Industry Representatives Research Articles

Optimising decision support tools for the agricultural sector

AbstractSeveral challenges threaten the viability of agriculture in the Mediterranean region, for instance, climate change and variability, land degradation and desertification, environmental and social pressures in rural areas, and the arrangement and extent of properties. These challenges require the attention of farm managers and effective decision-making that can safeguard the natural resource base, enhance resilience and food security, and promote sustainable production landscapes. Decision Support Tools (DSTs) offer valuable assistance in addressing these challenges by improving the decision-making process for both farmers and advisors. They enable data-informed decisions that can enhance the sustainability performance of agricultural businesses in the region. A crucial component of designing a proficient DST is the prompt involvement of stakeholders using a participatory approach to define the needs and requirements of end users. In this study, we engaged twenty-nine stakeholders, including farmers, advisors, extension officers, policy makers, and industry representatives from the Argolida regional unit and the Greek National Ministry of Rural Development and Food. This engagement was aimed at conducting a comprehensive analysis of user needs. To achieve this, we employed the Q-methodology approach to gain a thorough comprehension of the viewpoints and requirements of these diverse stakeholder groups. The results illustrated factors such as the need for user-friendly interfaces, the importance of data accuracy and reliability, the benefit of flexibility and adaptability, and the need for appropriate training and support. These findings can aid the effective development of DSTs so that emerging challenges can be framed in a manner that will facilitate solutions.

Engaging Young People in Occupations Served by Vocational Education: Case Study From Healthcare

Purpose: Globally, countries with both developed and developing economies are struggling to secure sufficient participation in vocational education to generate the range and quantum of skills required for their communities and realising national social and economic goals. In an era of high aspiration, vocational education and the occupations it serves are increasingly seen as being a less than desirable outcome by young people and their parents. Hence, there is a need to identify means by which to inform and engage young people in considering vocational education and the occupations it serves. The case study discussed in this paper is contextualised within the Australian state of Queensland, which, like many other countries is struggling to have a workforce sufficient to meet communities' healthcare needs as its population both grows and ages. Methods: The study data were collected from 1) interviews with healthcare-related stakeholders including health industry representatives, teachers or practitioners, and healthcare providers, 2) focus groups with senior secondary students, and 3) surveys with these participant groups. It provides a descriptive analysis of efforts to secure greater participation by young people in allied health roles, and, in particular, young Australian Indigenous people. Findings: The study participants included those from regional and metropolitan centres and from state and independent schools, and in all of which the focus on engagement was central. Findings indicated that engagement was necessary to advise young people about these occupations, the effective preparation for them, and likely retention in the workforce. Conclusion: This study highlights the need for intentional strategies to engage young people, their parents/guardians and with those efforts likely needing to be organised and enacted at the local level. This requires collaboration and engagement from education, industry, and local communities. Essentially, a systemic approach is required, specifying roles for government, employers, educational systems, and teachers and parents who engage directly with young people. In all, engagement, advice and opportunities locally are all emphasised in the study reported here.

Turkish Radio and TV Broadcasting Corporation’s new streaming application and the continuity of music policy as an educational institution

While numerous studies focus on streaming platforms as new business models or as novel elements in the supply chain, there is a notable gap in research addressing how streaming is operationalized within the context of state cultural policies. This study aims to fill this gap by conducting a preliminary examination of Turkish Radio and Television Broadcasting Corporation’s (TRT’s) digital transformation through its music streaming platform, TRT Listen. This research contributes to the international literature by highlighting various potential approaches to the digitalization of public radio broadcasting. This study, which examines the purpose and realization of TRT Listen, first provides a historical overview of TRT’s radio broadcasting and thus reveals the continuity in TRT’s cultural policy, which is shaped as a mission to educate the public and inculcate a national cultural identity, from radio broadcasting to the platform app. Two different research methods were used in this study: walk-through technique for the app and in-depth interviews with TRT’s staff and music industry representatives. The basic argument suggests that TRT Listen represents a continuation of historical music policies and nation state cultural agenda inherited from TRT’s radio era. However, at the operational level, this strategic continuity seems to disappear in the audience engagement techniques of digital platforms. The three main discussion sections of this article – TRT Listen’s strategic orientation, content curation and copyright management – reveal the platform’s mission to educate the public culturally in Turkey.

A Curricular Model for Simulation Within Orthopaedic Residency Training.

