Future Priorities Research Articles

Identifying gaps in nature reserves by integrating future ecosystem service priority areas

ContextIncorporating ecosystem services (ES) into nature reserves (NR) planning has significant impacts on the environment and human wellbeing. However, the effects of uncertain future socio-environmental dynamics on ES conservation and the gaps in existing NR are unclear.ObjectiveThe present study aims to integrate multiple ES dynamics into future NR planning and quantify the gaps with existing NR.MethodsWe first presented a methodological scheme to assess ES dynamics under the Shared Socioeconomic Pathway and Representative Concentration Pathway (SSP-RCP) scenarios in the Yangtze River Economic Belt (YREB) in China during from 2015 to 2100. We then employed a representativeness–vulnerability framework to identify priority conservation areas within the YREB.ResultsExcept for SSP1-1.9 and SSP4-3.4, all scenarios projected an increase in ecosystem service value (ESV). SSP3-7.0 and SSP4-3.4 were expected to induce the largest ESV changes, with increases of 6.35% and decreases of 6.08%, respectively, during 2015–2100. By integrating future ESV changes into NR planning, we identified priority conservation areas at different time points from 2015 to 2100. Through overlay analysis, we derived bottom-line conservation areas across multiple scenarios and timeframes. The identified bottom-line conservation areas are mainly distributed in eastern Sichuan, western Guizhou, eastern Hubei, and southern Jiangsu, covering 8.62% of the YREB. Notably, only 4.81% of the existing NR areas in the YREB overlap with the identified bottom-line conservation areas.ConclusionsOur analyses reveal gaps between the existing NR and the potential future priority conservation areas in the YREB when considering multiple ES. We emphasize the need to define bottom-line conservation areas based on ES dynamics under various scenarios to address future uncertainties and complexities.

Exploring the landscape of Canadian midwifery research: strengths, gaps and priorities – results of a scoping review

ObjectivesThe 2014 Lancet Series on Midwifery developed the Quality of Maternal and Newborn Care (QMNC) framework outlining care needed for all childbearing people and newborns. Furthermore, this was a global...

Living on the Edge: Paradoxical Experiences with Ethics (Reprinted with permission).

Paradox is living phenomenon that provides insights into straight thinking and diverse human experiences important to the discipline of nursing from a nursing philosophical theory-based approach. The author here delves into the metaphorical experience of living on the edge and the paradoxical concepts that assist the discipline in its thinking about artificial intelligence. Possible ethical implications of utilizing artificial intelligence from a humanbecoming ethos of understanding is utilized. The metaphorical implications for future disciplinary priorities are presented.

Genetic Warfare: The Plant Genome's Role in Fending Off Insect Invaders.

The plant defense against insects is multiple layers of interactions. They defend through direct defense and indirect defense. Direct defenses include both physical and chemical barriers that hinder insect growth, development, and reproduction. In contrast, indirect defenses do not affect insects directly but instead suppress them by releasing volatile compounds that attract the natural enemies of herbivores. Insects overcome plant defenses by deactivating biochemical defenses, suppressing defense signaling through effectors, and altering their behavior through chemical regulation. There is always a genetic war between plants and insects. In this genetic war, plant-insect co-evolution act as both weapons and messengers. Because plants always look for new strategies to avoid insects by developing adaptation. There are molecular processes that regulate the interaction between plants and insect. Here, we examine the genes and proteins involved in plant-insect interactions and explore how their discovery has shaped the current model of the plant genome's role. Plants detect damage-associated and herbivore-associated molecular patterns through receptors, which trigger early signaling pathways involving Ca2+, reactive oxygen species, and MAP kinases. The specific defense mechanisms are activated through gene signaling pathways, including phytohormones, secondary metabolites, and transcription factors. Expanding plant genome approaches to unexplored dimensions in fending off insects should be a future priority in order to develop management strategies.

