Horizon scanning to identify priority research questions for the South African marine shore-based recreational fishery

Recreational fisheries hold immense ecological, social, and economic value. The management of these fisheries is increasingly important as we move forward in the Anthropocene. Recreational fisheries managers face several challenges as fisheries often involve diverse social and ecological systems comprised of complex feedback and stakeholder motivations and needs. Here, we used a horizon scanning exercise to yield 100 research questions related to recreational fisheries science and management in the Anthropocene. Initial research questions (n = 205) were collected from recreational fisheries experts (i.e., stakeholders, managers, researchers) from various sectors (i.e., industry, government, NGOs) and geographic locations (14 countries: Australia, Brazil, Canada, Czech Republic, Germany, Italy, New Zealand, Norway, South Africa, Spain, Sweden, Switzerland, United Kingdom, USA). These questions were subsequently categorized, thematized, and refined by our authorship team, eventually yielding what we considered to be the top 100 research questions of relevance to management of recreational fisheries. The key themes include: human dimensions; bioeconomics; resource monitoring and data acquisition; governance; management—regulatory actions; management—stock and habitat enhancement; catch-and-release; impacts of recreational fisheries on populations, communities and ecosystems; threats and sustainability; and angler outreach, education and engagement. It is our intention that this comprehensive and forward-looking list will create a framework to guide future research within this field, and contribute to evidence-based recreational fisheries management and policy.

Of late, there are many legal representations from select quarters to halt all medical interventions in children with differences of sex development (DSD). In this survey on management decisions in DSD, we distil the views of Indian stakeholders: parents, physicians, and grown-up patients with DSD on their management decisions to identify decisional satisfaction or gender dysphoria. The survey domains included the patient demographics, final diagnosis, decision on the sex of rearing, surgical interventions, opinion of the stakeholders on the preferred age of sex assignment, final sex of rearing, and agreement/disagreement about sex assignment (gender dysphoria). A total of 106 responses were recorded (66% parents, 34% grown-up patients aged 12-50 years). Among parents, 65/70 (95%) preferred the sex to be assigned soon after birth. All grown-up patients preferred sex to be assigned soon after birth. Regarding decisions on surgery, 74% of physicians and 75% of the grown-up patients felt parents should be allowed to decide interventions. Among Indian parents, 90% felt they should have the right to decide surgery in the best interest of their child for a safe social upbringing. Overall, gender dysphoria among Indian DSD patients was <1% (1/103, 0.97%). The predominant preference and opinion of major Indian stakeholders (physicians, parents, and grown-up DSD patients) support the existing approach toward DSD management, including early sex assignment and necessary medical intervention.

Introduction:As science advances the number of newly developed health technologies increases, but the lifecycles of health technologies becomes shorter. Thus, the importance of horizon scanning systems for identifying promising new health technologies and evaluating their potential impact is increasing. Engaging and collecting opinions from various stakeholders in this search process is very important. The purpose of this study was to develop a strategy for involving various stakeholders in all steps of the horizon scanning system in Korea.Methods:The horizon scanning system consists of five steps: identification, filtration, prioritization, assessment, and dissemination. We identified the stakeholders to be considered at each stage, and examined who would be involved and how. In addition, we planned how to synthesize and apply stakeholder opinions and to test the feasibility of these methods by using them in a horizon scanning system.Results:In the identification stage, developers, health professionals, and consumers suggested new and emerging health technologies to investigate. In the filtration stage, the person in charge of licensing judged the technologies based on appropriateness, innovativeness, and potential of market entry. In the prioritization phase, experts from eight to ten related fields (clinical, health technology and drugs, policy, methodology, patient organizations, etc.) participated and judged the technologies according to seven criteria (burden of disease, clinical impact, innovativeness, economic impact, acceptability, social impact, and evidence). In the assessment stage, between one and four clinical and methodological experts assessed the potential impact of the selected promising health technologies using seven evaluation items (unmet needs, improved patient health, health equity, change in medical behaviors, acceptability with respect to the patient and clinical condition, change in medical costs, and social, ethical, political, and cultural aspects). Before its dissemination, the final report was delivered to relevant industries for feedback (with particular emphasis on accuracy of data on the technology).Conclusions:There are many stakeholders in the horizon scanning system for new and emerging health technologies, depending on the healthcare system, policy, environment, etc. This study confirmed that stakeholder opinions on new technologies can vary. In addition, standards of social value judgment may change over time. It is therefore very important for horizon scanning systems to engage various stakeholders, collect their opinions, and make rational scientific decisions.

