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Our World Transcript — 29 July 2006


This transcript is provided as a service; there may be some variation between it and the program as broadcast.

MUSIC: "Our World" theme

Straight ahead on "Our World" ... Considering the threats to business of a possible flu pandemic ... studying hurricane origins in Africa ... and doctor-patient communications in a nation of immigrants ...

ENRIQUEZ: "Sometimes that helps you understand what their real concerns are. But it's difficult to get into that detail if you don't speak the language."

Those stories, we take to the oceans with our Website of the Week, and more. I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."

Drugmaker GlaxoSmithKline said Wednesday its experimental avian flu vaccine produced the highest immune response yet in tests on humans, and did so using a very small amount of the vaccine.

The tiny dosage — less than four micrograms — is good news, since the less needed per person, the easier it will be to manufacture enough of the vaccine.

The company's results have not yet been peer-reviewed by outside scientists or government regulators. In any event, it is not at all clear that this vaccine, or any of the others based on the current version of the avian flu virus, will be useful in a pandemic.

The current virus, called H5N1, does not spread easily from person to person. Experts fear that if the virus mutates to a form that can spread among people, then a pandemic is possible. But there is no way to know how effective a vaccine developed now would be against an unknown mutation.

Meanwhile, in Washington this week, government officials briefed business leaders on preparation for the possibility of a flu pandemic. There were pandemics three times in the past century — the most serious in 1918, when tens of millions of people died worldwide.

White House official Rajeev Venkayya says there is reason to worry.

VENKAYYA: "We have no way to know whether this virus — which has thus far killed about 130 individuals [and] infected to our knowledge about 230 individuals worldwide — will ever become a pandemic virus. We think a lot about this because if you look at those last three pandemics and the characteristics of those viruses, you could find snippets of genetic material from bird viruses in each one of them."

Venkayya spoke at the U.S. Chamber of Commerce. The head of the chamber's Homeland Security Division, Anne Beauchesne, summarized the concerns felt by many businesses.

BEAUCHESNE: "Few industries will be insulated from the economic effects resulting from absenteeism in the workplace, or from the downstream effects stemming from supply chain and travel disruption. Business leaders have every reason to ask: so, how real is the threat? Should we be paying more attention to it? What steps should we take to prepare?"

Planning is seen as vital since studies estimate that 40 percent of American workers will stay home in the event of a pandemic — sick themselves, caring for ill family members, or just afraid to go out.

Lynn Slepski, a public health nurse at the U.S. Department of Homeland Security, said there are a variety of ways businesses can try to safeguard their workforce. Some are practically free and will pay off even if there is no pandemic emergency.

SLEPSKI: "Do you know that there was a hand-washing study done with U.S. Navy recruits? The base commander told them, thou shalt wash your hands five times a day. Do you know what it did to their rate of disease that year, the number of colds that they had? It dropped it by 45 percent. Just asking people to wash their hands."

Other steps involve reducing exposure to potentially infectious individuals. "Social distancing" is what public health experts call it. Hold conference calls instead of face-to-face meetings. Work from home if possible.

It might seem that the ultimate extension of social distancing would be halting international travel and closing a country's borders. But Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, dismissed that as a "very draconian" idea.

FAUCI: "It does work somewhat — and I wouldn't say close the border; I would say things like quarantine — if you have a relatively inefficient virus in its spread, and you start quarantining when it's very limited in its spread. Once it explodes, the horse is out of the barn."

Experts point out that even with the ordinary seasonal flu, an infected person might not show symptoms, yet still be able to spread the disease, which further complicates prevention efforts.

If you think your risk of skin cancer depends on your skin color, you may be right. But as we hear from health reporter Rose Hoban, the link may not be what you expect.

HOBAN: Research from the University of Cincinnati indicates people of color die from skin cancers more frequently than whites. Dr. Hugh Gloster reviewed data collected for the past 50 years from medical centers around the world. He found that some features of different skin cancers, such as melanoma, are unique to dark-skinned people.

GLOSTER: Melanomas in people of color almost always arise on the sole of the foot. Other unusual areas would be under the nails, on the palms, and also in the mouth.

HOBAN: In general, skin cancers occur less frequently in Blacks, Hispanics and Asians, but when they do occur, they are more often fatal than they are for whites. Gloster says many dark-skinned people mistakenly believe their skin color protects them from the sun and therefore from skin cancer.

