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Abstract Background The accommodation of eating disorder (ED) behaviours by carers is one of the maintaining processes described in the cognitive interpersonal model of anorexia nervosa. This systematic scoping review aimed to explore studies examining accommodating and enabling behaviour, including how it impacts upon the carer’s own mental health and the outcome of illness in their loved ones. Methods and results In this systematic scoping review, five databases (PubMed, Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for studies measuring accommodating and enabling behaviour in carers of people with EDs. A total of 36 studies were included, of which 10 were randomised trials, 13 were longitudinal studies, nine were cross-sectional studies and four were qualitative studies. Carers of people with EDs were found to have high level of accommodating and enabling behaviour which reduced following treatment, although no single type of intervention was found to be superior to others. Higher accommodation in carers was associated with higher level of emotional distress, anxiety and fear. There was mixed evidence around whether accommodating and enabling behaviour in carers impacted the outcome of illness in their loved ones. Conclusion Accommodating and enabling behaviours are frequently seen in carers of people with AN, and carer-focused interventions are able to reduce these behaviours, although it is unclear if any intervention shows superiority. There may be nuances in the impact of these behaviours related to interactions within the support network and variations in the forms of co-morbidity in patients. More studies with a larger sample size and which include both mothers and fathers are required.

Abstract Background Public health education (PHE) in social environments plays a crucial role in mitigating the impact of public health events, especially with the recent surge in global incidents. Social learning theory (SLT) provides a strong theoretical foundation for implementing PHE. The objective of this study is to conduct a systematic scoping review of PHE using SLT, synthesizing the target populations, types of research, main findings, and future directions. Methods The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) guidelines. We conducted a comprehensive search of five electronic databases (Web of Science, Scopus, PubMed, ProQuest, and APA PsycInfo) for English articles related to PHE using SLT. Two reviewers independently screened the titles and abstracts. Descriptive statistics were utilized to analyze the characteristics of the articles included in the study, followed by a comprehensive narrative analysis of the results. Results Research on PHE using SLT mainly focuses on adolescents, students, special patients, and vulnerable populations. The study sample includes seven research types and nine commonly used experimental methods. Four modes of PHE using SLT are identified, along with four types of summarized research results. Conclusion PHE research based on SLT can be prioritized for preventing widespread infectious diseases, spreading fundamental public health information, and assisting patients with particular illnesses. To enhance the implementation of PHE, researchers and policymakers should integrate online and offline health education resources, ensure the accessibility of up-to-date information, and leverage digital technologies in PHE. More highly interactive and participatory health education courses will be established in social learning environments to encourage public participation in PHE.

Despite the considerable engagement of university teachers in educational research, there have been no systematic, evidence-based investigations into teacher research in higher education. Therefore, a systematic scoping review on peer-reviewed teacher research articles published in academic journals from 2010 to 2019 was conducted to explore the nature and scope of teacher research in higher education. The review searched studies from eight electronic databases, including British Education Index, Education Abstracts, Eric (subscription version), ProQuest Education Journals, Scopus, Taylor and Francis Online Journals, Web of Science and ScienceDirect. The initial search generated 627 studies published in 2010–2019. After initial screening and full-text screening, 275 articles met the final inclusion criteria of the review, based on which a quantitative descriptive analysis was produced. A key finding from the review is that a significant volume of teacher research has been published by university teachers from various disciplines. However, very little of it was underpinned by solid theoretical frameworks which was a deficiency in the available literature. There is a clear need for university teachers who develop careers as academics specialising in teaching and educational research to understand the criteria of sound theory and design that facilitate publication in top-tier journals.

IntroductionMeta-analytical findings indicate that high-quality dyadic teacher-student relationships (TSRs) can act as social protective factors against the development or persistence of emotional and behavioral problems (EBPs) by fostering students’ social-emotional and cognitive learning. However, previous research primarily focused on samples of students without EBPs and relied on teacher-rated TSRs. Research on dyadic TSRs from the perspective of students with EBPs is scarce, yet their self-perceptions could offer valuable insights into whether and how dyadic TSRs serve as protective factors for them. Therefore, this systematic scoping review is guided by the central question of how research on dyadic TSRs from the perspective of students with EBPs has been conducted and what insights have been gained to date.MethodsThis question is explored through a narrative synthesis of existing studies, thereby identifying current research approaches, empirical findings, practical implications, and future research needs. A database search using keywords related to EBPs and TSRs yielded 24 included studies.Results and discussionSynthesizing these studies reveals five overarching conclusions. First, students with EBPs and their teachers tend to experience dyadic TSRs less favorably than typically developed (TD) students and their teachers. Second, relationship-enhancing interventions focusing on either teacher-student interactions, contextual factors or individual characteristics of teachers and students appear to be effective for students with EBPs. Third, students with EBPs seem to perceive stronger positive affective relationships with their teachers than teachers do with them. Fourth, students with EBPs may perceive their dyadic TSRs as ambivalent, exhibiting both highly positive and highly negative aspects. Fifth, for the social–emotional and academic development of students with EBPs, dyadic TSR-quality seems to be a risk or protective factor, acting differently than in TD-student. However, due to the diverse nature of the included studies, these conclusions remain only preliminary. Consequently, the review concludes with 10 key recommendations that might guide future research on dyadic TSRs from the perspective of students with EBPs.

