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Background Every year since 1982 the BMJ has published a “Christmas issue” as the final issue of the year. Articles in the special issue are lighthearted, sometimes frivolous, but often with serious underlying concerns. There is fierce competition to have a paper published in the Christmas issue. Hypothesis That there is no difference between the numbers of citations, reads and downloads, and Altmetrics scores of papers published in the BMJ’s Christmas issues and the numbers of citations, reads and downloads, and Altmetrics scores of papers published in other issues. Methods We shall search the last issues of the BMJ in each year from 2000 to 2019 inclusive (20 years). We shall use Google Scholar to determine how many citations papers published in each issue have received by July 2022. We shall classify the papers using the terms used in the journal itself and in the Medline entries, where available. We shall initially compare the Christmas issues with the issues that have been published at the end of August in each year studied. Later, we may compare them with issues published at other times of the year. We shall also compare the most cited journal articles at Xmas with the least cited articles, to establish whether careful selection of title or subject might allow citation success and Xmas exposure to be combined. We shall also compare reads and downloads for papers published onwards from 2008, when the BMJ started to count those numbers. Since Altmetrics scores reportedly correlate with citations and readability of articles, we shall also compare Altmetrics scores for papers published onwards from 2014. Inclusion criteria We shall include editorials, papers of various kinds uniformly described in Medline as “journal articles”, and fillers. “Journal articles” generally include research articles of all types (e.g. systematic reviews and meta-analyses, RCTs, and retrospective and prospective observational studies), case reports, historical articles, and nonsystematic review articles. Exclusion criteria We shall exclude book reviews and obituaries and items such as those labelled “Editor’s choice”, “This Week in the BMJ”, “News”, “In brief”, “Short cuts”, and “Minerva”. Analysis We shall calculate medians and interquartile ranges and compare them using nonparametric tests. We shall analyse the complete set of data, the pairs of data in each year (Christmas and August), and subsets of different types of articles (e.g. those labelled “journal articles”).

In the present study, we plan to collect background information about the RDM mistakes of retracted papers by surveying their authors. We will use our RDM taxonomy to categorize the different mistakes and their causes. The results of the proposed study could provide valuable information on what types of these honest mistakes could lead to such a serious consequence as a retraction. We plan to suggest useful tools and practices to prevent these mistakes for those researchers who wish to minimize the risk of a retraction.

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This registration contain information about my research article "A novel deep learning method for recognizing texts printed with multiple different printing methods" and its extended/underlying data which are required by publisher (F1000Research).

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Open Science is a movement that aims to share and make scientific knowledge available to society as a whole and to scientific communities around the world, encouraging transparency, rigor, and integrity in all stages of the scientific process, enabling the results to be shared and reused by everyone. Thus, this cross-sectional observational study aims to evaluate the adherence to open science practices of the 100 most cited studies in the dentistry field of the last 10 years, in addition to assessing whether there is any association between the number of citations and adherence to practices of open science.

Open Science is a movement that aims to share and make scientific knowledge available to society as a whole and to scientific communities around the world, encouraging transparency, rigor, and integrity in all stages of the scientific process, enabling the results to be shared and reused by everyone. Thus, this cross-sectional observational study aims to evaluate the adherence to open science practices of the 100 most cited studies in the dentistry field of the last 10 years, in addition to assessing whether there is any association between the number of citations and adherence to practices of open science.

In their fifth meeting at the Vrije Universiteit Amsterdam in 2017 (5th WCRI), the World Conference on Research Integrity (WCRI) adopted the Amsterdam Agenda (AA). The AA is a policy statement stipulating six key elements that researchers doing research on aspects of research integrity preferably should use when preregistering their empirical research projects (https://www.wcrif.org/guidance/amsterdam-agenda). The applicants of this submission form performed an ad hoc study in 2019 using data supplied by paper and poster presenters of the 6th WCRI in Hong Kong, 2019, to find out to which degree researchers had pre-registered the study they were going to present at the 6th WCRI, using either the recommendations of the AA or other recommendations. The first applicant (Sijtsma) presented the results in the final plenary session of 6th WCRI. The pilot study showed that 19% of the 308 presenters had preregistered their research. Of the 56 usable cases, less than half of them provided information on one or more of the six key elements of the AA. Others provided information that invalidated their data, such as an uninformative URL. There was no discernable difference between qualitative and quantitative research. We published our results in the journal Research Integrity and Peer Review (Sijtsma et al., 2021). Our study suffered from two limitations. First, we did no plan our research a priori but used the raw data the 6th WCRI organizers made available on an ad hoc basis. These raw data came from the information 6th WCRI participants provided while registering and submitting their paper and poster proposals. This implied that we had to work with data that were not collected with our study questions in mind. Second, given highly restrictive time limits, the WCRI organizers were unable to receive participants’ consent for using their data once we planned our research, and we were unable to receive timely consent of an ethics committee and to preregister our research. The present proposal continues the 2019 research, but improves both its content and fully obeys procedural requirements. That is, we plan the data collection a priori, ask participants for their consent to use their anonymized data, request consent by an ethics committee, and pre-register the study. Sijtsma, K., Emons, W. H. M., Steneck, N. H., & Bouter, L. M. (2021). Steps toward preregistration of research on research integrity. Research Integrity and Peer Review, 6. https://doi.org/10.1186/s41073-021-00108-4

Description: This serves as a pre-registration for the study of executive functioning assessment in virtual reality. Draft summary Virtual reality immerses the individual in a computerised situation in which they can move coherently in space and interact with objects in the virtual environment. Virtual reality is an interesting technology for cognitive assessment because it is more embodied than traditional paper-and-pencil testing situations. Virtual reality is more respectful of the conception of function-based neuropsychology, as opposed to construct-based neuropsychology. Virtual reality also facilitates the tracking of kinematic information on the one hand and the temporal tracking of activities on the other, which can add to the quality of the assessment. This study aims to present three virtual reality environments dedicated to the evaluation of cognitive functions. It also aims to evaluate the relationship between standard paper/pencil and tablet assessments and virtual reality assessments. Based on the results, the discussion will focus on the advantages (or disadvantages) of kinematic tracking and embodied, situated and spatialized tests for cognitive assessment.

MicroRNAs are small (approximately 22 nucleotides), endogenous, noncoding, highly stable, and gene-regulating RNAs. Their dysregulation were linked to many diseases, such as diabetes and cancers. Since the first microRNA was found in 1993, a lot of microRNAs with countless papers were discoveried. At the same time, many papers on microRNA research were retracted, which had a bad impact on evidence-based research and clinical decision-making. This study aims to analysis the trends and characteristics of retracted papers on microRNA study to facilitate good research and better science.

