulf Coast Region of Texas

Akom Phosuwan et al. — Sun, 23 Aug 2009 21:58:35 PDT

The application of information technology in program evaluation has gained increased attention in recent years. This paper discusses informatics-facilitated evaluation results of a federally-supported self-registration system for vulnerable people in emergency preparedness and response (known as 2-1-1 registration system) in the Gulf Coast Region state of Texas. The purpose of this project is to assess registration system utilization and available service provision, with a special focus on how to improve enrollment for annual year for those zipcodes with low registration, and inform the enhancement of participating health providers to address the zipcodes with high registrants. This project is part of a larger project “HealthQuilt”, which involves in preparedness outreach evaluation of Harris county catchment area using emerging online consumer geo-informatics service from Google mapping system - a worldwide Web-based distribution system of free geospatial service and maps. We created 3 interactive maps demonstration of 2-1-1 registrants and the locations of clinics that are participating in the project. The results show geographically diverse distribution of 2-1-1 registrants by zip-code and the collaborating clinics in Greater Houston. This project presents a potential prototype system for monitoring the progress of 2-1-1 enrollment in the target area, and for increasing the number of registrants in other jurisdictions with similar needs.

Swine Flu Myths - Experts Debunk Four Common Myths About Swine Flu

Chiehwen Ed Hsu — Thu, 28 May 2009 18:23:49 PDT

To date, no evidence has been found to link eating or handling pork to contracting swine flu. As the cases of the new swine flu virus continue to rise, so too do the misconceptions about the illness. "By eating pork or handling pork products you won't [contract] H1N1," said Ed Hsu, an associate professor of health informatics at the University of Texas Health Science Center and a contributor to ABC News's OnCall+ Swine Flu site. "There is no scientific evidence or literature or any studies that suggest that one contracts H1N1 virus through eating pork or handling pork products." Additionally, USDA guidelines say to cook pork products to an internal temperature of at least 160 degrees Fahrenheit, in order to kill pathogens that live on raw pork. That temperature would kill the swine flu virus.