Our understanding of where landslide hazard and impact will be greatest is largely based on our knowledge of past events. Here, we present a method to supplement existing records of landslides in ...Great Britain by searching an electronic archive of regional newspapers. In Great Britain, the British Geological Survey (BGS) is responsible for updating and maintaining records of landslide events and their impacts in the National Landslide Database (NLD). The NLD contains records of more than 16,500 landslide events in Great Britain. Data sources for the NLD include field surveys, academic articles, grey literature, news, public reports and, since 2012, social media. We aim to supplement the richness of the NLD by (i) identifying additional landslide events, (ii) acting as an additional source of confirmation of events existing in the NLD and (iii) adding more detail to existing database entries. This is done by systematically searching the Nexis UK digital archive of 568 regional newspapers published in the UK. In this paper, we construct a robust Boolean search criterion by experimenting with landslide terminology for four training periods. We then apply this search to all articles published in 2006 and 2012. This resulted in the addition of 111 records of landslide events to the NLD over the 2 years investigated (2006 and 2012). We also find that we were able to obtain information about landslide impact for 60–90% of landslide events identified from newspaper articles. Spatial and temporal patterns of additional landslides identified from newspaper articles are broadly in line with those existing in the NLD, confirming that the NLD is a representative sample of landsliding in Great Britain. This method could now be applied to more time periods and/or other hazards to add richness to databases and thus improve our ability to forecast future events based on records of past events.
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•Robust method to obtain natural hazard information from regional newspaper archives•Added 111 landslide events (2006 & 2012) to the GB National Landslide Database•Demonstrates the methodology's potential to enrich other hazard inventories
In the phase III CheckMate 227 study, first-line nivolumab + ipilimumab significantly prolonged progression-free survival (co-primary end-point) versus chemotherapy in patients with advanced ...non–small-cell lung cancer (NSCLC) and high tumour mutational burden (TMB; ≥10 mutations/megabase).
To evaluate patient-reported outcomes (PROs) in this population.
Disease-related symptoms and general health status were assessed using the validated PRO questionnaires Lung Cancer Symptom Scale (LCSS) and EQ-5D, respectively. LCSS average symptom burden index (ASBI) and three-item global index (3-IGI) and EQ-5D visual analogue scale (VAS) and utility index (UI) scores and changes from baseline were analysed descriptively. Longitudinal changes were assessed by mixed-effect model repeated measures (MMRMs) and time to first deterioration/improvement analyses.
In the high TMB population, PRO questionnaire completion rates were ∼90% at baseline and >80% for most on-treatment assessments. During treatment, mean changes from baseline with nivolumab + ipilimumab showed early, clinically meaningful improvements in LCSS ASBI/3-IGI and EQ-5D VAS/UI; with chemotherapy, symptoms and health-related quality of life remained stable (LCSS ASBI/3-IGI, EQ-5D UI) or improved following induction (EQ-5D VAS). MMRM-assessed changes in symptom burden were improved with nivolumab + ipilimumab versus chemotherapy. Symptom deterioration by week 12 was lower with nivolumab + ipilimumab versus chemotherapy (22.3% versus 35.0%; absolute risk reduction: 12.7% 95% confidence interval 2.4–22.5), irrespective of discontinuation. Time to first deterioration was delayed with nivolumab + ipilimumab versus chemotherapy across LCSS and EQ-5D summary measures.
First-line nivolumab + ipilimumab demonstrated early, sustained improvements in PROs versus chemotherapy in patients with advanced NSCLC and high TMB.
Clinical trial registration: NCT02477826.
•Nivolumab + ipilimumab improved patient-reported outcomes versus chemotherapy in non–small-cell lung cancer.•Improvements were seen in lung cancer symptoms and in general health status.•Improvements with nivolumab + ipilimumab were rapid and durable.•Disease-related symptom deterioration was delayed with nivolumab + ipilimumab.
