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At least 37 records · Page 2Linked to original sources

PubMed2005

An online operational rainfall-monitoring resource for epidemic malaria early warning systems in Africa.

Periodic epidemics of malaria are a major public health problem for many sub-Saharan African countries. Populations in epidemic prone areas have a poorly developed immunity to malaria and the disease remains life threatening to all age groups. The impact of epidemics could be minimized by prediction and improved prevention through timely vector control and deployment of appropriate drugs. Malaria Early Warning Systems are advocated as a means of improving the opportunity for preparedness and timely response. Rainfall is one of the major factors triggering epidemics in warm semi-arid and desert-fringe areas. Explosive epidemics often occur in these regions after excessive rains and, where these follow periods of drought and poor food security, can be especially severe. Consequently, rainfall monitoring forms one of the essential elements for the development of integrated Malaria Early Warning Systems for sub-Saharan Africa, as outlined by the World Health Organization. The Roll Back Malaria Technical Resource Network on Prevention and Control of Epidemics recommended that a simple indicator of changes in epidemic risk in regions of marginal transmission, consisting primarily of rainfall anomaly maps, could provide immediate benefit to early warning efforts. In response to these recommendations, the Famine Early Warning Systems Network produced maps that combine information about dekadal rainfall anomalies, and epidemic malaria risk, available via their Africa Data Dissemination Service. These maps were later made available in a format that is directly compatible with HealthMapper, the mapping and surveillance software developed by the WHO's Communicable Disease Surveillance and Response Department. A new monitoring interface has recently been developed at the International Research Institute for Climate Prediction (IRI) that enables the user to gain a more contextual perspective of the current rainfall estimates by comparing them to previous seasons and climatological averages. These resources are available at no cost to the user and are updated on a routine basis.

Africa↗

PubMedDate not supplied

Prediction of in-hospital mortality and length of stay using an early warning scoring system: clinical audit.

This aim of this study was to assess the impact of the introduction of a standardised early warning scoring system (SEWS) on physiological observations and patient outcomes in unselected acute admissions at point of entry to care. A sequential clinical audit was performed on 848 patients admitted to a combined medical and surgical assessment unit during two separate 11-day periods. Physiological parameters (respiratory rate, oxygen saturation, temperature, blood pressure, heart rate, and conscious level), in-hospital mortality, length of stay, transfer to critical care and staff satisfaction were documented. Documentation of these physiological parameters improved (P<0.001-0.005) with the exception of oxygen saturation (P=0.069). The admission early warning score correlated both with in-hospital mortality (P<0.001) and length of stay (P=0.001). Following the introduction of the scoring system, inpatient mortality decreased (P=0.046). Staff responding to a questionnaire indicated that the scoring system increased awareness of illness severity (80%) and prompted earlier interventions (60%). A standardised early warning scoring system improves documentation of physiological parameters, correlates with in-hospital mortality, and helps predict length of stay.

Adult↗

PubMed2006

Global early warning systems for natural hazards: systematic and people-centred.

To be effective, early warning systems for natural hazards need to have not only a sound scientific and technical basis, but also a strong focus on the people exposed to risk, and with a systems approach that incorporates all of the relevant factors in that risk, whether arising from the natural hazards or social vulnerabilities, and from short-term or long-term processes. Disasters are increasing in number and severity and international institutional frameworks to reduce disasters are being strengthened under United Nations oversight. Since the Indian Ocean tsunami of 26 December 2004, there has been a surge of interest in developing early warning systems to cater to the needs of all countries and all hazards.

Disaster Planning↗

PubMedDate not supplied

Introducing an early warning scoring system in a district general hospital.

One of the critical care outreach service's aims in this local hospital was to develop an assessment tool to help identify patients in danger of deterioration. This paper describes the introduction of an early warning scoring system between April 2001 and March 2002 to the surgical unit of a district general hospital. The informal and gradual approach used to optimize the effectiveness of introducing the early warning scoring system is highlighted. Explanations are given of the training processes undertaken, the pilot evaluation and lessons learned from the process. Using the experiences of the outreach service in introducing the early warning scoring system, this paper aims to provide thought for others considering a similar initiative in their area

APACHE↗

PubMed2006

Early warning of Ross River virus epidemics: combining surveillance data on climate and mosquitoes.

