Future Priority Areas Research Articles

Private practice dietetics workforce: A review of the literature

Private practice is the fastest growing employment sector for dietitians in Australia, including for new graduates(1). There is an anecdotal concern that current graduate cohorts are not adequately prepared for private practice. The present study aims to assess the existing literature relevant to workforce development specific to private practice dietetics, including areas such as workforce size, distribution, competency, practices and global challenges. The secondary aim is to identify gaps in the literature to inform future priority areas and to inform private practice dietetics workforce development research. Five databases were systematically searched from inception to August 2023 and grey-literature was searched using the Google search engine using key search terms to identify studies for inclusion. Of the 2361 peer-reviewed publications and 1800 grey literature, eighty were included. Directed content analysis and qualitative constant comparison technique were used to deductively extract data from eligible private practice literature. Intelligence sources covering the following themes proved to be limited: workforce size, distribution, attributes, demography, supply/preparation, competencies, continued professional development and challenges. However, clear structural issues present workforce challenges for private practice dietitians. There is an overwhelming paucity of comprehensive literature on the private practice dietetics workforce across the world. Private practice dietetics workforce development research is warranted to address current research gaps in a coordinated, collaborative approach to ensure this rapidly expanding workforce is well supported.

Assessment of CRM and E-Marketing Strategies on Agri-SMEs Performance in Bauchi State, Nigeria

Nigeria's economy depends heavily on its agriculture industry; however, some obstacles prevent Small and Medium Enterprises from growing and being sustainable, especially in states like Bauchi. Although customer relationship management and e-marketing strategies can address these issues, there are still a number of obstacles preventing their widespread implementation. This study investigates the variables that influence the implementation of these strategies and their effects on the performance of Agri-SMEs in Bauchi State, Nigeria. Data from a sample of 150 Agri-SME operators in Bauchi State were gathered using a quantitative research approach and structured questionnaires. While regression analysis was used to test the hypotheses. The regression coefficients and average scores obtained from the study indicate a low R-square value and absence of statistically significant variables in the model, indicative of a weak predictive potential. The study concludes that although CRM and e-marketing have the potential to benefit Agri-SMEs, it is unclear how they would affect performance in Bauchi State. Future priority areas include nonlinear interactions, complex corporate settings, and the necessity of comprehensive strategies, capacity building, and governmental assistance. To facilitate the successful implementation of digital strategies in agriculture, Agri-SMEs should focus on comprehensive strategy formulation and capacity building, and policymakers should prioritise infrastructure and policy assistance.

Status and conservation challenges of the second-largest seagrass bed in India: Chilika lagoon.

Studies related to seagrass ecology, conservation, and management are sparse and highly biased in India. Even though the geographical distribution of seagrass is diverse in India, about 74% of the scientific publications have been made from Palk Bay and the Gulf of Mannar from Tamilnadu. Chilika, the largest lagoon in Asia, harbors the second largest seagrass meadow in India 22% of the total. The lagoon acts as a potential blue carbon stock and helps in thriving a rich floral and faunal biodiversity. However, the critical role of seagrass in this unique lagoon ecosystem is still poorly understood. This review is aimed at synthesizing the published literature about seagrass in Chilika. We believe this information would encourage more in-depth and diverse seagrass studies in the region and identify future priority areas for research. A total of seven species have been recorded from 169.2 sq. km of seagrass patch in Chilika. For the last two decades, no significant signs of decline in seagrass beds from this lagoon have been reported. Still, various natural and anthropogenic stressors could put this unique ecosystem under severe stress. Moreover, lax enforcement of existing legislation and a general lack of knowledge among the stakeholders about their ecosystem services can be significant impediments to their conservation. More targeted research on Chilika seagrass in changing climate regimes and their sustainable intensification is the need of the hour.

European Respiratory Society statement on frailty in adults with chronic lung disease.

Frailty is a complex, multidimensional syndrome characterised by a loss of physiological reserves that increases a person's susceptibility to adverse health outcomes. Most knowledge regarding frailty originates from geriatric medicine; however, awareness of its importance as a treatable trait for people with chronic respiratory disease (including asthma, COPD and interstitial lung disease) is emerging. A clearer understanding of frailty and its impact in chronic respiratory disease is a prerequisite to optimise clinical management in the future. This unmet need underpins the rationale for undertaking the present work. This European Respiratory Society statement synthesises current evidence and clinical insights from international experts and people affected by chronic respiratory conditions regarding frailty in adults with chronic respiratory disease. The scope includes coverage of frailty within international respiratory guidelines, prevalence and risk factors, review of clinical management options (including comprehensive geriatric care, rehabilitation, nutrition, pharmacological and psychological therapies) and identification of evidence gaps to inform future priority areas of research. Frailty is underrepresented in international respiratory guidelines, despite being common and related to increased hospitalisation and mortality. Validated screening instruments can detect frailty to prompt comprehensive assessment and personalised clinical management. Clinical trials targeting people with chronic respiratory disease and frailty are needed.

