Knowledge and perception of Sepsis among Doctors in Karachi Pakistan

Objectives: To assess knowledge and perception among Pakistani physicians towards sepsis. Methods: This cross-sectional study was conducted in Indus Hospital and Health Networks from September 2020 to March 2021. The International Sepsis Survey questionnaire was adapted, and its link was sent to trainee physicians as well as specialists, and consultants practicing in various hospitals via social media. Knowledge and perception were scored and 50% was considered the cut-off score for adequacy. Data was analyzed using SPSS version 26. Results: Analysis was done on 222 respondents who completed the survey. 37.9% of the participants had adequate knowledge. Knowledge regarding sepsis was significantly associated with specialty, ICU/CCU/HDU, and work experience (P-value <0.0001). More recent trainee physicians and those with more experience in critical care areas demonstrated better knowledge. Over 2/3rd of the respondents strongly agreed that sepsis remains one of the unmet needs in critical care today. Conclusion: A common belief exists that sepsis remains a challenge to treat among doctors. Moreover, there is consensus that it is the most frequently miss diagnosed condition in critical care and a dire need exists for its early diagnosis. Additionally, prompt management of presumed sepsis is imperative to improve outcomes. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5775 How to cite this:Ahmed F, Abbasi L, Herekar F, Jiwani A, Patel MJ. Knowledge and perception of Sepsis among Doctors in Karachi Pakistan. Pak J Med Sci. 2022;38(2):380-386. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5775 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Writing for the Wider Public - Readability of Publicly Available Board Reports

Objective: This work aims to evaluate the readability of publicly available board reports from the Local Health Networks (LHNs) in South Australia and the National Health Service (NHS) Trusts in England. Method: Publicly available board reports from the LHNs in South Australia and NHS Trusts in England were identified, screened, and evaluated from January 2020 to August 2020. Results: The average Flesch Reading Ease score for all LHNs reviewed ranged from 34 ± 10.2 to 57 ± 0.0 (Difficult to Fairly Difficult). In comparison, the average Flesch Reading Ease score for all the NHS Foundation Trusts ranged from 46 ± 1.7 to 60 ± 3.0 (Difficult to Standard). The average Reading Ease score for metropolitan and non-metropolitan LHNs was 43 ± 8.1 and 41 ± 6.0 (Difficult to read). In contrast, the average Reading Ease score for metropolitan and non-metropolitan NHS Trust was Fairly Difficult with 53 ± 4.2 and 50 ± 3.5 respectively. Conclusion: The evaluation results suggest that there is scope for improving the quality of publicly available board reports from the boards reviewed in terms of their readability by the public.

Understanding the Development, Evaluation, and Sustainability of Community Health Networks Using Social Network Analysis: A Scoping Review

Objective Identify the scope of the literature which reports use of social network analysis to inform, support, or evaluate health promotion–focused community network/partnership development. Data Source A comprehensive search (not date-limited) of PubMed, CINAHL, Web of Science Core Collection, PsycInfo, and the Cochrane Library Database for Systematic Reviews. Inclusion and Exclusion Criteria Criteria for inclusion included published in the English language and used social network analysis to inform, support, or evaluate development of community networks/partnerships aiding health promotion efforts. Studies were excluded if they did not use social network analysis or were not focused upon health promotion. Data Extraction Three of the four authors extracted data using a summary chart to document information regarding study aims, target issue/population, methods, and key outcomes of the social network analysis. Data Synthesis The extracted data were qualitatively analyzed by 3 authors to categorize key social network analysis outcomes into categories. Results Ninety-seven studies representing 9 geographical regions were included, with the majority (69) published after 2010. Key outcomes included the effectiveness of social network analysis to identify network characteristics, track network change over time, compare similar networks across locations, and correlate network attributes with outcomes. Conclusion Findings support the utility of social network analysis to inform, support, and evaluate development of sustainable health promotion–focused networks/partnerships.

Environmental health: The most neglected part of one health

One health concept and perspectives have gained momentum in past few years in global health sector. Keeping in view the increased popularity of “one health” American Veterinary & Medical Association has defined it as the emerging interdisciplinary field that inherently collaborates human, animal and environmental aspects to combat emerging global health problems especially related to zoonotic public health emergencies. According to key findings of “One Health Networks (OHNs)” environmental factor is the most neglected part of one health triad that consists of human-animal-environment interface. Currently, human and animal health has been constantly threatened by rise of novel challenges like antimicrobial resistance, environmental pollution, epizootics, pandemics, development of multifactorial chronic ailments etc which needs an interdisciplinary and intersectoral expertise. Ecosystem heath and its adverse effects on human and animal health have gained greatest attention over recent years as it serves as melting pot for all infectious diseases. Despite of achieving global success in the field of “One health” it is still in embryonic stage in our country. So, the success of one health requires breaking down the shackles that still separate human and veterinary medicine from environmental, evolutionary and ecological sciences that will ultimately lead to desired equilibrium and dynamics in maintaining healthy ecosystems.

Pediatric Emergency Telehealth

Pediatric Emergency Telehealth (PET) has enormous potential to help address the health care needs of children and families. In some regions, health care is particularly fragmented or difficult to access for the pediatric patient. Telehealth may bridge those gaps, improve continuity of care, and enhance communication between children’s hospitals and general pediatricians practicing in both rural and urban communities. Launching a PET service requires careful preparation with community health networks and stakeholders to ensure that the model is providing adjunct services as opposed to on-demand primary care services. General pediatricians’ offices that lack the capability to implement a virtual care system may seek consultation from the PET service in terms of triage, recommendations, or direct patient care. A substantial effort is required at initiation of a PET program but is useful in mitigating disease exposure such as Covid-19, as well as improving emergency department metrics such as patient satisfaction, length of stay, wait times, and revenue capture.

Expansion of Health Networks as a Building Block of a Functioning Health Landscape

A health network is made up of institutions and organizations, resources, and people whose main purpose is to promote and improve health. The health care system in Germany is self-administering and is managed by multiple institutions and stakeholders which entails different organizations involved in the running of the health care as well as the structure of the health care system. The health care system is composed of three main areas: 1) outpatient care services, 2) inpatient care, 3) rehabilitation institutions. Some of the organizations and institutions that are mandated to run the health system include associations and representatives of different professions and service providers, regulatory bodies, health insurance companies, the Federal Ministry of Health, self-help groups, and patient-centered organizations. The German health care system is made up of four main principles: 1) compulsory insurance, 2) the principle of solidarity, 3) financing through insurance premiums, 4) selfgovernance. The goal of health care networks is to improve the overall performance of the health care systems concerning: 1) economic efficiency, 2) quality of health care services, 3) medical innovation, 4) as well as patient satisfaction.