BACKGROUND: Ross River virus disease is spread by mosquitoes, and an average of 5000 people are infected each year in Australia. It is one of the few infectious diseases for which climate-based early warning systems could be developed. The aim of this study was to test whether supplementing routinely collected climate data with mosquito surveillance data could increase the accuracy of disease prediction models. METHODS: We focused on a temperate region of Western Australia between July 1991 and June 1999. We developed "early" and "later" warning logistic regression models to test the sensitivity of data on climate (tide height, rainfall, sea surface temperature) and mosquito counts for predicting epidemics of disease. RESULTS: Climate data on their own were moderately sensitive (64%) for predicting epidemics during the early warning period. Addition of mosquito surveillance data increased the sensitivity of the early warning model to 90%. The later warning model had a sensitivity of 85%. CONCLUSIONS: We found that climate data are inexpensive and easy to collect and allow the prediction of Ross River virus disease epidemics within the time necessary to improve the effectiveness of public health responses. Mosquito surveillance data provide a more expensive early warning but add substantial predictive value.

Alphavirus Infections↗

PubMed2004

Outcome value and early warning indications as determinants of willingness to learn from experience.

In this study of willingness to learn from experience, it was hypothesized that managers would show a negative outcomes bias, that is, a stronger tendency to initiate "learning-from-experience" processes after negative outcomes than after positive outcomes. Another aim of the study was to explore the impact of the existence of early warning signals about decision outcomes on the magnitude of the negative outcome bias. Eighty-three managers were asked to read vignettes describing a managerial decision and its outcomes. The outcomes were either positive or negative, and in half of the cases early warning signals existed that made it possible to predict potential negative outcomes while in the other half there were no such signals. The managers were asked to evaluate the need for a learning-from-experience process in general and to rate the degree to which several specific learning processes should be instituted in each of the scenarios. As hypothesized, a negative-outcome bias was found. The more negative the outcomes described, the stronger the managers' inclination to recommend a more intensive learning process. Similarly, a need to ensure control and follow-up procedures was reported mostly after negative outcomes. The existence of early warning signals before the decision was taken did not influence the motivation to learn. Theoretical implications regarding the impact of negative outcomes in general and implications for understanding learning from experience processes in particular are discussed.

Affect↗

PubMed2005

A physiologically-based early warning score for ward patients: the association between score and outcome.

We analysed the physiological values and early warning score obtained from 1047 ward patients assessed by an intensive care outreach service. Patients were either referred directly from the wards (n = 245, 23.4%) or were routine critical care follow-ups. Decisions were made to admit 135 patients (12.9%) to a critical care area and limit treatment in another 78 (7.4%). An increasing number of physiological abnormalities was associated with higher hospital mortality (p < 0.0001) ranging from 4.0% with no abnormalities to 51.9% with five or more. An increasing early warning score was associated with more intervention (p < 0.0001) and higher hospital mortality (p < 0.0001). For patients with scores above one (n = 660), decisions to admit to a critical care area or limit treatment were taken in 200 (30.3%). Scores of all physiological variables except temperature contributed to the need for intervention and all variables except temperature and heart rate were associated with hospital mortality.

Adult↗

PubMed2004

Enterobacterial responses to external protons, including responses that involve early warning against stress and the functioning of extracellular pheromones, alarmones and varisensors.