This paper aims to provide a five-step conceptual framework to analyze the impacts to the built environment from multi-hazard interactions. Our methodology includes a critical literature review and ...stakeholder workshops. This framework's five steps are the following: (I) identify hazards and their interactions, (II) multi-hazard modelling, (III) analysis of the hazards' spatio-temporal evolution of impacts, (IV) identification of impact interactions, (V) a multi-hazard risk or impact assessment. Our approach is based on the systematic analysis of the spatial and temporal evolution of hazards to determine potential impact interactions. In Step IV, we classify the spatial-temporal overlap of hazard impacts into four types: (i) spatial-temporal overlapping, (ii) temporal (but not spatial) overlapping, (iii) spatial overlapping (with residual and subsequent damage), (iv) independent single hazards. Building on current multi-hazard approaches and guidelines, this framework is generally applicable to a broad range of hazards, includes both hazard and impact interactions, and considers residual damage and recovery processes. The framework is applied to a real-world case study in Po Valley, Italy, of a hypothetical damage scenario from an earthquake shock that weakens the levee system, and then combined with intense rain results in a levee collapse and flood. The framework application is supported by a visualization of each step, useful to identify key elements for multi-hazard impact modelling. Practical uses of the framework include the creation of checklists for decision-making, narrowing future research needs in multi-hazard risk, and integrating multi-hazard aspects into international disaster risk management guidelines.
•We systematically analyze and organize available literature on multi-hazard risk.•We present a framework to analyze impacts resulting from hazard interactions.•We present an approach based on the analysis of spatial and temporal evolution of hazards.•We take into account residual damage and recovery dynamics of the elements at risk.•We provide an application to a combined seismic and flood damage scenario in the Po Valley.
...these and similar statistics are likely to underestimate the magnitude of impact and interactions between landslides and transportation networks due to (i) under-reporting of landslides and (ii) ...the potentially large regional implications of a landslide blocking a transportation corridor (e.g. Meyer et al., 2015), under-evaluating the potential impact of road networks on water and sediment flow paths at the catchment scale (Sidle and Ziegler, 2012; Tarolli and Sofia, 2016). Methods span both physical and planning measures and include minimising exposure by monitoring/early warning coupled with road closure systems (Graziella et al., 2015; Ferrigno et al., 2017), minimising hazard by slope engineering to reduce landslide susceptibility (Fowze et al., 2012), calculation of acceptable risk (Mignelli et al., 2012) and risk-adapted planning for siting of new roads (Lennartz, 2013). Challenge 4 – understanding future drivers of landslide –transportation network interactions: better planning of existing and new transportation networks requires an understanding of both (i) future changes of drivers of landslides (i.e. climate change) and (ii) future expansion of transport networks, particularly in the Global South. ...of incomplete records, it is likely that we are underestimating the influence of transport networks on landslide occurrence and the impact of landslides upon the transport network.
Reducing disaster risk is critical to securing the ambitions of the Sustainable Development Goals (SDGs), and natural hazard scientists make a key contribution to achieving this aim. Understanding ...Earth processes and dynamics underpins hazard analysis, which (alongside analysis of other disaster risk drivers) informs the actions required to manage and reduce disaster risk. Here we suggest how natural hazard research scientists can better contribute to the planning and development of sustainable and resilient communities through improved engagement in disaster risk reduction (DRR). Building on existing good practice, this perspective piece aims to provoke discussion in the natural hazard science community about how we can strengthen our engagement in DRR. We set out seven recommendations for enhancing the integration of natural hazard science into DRR: (i) characterise multi-hazard environments; (ii) prioritise effective, positive, long-term partnerships; (iii) understand and listen to your stakeholders; (iv) embed cultural understanding into natural hazard research; (v) ensure improved and equitable access to hazard information; (vi) champion people-centred DRR (leaving no one behind); and (vii) improve links between DRR and sustainable development. We then proceed to synthesise key actions that natural hazard scientists and research funders should consider taking to improve education, training, and research design and to strengthen institutional, financial, and policy actions. We suggest that these actions should help to strengthen the effective application of natural hazard science to reduce disaster risk. By recognising and taking steps to address the issues raised in these recommendations, we propose that the natural hazard science community can more effectively contribute to the inter-/transdisciplinary, integrated work required to improve DRR.
