Hydrometeorological multi-model ensemble simulations of the 4 November 2011 flash flood event in Genoa, Italy, in the framework of the DRIHM Project

The e-Science environment developed in the framework of the EU-funded DRIHM project was used to demonstrate its ability to provide relevant, meaningful hydrometeorological forecasts. This was illustrated for the tragic case of 4 November 2011, when Genoa, Italy, was flooded as the result of heavy, convective precipitation that inundated the Bisagno catchment. The Meteorological Model Bridge (MMB), an innovative software component developed within the DRIHM project for the interoperability of meteorological and hydrological models, is a key component of the DRIHM e-Science environment. The MMB allowed three different rainfall-discharge models (DRiFt, RIBS and HBV) to be driven by four mesoscale limited-area atmospheric models (WRF-NMM, WRF-ARW, Meso-NH and AROME) and a downscaling algorithm (RainFARM) in a seamless fashion. In addition to this multi-model configuration, some of the models were run in probabilistic mode, thus giving a comprehensive account of modelling errors and a very large amount of likely hydrometeorological scenarios (> 1500). The multi-model approach proved to be necessary because, whilst various aspects of the event were successfully simulated by different models, none of the models reproduced all of these aspects correctly. It was shown that the resulting set of simulations helped identify key atmospheric processes responsible for the large rainfall accumulations over the Bisagno basin. The DRIHM e-Science environment facilitated an evaluation of the sensitivity to atmospheric and hydrological modelling errors. This showed that both had a significant impact on predicted discharges, the former being larger than the latter. Finally, the usefulness of the set of hydrometeorological simulations was assessed from a flash flood early-warning perspective

Meta-ethnography of experiences of early discharge, with a focus on paediatric febrile neutropenia

PURPOSE (STATING THE MAIN PURPOSES AND RESEARCH QUESTION): Many children have no significant sequelae of febrile neutropenia. A systematic review of clinical studies demonstrated patients at low risk of septic complications can be safely treated as outpatients using oral antibiotics with low rates of treatment failure. Introducing earlier discharge may improve quality of life, reduce hospital acquired infection and reduce healthcare service pressures. However, the review raised concerns that this might not be acceptable to patients, families and healthcare professionals. METHODS: This qualitative synthesis explored experiences of early discharge in paediatric febrile neutropenia, including reports from studies of adult febrile neutropenia and from other paediatric conditions. Systematic literature searching preceded meta-ethnographic analysis, including reading the studies and determining relationships between studies, translation of studies and synthesis of these translations. RESULTS: Nine papers were included. The overarching experience of early discharge is that decision-making is complex and difficult and influenced by fear, timing and resources. From this background, we identified two distinct themes. First, participants struggled with practical consequences of treatment regimens, namely childcare, finances and follow-up. A second theme identified social and emotional issues, including isolation, relational and environmental challenges. Linking these, participants considered continuity of care and the need for information important. CONCLUSIONS: Trust and confidence appeared interdependent with resources available to families-both are required to manage early discharge. Socially informed resilience is relevant to facilitating successful discharge strategies. Interventions which foster resilience may mediate the ability and inclination of families to accept early discharge. Services have an important role in recognising and enhancing resilience

Prevalence of prenatal exposure to substances of abuse: questionnaire versus biomarkers

Alcohol and drugs of abuse consumption in young adults, including women of childbearing age, has experienced significant increase over the past two decades. The use of questionnaires as the only measure to investigate prenatal alcohol and drugs of abuse exposure underestimates the real prevalence of exposure and could mislead to wrong conclusions. Therefore, the aim of this article was to compare reported rates of prenatal alcohol and drugs of abuse consumption with biomarkers of exposure by a comprehensive review of the available literature. We searched MEDLINE and EMBASE databases for articles catalogued between 1992 and 2015. We identified relevant published studies that assessed the comparison between prenatal exposure to alcohol and drugs of abuse assessed by self-reported questionnaire of consumption versus biomarkers of exposure. Thirteen studies were included regarding alcohol consumption, and seven of them about drugs of abuse. Women who admitted consumption during pregnancy by questionnaire varied from 0 to 37% for alcohol, from 0 to 4.3% for cocaine, and 2.9% for tetrahydrocannabinol (THC). Positive biomarkers results ranged from 16 to 44% for alcohol, 15.4% for cocaine, and from 4 to 12.4% for THC. Biomarkers should always complement questionnaires, as it has been shown that self-report may underestimate prenatal exposure to substances of abuse

HEAVY PRECIPITATION SYSTEMS IN THE MEDITERRANEAN AREA: THE ROLE OF THE GPM

Heavy precipitation systems typical of the Mediterranean area that often devastate the coastal regions, are described and analyzed here by exploiting active and passive microwave measurements and state of the art precipitation products available in the Global Precipitation Measurement (GPM) mission era. The GPM is boosting its key role in integrating the established observational ground-based and satellite-borne tools not only for precipitation monitoring, but also for understanding and characterizing severe weather in the Mediterranean. In this Chapter, we present three events that have recently challenged observational and forecasting capabilities, and caused damages at the ground. Making use of ground based and satellite-borne instruments, we address the problem of estimating precipitation of a small-scale and short-living intense thunderstorm, the capability to render the 3D structure of a mesoscale organized convective system, and the key role of satellite view in the classification and monitoring of a tropical-like cyclonic system. To this end, we exploited satellite measurements probably beyond the role they have been designed for, showing few strategies to blend satellite data and products with conventional meteorological data, with the aim to increase the knowledge of severe systems in the Mediterranean area and to support operational forecasting activities in a climate change perspective