American Board of Orthopaedic Surgery/American Council on GraduateMedical Education Residency Review Committee training requirements have necessitated the need for the adoption of simulation education into existing programmatic requirements. Current guidelines focus only on interns at a potentially significant cost to programs; both in total dollar amount and time. The authors aim to provide a model that can maximize utility for all resident levels, manage cost by maximizing the use of cadaveric material, and allow integration of varied industry support. The Oregon Health & Science University Orthopaedic education program has developed a high-fidelity training curriculum that (1) is applicable to both junior and senior residents (2) has minimized the cost per resident with the reuse of cadaveric specimens and (3) has nurtured partnerships with industry stakeholders to reduce bias in training by collaborating with most major industry representatives. The simulation curriculum outlined in this manuscript may serve as a reference for other programs and institutions to develop their own residency educational curriculum models.

Views of Service Users, Their Family or Carers, and Health Care Professionals on Telerehabilitation for People With Neurological Conditions in Ghana: Qualitative Study.

Up to 50% of people in low- and middle-income countries do not receive the rehabilitation they require. Telerehabilitation has the potential to improve access to neurorehabilitation services especially in low- and middle-income countries. Although there are reports of the barriers and facilitators to telerehabilitation in such settings, almost all are anecdotal. Furthermore, family or carers have a significant influence on the adoption and success of telerehabilitation, but their views have not been reported. This study aimed to investigate the views of service users, their family or carers, and health care professionals (HCPs) on telerehabilitation for people with neurological conditions in Ghana. Two focus groups were held at Komfo Anokye Hospital in Kumasi, Ghana: one in person for service users (n=11) and their family or carers (n=9), conducted in the Ghanaian language of Twi, and one hybrid for HCPs (n=18) conducted in English. The mean (SD) age of the service users was 59.8 (8.6) years; 5 users had a stroke and 6 had Parkinson disease. The HCP group consisted of 7 speech and language therapists, 3 physiotherapists, 3 occupational therapists, 3 medical staff, 1 nurse, and 1 industry representative. Focus groups were semi-structured and explored previous experiences of telerehabilitation, perceived benefits and challenges, and solutions to overcome these challenges. Focus groups were audio transcribed, and the service user transcript was translated into English. The resulting transcripts were analyzed using thematic analysis. Overall, participants were positive about the role of telerehabilitation but recommended hybrid delivery, with in-person rehabilitation in the early stages and telerehabilitation in the later stages. In relation to telerehabilitation in Ghana, there were 3 main themes: benefits, challenges or barriers, and implementation. Benefits included the convenience and lower cost for service users, the higher dose of therapy possible, and increased access for people in remote areas. However, challenges included lack of a stable internet connection, cost of phones and data packages, and low levels of literacy. Implementation issues included cultural relevance, information governance, and the platform used to deliver telerehabilitation, with most participants being familiar with WhatsApp. Telerehabilitation has the potential to be a useful method of delivering rehabilitation to people with neurological conditions in Ghana, especially in a hybrid rehabilitation model with telerehabilitation augmenting in-person sessions. However, many people were unaware of telerehabilitation, and challenges such as a reliable internet connection, cultural relevance, and costs need to be addressed. Clinical trials of low-cost telerehabilitation interventions contextualized to the specific user group are required.

NORMATIVE BODY IMAGE: FUNCTIONAL CHARACTERISTICS

The article uses in-depth interviews to determine the perceptions of subjects, whose activities are related to body construction, about the functional characteristics of the normative body, which is understood as socially approved and formed in the process of social ties and relations model. The survey was conducted in the spring of 2023, the object of the study were representatives of the beauty industry (n=2), medical workers (n=3), fitness trainers (n=2), and a practicing psychologist (n=1). In the course of the research the following tasks were put forward: to define the image of a normative body and to reveal the main characteristics of the body as corresponding to modern normative models. The survey materials showed that in the informants' assessments the modern normative body image is a body, first of all, a healthy body. Informants identified the pandemic as a factor that influenced the change in the vector of body standardization: from aesthetics to functionality. The professional community has defined the functional properties of the body, identifying the following normative models: "the body as a tool for expressing oneself in activities ", "the body as a source of competitive advantage", "the body as a demonstration of status", "the body as a tool for everyday mobility", "the body as a condition for longevity", "the body as a result of personal development", "the body as a process of evolutionary development", "the body as a basis for the realization of reproductive function", "the body as a source of comfort". The diversity of images of the normative body raises the question of creating conditions at the level of institutional structures for the formation of such a body, which, in accordance with the ideas of different sex and age groups, would be in demand both in the social system and by the individual.