Future Priorities for Observing the Dynamics of the Southern Ocean

Future Priorities for Observing the Dynamics of the Southern Ocean

Foresight and Forecast: The Future of Gerontological Nursing for the Next 50 Years

The World Health Organization recognizes that aging is a life-long process. Aging is a universal phenomenon, and the number of people aged ≥65 years is expected to increase exponentially over the next 30 to 50 years. Thus, the universality and globalization of aging requires that our interconnected societies be equipped to meet the needs of humans across all developmental and life stages. The coronavirus disease 2019 pandemic taught us to be agile, innovative, and always prepared to tackle new health issues that target older adults and their communities. Thus, the future of gerontological nursing must support optimal aging through practice, education, research, and policy initiatives. In recognition of the Journal of Gerontological Nursing's 50th anniversary, the current article forecasts future priorities and how gerontological nursing will address persistent challenges while capitalizing on opportunities to optimize health congruent with individuals' preferences and abilities, improve the care of older adults, and advance the study of aging. [ Journal of Gerontological Nursing, 50 (12), 31–40.]

Critical security research and the war on terror: From the margins to the mainstream?

Abstract Contemporary reckoning with the catastrophic outcomes of the post-9/11 era opens important questions for the future of counterterrorism policy. It also raises significant issues for thinking through the future priorities and purposes of security scholarship. In this article we make two core claims. First, recent years have seen considerable mainstreaming of ostensibly critical ideas on (counter)terrorism within political debate, media commentary, and – crucially – security policy. Second, such ideas – including around the futility of ‘war’ on terror; the ineffectiveness of torture; the unstable framing of threats such as radicalisation; and the inefficiency of excessive counterterrorism expenditure – were widely dismissed as lacking in policy relevance, even being utopian, when articulated by critically oriented scholars. This development, we argue, raises important ontological questions around the ending of security paradigms such as the war on terror. It also prompts vital political, epistemological, and normative questions around the status of overtly critical scholarship when its ideas and recommendations achieve wider currency.

An approach based on ecosystem services for assessing progress towards sustainable development goals at both national and provincial levels in China

Ecosystem services (ESs), the benefits nature provides to people, are an important basis for fulfilling sustainable development goals (SDGs). Therefore, an ES-based approach will help deepen our understanding of the relationships between natural systems and human well-being and provide co-benefit pathways for sustainable development. However, monitoring progress towards achieving the SDGs based on the contributions of ESs to SDGs is lacking. Using the linkages between ESs and SDGs, this study quantified progress towards the SDGs in China from 2000 to 2020 and determined future development priorities at both the national and provincial levels. Our results indicated that (1) during the period 2000–2020, China showed decreasing trends in the 11 SDGs and SDG index scores; (2) there were significant differences in the scores for SDGs and the SDG index across 31 provinces; (3) SDG 3, SDG6, SDG11, SDG13, and SDG15 were recognized as the highest national priorities, concerning health and environment; and (4) 31 provinces faced diverse economic, social, and environmental development challenges. The ES-based approach may assist policy-makers in monitoring and comparing progress towards the SDGs in an integrated and composite way, prioritizing local action, and providing a scientific basis for formulating policies to achieve SDG implementation.

Causalities and priorities for SDG targets in the human-earth system

The six Sustainable Development Goals (SDGs)—Food (2), Water (6), Energy (7), Economy (8), Climate (13), and Ecology (15)—collectively referred to as FWEECE, form the interdependent core of the human-earth system. Understanding their complex interactions is crucial for identifying transformative actions that maximize synergies and minimize trade-offs, thereby helping to rescue the 2030 Agenda. However, current research on SDG causal interactions in FWEECE remains limited. This study used structured expert elicitation to evaluate the causal interactions of 50 SDG targets in FWEECE. We applied network analysis, community detection, similarity analysis, systematic analysis, and prospective structural analysis to identify the higher-order influence, modularity, similarity, potential role, and structural function of each target within the network. Our results indicated that targets 8.4 (sustainable consumption and production) and 6.4 (increasing water-use efficiency) could be top prioritized in the global governance actions. Five targets related to food systems, water quality, climate resilience, and ecosystem protection (2.4, 13.1, 6.3, 15.1, and 15.5) were secondary priorities, while target 2.3 (increasing agricultural productivity) was considered as a high-risk. The trade-offs among food production, economic growth, and ecosystem conservation remained a major challenge for achieving FWEECE. This study provides new insights for future global priorities and is significant for promoting policy coherence and human-earth system coordination.