Several striking findings, related to biological effects of external acidity, are reviewed here. The first of these relates to the role of PhoE in the penetration of H+ and protonated metabolites into the cell. PhoE is an anion pore and would not be expected to take up protons. The work reviewed here, however, shows that the loss or repression of PhoE leads to poor H+ passage through the outer membrane (OM), whilst derepression of PhoE leads to facilitated passage. It is now believed that H+ crosses through the PhoE pore in association possibly with oligopeptides, and that other protonated molecules, such as the acid tolerance EIC, use the same means to cross the OM. Additionally, several processes that form early warning systems against acidity are reviewed here. First, the properties of the acid tolerance EIC alarmones allow them to diffuse to regions not yet facing acid stress, and there give early warning and induce sensitive organisms to tolerance. Second, some agents, such as glucose, induce acid tolerance in organisms, long before these organisms are exposed to catabolically-produced acidity, preparing them, in advance, to resist this impending acid challenge. Third, the occurrence of multiple forms of ESCs (i.e. of varisensors) ensures that where organisms have been grown under conditions that sensitise them to acid stress, the ESCs formed are modified so as to be activated at much higher pH values, ensuring that lethality by acid is reduced or abolished. Fourthly, normally only EICs induce tolerance. Strikingly, however, pH 8.5 or 9.0-grown cells are induced to tolerance by ESC formed at pH 6.5. This is believed to provide another early warning system, protecting alkali-grown cells against sudden acidification of media. Two other finding reviewed here should be emphasised. First, the hydrophobic antibiotic novobiocin is ineffective against enterobacteria, due to its failure to penetrate the OM barrier. This only applies to cultures in pH 7.0 media, however, cells growing at pH 5.0 being exquisitely sensitive to novobiocin, due to a conformational change to the antibiotic at acidic pH, which allows ready penetration through the OM. Second, acidic pHs affect the synthesis and effects of another antibiotic, namely colicin V. Thus pH 5.0 prevents both synthesis of this agent and its effects on sensitive cells. Exposure to external acidity leads to numerous other effects, including those that influence growth, cell division, plasmid transfer and chemotaxis; these have also been reviewed here.

Bacterial Physiological Phenomena↗

PubMed2003

[Infection surveillance in North Rhine-Westphalia--standard reports, barometer and early warning system].

The increasing significance of communicable diseases requires new surveillance tools. Modern electronic instruments in analysis and communication replace the former "handbased" statistics and allow the development of early warning systems. In North Rhine-Westphalia (NRW) the Institute of Public Health started an approach to develop a modular surveillance system prior to the the implementation of the new German infectious disease protection act. The first module called "Automated infectious disease notifications and information system (AIM+)" generates various standard hypertext reports which are published as "Infectious disease reports NRW" on the internet (www.loegd.nrw.de). In addition the infectious disease information is linked with a geographical information system (GIS) giving spatial and temporal patterns. The second module called "Infectious disease barometer NRW" offers a quick actual overview highlighting several selected diseases. It can be electronically sent out to any interested person. The third module "Early warning system" realizes an effective early detection system by combining six statistical procedures with a total of 11 separate methods. In case of detecting clusters and outbreaks it automatically generates warning reports to the responsible parties. All three modules together improve the epidemiological surveillance of the population in NRW, support the translation of information to prevention and control measures, and therefore strengthen epidemiological policy-making.

Communicable Disease Control↗

PubMed2006

Late lessons from early warnings: Toward realism and precaution with endocrine-disrupting substances.

The histories of selected public and environmental hazards, from the first scientifically based early warnings about potential harm to the subsequent precautionary and preventive measures, have been reviewed by the European Environment Agency. This article relates the "late lessons" from these early warnings to the current debates on the application of the precautionary principle to the hazards posed by endocrine-disrupting substances (EDSs). Here, I summarize some of the definitional and interpretative issues that arise. These issues include the contingent nature of knowledge; the definitions of precaution, prevention, risk, uncertainty, and ignorance; the use of differential levels of proof; and the nature and main direction of the methodological and cultural biases within the environmental health sciences. It is argued that scientific methods need to reflect better the realities of multicausality, mixtures, timing of dose, and system dynamics, which characterize the exposures and impacts of EDSs. This improved science could provide a more robust basis for the wider and wise use of the precautionary principle in the assessment and management of the threats posed by EDSs. The evaluation of such scientific evidence requires assessments that also account for multicausal reality. Two of the often used, and sometimes misused, Bradford Hill "criteria," consistency and temporality, are critically reviewed in light of multicausality, thereby illustrating the need to review all of the criteria in light of 40 years of progress in science and policymaking.