Five decades ago, a landmark paper in Science titled The Cave Environment heralded caves as ideal natural experimental laboratories in which to develop and address general questions in geology, ecology, biogeography, and evolutionary biology. Although the 'caves as laboratory' paradigm has since been advocated by subterranean biologists, there are few examples of studies that successfully translated their results into general principles. The contemporary era of big data, modelling tools, and revolutionary advances in genetics and (meta)genomics provides an opportunity to revisit unresolved questions and challenges, as well as examine promising new avenues of research in subterranean biology. Accordingly, we have developed a roadmap to guide future research endeavours in subterranean biology by adapting a well-established methodology of 'horizon scanning' to identify the highest priority research questions across six subject areas. Based on the expert opinion of 30 scientists from around the globe with complementary expertise and of different academic ages, we assembled an initial list of 258 fundamental questions concentrating on macroecology and microbial ecology, adaptation, evolution, and conservation. Subsequently, through online surveys, 130 subterranean biologists with various backgrounds assisted us in reducing our list to 50 top-priority questions. These research questions are broad in scope and ready to be addressed in the next decade. We believe this exercise will stimulate research towards a deeper understanding of subterranean biology and foster hypothesis-driven studies likely to resonate broadly from the traditional boundaries of this field.

Back ground: Current pricing and reimbursement models that focus on one indication at a time are not suited to address the market access of multi-indication medicines. Therefore, the aim of this study is to co-create with Belgian stakeholders a multi-indication pricing model and procedural pathway, to identify conditions for implementation, and to illustrate the multi-indication pricing model with a case study.Methods: Different multi-indication pricing models were identified from the literature, case studies and pilots in other countries. Semi-structured interviews were conducted with 21 representatives from the National Institute for Health and Disability Insurance, insurance funds, clinicians, patients, the policy cell of the Minister of Health, pharmaceutical industry and academia. These provided insight in the opinions of stakeholders about possible multi-indication pricing models and their feasibility in the Belgian context. Agreement on the preferred multi-indication pricing model and procedural pathway was reached in a multi-stakeholder round table.Results: The international review generated four main multi-indication pricing models that vary in terms of whether a uniform price or differential prices are applied, whether prices are adjusted for the volume and/or value of the medicine in each indication, and whether a proactive or retroactive dynamic pricing approach is used. However, Belgian stakeholders preferred a fifth model, which sets a single price as the volume- and value-weighted average price across all indications at launch. Over time, the price is adapted based on volume and value of the medicine in real-life practice for each indication. To implement this model, a legal framework, horizon scanning and early dialogue, data infrastructure, an evidence plan for the medicine, technical expertise and governance model need to be developed.Conclusion: Although the multi-indication pricing model preferred by Belgian stakeholders raises the administrative burden, it allows for the price of a medicine to vary during the lifecycle based on its initial and real-life performance in multiple indications.