Arctic community-based monitoring (CBM) programs have proliferated in recent decades. While the desire to influence decision-making is frequently listed as a motivation for CBM, there is a dearth of literature examining whether and how this goal is achieved in the Arctic. We draw on a systematic scoping literature review to examine the current state of the literature on Arctic CBM and environmental decision-making. Relevant articles (n = 27) were identified through inclusion/exclusion criteria (i.e., English language, peer reviewed, published between 1991 and 2021, and based on primary research) and analyzed using a data extraction questionnaire. We find that there is a growing focus on the relationship between Arctic CBM and decision-making in a range of decision contexts, most notably including co-management institutions. We note that less attention was paid to the potential effects of the often unequal, settler-colonial politics within the broader environmental governance system on the relationship between CBM and decision-making. Indigenous peoples and Indigenous Knowledge systems play a significant role within the included references, but less than half of the included references incorporated Indigenous governance concepts to a major extent. Based on our findings, we recommend future studies engage critical analysis of the influence of the governance and politics in the Arctic (1) on environmental decision-making; (2) the politics of knowledge; and (3) the use of digital technologies in the collection, storage, and mobilization of CBM data.

Continuing education offers healthcare professionals the opportunity to adapt to the many changes in society and to improve their skills and knowledge to provide optimal care for patients. As technology evolves, healthcare workers can benefit from virtual peer-to-peer and mentor interactions with digital technology as a platform for continuing professional development (CPD). Nevertheless, healthcare professionals’ experiences in CPD in online learning settings have not been tackled clearly. The aim of our systematic scoping review is to investigate the effects of distance and hybrid learning settings in continuing education on learning outcomes and perceptions among healthcare professionals. A quantitative literature search was conducted following the preferred reporting items for systematic reviews and meta-analyses scoping research, allowing data collection of healthcare study scores from previous articles tackling the subject. A total of 17 articles met the inclusion criteria and were reviewed. We identified four main categories of learning outcomes: knowledge acquisition, skills and performance, participants’ attitudes toward training, satisfaction, confidence, and self-efficacy. This systematic scoping review highlights that continuing distance education improves health professional learning outcomes. Continuing education in online learning setting allow more learning accessibility for healthcare professionals, as it was found to be a solution for temporal and physical constraints.

Abstract Background Interest in applying a complex systems approach to understanding socioeconomic inequalities in health is growing, but an overview of existing research on this topic is lacking. In this systematic scoping review, we summarize the current state of the literature, identify shared drivers of multiple health and health behavior outcomes, and highlight areas ripe for future research. Methods SCOPUS, Web of Science, and PubMed databases were searched in April 2023 for peer-reviewed, English-language studies in high-income OECD countries containing a conceptual systems model or simulation model of socioeconomic inequalities in health or health behavior in the adult general population. Two independent reviewers screened abstracts and full texts. Data on study aim, type of model, all model elements, and all relationships were extracted. Model elements were categorized based on the Commission on Social Determinants of Health framework, and relationships between grouped elements were visualized in a summary conceptual systems map. Results A total of 42 publications were included; 18 only contained a simulation model, 20 only contained a conceptual model, and 4 contained both types of models. General health outcomes (e.g., health status, well-being) were modeled more often than specific outcomes like obesity. Dietary behavior and physical activity were by far the most commonly modeled health behaviors. Intermediary determinants of health (e.g., material circumstances, social cohesion) were included in nearly all models, whereas structural determinants (e.g., policies, societal values) were included in about a third of models. Using the summary conceptual systems map, we identified 15 shared drivers of socioeconomic inequalities in multiple health and health behavior outcomes. Conclusions The interconnectedness of socioeconomic position, multiple health and health behavior outcomes, and determinants of socioeconomic inequalities in health is clear from this review. Factors central to the complex system as it is currently understood in the literature (e.g., financial strain) may be both efficient and effective policy levers, and factors less well represented in the literature (e.g., sleep, structural determinants) may warrant more research. Our systematic, comprehensive synthesis of the literature may serve as a basis for, among other things, a complex systems framework for socioeconomic inequalities in health.

The significance of life skills within educational settings has grown; however, there remains a gap regarding a comprehensive understanding of the overarching concept. This systematic scoping review addresses that need, with the aim to identify and map empirical research published between 2013 and 2023 focused on life skills in compulsory education (grade 1–10). In addition to mapping the studies according to their characteristics, how life skills are defined is also examined, with a specific focus on collectivistic and individualistic perspectives. Through a rigorous search process, 50 studies were identified. The studies are mainly concerned with evaluating the efficacy of life skills programs or interventions for adolescents. They define life skills by both the type of skill and what it achieves. Key trends include an emphasis on an individualistic understanding of the term, lacking collectivistic perspectives. The implications focus on life skills education connected to lifelong learning, Bildung, and holistic growth from a collectivistic perspective, suggesting that future research could include life skills education for younger children for more sustainable effects favorable for desired societal outcomes.