Social interactions have large effects on individual physiology and fitness. In the immediate sense, social stimuli are often highly salient and engaging. Over longer time scales, competitive interactions often lead to distinct social ranks and differences in physiology and behavior. Understanding how initial responses lead to longer-term effects of social interactions requires examining the changes in responses over time. Here we examined the effects of social interactions on transcriptomic signatures at two times, at the end of a 45-minute interaction and 4 hours later, in female Polistes fuscatus paper wasp foundresses. Female P. fuscatus have variable facial patterns that are used for visual individual recognition, so we separately examined the transcriptional dynamics in the optic lobe and the non-visual brain. Results demonstrate much stronger transcriptional responses to social interactions in the non-visual brain compared to the optic lobe. Differentially regulated genes in response to social interactions are enriched for memory-related transcripts. Comparisons between winners and losers of the encounters revealed similar overall transcriptional profiles at the end of an interaction, which significantly diverged over the course of 4 hours, with losers showing changes in expression levels of genes associated with aggression and reproduction in paper wasps. On nests, subordinate foundresses are less aggressive, do more foraging and lay fewer eggs compared to dominant foundresses and we find losers shift expression of many genes in the non-visual brain, including vitellogenin, related to aggression, worker behavior, and reproduction within hours of losing an encounter. These results highlight the early neurogenomic changes that likely contribute to behavioral and physiological effects of social status changes in a social insect., Author summary Aggressive interactions often create inequalities–some individuals win while others lose. Winning versus losing can lead to large physiological differences between individuals, including different neurogenomic profiles between winners and losers. How this information about contest outcome leads to distinct neurogenomic profiles is poorly understood. Here we examine gene expression in response to aggressive social encounters in paper wasps, which naturally form dominance hierarchies on their nests in the wild. Shortly following encounters winners and losers have similar expression profiles, likely because similar mechanisms are engaged by social experiences. Four hours later, we find divergent neurogenomic profiles between winners and losers, with losers showing larger shifts in expression compared to winners. Many of the most dynamically expressed genes have been previously associated with dominance and caste differences in paper wasps showing how a single interaction can engage many of the same genomic networks that are involved in mediating more dramatic differences in queen-worker behavioral differences are also involved in responses shortly following social interactions.

Aims - To examine eligibility and assessment criteria of research publication recognition awards. - To evaluate potential gender and country biases in the lists of past awardees of the above awards. - To communicate the need for improving awards policies and how this can be done – ultimately making individual publication-related awards more equitable.

Aims - To examine eligibility and assessment criteria of research publication recognition awards. - To evaluate potential gender and country biases in the lists of past awardees of the above awards. - To communicate the need for improving awards policies and how this can be done – ultimately making individual publication-related awards more equitable.

The advantages of administering questionnaires online include savings of time, savings of money, avoidance of data entry errors (Pasveer & Ellard, 1998) and less missing data (Stanton, 1998; Wood et al., 2006). In addition, participants are provided with the flexibility to complete the questionnaires whenever it fits into their schedule. In 2005, almost two decades ago, a still ongoing cross-sectional observational study on psychosocial aspects and psychological stress of cancer outpatients was launched at the Medical University of Vienna, including two standardised questionnaires, namely the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983) and the Posttraumatic Symptom Scale (PTSS-10; Maercker, 2003; Stoll et al. 1999). Administration mode of this study will be switched from paper-pencil to online assessment. For boths questionnaires, we aim to investigate whether measurement equivalence between administration modes can be assumed.

COVID-19 has accelerated a virtual era of consultations, which adds difficulties when assessing pain. Pen-to-paper pain diagrams, a well-used method will be replaced by electronic pain diagrams, a newer technology. This scoping review aims to assess the usability of pain diagrams, give recommendations on use and develop a gap map to allow routes for future research to ensure pain diagrams are effective, leading to more consistent use in virtual healthcare.

The aim of this review is firstly to identify patient-reported outcome measures administered to children and youth up to and including the age of 24 years to assess for outcomes related to their physical health condition, mental health status, overall wellbeing, thoughts, feelings, and personal experiences. Secondly, the review aims to critically appraise and compare the measurement equivalence between electronic/digital/telephone-administered and paper-based patient-reported outcome measures administered to children and youth.

Scientific publications may be retracted for different reasons, including misconduct. Empirical data suggest an increasing rate of retractions within the biomedical literature. To our knowledge, a comprehensive assessment of retractions of biomedical papers from authors affiliated with a scientific institution in Germany has not yet been performed.

This page contains the document for the pre-registration of the paper with the preliminary title "Familial resemblance in psychosocial vulnerability: A study of patients with depressive and anxiety disorders and their siblings".

This is a frozen copy of a pre-registered project containing the data for following publication: Hoorelbeke, K., Van den Bergh, N., De Raedt, R., Wichers, M., & Koster, E.H.W. (2021). Preventing recurrence of depression: Long-term effects of a randomized controlled trial on cognitive control training for remitted depressed patients. Clinical Psychological Science.

A systematic review of publications from 7 databases on the hypothesis of chemical imbalances causing mental distress ("the chemical imbalance theory")

Personalised Nutrition for Older Adults: Design Challenges, SME barriers, and Options and Competencies for Innovation

Scoping review

Data supporting the peer-reviewed manuscript: Defining and validating regenerative farm systems using a composite of ranked agricultural practices Tommy Fenster Claire E. LaCanne Jacob R. Pecenka Ryan B. Schmid Michael M. Bredeson Katya Busenitz Alex Michels Kelton D. Welch Jonathan G. Lundgren

Publisher Copyright: © 2022 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology. Background: Paediatric atopic dermatitis (AD) can be burdensome, affecting mental health and impairing quality of life for children and caregivers. Comprehensive guidelines exist for managing paediatric AD, but practical guidance on using systemic therapy is limited, particularly for new therapies including biologics and Janus kinase (JAK) inhibitors, recently approved for various ages in this indication. Objectives: This expert consensus aimed to provide practical recommendations within this advancing field to enhance clinical decision-making on the use of these and other systemics for children and adolescents aged ≥2 years with moderate-to-severe AD. Methods: Nineteen physicians from Northern Europe were selected for their expertise in managing childhood AD. Using a two-round Delphi process, they reached full or partial consensus on 37 statements. Results: Systemic therapy is recommended for children aged ≥2 years with a clear clinical diagnosis of severe AD and persistent disease uncontrolled after optimizing non-systemic therapy. Systemic therapy should achieve long-term disease control and reduce short-term interventions. Recommended are cyclosporine A for short-term use (all ages) and dupilumab or methotrexate for long-term use (ages ≥6 years). Consensus was not reached on the best long-term systemics for children aged 2–6 years, although new systemic therapies will likely become favourable: New biologics and JAK inhibitors will soon be approved for this age group, and more trial and real-world data will become available. Conclusions: This article makes practical recommendations on the use of systemic AD treatments for children and adolescents, to supplement international and regional guidelines. It considers the systemic medication that was available for children and adolescents with moderate-to-severe AD at the time this consensus project was done: azathioprine, cyclosporine A, dupilumab, methotrexate, mycophenolate mofetil and oral glucocorticosteroids. We focus on the geographically similar Northern European countries, whose healthcare systems, local preferences for AD management and reimbursement structures nonetheless differ significantly.

