Ebook: Scientific Networking and the Global Health Network Supercourse

Faina Linkov

University of Pittsburgh

Natural and man-made disasters, like floods, eruptions of volcanoes, etc., have tormented mankind since antiquity. Despite all the warning signs, it is certain that when the eruption of Vesuvius started on the morning of 24 August, CE 79, it caught the local population of Pompeii utterly unprepared for the major disaster that ultimately ruined the entire city. What makes our world today different from the population of ancient Pompeii 2,000 years ago is better abilities to share scientific data about the warning signs of disasters. Modern technologies are giving us an unprecedented opportunity to share disaster preparedness and mitigation information very rapidly and effectively. Technologies such as the Internet, telecommunications, etc., have a great potential to help us prepare for disasters, however, oftentimes scientists are not taking advantage of them. In an effort to change this situation, our group conducted a NATO funded workshop on the scientific networking.

Networking of scientists from various disciplines is an important aspect of disaster forecast and prevention. Since the breakdown of the Soviet Union in 1991, man-made disasters became a very real possibility in Russia and other Former Soviet Union (FSU) countries. Collapse of public health infrastructure in the countries of the FSU became a realistic threat to the health of the people throughout the FSU, Europe, the Mediterra- nean region, and worldwide. An earthquake or famine in the FSU could be the tipping point leading to a chain reaction of political, economic, and health destabilization in the FSU, markedly escalating nuclear and other types of threat for all other countries. FSU scientists have few connections with their colleagues in Europe and the Western world, and their work is rarely published in peer-reviewed journals. It is likely that the improvement in scientific networking among FSU scientists and their counterparts in other countries would lead to better disaster information sharing and ultimately to better prevention and mitigation of natural and man-made disasters. FSU scientists networking with U.S. scientists and others worldwide would be a powerful form of public health mitigation against natural disasters, and escalating man-made disasters (e.g., nuclear war). The Global Health Network Supercourse (GHNS), supported initially by NASA, and then by the National Institutes of Health (NIH) created a network of over 600 scientists in the FSU region. As a part of the Supercourse project, directors of this workshop were successful in networking over 31,000 public health professionals in 151 countries. This network shares a free library of 2,500 low-bandwidth Supercourse lectures at www.pitt.edu/∼super1. The Supercourse project is currently supported by the National Library of Medicine (NIH).

The networking of scientists researching the area of natural and man-made disasters became the topic of NATO funded Advanced Research Workshop that took place in Kaunas, Lithuania, in August 2005. Strengthening and improving existing networking and finding new cost-effective information distribution channels became the leading topic of this workshop. This workshop demonstrated how to use cost-effective Internet- based information distribution channels to:

• Share disaster low-bandwidth preparedness and mitigation research information in the library of the Supercourse lectures as demonstrated at <www.pitt.edu/∼super1>

• Create scientific networking locally and with other countries

• Collaborate on disaster preparedness and mitigation research projects

• Increase one's chances of publication in peer-reviewed journals

This workshop was significant not only because it allowed exchanging the knowledge among scientists from NATO countries, but also because it provided a fertile ground for forging life-long friendships. These friendships will serve as a cornerstone for the future multinational collaborative projects in the area of disaster preparedness and mitigation. As meeting participants discussed in one of the sessions, networking is not about computers or other technologies, but it is about friends. Improved networking among friends in the area of disaster preparedness and mitigation is promising to make us better prepared for crisis situations in NATO countries and around the world.

There is a critical need in NATO countries for better communication in public health and prevention across countries. In addition, there is a very important need to cooperate, communicate, and educate among the different “silos” of information including public health in academia, public health centers, ministries of health, the military and industry. The technologies used to share information now among groups are in many ways not much different than those used 50 years ago. We propose that we need to establish a Prevention Supercourse for NATO countries so that we can seamlessly share prevention information across our “stove piped” prevention information systems. For example, should an earthquake hammer Latvia, it would be essential to obtain the best possible information about earthquakes from the military in France, the Red Cross in Italy, and structural engineers in Estonia. Building a NATO network for disasters and prevention would produce rapid sharing of information for the emergency response as well as educational materials which could reduce the “epidemiology of fear.” In the current paper we outline how this could be constructed.

