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SCCM Pod-362 Time of Admission to the PICU and Mortality

Margaret Parker, MD, MCCM, speaks with Michael C. McCrory, MD, MS, about the article, Time of Admission to the PICU and Mortality, published in the October 2017 issue of Pediatric Critical Care Medicine.




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SCCM Pod-364 Characterization of Pediatric In-Hospital CPR Quality Metrics

Margaret Parker, MD, MCCM, speaks with Dana E. Niles, MS, about the article Characterization of Pediatric In-Hospital Cardiopulmonary Resuscitation Quality Metrics Across an International Resuscitation Collaborative, published in the May 2018 issue of Pediatric Critical Care Medicine.




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SCCM Pod-367 Variability in Antibiotic Use Across PICUs

Margaret Parker, MD, MCCM, speaks with Thomas V. Brogan, MD, about the article Variability in Antibiotic Use Across PICUs, published in the June 2018 issue of Pediatric Critical Care Medicine. Dr.




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SCCM Pod-369 Hospital Variation in Risk-Adjusted Pediatric Sepsis Mortality

Margaret Parker, MD, MCCM, speaks with Stefanie G. Ames, MD, about the article Hospital Variation in Risk-Adjusted Pediatric Sepsis Mortality, published in the May 2018 issue of Pediatric Critical Care Medicine.




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SCCM Pod-372 Nutrition Support Therapy in the Pediatric Critically Ill Patient

Margaret Parker, MD, MCCM, speaks with Nilesh M. Mehta, MD, about the article, Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition, published in the July 2017 issue of Pediatric Critical Care Medicine




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SCCM Pod-384 Updated Pediatric Severe Traumatic Brain Injury Guidelines

Margaret M. Parker, MD, MCCM, and Patrick M. Kochanek, MD, MCCM, discuss the updated pediatric severe traumatic brain injury guidelines




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SCCM Pod-389 Infections on Extracorporeal Life Support

Margaret M. Parker, MD, MCCM, and Luregn Schlapbach, MD, FCICM, review a survey of international practice on prevention, diagnosis, and treatment of infections on extracorporeal life support in adults and children published in Pediatric Critical Care Medicine




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SCCM Pod-391 Pediatric Nutritional Guidelines

Margaret M. Parker, MD, MCCM, and Elizabeth Emrath, MD, discuss Dr. Emrath's talk on the new pediatric nutritional guidelines from the 48th Critical Care Congress precourse Current Concepts in Pediatric Critical Care




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SCCM Pod-393 Updated Pediatric Admission, Discharge, and Triage and Levels of Care Guidance

Margaret M. Parker, MD, MCCM, and Lorry R. Frankel, MD, FCCM, discuss the updated pediatric critical care admission, discharge, and triage criteria and levels of care guidance published in the September issue of Pediatric Critical Care Medicine




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SCCM Pod-394 Polyneuropathy in Critically Ill Mechanically Ventilated Children

Margaret M. Parker, MD, MCCM, speaks with Rakesh Lodha, MD, on his article titled Polyneuropathy in Critically Ill Mechanically Ventilated Children: Experience from Tertiary Care Hospital in North India, published the September issue of Pediatric Critical Care Medicine




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SCCM Pod-399 Risk for Mortality in Critically Ill Children Needing Renal Replacement Therapy

Margaret M. Parker, MD, MCCM, speaks with Danny Hames, MD, on his article titled: Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy, published in the November 2019 issue of Pediatric Critical Care Medicine.




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SCCM Pod-404 Population-Based Epidemiology and Outcomes of Acute Kidney Injury in Critically Ill Children

Margaret M. Parker, MD, MCCM, speaks with Rashid Alobaidi, MD, on his article titled Population-Based Epidemiology and Outcomes of Acute Kidney Injury in Critically Ill Children published in the January 2020 issue of Pediatric Critical Care Medicine.




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SCCM Pod-406 Surviving Sepsis Campaign Children's Guidelines

Margaret M. Parker, MD, MCCM, and Scott L. Weiss, MD, FCCM, discuss the release of: Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children




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SCCM Pod-411 Clinical Moral Distress

Margaret M. Parker, MD, MCCM, and Christopher S. Parshuram, MBChB, PhD, discuss clinician moral distress in Canadian pediatric and neonatal intensive care units.