Ocean literacy research community: co-identifying gaps and priorities to advance the UN Ocean Decade

IntroductionThe overarching goal of the UN Ocean Decade is to “change humanity's relationship with the ocean.” While this may be a challenge, it is, at the same time, a once in a generation opportunity. How can 8 billion people, including those who don't live near coastal areas, be inspired to value and care for the ocean? This is the essence of ocean literacy, and the driver of ocean literacy research (OLR).MethodsIn 2021, we began a research initiative to co-create a global OLR agenda by the developing OLR community, to better understand existing research themes, gaps, future priorities, actions, and impacts of ocean literacy initiatives. To deliver this, a series of virtual workshops – with the first taking place as part of the UN Ocean Decade Laboratories – was complemented by a participatory methodology using digital survey and mapping tools for crowdsourced collaboration.Results and discussionThrough this process, four initial OLR priorities were identified, including measuring ocean literacy, the role of ocean literacy as a policy mechanism, and alignment of OLR with climate change and the blue economy agendas. Finally, a working definition of OLR was developed to further guide OLR priorities for the UN Ocean Decade and beyond.

Parkinson disease therapy: current strategies and future research priorities.

Parkinson disease (PD) is the fastestgrowing neurological disorder globally and poses substantial management challenges owing to progressive disability, emergence of levodopa-resistant symptoms, and treatment-related complications. In this Review, we examine the current state of research into PD therapies and outline future priorities for advancing our understanding and treatment of the disease. We identify two main research priorities for the coming years: first, slowing the progression of the disease through the integration of sensitive biomarkers and targeted biological therapies, and second, enhancing existing symptomatic treatments, encompassing surgical and infusion therapies, with the goal of postponing complications and improving long-term patient management. The path towards disease modification is impeded by the multifaceted pathophysiology and diverse mechanisms underlying PD. Ongoing studies are directed at α-synuclein aggregation, complemented by efforts to address specific pathways associated with the less common genetic forms of the disease. The success of these efforts relies on establishing robust end points, incorporating technology, and identifying reliable biomarkers for early diagnosis and continuous monitoring of disease progression. In the context of symptomatic treatment, the focus should shift towards refining existing approaches and fostering the development of novel therapeutic strategies that target levodopa-resistant symptoms and clinical manifestations that substantially impair quality of life.

Reflections on the Global Biodiversity Framework: Achievements, gaps, and future priorities

Reflections on the Global Biodiversity Framework: Achievements, gaps, and future priorities

Understanding the role of machine learning in predicting progression of osteoarthritis.

