From Commission to Social Movement: Research-led Design in Action

In May 2013 the Center for Research Design and Entrepreneurship received a commission from the company Maersk Oil Qatar to design a brochure about the proper installation and use of child car seats. The team tasked with creating the brochure began with a question: how can design change peoples’ behavior? This question was the first step toward the quick evolution and exponential expansion of the project from a single brochure on child car seats to a nation-wide campaign and social movement encompassing all aspects of road safety. In Qatar traffic accidents account for one out of every eight deaths, and are responsible for more deaths than cancer or cardiovascular diseases. The dangerous conditions on Qatari roads are the product of a lack of education about safe driving practices, in some cases a lack of experience, and widespread distracted driving behaviors. The need to address this issue is vital for Qatar, however, it does present a complex set of challenges, including what can be done to effect changes in peoples’ behavior. The Center for Research Design and Entrepreneurship at VCUQatar began with ideas for the commissioned brochure on child car seats as a foundation and turned to both qualitative and quantitative research methodologies to answer key questions about changing behaviors and the impact of design. Working with psychologists at VCUQatar, the team combined design thinking and research to develop a series of pilot projects, which led to the development of the “ONE SECOND” campaign. The government of Qatar has adopted this campaign and the team is now responsible for deploying the project nationwide. This panel discusses the evolution of the project from small and focused to large scale and widespread, and the integration of research and design at each step. We will also delve into the “ONE SECOND” campaign as an example of a successful integrative-interdisciplinary research project that demonstrated a practical model that could be applied for any future social problem

HERBAL MEDICINES QUESTIONNAIRE AND EVALUATION OF ATTITUDE, PERCEPTIONS AND SELF-USE AMONG HEALTH CARE PROFESSIONALS IN RAK, UAE: PILOT STUDY

Objective: The aim of this study was to assess the perceptions of different healthcare professionals towards HM. Methods: The 16-item questionnaire on the belief of health care professionals in herbal medicine was designed by the interdisciplinary task force. Eligible participants were health care providers who were English-and Arabic-literate. The response rate was 78% of participants (781 of 1000) were respondents. In total, 553 out of 781 (71%) participants indicated that they had previously used herbal medicines. The remaining 228 participants did not believe in herbal medicine due to lack of scientific evidence, ineffectiveness and other reasons. Results: The findings of this study indicate that health care professionals including pharmacists believe they have a responsibility to provide information on HM to their patients. However, the current consensus among the respondents is that current HM-focused knowledge is inadequate for such an application. Conclusion: Health care professionals believe in using HM for their needs and have a responsibility to provide information on HM to their patients

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

From Commission to Social Movement: Research-led Design in Action

In May 2013 the Center for Research Design and Entrepreneurship received a commission from the company Maersk Oil Qatar to design a brochure about the proper installation and use of child car seats. The team tasked with creating the brochure began with a question: how can design change peoples’ behavior? This question was the first step toward the quick evolution and exponential expansion of the project from a single brochure on child car seats to a nation-wide campaign and social movement encompassing all aspects of road safety. In Qatar traffic accidents account for one out of every eight deaths, and are responsible for more deaths than cancer or cardiovascular diseases. The dangerous conditions on Qatari roads are the product of a lack of education about safe driving practices, in some cases a lack of experience, and widespread distracted driving behaviors. The need to address this issue is vital for Qatar, however, it does present a complex set of challenges, including what can be done to effect changes in peoples’ behavior. The Center for Research Design and Entrepreneurship at VCUQatar began with ideas for the commissioned brochure on child car seats as a foundation and turned to both qualitative and quantitative research methodologies to answer key questions about changing behaviors and the impact of design. Working with psychologists at VCUQatar, the team combined design thinking and research to develop a series of pilot projects, which led to the development of the “ONE SECOND” campaign. The government of Qatar has adopted this campaign and the team is now responsible for deploying the project nationwide. This panel discusses the evolution of the project from small and focused to large scale and widespread, and the integration of research and design at each step. We will also delve into the “ONE SECOND” campaign as an example of a successful integrative-interdisciplinary research project that demonstrated a practical model that could be applied for any future social problem.</p