IL-23 is a key cytokine in the pathogenesis of spondyloarthritides, including PsA and axial spondyloarthritis, as well as related conditions, such as psoriasis and IBD. Genetic associations, animal models and translational studies in humans demonstrate the key role played by IL-23, especially when coupled with downstream overexpression of IL-17 via stimulation of T helper 17 (Th17) and other cells by IL-23. Whereas IL-23 inhibition has shown clear-cut benefit in psoriasis and peripheral manifestations of PsA, trials of IL-23 inhibitors have failed in the treatment of ankylosing spondylitis. More recently, exploratory data from PsA patients with axial symptoms suggests that improvement may occur, but needs confirmation in dedicated axial spondyloarthritis (axSpA) trials. Hypotheses for these apparently conflicting findings about IL-23 inhibition in various forms of spondylitis are discussed.

Long non-coding RNAs (lncRNAs) are a heterogeneous group of transcripts that lack protein coding potential and display regulatory functions in various cellular processes. As a result of their cell- and cancer-specific expression patterns, lncRNAs have emerged as potential diagnostic and therapeutic targets. The accurate characterization of lncRNAs in bulk transcriptome data remains challenging due to their low abundance compared to protein coding genes. To tackle this issue, we describe a unique short-read custom lncRNA capture sequencing approach that relies on a comprehensive set of 565,878 capture probes for 49,372 human lncRNA genes. This custom lncRNA capture approach was evaluated on various sample types ranging from artificial high-quality RNA mixtures to more challenging formalin-fixed paraffin-embedded tissue and biofluid material. The custom enrichment approach allows the detection of a more diverse repertoire of lncRNAs, with better reproducibility and higher coverage compared to classic total RNA-sequencing.

Background The European Commission is funding projects that aim to establish data-sharing platforms. These platforms are envisioned to enhance and facilitate the international sharing of cohort data. Nevertheless, broad data sharing may be restricted by the lack of adequate recognition for those who share data. Objective The aim of this study is to describe in depth the concerns about acquiring credit for data sharing within epidemiological research. Methods A total of 17 participants linked to European Union–funded data-sharing platforms were recruited for a semistructured interview. Transcripts were analyzed using inductive content analysis. Results Interviewees argued that data sharing within international projects could challenge authorship guidelines in multiple ways. Some respondents considered that the acquisition of credit for articles with extensive author lists could be problematic in some instances, such as for junior researchers. In addition, universities may be critical of researchers who share data more often than leading research. Some considered that the evaluation system undervalues data generators and specialists. Respondents generally looked favorably upon alternatives to the current evaluation system to potentially ameliorate these issues. Conclusions The evaluation system might impede data sharing because it mainly focuses on first and last authorship and undervalues the contributor’s work. Further movement of crediting models toward contributorship could potentially address this issue. Appropriate crediting mechanisms that are better aligned with the way science ought to be conducted in the future need to be developed.

Since the innovation of our new half-piece elastometric respirator, this type of filtering facepiece respirator (FFR) has been used widely in Thailand. Decontamination methods including ultraviolet C (UVC) germicidal irradiation and 70% alcohol have been implemented to decontaminate these respirators. We then examined the inactivation potential of different decontamination processes on porcine epidemic diarrhea virus (PEDV) and numerous bacterial strains, most of which were skin-derived. To enable rigorous integrity of the masks after repeated decontamination processes, fit tests by the Bitrex test, tensile strength and elongation at break were also evaluated. Our results showed that UVC irradiation at a dose of 3 J/cm2 can eradicate bacteria after 60 min and viruses after 10 min. No fungi were found on the mask surface before decontamination. The good fit test results, tensile strength and elongation at break were still maintained after multiple cycles of decontamination. No evidence of physical degradation was found by gross visual inspection. Alcohol (70%) is also an easy and effective way to eradicate microorganisms on respirators. As the current pandemic is expected to continue for months to years, the need to supply adequate reserves of personnel protective equipment (PPE) and develop effective PPE reprocessing methods is crucial. Our studies demonstrated that the novel silicone mask can be safely reprocessed and decontaminated for many cycles by UVC irradiation, which will help ameliorate the shortage of important protective devices in the COVID-19 pandemic era.

Acknowledgements: We thank Veronica Phillips, Assistant Librarian, University of Cambridge Medical Library, for her help developing the search strategy., Background Introduction of risk stratification within population-based cancer screening programmes has the potential to optimise resource allocation by targeting screening towards members of the population who will benefit from it most. Endorsement from healthcare professionals is necessary to facilitate successful development and implementation of risk-stratified interventions. Therefore, this review aims to explore whether using risk stratification within population-based cancer screening programmes is acceptable to healthcare professionals and to identify any requirements for successful implementation. Methods We searched four electronic databases from January 2010 to October 2021 for quantitative, qualitative, or primary mixed methods studies reporting healthcare professional and/or other stakeholder opinions on acceptability of risk-stratified population-based cancer screening. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Data were analysed using the Joanna Briggs Institute convergent integrated approach to mixed methods analysis and mapped onto the Consolidated Framework for Implementation Research using a ‘best fit’ approach. PROSPERO record CRD42021286667. Results A total of 12,039 papers were identified through the literature search and seven papers were included in the review, six in the context of breast cancer screening and one considering screening for ovarian cancer. Risk stratification was broadly considered acceptable, with the findings covering all five domains of the framework: intervention characteristics, outer setting, inner setting, characteristics of individuals, and process. Across these five domains, key areas that were identified as needing further consideration to support implementation were: a need for greater evidence, particularly for de-intensifying screening; resource limitations; need for staff training and clear communication; and the importance of public involvement. Conclusions Risk stratification of population-based cancer screening programmes is largely acceptable to healthcare professionals, but support and training will be required to successfully facilitate implementation. Future research should focus on strengthening the evidence base for risk stratification, particularly in relation to reducing screening frequency among low-risk cohorts and the acceptability of this approach across different cancer types.