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SCCM Pod-412 COVID-19 in Critically Ill Children

Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH




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Poke Me: The Budget ignores urban India, where two-third of India's GDP is generated

As per the new Budget, the profit-linked income tax exemption for promoters of affordable housing with a 30 sq m limit will apply only to the four metropolitan cities.




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Poke Me: The removal of Dhoni from the captaincy of Rising Pune Supergiants is legit

This is not about making a value judgment. Whether the decision is good or bad can only be known at the end of the 10th season of the IPL.




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POKE ME: Government, get out of skilling. Motivate the bureaucracy to create the right ecosystem instead

What we need before Skill India is perhaps a Skill Government mission. And what’s more, in this Budget season, a visionary leader can do this without much fund allocation.




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POKE ME: H-1B issue in US provides the right push – and opportunity – for India

Trumpnomics will probably kick-start the decline of the US as we know it. Getting back our best brains, trained in the best institutes, will be the biggest capital we can have to climb to the pinnacle.




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Poke Me: H-1B issue in US provides the right push – and opportunity – for India (Reader's React)

This week's "Poke Me" invited your comments on "H-1B issue in US provides the right push – and opportunity – for India".




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Poke Me: Does Indian cricket need a behemoth like the BCCI to run the show? No.

In trying to answer this question, the first thing that needs to be done is to define what the BCCI does. What are its primary tasks and objectives?




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POKE ME: SEBI needs to loosen up and keep its eye on investor interest using economics

Many of the securities laws are spread over circulars, which are vague and ever-changing. It is not clear how ordinary companies can keep track with daily changes and excessive complexity of regulations.




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Poke Me: SEBI needs to loosen up and keep its eye on investor interest using economics (Reader's React)

Sebi must ensure that no one is hanged without a fair hearing, levy of penalty on Reliance speaks about the regulator’s firmness, a reader said.




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Poke Me: The Supreme Court should have taken a more streetwise look before ordering a 'highway prohibition'

For those of us who’ve lived in Dehradun for decades, the Supreme Court order banning sale of liquor on highways, is the cruellest joke you could play on a small town.




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Poke Me: How Dry Is My Valley (Readers React)

This week's "Poke Me" invited your comments on "How Dry Is My Valley". Here are the selected opinions that were published in the ET print edition on Saturday.




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Poke Me: An unreasonable ratio between a company's lowest and highest salary can cause problems

Murthy’s long missive about the pay culture in Infosys echoes the pay reforms debate in advanced economies.




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Poke Me: Time to Tweak Capitalism (Readers React)

This week's "Poke Me" invited your comments on "Time to Tweak Capitalism". Here are the selected opinions that were published in the ET print edition on Saturday.




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Poke Me: It may be a mantra, but India’s demographic dividend can become a burden if unattended

India is currently in a sweet spot, with its working-age population expected to grow by a third over the next three decades, at a time when China and Russia will see a fall of over 20% .




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Poke Me: Young and the restless(Readers React)

This week's "Poke Me" invited your comments on "Young and the restless". Here are the selected opinions.




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POKE ME: Rallying to protect our rivers is great. But let’s get the science right

Drying trends have been reported in Krishna and Kaveri and the pollution problem in the Ganga is well recognised. The future of our rivers appears bleak.




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No timeline fixed for release of e-commerce policy: Piyush Goyal

On February 23, 2019, the first draft of the National e-Commerce policy was placed in public domain for suggestions. Comments from over 120 stakeholders- companies both Indian and foreign, industry associations, think tanks, foreign governments were received. Post this, a series of meetings have been held with different stakeholders.




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Alexa, report to the e-commerce regulator

​​​The intention is to bring all B2B, B2C, consumer-facing, consumer-based content platforms, apps-based commerce and IoT device-based services under the policy, potentially engulfing products like the Amazon Echo, which is powered by artificial intelligence-driven virtual assistant Alexa, and MG Hector, the Internet-enabled vehicle from Morris Garages in the regulatory realm of e-commerce.