Abstract Background The greatest proportion of burn injuries globally occur in South Asia, where there are also high numbers of intentional burns. Burn injury prevention efforts are hampered by poor surveillance data on injury intent. There is a plethora of local routinely collected data in the research literature from South Asia that could be used for epidemiological purposes, but it is not known whether the definitions and methods of differentiation of injury intent are sufficiently homogenous to allow valid study comparisons. Methods We will conduct a systematic scoping review to understand terminology and methods used to differentiate injury intent of hospital burn patients in South Asia. The objectives of the study are to: determine the breadth of terminology and common terms used for burn injury intent; to determine if definitions are comparable across studies where the same term is used; and to appraise the rigour of methods used to differentiate burn injury intent and suitability for comparison across studies. The databases Embase, MEDLINE, CINAHL, PsycINFO, and PakMediNet will be searched. Screening and data extraction will be completed independently by two reviewers. To be included, the article must be as follows: peer reviewed, primary research, study cutaneous burns, based on hospital patients from a country in South Asia, and use intent terminology or discuss a method of differentiation of injury intent. Results will be restricted to English language studies. No date restrictions will be applied. A plain language summary and terminology section are included for non-specialist readers. Discussion Results will be used to inform stakeholder work to develop standardised terminology and methods for burn injury intent in South Asia. They will be published open access in peer-reviewed journals wherever possible. Systematic review registration This review has been registered with the Open Science Framework ( https://doi.org/10.17605/OSF.IO/DCYNQ ).

Abstract Background De-implementation of low-value care can increase health care sustainability. We evaluated the reporting of direct costs of de-implementation and subsequent change (increase or decrease) in health care costs in randomized trials of de-implementation research. Methods We searched MEDLINE and Scopus databases without any language restrictions up to May 2021. We conducted study screening and data extraction independently and in duplicate. We extracted information related to study characteristics, types and characteristics of interventions, de-implementation costs, and impacts on health care costs. We assessed risk of bias using a modified Cochrane risk-of-bias tool. Results We screened 10,733 articles, with 227 studies meeting the inclusion criteria, of which 50 included information on direct cost of de-implementation or impact of de-implementation on health care costs. Studies were mostly conducted in North America (36%) or Europe (32%) and in the primary care context (70%). The most common practice of interest was reduction in the use of antibiotics or other medications (74%). Most studies used education strategies (meetings, materials) (64%). Studies used either a single strategy (52%) or were multifaceted (48%). Of the 227 eligible studies, 18 (8%) reported on direct costs of the used de-implementation strategy; of which, 13 reported total costs, and 12 reported per unit costs (7 reported both). The costs of de-implementation strategies varied considerably. Of the 227 eligible studies, 43 (19%) reported on impact of de-implementation on health care costs. Health care costs decreased in 27 studies (63%), increased in 2 (5%), and were unchanged in 14 (33%). Conclusion De-implementation randomized controlled trials typically did not report direct costs of the de-implementation strategies (92%) or the impacts of de-implementation on health care costs (81%). Lack of cost information may limit the value of de-implementation trials to decision-makers. Trial registration OSF (Open Science Framework): https://osf.io/ueq32 .

Abstract Background Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. Methods This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles’ titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. Results A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. Conclusion BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.

Much has been achieved by research into ecological restoration as a nature-based solution to the destruction of ecosystems, particularly in Canada. We conducted a national-level synthesis of Canadian restoration ecology research to understand strengths and gaps. This synthesis answers the following questions: Who is studying restoration? What ecosystem types are studied? Where is restoration studied? Which themes has restoration research focused on? Why is restoration happening? And how is restoration monitored and evaluated? We employed systematic searching for this review. Our results show that restoration research is conducted mainly by academics. Forest, peatland, grassland, and lake ecosystem types were the most commonly studied. There was a concentration of research in four provinces (Ontario, Quebec, Alberta, and British Columbia). Research into restoration has changed its thematic focus over time from reforestation to climate change. Legislation was the most common reason given for restoration. Restoration research frequently documented results of less than 5 years of monitoring and included one category of response variable (e.g., plant response but not animal response). Future research could investigate the outcomes of restoration prompted by legislation. At the dawn of the UN Decade on Ecosystem Restoration, this work demonstrates Canada's momentum and provides a model for synthesis in other countries.

Immunoglobulin light chain (AL) amyloidosis is the most common type of systemic amyloidosis in China and is associated with increased morbidity and a poor prognosis. However, the clinical characteristics of Chinese patients with AL amyloidosis have not been systematically investigated. This scoping review aimed to summarize the available literature regarding the clinical characteristics of patients with AL amyloidosis and identify potential knowledge gaps. We searched three electronic databases from inception to 7 February 2021. PICOS (Patient, Intervention, Comparison, Outcome and Study) design structure was used to formulate the data extraction. All statistical calculations and analyses were performed with R (version 3.6.0). Sixty-seven articles with 5022 patients were included. Results suggest Chinese patients were younger (57 years) at the time of diagnosis when compared with other patient populations and were predominantly male (61.2%). The time interval from the onset of symptoms to diagnosis was between 6 and 12 months. It was found that 41.1% of Chinese patients with AL amyloidosis were diagnosed with an advanced stage III disease when diagnosed, and 20.2% had a concurrent disease. The most involved organs were the kidneys (84.3%) and the heart (62.5%). In conclusion, our study shows some similarities and differences with other studies on the clinical characteristics of Chinese patients with AL amyloidosis, including the age at diagnosis, Mayo stage, and organ involvement. However, a nationwide epidemiological investigation is still needed to provide a comprehensive overview of this patient population in China.

