Early Warning System
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2022 ◽  
Vol 22 (1) ◽  
Davina Allen ◽  
Amy Lloyd ◽  
Dawn Edwards ◽  
Kerenza Hood ◽  
Chao Huang ◽  

Abstract Background Paediatric mortality rates in the United Kingdom are amongst the highest in Europe. Clinically missed deterioration is a contributory factor. Evidence to support any single intervention to address this problem is limited, but a cumulative body of research highlights the need for a systems approach. Methods An evidence-based, theoretically informed, paediatric early warning system improvement programme (PUMA Programme) was developed and implemented in two general hospitals (no onsite Paediatric Intensive Care Unit) and two tertiary hospitals (with onsite Paediatric Intensive Care Unit) in the United Kingdom. Designed to harness local expertise to implement contextually appropriate improvement initiatives, the PUMA Programme includes a propositional model of a paediatric early warning system, system assessment tools, guidance to support improvement initiatives and structured facilitation and support. Each hospital was evaluated using interrupted time series and qualitative case studies. The primary quantitative outcome was a composite metric (adverse events), representing the number of children monthly that experienced one of the following: mortality, cardiac arrest, respiratory arrest, unplanned admission to Paediatric Intensive Care Unit, or unplanned admission to Higher Dependency Unit. System changes were assessed qualitatively through observations of clinical practice and interviews with staff and parents. A qualitative evaluation of implementation processes was undertaken. Results All sites assessed their paediatric early warning systems and identified areas for improvement. All made contextually appropriate system changes, despite implementation challenges. There was a decline in the adverse event rate trend in three sites; in one site where system wide changes were organisationally supported, the decline was significant (ß = -0.09 (95% CI: − 0.15, − 0.05); p = < 0.001). Changes in trends coincided with implementation of site-specific changes. Conclusions System level change to improve paediatric early warning systems can bring about positive impacts on clinical outcomes, but in paediatric practice, where the patient population is smaller and clinical outcomes event rates are low, alternative outcome measures are required to support research and quality improvement beyond large specialist centres, and methodological work on rare events is indicated. With investment in the development of alternative outcome measures and methodologies, programmes like PUMA could improve mortality and morbidity in paediatrics and other patient populations.

2022 ◽  
Vol 53 (1) ◽  
pp. 28-33
Yvonne Goellner ◽  
Eydie Tipton ◽  
Tammie Verzino ◽  
Laura Weigand

2022 ◽  
pp. 100878
Hui An ◽  
Hao Wang ◽  
Sarath Delpachitra ◽  
Simon Cottrell ◽  
Xiao Yu

2022 ◽  
pp. 104081
Luis Germano Biolchi ◽  
Silvia Unguendoli ◽  
Lidia Bressan ◽  
Beatrice Maria Sole Giambastiani ◽  
Andrea Valentini

2021 ◽  
Vol 4 ◽  
pp. 154-166
Iswanto Suwarno ◽  
Alfian Ma’arif ◽  
Nia Maharani Raharja ◽  
Adhianty Nurjanah ◽  
Jazaul Ikhsan ◽  

A lava flood disaster is a volcanic hazard that often occurs when heavy rains are happening at the top of a volcano. This flood carries volcanic material from upstream to downstream of the river, affecting populous areas located quite far from the volcano peak. Therefore, an advanced early warning system of cold lava floods is inarguably vital. This paper aims to present a reliable, remote, Early Warning System (EWS) specifically designed for lava flood detection, along with its disaster communication system. The proposed system consists of two main subsystems: lava flood detection and disaster communication systems. It utilizes a modified automatic rain gauge; a novel configured vibration sensor; Fuzzy Tree Decision algorithm; ESP microcontrollers that support IoT, and disaster communication tools (WhatsApp, SMS, radio communication). According to the experiment results, the prototype of rainfall detection using the tipping bucket rain gauge sensor can measure heavy and moderate rainfall intensities with 81.5% accuracy. Meanwhile, the prototype of earthquake vibration detection using a geophone sensor can remove noise from car vibrations with a Kalman filter and measure vibrations in high and medium intensity with an accuracy of 89.5%. Measurements from sensors are sent to the webserver. The disaster mitigation team uses data from the webserver to evacuate residents using the disaster communication method. The proposed system was successfully implemented in Mount Merapi, Indonesia, coordinated with the local Disaster Deduction Risk (DDR) forum. Doi: 10.28991/esj-2021-SP1-011 Full Text: PDF

2021 ◽  
Vol 50 (1) ◽  
pp. 607-607
Dereddi Raja Reddy ◽  
Joshua Botdorf ◽  
John Crommett ◽  
John Cuenca ◽  
Imrana Malik ◽  

2021 ◽  
Tianhua Tang ◽  
Shan Nan ◽  
Ling Lin ◽  
Xinhao Jin ◽  
Weichao Liao ◽  

2021 ◽  
Vol 13 (24) ◽  
pp. 4977
Shuangshuang Wu ◽  
Xinli Hu ◽  
Wenbo Zheng ◽  
Matteo Berti ◽  
Zhitian Qiao ◽  

The triggering threshold is one of the most important parameters for landslide early warning systems (EWSs) at the slope scale. In the present work, a velocity threshold is recommended for an early warning system of the Gapa landslide in Southwest China, which was reactivated by the impoundment of a large reservoir behind Jinping’s first dam. Based on GNSS monitoring data over the last five years, the velocity threshold is defined by a novel method, which is implemented by the forward and reverse double moving average of time series. As the landslide deformation is strongly related to the fluctuations in reservoir water levels, a crucial water level is also defined to reduce false warnings from the velocity threshold alone. In recognition of the importance of geological evolution, the evolution process of the Gapa landslide from topping to sliding is described in this study to help to understand its behavior and predict its potential trends. Moreover, based on the improved Saito’s three-stage deformation model, the warning level is set as “attention level”, because the current deformation stage of the landslide is considered to be between the initial and constant stages. At present, the early warning system mainly consists of six surface displacement monitoring sites and one water level observation site. If the daily recorded velocity in each monitoring site exceeds 4 mm/d and, meanwhile, the water level is below 1820 m above sea level (asl), a warning of likely landslide deformation accelerations will be released by relevant monitoring sites. The thresholds are always discretely exceeded on about 3% of annual monitoring days, and they are most frequently exceeded in June (especially in mid-June). The thresholds provide an efficient and effective way for judging accelerations of this landslide and are verified by the current application. The work presented provides critical insights into the development of early warning systems for reservoir-induced large-scale landslides.

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