Introduction In 2003, the Registered Nurses’ Association of Ontario (RNAO) launched the Best Practice Spotlight Organization® (BPSO®) designation as a key knowledge-translation strategy to support the implementation of best practice guidelines (BPGs), rapid learning and sustainability of evidence-based practice changes[1]. RNAO has since developed two data systems to monitor and evaluate the impact of BPG implementation: Nursing Quality Indicators for Reporting and Evaluation® (NQuIRE®) and the MyBPSO reporting system. The NQuIRE data system collects aggregated de-identified data from BPSOs related to their BPG implementation efforts based on quality indicators. Recently, the RNAO has launched an artificial intelligence (AI) and machine learning (ML) initiative to assess data obtained from the two data systems and predict patterns in BPG implementation across organizations. AI and ML uses various computer techniques and advanced analytics to unwrap patterns of hidden information[2]. AI and ML techniques also aid in the performance of different tasks via statistical and algorithmic calculations that conventionally required human intervention in a comparatively faster way[2]. ML algorithms can be used to manage Big data and help with nursing assessments, interventions, clinical decision-making and documentation[3]. AI-powered techniques can also play a vital role in contributing to the understanding of BPG implementation. To better understand the impact of BPG implementation, RNAO intends to develop AI and ML techniques applicable to the NQuIRE and MyBPSO data systems. This makes it imperative to know which AI and ML methods exist to further support clinical decision-making and BPG implementation, which provided the basis for our scoping review. The goals of this scoping review are to gain a deeper understanding of implementation strategies and practice changes that improve clinical, organizational and health-system outcomes, and to advance BPSOs capacity for rapid learning and continuous quality improvement which can be uncovered via AI and ML techniques. Objectives The purpose of this scoping review is to understand the adaptation and implementation of various AI and ML techniques in a variety of health-care contexts utilizing different data systems which house nursing-related aggregated data. Keywords and subject headings associated with the following terms were combined: “health care”, “machine learning and deep learning”, and “data systems” (Appendix). Methods Standardized reporting guidelines stipulate certain items to include in research reports to improve methodological transparency and the uptake of research findings[4]. Specifically, scoping reviews follow systematic approaches to search and gather evidence while identifying knowledge gaps. Unfortunately, there is no existing scoping review protocol guidance. However, The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) provides a checklist of items for scoping review development[4], used as a guiding document for this review. The summary of RNAO’s scoping review is registered in the Open Science Framework database (registration doi: 10.17605/OSF.IO/ZP6CG)[5]. This scoping review will map out current available evidence on AI and ML techniques. This may include identifying core concepts related to AI and ML, relevant terminology or techniques associated with AI and ML, knowledge gaps and summative techniques that were potentially adapted to build AI. Members of the Monitoring & Evaluation team at RNAO (SS, CM and SN) initiated this scoping review by conceptualizing the application of AI and ML techniques in nursing databases and determining the need for further research. The RNAO Guideline Development and Research Team (LH, AB and NN), provided support and aided in development of the methodology of the scoping review. RNAO’s Chief Executive Officer (DG) and Associate Director and Chief Scientist, RNAO (SN) informed the scope and direction of the project and will provide feedback on the results. This scoping review followed the Arksey and O'Malley framework[6] which has been further advanced by Levac, Colquhoun and O’Brien[7]. The five steps of the methodological framework include: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing and reporting the results. Step 1: Identifying the research question This scoping review was conducted to build on evidence that supports RNAO’s AI and ML initiative. First, a research question was constructed to guide the scoping review[7]: What type of AI and ML techniques have been used in nursing data systems that are built on the use of aggregated data? In this protocol, nursing data systems refer to any data systems used to store clinical data related to the nursing scope of practice in health service organizations for future use or analysis. The term “aggregated data” refers to de-identified organizational information and aggregated data from quality indicators collected on a monthly basis. This does not include data registries, which only store data and are not part of data analysis at the organization level. Step 2: Identifying relevant studies A broad search strategy was developed to ensure the comprehensiveness of the evidence retrieved, which is a common aspect of all scoping reviews[6]. The MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Embase databases were searched for peer-reviewed literature. The search terms (Appendix) were drafted by SS and CM and were reviewed by LH and SN. Search terms included “nursing”, “artificial intelligence”, “data systems”, “statistics”, and “aggregated data”. Relevant Medical Subject Heading (MeSH) terms, CINAHL Subject Headings and keywords were added and combined using Boolean operators “AND” and “OR”. One reviewer ran the final search strategy (SS). Inclusion and exclusion criteria were developed through consultations with all authors. Grey literature was excluded from this scoping review because the focus was on scientific peer-reviewed literature and the fact that grey literature may be limited due to incomplete or incorrect identification. Grey literature is more difficult to process than other types of open-source citations owing to its nonstandard formats. The literature search was limited to articles published in the last two decades to ensure the evidence on AI and ML techniques was current. Our inclusion/exclusion criteria are described below: Inclusion criteria Quantitative studies All included citations must be: • Peer-reviewed • Published in the year 2000 or after • Available in English • Relevant to AI/ML in nursing • Based on aggregated data • Utilizing nursing data systems Exclusion criteria Qualitative studies and mixed-method studies • Grey literature such as theses, editorials, white paper publications • Conference abstracts • Discussion papers • Case studies • Published literature reviews, systematic/scoping reviews Step 3: Study selection Citations extracted from three databases were imported into EndNote[8] for de-duplication and then uploaded into DistillerSR[9] for screening. Two reviewers (SS and CM) independently screened citations in two stages: 1) a title and abstract screening and 2) full text review. The title and abstract screening was performed to determine relevancy of studies to the “use of AI and ML in the field of nursing or delivery of health care” while adhering to the inclusion criteria. For the full text review, the inclusion/exclusion criteria were even further refined to determine the utilization and analysis of aggregated data and nursing data systems. The full text articles were downloaded to DistillerSR[9], independently reviewed by SS and CM. Any disagreements were resolved through discussions by both reviewers. Step 4: Charting the data Data from included studies are extracted at this stage[7]. The data charting form will be created by the two reviewers (SS and CM) in Microsoft Excel 2019 (Microsoft Corp) and will be reviewed by SN and LH. Since data charting is an iterative process[7], the data charting form will be refined concurrently with data extraction. SS and CM will extract data from half of the citations and will then verify the half of the charted data they did not input. For the purpose of this scoping review, the proposed information to be extracted is as follows: • RefID (from DistillerSR) • First author (Year) • Study design • Country • Study setting • Eligibility criteria • Objective of study • Type of AI tool used • Description of AI method • Quantitative outcomes • Clinical outcomes • Additional comments/notes Step 5: Collating, summarizing and reporting the results There are three distinct steps to enhance the consistency of reporting: analyzing the data, reporting results, and applying meaning to the results[7]. A summary of the study findings will be presented in a manuscript following completion of the scoping review. Results Electronic database searches were conducted in March 2022 and a total of 2627 articles were retrieved and downloaded into EndNote[8]. After the removal of duplicates, 1518 articles remained. RNAO researchers aim to complete title and abstract screening, full text review, data charting and publishing a journal article by spring 2023. Conclusion and Future Directions The objective of this scoping review is to summarize the evidence available on current AI technologies used by data systems containing aggregated nursing-specific data. These insights will assist in ensuring that RNAO’s data systems are up to date with the most current AI and ML techniques. Preliminary findings indicate that AI and ML has been applied to the fields of oncology, pediatrics, neurology, and the use of Big data in nursing and health care. Recent publications also discuss the use of AI and ML techniques in COVID-19-related research. These findings will be presented in a final manuscript, and will also contain opportunities for implication of the findings and gaps for further research. Funding This work is funded by the Government of Ontario. All work produced by RNAO is editorially independent from its funding source. Conflicts of Interest None declared References 1. Registered Nurses’ Association of Ontario. Best Practice Spotlight Organizations (BPSO) (2023). Source: https://rnao.ca/bpg/bpso 2. Registered Nurses’ Association of Ontario. Nursing & Compassionate Care in the Age of Artificial Intelligence: Engaging the Emerging Future (2020). Source: https://rnao.ca/sites/rnao-ca/files/RNAO-AMS_Report-Nursing_and_Compassionate_Care_in_the_Age_of_AI_Final_For_Media_Release_10.21.2020.pdf 3. Ahmad, S., Jenkins, M. Artificial intelligence for nursing practice and management: Current and potential research and education. CIN Plus, 40(3), 139-144, 2022. 4. Tricco, A.C., Lillie, E., Zarin, W., O'Brien, K.K., Colquhoun, H., Levac, D., et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018 Oct 02;169(7):467-473. https://doi.org/10.7326/M18-0850 5. Singla, S., Medeiros, C., Howitt, L., Burt, A., Nizum, N., Naik, S., & Grinspun, D. (2022, November 24). A Scoping Review on the Use of Artificial Intelligence Techniques in Nursing Data Systems. https://doi.org/10.17605/OSF.IO/ZP6CG 6. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology 2005 Feb;8(1):19-32. https://doi.org/10.1080/1364557032000119616 7. Levac D, Colquhoun H, O'Brien K. Scoping studies: advancing the methodology. Implement Sci 2010; 5:69. https://doi.org/10.1186/1748-5908-5-69 8. EndNote. Available: https://endnote.com/ 9. DistillerSR. Available: https://www.distillersr.com/