Although there are clear economic and environmental incentives for producing energy from solar and wind power, there can be local opposition to their installation due to their impact upon the ...landscape. To date, no international guidelines exist to guide quantitative visual impact assessment of these facilities, making the planning process somewhat subjective. In this paper we demonstrate the development of a method and an Open Source GIS tool to quantitatively assess the visual impact of these facilities using line-of-site techniques. The methods here build upon previous studies by (i) more accurately representing the shape of energy producing facilities, (ii) taking into account the distortion of the perceived shape and size of facilities caused by the location of the observer, (iii) calculating the possible obscuring of facilities caused by terrain morphology and (iv) allowing the combination of various facilities to more accurately represent the landscape. The tool has been applied to real and synthetic case studies and compared to recently published results from other models, and demonstrates an improvement in accuracy of the calculated visual impact of facilities. The tool is named r.wind.sun and is freely available from GRASS GIS AddOns.
Ending the HIV epidemic requires that women living with HIV (WLWH) have access to structurally competent HIV-related and other health care. WLWH may not regularly engage in care due to inadequate ...quality; however, women's perspectives on the quality of care they receive are understudied.
We conducted 12 focus groups and three in-depth interviews with Black (90%) and Latina (11%) WLWH enrolled in the Women's Interagency HIV Study in Atlanta, GA, Birmingham, AL, Brooklyn, NY, Chapel Hill, NC, Chicago, IL, and Jackson, MS from November 2017 to May 2018 (n = 92). We used a semi-structured format to facilitate discussions about satisfaction and dissatisfaction with health care engagement experiences, and suggestions for improvement, which were audio-recorded, transcribed, and coded using thematic analysis.
Themes emerged related to women's health care satisfaction or dissatisfaction at the provider, clinic, and systems levels and across Institute of Medicine-defined quality of care domains (effectiveness, efficiency, equity, patient-centeredness, safety and timeliness). Women's degree of care satisfaction was driven by: 1) knowledge-based care resulting in desired outcomes (effectiveness); 2) coordination, continuity and necessity of care (efficiency); 3) perceived disparities in care (equity); 4) care delivery characterized by compassion, nonjudgment, accommodation, and autonomous decision-making (patient-centeredness); 5) attention to avoiding side effects and over-medicalization (safety); and 6) limited wait time (timeliness).
Quality of care represents a key changeable lever affecting engage in care among WLWH. The communities most proximally affected by HIV should be key stakeholders in HIV-related quality assurance. Findings highlight aspects of the health care experience valued by WLWH, and potential participatory, patient-driven avenues for improvement.
In CheckMate 227 (NCT02477826), patients with treatment-naive stage IV or recurrent NSCLC and 1% or greater tumor programmed death ligand 1 expression had significantly improved overall survival with ...nivolumab plus ipilimumab versus chemotherapy. We present the patient-reported outcomes (PROs).
Patients (N = 1189) were randomized to nivolumab plus ipilimumab, nivolumab, or chemotherapy. PROs were exploratory. Changes in Lung Cancer Symptom Scale (LCSS) average symptom burden index, LCSS 3-item global index, EQ-5D visual analog scale (VAS), and EQ-5D utility index were analyzed descriptively. Mixed-effect model repeated measures and time-to-first deterioration and improvement analyses were conducted.
PRO completion rates were generally greater than 80%. On-treatment improvements from baseline in LCSS measures of symptom burden and global health status with nivolumab plus ipilimumab generally met or exceeded the minimal important difference (smallest clinically meaningful change) from weeks 24 and 30, respectively; improvements with chemotherapy generally remained below the minimal important difference. Mean on-treatment EQ-5D VAS scores for both treatments approached the U.K. population norm at week 24, remaining so throughout the treatment period. Mixed-effect model repeated measures analyses revealed numerically greater improvements from baseline with nivolumab plus ipilimumab versus chemotherapy across LCSS average symptom burden index and 3-item global index, and EQ-5D VAS and utility index. Nivolumab plus ipilimumab had delayed time-to-first deterioration (hazard ratio 95% confidence interval 0.74 0.56 to 0.98) and a trend for more rapid time-to-first improvement (1.24 0.98 to 1.59) versus chemotherapy.
Nivolumab plus ipilimumab revealed delayed deterioration and numerical improvement in symptoms and health-related quality of life versus chemotherapy in patients with advanced NSCLC and 1% or greater programmed death ligand 1 expression.