Nowadays, extreme weather and atmospheric conditions are becoming more frequent and more intense. It seems obvious that together with climate change, the vulnerability of the public and of individual regions to the risks of various types of natural hazards also increases. This would increase the importance of organization concerning potential measures to protect against these extraordinary events, and to prepare for reducing their ramifications.

One such initiative is the creation of an early warning system for inhabitants of a given area of a country, to help guard against the extraordinary threat associated with a natural disaster; especially floods. The creation of such a system is aimed at increasing public safety and limiting losses caused by the occurrence of natural, technological, and synergistic hazards. Particular emphasis during the construction of a current system is placed on supporting flood risk management, which is aimed at increasing the safety of citizens and reducing losses caused by the occurrence of flooding in Poland. This would be possible by the identification of areas threatened by flooding throughout the country, and then limiting economic expansion in these areas.

Ultimately, the project aims to consolidate information regarding hazardous events and gather them in a professional Information Technology (IT) system, using an integrated database and a modern module for disseminating information to end users. The system is to provide access to this information for both the administration and the individual citizen.

This article presents the potential of a so called “IT System for the Country’s Protection Against Extreme Hazards,” which is currently being developed in Poland, with particular emphasis on reducing the risks related to natural disasters and minimizing the problems of crisis management in Poland. This article is also aimed at opening discussions and creating a basis for the exchange of information from countries implementing similar solutions, especially neighboring countries, with which joint action could be undertaken.

The EU established an early warning system by introducing the Macroeconomic Imbalance Procedure (MIP) in the wake of the recent recession. Nevertheless, it has been found by some authors to be rather vague when launching the Excessive Imbalances Procedure. Performed analysis reflects on such views and treats the MIP indicators as a system while assessing the significance of all particular variables separately. This assessment was accomplished by applying a multivariate unbalanced logit model, utilising all 14 MIP headline indicators, using time horizons ranging from one to three years before crisis, which was represented by periods with output gap lower than negative 2 per cent. The approach was confronted with the estimates of a linear probability model to provide an idea about the robustness of the results. In the short term, activity rates, youth unemployment rates and private sector debt are the best performing indicators, complemented by current account balances in the long term.

Objectives: Selecting technologies for formal assessment poses a great challenge to health technology assessment agencies. This study aims to contribute to the creation of a reference framework for the identification, filtering, and prioritization of new and emerging technologies which could be demanded in clinical practice within the next 1–2 years.

Methods: Technologies were identified using a prevalidated systematic Medline strategy. They were classified by medical specialty and then sent to selected professionals belonging to the medical units or areas responsible for their application, until there was a minimum of three participants per health care setting. A self-administered questionnaire was drawn up and health professionals were asked to: (1) assess the degree of innovation of the technologies, and (11) score their foreseeable clinical impact on the basis of predefined prioritization criteria (n = 4). Intra-rater reliability was analyzed using the intraclass correlation coefficient (ICC).

Results: The Medline search yielded 246 potentially relevant technologies. When analyzed by health care area or unit, sixty-eight were deemed to be high-impact innovative technologies (median score >6), with ICCs ranging from 0.03 to 0.83. The final list resulting from the aggregate analysis comprised fifty-one technologies.

Conclusions: This study constitutes an innovative contribution to horizon scanning, providing a systematic and reproducible basis for the identification and selection of relevant new and emerging technologies based on the views and values of health professionals involved in their use. In our opinion, the current proposal could be helpful and useful to many other organizations worldwide, serving to complement already existing strategies.

Recent changes in the epidemiology of alveolar echinococcosis (AE) in Eurasia have led to increasing concerns about the risk of human AE and the need for a thorough evaluation of the epidemiological situation. The aim of this study was to explore the use of a National Register to detect complex distribution patterns on several scales. The data were human AE cases from the FrancEchino register, diagnosed in France from 1982 to 2011. We used the Kulldorff spatial scan analysis to detect non-random locations of cases. We proposed an exploratory method that was based on the successive detection of nested clusters inside each of the statistically significant larger clusters. This method revealed at least 4 levels of disease clusters during the study period. The spatial variations of cluster location over time were also shown. We conclude that National Human AE registers, although not exempted from epidemiological biases, are currently the best way to achieve an accurate representation of human AE distribution on various scales. Finally, we confirm the multi-scale clustered distribution of human AE, and we hypothesize that our study may be a reasonable starting point from which to conduct additional research and explore the processes that underlie such distributions.

Increased frequency and severity of stressors associated with climate change are drastically altering ecosystems. Caribbean coral reefs differ markedly from just 30 years ago, with much restructuring attributable to infectious disease outbreaks. Using a classic epidemiological approach, we demonstrate how density-dependent demographic rates serve as a mechanism for intrinsic coral resilience to population perturbations arising from disturbances such as disease. We explore the impact of allowing infection status to influence demographic rates and ascertain outbreak thresholds that are corroborated by epizootic patterns observed in the field. We discuss how our threshold calculations may provide metrics of coral epizootic early warning systems. Integrating our infection model with equations describing the interspecific competition for space between coral and macroalgae, we provide new mechanistic understanding of the influence that coral life history dynamism and infectious disease have on the changing face of these threatened ecosystems.