This is an undergraduate research project that will be submitted to the Department of Experimental Psychology at the University of Oxford. This secondary analysis will use longitudinal Co-SPACE data to look specifically at the changes in mental health symptoms of children and young people (CYP) with neurodevelopmental disorders (NDDs) (autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), or both) in the 2 major UK lockdowns during the COVID-19 pandemic. We will also include a control sample of age- and gender-matched children without an NDD and compare changes in their mental health symptoms to those of children with NDDs. We will look at the change in scores on the 3 subscales of the strength and difficulties questionnaire (SDQ) (emotional problems, conduct/behavioural problems, and hyperactivity/inattention) across 2 different time periods of 3 months: April, May and June 2020, and January, February and March 2021. The patterns for the 2 time periods will be compared to see if they are similar or different to one another. In addition, we will investigate the effects of specific diagnosis, age and gender on the direction and magnitude of change in mental health symptoms at both time periods. We will look at peer relationships as an extra predictor for CYP with NDDs only, in lockdown 1 only, as previous research suggests an association between quality of peer relationships and presence of NDDs, and between quality of peer relationships and mental health. The data on peer relationships does not exist for lockdown 2, hence why we will only analyse this for lockdown 1. The ongoing Co-SPACE study has already reported upon mental health trajectories for CYP without a NDD compared to those with an NDD and/or special educational needs (SEN), but they have not looked at CYP with NDDs exclusively (it has always been combined with SEN), and they have not looked at the influence of different predictor variables such as age and gender in the context of CYP with NDDs only. They have also not separated the effects of specific diagnoses or looked at the effect of comorbid ASD and ADHD diagnoses. Furthermore, in addition to Co-SPACE research, other papers from the UK and worldwide present a complicated and often contradictory picture of the effect of the pandemic on the mental health of CYP with NDs. Most research is cross-sectional, or has only looked at the first national lockdown, and few have looked at NDDs specifically. Some papers report a deterioration in the mental health of those with NDDs during the pandemic, and others an improvement. To complicate the picture further, there is evidence that individual mental health trajectories may differ widely based on a variety of variables, such as specific diagnosis, gender, and age. Hence, it is necessary for research to be done over a longer time period in the pandemic, focusing on looking at CYP with NDDs (without combining with SEN) in comparison to CYP without NDDs, and looking in the context of variables that may influence changes in mental health symptoms. Our secondary analyses will cover these gaps in the literature.

Objective: The objective of this scoping review is to identify and map the characteristics of adaptations to implementation frameworks for minority ethnic groups, to improve health equity. Introduction: Despite the potential of implementation science, critical gaps remain within the field to facilitate health equity, particularly for people from minority ethnic groups. Most of the existing implementation frameworks do not address issues of power, structural racism and inequality. In response to calls to the field to prioritise ethnic equity approaches, theoretical and empirical adaptations to implementation frameworks have been made to improve health equity for minority ethnic groups during implementation. These have not been mapped in one paper. Inclusion criteria: Participants are people from minority ethnic groups with a diagnosed or suspected health problem, symptoms of a health condition or seeking healthcare. The concept is papers describing, using, or evaluating implementation frameworks which have been adapted to improve health equity for people from minority ethnic groups. The context is any physical or mental health intervention or innovation, in any health system/setting, in middle-high income countries. Methods: Bibliographic searches of MEDLINE, Embase, PsycINFO and CINAHL will be conducted, spanning the period from 2004 to current. Following a pilot test, titles, abstracts and then full text will be screened in EndNote/Rayyan by one researcher according to predetermined criteria. At each stage of screening, 10% of references will be screened by a second researcher. Extracted data will be presented in multiple tables and will be analysed narratively.