Introduction Pharmacists are routinely involved in optimising medicines for mental health patients during inpatient admissions through attending ward rounds and providing a clinical pharmacy service. (1) Despite literature demonstrating the benefits, specialist pharmacists are not routinely integrated in Community Mental Health Teams (CMHTs) (2) and there is little research to identify the barriers to pharmacists’ integration. The opinions of stakeholder who influence the design of community mental health services, are key to understanding these issues. Aim To explore the views of relevant stakeholders in one health board (HB) in Wales, regarding integration of pharmacists into CMHTs, and to make recommendations to overcome identified barriers to integration. Methods Semi-structured interviews using open questions with key stakeholders within two CMHTs and the HB’s adult mental health clinical board. Participants were selected purposively to allow recruitment of individuals who would provide insight into the proposed question(s). Written, informed consent was obtained. A deductive approach was used to define interview questions. Interviews were transcribed and analysed thematically using an inductive approach to explore the data without any pre-conceived ideas and identify additional key themes. The study was registered with the HB. Results Interviews (3 pharmacists, 2 consultant psychiatrists, 1 integrated manager, 2 clinical nurse leads and 2 general managers) lasted between 30-45 minutes. Analysis revealed five main themes; relationship with the pharmacist, including previous experiences and individual pharmacist’s personal attributes; CMHT workload relevant to pharmacists’ skills; workforce and financial pressures; the need for ongoing support for and from pharmacists; and pharmacists’ expertise including non-medical prescribing. Previous experience of working with specialist mental health pharmacist influenced participants’ views, those with limited experience were less clear about what a pharmacist’s role would be in CMHTs“…we haven’t had specialist pharmacist linked to us ………“Always can get in touch with pharmacy by e-mail or phone. Can see advantage of a pharmacist in the building, the medics would really like that it wouldn’t need to be every week maybe a morning every two weeks. We know where pharmacy are, not a dire need. Others identified a clear role for pharmacists, “running clinic for us especially when we have referrals from GP purely asking for medication reviews having [pharmacist] here the benefit surpasses most of the options we can offer through medic”. Participants believed pharmacists needed training in risk assessment and consultation skills and they should be prescribers to contribute effectively. Nine participants had worked previously with pharmacists, all advocated their integration into CMHTs. Conclusion This small-scale study suggests there is a desire to integrate pharmacists into CMHTs with a strong emphasis on their role in addressing medicine-related workload pressures. Positive relationships formed from prior experience of working with pharmacists strongly influenced support for integration. There are potential roles for pharmacists that would improve timeliness and quality of care for people supported by CMHTs. Resource constraints such as lack of funding and availability of appropriately trained pharmacists need to be resolved. Further work is necessary to investigate how these barriers can be addressed and to evaluate the cost-effectiveness of any pharmacy service delivered. References (1) Royal Pharmaceutical Society England (2018). No health without mental health: How can pharmacy support people with mental health problems? London. Royal Pharmaceutical Society England (2) Robinson, J. (2017). Challenging the Stigma. The Pharmaceutical Journal, November 2017, Vol 299, No 7907, [online] | DOI: 10.1211/PJ.2017.20203915 [Accessed 1 Mar. 2019]

Recreational fishing is popular worldwide, but many low‐ and middle‐income countries (LMICs) are experiencing increased participation and reduced catches. Like other LMICs, the recreational fishery in Namibia is facing concerns regarding its sustainability. Empirical evidence suggested limited knowledge of the fish and fishery as one plausible cause. Herein, we used a horizon scan survey to identify critical questions by anglers and decision makers to facilitate sustainable and adaptive management strategies. Of 115 questions and concerns raised by 59 stakeholders, including fisheries managers, anglers (specialists and non‐specialists), and scientists, 58 of the top research questions were organised within 11 high‐priority themes, including: governance; human dimensions; regulatory actions; compliance; knowledge of fish populations; resource monitoring and data acquisition; angler outreach, education, and engagement; competing sectors/groups; bioeconomics; catch‐and‐release practises and perceived threats. Questions raised by non‐specialist anglers differed from those raised by specialist anglers and scientists, which highlighted the potential importance of integrating fisher ecological knowledge into fishery management. Although questions were in the context of recreational fisheries, we recommend that some of the themes identified herein may be applicable to other LMICs and may also improve understanding of other fisheries, such as small‐scale or commercial fisheries.

Concerns and uncertainties about the future have always posed challenges for societies. Identifying potential risks and taking preventive measures constitute key responsibilities for decision-makers. Horizon Scanning Systems are defined as tools that provide scientific foresight and guidance for policymakers. These systems are utilized not only in health but also in education, agriculture, and other sectors through technological assessment. Globally, horizon scanning has attracted particular attention in oncology, public health, and medical sciences more broadly. Designed to generate scientific insights into uncertainties and to guide preventive strategies, these systems play a critical role in the development of new technologies, especially in pharmaceuticals and medical devices. Horizon scanning has also been increasingly applied in stem cell research, occupying a notable place in literature. This study seeks to explore how horizon scanning systems, as information providers and analyzers, have been employed in the literature. A review was conducted, focusing on the past 25 years, during a period of rapid technological and scholarly advancement. In addition to global activities, studies carried out in Türkiye were also examined. Findings indicate that institutionalized and concrete efforts are particularly concentrated in the European region. Regarding the research question on Türkiye, no web-based studies specifically addressing the national context were identified. While institutional sources show that the topic has been recognized in Türkiye, a systematic structure has not yet been established. Official sources reveal an expressed interest in the subject; however, concrete steps are still required.