Animals↗

PubMed2006

Web services based syndromic surveillance for early warning within French Forces.

OBJECTIVES: Syndromic surveillance for early warning in military context needs a robust, scalable, flexible, ubiquitous, and interoperable surveillance system. METHODS: We have designed our surveillance system as a collaborative network of web services on the basis of a skill oriented decomposition of the overall task and a formal model of epidemiological events. RESULTS: The services (integration devices, epidemiologic receivers, information processing devices, GUI clients) are distributed in several locations in France and French Guiana using a secured network. CONCLUSIONS: This system is in operation since several months. It has already early detected two outbreaks before conventional surveillance systems.

Biological Warfare↗

PubMed2005

Early warning signs of relapse following a first episode of psychosis.

Research in schizophrenia has provided empirical support for the use of self-report inventories for early warning signs of relapse, but to date no published studies have reported on the predictive validity of self-reported early warning signs of relapse in a first-episode cohort. Sixty patients, who had remitted following their first episode of psychosis, participated in a 9-12 month prospective follow-up study. Outcome data on putative prodromal symptoms was available on 46 participants. The Early Signs Scale (ESS) achieved adequate sensitivity but poor specificity and positive predictive validity (PPV) in predicting relapse or symptom exacerbations, although a post hoc increase in the established cut-off significantly improved the outcome. The findings provide qualified support for the use of the ESS in relapse prevention with first-episode patients who are in remission. Further prospective studies with larger numbers of first-episode patients will enable sample sizes enable the comparison of the effectiveness of several prodromal scales using ROC analysis, or a combination of risk factors using regression models.

Adolescent↗

PubMedDate not supplied

Early warning scores predict outcome in acute pancreatitis.

The Early Warning Score (EWS) is a widely used general scoring system to monitor patient progress with a varying score of 0-20 in critically unwell patients. This study evaluated the EWS system compared with other established scoring systems in patients with acute pancreatitis. EWS scores were compared with APACHE scores, Imrie scores, computed tomography grading scores, and Ranson criteria for 110 admissions with acute pancreatitis. A favorable outcome was considered to be survival without intensive therapy unit admission or surgery. Nonsurvivors, necrosectomy, and critical care admission were considered adverse outcomes. EWS was the best predictor of adverse outcome in the first 24 hours of admission (receiver operating curve, 0.768). The most accurate predictor of mortality overall was EWS on day 3 of admission (receiver operating curve, 0.920). EWS correlated with duration of intensive therapy unit stay and number of ventilated days (P < 0.05) and selected those who went on to develop pancreas-specific complications such as pseudocyst or ascites. EWS of 3 or above is an indicator of adverse outcome in patients with acute pancreatitis. EWS can accurately and reliably select both patients with severe acute pancreatitis and those at risk of local complications.

Acute Disease↗

PubMed2004

New developments in sensor technology for water quality surveillance and early warning.

Sensor technologies offer particular advantages for surveillance, early warning and process control. This work aimed to provide information about practical new sensing devices that can be used for rapid field assessment of water pollution. A questionnaire completed in 2002 gathered information and data for a catalogue of sensors and instruments that can potentially be applied to soils, sediments, surface and groundwater. Demonstrations of practical sensing technologies took place at a former metal mining site near to Sevilla in 2002, and focusing on diffuse pollution in Koblenz in 2003. These exercises have confirmed that sensors and analytical methodologies can be applied on site to determine various analytes. The instruments provided information useful to manage existing water pollution problems. Some of the scientific innovations of the newest technologies consisted of improved sensitivity, the improved relevance of assays based on biomarkers, the reduced impact on the environment and the capability to detect new contaminants. Sensor technologies were also found to be useful to detect the effects of pollutant mixtures. The portability of these instruments is advantageous for on site and in situ analyses. They will help industry and regulators to deal with existing pollution and attain good water quality.