In recent years, there have been numerous discussions regarding the training of health professionals in light of an increasingly demanding and difficult environment. The 2014 publication of new National Curriculum Guidelines for the Undergraduate Medical Course is an illustration of this concern. Article 26 of Resolution No. 03 of June 20, 2014, of the Ministry of Education, which establishes the National Curriculum Guidelines for undergraduate medical education, stipulates that the course should be centered on the student as the subject of learning and supported by the teacher as a facilitator and mediator of the process, with the goal of providing the student with a complete and adequate education. Article 29 stipulates, on the other hand, that the course must employ methodologies that encourage the active participation of the student in the construction of knowledge and in the integration of content, ensuring the inseparability of teaching, research, and extension, and promoting integration and interdisciplinarity in accordance with the curricular development axis. Resolution No. 3 of the CNE/CES, dated November 7, 2001, expresses a similar concern for fostering the student's critical-reflective reasoning to meet the current professional profile. Article 9 of the National Curricular Guidelines for Undergraduate Nursing Courses (DCNs) stipulates that the Undergraduate Nursing Course must have a pedagogical project that is collaboratively developed, centered on the student as the subject of learning, and supported by the teacher as a facilitator and mediator of the teaching-learning process. This pedagogical initiative should aim to provide students with a complete and adequate education by integrating teaching, research, and extension or assistance. The publication of these guidelines sparked numerous discussions regarding the efficacy of the teaching methods employed in undergraduate courses in medicine and nursing. In this scenario, the study of active methodologies as novel teaching strategies that can contribute to more effective training has been highlighted. Active methodologies emerged in the 1980s and propose a teaching-learning process in which students are encouraged to adopt an active and accountable stance in their learning process, seeking autonomy, self-regulation, and meaningful learning (MOTA, A.; WERNER DA ROSA, 2018). In a sense, these methodologies oppose traditional methods and techniques that emphasize the transmission of knowledge, with the instructor at the center of the process based on his clinical and academic experience. Traditional teaching models are characterized by the prevalence of expository classes, fragmented practices, and a high level of intellectual and affective dependence on the teacher (FIGUEIREDO et al., 1996). Currently, their efficacy and validity are being questioned for both approaches. In addition, although the use of Active Methodologies is gaining popularity, there are few high-quality studies on this topic, necessitating the need for more scientific evidence to guide pedagogical actions in undergraduate courses. This study will utilize Kirkpatrick's evaluation model as a foundation for a comprehensive evaluation of the efficacy of active learning methodologies for undergraduate students in Medicine and Nursing. Kirkpatrick's model, which consists of four levels of evaluation—reaction, learning, behavior, and outcomes - will provide a solid framework for evaluating the impact of these methodologies on students' academic performance and their application to professional practice following the conclusion of the courses. OBJECTIVE Active methodologies have been widely cited in the last decade; however, the effectiveness of this teaching method is still much debated. The objective of this research is to comprehensively and systematically analyze the effectiveness of active methodologies on the performance of students enrolled in undergraduate courses in Medicine and Nursing, using Kirkpatrick's evaluation model as a basis. Through this research, we intend to identify the most relevant and up-to-date evidence on the impact of active methodologies on students' academic performance, classifying the results according to Kirkpatrick's four levels of evaluation: Reaction: Evaluate students' satisfaction with the use of active methodologies in the teaching of Medicine and Nursing, analyzing their feedback and perceptions about the learning process. Learning: To investigate the knowledge acquired and skills developed by students under the application of active methodologies, measuring the acquisition of specific competences. Behavior: Analyze the transfer of learning to the clinical environment and professional practice, verifying if the knowledge and skills obtained are effectively applied in the real-world work context. Outcomes: To examine students' academic and professional outcomes, including performance in assessments, exam pass rate, and career success after graduation in Medicine and Nursing. In addition, this research seeks to provide evidence-based recommendations and guidance for educators and higher education institutions in order to facilitate the choice and effective implementation of active methodologies, aiming to enhance the quality of teaching and academic success of Medicine and Nursing students. Type of Study Overview of a Systematic Review SEARCH The following databases were chosen to be searched: Cochrane Library, MEDLINE via PubMed, EMBASE via Elsevier, VHL Regional Portal, and ERIC. The search terms to be used were: "Medical Graduation", "Nursing Graduation", "Learning", "Active Methodologies" and "Systematic Reviews". PARTICIPANTS Studies that include undergraduate medical and nursing students of both genders, all ages, races, and cultures will be included. INCLUSION CRITERIA This Overview will include Systematic Reviews (with or without meta-analysis), which, in addition to comparing active and traditional methodologies, have included studies that used valid learning assessment instruments. EXCLUSION CRITERIA Systematic Reviews that analyze studies comparing active methodologies with each other. Scope reviews, narrative reviews, overviews, primary studies, editorials, letters, and conference papers INTERVENTION We will include systematic reviews that address the use of active methodologies compared to traditional methodologies in the learning process in undergraduate courses in nursing and medicine, analyzing the evidence of the effectiveness of this method. CONDITION OR DOMAIN BEING STUDIED OUTCOMES Assessment of the acquisition of knowledge, skills, and attitudes (level 2 of the Kirkpatrick assessment instrument will be hierarchically prioritized, but in its absence, other instruments that assess the same outcomes will be accepted). The Kirkpatrick Model of Effectiveness Assessment is traditionally applied in corporate training programs but is also used in other courses due to its relevance among theorists and researchers of the subject. This model consists of four levels of evaluation: reaction, learning, behavior, and outcome. By analyzing level 2, we will find concrete data on students' learning and on the effectiveness of the teaching offered at graduation. As secondary outcomes, long-term knowledge retention and student engagement will be assessed. DATA EXTRACTION (SELECTION AND CODING) Study selection: First, two authors (M and MESP) will independently screen titles and abstracts using Qatar Computing Research Institute's Rayyan web application (doi: 10.1186/s13643-016-0384-4). Each reference will be reviewed by at least two authors. As training, at the beginning of this phase, 5% of the articles were screened independently by the authors, who resolved disagreements through a consensus-based discussion before continuing with the screening of the remaining articles. After title and abstract screening, the two authors (M and MESP) will independently apply the inclusion and exclusion criteria to the selected full texts. Each article will be judged by at least two authors. At this stage, decisions will be tracked using Excel spreadsheets. Reasons for exclusion will be documented. At each stage, researchers will be anonymous about each other's decisions, and consensus-based discussions will be used to resolve disagreements. Data extraction: Data extraction will be performed in Excel spreadsheets. Mainly, authors will extract: Author and year of publication, country or region Objectives of the systematic review -Methodologies involved -Target population -Dates of Search -Archives searched Number of studies included in each review -Continents of studies included in each review Design of studies included in each review -Years of studies included in each review Participants of studies included in each review -Determinants for method adoption Any other valuable comments or reflections For each article, at least one author will extract the data, and at least one other author will check the extracted data. Disagreements will be resolved through a consensus-based discussion. If the systematic review does not provide a summary of results regarding methods, the primary studies identified in the review will be read to extract and summarize the data. In this case, only primary studies referring exclusively to the population to be studied (undergraduate students) will be considered. RISK OF BIAS (QUALITY) ASSESSMENT To assess the study quality of systematic reviews, the authors will use AMSTAR 2 (Shea et al., 2017). For each paper, at least one author will do the assessment, and at least one other author will do the checking. Disagreements will be resolved through a consensus based discussion. Strategy for Data Synthesis The authors will carry out a narrative synthesis of the determinants of learning for active and traditional methods compared. In addition, the extracted data will be presented in one or more Summary of Findings tables. Outcome data will be pooled across reviews by removing studies that are duplicated across reviews. If pooling is possible, outcome data will be summarized in meta-analyses using the inverse variance method or inverse generic variance with a random effects model. If it is not possible to pool data between reviews, data will be displayed individually in the same graph for comparison between studies. SUBGROUP OR SUBSET ANALYSIS In the presence of heterogeneity, the following subgroups will be investigated: type of course (medicine or nursing), time of use of teaching methodology, and type of teaching methodology employed. REFERENCES Brasil. Ministério da Educação. Conselho Nacional de Educação. Câmara de Educação Superior. Resolução Nº. 3 de 20 de junho de 2014. Institui diretrizes curriculares nacionais do curso de graduação em Medicina e dá outras providências. Diário Oficial da União, Brasília, 23 jun. 2014. Brasil. Ministério da Educação. Conselho Nacional de Educação. Câmara de Educação Superior. Resolução CNE/CES nº. 3, de 7/11/2001. Institui Diretrizes curriculares nacionais do curso de graduação em enfermagem. Diário Oficial da união 09 nov 2001;Seção 1. Figueiredo JFC, Rodrigues MLV, Cianflone ARL, Colares MFA. Contribuição de diferentes atividades para o processo de aprendizagem, na percepção de alunos de medicina. Medicina (Ribeirão Preto) 1996 Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editores). Manual Cochrane para revisões sistemáticas de intervenções versão 6.3 (atualizado em fevereiro de 2022). Cochrane, 2022. Disponível em www.training.cochrane.org/handbook. Kirkpatrick DL, Kirkpatrick JD. Como avaliar programas de treinamento de equipes: os quatro níveis. 1ª ed. José Henrique Lamensdorf, tradutor. Rio de Janeiro: Senac; 2010 MOTA, A.; WERNER DA ROSA, C. Ensaio sobre metodologias ativas: reflexões e propostas. Revista Espaço Pedagógico, v. 25, n. 2, p. 261-276, 28 maio 2018.

