Coordinated Research Agenda Research Articles

Global research priorities for intrauterine suction and sponge tools for postpartum haemorrhage management in low-income and middle-income countries: a modified Delphi approach

IntroductionPostpartum haemorrhage (PPH) remains the leading cause of maternal mortality and morbidity globally. Innovative PPH management tools have emerged using suction and sponge tamponade but currently lack substantial evidence. Broader...

Impact of novel methods and research approaches in plant pathology: Are individual advances sufficient to meet the wider challenges of disease management?

AbstractAdvances continue to be made by plant pathologists on topics in plant health, environmental protection and food security. Many advances have been made for individual crops, pathogens and diseases that in many cases have led to their successful management. A wider impact of research depends on recognition of the multifaceted challenges posed by plant diseases and the need to integrate studies in a systems level approach. The adoption of high‐throughput sequencing for diagnosis and detection is widespread but impact depends upon the agricultural and ecological context combined with improved surveillance. Deployment of host resistance in the field needs to be aligned with a greater appreciation of plant genetic diversity and the complementary contribution made by tolerance of disease. Epidemiological understanding of the spatiotemporal spread of plant diseases has improved through population dynamic and genetic analyses. Research emphasis on the plant microbiome has invigorated soil microbial studies, especially for disease complexes and declines, but the challenge is to move to interventions that benefit plant health. Analysis of the impacts of climate change has been made for single‐crop disease studies, but seldom have these been placed in the context of pathogen adaptation, new crops, wild plants, vectors and soil microbes. Advances in informatic analysis illustrate not only the global impacts of plant disease introductions, but also the challenges inherent in marshalling and integrating information. Advances have been made in applying artificial intelligence technologies across many areas of plant pathology but have yet to be integrated within any coordinated research agenda.

Supporting Alzheimer’s disease and related dementia research in low‐ and middle‐income countries

AbstractThe greatest increases for AD/ADRD will occur in low‐ and middle‐income countries (LMICs), where approximately 71% of the global cases will reside. These projections might be confounded by temporal changes due to shorter survival after dementia, lack of education and awareness, lack of access to healthcare, inadequate diagnostic assessment, and variability in costs of care of the elderly with AD/ADRD, all of which could lead to under‐accounting of the AD/ADRD burden. Nevertheless, the projected increase underscores the importance of developing a strong, coordinated research agenda that will inform mitigation and prevention strategies for AD/ADRD in LMICs. National Institute on Aging (NIA) at the National Institutes of Health (NIH) is positioned to play a leading role in this endeavor, as the leading federal government institute for supporting research on aging and AD/ADRD. NIA’s interests, activities and scientific initiatives related to global health research has increased over the past year through collaborations with other NIH institutes and centers (including Fogarty International Center) and engagement with the global scientific community. Research supported under these initiatives could further inform future scientific priorities areas for AD/ADRD. Given the growth trajectory of its global health portfolio, NIA will continue to support coordinated approaches to identify research gaps and new opportunities to address the growing burden of AD/ADRD in LMICs, globally.

Insights into placemaking, senior people, and digital technology: a systematic quantitative review

ABSTRACT How placemaking involves senior people and implements cutting-edge technology is a question that this review aims to shed light on. This paper provides a systematic quantitative review of 26 original, peer-reviewed research articles on placemaking, digital technology, and senior people. It discusses the scope of the research, the critical concepts cited, the senior involvement type (inclusive/exclusive), and the digital instrument implementation type (advanced/simple). In addition, it includes a scatter analysis between (advanced/simple) digital instrument implementation and (inclusive/exclusive) senior people involvement in placemaking initiatives. This review indicates that although interest in digital placemaking has increased in the last decade, senior people are underrepresented. This review can open windows for developing a more coordinated research agenda that considers seniors as active players of (advanced) digital placemaking.

Treatment of child wasting: results of a child health and nutrition research initiative (CHNRI) prioritisation exercise

Background: Child wasting is highly prevalent, with around 49.5 million children under five years affected globally. More evidence is needed to inform the scale up of effective treatment of wasted children worldwide. The aim of this study was to identify and prioritise the main outstanding research questions relating to the treatment of wasting to inform future research agendas. Methods: A research prioritisation exercise was undertaken using the Child Health and Nutrition Research Initiative method. Research gaps were identified from multiple sources, grouped in themes and condensed into a list of 53 research areas by a group of experts. An online survey was developed and circulated globally to individuals working in the global nutrition sector. Participants evaluated each research area according to four agreed criteria. Research areas were then ranked according to an overall research priority score. Results: A total of 394 individuals from 63 countries participated in the survey. Research areas prioritised by the group focused on the effective detection and diagnosis of ‘high risk’ wasted children in the community; provision of a continuum of care; and early life course interventions. The group also prioritised evidence to inform guidance on the impatient management of wasted children with diarrhoea; prevention of post-treatment relapse and mortality; and the optimisation of ready-to-use therapeutic foods in treatment programmes. Conclusions: Critical gaps in our understanding of the treatment of wasting must be filled to inform guidance, policy and programming to ensure that all wasted children receive the treatment services that they need. A coordinated research agenda across treatment and prevention is urgently needed to maximise the impact of funding investments towards the meeting of global targets to reduce child wasting.