This paper explains the roots and aims of the Internet Prevention (I-Prevention) program created in the frame of Supercourse project—online library of lectures in public health, epidemiology, and global health <http://www.pitt.edu/∼super1>. We present a new, multinational project in public health for former Soviet Union (FSU) countries, which should help these newly independent countries create their countries' public health and prevention programs on the basis of the best knowledge available. The global participation through an Internet-based disease prevention system is the primary goal of the research. We networked scientists involved in prevention and the Internet in Russia and FSU countries. We established a bilingual set of lectures on the Internet on prevention medicine. We created a Russian language library of lectures as a backbone for a Russian language “telepreventive medicine” program.

Hurricane Katrina became one of the most destructive and costliest natural disasters in the history of the United States. In addition to causing death and destruction, Hurricane Katrina, followed by Hurricanes Rita and Wilma, heightened societal fears and misperceptions about the nature of hurricanes. Teachers and public health educators across the country and worldwide had only limited materials to educate their students on the risk and risk factors of hurricanes and disasters. When materials were available they were difficult to find by people outside of the scientific community, and their format was not user-friendly. Overall, the scientific community was poorly prepared to deliver basic scientific facts about hurricanes to their own students, students of the world, and the general public. The Global Network Supercourse group decided to change this situation and deliver a basic lecture on the science of hurricanes to the audience of public health professionals and educators. To address the problem of the “epidemiology of fear” associated with disasters; our group developed several scientific lectures dealing with basic facts about hurricanes, and made them available through the Supercourse network of over 30,000 scientists 151 countries. As scientists and as public health educators, the Supercourse group will continue to deliver cost-effective public health knowledge about the science of natural and man-made disasters to prevent the “epidemiology of fear” from infecting our collective consciousness. What was done by the Supercourse group with JIT knowledge on hurricanes could potentially serve as a model for teaching the public about all natural and man-made disasters through “lectures on demand.”

The Global Health Network Supercourse is assessed as a model for knowledge development and information sharing, and is considered to be new paradigm to reorganize all the global safety system. The difficulties which impede realization of the idea and implementation of networking are analyzed. Principles of InfoSec system building; dispelling myths; are implementing codes of practice described in ISO 17799 explored. And the interdisciplinary triangle of information security, library sciences and law is proposed to promote the idea of the network on a global scale.

The United States has made some critical progress in beginning to measure the capabilities through the use of metrics and other evaluation tools. This action was called for by the lead author as part of the National Advisory Committee on Children and Terrorism after a lag period of relatively few evaluations except some capability instruments by the U.S. Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Health Officials (ASTHO). A recent review by Drexel University's Center for Public Health Readiness and Communication found some other evaluations with merit that correlated with national public health expert concern about preparedness. Recently, the CDC, as part of their larger U.S. cabinet, the Department of Health and Human Services (DHHS) began to work with the U.S. Department of Homeland Securities (DHS) National Response Plan experts and other collaborators to develop a set of critical capabilities that are part of a larger DHS initiative to measure Target Capabilities. Some public health experts in the U.S. do not see this trend towards capabilities over capacity as necessarily a great improvement, but it promises to track progress potentially more reliably and more often than in the past. On the other hand, it remains to be seen whether or not such Target Capabilities and more importantly, the anticipated decreased funding stream for “public health preparedness” will fully prepare some key sectors of our populations for various emergency situations

Globalization and technology present challenges and opportunities for both new and existing channels of scientific networking. Scientific research activities can be considered a foundation of cooperative work in a worldwide context. In this regard, joint research projects and research networks are enabling structures for scientific collaboration that is critical for developed and developing countries. The idea of scientific networking is beneficial for both the individual and the community, for example, when the expertise, the skills, and the vision of different members of the group can be shared by the community in a particular country or even by other countries particularly between developed and developing countries. Information can be turned into knowledge and, therefore, information sharing can lead to knowledge sharing. But knowledge sharing—which is the core of scientific collaboration—is a process that embeds the notion of the willingness to share. Cooperation can be defined as the work in progress, bringing the specialties of different participants that complement each other to the network. With the advent of Internet, the networking function is very easily accomplished. What is then important is that each scientist tries to establish a cooperative database that is globally accessible or at least tries to provide his/her scientific contribution to pre-established databases.