An agenda for excellence: the role of music therapy for people living with chronic pain

Research on the role of music and music therapy conducted for several decades reflect a dearth of literature on the health and well-being benefits of music-based and music therapy interventions for people living with chronic pain. To support advances of research on music therapy for chronic pain, the authors met regularly as members of a Special Interest Group on music, music therapy and chronic pain. The authors, from five different countries, representing the perspectives of music therapy, community music, pain medicine, and service user, discussed theoretical and methodological issues to be addressed in future studies. This article summarizes our collective thoughts in relation to priority questions for future research in music therapy and chronic pain, ethical challenges, research methods, practice techniques and future priority areas. The article sets an agenda for high quality research and practice for music therapy in the treatment and care of people living with chronic pain.

Climate change affects Galliformes taxonomic, phylogenetic and functional diversity indexes, shifting conservation priority areas in China

AbstractAimComprehensive biodiversity protection necessitates the consideration of multiple indexes of diversity, and how the distribution patterns of priority areas may shift under climate change. Galliformes is a globally endangered avian order vulnerable to climate change that provide an important indicator for wildlife conservation effectiveness. Here, we identified priority areas for conserving Galliformes taxonomic, phylogenetic, and functional diversity in China and their spatial dynamics subject to climate change, and examined how well existing protected areas align with current and future priority areas.LocationChina.MethodsWe applied species distribution modelling and Zonation algorithms to identify conservation priority area dynamics for 47 galliform species across three biodiversity indexes subject to three future climate change scenarios to 2050s and 2070s. We overlaid these identified priority areas onto existing national nature reserves and national parks to assess and project their effectiveness.ResultsCurrent priority areas proved spatially incongruent between indexes, with an optimal area overlap comprising just 10.3% of China's land area, lying largely outside of existing protected areas. Furthermore, over 80% of modelled optimal priority areas currently lacked formal conservation status. Future priority areas will shift substantially under climate change, to an extent dependent on greenhouse gas emission scenarios. Nevertheless, we identified five large regions where optimal Galliformes diversity indexes should remain stable under all scenarios, thus providing potential climatic refugia, if protected from human encroachment.Main ConclusionsThe current deficits we identified for Galliformes protection in China resonate with a broader need for hierarchical conservation strategic planning across regions and ecosystems to ensure long‐term biodiversity protection, accommodating for climate change.

Microhabitat use and selection by Pristidactylus scapulatus (Squamata Leiosauridae) in the Puna region of the Central Andes in Argentina

Understanding a species use of space is important as it provides information about the potential resources available in its habitat. The objective of this work was to evaluate the use and selection of microhabitat as it relates to availability for Pristidactylus scapulatus in the Puna region of the Central Andes in Argentina. The work was carried out at Quebrada de La Puerta in the province of San Juan and data recorded for the species included microhabitat use and availability according to established categories. To assess microhabitat selection, we applied a design of usage vs availability and calculated the Manly index to obtain a function of resource selection. The species utilised the rock microhabitat in greater proportion with respect to its availability, and in lesser measure utilised shrub and bare soil, whereas it rejected the use of cactus and dead leaves substrate. The Manly index showed that the selection of rock substrate was significant with respect to the other microhabitats. We conclude that this population of P. scapulatus has clearly saxicolous habits, though it is necessary to be aware of other aspects of its natural history to truly understand how its microhabitat selection relates to feeding or reproduction in hostile environments like the Puna. In this way we contribute to the scarce existing knowledge of its biology and we provide an information basis for the creation of future priority areas for conservation and for habitat management plans in Puna environments.

Impacts of global change on the phyllosphere microbiome.

SummaryPlants form complex interaction networks with diverse microbiomes in the environment, and the intricate interplay between plants and their associated microbiomes can greatly influence ecosystem processes and functions. The phyllosphere, the aerial part of the plant, provides a unique habitat for diverse microbes, and in return the phyllosphere microbiome greatly affects plant performance. As an open system, the phyllosphere is subjected to environmental perturbations, including global change, which will impact the crosstalk between plants and their microbiomes. In this review, we aim to provide a synthesis of current knowledge of the complex interactions between plants and the phyllosphere microbiome under global changes and to identify future priority areas of research on this topic.