Community pharmacy ethical practice in Jordan: assessing attitude, needs and barriers

Background: Having a local code of ethics, based on moral obligations and virtues, known to all practicing pharmacists is important in order to guide them in relationships with patients, health professionals, and society. Objective: To investigate pharmacists’ attitude and barriers towards applying the ethical principles published by the Jordanian Pharmacists Association in the Jordanian code of ethics. Methods: The study objectives were addressed in a cross-sectional study completed by a convenience sample of community pharmacists, in both cities; Amman and Irbid A questionnaire was used to achieve the study objective. The questionnaire was developed and validated, investigating pharmacists’ socio-demographic and practice characteristics, perceived attitude toward certain practice scenarios, and perceived barriers towards applying the locally published ethical principles while dealing with their patients. The questionnaire was self-completed by pharmacists between January and August 2017. Collected data was analyzed using SPSS version 21. Descriptive statistics and parametric tests were used with p<0.05 set a priori as significant. Results: Seven hundred and four pharmacists (Amman n=486; Irbid n=218) responded to the questionnaire, providing completely answered questionnaires with a response rates of 69.4% in Amman and 99.6% in Irbid. Pharmacists from both cities revealed that they use the Internet as their main resource to obtain ethical information when they need it, to help them deal with their patients (34.0% from Amman and 31.5% from Irbid). More pharmacists in Amman (57.0%) had access to resources regarding ethical information at their practice sites compared to pharmacists in Irbid (24.0%). Significant differences in attitude was found between pharmacists practicing in both cities, as significantly less pharmacists from Amman (37.8%) declared that they would sell a medication for an unreported indication according to national and international guidelines, if recommended by the consultant, compared to pharmacists from Irbid (77.7%, p<0.001). Conclusions: Despite having ethical guidance from the Jordanian Pharmacists Association, the majority of pharmacists in Jordan do not use this resource; instead, most choose to access ethical guidance on-line. Pharmacists from the capital, Amman, reported to adhere more with the guidelines when selling a medication for an unreported indication compared to pharmacists from the smaller city, Irbid. Results of this study call for more actions from the authorities in the country responsible for setting and enforcing the pharmaceutical Code of Ethics

Modulatory Effect of Intermittent Fasting on Adipose Tissue Inflammation: Amelioration of Cardiovascular Dysfunction in Early Metabolic Impairment

Cardiometabolic syndrome (CMS) is a cluster of maladaptive cardiovascular, renal, thrombotic, inflammatory, and metabolic disorders. It confers a high risk of cardiovascular mortality and morbidity. CMS is triggered by major shifts in lifestyle and dietary habits with increased consumption of refined, calorie-dense diets. Evidence indicates that diet-induced CMS is linked to Adipose tissue (AT) inflammation. This led to the proposal that adipose inflammation may be involved in metabolic derangements, such as insulin resistance and poor glycemic control, as well as the contribution to the inflammatory process predisposing patients to increased cardiovascular risk. Therefore, in the absence of direct pharmacological interventions for the subclinical phase of CMS, time restricted feeding regimens were anticipated to alleviate early metabolic damage and subsequent comorbidities. These regimens, referred to as intermittent fasting (IF), showed a strong positive impact on the metabolic state of obese and non-obese human subjects and animal models, positive AT remodeling in face of overnutrition and high fat diet (HFD) consumption, and improved CV outcomes. Here, we summarize the available evidence on the role of adipose inflammation in triggering cardiovascular impairment in the context of diet induced CMS with an emphasis on the involvement of perivascular adipose tissue. As well, we propose some possible molecular pathways linking intermittent fasting to the ameliorative effect on adipose inflammation and cardiovascular dysfunction under such circumstances. We highlight a number of targets, whose function changes in perivascular adipose tissue inflammation and could be modified by intermittent fasting acting as a novel approach to ameliorate the inflammatory status