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• Conference Call:  Border Health Network (November 17, 2004)

  • Participants:  Investigators from USEPA, CDC, NLRC, CDPH-EHIB, Fogarty Staff (SJ)

  • Purpose:  To review and coordinate programs and operations between state and federal border health workers. 

  • Summary:  There were two presentations during this conference call.   1st: “The impact of a promotora on increasing routine chronic disease prevention among women aged 40 and older at the U.S.-Mexico Border” by Jennifer B. Hunter; 2nd: “The border that divides and unites: Addressing border health in CA” by Konane M. Martinez.  Both of their researches focused on the improvement of health issues along the border.  Jennifer B. Hunter addressed a randomized controlled intervention study.  The purpose of the study was to test the effectiveness of a community health workers program which focuses on increasing compliance with annual preventive exams among uninsured Hispanic women living in a rural U.S.-Mexico border area. According to the survey,  women who received the promotora intervention were associated with a 35% increase in re-screening using the post-card-only reminders. Using promotora to increase compliance with routine screening exams was an effective strategy for reaching this female population.  Konane M. Martinez presented on the urgent organizational and system-wide needs of border health issues in California. The research project involved thirty-two participants in seventeen agencies and organizations on the U.S. side of the California-Mexico border. The study found that agencies, both public and private, advocate a particular approach to health in the border area. Due to distinctive demographic, ecological, social and cultural factors in the border region, a set of special health indicators has emerged that require a binational approach. Most commonly considered “border health” issues include those that are shared due to common geographic, social, demographic, economic and cultural realities in the regions.

• Presentation: Emergency Management (November 12, 2004)

  • Participants:  Administrators who are responsible for emergencies from various governmental agencies: San Luis Obispo County (SLO/ OES, SLO SO Bomb Squad, CDF-Hazmat, EMSA, Public Health, MDFD, MDPD, Duke Power), Ventura County (FD/ Hazmat, SO Bomb Squad, BD Fire Hazmat), State/ Fed (OES Southern Region, CDHS, Hearst Castle California Department of Parks, Hearst Castle Fire, CA National Guard  95th Civilian Support Team), & FBI.

  • Purpose: To determine the responsibilities of various governmental agencies and to coordinate different agencies during accidents. 

  • Summary:  The training began at 8:30am. The instructors and participants introduced themselves. One of the instructors presented a scenario about an accidental chemical released by a airplane over the football field of  the California State University, San Luis Obispo on Saturday’ morning. There were 10,000 people that were watching the football game. There were 4,000 students living in the dormitory near the football field. The participants were divided into two groups to discuss: How to rescue the people potentially impacted by the accidental release? What is the outcome of the emergency? What is their agencies’ response?  How to coordinate different agencies to minimize potential adverse health impacts? What are needs of other agencies?  The participants listed methods for determining various chemicals’ characteristics and its toxic properties, controlling adverse health impacts, and determining the needs of people impacted.  The afternoon training session was: “Basics of the Incident Command System and Unified Command”. It includes “ICS and Unified Command Overview” and “ICS-Unified Command Organization Development”. “Unified Command” describes the purposes and advantages of multi-jurisdiction and/ or multi-agency Unified Command, and how Unified Command can be applied to incident situations. It also describes the Unified Command organization, how Unified Command is established, and the roles of its major roles. ICS (the incident command system) is used to manage an emergency incident or a non-emergency event. It can be applied in: 1. Fires, HAZMAT, and multi-casualty incidents. 2. Multi-jurisdiction and multi-agency disasters. 3. Wide-area search and rescue missions. 4. Oil spill response and recovery incidents. 5. Single and multi-agency law enforcement incidents. 6. Air, rail, water, or ground transportation accidents. 7. Planned events (e..g. celebrations, parades, concerts),  8. Private sector emergency management programs. 9. State or local major natural hazards management.   I found that the information provided in these 2 modules were effective ways to handle accidents and to minimized the impact to the nearby communities.  The training course provided me with important anti-terrorism information, accident control techniques, and methods of how to coordinate various responsible agencies during an accident. It should be useful for our jobs in SCDC.  

• Presentation: Microbial Cell Wall Agents and Pulmonary Disease ” (November 11, 2004)

  • Participants:  Scientists and Fogarty staff (SJ) 

  • Purpose: To gain a better understanding of microbial cell wall agents and their role in pulmonary disease. 