Machine learning (ML), a branch of artificial intelligence that uses algorithms to learn from data and make predictions, offers a pathway towards more personalized and tailored surgical treatments. This approach is particularly relevant to prevalent joint diseases such as osteoarthritis (OA). In contrast to end-stage disease, where joint arthroplasty provides excellent results, early stages of OA currently lack effective therapies to halt or reverse progression. Accurate prediction of OA progression is crucial if timely interventions are to be developed, to enhance patient care and optimize the design of clinical trials. A systematic review was conducted in accordance with PRISMA guidelines. We searched MEDLINE and Embase on 5 May 2024 for studies utilizing ML to predict OA progression. Titles and abstracts were independently screened, followed by full-text reviews for studies that met the eligibility criteria. Key information was extracted and synthesized for analysis, including types of data (such as clinical, radiological, or biochemical), definitions of OA progression, ML algorithms, validation methods, and outcome measures. Out of 1,160 studies initially identified, 39 were included. Most studies (85%) were published between 2020 and 2024, with 82% using publicly available datasets, primarily the Osteoarthritis Initiative. ML methods were predominantly supervised, with significant variability in the definitions of OA progression: most studies focused on structural changes (59%), while fewer addressed pain progression or both. Deep learning was used in 44% of studies, while automated ML was used in 5%. There was a lack of standardization in evaluation metrics and limited external validation. Interpretability was explored in 54% of studies, primarily using SHapley Additive exPlanations. Our systematic review demonstrates the feasibility of ML models in predicting OA progression, but also uncovers critical limitations that currently restrict their clinical applicability. Future priorities should include diversifying data sources, standardizing outcome measures, enforcing rigorous validation, and integrating more sophisticated algorithms. This paradigm shift from predictive modelling to actionable clinical tools has the potential to transform patient care and disease management in orthopaedic practice.

3.L. Round table: Outcomes from a public debate on the future health priorities of the European Union

Abstract Objective and background In the run up to the European elections, the European Observatory on Health Systems and Policies facilitated a public debate on the future health priorities of the European Union. The purpose of the debate was to provide insights to the European Commission on the views of stakeholders and the public health community with regards to the future of the European Health Union (EHU). The EHU was established as a comprehensive health systems and public health response to the COVID-19 pandemic, featuring enhanced budgets, expanded mandates for existing bodies, and the introduction of new entities like the Health Emergency Response Authority (HERA) alongside new strategies. Methods The methodology for this comprehensive debate included workshops and plenary sessions at various conferences like the 2023 EUPHA conference in Dublin, an interactive webinar series, and a detailed stakeholder survey featuring both closed and open-ended questions. Data was collected and analyzed using diverse qualitative and quantitative tools, including AI-driven analysis of survey responses. Preliminary outcomes Preliminary analysis shows that participants actively engaged in the debate, and mostly expressed support for the EHU’s achievements to date. There was a consensus on the significant value added by the EHU, with many advocating for stronger EU action on a range of discussion topics. Stakeholders and the public health community could also relate to the discussion framework designed to guide the public debate, which included nine topics: enhancing health security; addressing the determinants of health through Health in All Policies and Health for All Policies; supporting health system transformation; enhancing the labour market for health and care workers; achieving universal health coverage; implementing digital solutions and AI; improving the performance and resilience of health systems; addressing long-term challenges, such as population ageing or climate change; and strengthening the EU’s global voice and leadership. The importance placed on these topics varied among different groups. Young participants prioritized climate-related actions, the public health community emphasized addressing the determinants of health, and policymakers concentrated on issues related to health system resilience, universal coverage, and transformation. Digital solutions and AI were recognized as crucial, but they were typically considered integral and transversal to broader issues rather than standalone priorities. The debate also surfaced priorities not initially included in the discussion framework, such as health promotion, prevention, and equity within health systems, which were repeatedly highlighted. Key messages • The debate on the EU’s future health priorities demonstrates that stakeholders and the public health community acknowledge the value of the EHU and would like to see further action to build on it. • Stakeholders and the public health community have formulated concrete action to take the EHU further. Speakers/Panelists Giada Scarpetti TU Berlin, Berlin, Germany Caroline Costongs EuroHealthNet, Brussels, Belgium Isabel de La Mata DG SANTE, European Commission, Luxembourg, Luxembourg

Reviewing and assessing emerging trends and needs for research, development and innovation (RDI) and capacity building in a short, medium and long-term perspective

Abstract An important aim of the Partnership is to identify current and future health services and systems priorities and to identify capacity building and training needs to support RDI activities in health and care systems in the Partnership countries and the EU as a whole. This is being done by means of periodical reviews, among others building on scientific research literature, strategic and policy documents and consultations of stakeholders. At the conference workshop, results of the mapping are presented, with a special focus on priority areas that can contribute to health systems transformation towards sustainable and people-centred health and care systems accessible to all. The session will allow participants provide reflections on and refinements to potential common priorities across national RDI agendas. This will provide direction for future research calls, based on an inventory of priorities that are considered by both policy audiences, research and wider stakeholder communities that should be addressed at EU and national levels.