BackgroundIn Australia, government-subsidised access to high-cost medicines is "targeted" to particular sub-sets of patients under the Pharmaceutical Benefits Scheme to achieve cost-effective use. In order to determine how this access system could be improved, the opinions of key stakeholders on access to biological agents for rheumatoid arthritis were explored.MethodsThirty-six semi-structured interviews were conducted with persons from relevant stakeholder groups. These were transcribed verbatim, and analysed thematically.ResultsControlled access to expensive medicines was considered to be equitable and practical; however, there was disagreement as to the method of defining the target patient populations. Other concerns included timeliness of access, excessive bureaucracy, and the need for additional resources to facilitate the scheme. Collaboration between stakeholders was deemed important because it allows more equitable distribution of limited resources. The majority considered that stakeholder consultation should have been broader. Most wanted increased transparency of the decision-making process, ongoing and timely review of access criteria, and an increased provision of information for patients. More structured communication between stakeholders was proposed.ConclusionThe Pharmaceutical Benefit Scheme is adapting to meet the changing needs of patients. Provision of subsidised access to high-cost medicines in a manner that is affordable for individuals and society, and that is equitable and efficiently managed is challenging. The views of stakeholders on targeted access to anti-rheumatic biological medicines in Australia acknowledged this challenge and provided a number of suggestions for modifications. These could serve as a basis to inform the debate on how to change the processes and policies so as to improve the scheme.

