Modification and Assessment of the Bedside Pediatric Early Warning Score in the Pediatric Allogeneic Hematopoietic Cell Transplant Population

OBJECTIVES: To determine the validity of the Bedside Pediatric Early Warning Score system in the hematopoietic cell transplant population, and to determine if the addition of weight gain further strengthens the association with need for PICU admission. DESIGN: Retrospective cohort study of pediatric allogeneic hematopoietic cell transplant patients from 2009 to 2016. Daily Pediatric Early Warning Score and weights were collected during hospitalization. Logistic regression was used to identify associations between maximum Pediatric Early Warning Score or Pediatric Early Warning Score plus weight gain and the need for PICU intervention. The primary outcome was need for PICU intervention; secondary outcomes included mortality and intubation. SETTING: A large quaternary free-standing children's hospital. PATIENTS: One-hundred two pediatric allogeneic hematopoietic cell transplant recipients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the 102 hematopoietic cell transplant patients included in the study, 29 were admitted to the PICU. The median peak Pediatric Early Warning Score was 11 (interquartile range, 8-13) in the PICU admission cohort, compared with 4 (interquartile range, 3-5) in the cohort without a PICU admission (p < 0.0001). Pediatric Early Warning Score greater than or equal to 8 had a sensitivity of 76% and a specificity of 90%. The area under the receiver operating characteristics curve was 0.83. There was a high negative predictive value at this Pediatric Early Warning Score of 90%. When Pediatric Early Warning Score greater than or equal to 8 and weight gain greater than or equal to 7% were compared together, the area under the receiver operating characteristic curve increased to 0.88. CONCLUSIONS: In this study, a Pediatric Early Warning Score greater than or equal to 8 was associated with PICU admission, having a moderately high sensitivity and high specificity. This study adds to literature supporting Pediatric Early Warning Score monitoring for hematopoietic cell transplant patients. Combining weight gain with Pediatric Early Warning Score improved the discriminative ability of the model to predict the need for critical care, suggesting that incorporation of weight gain into Pediatric Early Warning Score may be beneficial for monitoring of hematopoietic cell transplant patients

Improving the Effectiveness of the Dissemination Method in Disaster Early Warning Messages

The dissemination of disaster early warning messages has a significant role in the effectiveness and serviceability in an Early Warning System (EWS). Providing the community in a disaster area with an adequate dissemination and communication of early warning messages will improve people's awareness and reaction to a natural hazard. People who live in a disaster area play a crucial role in the success of EWS. Malaysian, Sri Lankan, Bangladeshi and Indonesian authorities employ mobile phone applications, such as text messages (SMS), as a tool for disaster warning messages. However, there are many challenges in methods for disseminating early warning messages. One of the challenges is the dissemination method in which only notification messages are sent. In this paper, we propose confirmation or verification messages, as part of disaster early warning messages, by using text messages. Confirmation messages are messages that use a verification channel to provide up-to- date official information about the latest natural disaster conditions. Keywords: disaster management, early warning messages dissemination, SM

2016 Early Warning Forecast

Lutheran World Relief, an international NGO working in 35 countries to develop sustainable solutions to poverty and food insecurity, marked GivingTuesday by releasing its 2016 Early Warning Forecast of regions it is monitoring for potential humanitarian crises over the coming year.The regions highlighted in the report are those that LWR is actively monitoring and, in many cases, is already in-country working to help mitigate the worst effects of a potential crisis, develop disaster response plans and strengthen community resilience, especially in the most vulnerable rural areas

Earthquake early warning system

As the climate undergoes changes, the number of natural disasters increase and the severity of these occurrences increases over time. As the population of human race increases, natural protective terrains and barriers were destroyed for urbanization due to the exploitation of vulnerable areas on the earth. Earthquakes are unpredictable and as an initiative to adapt to climate changes and as a strategy to reduce earthquake disaster risk, early warning systems (EWS) has been internationally recognized to play a role in providing alerts to the public so that safety precaution procedures and protocols can be implemented in response to earthquake occurrences..

Early warning systems

Banks and banking ; Bank supervision ; Problem banks

Early warning: a people-centred approach to early warning systems and the 'last mile'

The people-centred approach to early warning focuses on how communities can understand threats and avoid them. Disasters are partly caused by external hazards, but they also stem simply from vulnerability: people being in the wrong place without adequate protection. Perhaps the most well-known risk assessment method of recent years is the “vulnerability and capacity assessment”, developed by the Red Cross Red Crescent. There is a consensus that information must extend to communities so as to facilitate their adoption of protective actions. The linking of early warning and early action with development aspirations is what motivates people to engage. Factors as diverse as knowledge, power, culture, environment, lifestyle and personality often determine whether people heed warnings. Engaging people outside any warning system is called the “last mile” – a term that expresses the sentiment that warnings often do not reach those who need them most. Addressing vulnerability in disaster reduction is often similar to promoting development, but in the developed world “top-down” approaches to risk assessment and early warning dominate

The SuperNova Early Warning System

A core collapse in the Milky Way will produce an enormous burst of neutrinos in detectors world-wide. Such a burst has the potential to provide an early warning of a supernova's appearance. I will describe the nature of the signal, the sensitivity of current detectors, and SNEWS, the SuperNova Early Warning System, a network designed to alert astronomers as soon as possible after the detected neutrino signal.Comment: 3 pages, appearing in refereed proceedings of "Hotwiring the Transient Universe 2007", eds. A. Allan, J. S. Bloom, R. Seaman, Astron. Nachr. vol. 329, March 200

Gender equity in disaster early warning systems

Capacities of societies, communities and individuals or a social-ecological system to deal with adverse consequences and the impacts of hazard events define the resilience. New and innovative Emergency Communications, Warning Systems (ECWS) technologies and solutions improve resilience of the nations. Research shows that different types of systems (e.g. decision support, resource management, early warning, communications, and inter-agency) are highly valued in emergency and disaster events reducing live losses. As many individuals have online access today and young women have increased their online communication and young men tend to explore technology resources, the potential of using user friendly third revolution digital technology such as semantic features and devices (e.g. SMART phones) have the potential to improve the access to early warning/risk in-formation supporting community decision making saving lives. These personal and social relations that reflect gender dimensions can certainly be examined improving resilience making communities more prepared for disasters with proactive decision making for early warning. Fostering awareness about gender equity which is the recognition of women and men as active participants in development can tailor made within the context of resilience and more specifically within early warning systems saving lives of the people at immediate risk including the dependence of mother’s care (children and older people). In this context, this paper attempts to synthesis literature on the topic of gender equity within disaster early warning systems

A Predictive Model for Financial Crises: An Exploratory Public Policy Tool

This paper aims to establish an early warning system for Malaysia to project future financial crises. We investigate the macroeconomic and financial factors in predicting financial crises using the logit econometric model and monthly data with the sample period from January 1980 to December 2003. Four indicators namely regional crisis dummy, current account balance, M2 growth and real exchange rate show significance and therefore, are incorporated in crisis prediction. The early warning system’s predictive power is then examined against various crises periods including the 1997 Asian financial crisis. The empirical results show that the early warning system exhibits forecasting ability. Both in-sample and out-ofsample performance evaluations affirm the system’s ability to predict the 1997 Asian financial crisis with at least one early warning signal issued within the 12-month period prior to the actual crisis. The early warning system should be treated as a supplement to policymakers existing forecasting tools in estimating the probability of crisis and assessing a country’s vulnerability rather than as an exclusive tool for crisis prediction.- financial crisis, economic modelling, policy modelling, monetary policy