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I can't risk lives of my policemen to manage crowd at liquor shops: Delhi Police Commissioner SN Shrivastava

Police should have welfare systems similar to the ones implemented by the armed forces, says Delhi Police Commissioner SN Shrivastava.




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5 compact, powerful smartphones

Mobile phone manufacturers are focusing on increasing the screen size of devices. However, if you are someone who prefer a more compact phone, ET Wealth rounds up some of the best options.




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Economic revival will depend on our covid policy

Cement is a perfect barometer to gauge economic activity. On May 5, a day after India began a graded opening up in its fight against the scourge of the novel coronavirus, economic activity could be tracked by the movement of rakes carrying cement: 7 out of every 10 trains were chugging towards green and orange zones, bypassing the prosperous districts in the red zone.The government, by then, had colour-coded all 733 districts in the country. The 130 districts that were the worst affected by Covid-19 were in the red zone. Suddenly, the country’s biggest and most vital commercial hubs such as Mumbai, Delhi, Pune, Ahmedabad and Chennai were hotspots. The virus-free 319 districts were coded green and the rest 284 districts, which were only moderately affected, were called orange. The many guidelines issued by the Ministry of Home Affairs, state chief secretaries and even resident welfare societies boiled down to the same thing — the harshest lockdown will be in the red zone, there will be partial relaxation in orange zones while green will be opened up, albeit with conditions.Cement movement is a good measure of economic activity on the ground as it is often ferried straight to project sites. When the nationwide lockdown began on March 25, all non-essential work, including construction, came to a grinding halt. And the rakes carrying cement stopped running. 75649505The railway data, previewed by ET Magazine, shows that 254 trains carrying cement were on the move on May 5 when Lockdown 3.0 began: 84 of them were travelling towards green zones, 99 to orange and only 71 to red.India in Numbers- Source: McKinsey (% of population- 2011 census)Total Districts in India: 733GREEN ZONE- 319 Districts- 24 per cent populationORANGE ZONE- 284 Districts- 43 per cent populationRED ZONE- 130 Districts- 33 per cent population49-57% Economic activity during the lockdown 41% Red districts’ share of economic activities 50% Share of red districts in households with annual disposable income of over Rs 4.85 lakh 143 mn Minimum number of inactive non-farm workers during lockdown (Note: Green districts are Covid-free for previous 21 days; red and orange zones are identified on the basis of positive cases, doubling rate, testing, etc.)The colour-coded division and lockdown of India raises three big questions. One, are the green and orange zones robust enough to fire up the nation’s $2.7 trillion economy? Two, can the lockdown in the red zones be stretched beyond May 17 even as the number of Covid-19 cases in the country jump to about 60,000 on Saturday morning, with almost all of the new active cases coming from the red districts? Three, if the lockdown is prolonged in the metropolises, have we calculated the impact on the economy? In essence, how should India navigate a health emergency and an economic crisis — both unprecedented in its nature and magnitude? 75649443Bibek Debroy, chairman of the Prime Minister’s Economic Advisory Council, resorts to Greek mythology to explain the dilemma India is in and the possible way out for it. Homer’s hero Odysseus, Debroy says, chose to sail closer to the sea beast Scylla and lose a few sailors, rather than lose his entire ship by travelling near the monstrous whirlpool Charybdis. In Debroy’s telling, the sea monster Scylla is the Covid pandemic and Charybdis is the economic toll. (See the column, “The Ship Inches a Little Away From Whirlpool”).That Greek myth could be a clue to what the Indian government is likely to do after May 17: lift the clampdown on entire districts and impose severe restrictions only on containment zones; kick-start the economy even as Covid cases and the death toll rise alongside. Says Debroy: “Mortality and morbidity apply to enterprises too; MSMEs more pronounced than most. The baseline GDP growth was already in slowdown mode and a capital crunch was compounded by lockdown’s labour constraint. There were both supply and demand shocks. That Scylla/Charybdis metaphor is apt, because Homer’s account tells us what Odysseus did.” 75649534“All the big cities are in red zones. Even if a factory opens in orange or green zone, who will it produce for? Red zones cannot turn orange quickly. So will you not allow the sale of nonessential items in red zones?” Arvind Mediratta, MD & CEO, Metro Cash & Carry.The worry about the nation’s economic health is palpable. If the lockdown continues in the commercial hubs any longer, the losses will pile up for many companies; the smaller firms likely to go under first. It will have a debilitating effect on the economy in general and jobs in particular. The Indian economy would be on the ventilator then.As those cement-carrying rakes show, there are many factories in orange and green zones as well, miles away from city limits. Work can begin there, and some have already started production. 