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The rapid expansion of electoral gender quotas in the past few decades has been met with considerable scholarly and public attention. Despite this, there has been little empirical work examining the global legislative consequences of gender quotas over time. Developing a unique time-series cross-sectional data set from 139 states during the peak period of quota adoption and implementation (1995–2012), we test whether and how quotas are associated with subsequent changes in government spending priorities. We find that substantial quota shocks—those associated with a large increase in women’s parliamentary representation—are followed by increased government expenditures toward public health. Further, we find that increases in health spending are offset by relative decreases in military spending and other spending categories. Our findings provide strong evidence that quota policies influence government priorities in historically feminized policy areas but principally when they are complied with and have substantial numerical consequences.

To determine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. A three-year experimental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Cameroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. With the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problems with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.

Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify 'high-level' priorities in health ecosystem priority setting, and at the preparation phase for health research. The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar's Portal. i) published in English; ii) published within the timeframe of 2007-Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1-Deliberative and Tier 2-Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep Inclusion Method/CHoosing All Together (US). The critical study limitations include challenges in comprehensively identifying the patient engagement literature for review, bias in article selection due to the identified scope, missed information due to a more limited use of exhaustive search strategies (e.g., in-depth hand searching), and the heterogeneity of reported study findings. The four public and patient engagement priority setting processes identified were successful in setting priorities that are inclusive and objectively based, specific to the priorities of stakeholders engaged in the process. The processes were robust, strategic and aimed to promote equity in patient voices. Key limitations identified a lack of evaluation data on the success and extent in which patients were engaged. Issues pertaining to feasibility of stakeholder engagement, coordination, communication and limited resources were also considered.

Because habitat loss is the main cause of extinction, where and how much society chooses to protect is vital for saving species. The United States is well positioned economically and politically to pursue habitat conservation should it be a societal goal. We assessed the US protected area portfolio with respect to biodiversity in the country. New synthesis maps for terrestrial vertebrates, freshwater fish, and trees permit comparison with protected areas to identify priorities for future conservation investment. Although the total area protected is substantial, its geographic configuration is nearly the opposite of patterns of endemism within the country. Most protected lands are in the West, whereas the vulnerable species are largely in the Southeast. Private land protections are significant, but they are not concentrated where the priorities are. To adequately protect the nation’s unique biodiversity, we recommend specific areas deserving additional protection, some of them including public lands, but many others requiring private investment.

Patient and public involvement is at the core of our chosen methodology and central to our Priority Setting Partnership from inception. We included childhood cancer survivors, caregivers, health professionals who provide care for them, and representatives from community support organisations as Steering Group members and partners. Together, the Steering Group co‐developed and refined the project scope to ensure relevance, designed and reviewed survey questions and recruitment materials, and supported survey participant recruitment through their networks. They played a key role in interpreting survey results and workshop data and advised on the framing and language used to disseminate findings, thus ensuring the outputs were accessible, meaningful, and resonant with affected communities. They also participated as the long‐term advisory panel overseeing the project, monitoring the fairness and transparency in decision‐making. Additionally, two individuals with lived experience (from the Steering Group) contributed to the writing and editing of this manuscript. In accordance with these contributions, they are included as co‐authors.