This systematic scoping review was conducted to determine the extent of existing research on professionals’ attitudes toward school attendance problems (SAPs), including school refusal (SR), truancy (TR), school withdrawal (SW), and school exclusion (SE), in basic education. Five databases (ERIC, Academic Search Ultimate, Scopus, PsycINFO, and Web of Science) were systematically searched for relevant literature. Forty-five studies met the inclusion criteria that were set prior to the search and were eligible for inclusion. The results of this systematic scoping review reveal that there has been a continuous increase in studies addressing professionals’ attitudes toward SAPs since 2000, with the greatest number of studies published after 2019 and in Europe. Most studies were descriptive, cross-sectional, and used a qualitative approach and the most common informants were school-based professionals (i.e., teachers, school administrators, and other school staff). The included studies used a variety of concepts referring to SAPs and types of SAPs, underlining the present challenges in terminology and definitions that characterize the research field. The results of this review contribute to identifying gaps in knowledge and offer guidelines for future research as a prerequisite to enhance the contemporary comprehension of SAPs in research and in practice.

Abstract Background New health care professionals, such as the physician associate or assistant (PA), have expanded the ability of health systems to meet the needs of the population in both primary and secondary health care settings. Although PAs are widely deployed in the emergency department (ED), their role in the ED has not previously been formally described. This systematic scoping review synthesizes and critically analyzes existing literature on the impact and perception of the role of PAs working in the ED. Methods We performed a systematic scoping review. We searched Medline, PubMed, Scopus, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE) and EMCare for English language peer‐reviewed studies describing PA roles in the ED. Both qualitative and quantitative studies were included. We assessed the quality of the articles using QualSyst and the mixed methods appraisal tool. Themes regarding PA roles in the ED were identified. Results We included a total of 31 studies. Themes identified in the review included perceptions of the PA, wait times, acuity of patients seen, length of stay, those leaving without being seen (LWBS), clinical outcomes, pre‐admission rates, well‐being and scope of practice. Both the doctors' and patients' perception of PAs in the ED were generally high. The hindrance of them not being able to prescribe was evident. Studies showed a reduction in waiting times, length of stay, readmission rates, and those leaving without being seen when PAs work in the ED seeing moderate‐ to low‐acuity patients. Evidence shows that PAs have a positive impact and the perceptions of the PAs are high in international EDs. There is significant evidence of PAs being key members of the health care team. Their work is particularly helpful for low‐ to moderate‐acuity patients. With the increase in health care demand and a suffering UK National Health Service (NHS), the evidence synthesized in this review supports the potential positive impact PAs can have on the NHS and more specifically, the improvements of ED throughput metrics. Conclusions This review identified the roles and positive influence of PAs in the ED. These findings highlight current and future challenges for PAs in the ED.

Plain English summary This article summarizes what is publicly found in scientific papers about patient engagement in drug development initiatives between 2011 and 2021. It also introduces a new Framework to use to look at these patient engagement efforts. The Framework breaks these efforts down based on the depth of patient engagement in the drug development process and different degrees of influence or power patients have or intensity of engagement. In terms of depth of patient engagement in the process of drug development, most patient engagement initiatives described efforts involved in designing studies where goals were already set. Next were patient engagement efforts related to finetuning details where patients could make minor contributions. The fewest efforts were found related to setting up a research and development program where patients potentially could make significant impact. In terms of intensity of patient engagement, most initiatives aligned with consultation and involvement intensities, and few examples aligned with the highest intensity of patient engagement that was considered partnership. While patient engagement in drug development is becoming more common, the approaches to doing so vary widely. We have developed a new Framework to help characterize these efforts related to patient influence in the process as well as depth of their engagement.

The systematic mapping study (SMS) is a relatively new method of generating new information from existing studies. First defined as a methodology in 2007, it offers a method to filter existing information to produce novel insight into the observed research domain, and pinpoint new directions of research. In this study, the systematic mapping study method was utilized to determine how SMS as a method has spread and was utilized during the first decade since its conceptualization. In general, it was found that the SMS method is still at its early phase in utilization, and is mainly used in software engineering and healthcare studies, but also in several other scientific domains. SMS research and the scientific outputs rely on transparent protocols when conducting the actual search and identification process, and so far, the applied protocol and research procedure correlates strongly with the application domain; different domains have their own protocols. The SMS method can be recommended, for example, when the aim is to gain knowledge on how a specific topic is studied and where there are research gaps. There are still areas that are debated or where successful implementation is difficult, the biggest problems being the amount of work it requires and possible lack of quality analysis of the articles.