Disasters are generally considered “low probability–high impact events.” Disasters always arise from some disequilibrium between hazards in the environment and the vulnerabilities of human communities. In the 21^st century natural and complex disasters caused a dramatic increase in the demand for emergency medical care. Epidemiological data are well recognized as essential to understand to competent disaster management. Studies of disaster impact on public health have suffered by the lack of these data, especially the lack of real time .The analysis of hazards and vulnerabilities represent the key to managing and mitigate disasters assessment. The objective of this project is to create a country database (DB), an Italian Database, to collect all available information about the past country disasters and to establish a model for future, with a an analysis of factors that are most likely to produce hazards. The aim of this model is to investigate the impact of disasters upon the physical security and the health of people; factors that are most likely to produce hazards.

The legitimate functions of science, industry, medicine, and public health must be preserved, while at the same time addressing the risks they engender. In order to achieve this, there must be an understanding that the traditional boundaries between health and security need to be redrawn. The threat of infectious disease—whether naturally occurring or as a result of deliberate use —is real and growing, and the global community must find appropriate ways to counter this threat without crippling the very institutions that are critical to health security. Georgia, as part of former Soviet Union, used to share legislation including regulations on biosafety. Even though it's been more than decade since Georgia became independent, and while new Georgian laws have been adopted (parts of sanitary norms and regulations were renewed), many laws remain unchanged. The need for new Georgian regulations on biosafety/biosecurity is evident. The draft of new Georgian legislation on biosafety includes four documents: (1) Select Agents Rule; (2) Rules of Import, Export, Containment, Transfer and Handling of Cultures of Infectious Diseases Causative Agents (Bacteria, Viruses, Rikketsia, etc.), Protozoa, Mycoplasma and Genetic Materials, also Toxins and Poisons of Biological Origin; (3) Sanitary Norms For Labs Working with Especially Dangerous Pathogens; and (4) Guidelines for Safe Transportation of Infectious Substances and Diagnostic Materials. This new legislation package will be supported by all involved agencies like the Central Sanitary Inspection of the Ministry of Labor, Health and Social Affairs of Georgia, Ministry of State Security of Georgia, Ministry of Infrastructure of Georgia and Ministry of Interior of Georgia. Legislation on biosafety/biosecurity, like all the other legislation, rules, and regulations can be ideal, even applicable, but there must be readiness in the community to follow them. This requires creating mechanisms for their implementation.

A comparison of the reliability of the electric energy system in Russia with pertinent U.S. experiences is discussed. Unique digits of accidents and emergencies at the third Russian electricity production corporation, Irkutskenergo, in 2004 are reported. Networking and Information Security approaches are argued as helpful in solving problems of disaster prevention in the industry.

The paper presents main functioning results, feasibilities and limitations of the State Registry of Ukraine for the Chernobyl NPP accident survivors. The structure of the individual records, completeness, and quality of the registered data allow assessing of the demographical and health status changes trends in victims forming the cohorts for profound research of the health outcomes. Registered data on doses received and diseases diagnosed in victims are of uncertain quality and require additional verification.

Nuclear accidents or disasters are quite different from other natural or man-made events because of their detrimental radiation impact and delay in the occurrence of conditions. One of the largest nuclear accidents took place in Chernobyl, Ukraine, in April 1986. This article describes lessons learned from this accident. The author also describes his collaboration with the Global Health Network Supercourse project and his experiences with sharing disaster data via the Internet.