Development and piloting of a prevention assessment and response tool for healthcare-associated Staphylococcus aureus bloodstream infection (the SAB-PART Study) using a Delphi method

Healthcare-associated Staphylococcus aureus bloodstream infection (HA-SAB) causes preventable harm in hospitalized patients. Currently, there is no standardized method available to review HA-SAB events in order to identify and target preventable risks requiring action at an organizational level. To develop a tool to classify SAB events, and the necessary response actions, according to the degree of preventability. Following a literature review, a tool was developed. Consensus feedback and development of the tool was sought from experts (N= 11) in healthcare-associated infection surveillance using a Delphi technique. The completed tool was retrospectively applied to HA-SAB events (N= 43) that occurred at a large healthcare organization. Survey completion rates were high (91-100%). Clinicians' poor adherence to infection prevention practices and lack of engagement with feedback processes was established as the key modifiable element. A second key theme was the need for structured and detailed response actions. This feedback was incorporated into the tool and refined until consensus on all elements was achieved. Pilot application of the tool found that 56% of HA-SAB events were highly or possibly preventable; modifiable factors for HA-SAB prevention were not present in the remainder of cases. A prevention assessment and response tool was successfully developed via a consensus method to assist organizations in investigating and responding to individual cases of HA-SAB and identify future priority areas for SAB reduction strategies. Wider use of the tool with routine surveillance activities is required to evaluate impact upon infection prevention programmes and patient outcomes.

How to Identify Future Priority Areas for Urban Development: An Approach of Urban Construction Land Suitability in Ecological Sensitive Areas.

The suitability of urban construction land (SUCL) is key to the appropriate utilization of land resources and represents an important foundation for regional exploration and land management. This study explores the SUCL conceptual framework by considering the theory of human-land relationships. The upper reaches of the Yangtze River were studied, a typical ecologically-sensitive area of China. The spatial pattern and control of the SUCL were determined using the improved entropy method. The results show that an area of 91 × 104 km2 was categorized as prohibited or restricted, and these categories account for 28.61% and 50.66% of the total area, respectively. Priority areas and suitable areas are mainly located in the Chengdu Plain, the urban agglomeration of southern Sichuan Province, Chongqing, and the economic corridor in the west, and the surrounding cities of Guiyang and Kunming. SUCL hotspots feature obvious spatial heterogeneity and are concentrated in Sichuan Basin and Guizhou Plateau. The SUCL is obviously constrained by the physical geography of this region. In addition, towns affected by the pole–axis effect have stronger suitability for development and construction. These findings will be very useful for land managers as they provide relevant information about urban development in mountainous areas.

An interdisciplinary assessment of private conservation areas in the Western United States

Conservation easements are the fastest growing private conservation strategy in the United States. However, mechanisms to assess private land conservation as well as their support by the general public are not well understood. This study uses the ecosystem services framework for assessing existing private lands in Idaho and identifies areas for future conservation easements. Using conservation targets of the land trust as a guide for selecting ecosystem services, we (a) mapped the spatial delivery of conservation targets across public and private lands, (b) explored public awareness in terms of social importance and vulnerability, and (c) mapped future priority areas by characterizing conservation bundles. We found that public lands provided the highest levels of conservation targets, and we found no difference in conservation target provision between private areas and conservation easements. The spatial characterization of conservation target bundles identified potential future priority areas for conservation easements, which can guide planning of land trust conservation efforts.

Current management strategies to target the increasing incidence of diabetes within Pakistan.