IntroductionDrug utilization is currently assessed through traditional data sources such as big electronic medical records (EMRs) databases, surveys, and medication sales. Social media and internet data have been reported to provide more accessible and more timely access to medications' utilization.ObjectiveThis review aims at providing evidence comparing web data on drug utilization to other sources before the COVID-19 pandemic.MethodsWe searched Medline, EMBASE, Web of Science, and Scopus until November 25th, 2019, using a predefined search strategy. Two independent reviewers conducted screening and data extraction.ResultsOf 6,563 (64%) deduplicated publications retrieved, 14 (0.2%) were included. All studies showed positive associations between drug utilization information from web and comparison data using very different methods. A total of nine (64%) studies found positive linear correlations in drug utilization between web and comparison data. Five studies reported association using other methods: One study reported similar drug popularity rankings using both data sources. Two studies developed prediction models for future drug consumption, including both web and comparison data, and two studies conducted ecological analyses but did not quantitatively compare data sources. According to the STROBE, RECORD, and RECORD-PE checklists, overall reporting quality was mediocre. Many items were left blank as they were out of scope for the type of study investigated.ConclusionOur results demonstrate the potential of web data for assessing drug utilization, although the field is still in a nascent period of investigation. Ultimately, social media and internet search data could be used to get a quick preliminary quantification of drug use in real time. Additional studies on the topic should use more standardized methodologies on different sets of drugs in order to confirm these findings. In addition, currently available checklists for study quality of reporting would need to be adapted to these new sources of scientific information.

BackgroundMachine learning (ML), is an approach to data analysis that makes the process of analytical model building automatic. The significance of ML stems from its potential to evaluate big data and achieve quicker and more accurate outcomes. ML has recently witnessed increased adoption in the medical domain. Bariatric surgery, otherwise referred to as weight loss surgery, reflects the series of procedures performed on people demonstrating obesity. This systematic scoping review aims to explore the development of ML in bariatric surgery.MethodsThe study used the Preferred Reporting Items for Systematic and Meta-analyses for Scoping Review (PRISMA-ScR). A comprehensive literature search was performed of several databases including PubMed, Cochrane, and IEEE, and search engines namely Google Scholar. Eligible studies included journals published from 2016 to the current date. The PRESS checklist was used to evaluate the consistency demonstrated during the process.ResultsA total of seventeen articles qualified for inclusion in the study. Out of the included studies, sixteen concentrated on the role of ML algorithms in prediction, while one addressed ML's diagnostic capacity. Most articles (n = 15) were journal publications, whereas the rest (n = 2) were papers from conference proceedings. Most included reports were from the United States (n = 6). Most studies addressed neural networks, with convolutional neural networks as the most prevalent. Also, the data type used in most articles (n = 13) was derived from hospital databases, with very few articles (n = 4) collecting original data via observation.ConclusionsThis study indicates that ML has numerous benefits in bariatric surgery, however its current application is limited. The evidence suggests that bariatric surgeons can benefit from ML algorithms since they will facilitate the prediction and evaluation of patient outcomes. Also, ML approaches to enhance work processes by making data categorization and analysis easier. However, further large multicenter studies are required to validate results internally and externally as well as explore and address limitations of ML application in bariatric surgery.

Abstract Background Early childhood caries disproportionately affects vulnerable groups and remains a leading cause of preventable hospital admissions for Western Australian children. The Western Australia State Oral Health Plan seeks to improve child oral health through universal and targeted health promotion initiatives with primary caregivers. These initiatives require evidence of primary caregiver oral health knowledge and behaviours and baseline data on early childhood caries. The objective of this systematic scoping review was to understand current oral health knowledge and practices of primary caregivers of children aged 0–4 years, identify influential socioecological determinants, and identify data on early childhood caries in the Western Australian context. Methods A systematic scoping review framework identified articles published between 2010 and 2021, using Scopus, PubMed, Medline, CINAHL, PsycINFO, selected article reference lists, and oral health websites. The lack of Western Australian specific literature prompted the inclusion of Australia-wide articles. Articles were screened via author consensus, with eight selected. Results Western Australia and nation-wide data on early childhood caries are limited and mostly dated. WA data from children aged 2–3 years, collected in 2006, suggests the prevalence is 2.9% in this state, with national data of children from 0 to 3 years, collected from 2006 and 2008, suggesting an early childhood caries prevalence of 3.4–8% of children aged 18 months, rising sharply by 36 months of age. Nationally, fewer than half the primary caregivers reported following evidence-based oral health recommendations for their young children. Perceptions of the role of dental services for young children tends to be focussed on treatment, rather than surveillance and prevention. Knowledge of dietary and oral hygiene practices is inconsistent and awareness of the Child Dental Benefit Schedule low. Young children’s oral health status is clearly associated with socioecological factors, including socioeconomic status. Conclusions Recent early childhood caries data and evidence of primary care-givers’ oral health knowledge and behaviours are unavailable in Western Australia, a similar situation exists nationwide. To realise the Western Australian and National Oral Health Plans, research is required to address this knowledge gap.