GLOSTER: What can fool you is the skin cancers, at least two of the three most common types, two of them appear to not really be sun-related, and the reason we know that is that they occur in non-sun-exposed sites, primarily.

HOBAN: He says because of those erroneous beliefs, people of color don't immediately seek out medical attention when they notice changes on their skin. Gloster says this contributes to the high death rate for blacks from skin cancer.

GLOSTER: We need to maintain a high index of suspicion for skin cancer in skin of color. Encourage patients to seek regular full skin exams and also examine themselves, paying particular attention to those areas that we commonly don't consider skin cancers would occur, such as palms, soles, fingers, toes, under the nails and mucosal surfaces like in the mouth and genitalia.

HOBAN: Gloster says everyone should follow-up with a doctor if they notice any changes on their skin. I'm Rose Hoban.

It's getting to be hurricane season again in the tropical Atlantic Ocean, and and storms that batter the United States, the Caribbean, and Central America generally originate off the coast of West Africa. Scientists this week announced a new study aimed at better understanding the storms, not only to improve forecasts but also to reduce the destruction hurricanes usually inflict. VOA's David McAlary reports.

McALARY: The U.S. agency responsible for ocean and atmosphere matters, NOAA, says thunderstorms off West Africa account for 60 percent of all hurricanes in the tropical Atlantic and 85 percent of the biggest ones.

But that does not mean that most of these so-called African atmospheric waves intensify to hurricanes. There are 60–70 of these distrubances each year, but only about half a dozen begin spinning enough to blossom into tropical cyclones.

Scientists like Jeffrey Halverson of the University of Maryland want to know why more do not.

HALVERSON: "About 10 percent of these waves change their character from being long traveling lines of thunderstorms. They begin acquiring some rotation. That's the big mystery — why so very few of those waves actually start picking up some spin. We don't really know where that spin comes from. That's part of the big question we're out to answer as they come off Africa."

McALARY: The hurricane research director at NOAA, Jason Dunion, says two factors seem to suppress cyclone development — cold sea surface temperatures off West Africa and dry air and dust blowing from the Sahara Desert. But Dunion says if a storm survives to reach warmer waters and it begins spinning, it can merge with other such vortices into a larger one, a prerequisite for a twisting, churning hurricane.

DUNION: "How do those come together? There certainly are some things we know, but there are a lot of mysteries out there. Some of it is because we just haven't observed it all that much."

McALARY: That will change with the research mission Dunion's agency is jointly operating during August with the U.S. space agency NASA and academics like Halverson. From their base on Cape Verde islands off West Africa, they will take moisture, temperature, wind speed and other readings about storms from several U.S. satellites, an aircraft that flies through storms, weather balloons, and ground stations.

Dunion says the ability to track the path of emerging hurricanes has improved greatly in recent years, but the science of monitoring their growth and intensity is lagging far behind.

Jeff Halverson says this is a vital need.

HALVERSON: "Better understanding the physics that generate these storms will extend the time of skillful forecasts, and thus save lives and property."

McALARY: The U.S. hurricane researchers will share data with European and African scientists working to understand the influence of the West African monsoon on regional and global weather. David McAlary, VOA News, Washington.

The science at the center of the debate over climate change came under scrutiny this week by members of the U.S. House of Representatives' Committee on Energy and Commerce. Now, there is widespread agreement within the scientific community that global temperatures are increasing, but skeptics — including some in the Bush administration — continue to question whether a major cause of this increase is human activity — specifically, our burning of fossil fuels that give off carbon dioxide.

Using a variety of historic measures, climate scientist Michael Mann of Penn State University analysized historic and modern temperature records and, starting in the late 1990s, published a series of charts showing temperatures remaining relatively steady for centuries, then getting sharply warmer starting in the 20th century. The charts resemble a hockey stick — long and flat, then angling sharply upwards.

Some skeptics have challenged the underlying assumptions and mathematical models behind the chart. But on Capitol Hill Thursday, Mann said his initial findings have been confirmed.

MANN: "Criticism on our work in the late 1990s has been on the statistical conventions we used. My co-authors and I have not used those conventions in our later work. The critique goes only to our first reconstruction effort and does not apply to our more recent studies, all of which indicate the same basic hockey stick result."