75649555“There is total disruption. Supply chains are badly affected. Liquidity is a big issue. The govt must announce a stimulus package. I also urge the govt to stop the imports of all products that can be made in India” Gautam Singhania, CMD, RaymondBut the million-rupee question is, who are they producing for? The 130 districts in the red zone are critical centres of not just production but also consumption. Even as they account for 41% of national economic activity, 38% of industrial output and 40% of non-farm employment, they also have half of India’s consuming-class households — those with an annual disposable income of more than Rs 4.85 lakh each — according to a recent McKinsey report titled “Reopening India: Implications for Economic Activity and Workers”.Breaking the Value ChainFurthermore, dividing swathes of the country into zones and restricting movement of goods and people will have a disastrous effect on production, labour, supply and distribution chains, which are deeply intertwined. In the textiles sector, for example, if cotton is bought in the western parts of India, yarn is spun in the north and west, while weaving mostly takes place in the south, and apparel is manufactured in clusters in the north and south, as the McKinsey report further points out. Similarly, in the chemical industry, the acetic acid value chain supplies to a variety of industries such as pharmaceuticals, pesticides, paper, food processing and construction. Any blockage will have a ripple effect on sectors.Arvind Mediratta, managing director and CEO of Metro Cash and Carry, says dividing the country into colour-coded districts is unrealistic and the rules guiding it are arbitrary. “It seems those who designed it (colour-coded zones) are not aware of ground realities. All the big cities are in red zones. Even if a factory opens in orange or green zone, who will it produce for? Also, the implementation on the ground is arbitrary. In red zones today, you can buy liquor but not kitchen items,” says Mediratta.Mohit Anand, managing director of Kellogg, South Asia, says solutions have to be found locally. “Each region has its own issues, each warehouse and factory has a different problem. India is like 21 countries put together and, hence, the solutions also have to be hyperlocal in nature,” he says. In red zones, not only are malls and market places shut but ecommerce firms are barred from selling non-essential items. An Amazon spokesperson says when restrictions were lifted, the company saw a huge demand from orange and green zones for smart devices, kitchen appliances, baby clothes and products related to study-from-home. “The opening up of these areas for ecommerce has meant that thousands of small businesses received orders for the first time in the past many weeks of lockdown,” the spokesperson adds. Consumers and businesses in the red zone, meanwhile, have to wait. 75649590“MMCAS (manufacturing, mining, construction and allied services) constitutes about 50% of GVA and about 35% of employment. This segment must be freed up, even in red zones” Arvind Virmani, Former chief economic adviser.Out of WorkThe lockdown has seen a massive reverse migration of workers. Deprived of work and wages for weeks, hundreds of thousands of labourers have left cities. In sheer desperation, many hid in trucks and freight trains and trudged hundreds of kilometres to reach home. It was only after 40 days of lockdown that the government arranged special trains for them— by Saturday, 302 trains have ferried around 3.4 lakh migrant workers to their native states.Some states are worried about reverse migration at a time when factories are reopening and life in green pockets are returning to normalcy. Karnataka even made an abortive attempt to stop such special trains to stonewall the return of migrant labourers. Rajasthan Deputy Chief Minister Sachin Pilot says workers should be persuaded to stay back. He says: “There is a cost to the migrants’ travelling back to their native districts. Once a worker goes home, she won’t return in the next three-four months. I feel that only those who are desperate and determined to return home should go; the rest should stay back, taking temporary jobs. They won’t be gainfully employed in their native areas.” The loss of workforce will particularly affect states such as Maharashtra, Delhi, Andhra Pradesh, Telangana, Karnataka and Kerala that rely heavily on migrant workers in construction and services sectors. 75649620“After Covid-19 there will be new normals: new models of engagement between companies and their clients” Keshav Murugesh, Group CEO, WNS Global ServicesMontek Singh Ahluwalia, former deputy chairman of the Planning Commission, says labourers will not return to cities anytime soon, and it will be one of the factors that will prolong the economic pain. He says green and orange zones cannot help in economic revival “as 60% of the economy is in the red zone”. Even if restrictions in all the zones are lifted, he says, it will take some more time for economic activity to get back to normal. “The reverse migration that has taken place may not be quickly reversed. Recession in the world economy and reduced level of remittances will have a negative impact. Private sector investment plans which have been interrupted will take time to resume. That is why many analysts are predicting that we may see negative growth in 2021, with recovery beginning only next year,” Ahluwalia adds.In this pervasive