In the global South, rural and resource-based livelihoods increasingly face water-related risks. The conceptualization and application of the water security concept in relation to rural livelihoods has not been reviewed in this context. To fill this gap, a systematic scoping review of refereed journal articles (2000–2019) was conducted to examine how water security is defined, driven, and addressed for rural livelihoods in the global South. Publications (n = 99) featured diverse methodologies and geographical contexts, and recognized simultaneous drivers of water insecurity and solution strategies for water security. Several shortcomings were evident. First, only 30.3% of publications defined the concept, mostly using frames of ‘adequate’, ‘sufficient’, and ‘acceptable’ water-related risks. Few definitions recognized the role of water security interventions in increasing capabilities and prosperity. Second, technical and managerial responses to proximate drivers of water-related risk – namely climate-related dynamics, water re-allocation, extraction, and mismanagement – outnumbered efforts to identify and transform the underlying social, economic, and political inequities that create and sustain water insecurity. Last, studies focused heavily on agriculture, while labour, transhumance pastoralism, and aquaculture were underrepresented. A research agenda that increases the synergies between the wider water security and rural livelihoods scholarship is advanced to address these shortcomings. HIGHLIGHTS A systematic scoping review clarifies how water security is framed and addressed for rural livelihoods.; Water security focused on conditions of adequacy – not on advancing prosperity.; Diverse rural livelihoods were underrepresented.; Systemic processes that create and sustain water insecurity received less attention.; A research agenda to better understand and address water-related risks for rural livelihoods is provided.;

In recent years, inclusive education research in Italy and internationally has reflected upon teacher agency and its implications for students’ full inclusion. Since teacher agency for inclusive education is an emerging theoretical construct, interpreted in different ways in the literature, it is first necessary to aggregate existing studies, appraising both theoretical conceptualizations and available evidence. To this objective, we conducted a systematic scoping review of recent international literature on the topic. Eight theoretical frameworks emerged from the literature. Also, barriers to teacher agency were mapped e.g., the dominant ableist culture, the perceived inadequacy in the relationship with the students with disability, the special education teacher unpreparedness on specific learning contents, the marginalization of the special education teacher, and the lack of school administration support. On the other hand, teachers proved they are capable of change towards more inclusive practices thanks to resilience, teamwork, and beliefs on students’ abilities. Mappare evidenze e framework teorici dell’agency docente in relazione all’inclusione: una scoping review sistematica. Negli ultimi anni, la ricerca sull’inclusione scolastica in Italia e all’estero si è interrogata sull’agentività dei docenti e sulle implicazioni pratiche che essa comporta ai fini della piena inclusione di tutte/i le/gli studentesse/i. Dal momento che l’agency inclusiva è un costrutto teorico emergente, interpretato in modi differenti in letteratura, è anzitutto necessario aggregare gli studi esistenti, dal punto di vista delle concettualizzazioni teoriche e delle evidenze disponibili. Per questo, abbiamo condotto una scoping review sistematica della più recente letteratura internazionale sul tema. Emerge il ricorso a otto framework teorici e si evidenziano gli ostacoli all’esercizio dell’agency inclusiva, tra cui la cultura abilista dominante, la percezione di inadeguatezza nel rapporto con le/gli studentesse/i, l’impreparazione dell’insegnante di sostegno su alcuni specifici contenuti disciplinari, la disuguaglianza di status fra docente curricolare e di sostegno, la mancanza di supporto da parte della struttura di governance della scuola. D’altro canto, le/gli insegnanti dimostrano di essere in grado di modificare le pratiche in senso inclusivo, grazie alla loro resilienza, al lavoro in team e a profonde convinzioni sulle capacità delle/i studentesse/i.

Organophosphate flame retardants (OPFRs) are increasingly and widely used as substitutes for brominated flame retardants in daily life. The chemical structure of OPFRs is very similar to that of organophosphorus pesticides, leading to concerns about their neurotoxicity. A few epidemiological studies have been published with inconsistent results on this topic, and a systematic scoping review is needed to provide an overview or map of the current evidence on the relationship of OPFRs with neurodevelopmental toxicity. Therefore, MEDLINE (accessed through PubMed), Web of Science, and CNKI (Chinese National Knowledge Infrastructure) were systematically searched for articles published in the last two decades. Nine eligible articles were included in the present systematic scoping review for adherence to the predefined PECOS (population, exposure, comparison, outcome, study design) statement. Six studies were conducted in the USA, and the remaining three studies were conducted in Austria, Norway and China. A total of 2 581 children (1 203 females and 1 378 males) were included. Half of the included studies focused on the adverse effects of OPFR exposure on cognition in children, while others primarily focused on the behaviors of children. In summary, the current evidence suggests inverse associations between early-life exposure to OPFRs and the childhood intelligence quotient and internalizing behavior and positive relationships of OPFR exposure with externalizing behavior. However, some differences in the timing of sample collection for exposure measurements, in the individual OPFR metabolites available, in the neurodevelopmental scales for outcome measurement, and in the statistical methods used to analyze the data are noted. In addition, further studies are warranted to evaluate some important issues, such as sex differences in the association, exposure-sensitive periods, and cumulative exposure risk assessment.