Objective: To identify and map the airway clearance techniques (ACTs) used for people with chronic obstructive pulmonary disease (COPD) and the factors that affect clinical decision making worldwide. Introduction: People with COPD commonly experience mucus hypersecretion and sputum retention, which contributes to an increase in their respiratory symptoms and the risk of exacerbations. Managing sputum is thus a main concern in this population. However, the use of ACTs in people with COPD in different healthcare settings and stages of the disease is still uncertain. The factors that influence clinical choices on selecting specific ACTs are also unclear. Inclusion criteria: This scoping review will include original research and grey literature that explore the use of ACTs for people with chronic respiratory diseases, in any healthcare context. Methods: The review will be conducted following the Joanna Briggs Institute (JBI) methodology for scoping reviews. Searches will be conducted in databases of peer-reviewed publications and grey literature. Search results will be exported to Covidence for title, abstract, and full-text screening. Studies published in English, Portuguese, Danish, Norwegian, Swedish, Spanish, French, or Greek will be considered. Data will be extracted using a pilot-tested template, and findings will be presented using a narrative summary and supplemented by figures or tables. Keywords: sputum, chronic obstructive pulmonary disease, hypersecretion, airway clearance, chest physiotherapy Introduction Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by restriction of airflow and breathing problems (1). The estimated global prevalence of COPD is greater than 10%, affecting more than 384 million people worldwide (2). COPD is associated with high morbidity, mortality, and healthcare costs, which will only increase as the world population grows older (1). COPD is considered the third leading cause of death worldwide, causing 3.23 million deaths in 20193. The management of bronchial secretion is one of the main problems encountered in COPD (4,5). People with COPD commonly experience mucus hypersecretion and sputum retention, which contributes to an increase in breathing problems and a higher risk of exacerbations6. The term airway clearance technique (ACT) refers to various strategies used to eliminate excess secretion from the airways. A wide range of techniques has been developed and are used for airway clearance in people with COPD, such as techniques that patients can practice independently or with assistance or by using devices (7-9). However, there is uncertainty about the effectiveness of these techniques, and which technique is used may differ according to the healthcare professional and patient preferences, country of use, and healthcare setting (10). In preparation for this scoping review protocol, an initial search of the literature was conducted in Prospero, Embase, Medline, Cochrane Database of Systematic Reviews, and Joanna Briggs Institute (JBI) Evidence Synthesis. No previous or ongoing scoping review on ACTs for people with COPD was identified, though we did identify a few systematic reviews (11-16). However, these reviews were published between 2000-2013 and therefore did not include recent evidence. Only two newer systematic reviews were identified (17,18). The main objective of these systematic reviews was to evaluate the effect of ACTs for people with COPD and therefore only included randomized controlled trials, which limits the identification of different techniques and mapping of the ACTs used in real-life settings. In order to support healthcare professionals in choosing optimal techniques for airway clearance and lay a foundation for the development of future clinical recommendations, we need a full understanding of all available ACTs for people with COPD. The main objective of this scoping review is to identify and map ACTs used for people with COPD within any healthcare or research context. The secondary objectives are to 1) systematically map the local recommendations and current guidelines for the use of ACTs for people with COPD; 2) map ACTs used for people with COPD per country, stage of the COPD (i.e., stable vs. acute), and healthcare context (i.e., hospital, home or community); and 3) explore the factors that are included in the choice of the appropriate ACT in clinical practice and research. Review Questions What ACTs are used for people with COPD? How do we decide which ACT to use? Secondary research questions: 1) What are the recommendations of current guidelines and local guidance, for the use of ACTs in people with COPD? 2) What is the distribution of ACTs used per country, COPD stage (i.e., stable vs. acute), and healthcare setting (i.e., inpatient vs. outpatient at home vs. outpatient in the community)? 3) What do clinicians or researchers take into account when they decide which ACT to use? Inclusion criteria Participants This review will consider studies describing the use of ACTs with the goal of improving the airway clearance of adults (≥18 years old) with a diagnosis of COPD, including those with stable COPD or exacerbations of COPD. People admitted to an intensive care unit due to severe acute exacerbation of COPD will be excluded. Studies including participants with additional respiratory diagnoses will not be excluded unless COPD is not the main condition. It will also consider audits and surveys that investigate the use of ACTs in these patients and the factors that influence clinical decision making for their selection. Concept This review will examine studies that investigate the concept of ACTs, which refer to a variety of strategies aimed at promoting the mobilization and removal of secretions from the airways. Specifically, this scoping review will focus on techniques developed to enhance airway clearance and alleviate symptoms associated with sputum. Techniques with different primary objectives, including exercise, respiratory muscle training, breathing pattern retraining techniques, and non-invasive ventilation (NIV), will be excluded from this review. Cough maneuvers, which are a physiological mechanism for expectorating sputum, will not be considered as an individual ACT, as they are frequently used as a control treatment arm in trials. Additionally, humidification and pharmacological approaches, such as mucoactive agents, will be excluded. Context This review will encompass studies that examine the delivery of ACTs in both institutional and non-institutional settings, i.e., homes and communities, to ensure a comprehensive scope. Examples of relevant contexts may include hospital inpatient services, outpatient clinics, community services, or home-care settings. The studies included in this review will not be restricted based on the location of the sample, cultural background, race, or date of publication. Types of sources This scoping review will consider quantitative, qualitative, and mixed-methods study designs, as well as clinical practice guidelines, systematic reviews, audits, and surveys on the use of ACTs for inclusion. If systematic reviews meet the inclusion criteria during the title and abstract screening, the individual studies included in the review will be screened for eligibility. Only systematic reviews that report findings for the role of ACTs in people with COPD will be included in data extraction. Conference abstracts will not be included. In addition, grey literature will be searched at Global Initiative for Chronic Obstructive Lung Disease (GOLD) and physiotherapy association websites of the United Kingdom, Portugal, Denmark, Norway, Sweden, Greece, Spain, Belgium, France, Australia, Canada, and the United States, position statements and other practice guidance related to ACTs. Methods The scoping review will be conducted in accordance with the JBI methodology for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) extension for scoping reviews (19,20). The protocol will be registered with the Open Science Framework (OSF) from the Center for Open Science prior to