Effective Pension Fund Management Strategy: A Comprehensive Study with Methodological Insights from the Indian Financial Landscape

This research paper explores effective pension fund management strategies within the Indian financial landscape, aiming to identify key factors influencing pension fund performance. Given the complexity and significance of pension fund management in ensuring financial security for retirees, this study employs a quantitative analysis approach to examine the relationships between Assets Under Management (AUM), management fees, fund age, and Return on Investment (ROI). Utilizing a hypothetical dataset representative of the Indian pension fund industry, the research adopts regression analysis to delve into how these variables impact fund performance. Key findings reveal a positive correlation between AUM and ROI, indicating that larger pension funds tend to achieve higher returns, likely due to economies of scale and access to a wider range of investment opportunities. Conversely, higher management fees are associated with lower ROIs, emphasizing the importance of cost efficiency in enhancing fund performance. Additionally, the analysis suggests that older funds, with their accumulated experience and established investment strategies, tend to perform better. These insights underscore the critical roles played by scale, cost management, and experience in pension fund management. The study contributes to filling a significant gap in the literature by providing empirical evidence on the impact of management strategies on pension fund performance in the Indian context. The findings have broader implications for fund managers and policymakers, highlighting the necessity of strategic fund management practices to optimize returns for beneficiaries.

Industrial process heat decarbonization: A user-centric perspective

Eliminating greenhouse gas emissions from industrial process heat (IPH) is considered a key element of decarbonizing the overall industrial sector. However, industrial users and the processes by which they may adopt and implement technologies for decarbonization have largely been overlooked in the United States by an emphasis on developing and commercializing new technologies. While recent deployment and demonstration programs are an indication that decarbonization policy is beginning to acknowledge industrial users, little research has been conducted to understand how users mediate technical and nontechnical requirements to decarbonize IPH. Our exploratory analysis uses interviews with industry representatives and document analysis to begin developing a user-centric perspective. We find that successful adoption and implementation of decarbonized IPH technologies may require adaptation to diverse and potentially unique combinations of user requirements and local contexts. Instead of pursuing “crosscutting” IPH technologies, a more effective and expeditious approach may be to develop crosscutting decision-making that spans multiple technologies. This approach may offer unexplored opportunities to improve demonstration and deployment programs, but more user-centric research is needed.

The Transit Fix—Border Externalization and the Interplay of Capital and Race in the Transit “Migration” State

Abstract What happens after border externalization? States and regional organizations of the Global North increasingly engage in transnational migration management that seeks to prevent potential irregular migration beyond their territory. Despite the impressive financial and political resources the involved actors mobilize to reach this goal, little is known about the effects of this strategy on their target states and populations. This paper conceptualizes border externalization as a spatial intervention that absorbs contingent migrant flows into an interplay of capital and race. It argues that the immobilization and differential integration produced through externalization can serve as a spatial fix for labor shortages in transit “migration” states. This differential integration disempowers the targeted migrant population and aggravates racial antagonisms. Hence, border externalization is not just a (by-)product of racist ideology and policy, but also intensifies racial hierarchies in the space it intervenes into. The paper studies this through the case of the “EU-Turkey Deal” and Turkey’s Syrian refugee population, building on document analysis and primary interview data with industry representatives, farmers, NGO workers, and government officials. On a theoretical level, the paper thereby contributes to the recent trend that reinserts the border into global processes of racialized capital accumulation.

Balancing conflicting interests: stakeholders’ interpretations of ‘moderation’ in Swedish gambling advertising legislation

ABSTRACT On January 1st, 2019, a license-based system allowing online commercial companies to operate and advertise in the Swedish market was introduced. According to the Gambling Act, advertising should be ‘moderate’. Legislative changes are windows of opportunities where stakeholder interpretation and adaption may result in new agenda-setting based on conflicting interests. This article examines how stakeholder groups initially perceived and interpreted this key concept of moderation. Data from semi-structured interviews, seminars and press conferences, as well as policy documents and statements, were analyzed using a framework method approach. Contrary to what is stated in the legislation, stakeholders defined ‘moderation’ in terms of both content and volume. Although industry and media representatives requested further guidance for interpreting ‘moderation’, they favored self-regulation and allowing market consolidation. There was a notable ambivalence within and between stakeholder groups concerning balancing freedom of expression, market protection, consumer protection and public health. In conclusion, legislation is a blunt steering instrument when key concepts are largely left to stakeholders, with opposing interests, to interpret. Our study shows the incremental and interactive character of policy-making, where new legislation resulted in new policy responses. Case law and market consolidation take time and regulatory interventions need to take this into account.