Anthony W Olson,1,2 Timothy P Stratton,2 Brian J Isetts,3 Rajiv Vaidyanathan,4 Jared C Van Hooser,2 Jon C Schommer3 1Research Division, Essentia Institute of Rural Health, Duluth, MN, USA; 2Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota – College of Pharmacy, Duluth, MN, USA; 3Department of Pharmaceutical Care and Health Systems, University of Minnesota – College of Pharmacy, Minneapolis, MN, USA; 4Department of Marketing, University of Minnesota Duluth – Labovitz School of Business and Economics, Duluth, MN, USACorrespondence: Anthony W Olson 502 E 2nd Street, Duluth, MN, 55805, USATel +1 218 786 1754Fax +1 218 786 8159Email anthony.olson@essentiahealth.orgAbstract: “Patient-Centeredness” (PC) is a theoretical construct made up of a diverse constellation of distinct concepts, processes, practices, and outcomes that have been developed, arranged, and prioritized heterogeneously by different communities of professional healthcare practice, research, and policy. It is bound together by a common ethos that puts the holistic individual at the functional and symbolic center of their care, a quality deemed essential for chronic disease management and health promotion. Several important contributions to the PC research space have adeptly integrated seminal PC conceptualizations to improve conceptual clarity, measurement, implementation, and evaluation in research and practice. This systematic scoping review builds on that work, but with a purpose to explicitly identify, compare, and contrast the seminal PC conceptualizations arising from the different healthcare professional groups. The rationale for this work is that a deeper examination of the underlying development and corresponding assumptions from each respective conceptualization will lead to a more informed understanding of and meaningful contributions to PC research and practice, especially for healthcare professional groups newer to the topic area like pharmacy. The literature search identified four seminal conceptualizations from the healthcare professions of Medicine, Nursing, and Health Policy. A compositional comparison across the seminal conceptualizations revealed a shared ethos but also six distinguishing features: (1) organizational structure; (2) predominant level of care; (3) methodological approach; (4) care setting origin; (5) outcomes of interest; and (6) language. The findings illuminate PC’s stable theoretical foundations and distinctive nuances needed to appropriately understand, apply, and evaluate the construct’s operationalization in contemporary healthcare research and practice. These considerations hold important implications for future research into the fundamental aims of healthcare, how it should look when practiced, and what should reasonably be required of it.Keywords: patient-centeredness, medicine, nursing, health policy, pharmacy, systematic scoping review

This review concerns how quality in ECEC is thematized and examined in Norwegian research published in 2010–2021. The review contributes to developing relevant professional knowledge and insight into what quality in ECEC is, should be or can be. A systematic scoping review includes 97 empirical studies of quality in the Norwegian ECEC context. The results show an increase in studies addressing quality after the year 2017. Most studies use interviews and observations, i.e., qualitative data. Research based on quantitative studies mainly applies to questionnaires, whereas multi-method designs occur with the third greatest frequency. The majority of the studies are descriptive or explore relationships. A few studies concern method development, interventions or reviews of the literature. ECEC staff and ECEC teachers are the most common informants. Two-thirds of the studies included were published in English, and only one-third were published in Norwegian. Thematically, process quality emerges as the most studied dimension of quality, dominated by investigating the aspect of staff–child interactions. About one-third of the studies investigate structural quality, with most attention paid to the physical environment and the organization of the ECEC provisions. Less research is directed at result (outcome) quality and curriculum quality. This overview contributes to increased knowledge about how quality is understood and used in research, as an essential prerequisite for creating a safe and sound everyday life for children in ECEC.

Abstract Background This systematic scoping review aimed to identify changes in biomarkers of microbiological, immunological and biochemical origin during experimental gingivitis (EG) studies that might indicate resistance and resilience. Methods The term ‘experimental gingivitis’ was run in PubMed from inception to April 11th, 2018. From the 411 studies retrieved, 22 studies were included for this review. Results Studies reporting data on biomarker changes during and after full mouth EG trial were included. Two studies reported findings on changes in biomarkers of microbiological, 12 on immunological and eight on biochemical origin. Changes were reported in the induction phase, and occasionally in the resolution phase. The microbiological composition of both supragingival and subgingival dental plaque changed over the course of EG to a more pathogenic direction, but showed a shift back to a more normal composition. This indicates resilience of the oral microbiome. For immunological biomarkers, it was challenging to retrieve a robust pattern of changes across multiple studies. IL-1β and IL-6 in saliva and in gingival crevicular fluid increased during induction phase and returned in the resolution phase below baseline values. The biochemical parameters cystatin-SN, cystatin-S and lactoferrin in saliva were increased at the end of induction phase, however also here no clear pattern emerged based on all available studies. Conclusions More research is needed to investigate which microbiological, immunological, and biochemical biomarkers can be useful for future investigations into the resistance and resilience of the oral cavity to experimental gingivitis.

Within the context of eHealth interventions, a shared understanding of what constitutes engagement in and with eHealth technologies is missing. A clearer understanding of engagement could provide a valuable starting point for guidelines relating to the design and development of eHealth technologies. Given the cross-disciplinary use of the term “engagement,” investigating how engagement (and its components) is conceptualized in different domains could lead to determining common components that are deemed important for eHealth technological design. As such, the aim of this paper was 3-fold: (a) to investigate in which domains engagement features, (b) to determine what constitutes engagement in these different domains, and (c) to determine whether there are any common components that seem to be important. A comprehensive systematic scoping review of the existing literature was conducted in order to identify the domains in which engagement is used, to extract the associated definitions of engagement, and to identify the dimensionality or components thereof. A search of five bibliographic databases yielded 1,231 unique records. All titles, abstracts, and full texts were screened based on specific inclusion and exclusion criteria. This led to 69 articles being included for further analyses. The results showed that engagement is used in seven functional domains, categorized as follows: student (n = 18), customer (n = 12), health (n = 11), society (n = 10), work (n = 9), digital (n = 8), and transdisciplinary (n = 1) domains. It seems that some domains are more mature regarding their conceptualization and theorizing on engagement than others. Further, engagement was found to be predominantly conceptualized as a multidimensional construct with three common components (behavior, cognition, and affective) shared between domains. Although engagement is prolifically used in different disciplines, it is evident that little shared consensus as to its conceptualization within and between domains exists. Despite this, engagement is foremost seen as a state of being engaged in/with something, which is part of, but should not be confused with, the process of engagement. Behavior, cognition, and affect are important components of engagement and should be specified for each new context.