  • Summary: Dr. Rylander’s research focuses on cell immune reaction induced by acute or chronic inhalation of endotoxin and glucan (i.e., neutrophils, macrophage, IgG, etc.).  His studies showed that the increasing of amount of glucan in floor cause higher level of eosinophils and IgE in the blood.  Through his presentation, I learned that microbial cell wall agents (e.g., glucan and endotoxin) interfere with defense mechanisms which in turn results in infections, inflammation and sensitization reactions. Microbial cell wall agents are presented in many environments.  These may induce different cellular reactions and are related to specific diseases. Microbial cell wall agents (e.g., glucan and endotoxin) can be measured using risk assessment techniques. Standard methods (e.g., limulus assay) or alternative methods (gas chromatography, immunological methods, etc.) are used in the detection of glucan and endotoxin.  Dr. Rylander’s has determined “unofficial” guidelines for airway inflammation: endotoxin (10 ng/m3) and glucan (2-5 ng/m3).  For toxic pneumonitis: endotoxin (200 ng/m3) and for increase of IgE: glucan (25 ng/m3).

• Presentation: Stir It Up: Lessons in Community Organizing and Advocacy (November 10, 2004)

  • Participants:  Staffs from various governmental agencies.

  • Purpose: To learn about community organizing.

  • Summary: The author of “Stir It Up: Lessons in Community Organizing and Advocacy,” Rinku Sen addressed issues in community organizing. She discussed trends in community organizing (i.e., fundraising tips for advocacy groups, the changing nature of community organizing, building alliances, and effectively working with the media.)  Rinku Sen presented successful examples in community organizing and fund raising.  Participants discussed problems that they faced in their organizations.  They covered such topics as:  “what is the mission,” “how many constituencies” “where are the issues,” “which institution is included,” and “policies, various techniques, & direct action”.  From this presentation, I learned new ideas and concepts about “community organizing of environmental health issues.”

• Meeting: Toxicity to the Developing Brain: Recent Research and Mechanisms of Effect” (November 9, 2004)

  • Participants: Researchers from CAL-EPA, CDPH. & other governmental agencies

  • Purpose:  Highlighting research conducted in California on how early life exposures to chemicals may alter proper brain development

  • Summary:  The meeting featured 4 presentations:  “Soy Consumption, Manganese Toxicity, and Studies of Hyperactivity;” “Genetic Susceptibility to Neurotoxic Non-coplanar PCBs;” “The Influence of Environmental Factors on Critical Period Auditory Plasticity in Rats,” and “Organophosphate Toxicology: Secondary Nonacetylcholinesterase Targets”.  Their researches focus on brain impacts of early-life chemical exposures in human.  The results of the four presentations indicated that early-life exposure to manganese, non-coplanar PCBs, PCB95, organophosphate insecticides exposure may induce attention deficit hyperactivity disorders, autism, hearing loss and other long-term learning and perception deficits. The speakers mainly discussed the mechanisms of toxicity of environmental risks. Some environmental risks increases adverse health impacts because of inherent genetic susceptibility.  The 4 presentations indicated that low exposure of some chemicals can induce serious health outcomes.   We should take it into consideration how to minimize their adverse health impacts.

• Meeting: Pulling Together—A Workshop to Improve Interagency Collaboration at Hazardous Waste Sites (October 21, 2004)

  • Participants: Scientists, researchers and experts from various governmental agencies (e.g., U.S. EPA, ATSDR, CDPH, Local Public Health Agencies, CA EPA Department of toxic Substances Control, & the City Council )

  • Purpose:  To learn how to build Inter-Agency Collaboration at Hazardous Waste Sites

  • Summary:  Several topics were discussed in this meeting (i.e., “Dialogue: Improving Communication”; “Roles and Responsibilities”; “Agency Mission and Priorities”; and “Collaboration Interest and Collaborative Strategies”.  The presenter of “Dialogue: Improving Communication” stressed that “conversation” is significant because it will increase understanding, explore differences and create new ideas among collaborators. In the afternoon, participants stated their agency’s roles and responsibilities, missions and priorities to identify potential areas of interest.  Afterwards, they discussed potential areas of conflict.  The anticipants clearly defined why and how working together will improve their own effectiveness and contribute to the final outcome at the hazardous waste sites.  They also defined if they would be willing to contribute to ensure the success of the joint projects.  Finally, the collaborators clearly defined their tasks and deadlines.  I am very interested in this kind of collaborative style. I believe that it encourages experts in different fields to work together for a common goal. I feel that the information that I learned from this meeting will be useful for my work in the future.

• Meeting:  NOVEX Exercise at CSTI campus in San Luis Obispo, California.  (November 12, 2004 )

  • Participants:  Instructors, research scientists, officers, and coordinators came from CSTI, CDPH, FBI, CST, and local government employees.

  • Purpose:  For the Civilian Support Teams of the California National Guard to improve operational readiness and knowledge of local organization and operating procedures by participating in joint exercises and training.

