Improving sepsis screening and care in a developing nation health setting: a description of implementation

2021 ◽  
Author(s):  
Laura Alberto ◽  
Andrea P. Marshall ◽  
Rachel M. Walker ◽  
Fernando Pálizas ◽  
Leanne M. Aitken
Keyword(s):  
Developing Nation ◽  
Sepsis Screening

PHYSICOCHEMICAL ANALYSIS OF GROUND WATER AND SURFACE WATER IN KOTA REGION, RAJASTHAN, INDIA

2018 ◽  
Vol 24 (1) ◽  
Author(s):  
NITU SINGH ◽  
FATIMA SULTANA
Keyword(s):  
Surface Water ◽  
Ground Water ◽  
Growth And Development ◽  
Physicochemical Parameters ◽  
Total Dissolved Solids ◽  
Physicochemical Analysis ◽  
Total Hardness ◽  
Developing Nation ◽  
The Sustainable Development ◽  
Chloride Sulfate

India is a developing nation and is dependent on its natural resources for growth and development. Water, being one of the vital natural resource, must be used judicially for the sustainable development. Present study focuses on the analysis of physicochemical parameters (pH, Turbidity, Alkalinity, Total Hardness, Total dissolved solids, Conductivity, Chloride, Sulfate, Fluoride contents) of ground water and surface water in Kota City (Rajasthan). The study shows the adverse impact of exploitation and urbanization on water resources of Kota City (Rajasthan). Some physicochemical parameters exceed the desirable limits as defined by WHO and Indian Standards in the selected sites. The level of pollution in ground water and surface water of Kota City is increasing due to urbanization.

Consumers‟ Acceptance of „Halal‟ Credit Card Services: An Empirical Analysis

2015 ◽  
Vol 3 (1) ◽  
pp. 51 ◽  
Author(s):  
Zaimy Johana Johan ◽  
Lennora Putit
Keyword(s):  
Perceived Control ◽  
Credit Card ◽  
Credit Cards ◽  
Product Knowledge ◽  
Key Factors ◽  
Developing Nation ◽  
Business Transactions ◽  
Factors Influencing ◽  
Financial Credit ◽  
Survey Questionnaires

Many past researches have been carried out in an attempt to continuously understand individuals‟ consumption behaviour. This study was conducted to investigate key factors influencing consumers‟ potential acceptance of halal (or permissible) financial credit card services. Specifically, it anticipated the influence of attitude, social influences and perceived control on consumers‟ behavioural intention to accept such services. In addition, factors such as religiosity and product knowledge were also postulated to affect consumers‟ attitude towards the act of using halal credit cards for any retail or business transactions. Using non-probability sampling approach, a total of 500 survey questionnaires was distributed to targeted respondents in a developing nation but only 220 usable feedbacks were received for subsequent data analysis. Regression results revealed that religiosity and product knowledge significantly influence consumers‟ attitude toward using halal credit card services.  Attitude in turn, subsequently has a significant impact on consumers‟ intention to accept halal financial credit card services. Several theoretical and managerial contributions were observed in this study.   

111 Burn Sepsis Screening Tool to Facilitate Diagnosis of Burn Sepsis

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S74-S75
Author(s):  
Kaitlyn Libraro ◽  
Palmer Bessey ◽  
Jamie Heffernan ◽  
James Gallagher
Keyword(s):  
Critically Ill ◽  
Screening Tool ◽  
Burn Injury ◽  
Clinical Signs ◽  
Case Fatality ◽  
Inhalation Injury ◽  
Clinical Feature ◽  
Sepsis Diagnosis ◽  
Acute Decompensation ◽  
Sepsis Screening