Moments later, one of Mann's sharpest critics, Edward Wegman of George Mason University near Washington, cited what he considered flaws in Mann's methodology.

WEGMAN: "I am baffled by the claim that that incorrect method doesn't matter because the answer is correct anyway. The 'method wrong' plus 'answer correct' is just bad science."

The dispute over methods is a legitimate subject of scientific debate. But the president of the National Academy of Sciences, Ralph Cicerone, focused not on what is in dispute, but rather on what is known.

CICERONE: "There is no doubt that the Earth is warming, and this continuing warming has been accompanied by worldwide changes in many other indicators, such as decreases in arctic sea ice and shifts in ecosystems."

Althought Cicerone's comments did not specifically address the causes of global warming, he pointed out that the mathematical models that were developed to analyze and predict climate change accurately show the warming of the past century only if human-caused greenhouse gases are factored in.

Time again for our Website of the Week, when we showcase interesting and innovative online destinations.

This time, it's a website for people who are interested in weather, need to follow an oceangoing freight shipment, or just want to travel vicariously.

MUELLER: "Ship tracker is a map view of thousands of weather reports that are submitted by ships around the world, by cruising yachts and by automated buoys. It allows anybody to see where a ship is, what the weather is around them, what ships are nearby, and get a feel for what they're doing."

Hal Mueller is the creator of Sailwx.info (pronounced Sailweather-dot-info), including the ship tracker and other features.

The information that appears on the site comes from voluntary reports submitted by ocean-going vessels via the World Meteorological Organization. Typically 500–1,000 ships are reporting at any given time. That is, Mueller says, just a small percentage of the ships at sea, but looking at the world map on his website, it seems full of red dots, each representing a report from the world's oceans.

You can search by location or by vessel, or just click on a particular ship and get a map showing its recent positions.

The site gets 15– to 20,000 visitors a day, and Hal Mueller says they represent a wide variety of users.

MUELLER: "There are a lot of oceanographers and vessel operators who I see coming to the site. You also see people tracking their relatives on cruise ships. And I've also seen a lot of people obviously tracking freight containers across the ocean."

The site also has a variety of weather features, including detailed information on severe storms. Ever since the first mariners set sail, weather has been an important part of life at sea, and even in the satellite age, the weather information reported by oceangoing ships remains a vital part of the global forecasting process.

MUELLER: "When you predict what you're really doing is running a computer simulation. But you still need to have a ship or a human observer of some sort down on the ground, measuring the humidity, measuring the wind speed so that you can calibrate these images, calibrate your models, compare what the model is predicting with what's actually happening."

Hal Mueller's site features ship tracking, ocean weather and more at Sailweather-dot-info -- that's sail, w-x for weather, dot-info, or get the link from our site, VOA News.com/ourworld.

MUSIC: Ween: "Ocean Man"

And you're listening to VOA's science and technology magazine, Our World. I'm Art Chimes in Washington.

More and more medical centers around the world are using a new, non-invasive procedure to detect heart disease, even in people who have no obvious symptoms. VOA's Rosanne Skirble has more on this rapidly evolving technology.

SKIRBLE: Many people who have heart disease don't know it. They show no signs or symptoms. However, over time, the buildup of fat and other body chemicals clogs the arteries that feed the heart and increases the risk of a heart attack. So doctors, like cardiologist Samir Kapadia, take an inside look to assess the situation:

KAPADIA: "We typically do angiography, meaning we put catheters into the arteries and then inject dye to see if we can see different parts of the artery wall."

SKIRBLE: But angiography is a costly, invasive procedure. An alternative - for some patients - is the cardiac CT-scan, which won approval from the U.S. Food and Drug Administration in 2004. Dr. Mario Garcia from the Cleveland Clinic Foundation and colleagues at eleven medical centers around the world studied the performance of these so-called 16-detector scanners.

SKIRBLE: Researchers compared CT-scans and invasive angiograms for almost 200 patients. The findings, published [July 26] in the Journal of the American Medical Association, are not an overwhelming endorsement.

GARCIA: "If you have a positive result on a cardiac CT, the diagnosis could be in doubt, but if the result is negative, you virtually exclude the possibility of having a blockage."