In the development of practice guidelines, priority setting of topics, questions, and outcomes ensures relevance and resource efficiency. The objective of this study was to describe priority setting processes as described in guidance documents by guideline-producing organizations. We conducted a descriptive summary of guideline-producing organizations' publicly available guidance documents on practice guideline development (eg, guideline handbooks). We screened guideline-producing organizations' documents and abstracted data in duplicate and independently. We abstracted data on the elements of the priority setting process, including generation of initial list, method or tool used in the priority setting process, use of priority setting criteria, and refinement. Of the 133 identified organizations with publicly available guidance documents, 94 (71%) reported on a priority setting process for guideline development, with 16 also reporting on a priority setting process for guideline updating (12%). Most of the organizations addressed, in their guidance documents, topic priority setting (94%), whereas a minority addressed priority setting of questions (36%), outcomes (29%), implementation (12%), quality measures (15%), and future research (5%). In the guidance documents, generation of the initial list was the most addressed element for topics (88%), questions (65%) and outcomes (59%), followed by the use of criteria for topics (89%) and questions (59%), and refinement for outcomes (52%). A minority of organizations provided guidance to a published priority setting method or tool, which was only for topics (24%). The top used criteria for priority setting of topics were the impact of intervention on health outcomes (74%), variation/gaps in practice (69%), availability of evidence (69%), and disease health burden (68%); whereas for questions, top criteria were availability of evidence (60%), followed by interest at health professional/organization level (50%), uncertainty or controversy about best practice (40%), and variation/gaps in practice (40%). This analysis of guideline-producing organizations revealed that a majority reported a priority-setting process, which primarily focused on topic selection and less on aspects like questions and outcomes. Although generating an initial list and using priority-setting criteria are common, few organizations report in their guidance documents using formal priority-setting tools, addressing refinement, or providing guidance for guideline updating or adaptation. A standardized priority setting process for all aspects of guideline development is needed. [Display omitted] Key findings•Priority setting of guideline development was more common than that of updating.•Most organizations’ guidance documents addressed topic priority setting (94%).•Priority setting of other aspects was addressed less often and in less detail.What this adds to what is known?•A standardized priority setting process for guideline development aspects is needed.What is the implication, what should change now?•Optimal priority setting methods may better guide processes in guideline organizations.

Introduction James Lind Alliance (JLA) Priority Setting Partnerships (PSPs) produce ‘Top 10’ lists of health and care research priorities through a structured, shared decision‐making process with patients or service users, carers and health or care professionals who identify questions that are most important to them. To date, over 150 PSPs in different areas of health and care have published research priorities. Some PSPs share similar priorities, which could be combined, promoted and addressed through collaborative research to increase value and reduce research waste. Aim The aim of this study was to identify overarching themes common to JLA PSP priorities across different areas of health and care. Methods Our analysis included ‘Top 10’ research priorities produced by UK‐based JLA PSPs between 2016 and 2020. The priorities were coded deductively by the Health Research Classification System (HRCS) health category and research activity. We then carried out online workshops with patients, service users and carers to generate new codes not already captured by this framework. Within each code, multistakeholder inductive thematic analysis was used to identify overarching themes, defined as encompassing priorities from three or more PSPs covering two or more health categories. We used codesign methods to produce an interactive tool for end users to navigate the overarching themes. Results Five hundred and fifteen research priorities from 51 PSPs were included in our analysis. The priorities together encompassed 20 of 21 HRCS health categories, the most common being ‘generic health relevance’ (22%), ‘mental health’ (18%) and ‘musculoskeletal’ (14%). We identified 89 overarching themes and subthemes, which we organised into a hierarchy with seven top‐level themes: quality of life, caregivers and families, causes and prevention, screening and diagnosis, treatment and management, services and systems and social influences and impacts. Conclusion There are many overarching themes common to research priorities across multiple areas of health and care. To facilitate new research and research funding, we have developed an interactive tool to help researchers, funders and patients or service users to explore these priority topics. This is freely available to download online. Patient or Public Contribution Patients or service users and carers were involved throughout the study, including deciding the aims, designing the study, analysing priorities to identify themes, interpreting and reporting the findings.