Social Inclusion for People with Intellectual Disability and on the Autism Spectrum through Assistive Technologies: Current Needs and Future Priorities

Context Contemporary technologies, such as mainstream and specialised Assistive Technologies (ATs), are seen as effective. However, there is a noticeable gap between technological progress and the ability to customise these technologies to meet the unique needs and characteristics of neurodivergent individuals, particularly those on the Autism Spectrum and people with Intellectual Disability (pwID). Purpose The goal of this study is to investigate the present requirements and future priorities acknowledged by specialists in the field regarding the progress of social inclusion for this population, making use of ATs. Methods and results A qualitative survey involving 24 international experts, and its respective thematic analysis reveals challenges in social inclusion, emphasizing communication and physical accessibility, awareness gaps, and stigma. Concurrently, issues surrounding ATs include limited access, insufficient training, and a lack of awareness and skills, with individuals, and families being inadequately involved. Conclusion and implications The study proposes strategies for overcoming these challenges, with a focus on accessibility, awareness, skills, family involvement, and customization. Identified research needs encompass scientific development, inclusive approaches, and changes in technological development paradigms.

Smart chitosan-based nanofibers for real-time monitoring and promotion of wound healing

Timely healing of acute wounds and stopping wound chronicity are current and future priorities in wound therapy. It is urgent and relevant to develop a wound dressing that has antimicrobial and monitors the wound microenvironment in real time. In this study, quaternary ammonium chitosan (HTCC) was selected as the antimicrobial agent and CS/PEO/HTCC nanofiber membranes (CPHs) were prepared by electrostatic spinning technique. The nanofiber membrane (CPH91) with the best antimicrobial performance was screened by the disk diffusion method and drug susceptibility testing by dilution method, and its antimicrobial effect on S. aureus was better than that of E. coli. Subsequently, functional carbon dots (CDs) were synthesized by solvothermal method and doped into CPH91 nanofibers by electrospinning. A good linear relationship between pH value (5.0–8.0) and the fluorescence intensity of CDs was observed. In addition, the nanofibers (CPH91@CDs) had good morphology, hydrophilicity, and biocompatibility. Changes in fluorescence intensity of CPH91@CDs at different pH (5.0–8.0) were monitored and converted into RGB values that were linearly fitted to pH value. Finally, the potential of CPH91@CDs of improving wound healing and instantaneously controlling wound healing process was confirmed by an infected wound model (S. aureus) on the back of SD rats.

Longitudinal biomonitoring of mycotoxin exposure during pregnancy in the Yale Pregnancy Outcome Prediction Study