gloom, some indicators offer flickers of hope. Bengaluru-based trucking platform BlackBuck has seen a spike in bookings on the back of a good harvest. The agri pickup is likely to continue into the kharif season, with the India Meteorological Department forecasting a good monsoon. Cofounder Rajesh Yabaji says: “We have seen 80,000 bookings since we opened up our commission-free platform in April-end. Now, we estimate truck traffic to be at 50% of pre-lockdown trucking movement.”On April 29 and 30, two freight trains originating from Karnataka ferried about 350 new tractors to Rajasthan and Gujarat, responding to demand in western India ahead of the kharif season.Companies are ramping up production of agri-related items to meet seasonal demand from rural India. Hemant Sikka, president, farm equipment sector, Mahindra & Mahindra, says the company has resumed production in its tractor plants in Rudrapur (Uttarakhand), Nagpur (Maharashtra) and Mohali (Punjab) after getting necessary approvals. 75649661“With dealerships opening up, bounty harvest and forecast of a normal monsoon, the tractor industry will perform well” Hemant Sikka, President, farm equipment sector, Mahindra & Mahindra.“The highest levels of safety protocols and social distancing are being ensured at the plants, especially on the shop floor. With dealerships gradually opening up, a bounty harvest and forecast of a normal monsoon, I am positive that the tractor industry will perform well and ensure rural growth and prosperity during the year,” says Sikka.Farming sector is likely to get a boost this year with labourers who are back from the cities lending a hand on the fields. The number of people engaged in work under NREGA (National Rural Employment Guarantee Act) has swelled multiple times. In Rajasthan, as against 62,000 NREGA workers on April 18, there were 16.5 lakh on May 5. All of them are engaged in their own farmland, receiving Rs 220 daily from the government.While agriculture could be a sector to watch out for in the coming months, the Covid-19 crisis will inflict a body blow to sectors such as hospitality and tourism, which are likely to remain dormant for quite some time even after the lockdown is lifted. 75649456After Covid The post-Covid world will be vastly different from the before-Covid universe we have left behind. Keshav Murugesh, group CEO of WNS Global Services and former chairman of Nasscom, says there will be “new normals”. Clients and BPO companies will come up with ingenious models of engagement. Work from home could become the norm even if it leads to productivity loss. “At WNS, we are in no hurry to go back to office in May although work from home would mean productivity would drop to 85%,” says Murugesh, adding that uninterrupted power supply at homes is essential for making the model a success in the longer term.Saugata Gupta, managing director of consumer goods company Marico, says they are strategising on new pricing to sell their products effectively in a post-Covid environment. “We have to be cognisant of the fact that with mounting pressure on consumers’ disposable income, there will be a risk of downtrading. So, one has to be very careful on pricing, and we have to ensure a good value to consumers. Any gains on input costs need to be passed on to consumers,” says Gupta, adding that the opening up of green zones is good news for them as many of their products are popular in rural markets. 75649645“Each region has its own problems. India is like 21 countries put together, and solutions also have to be hyperlocal in nature” Mohit Anand, MD, Kellogg, South AsiaGautam Singhania, chairman and MD of Raymond, says there seems to be a communication gap between the Centre and states. He says: “There is total disruption. The supply chains are badly affected. Liquidity is a big issue and banks are not willing to pump in cash now. It is high time the government took this up, and announced a stimulus package.” He proposes a ban on imports. “For one year, we should follow the motto of buying only Indian products. I urge the government to stop imports of products that can be made in India. This is a question of survival.”India Inc, by and large, has come to terms with the new reality that till a vaccine for Covid-19 is discovered, the companies will be forced to shed some productivity by allowing employees to work from home and by deploying fewer labourers to ensure social distancing.The government, however, cannot remain in stasis till a vaccine is discovered. It has to take a call on whether a blanket ban on economic activities in red districts is the way forward. Former chief economic adviser Arvind Virmani says economic activities should be allowed in red zones. “We estimate that MMCAS (manufacturing, mining, construction and allied services) constitutes about 50% of GVA (gross value added) and about 35% of employment. This segment of economy must be freed up entirely, even in red zones, with restrictions such as physical distancing,” he says.The virus is not going away anytime soon. The hastily drawn colour codes will have to be smudged away now. Otherwise, an economic contagion will be upon us.Read More1. Our first objective is to provide value to customers: Saugata Gupta, MD, Marico2.Economy likely to show negative growth in current year: Montek Singh Ahluwali3. Rajasthan’s thrust will be on textile, agriculture and domestic tourism: Sachin Pilot4. With a phased opening, India tries to avoid a grave economic toll: Bibek Debroy