Seascape ecology, the marine-centric counterpart to landscape ecology, is rapidly emerging as an interdisciplinary and spatially explicit ecological science with relevance to marine management, biodiversity conservation, and restoration. While important progress in this field has been made in the past decade, there has been no coherent prioritisation of key research questions to help set the future research agenda for seascape ecology. We used a 2-stage modified Delphi method to solicit applied research questions from academic experts in seascape ecology and then asked respondents to identify priority questions across 9 interrelated research themes using 2 rounds of selection. We also invited senior management/conservation practitioners to prioritise the same research questions. Analyses highlighted congruence and discrepancies in perceived priorities for applied research. Themes related to both ecological concepts and management practice, and those identified as priorities include seascape change, seascape connectivity, spatial and temporal scale, ecosystem-based management, and emerging technologies and metrics. Highestpriority questions (upper tercile) received 50% agreement between respondent groups, and lowest priorities (lower tercile) received 58% agreement. Across all 3 priority tiers, 36 of the 55 questions were within a ±10% band of agreement. We present the most important applied research questions as determined by the proportion of votes received. For each theme, we provide a synthesis of the research challenges and the potential role of seascape ecology. These priority questions and themes serve as a roadmap for advancing applied seascape ecology during, and beyond, the UN Decade of Ocean Science for Sustainable Development (2021–2030).

BackgroundWell-defined, systematic, and transparent processes to identify health research gaps, needs, and priorities are vital to ensuring that available funds target areas with the greatest potential for impact.ObjectiveThe purpose of this review is to characterize methods conducted or supported by research funding organizations to identify health research gaps, needs, or priorities.MethodWe searched MEDLINE, PsycINFO, and the Web of Science up to September 2019. Eligible studies reported on methods to identify health research gaps, needs, and priorities that had been conducted or supported by research funding organizations. Using a published protocol, we extracted data on the method, criteria, involvement of stakeholders, evaluations, and whether the method had been replicated (i.e., used in other studies).ResultsAmong 10,832 citations, 167 studies were eligible for full data extraction. More than half of the studies employed methods to identify both needs and priorities, whereas about a quarter of studies focused singularly on identifying gaps (7%), needs (6%), or priorities (14%) only. The most frequently used methods were the convening of workshops or meetings (37%), quantitative methods (32%), and the James Lind Alliance approach, a multi-stakeholder research needs and priority setting process (28%). The most widely applied criteria were importance to stakeholders (72%), potential value (29%), and feasibility (18%). Stakeholder involvement was most prominent among clinicians (69%), researchers (66%), and patients and the public (59%). Stakeholders were identified through stakeholder organizations (51%) and purposive (26%) and convenience sampling (11%). Only 4% of studies evaluated the effectiveness of the methods and 37% employed methods that were reproducible and used in other studies.DiscussionTo ensure optimal targeting of funds to meet the greatest areas of need and maximize outcomes, a much more robust evidence base is needed to ascertain the effectiveness of methods used to identify research gaps, needs, and priorities.

Scoping reviews have been identified as appropriate methodologies to contribute to our knowledge. The objective of this review is to summarize how scoping reviews can be used to identify research priorities. Based on our experience as evidence synthesis methodologists and researchers, the Joanna Briggs Institute (JBI) scoping review methodology group, have identified the potential roles of scoping reviews in identification of research priorities. Scoping reviews typically ask broad questions that allow researchers to obtain an overview or map of the existing evidence. Scoping reviews also incorporate multiple levels of evidence that enriches the strength of the knowledge that is gained. This value is revealed by the use of scoping reviews to contribute to and perform the following functions: 1) map a research area and identify gaps that need to be addressed; 2) prioritize research topics by identifying key issues to investigate; 3) identify the type of study designs that have been used to investigate a particular topic, and/or the range of outcomes measured following a specific intervention; 4) identify the essential contextual factors that are relevant to the study of a particular research topic; 5) identify equity issues in the research field; 6) assist in engaging stakeholders and/or experts in the field by facilitating the inclusion of these stakeholders within the research process; and 7) provide the relevant new knowledge to enhance and support applications for funding. To ensure this contribution to identifying research priorities is reliable, scoping reviews must be performed following the existing rigorous methodological processes and adhere to the currently available reporting guidelines. By doing so, scoping reviews have great potential to identify research priorities, to guide the expansion of research and the generation of new knowledge. •Scoping reviews offer a broad evidence map including research priorities.•Seven methods show how scoping reviews pinpoint research priorities.•They include mapping gaps, topic prioritization, study designs, and context.•They cover equity, stakeholder engagement, and funding advocacy.•Scoping reviews act as synthesis tools to set research priorities.