Abstract Introduction Sepsis following critical burn injury is an ominous development that can lead to death. Most patients will manifest a systemic inflammatory response syndrome (SIRS), even without being septic. This may obscure the clinical recognition of developing sepsis and delay the initiation of effective treatment. We developed a burn sepsis screening tool (BSST) to facilitate the recognition of developing burn sepsis. The purpose of this study was to review the utility of that tool. Methods The BSST was based on several clinical signs, laboratory values, and changes in physiologic support modalities associated with sepsis. It consisted of nine parameters that could be scored as indicating or not indicating sepsis or not applicable. If three were positive, the patient was identified as septic, and a search for a septic source was undertaken and treatment initiated. The BSST was completed on patients judged to be critically ill during morning rounds over a period of nine months. The values were transcribed into a secure web database and analyzed using SAS 9.4. Results There were 593 individual encounters on 31 critically ill patients with burns and/or inhalation injury for which the BSST was completed. The mean age of the patients was 57 ± 4 years (Mean ± SEM), and the burn size was 24 ± 15 % TBSA. Eleven patients were women (36%) and 7 patients had inhalation injury (23%). The expected case fatality was 21 - 30% depending on the statistical model used. Six patients (19%) died. The length of stay was 64 ± 10 days and ranged from 3 to 267 days. A patient was judged to be septic in only 45 of the daily encounters (8.0 % ± 1.1). There were 21 instances of a new septic event made in 12 patients. Episode of sepsis separated by at least 5 days of no sepsis, were considered to be a new septic event. There was a substantial amount of data that was missing or not applicable. There were no significant differences in the septic parameters on days with new sepsis diagnosis when compared to the day prior, or compared to all encounters in patients that were never septic. Patients deteriorated acutely between BSST completions on only two occasions and both were stabilized. Conclusions The BSST was used consistently to help evaluate the daily status of critically ill burn injured patients. The expected case fatality of the group was moderately high, based on statistical models derived from the ABA Burn Registry. The observed outcome was as good as or better than predicted. Acute decompensation was rare. The BSST added daily administrative work to rounds, and the data recorded were often incomplete. Although the BSST did not demonstrate any single clinical feature that identified the transition from SIRS to sepsis, it did add structure and rigor to daily rounds. That contributed to the effectiveness of rounds, and it may have been responsible, in part, for the favorable outcomes.

scholarly journals Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1292
Author(s):  
Luisa Agnello ◽  
Alessandro Iacona ◽  
Salvatore Maestri ◽  
Bruna Lo Sasso ◽  
Rosaria Vincenza Giglio ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Early Detection ◽  
Diagnostic Accuracy ◽  
Positive Likelihood Ratio ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Distribution Width ◽  
Independent Validation ◽  
Sepsis Screening

(1) Background: The early detection of sepsis is still challenging, and there is an urgent need for biomarkers that could identify patients at a high risk of developing it. We recently developed an index, namely the Sepsis Index (SI), based on the combination of two CBC parameters: monocyte distribution width (MDW) and mean monocyte volume (MMV). In this study, we sought to independently validate the performance of SI as a tool for the early detection of patients at a high risk of sepsis in the Emergency Department (ED). (2) Methods: We enrolled all consecutive patients attending the ED with a request of the CBC. MDW and MMV were measured on samples collected in K3-EDTA tubes on the UniCel DxH 900 haematology analyser. SI was calculated based on the MDW and MMV. (3) Results: We enrolled a total of 703 patients stratified into four subgroups according to the Sepsis-2 criteria: control (498), infection (105), SIRS (52) and sepsis (48). The sepsis subgroup displayed the highest MDW (median 27.5, IQR 24.6–32.9) and SI (median 1.15, IQR 1.05–1.29) values. The ROC curve analysis for the prediction of sepsis showed a good and comparable diagnostic accuracy of the MDW and SI. However, the SI displayed an increased specificity, positive predictive value and positive likelihood ratio in comparison to MDW alone. (4) Conclusions: SI improves the diagnostic accuracy of MDW for sepsis screening.

Determinants of Successful Financial Inclusion in Low-Income Rural Population

2020 ◽  
Vol 68 (1) ◽  
pp. 82-100
Author(s):  
Yashwant Kumar Vaid ◽  
Vikram Singh ◽  
Monika Sethi
Keyword(s):  
Low Income ◽  
Rural Population ◽  
Geographical Area ◽  
Developing Nations ◽  
Point Of View ◽  
Financial Inclusion ◽  
Main Concern ◽  
Policy Makers ◽  
Developing Nation ◽  
Financial Products

Finance plays a key role in the growth of developed as well as developing nations. A financially well included society leads to stronger growth. Financial inclusion aims at providing easy and affordable access to financial products and services. The main concern for any developing nation from a growth point of view is advancement of low-income rural population just as much as the high-income population. Taking a note of this, identifying the key determinants that would lead to successful financial inclusion of low-income rural population is equally, if not more, important. The inclusion strategies have to be built around these determinants to promote inclusion and thus, a clear picture of these determinants is a must have for strategy and policy makers. Though the factors may be somewhat similar across the nation, but their significance and impact on financial inclusion varies greatly from one geographical area to other. In line with this, the purpose of this study is to identify the dimensions of successful financial inclusion in the low-income rural segments with special reference to Raipur, Chhattisgarh. The study uses factor analysis to identify the determinants and path analysis to analyse the significance of these factors in financial inclusion.

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