Informing the research agenda for optimizing audit and feedback interventions: results of a prioritization exercise

BackgroundAudit and feedback (A&F) interventions are one of the most common approaches for implementing evidence-based practices. A key barrier to more effective A&F interventions is the lack of a theory-guided approach to the accumulation of evidence. Recent interviews with theory experts identified 313 theory-informed hypotheses, spread across 30 themes, about how to create more effective A&F interventions. In the current survey, we sought to elicit from stakeholders which hypotheses were most likely to advance the field if studied further.MethodsFrom the list of 313, three members of the research team identified 216 that were clear and distinguishable enough for prioritization. A web-based survey was then sent to 211 A&F intervention stakeholders asking them to choose up to 50 ‘priority’ hypotheses following the header “A&F interventions will be more effective if…”. Analyses included frequencies of endorsement of the individual hypotheses and themes into which they were grouped.Results68 of the 211 invited participants responded to the survey. Seven hypotheses were chosen by > 50% of respondents, including A&F interventions will be more effective… “if feedback is provided by a trusted source”; “if recipients are involved in the design/development of the feedback intervention”; “if recommendations related to the feedback are based on good quality evidence”; “if the behaviour is under the control of the recipient”; “if it addresses barriers and facilitators (drivers) to behaviour change”; “if it suggests clear action plans”; and “if target/goal/optimal rates are clear and explicit”. The most endorsed theme was Recipient Priorities (four hypotheses were chosen 92 times as a ‘priority’ hypotheses).ConclusionsThis work determined a set of hypotheses thought by respondents to be to be most likely to advance the field through future A&F intervention research. This work can inform a coordinated research agenda that may more efficiently lead to more effective A&F interventions.

Nationwide introduction of a new competency framework for undergraduate medical curricula: a collaborative approach.

Switzerland recently introduced PROFILES, a revised version of its national outcomes reference framework for the undergraduate medical curriculum. PROFILES is based on a set of competencies adapted from the CanMEDS framework and nine entrustable professional activities (EPAs) that students have to be able to perform autonomously in the context of a predefined list of clinical situations. The nationwide implementation of such a competency- and EPA-based approach to medical education is a complex process that represents an important change to the organisation of undergraduate training in the various medical schools. At the same time, the concepts underlying PROFILES also have to be reflected at the level of the Federal Licencing Examination (FLE) and the national accreditation process. The vice-deans for education mandated a Swiss Working Group for PROFILES Implementation (SWGPI) to elaborate a guide presenting the principles and best practices based on the current scientific literature, to ensure the coherence between the future developments of the medical curricula and the evolution of the FLE, and to propose a coordinated research agenda to evaluate the implementation process. On the basis of the literature and analysis of our national context, we determined the key elements important for a successful implementation. They can be grouped into several areas including curricular design and governance, the assessment system and entrustment process, faculty development and change management. We also identified two dimensions that will be of particular importance to create synergies and facilitate exchange between the medical schools: a systematic approach to curriculum mapping and the longitudinal integration of an e-portfolio to support the student learning process. The nationwide collaborative approach to define strategies and conditions for the implementation of a new reference framework has allowed to develop a shared understanding of the implications of PROFILES, to promote the establishment of Swiss mapping and e-portfolio communities, and to establish the conditions necessary for ensuring the continuous alignment of the FLE with the evolving medical curricula.

Nationwide introduction of a new competency framework for undergraduate medical curricula: a collaborative approach.