Optimal delivery of medication via dry powder inhalers, the most commonly prescribed inhaler type, is dependent on a patient achieving a minimum level of inspiratory flow during inhalation. However, measurement of peak inspiratory flow (PIF) against the simulated resistance of a dry powder inhaler is not frequently performed in clinical practice due to time or equipment limitations. Therefore, defining which patient characteristics are associated with lower PIF is critically important to help clinicians optimize their inhaler choice through a more personalized approach to prescribing. The objective of this scoping review was to systematically evaluate patient and disease characteristics determining PIF in patients with chronic obstructive pulmonary disease (COPD). Medline, Cochrane and Embase databases were systematically searched for relevant studies on PIF in patients with COPD published in English between January 2000 and May 2021. The quality of evidence was assessed using a modified Grading of Recommendations Assessment, Development and Evaluation checklist. Of 3382 citations retrieved, 35 publications were included in the review (nine scored as high quality, 13 as moderate, nine as low, and four as very low). Factors correlating with PIF in >70% of papers included both patient characteristics (lower PIF correlated with increased age, female gender, shorter height, decreased handgrip and inspiratory muscle strength, and certain comorbidities) and disease characteristics (lower PIF correlated with markers of lung hyperinflation, lower peak expiratory flow [PEF] and increased disease severity). Other factors correlating with adequate/optimal or improved PIF included education/counseling and exercise/inspiratory muscle training; impaired physical function and errors in inhalation technique/non-adherence were associated with low/suboptimal PIF. In conclusion, clinicians should measure PIF against the simulated resistance of a particular device wherever possible. However, as this often cannot be done due to lack of resources or time, the patient and disease characteristics that influence PIF, as identified in this review, can help clinicians to choose the most appropriate inhaler type for their patients.

Olson AW, Stratton TP, Isetts BJ, Vaidyanathan R, Van Hooser JC, Schommer JC. J Multidiscip Healthc. 2021;14:973–986. The authors have advised that there are errors in Table 2 on page 981. The text “Clinical & Patient-reported” and “Patient-reported only” for the Nursing and Health Policy columns in the 5. Outcomes of Interest row should read “Patient-reported only” and “Clinical & Patient-reported”, respectively. The text ““Patient”-Centered” and ““Person”-Centered” for the Nursing and Health Policy columns in the 6. Language row should read ““Person”-Centered” and ““Patient”-Centered”, respectively. The authors apologize for these errors and advise it does not affect the conclusions of the paper. Read the original article

Background: Substantial investments are being made in health ­information ­technology (HIT) based on assumptions that these systems will save costs through increased quality, safety and efficiency of care provision. Whilst ­short-term ­benefits have often proven difficult to demonstrate, there is increasing interest in achieving benefits in the medium and long term through secondary uses of ­HIT-derived data. Aims: We aimed to describe the range of secondary uses of HIT-derived data in the international literature and identify innovative developments of particular relevance to UK policymakers and managers. Methods: We searched nine electronic databases to conduct a systematic scoping review of the international literature and augmented this by consulting a range of experts in the field. Results: Reviewers independently screened 16,806 titles, resulting in 583 ­eligible studies for inclusion. Thematic organisation of reported secondary uses was ­validated during expert consultation (n = 23). A primary division was made between patient-identifiable data and datasets in which individuals were not identified. Secondary uses were then categorised under four domain headings of: i) research; ii) quality and safety of care provision; iii) financial management; and iv) healthcare professional education. We found that innovative developments were most ­evident in research where, in particular, dataset linkage studies offered important ­opportunities for exploitation. Conclusions: Distinguishing patient-identifiable data from aggregated, de-identified datasets gives greater conceptual clarity in secondary uses of HIT-derived data. Secondary uses research has substantial potential for realising future benefits through generating new medical knowledge from dataset linkage studies, developing precision medicine and enabling cross-sectoral, evidence-based policymaking to benefit population-level well-being.

Realist review has emerged as a specific literature review approach that is concerned with explaining the outcomes of complex intervention programs. We undertook a systematic scoping review to examine the current practice of realist review. A systematic scoping review is a process of mapping the existing evidence base on a particular topic. We identified a growing body of literature using the realist review approach. We selected 54 reviews for our study. These reviews covered a range of topics, including health care, education, management, and public safety. We found that the initial process of exploratory scoping of the literature was described in only 58 per cent of the reviews. The approaches regarding appraisal, analysis, and synthesis of the selected studies were poorly described in most reviews. Overall, there was little uniformity and transparency regarding many methodological issues. Specific methodological guidance may need to be developed if realist reviews are to have a more uniform and transparent approach.