Environmental considerations along the life cycle of pharmaceuticals: Interview study on views regarding environmental challenges, concerns, strategies, and prospects within the pharmaceutical industry

Environmental impacts of medicines arise throughout their entire life cycle. The pharmaceutical industry has a key role in reducing these impacts in early production phases, but currently has limited possibilities to reduce the environmental exposure arising from drug consumption and end-of-life. The aim of this interview study was to explore the current environmental actions within the industry, as well as the views and attitudes toward the strategies to address the environmental challenges and concerns. Semi-structured interviews were conducted among representatives (n = 15) from twelve pharmaceutical companies operating in Finland in February-May 2021. The data were analyzed using qualitative content analysis.The representatives of pharmaceutical industry were overall well aware of the multifaceted environmental challenges related to the life cycle of pharmaceuticals and of their role in improving sustainability in production. Improving waste management and reducing impacts from companies’ own operations were the most commonly mentioned actions already taking place within the companies (15/15). “Environmental impacts arising from drug consumption” (6/15) and “centralized drug manufacturing in countries with lax environmental regulation” (4/15) were most frequently brought up challenges difficult to resolve. “Development of environmentally more sustainable drug production in the company” was the most frequently raised key development need (5/15). To address this, establishment of tangible economic drivers, regulatory incentives, or reputational rewards were called for. “Incorporation of environmental aspects into decision-making in different situations” was suggested by 11/15 interviewees as a means to promote sustainable development, e.g. in selection of medicines by physicians and consumers. However, the attitudes towards the types of criteria and their evaluation differed between interviewees. Attitudes towards the “incorporation of environmental fate assessment into early phases of drug design and development” were mostly positive (10/11), suggesting that there is a keen interest in the industry to foster the introduction of new tools enabling the development of pharmaceuticals intrinsically less harmful for the environment.

Understanding Canadian stakeholders’ views on measuring and valuing health for children and adolescents: a qualitative study

ObjectiveValuing child health is critical to assessing the value of healthcare interventions for children. However, there remain important methodological and normative issues. This qualitative study aimed to understand the views of Canadian stakeholders on these issues.MethodsStakeholders from health technology assessment (HTA) agencies, pharmaceutical industry representatives, healthcare providers, and academic researchers/scholars were invited to attend an online interview. Semi-structured interviews were designed to focus on: (1) comparing the 3-level and 5-level versions of the EQ-5D-Y; (2) source of preferences for valuation (adults vs. children); (3) perspective of valuation tasks; and (4) methods for valuation (discrete choice experiment [DCE] and its variants versus time trade-off [TTO]). Participants were probed to consider HTA guidelines, cognitive capacity, and potential ethical concerns. All interviews were recorded and transcribed verbatim. Framework analysis with the incidence density method was used to analyze the data.ResultsFifteen interviews were conducted between May and September 2022. 66.7% (N = 10) of participants had experience with economic evaluations, and 86.7% (N = 13) were parents. Eleven participants preferred the EQ-5D-Y-5L. 12 participants suggested that adolescents should be directly involved in child health valuation from their own perspective. The participants were split on the ethical concerns. Eight participants did not think that there was ethical concern. 11 participants preferred DCE to TTO. Among the DCE variants, 6 participants preferred the DCE with duration to the DCE with death.ConclusionsMost Canadian stakeholders supported eliciting the preferences of adolescents directly from their own perspective for child health valuation. DCE was preferred if adolescents are directly involved.

From rookie to Trustee: personal experiences of an industry representative.

From rookie to Trustee: personal experiences of an industry representative.