Switzerland recently introduced PROFILES, a revised version of its national outcomes reference framework for the undergraduate medical curriculum. PROFILES is based on a set of competencies adapted from the CanMEDS framework and nine entrustable professional activities (EPAs) that students have to be able to perform autonomously in the context of a predefined list of clinical situations. The nationwide implementation of such a competency- and EPA-based approach to medical education is a complex process that represents an important change to the organisation of undergraduate training in the various medical schools. At the same time, the concepts underlying PROFILES also have to be reflected at the level of the Federal Licencing Examination (FLE) and the national accreditation process. The vice-deans for education mandated a Swiss Working Group for PROFILES Implementation (SWGPI) to elaborate a guide presenting the principles and best practices based on the current scientific literature, to ensure the coherence between the future developments of the medical curricula and the evolution of the FLE, and to propose a coordinated research agenda to evaluate the implementation process. On the basis of the literature and analysis of our national context, we determined the key elements important for a successful implementation. They can be grouped into several areas including curricular design and governance, the assessment system and entrustment process, faculty development and change management. We also identified two dimensions that will be of particular importance to create synergies and facilitate exchange between the medical schools: a systematic approach to curriculum mapping and the longitudinal integration of an e-portfolio to support the student learning process. The nationwide collaborative approach to define strategies and conditions for the implementation of a new reference framework has allowed to develop a shared understanding of the implications of PROFILES, to promote the establishment of Swiss mapping and e-portfolio communities, and to establish the conditions necessary for ensuring the continuous alignment of the FLE with the evolving medical curricula.

Chemicals Denial—A Challenge to Science and Policy

Much research shows that science denial regarding climate change is widespread and problematic for science and scientists, as well as for policy-makers. Climate denial delays goal achievement. As shown in this article, science denial commonly occurs also in the field of chemicals assessment and policy, but the research on the topic is scarce. The peer-reviewed studies that exist mostly concern a limited number of specific cases, such as DDT, CFCs and endocrine disrupting chemicals. The characteristics of ‘chemicals denial’ show similarity with those of climate denial, including reliance on fake experts, cherry-picked facts and attacks on scientists, with a key aspect being the questioning of causal relationships. Considering the gaps between chemicals policy goals and the state of the environment, further scientific exploration in the field is needed. Developing a better coordinated research agenda and a common terminology are therefore warranted strategies. A key concept in such endeavors could be ‘chemicals denial’.

How to develop a research agenda in two days

PurposeThe purpose of this paper is to provide an overview of the aims, objectives and structure of a two-day Think Tank, “Gender in Organisations in the Middle East North Africa (MENA) region”, held at the American University of Sharjah, United Arab Emirates on 18–19 March 2019.Design/methodology/approachThe paper will explain the design decisions made to achieve the objectives of the event, which will be of interest to equality, diversity and inclusion readers who may wish to hold such events themselves. It will then explain each of the Think Tank sessions and provide an overview of the keynote speakers’ presentations and the ensuing plenary discussions.FindingsThe Think Tank was an extremely useful vehicle for facilitating discussion on the development of a research agenda to advance knowledge in respect of gender in organisations in the MENA region. The design of the Think Tank enabled collaborative discussion amongst academics drawn from across the globe, who shared their knowledge and experience to develop a coordinated research agenda, to guide action and attention on key issues identified by the group.Originality/valueThe Think Tank is believed to be the first of its type in the MENA region. The authors believe this collaborative and time-efficient approach advances research agendas in respect of key issues of interest to equality, diversity and inclusion scholars. The Think Tank format is a valuable addition to the processes currently utilised to achieve such outcomes, e.g. conferences and symposia.

A Coordinated Research Agenda for Nature-Based Learning.

Evidence is mounting that nature-based learning (NBL) enhances children’s educational and developmental outcomes, making this an opportune time to identify promising questions to carry research and practice in this field forward. We present the outcomes of a process to set a research agenda for NBL, undertaken by the Science of Nature-Based Learning Collaborative Research Network, with funding from the National Science Foundation. A literature review and several approaches to gathering input from researchers, practitioners, and funders resulted in recommendations for research questions and methodological improvements to increase the relevance and rigor of research in this field. Some questions seek to understand how learning in nature affects what children learn, how they learn, and how it varies based on age, gender, socioeconomic status, ethnic background, special needs, and individual differences. Outcomes of interest cover academic performance, practical skills, personal development, and environmental stewardship. Other questions seek to find causal explanations for observed outcomes. To create optimal conditions for NBL, the research agenda includes practical questions about how to prepare teachers to work successfully in nature and how to support their adoption of this approach. Not least, the research agenda asks whether learning in nature can address major societal issues by moderating the effect of socioeconomic disadvantage on children’s academic achievement, personal development and wellbeing, and how these benefits might be attained at reasonable costs. A deeper understanding of how, why and for whom different forms of nature contact enhance learning and development is needed to guide practice and policy decision-making.