This paper argues for an increased focus of multinational research studies to specifically be designed to assess and interpret human and ecological risk aspects of environmental radiation from underground nuclear tests, dumping of radioactive wastes, and release of radionuclides into the marine environment from former and active nuclear weapon production and military facilities. Here, we present a unique, multi- and interdisciplinary model expedition to Amchitka Island, Alaska, to determine any current threat to human health and the environment from radionuclide release into the marine system from underground nuclear tests detonated during the Cold War. Physical methods were used to obtain data to reduce uncertainty regarding transport of radionuclides into the marine environment. Extensive water and sediment sampling and analysis were performed to assure the radiological safety of scientific divers and intertidal gatherers. Radiation survey and personnel monitoring were employed throughout the expedition to quickly identify radiation sources and record individual radiation doses, respectively. Scientists sampled biota at each tropic level, including sedentary and mobile species. Both a screening and in depth radiological analysis of samples for anthropogenic and natural radionuclides was done to determine the safety of human foods, human and ecological risk and establish a baseline of biological data to aid in the development of a long-term stewardship plan. While other expeditions have been conducted in far northern latitudes in connection with above- and underwater nuclear detonations, sunken submarines, and releases from accidents and reprocessing plants, they fail to integrate all procedures necessary to fully evaluate human and environmental risk. Moreover, this expedition is the first to study the effects of underground detonations in northern latitudes providing a model for similar work on Novaya Zemlya, the Russian north latitude marine underground testing site.

The Hashemite Kingdom of Jordan is a small country in the Middle East (89,342 sq. km) with a population of only about 4.8 million (1998). Exposure to air pollution aggravates respiratory diseases. Kuo, Lai, Lee, Tai, and Lee (2002) found a positive relationship between prevalence of asthma diagnosed by lung function test and air pollution. In the current study lower respiratory tract symptoms were prevalent more than upper respiratory tract symptoms. No study was found to distinguish the prevalence rates of respiratory symptoms in this manner.

Although an approach to take measures before problems actually occur is not possible in many developing countries, even for certain services that are regularly provided, it is hard but not impossible to devolp an understanding of service that is planned, implemented, and evaluated in advance of any unusual situation (i.e. disaster). This study aims to analyze the experiences gained in the 1999 Earthquake of Turkey's Marmara Region, and the studies concerning rehabilitation and preparedness for a new earthquake, which have been continuing from the earthquake until 2005, and to present acquired information from the point of view of public health, along with the experiences gained. On August 17, 1999, Turkey's Marmara Region was shook by an earthquake of a magnitude of 7.4 as measured on the Richter scale. The outcome was frightful: 17,480 deaths, 43,953 injyured, and 200,000 homeless. Futhermore, this earthquake gave rise to a multitude of serious public health problems such as difficulties in the provision of safe water, sewage problems, housing difficulties, those related to the collection of wastage, etc. The primary, as well as secondary and tertiary, health services systems were absolutely unprepared for such a disaster: There was no mobile hospital and no burn or trauma centers. The number of hospital beds and health personel were not sufficient enough to meet the needs. Intensive care, and hemodialysis services as well as the supply of blood were inadequate. Basic health¹ services could not be provided satisfactorily either. Due to the lack of personnel in the health centers, basic needs such as immunization, mother and child health services, the examination of patients, and laboratory analyses could not be met acceptabily. There were also difficulties in inhuming the deceased. In addition, the earthquake triggered a number of serious environmental risks. 6,500 tons of acrylonitrile ran out of the AKSA acrylic factory into the sea and the soil. A series of explosions happened at TUPRAŞ (petroleum factory) just after the earthquake caused very serious damage. Soon, after the earthquake came a period of rehabilitation and restoration activities such as settlement of homeless people in transitory homes, and accelerated construction of new houses and appartements for them; reopening of schools and workplaces; and providing psychological help and support to the survivors. In 2000, a National Earthquake Council was formed according to the European Code of Ethics Concerning Earthquake Prediction; And emergency preparedness plans have been processed by this council as well as by the local authorities, universities, and by various NGOs. Futhermore, many projects concerning disaster prevention and rescue are in progress. As a result, although it is hard to get prepared for an unusual situation such as earthquake, studies for preparedness for an earthquake have been accelerated in Turkey after the earthquake in Turkey's Marmara Region.

Human health is influenced by a complex interaction of different factors, including the environmental parameters. The impact of anomalous rates of different geo-factors is well known (e.g., natural and man-made geochemical anomalies), whereas the influence of the background rates of environmental parameters receives little acknowledgement. This paper discusses the statistical relationship of the different environmental factors to selected human diseases on a countrywide-scale in Lithuania. Five groups of geo-factors are analyzed: (1) gravity and magnetic fields, (2) concentrations of geochemical elements in the soil, (3) sub-soil lithologies, (4) relief and some landscape features, (5) drinking water chemistry. Environmental factors were correlated with the spatial variations of the schizophrenia, alcoholic psychosis, suicides, cancer, infection, cardiovascular, respiratory diseases. The statistical approach was applied to ensure an objective identification of the interacting factors. The different formats of data were unified using GIS techniques that enabled scaling of geological databases to 45 administrative regions of Lithuania. Some strong correlations were identified that imply the importance of the living environment on the human health and psychic disorders.