According to the recently published National Diabetes Survey of Pakistan (NDSP 2016–2017), the prevalence of diabetes is 26.3%. Hence, Pakistan has around 27.4 million people >20 years of age suffering with diabetes. Compared to previous estimation of having around 7 million diabetic patients based on a survey done in 1994–1998, the figures are disturbingly alarming. The four main strategies to tackle the rising incidence of diabetes in Pakistan are as follows: 1) creating multidisciplinary teams through capacity building of the health care professionals (HCPs), including doctors, dieticians, diabetes educators, diabetes foot assistants, and program managers in standardized evidence-based protocols, enhancing their knowledge and skills in managing diabetes and their related comorbidities; 2) promoting primary prevention and awareness all over Pakistan using screening methods such as Risk Assessment of Pakistani Individuals for Diabetes (RAPID); 3) defining strategies for the management and prevention of diabetes and its complication through forums such as the Pakistan Diabetes Leadership Forum (PDLF); and 4) implementing a nationwide diabetes care program including registration, treatment, and referral protocols. The epidemic of diabetes in an under-resourced and overburdened health care system of Pakistan poses a serious challenge not only for the doctors but also for the multiple stakeholders involved in the community systems. There is a need for promoting and screening the population using RAPID and registering people with diabetes through Diabetes Registry of Pakistan (DROP). Future priority areas and interventional strategies shall include the following: implementing a diabetes health care service model in both rural and urban population using evidence-based clinical guidelines along with lifestyle modifications (LSMs) and prevention policies. Current management strategies and proposed future directions may successfully target the increasing incidence of diabetes.

Dietetics workforce preparation and preparedness in Australia: A systematic mapping review to inform future dietetics education research.

The present study aimed to systematically map and summarise existing research regarding dietetics workforce preparation and preparedness that has been conducted in Australia. The secondary aim was to then identify gaps in the literature to inform future priority areas in Australian dietetics education research. The databases MEDLINE, CINAHL, Embase, ERIC, Informit and PsycINFO were systematically searched from inception until July 2017 using key search terms to identify eligible studies. Extracted data were independently reviewed, and study quality was appraised by multiple researchers. Results were categorised by setting and primary focus/foci and then narratively summarised. Sixty-eight studies were included from 3779 records identified. Dietetics education research in Australia has spanned almost 30 years with more than half of studies (51%; 35/68) published in the last five years. The greatest proportion of research was conducted in the university setting (43%; 29/68), with students as participants (48%; 43/90) and was focused on the medical nutrition therapy area of dietetics practice (43%; 29/68). Published studies involving graduates (14%; 13/90); conducted in the workplace (12%; 8/68); and regarding emerging areas of dietetics practice (0%; 0/90) are lacking. Employment outcomes of dietetics graduates across Australia were last published over 25 years ago. This review provides a map for dietetics educators and researchers in Australia to guide future research regarding the preparation and preparedness of dietitians. Advancing the Australian dietetics workforce of the future will require a strategic, coordinated and collaborative approach to address the research gaps identified in this review.

Clinical Trial End Points for Hemodialysis Vascular Access: Background, Rationale, and Definitions.

Hemodialysis vascular access is the “lifeline” for patients on hemodialysis. Unfortunately, because of its poor patency and significant complication rate, it is also the “Achilles heel” of hemodialysis. For example, the current unassisted arteriovenous fistula (AVF) maturation rate is only

Clinical management of genital chronic GvHD.

Chronic GvHD (cGvHD) of the genital tract is an underreported and infrequently recognized complication of allogeneic hematopoietic cell transplantation in both male and female long-term survivors. Its pathophysiology, clinical manifestations and management are not well understood, and studies are limited. We thus provide a comprehensive review of genital cGvHD in both men and women, as well as discuss related issues of sexual health and viral reactivation. We further provide guidance on screening, management and long-term follow-up, as well as future priority areas of study.

PALLIATIVE CARE RESEARCH ON THE ISLAND OF IRELAND OVER THE LAST DECADE: A SYSTEMATIC REVIEW

BackgroundAs palliative care research continues to expand across Europe, and the world, questions exist about the nature and type of research undertaken in addition to the research priorities for the...

Palliative care research on the island of Ireland over the last decade: a systematic review and thematic analysis of peer reviewed publications