A National Collaborative for Building the Field of Childhood Obesity Research

Rising rates of childhood obesity over the past 2 decades have spurred a number of public- and private-sector initiatives aimed at halting or even reversing this trend. Recognizing common interests in this issue, the Centers for Disease Control and Prevention, NIH, and the Robert Wood Johnson Foundation began conversations about creating a formal collaboration aimed at accelerating efforts to address childhood obesity by coordinating research agendas and providing support for evidence-building activities. The National Collaborative on Childhood Obesity Research (NCCOR) was launched in February 2009, and the U.S. Department of Agriculture joined in 2010. Using the model provided by other previously successful collaborations, such as the Youth Tobacco Cessation Collaborative, NCCOR has emphasized several principles suggested by Petrovich as key elements for successful partnerships: (1) delineate a common purpose by identifying key knowledge gaps in the field; (2) create a shared identity around that common purpose; (3) develop structures for democratic and respectful collaboration so as to strategically coordinate efforts for maximum national impact; (4) identify effective leaders capable of articulating challenges in the field and inspiring a commitment of minds and the resolve to address identified needs; (5) facilitate continuous knowledge exchange and synthesis to keep the field informed; and (6) support assessment of progress and feedback loops for ensuring continual progress. This paper examines how NCCOR has used these principles to help build the field of research, evaluation, and surveillance for childhood obesity prevention and management.

Organizing Environmental Flow Frameworks to Meet Hydropower Mitigation Needs.

The global recognition of the importance of natural flow regimes to sustain the ecological integrity of river systems has led to increased societal pressure on the hydropower industry to change plant operations to improve downstream aquatic ecosystems. However, a complete reinstatement of natural flow regimes is often unrealistic when balancing water needs for ecosystems, energy production, and other human uses. Thus, stakeholders must identify a prioritized subset of flow prescriptions that meet ecological objectives in light of realistic constraints. Yet, isolating aspects of flow regimes to restore downstream of hydropower facilities is among the greatest challenges of environmental flow science due, in part, to the sheer volume of available environmental flow tools in conjunction with complex negotiation-based regulatory procedures. Herein, we propose an organizational framework that structures information and existing flow paradigms into a staged process that assists stakeholders in implementing environmental flows for hydropower facilities. The framework identifies areas where regulations fall short of the needed scientific process, and provide suggestions for stakeholders to ameliorate those situations through advanced preparation. We highlight the strengths of existing flow paradigms in their application to hydropower settings and suggest when and where tools are most applicable. Our suggested framework increases the effectiveness and efficiency of the e-flow implementation process by rapidly establishing a knowledge base and decreasing uncertainty so more time can be devoted to filling knowledge gaps. Lastly, the framework provides the structure for a coordinated research agenda to further the science of environmental flows related to hydropower environments.

Research agendas for the sustainable management of tropical peatland in Malaysia

SUMMARYThere is a need for coordinated research for the sustainable management of tropical peatland. Malaysia has 6% of global tropical peat by area and peatlands there are subject to land use change at an unprecedented rate. This paper describes a stakeholder engagement exercise that identified 95 priority research questions for peatland in Malaysia, organized into nine themes. Analysis revealed the need for fundamental scientific research, with strong representation across the themes of environmental change, ecosystem services, and conversion, disturbance and degradation. Considerable uncertainty remains about Malaysia's baseline conditions for peatland, including questions over total remaining area of peatland, water table depths, soil characteristics, hydrological function, biogeochemical processes and ecology. More applied and multidisciplinary studies involving researchers from the social sciences are required. The future sustainability of Malaysian peatland relies on coordinating research agendas via a ‘knowledge hub’ of researchers, strengthening the role of peatlands in land-use planning and development processes, stricter policy enforcement, and bridging the divide between national and provincial governance. Integration of the economic value of peatlands into existing planning regimes is also a stakeholder priority. Finally, current research needs to be better communicated for the benefit of the research community, for improved societal understanding and to inform policy processes.

The landscape of comparative effectiveness research in rheumatology

Comparative effectiveness research (CER) is a growing area of investigation aimed at determining the most beneficial treatments for patients in view of their clinical characteristics. CER provides personalized treatment information that cannot be obtained from traditional clinical trials. However, many analytical challenges to performing CER remain, particularly in nonexperimental settings. The main obstacles to CER include bias from variation in use of treatments, and heterogeneity in types and quality of data across registries. Increasing standardization of care and consensus among stakeholders regarding CER methodology will strengthen the validity of CER from observational data. Innovations in outcomes measurement, and the ability to repurpose electronic health record data for research will increase the capability to assess treatment effects by CER in clinical practice. Investment in infrastructure, informatics, and data management to sustain high-quality registries, along with engagement of stakeholders to maintain a co-ordinated research agenda, are essential for successful CER in rheumatology.