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What RBI's announcement today means for your loans and fixed deposit interest rates

The RBI announced a host of measures today aimed at increasing liquidity in the economy.




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Corporate Sufi It Is

By denying women their rights, we deny rights to the entire humanity for we are also ignoring the contribution of half of humanity.




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9 more NRI police stations being set up in Punjab

Punjab Minister for NRI Affairs Bikram Singh Majithia said they were being set up keeping in view the demand for more such police stations by the NRI community.




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1700 Indian workers arrested or deported from Kuwait: Government

The minister said the government has already set up an Indian Workers Resource Centre in Dubai and will set up two more in Saudi Arabia and Malaysia.




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Paytm Payments Bank crosses Rs 600 crore in fixed deposits

"During this period of volatility in other asset classes, a large number of PPB bank account holders are moving their savings into fixed deposits during the ongoing lockdown," stated Paytm Payments Bank.




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Franklin Templeton Mutual Fund apologises unconditionally to Sebi

The fund house claimed that media outlets quoted its CEO Jenny Johnson out of context.




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Exide Life's term policy sales jump 200% in April due to COVID-19: COO

However, Ashwin B added that there has been a significant drop in sales of non-term policies, witnessing a decline of 50 per cent.




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Young working professionals to cut down expenses as post-Covid world brings uncertainty, job loss

Categories like essentials, at-home entertainment, health and insurance continue to show greater resiliency.




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Political Praxis

If rulers can change the law to suit themselves, the rule of law does not exist, even if the laws are applied uniformly to the rest of society.




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The Power of Ideas

Most of us are a lot like those monkeys. On the upside, we learn from one another, we don’t let down our mates, and we get along.




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Indian-American Ro Khanna appointed to White House COVID-19 advisory council

Khanna, 43, is the only Indian-American lawmaker to be named to the White House's Opening Up America Again Congressional Group which comprises Congressmen from both the Republican and the Democratic parties.




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Indians at greater risk from COVID-19 in UK's health sector: Report

"Indian men are 150 per cent more likely to work in health or social care roles than their white British counterparts," according to the report.




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COVID-19: Indian-American Senator appointed member of committee to address Washington's eco recovery

The committee will consist of four Democrat and three Republican senators. Democratic senators include David Frockt, Manka Dhingra, Christine Rolfes and Rebecca Saldana and Republicans include senators Randi Becker, Tim Sheldon, while one member is yet to be named.




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Time to rebalance your portfolio, invest more in equity mutual funds

The global economy is already in recession. Travel and tourism, restaurants, movie theatres and scores of other businesses have suddenly come to a standstill.




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Can football help you build your portfolio?

To talk about investments in parlance with football; an investment without a goal is like a game of football with one - it'll basically have no meaning.