When asked about the breakthrough that led to the polio vaccine, Jonas Salk once commented, "What people think of as the moment of discovery is really the discovery of the question." So how do scholars "discover" questions, and, perhaps more important, how do scholars know when they land on a question worth pursuing? The members of the 2019 Research in Medical Education (RIME) Program Planning Committee selected research questions as a theme for the year and hope that through the commentaries and papers presented in this supplement and the presentations at the RIME sessions of the Learn Serve Lead meeting, our community will illuminate questions to guide us toward breakthroughs on some of our gnarliest problems in health professions education. In this foreword to the RIME supplement, we—the past, present, and future RIME chairs—offer a few overarching thoughts about research questions based on our own experiences of teaching, reading, reviewing, generating, and discussing such questions with colleagues in the field. What Makes a Research Question Different From Other Questions? We ask all sorts of questions that serve a variety of purposes. In medical school, students learn to ask questions to establish rapport with a patient, elicit information to guide diagnosis, and check understanding of, or commitment to, a plan. In faculty development sessions, educators learn to ask questions that push a learner's thinking in a supportive way, set the stage for feedback, and help them identify a learner's goals, needs, and abilities. In quality improvement, health professionals learn to ask Why 5 times to get to the core of a problem.1 While all these types of questions are valuable and share some common features (e.g., open-ended, probing the unknown), they are not research questions. A research question straddles the realm of known and unknown. It recognizes a base of knowledge but finds a crack in the foundation or offers a different perspective on current interpretations that opens up new territory for exploration. The question cannot be answered by a single person or by merely looking up information. Rather, it requires a systematic process of collecting and analyzing new information. Typically the question is novel—not something that has been asked before or at least not in this way or in this context. A research question strikes a balance between a general idea and specific construct, meaning it must identify a problem and define a piece that can be studied in a reasonable amount of time given available resources, knowledge, and principles or methodologies identified as appropriate within the specific research community. Yet, it must not be so specific that it makes too minimal of a contribution or has limited relevance or generalizability. A research question is not the same as interview questions or survey items. While the difference may seem obvious, it is not uncommon for investigators to move back and forth between specific interview or survey questions and the broader research question in an attempt to find the optimal level and scope. What initially seems like an important research question may ultimately become a single question in an interview guide that explores a larger phenomenon. Alternatively, an observation might prompt a question that seems straightforward and perhaps not worthy of a whole study, but the initial investigation unearths complexities that warrant further pursuit. Who Generates the Best Research Questions? The "Aha! moment" appeals to us all, but such moments of inspiration rarely happen without the 99% perspiration expended in preparation. For the 2019 RIME plenary, we invited members of the RIME community who we know have invested substantial portions of their careers in tackling some of the most challenging problems in health professions education. Their deep knowledge of faculty development, feedback, systems of assessment, and equity pedagogy, coupled with their creativity and passion as educators and researchers, makes them well poised to guide the RIME community in identifying key questions to push the frontiers of research in health professions education. That said, our choice of panelists is not meant to suggest that all the best questions come from experts. By contrast, many of the papers selected for RIME come from newer investigators and teams of investigators who bring novel observations, fresh perspectives, and infinite curiosity to bear in ways that spark excellent research questions. Ultimately, crafting a promising research question takes preparation, patience, perseverance, and passion—regardless of who you are. How Do You Know a Promising Research Question When You See It? Scholars can find countless resources to help them write a good, effective research question.2–5 These resources emphasize criteria such as relevance, interest, originality, clarity, feasibility, answerability, and generalizability. Many also underscore the importance of situating the question in a theoretical or conceptual framework. While these criteria offer reasonable guidance, each must be interpreted in context, and this makes it far more difficult to evaluate a research question's prospects than those suggested by criteria. A research question deemed promising in one field, by a particular audience, or for a certain purpose, might fall flat when presented in another field, to a different audience, for another purpose. For example, a cognitive psychologist may consider questions about how undergraduate psychology students integrate and retain basic science information under 2 different instructional strategies highly relevant to medical education, while a medical educator might view the question with skepticism, largely due to generalizability and, correspondingly, relevance. Or, as another example, 1 reviewer might doubt the originality of a question about learners struggling with transitions in training while another reviewer appreciates the novel context or approach to the question (e.g., applying a different theoretical lens, asking the question at a structural level rather than at an individual level, or comparing struggles in 2 different types of programs). As such, it is also the job of a scholar to clearly articulate the motivation and relevance of the research question—what are the gaps, and how does this question add to the scholarly discussions and advances in the field? A promising research question would explain these facets in a way that is appreciated by the reviewer and the audience. The type and level of research question also factor into the promise it holds. One commonly used typology characterizes 4 types of questions based on their function: exploratory, explanatory, descriptive, emancipatory.6 Some problems may be newly emerging and thus better suited to descriptive and exploratory questions, while others are better understood and ready for explanatory questions or empowerment and transformation through emancipatory questions. Additionally, as discussed in greater detail in the RIME commentary, the level or focus of a question can range from micro (individual level; highly contextualized view of a phenomenon) to meso (interpersonal or interactional level; bridging theory and practice to study a phenomenon) to macro (cultural, societal, or system level; philosophical or theoretical aspects of a phenomenon).7,8 Many topics can be studied from any of these levels, which makes it all the more important for investigators to specify the position of their question relative to appropriate landmarks. If the terrain is well mapped at 1 level (e.g., we have much evidence of individual biases in various circumstances), the optimal questions may need to begin exploring other levels (e.g., we have little evidence of ways in which structural and cultural changes affect bias). Health professions education is an interdisciplinary field, with scholars who have varying backgrounds in research paradigms, theoretical frameworks, and methodologies. This diversity can make it even more challenging for our community to decide what constitutes a promising research question. While some members of our community may not be particularly bothered by the "epistemological anarchy" Eva uses to characterize our field,9(p1100) others see this as a signal that we need standards and expectations for research questions along with the supporting methodologies that can address the questions in an appropriate manner, acceptable to the interdisciplinary health professions education community. For example, Ringsted and colleagues orient readers to different types of research questions as they discuss different research purposes and approaches, along with the questions and methodologies suited to each.5 Of note—published research questions look neat and tidy. When presented this way, readers often assume that the investigators started out with a clear, insightful question. In some cases, this is true; in many, it is not. The research question can be a fluid entity rather than a fixed one. In qualitative research and certain types of reviews, the research question may morph over time as the investigator interacts with participants and/or literature, develops a better understanding of the problem, and reflects on their own assumptions and interpretations.2 Even in research that begins with hypotheses or specific questions for a meta-analysis or other types of reviews, the question presented in the final manuscript might differ from the one posed at the outset. The scope of the question might be adjusted, or questions might be added or modified to accommodate an unexpected finding. In this regard, the scale and specificity of research questions also depend on the state of the supporting literature. Some questions can be more nuanced and specific to address a particular, yet significant, gap in knowledge, whereas in other contexts, the question can also be broader in scope perhaps for topics that are still in earlier stages, prompting the study findings to yield additional questions and a research agenda for the community. A Few Parting Thoughts Many scholars find it easy enough to generate questions; far fewer find it easy to choose the ones worth pursuing. Investing time and effort in the research questions, both upfront and throughout the research process, matters. Agee astutely notes, "Good research questions do not necessarily produce good research, but poorly conceived or constructed questions will likely create problems that affect all subsequent stages of a study."2(p431) And yet, our purpose is not to set such high standards that scholars feel all research questions must be pure gold. Such standards would likely squelch many good prospects for research. Rather, our intent is to minimize the risk of mistaking glitter for gold by encouraging careful consideration of the purpose, value, and substance of our questions. One promising approach may be to think about the research question as part of a program of research rather than an isolated study. Such an approach pushes scholars and the community as a whole to think of questions as layers or links in a chain that contribute to a larger purpose and build value over time. It also can enrich the connections within our community by illuminating opportunities to work together on a common research agenda that may benefit from the contributions that different levels of focus, theoretical orientations, and methodologies have to offer. Another, related approach might be to reconsider how we read and write the "suggested directions for future research" sections of papers. How often do we, as readers, actually use these suggestions as a starting point for a study? And, when we write these recommendations, how often do we actually write them with an expectation that others might take them up and build on them? As a starting point, we offer this as an opportunity for scholars to engage in the thought experiment, asking "What's the next question?" as a way to deepen and refine their questions. We hope you enjoy delving into the many questions posed throughout the RIME supplement and the RIME meeting. May they inspire many promising insights and fruitful questions to enrich our field!