Medical Staff Involvement in Nursing Homes

Medical staff (physicians, nurse practitioners, physicians' assistants) involvement in nursing homes (NH) is limited by professional guidelines, government policies, regulations, and reimbursements, creating bureaucratic burden. The conceptual NH Medical Staff Involvement Model, based on our mixed-methods research, applies the Donabedian "structure-process-outcomes" framework to the NH, identifying measures for a coordinated research agenda. Quantitative surveys and qualitative interviews conducted with medical directors, administrators and directors of nursing, other experts, residents and family members and Minimum Data Set, the Online Certification and Reporting System and Medicare Part B claims data related to NH structure, process, and outcomes were analyzed. NH control of medical staff, or structure, affects medical staff involvement in care processes and is associated with better outcomes (e.g., symptom management, appropriate transitions, satisfaction). The model identifies measures clarifying the impact of NH medical staff involvement on care processes and resident outcomes and has strong potential to inform regulatory policies.

A Proposed Framework for Educational Innovation Dissemination

Although the need for new educational technologies is increasing, the process for disseminating these innovations remains a challenge. A literature review shows that few studies have thoroughly investigated this area. Furthermore, there is no comprehensive framework or coordinated research agenda that may be used to guide such investigation. This study draws on diffusion of innovation, technology acceptance, and related literatures as a basis to examine the process by which educational innovations are disseminated. In this article, we develop a framework for educational innovation dissemination and illustrate the process described by the framework using online education as an example. The stages of the dissemination process are discussed and it is shown how characteristics of the innovation, adopter, and environment may affect how well an innovation progresses through these stages. This leads to the development of a series of propositions that can be used as the basis for future investigation.

Duty Hours: Time to Study?

As the nation's teaching hospitals implement the next rendition of limits for physicians-in-training on work hours during residency, it is imperative to understand the impact of such sweeping changes. There are a number of important questions related to the impact of duty hours on resident education and patient outcomes. At the same time, the medical education community must not lose sight of the many research questions, independent of duty hours, that must be answered to optimally configure resident education. Developing and implementing a comprehensive, coordinated research agenda around resident education addresses these larger matters, as well as the issues related to duty hours specifically, and will drive innovation and testing of new approaches, with the goal of facilitating the spread of best practices that optimize resident education and patient care outcomes.1

Evolution of Coauthorship in Public Health Services and Systems Research

Public health services and systems research (PHSSR) focuses on the structure, organization, and legal basis of domestic public health activities and their effect on population health. An accurate description of the field is needed to empower funding agencies and other stakeholders to coordinate PHSSR activities and to foster the development of the field. The purpose of the study is to characterize the emerging community of researchers engaged in PHSSR. This study (1) describes dynamics of this growing community and (2) identifies research themes, subgroups within the field, and collaboration among groups. Coauthorship network visualization of selected research publications in the MEDLINE bibliographic database between 1988 and May 2010. PHSSR has emerged gradually with noticeable growth after 1994 and after 2004. The network of PHSSR research has a core-periphery structure. The core includes highly collaborative researchers focusing on topics pertaining directly to PHSSR, such as workforce, quality improvement and performance, law, and information infrastructure. The periphery consists of groups publishing either on general health services research topics or on epidemiologic and clinical topics. Although a nucleus group of productive and engaged individuals participate in PHSSR, most also publish broadly on health services research and population health. This trend suggests that this emerging field cannot yet support a singular focus on PHSSR. Lack of funding sources and defined career paths likely contribute to this pattern. An overview of collaboration in PHSSR is an important step in advancing a coordinated research agenda and attracting sustainable funding streams for this field.

Shared decision making in the Netherlands, is the time ripe for nationwide, structural implementation?

WHAT ABOUT POLICY REGARDING SDM? The Dutch health care system has been reformed in 2006 to make it more patient-oriented and demand-driven. We shortly describe four strategies of this health care reform. Although research projects are now fully spread over the country, a coordinated research agenda on SDM is lacking. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? The Dutch governmental healthcare internet portal for patients hosts 16 patient decision aids. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? There is quite a strong patient participation movement in the Netherlands, on macro and meso level. Limited effort, related to the local research projects has been put into training professionals in SDM skills. WHAT DOES THE FUTURE LOOK LIKE? We need concerted action on the level of educating health care professionals, empowering patients, making patient decision aids easily accessible, supporting the professionals in this new task, and measuring the process of SDM in performance indicators used in quality assurance. The Dutch Platform for SDM that will be launched in Maastricht in June 2011 is therefore a timely and relevant initiative.