Biosensing Techniques↗

PubMed2004

Malaria epidemic early warning and detection in African highlands.

Malaria epidemics have long been known to recur in the African highlands. Efforts to develop systems of early warning and detection for epidemics are outlined here with special emphasis on the Highland Malaria Project (HIMAL). This project has been conducting research on the operational implementation of a district-based surveillance and epidemic-monitoring system using a network of sentinel sites in four pilot districts of Kenya and Uganda. The potential use of weather monitoring as well as disease surveillance for effective early warning is being investigated.

Animals↗

PubMed1994

Development of a computer workstation for famine early warning and food security.

Beginning in 1990, the University of Arizona, Arizona Remote Sensing Center (ARSC) has been involved in a collaborative effort with the Global Information and Early Warning System (GIEWS) and the Remote Sensing Center of the Food and Agriculture Organization (FAO) of the United Nations in designing and developing an integrated computer workstation for famine early warning. The goal of the project is to provide food security analysts with a set of computer tools to manage a very large and diverse set of data for predicting the onset of food security emergencies for every country on Earth. The initial stage of the project involved the conceptual definition of system elements and the development of overall system architecture. We are now developing an open, flexible, and portable system designed to significantly assist the work of the analysts. System architecture provides a task-specific and user-friendly graphic user interface (GUI) within a Windows environment that will link image processing, geographic information system (GIS), spreadsheet, text, and graphics software packages into a single operational environment. A relational database management system (RDBMS) is serving as the back-end of the workstation to facilitate data storage and retrieval and as a means to preserve analysis methodologies.

Computer Systems↗

PubMed2026

Fungal drivers of mycotoxin contamination in wheat: Early warning and plasma-based control.

Mycotoxin contamination in wheat is a major food safety concern; however, quantitative evidence linking fungal community signals, mycotoxin exceedance risk, and wheat quality traits in naturally contaminated wheat remains limited. In this study, wheat samples were collected from mycotoxin-prone monitoring sites under unusually rainy conditions in 2022 to explore early-warning indicators and post-harvest mitigation strategies. According to the National Food Safety Standard of China GB 2761-2017, aflatoxin B1 (AFB1), deoxynivalenol (DON), and zearalenone (ZEN) exceeded the maximum limits in 52.24, 47.76, and 23.88% of samples, respectively; 38.81% exceeded the reference EU threshold for T-2 toxin, and 46.27% showed co-contamination with at least two mycotoxins above their respective thresholds. Although Alternaria, Cladosporium, and Epicoccum dominated the fungal community, Fusarium abundance was significantly associated with DON contamination and Fusarium-damaged kernels (FDKs). Mediation analysis identified DON as a significant mediator linking Fusarium abundance to FDKs, accounting for 68.41% of the total effect. In addition, Fusarium abundance above 3.70% showed strong predictive performance for DON exceedance, with an area under the curve of 0.906, indicating its potential as an early-warning indicator. Culture-based assays confirmed the toxigenic potential of Aspergillus and Fusarium isolates under simulated temperature and moisture conditions. After optimization using a toxin-spiked wheat flour model, dielectric barrier discharge cold plasma degraded AFB1, DON, and ZEN by 29.30-35.68%, disrupted the morphology of toxigenic fungi, and did not significantly affect wheat quality. This study provides practical insights into mycotoxin risk warning and post-harvest mitigation in wheat.

Triticum↗

PubMed1999

Attorneys' pressures on the expert witness: early warning signs of endangered honesty, objectivity, and fair compensation.

While most attorneys practice ethically and treat their retained experts fairly, there are a few that do otherwise. The authors describe "early warning signs" of the likelihood that the attorneys attempting to retain the psychiatric expert witness may compromise the expert's honesty and striving for objectivity. Experts themselves may have certain vulnerabilities that interfere with their ability to detect those early warning signs. Recommendations for the expert are offered.

Communication↗