  • Summary:  30 participants took part in this exercise.  A CSTI instructor gave us a scenario to work on. The participants were divided into three groups to discuss various types of organizational capabilities. I joined the public health group. We discussed: the response capacity of each organization/agency, the crucial issues that responders must consider, and the appropriate actions that must be taken. We list the items that we discussed in public health group, and then presented them to the entire group.  We had a question/answer session to discuss each group’s findings. The instructor also gave a presentation about ICS and Unified Command. The Incident Command System is used to manage both emergency and non-emergency incidents. It can be used for both small and large situation. Unified Command is a team effort process which allows all agencies to take responsibility for either geographical or functional incidents; and to establish a command set of incident objectives and strategies that all can subscribe to.  From the exercise, I learned about terrorism preparedness in USA.

• Meeting: Stir it up. (November 10, 2004)

  • Participants:   Staff from various governmental agencies.

  • Speaker:  Rinku Sent (author of Stir it Up, communications director of the Applied Research Center)

  • Purpose:  Discussing trends in community organizing, fundraising tips for advocacy groups, building alliances, & working effectively with the media.

  • Summary:  The author gave an overview of her book, Stir it Up.  Her presentation covered her work experience in community agencies for over ten years.  We discussed how to organize community groups and campaigns.  We covered various topics on how to maintain a successful long-term community campaign (e.g., organizing, implementing, gaining support and evaluating the end result). The experiences of the author and audience were very inspirational to me. 

• Meeting: Toxicity to the Developing Brain: Recent Research and Mechanisms of Effect. (November 9, 2004)

  • Participants: Scientists from universities and research laboratories & Fogarty Staff (SJ & LC)

  • Purpose:  To learn about recent researches being conducted in California on how early life exposures to chemicals alter proper brain development.

  • Summary:  The Genetic and Environment Toxicology Association (GETA) hosted this meeting. Distinguished speakers include Frank Crinella, Ph.D (UCI ), Tal Kenet, Ph.D (UCSF), Isaac N Pessah, Ph.D (UCB ), & Gary Quistad, Ph.D (UCB).  The speakers presented information about manganese, PCBs, and organophosphosphate pesticides.  They also discussed the toxicological mechanisms of various chemicals to help determine if exposure to chemicals early in life (e.g., infants) results in adverse health outcomes, such as, hearing loss, attention deficit hyperactivity disorders, autism or other long-term learning and perception deficits. 

  Meeting: Healthy City from an International Perspective.  (November 5, 2004)

  • Participants: Leonard J. Duhl (Professor of Public Health and Urban Policy), Fogarty Staff (RK, TK, SJ, & LC)

  • Purpose:  Discussion on how to design a healthy city program and the experiences of the other international healthy city programs.

  • Summary: During the meeting with Professor Duhl, we discussed various concepts and principle on how to design and implement a healthy city program in Shanghai. He also provided us several Healthy City examples in the other counties.

    Healthy city program shall adopt the WHO framework.  There is a worldwide healthy city network. Healthy city is still in the developmental phase, it is constantly changing. In order to become a healthy city, the city must meet the needs of the residents living in the city and/or community. There are many factors related to residents’ health and well-being.  What are the most important health issues to solve?  This is dependant on many factors, such as, citizen’s interest, scientific evidence and resource, etc.

• Workshop:  Pulling Together: Building Inter-Agency Collaboration at Hazardous Waste Site Workshop (December 29, 2004)

  • Participants: Scientists, officers and health educators of the National Association of County & City Health Official (NACCHO), U.S. Environmental Protection Agency (EPA), California Department of Public Health (CDPH), Agency for Toxic Substances and Disease Registry (ATSDR), State Health Agencies, State Environmental Agency and Local Public Health Agency.

  • Purpose:  To learn how to build effective and successful interagency relationships to deal with hazardous waste sites.

  • Summary: This workshop was organized by NACCHO.  All the participants introduced themselves (i.e., name, position, responsibilities, etc).   Then, we discussed 3 topics: roles and responsibilities, priorities, & collaborative strategies of various governmental agencies. Interagency teams discussed and defined their roles at specific sites and their priorities; they also talked about the difficulties and challenges in their workplaces. This was an important method to build effective working relationships and to improve interagency collaboration to deal with hazardous waste sites.  Afterwards, NACCHO summarized the day’s discussions and activities. This workshop was very educational for me.  I am interested improving my communication skills and problem solving abilities.  I realized the importance of good and effective communication skills.  Introducing oneself and listening to others are needed to bring people closer together. Participation and discussion are good ways to share opinion and information. It’s important to have a competent facilitator.  I now better understand how to solve complex interagency problems.   It is important to have a good understanding of an organization’s mission in order to determine their responsibilities and ultimate goals.