SKIRBLE: In other words, if the CT scan says you don't have a blockage, believe it. Dr. Garcia says if the scan indicates you do, it might not be right.

GARCIA: "The results of our study would suggest that the use of 16-detector scanners should be used with caution or be very restricted because it could lead to false-positive interpretations."

SKIRBLE: But the technology is evolving rapidly. Many centers are now investing in the more accurate 64-detector scanner.

Dr. Garcia says that the first generation, 16-detector machine is still a useful tool for people at low risk because it can correctly rule out blocked arteries. He says high-risk patients are better off having the invasive procedure. I'm Rosanne Skirble.

A health study released this month says many immigrants to the United States may be getting inadequate medical care, because of language barriers between patients and medical professionals. But as Chuck Quirmbach reports, some health facilities are working to add more multilingual staff and to reduce the chances of potentially dangerous medical errors caused by miscommunication.

QUIRMBACH: More than 22 million people who live in the United States don't speak or understand English very well. And that can be deadly. In a study published in the New England Journal of Medicine, Doctor Glenn Flores highlights some cases where language barriers prevent patients from communicating with health care providers — with serious consequences. In one instance, for example, English-speaking paramedics thought a Spanish-speaking man was suffering from a drug overdose.

FLORES: "They finally did a head CT scan and realized he had had a major bleed into his brain, probably originating from rupture of an artery in his brain. He ended being quadriplegic, and he got a $71 million settlement award from the hospital."

QUIRMBACH: Flores, a professor at the Medical College of Wisconsin, says that despite examples like that, the majority of U.S. health care facilities still do not have trained interpreters on site. But he acknowledges that increasing numbers of health care workers are bilingual, and that more clinics and hospitals do make sure their staff and patients understand each other.

Latino families gather in the waiting room at the Sixteenth Street Community Health Center in Milwaukee, Wisconsin. Forty percent, or about 7,000 of the patients who came into the clinic last year spoke little or no English. Fortunately for them, of the 30 doctors and nurses at the clinic, 28 also speak Spanish.

QUIRMBACH: One of them is Guatemalan-born pediatrician Francisco Enriquez.

After greeting several members of the Casillas family, Enriquez examines their young daughter Gabriella.

Dr. Enriquez says being able to speak to Mrs. Casillas in her native Spanish meant he could discuss Gabriella's condition and the treatment in much greater depth.

ENRIQUEZ: "Sometimes that helps you understand what their real concerns are. But it's difficult to get into that detail if you don't speak the language."

QUIRMBACH: The Sixteenth Street Clinic is expanding. So its directors are in the process of hiring more staff who are bilingual now, or who commit to learning Spanish. Clinic vice-president, Doctor Julie Schuller, says new hires are told that by speaking to patients in their own language they can provide the highest quality care.

SCHULLER: "By providing high quality care, we are avoiding errors, we are avoiding malpractice suits. The main focus for us is the high quality."

QUIRMBACH: Schuller says it's frustrating to go into medical facilities and see patients who are not being understood. So she urges other hospitals and clinics to look into adding interpreters to their staff, or at least to make use of translator hotlines that can be called day or night.

But Dana Richardson of the Wisconsin Hospital Association says many facilities are worried about the additional cost.

RICHARDSON: "What we have seen in the state of Wisconsin overall is an increasing number of minority-ethnic groups coming in, and so it's becoming a greater cost for the health community to provide these services."

QUIRMBACH: She says while hospitals recognize the value of having a multi-lingual flexibility, most simply cannot afford it.

The author of the language barrier study, Glenn Flores, suggests that U.S. medical schools could require their students to take medical Spanish, Chinese or other appropriate language. But for now, the number of immigrants is outpacing the health care industry's ability to provide adequate care in a language they can understand. For Our World, I'm Chuck Quirmbach in Milwaukee, Wisconsin.


MUSIC: "Our World" theme

That's our show for this week. If you want to get in touch, email us at ourworld@voanews.com. Or use our postal address -

Our World
Voice of America
Washington, DC 20237 USA.

Rob Sivak is our editor. Eva Nenicka is our technical director. And this is Art Chimes, inviting you to join us online at voanews.com/ourworld or on your radio next Saturday and Sunday as we check out the latest in science and technology...in Our World.

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