The objective of this paper is to determine the epidemiological profile and risk factors of traffic accidents in Tunisia in order to set up a national management strategy. We undertook a descriptive study, including all road accidents occurring throughout the entire territory of Tunisia during three consecutive years from 1996–1998. We studied a representative sample of 1,000 cases from the global database. The majority of accidents took place in large cities. Accidents in urban areas were four times more frequent than in the country; however, accidents occurring in rural areas led to eight time more deaths than in cities. Persons involved in road crashes were young, with an average age of 33.6 years. About 62% of the drivers were between 20 and 40 years old. Pedestrians were the most vulnerable type of road users, especially children and the elderly. Drivers' mistakes were inattention in 41.4% of accidents, followed by speed excess, and the disrespect of priority in 14.1% and 9.7% of cases, respectively. Inattention while crossing the street was the most frequent mistake of pedestrians (71%). Drivers used private vehicles in 50% of cases and motorcycles in second instances. The human factor was involved in 99% of traffic accidents, the environment in 9.3%, and vehicles in 4% of road accidents. We concluded that a national program of traffic accident prevention based on the education of young drivers is necessary to remedy this increasing public heath concern.

Zinc is an essential bio-element that plays a fundamental role in a wide range of biochemical processes; this metal functions as a co-factor of multiple enzymes, it is a major component of various proteins and the modulator of the mammalian immune and nervous system. With zinc playing such a crucial role in normal biological and physiological functions, a deficiency of this mineral would be expected to result in a number of adverse physiological consequences. Symptoms resulting from zinc deficiency include infections, hypogonadism, weight loss, emotional disturbance, dermatitis, alopecia, delayed wound healing, etc. Many symptoms of zinc deficiency result from poor diet consumption, lack of zinc in food crops grown in zinc depleted soils, dependence on processed foods, but often the most severe symptoms result from other factors including excessive alcohol use, liver diseases, malabsorption syndromes, renal disease, and sickle cell disease.

The problem of zinc deficiency has been known for more than 40 years and a solution is still outstanding. In our days when many people are moving around the world with various missions, it is necessary to study the influence of natural geological factors on the possible zinc deficiency of population. On the ground of pilot investigation of zinc abundance in blood serum of patients with liver diseases (hepatitis and liver cirrhosis) and biological media of people with alopecia it was demonstrated that there are some marks of zinc deficiency in Lithuanian people. The causes of this conditioned zinc deficiency are largely explained in terms of excessive alcohol consumption and living in zinc depleted environment. The zinc deficient status can be considered as the cause of emotional disorder (mostly depression) inducing the suicide.

Environmental risk assessment evaluates the quantitative and qualitative characteristics of the environment in order to highlight the risk on environment and human health due to the potential presence or use of specific pollutants. Risk is a probability of an adverse direct or indirect effect on the environment or human health. It is a combination of the probability of occurrence of an event and the possible extent of that event's adverse effects and consequences, in terms of adverse effects on the ecosystem and human injury. Risk is defined as the probability of an event to occur related to the seriousness and extent of its consequences. An environmental risk assessment should be conducted, by adopting a systematic approach, when it is determined that a management action may have consequences to either the state of the environment or human health or well-being.

Lithuanian young people are currently facing problems related to narcotic drugs and alcohol addictions. In order to fight against the spread of narcotic addiction in the country, it is necessary to identify people who are using narcotics, toxic drugs, and medicines. The purpose of this research study is to ascertain if soldiers have any opportunities to abuse the aforementioned substances while serving in the Lithuanian army, and to evaluate whether they know only the names of narcotic drugs or have more information about their use. Twenty-five cases of ethyl alcohol and narcotic drug use have been determined among 318 soldiers, who have been tested since 2002 (it composes 7.86% of the sample). There are no conditions for such harmful habits in the army.