35 research outputs found

    Earthquakes, Volcanoes and God: Comparative Perspectives from Christianity and Islam

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    This paper asserts that both Christian and Islamic traditions of faith affect the ways in which people both try to make sense of, and respond to, disasters. This contention is supported by the results of empirical research, which demonstrates that differing Islamic and Christian perspectives on human suffering caused by disasters are neither as diverse, nor are they so intractable, as is commonly supposed. Today pastoral convergence between the two traditions may also be discerned, together with a general acceptance of the policies of both State agencies and Non-Governmental Organisations (NGOs) which are concerned with hazard relief and the propagation of policies of disaster risk reduction (DRR). Indeed some important disaster relief NGOs have emerged from Islamic and Christian faith communities and are supported by charitable donations

    Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

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    Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14路2 per cent (646 of 4544) and the 30-day mortality rate was 1路8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7路61, 95 per cent c.i. 4路49 to 12路90; P < 0路001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0路65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability
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