Mycotoxins are fungal toxins that may trigger adverse health effects in pregnant women and their unborn children. Yet, data is scarce on the dynamic exposure patterns of mycotoxins in pregnant women, especially in the United States. This study assessed mycotoxin exposure profiles in women (n = 50) from the Yale Pregnancy Outcome Prediction Study (YPOPS) cohort at four distinct time points. Multi-analyte human biomonitoring assays based on liquid chromatography tandem mass spectrometry (LC-MS/MS), were developed for human serum and plasma matrices. The serum method was applied, together with an established urine method, to quantify mycotoxin levels in longitudinally collected matched serum (n = 200) and spot urine (n = 200) samples throughout pregnancy. The serum samples were mostly contaminated by the potential carcinogen ochratoxin A (detection rate: 46 %; median: 0.09 ng/mL), the hepato- and nephrotoxic citrinin (detection rate: 32 %; median: 0.02 ng/mL) and two enniatins (EnnB; detection rate: 97 %; median: 0.01 ng/mL and EnnB1; detection rate: 12 %; median: 0.003 ng/mL) which may act as immunotoxins. The most prevalent mycotoxins quantified in urine included deoxynivalenol (detection rate: 99 %; median: 23 ng/mL), alternariol monomethyl ether (detection rate: 69 %; median: 0.04 ng/mL), and zearalenone (detection rate: 63 %; median: 0.16 ng/mL). Seven other biomarkers of exposure including the highly estrogenic α-zearalenol and genotoxic Alternaria toxins, were also determined. Carcinogenic aflatoxins were not detected in any of the samples. Exposure assessment was based on the urinary data and performed by calculating probable daily intakes and comparing the human biomonitoring guidance value (HBM-GV) for deoxynivalenol. The results showed that the individuals exceeded the tolerable daily intake for deoxynivalenol and zearalenone on average at 28 % and 2 % over the different time points. Using the HBM-GV approach, the average exceedances for deoxynivalenol increased to 48 % indicating high exposure. For all the samples in which ochratoxin A was quantified, the estimated margin of exposure for neoplastic effects was below 10,000, indicating possible health concerns. Overall, this study showed that pregnant women were exposed to several regulated and emerging mycotoxins and that exposome-scale assessment should be a future priority in susceptible populations to better characterize xenobiotic exposure.

Healthcare professionals' perceptions on providing support to informal carers within stroke care.

The sudden nature of stroke onset does not provide carers with sufficient time to prepare for the demands associated with caring. Healthcare professionals can have a vital role in providing carers with support and training, which may reduce carer stress and strain, and allow for better health and rehabilitation outcomes for the stroke survivor. The experiences of healthcare professionals on supporting carers in stroke care, however, remain unclear. To understand the experiences and perceptions of healthcare professionals working in stroke care on implementing resources and support to informal stroke carers. Semi-structured interviews were conducted with 11 healthcare professionals (5 occupational therapists, 5 physiotherapists, 1 psychologist) with at least 12 months' experience in working with stroke survivors. Interviews ranged from 25-70 minutes in duration, and were recorded, transcribed, and analysed using thematic analysis. Three overarching categories that were explored were: (1) Experiences of working in stroke care and supporting carers; (2) Recommendations for a program designed for carers; and (3) Future priorities in stroke care. Participants discussed a variety of strategies they utilised to support carers including collaborating with other healthcare professionals and utilising skills and experience. Healthcare professionals highlighted the need for additional resources that are designed specifically for carers and explored key topics including carer stress and fatigue, support services, stroke education, and how to look after oneself. Participants identified priorities for stroke care including additional professional training and resource availability. This study provided a unique insight from the perspectives of healthcare professionals on supporting carers. Participants identified the need for additional training and resources to equip healthcare professionals to better support carers. Future programs designed for carers should be informed by the needs and experiences of both informal carers and healthcare professionals.

Expert insights on managing harmful algal blooms

Freshwater harmful algal blooms (HABs) are a global environmental, economic, social, and public health hazard. While there is an increasing understanding of the ecological considerations of HABs, there is limited understanding of human dimensions and management needs. We conducted semi-structured key informant interviews with 28 water managers and researchers to better understand how they perceive current management and to identify future management priorities in regard to HABs. For this study, we interviewed 31 key informants from three regions of the United States (New England, Ohio, and the Mountain West). We solicited insights across aspects of HABs management, including prevention, forecasting, monitoring, response, and communication. Nutrient management was the main consideration for the prevention of HAB events. Key informants noted that forecasting has the potential to be a valuable tool in the future but is not yet accurate enough at a local scale for widespread use. Monitoring was found to be implemented in varying ways across and even within the states and regions, with a need for more funding and standardization. HAB event responses vary greatly from chemical and physical treatments that suppress toxins to no-swim advisories, all with a mix of strengths and weaknesses. Finally, an increase in and improvement of communication efforts was identified as critical for reducing public health risks. These findings provide perceptions of current management practices and future plans while including opportunities to improve current freshwater HAB management efforts.