BackgroundAs palliative care research continues to expand across Europe, and the world, questions exist about the nature and type of research undertaken in addition to the research priorities for the future. This systematic review, which is the first stage of a larger scale study to identify the research priorities for palliative care on the island of Ireland, examined palliative care research conducted on the island over the last decade.MethodsA comprehensive search strategy was implemented and strict eligibility criteria were applied in order to identify relevant peer-reviewed journal articles. Inclusion criteria were all of the palliative care studies undertaken on the island of Ireland and published between January 2002 and May 2012. These were assessed in relation to year, setting, sample size, research methodology, and relevant findings.Results412 publications were identified for screening and their abstracts obtained. After eliminating articles that did not meet the inclusion criteria, 151 remained for further analysis. A thematic analysis of 128 studies published between 2006 and 2012 revealed eight core themes: (1) specific groups/populations; (2) services and settings; (3) management of symptoms (physical, psychological, social); (4) bereavement; (5) communication and education; (6) death and dying; (7) spirituality; and (8) complementary and alternative medicine/intervention (CAM). There was an upward trend in the number of publications in palliative care research over the last ten years with over 72% of studies being published within the previous four years. A slightly higher number of studies were quantitative in nature (surveys, questionnaires, standardised assessments) followed by qualitative (individual and focus group interviews, case studies, documentary analysis and retrospective case note reviews), mixed methods, and systematic reviews.ConclusionsWhilst there has been a welcome growth in palliative care research across Ireland, this has largely been needs-based and small scale studies. In contrast, international researchers and decision makers recommend the need for more outcomes focused multidisciplinary research. An examination of palliative care research is an essential first step in seeking to develop future priority areas for further research, highlighting opportunities for future collaboration both nationally and internationally.

StaR Child Health: Developing Evidence-Based Guidance for the Design, Conduct, and Reporting of Pediatric Trials

* Abbreviations: DMC — : data monitoring committee SDG — : standard development group StaR Child Health — : Standards for Research in Child Health WHO — : World Health Organization “Lack of research, poor research, and poorly reported research are violations of children’s human rights,” declared Dr Richard Horton in his plenary address to the audience of the first summit of Standards for Research in (StaR) Child Health. StaR Child Health was founded in 2009 to address the paucity and shortcomings of pediatric clinical trials. This initiative involves international experts who are dedicated to developing practical, evidence-based standards to enhance the reliability and relevance of pediatric clinical research. Through a systematic “knowledge to action” plan, StaR Child Health will make efforts to improve and expand the evidence-base for child health across the world. This article introduces the StaR Child Health agenda, the 11 initial priority topics that have been identified, and methods used to address these issues. Approximately 180 participants, including representatives from the World Health Organization (WHO), the US Food and Drug Administration, and the European Medicines Agency, gathered in Amsterdam for the first StaR Child Health summit in October 2009 (Table 1). The summit was held on the eve of the 20th anniversary of the adoption of the United Nations Convention on the Rights of the Child, which recognizes the right of all children “to the enjoyment of the highest attainable standard of health.”1 One impediment to achieving this universal right is the paucity and well documented shortcomings of pediatric research and more specifically clinical trials.2 It is recognized that the quantity, quality, and relevance of data involving children are substantially lower than for adults,3–5 despite data demonstrating that inadequate testing of interventions in children can result in ineffective or harmful treatments being offered or beneficial treatments being withheld.6 View this table: TABLE 1 Chronology of Key Events for StaR Child Health The mission of StaR Child Health is to improve the design, conduct, and reporting of … Address correspondence to Martin Offringa, MD, PhD, Senior Scientist and Program Head Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8. E-mail: martin.offringa{at}sickkids.ca

Climate Change in Indonesia: A Glimpse of Riau and East Kalimantan

Indonesia is the largest and widest archipelago in the world with a coastline length of 81,000 km alongwith 17,508 islands, which makes it one of the most vulnerable countries to climatic changes. This paper focusses on the climatic changes in Indonesia with special reference to Riau and East Kalimantan. It is based on secondary literature and examines the effects of greenhouse emissions, deforestation, changes in land use, etc. on environment, biodiversity, and livelihood options of the people living there. Finally, the article explores the national/governmental efforts and the international assistance provided to help Indonesia deal better with climate change adaptation. The future priority areas of intervention would be decentralized risk reduction initiatives and resource conservation, educating farmers and vulnerable communities, coastal area research, local interventions, and coordination between the provinces.

Grazing Research in the Humid East: A Historical Perspective

A historical perspective of the major developments in grazing research for the humid Eastern USA was addressed. Consideration was given to the emergence of the area of grazing research relative to the initial structure of agricultural institutions, the orientation of scientist within the constraints of the institutional boundaries (departments) and the carry‐through noted today. Early grazing research was constrained to the informal literature and discussed as informational, demonstrational, and experimental. The milestones that have been achieved, including statistical application, conceptual assessment, description of grazing management, methods of computing pasture yields, the origin and use of put‐and‐take stocking, pasture and animal biomass relationships, choice of stocking method, flexible grazing, and measurements in recent grazing research are presented and discussed relative to their origin and application. Furthermore, consideration was given to a number of important innovations with origin in the humid East that have contributed to the advancement of grazing research. Finally, brief consideration is given to future priority areas of grazing research and associated constraints.