Risk of weed seed and seedling emergence from poultry litter

AbstractIn areas surrounding large poultry industries, poultry litter is often an alternative nitrogen fertilizer for crop production. However, farmers who have not used poultry litter in the past have concerns regarding potential weed seed contamination. A survey was conducted to determine the occurrence of germinable weed seed in poultry litters (n = 61) submitted by growers and industry representatives across North Carolina. In a 9:1 potting media:poultry litter mix, a single grass seed germinated from the 61 surveyed poultry litters, equating to 0.3 viable seeds 100 g−1 poultry litter. Viable seed content averaged 1.1 seeds 100 g−1 litter using the extractable seedbank method on 25% of the litters from the survey, much higher than the grow out method, and the majority of seeds found were Amaranthaceae. A growth chamber experiment was then conducted and demonstrated that there was a negative relation between poultry litter application and weed seedling emergence. There was a 65%, 75%, and 85% reduction in Senna obtusifolia (L.) H.S. Irwin & Barneby, Setaria pumila (Poir.) Roem. & Schult., and Amaranthus palmeri S. Watson germination, respectively, from the control to highest application rate of poultry litter (26.9 Mg ha−1). A laboratory study showed that poultry litter leachates can decrease seed radicle length and integrity and is likely due to osmotic or salinity stress. The weed seed content in litter as well as the negative impact of poultry litter and its leachates on weed seedling emergence make it unlikely that poultry litter applications will significantly increase seedbanks above levels commonly observed in agricultural fields.

Carbon Accounting in the Digital Industry: The Need to Move towards Decision Making in Uncertainty.

In this paper, we present findings from a qualitative interview study, which highlights the difficulties and challenges with quantifying carbon emissions and discusses how to move productively through these challenges by drawing insights from studies of deep uncertainty. Our research study focuses on the digital sector and was governed by the following research question: how do practitioners researching, working, or immersed in the broad area of sustainable digitisation (researchers, industry, NGOs, and policy representatives) understand and engage with quantifying carbon? Our findings show how stakeholders struggled to measure carbon emissions across complex systems, the lack of standardisation to assist with this, and how these challenges led stakeholders to call for more data to address this uncertainty. We argue that these calls for more data obscure the fact that there will always be uncertainty, and that we must learn to govern from within it.

Advancing Endocrine Disruptors via In Vitro Evaluation: Recognizing the Significance of the Organization for Economic Co-Operation and Development and United States Environmental Protection Agency Guidelines, Embracing New Assessment Methods, and the Urgent Need for a Comprehensive Battery of Tests.

Efforts are being made globally to improve the evaluation and understanding of endocrine-disrupting chemicals. Recognition of their impact on human health and the environment has stimulated attention and research in this field. Various stakeholders, including scientists, regulatory agencies, policymakers, and industry representatives, are collaborating to develop robust methodologies and guidelines for assessing these disruptors. A key aspect of these efforts is the development of standardized testing protocols and guidelines that aim to provide consistent and reliable methods for identifying and characterizing endocrine disruptors. When evaluating the potential endocrine-disrupting activity of chemicals, no single test is capable of detecting all relevant endocrine-disrupting agents. The test battery approach is designed to reduce the risk of false negative results for compounds with toxic potential. A weight-of-evidence approach is therefore necessary for endocrine disruptor evaluation. This approach considers various types of data from multiple sources, assessing the overall strength, consistency, and reliability of the evidence. OECD guidelines are highly regarded for their scientific rigor, transparency, and consensus-based development process. It is crucial to explore and develop new methodologies that can effectively evaluate the risks associated with potential endocrine disruptors. Integrating these methods into a comprehensive weight-of-evidence framework will enhance risk assessments and facilitate informed decisions regarding the regulation and management of these substances, ensuring the protection of human health and the environment from their adverse effects.

Perspectives of COPD patients, publicly funded scientists, and industry representatives on responsibility and stakeholder engagement in drug discovery research

ABSTRACT Ensuring societal influence in research and innovation through stakeholder engagement is vital in the Responsible Research and Innovation (RRI) framework. By studying a drug discovery project, we examine how stakeholders can influence drug discovery and development meaningfully. Through semi-structured interviews, we explore: How do patients as potential users of a new drug, the scientists who discover it, and the industry that might develop it, think about responsibility and stakeholder engagement in drug discovery? Most of the responses voiced by our informants about responsibility and stakeholder engagement relate to the broader institutional and political context of health-related innovation, rather than the specific research project. We argue, that in order to make stakeholder engagement work within some forms of drug discovery research, it should be used as a forum for mobilizing political and organizational debate, taking critical dialogues beyond project-specific engagement in innovation.