This article provides an integrative review of the developing body of literature investigating academics’ ways of understanding research. The resulting review highlights implicit variation between different studies in the focus they have taken to addressing this research question, varyingly emphasising academics’ research intentions, questions, processes and/or outcomes. It is suggested that these four foci represent different dimensions of academics’ understandings of the nature of research. The review is followed by the report of an empirical study that brings these dimensions together in an integrated way by clarifying relationships between academics’ experiences of: research intentions (who is affected by the research), research outcomes (the anticipated impact of the research), research questions (the nature of the object of study), research process (how research is undertaken), and researcher affect (underlying feelings about research). The last dimension, researcher affect, has not been found in previous studies. This may be due to the focus taken in this study on ways of understanding ‘being a researcher’, rather than ways of understanding ‘research’ per se.

Priority setting for horizon scanning of new health technologies in Denmark: Views of health care stakeholders and health economists

Health and Social Care Delivery Research (HSDR) Programme is part of the National Institute for Health and Care Research (NIHR). As such, it aims to contribute to the NIHR's mission of improving the health and wealth of the nation by funding evaluative research projects that have the potential to improve the quality, accessibility and organisation of health and social care services by providing useful outputs for decision-makers, staff, service users, academic, and public audiences. More information about the programme can be found on the NIHR website. A logic model is a visual way of showing how an activity, programme or intervention is expected to work and bring about the benefits and changes it intends to achieve. By summarising the core elements, a logic model can be used to support programme planning, implementation, and evaluation. NIHR logic models presentin a linear flow diagramthe key activities, outputs, outcomes and impacts of each funding programme as a series of logical steps.

Objective: To develop an understanding of the current system and future development of training and education within a large UK ambulance trust, based upon the experiences, beliefs, and opinions of...

Road infrastructure is important for societal and economic development; therefore, it is crucial to maintain the durability and safety of the pavements. The present study investigates the domain of pavement maintenance by thoroughly analyzing the factors affecting the quality of pavement considering diverse groups of stakeholders. The study explored various flexible pavement defects (distress factors i.e., potholes, alligator cracks, longitudinal cracks, transverse cracks, hungry surfaces, streaking, shoving, rutting, and raveling). The opinions of stakeholders from various sectors such as public, private, and academia are collected through surveys, interviews, and detailed discussions. The collected data is analyzed using advanced statistical tools such as analysis of variance (ANOVA), post hoc test, criticality index, and Spearman rank correlation, which revealed patterns and correlations between stakeholder views. This study highlights diverse perspectives on pavement distress factors, providing valuable insights into the decision-making process. The findings of this research will help policymakers prioritize pavement maintenance based on the prevailing distresses, highlighting the importance of informed decision-making in pavement maintenance and management practices.