Background and Objectives: Horizon scanning systems need to handle a wide range of sources to identify new or emerging health technologies. The objective of this study is to develop a validated Medline bibliographic search strategy (PubMed search engine) to systematically identify new or emerging health technologies.

Methods: The proposed Medline search strategy combines free text terms commonly used in article titles to denote innovation within index terms that make reference to the specific fields of interest. Efficacy was assessed by running the search over a period of 1 year (2009) and analyzing its retrieval performance (number and characteristics). For comparison purposes, all article abstracts published during 2009 in six preselected key research journals and eight high impact surgery journals were scanned. Sensitivity was defined as the proportion of relevant new or emerging technologies published in key journals that would be identified in the search strategy within the first 2 years of publication.

Results: The search yielded 6,228 abstracts of potentially new or emerging technologies. Of these, 459 were classified as new or emerging (383 truly new or emerging and 76 new indications). The scanning of 12,061 journal abstracts identified 35 relevant new or emerging technologies. Of these, twenty-nine were located within the Medline search strategy during the first 2 years of publication (sensitivity = 83 percent).

Conclusions: The current search strategy, validated against key journals, has demonstrated to be effective for horizon scanning. Even though it can require adaptations depending on the scope of the horizon scanning system, it could serve to simplify and standardize scanning processes.

In this paper we describe the present range of organizations that have a role in the early warning of new and emerging health care technologies in the United Kingdom. We discuss in more detail the processes and prioritization criteria used by the U.K. horizon-scanning project for the NHS Health Technology Assessment Programme, and the principal methods of technology identification for the horizon-scanning project are outlined. The United Kingdom plans to develop an integrated system for the identification of technologies for commercial planning, health service research prioritization, financial planning, and provision of information to policy makers, purchasers, and providers of health care.

Objectives: To report on a workshop, and subsequent discussions, that reviewed the achievements and progress of the EuroScan collaboration since its establishment in 1999 to share information on the methods and results of early identification and assessment of new and emerging health technologies; considered challenges to the collaboration; and discussed its possible future direction.

Methods: A workshop was held in Stockholm in September 2006, with thirty-two participants from ten countries and representatives from EuroScan member agencies, policy makers involved in policy or decision making relating to new technologies, and invited external commentators from international HTA networks. The workshop used a mix of presentations, panel and audience discussions, and small group work to consider the achievements and challenges put forward.

Results: EuroScan has developed as a sustainable network, and has made progress on all tasks in its initial action plan, with the EuroScan information sharing database on new and emerging technologies being one of the collaboration's key achievements. Identified immediate concerns for the network included consideration of the impact of its current name and membership model; acknowledgement and publication of the full range of benefits of membership; contribution to and development of the database to encourage increased information sharing; and EuroScan's ongoing interaction with the wider HTA world.

Conclusions: The workshop was a useful mechanism for reviewing the work of EuroScan and for creating a platform to take the collaboration forward. The workshop affirmed the benefits of the network to individual members; posed some significant challenges to the network to consider; and acted as a stimulus for an interim name change to better represent the global membership, and a major review of the EuroScan database of identified and assessed emerging health technologies.

Objectives: The aim of this study was to define an effective early warning system, to identify and rank the characteristics of an effective early warning system for emerging health technologies, and to evaluate current early warning systems against these characteristics.

Methods: An iterative Delphi-type process with the thirteen members of the International Information Network on New and Changing Health Technologies (EuroScan). We synthesized key characteristics that network members had graded. Members were then asked whether these characteristics were present or fulfilled in their system.

Results: The definition of an effective early warning system developed was the following: a system that identifies innovations in the field of health technology likely to have a significant impact; and disseminates information relevant to the needs of the customer which is timely, so as to enable appropriate decision making (such as resource allocation), facilitate appropriate adoption, and identify further research requirements. Five primary and eleven secondary components of effective early warning systems were identified. The five primary characteristics concerned relevance, independence, resourcing, a clear pathway for the outputs to reach decision makers, and defined customers. Although the primary characteristics were present or fulfilled to some extent in the majority of evaluated early warning systems, there was considerable variability in the presence of the secondary characteristics in the evaluated systems.

Conclusions: Our study provides a definition for an effective early warning system and a shared understanding of the important characteristics and components of such systems. This work should provide guidance to those setting up new early warning systems as well as for those managing and reviewing current systems.

This Panel Session consisted of three country reports (Bagladesh, Bhutan, and Myanmar) and the common issues identified during the Panel discussions relative to water-related hazards and events in the Southeast Asia Region. The primary event discussed regardless of the hazards encountered was flooding. The merits of the responses generated in Bangladesh before, during, and following the 2004 floods provide evidence of what can be accomplished in community and national levels of preparedness.

Many key issues arose in the discussions: (1) command and control systems and SOPs; (2) ready resources; (3) public information and education and human resource development; (4) community-level preparedness; (5) accessibility to health care; (6) increased focus on disease prevention and control; (7) management of dead bodies; (8) need for a legal framework; (9) funding and the management of funds; and (10) relationships with themedia.