Positive tipping points for the sustainable growth of bivalve shellfish mariculture in England and Wales

Shellfish mariculture, the farming of marine bivalve shellfish, is a highly sustainable form of food production, which contributes significantly to the rural, coastal economies of England and Wales, and has considerable potential for growth. To unlock this potential, we explored the application of the positive tipping points (PTP) framework in an invited stakeholder workshop comprising key policy makers, regulators, industry representatives and academic researchers. Stakeholders mapped environmental and socio-economic factors constraining shellfish mariculture and identified key opportunities (leverage points) for positive intervention. The workshop focused on five case studies from southwest England addressing key constraints identified for the shellfish industry, including “licencing”, “spatial planning” and/or “classification” of shellfish sites and cultured species. These case studies presented new data on the effectiveness of a range of interventions: i) catchment scale, and ii) nature-based, solutions for water quality management in the Exe estuary; iii) risk-based methods for assuring shellfish quality/safety in the Camel estuary; iv) evidence gathering on ecosystem services (habitat provisioning) by shellfish mariculture in Lyme Bay and, v) policy developments on licencing of Pacific oysters in England. Stakeholders highlighted opportunities for new guidance, innovative tools and technology to aid environmental monitoring, regulation and quality assurance for shellfish mariculture and for tradeable ecosystem services beyond food production (including nutrient regulation, coastal protection and habitat provisioning). These and other interventions identified by stakeholders (including product diversification and market development) were then prioritised and sequenced for optimal implementation. Actions, actors and enabling conditions were identified using the PTP framework to realise prioritised opportunities.

Co‐production of agroecological innovations to improve sustainability in South American fruit farms

Abstract Agricultural intensification and expansion are the main drivers of biodiversity loss that continue to increase this century, especially in South America. International markets and global policy provide incentives and frameworks to address this, but these are unlikely to be effective unless farmers on the ground are enabled and motivated to respond to them by developing long‐term solutions that fit their production systems and local contexts. Here, we use a multi‐actor transdisciplinary approach to co‐design and test agroecological innovations suitable for intensive, exporting South American fruit farms. We focus on highly biodiverse regions experiencing habitat loss in the Mediterranean and dry tropical forest regions of Chile and Brazil, respectively. The innovations were designed to support local biodiversity without compromising productivity or quality. Fourteen farmers participated throughout the project, covering a total of 4178 ha of intensive table grape, mango and cherry production. All were under pressure from buyers to report action on biodiversity. Farmers worked with researchers and industry representatives through an iterative process of dialogues and workshops to select, co‐design and implement three agroecological innovations: perches for birds of prey, cover crops and native hedgerows. Farmers became engaged in monitoring their effectiveness and redesigning them to suit local contexts. We develop an extensive set of resources for ongoing dissemination, including an online sustainability metric to report the practices carried out. Eight farms continued to implement at least one agroecological innovation beyond the end of the project, motivated by its fit to their management system and their ability to report positive actions in their supply chains. Policy implications. Our model of knowledge co‐production demonstrates how transdisciplinary research in agriculture, fully localised in a particular food‐producing context, can enable farmers in the global South to engage with biodiversity conservation in response to top‐down market signals incentivising sustainability. We argue that many top‐down efforts to enhance the sustainability of food supply chains, whether through market incentives, voluntary codes or trade regulations, require locally based knowledge co‐production, in which multiple stakeholders from agriculture and the food industry can benefit from working with locally based researchers. Read the free Plain Language Summary for this article on the Journal blog.

The role of early-phase trials and real-world evidence in drug development.

Phase 3 randomized controlled trials (RCTs), while the gold standard for treatment efficacy and safety, are not always feasible, are expensive, can be prolonged and can be limited in generalizability. Other under-recognized sources of evidence can also help advance drug development. Basic science, proof-of-concept studies and early-phase RCTs can provide evidence regarding the potential for clinical benefit. Real-world evidence generated from registries or observational datasets can provide insights into the treatment of rare diseases that often pose a challenge for trial recruitment. Pragmatic trials embedded in healthcare systems can assess the treatment effects in clinical settings among patient populations sometimes excluded from trials. This Perspective discusses potential sources of evidence that may be used to complement explanatory phase 3 RCTs and to speed the development of new cardiovascular medications. Content is derived from the 19th Global Cardiovascular Clinical Trialists meeting (December 2022), involving clinical trialists, patients, clinicians, regulators, funders and industry representatives.