title and abstract screening, to improve research transparency and reduce the risk of bias. Search strategy The research team collaboratively developed the search strategy for this scoping review and worked with a university librarian to locate both published and unpublished primary studies, reviews, clinical practice guidelines, audits, and surveys related to the use of ACTs and their decision-making. An initial limited search of the JBI Evidence-Based Practice Database and Pubmed was conducted to identify relevant articles, using free text words, keywords, and Medical Subject Heading (MeSH) terms found in article titles and abstracts. The search strategy will be validated with 4 articles that would fit the review eligibility criteria and that were identified a priori by the research team. Then, the full search strategy will be adapted for each included information source, and four databases will be searched: Medline via Pubmed (1946 to 2023), Embase via Elsevier (1974 to 2023), Cinahl via EBSCOHost (1937-2023), and Scopus via Elsevier. The Cochrane database (1995-2021) will also be searched for healthcare interventions and practice guidelines (see Appendix I for a complete description of the Medline database search strategy). Ongoing studies will be identified by searches in the Clinical Trials gov and the International Clinical Trials Registry Platform (ICTRP). A combination of subject headings and keywords will be used to search titles and abstracts in the selected databases. In addition, references of relevant articles will be hand-searched to expand the search. Grey literature will also be searched from the most recent report from the Global Initiative for Chronic Obstructive Lung Disease and national and international physiotherapy association websites of the United Kingdom, Portugal, Denmark, Norway, Sweden, Greece, Spain, Belgium, France, Australia, Canada, and the United States, as well as for position statements and other practice guidance related to ACTs. Literature included in the review may be published in English, Portuguese, Danish, Norwegian, Swedish, Spanish, French, or Greek but must have an English abstract for screening purposes. Study/Source of evidence selection Following the search, all identified records will be collated and imported into Covidence (Veritas Health Innovation, Melbourne, Australia) where duplicates will be removed. The remaining studies will remain in Covidence for abstract and full-text screening. To ensure understanding of eligibility criteria and resolve any disagreements, a pilot test with 25 articles will be conducted by the research team. A 75% or more agreement will be sought before proceeding with screening (21). Then, two independent reviewers will assess the titles and abstracts against the inclusion criteria and the citations that meet the criteria will undergo full-text analysis. In each screening phase, citations achieving agreement for inclusion by the independent reviewers will be included. Disagreements between reviewers will be resolved through discussion or with another reviewer. The exclusion of papers that do not meet the inclusion criteria will be recorded and reported. The results of the search will be reported in a PRISMA-ScR flow diagram in the final scoping review (22). Data extraction At least two independent reviewers will extract data from the papers included in the scoping review using a data extraction tool adapted from Peters et al (21). The tool will address the review objectives and study design type. The extracted data will include specific details describing the population, concept, context, methods, and key findings relevant to the scoping review questions. The draft data extraction tool provided in Appendix II will be modified and revised as necessary during the process of extracting data from each included paper. Modifications will be detailed in the full scoping review. To ensure consistency of extraction and to identify any need to refine the data extraction tool, both reviewers will extract data from the first three references. Any disagreements between the reviewers will be resolved through discussion or with another reviewer. Data analysis and presentation The extracted data will be reported in a narrative summary providing the answer to our research questions, and key findings will be presented in a table within the manuscript. We will also illustrate themes and their relationships in an infographic or schematic. Discussion This is the first scoping review that will identify and map ACTs used for people with COPD worldwide and the relevant decision-making factors. By exploring a broad range of literature with the inclusion of original studies, audits and surveys on techniques, and recommendations from international societies, this scoping review will provide a comprehensive overview of all available ACTs in this population. In addition, this scoping review will map the factors influencing the decision-making process within any healthcare or research context. Since airway clearance is one of the main problems encountered in COPD, the results of this scoping review will be of interest to all healthcare professionals and policymakers involved in the management of COPD. The findings of this scoping review will allow these stakeholders to get a better understanding of the scope of ACTs for people with COPD within different population- and healthcare settings. In doing so, this scoping review will provide a foundation for the development of future international clinical guidelines, support healthcare professionals in choosing optimal ACTs and ensure that people with COPD receive the most appropriate care. References 1. Agustí A, Vogelmeier C, Faner R. COPD 2020: changes and challenges. American Journal of Physiology-Lung Cellular and Molecular Physiology. 2020; 319(5):L879-L83. 2. Adeloye D, Chua S, Lee C, Basquill C, Papana A, Theodoratou E, et al. Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J Glob Health. 2015; 5(2):020415. 3. Chronic obstructive pulmonary disease (COPD). World Health Organization (WHO). URL https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd). Accessed 07.04.2023. 4. Tian PW, Wen FQ. Clinical significance of airway mucus hypersecretion in chronic obstructive pulmonary disease. J Transl Int Med. 2015; 3(3):89-92. 5. Rogers DF. The Role of Airway Secretions in COPD: Pathophysiology, Epidemiology and Pharmacotherapeutic Options. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2005; 2(3):341-53. 6. Belli S, Prince I, Savio G, Paracchini E, Cattaneo D, Bianchi M, et al. Airway Clearance Techniques: The Right Choice for the Right Patient. Front Med (Lausanne). 2021; 8:544826. 7. Pakpahan R, Tarigan AP. The Effect of the Combination of Chest Physiotherapy and Active Cycle Breathing Technique on Respiratory Rate and Ability to Expend Sputum in Chronic Exacerbation Obstructive Lung Disease Patients at Haji Adam Malik Hospital Medan. European Journal of Molecular & Clinical Medicine. 2021; 8(3):616-23. 8. Shen M, Li Y, Ding X, Xu L, Li F, Lin H. Effect of active cycle of breathing techniques in patients with chronic obstructive pulmonary disease: a systematic review of intervention. Eur J Phys Rehabil Med. 2020; 56(5):625-32. 9. Saeed MA, Ruth Emily B, Abdullah SSA, Ali MA, Winston ASB, Michael IP, et al. Use of oscillatory positive expiratory pressure (OPEP) devices to augment sputum clearance in COPD: a systematic review and meta-analysis. Thorax. 2020; 75(10):855. 10. Bhowmik A, Chahal K, Austin G, Chakravorty I. Improving mucociliary clearance in chronic obstructive pulmonary disease. Respiratory Medicine. 2009; 103(4):496-502. 11. Ides K, Vissers D, De Backer L, Leemans G, De Backer W. Airway Clearance in COPD: Need for a Breath of Fresh Air? A Systematic Review. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2011; 8(3):196-205. 12. Osadnik CR, McDonald CF, Jones AP, Holland AE. Airway clearance techniques for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012; (3):Cd008328. 13. Hill K, Patman S, Brooks D. Effect of airway clearance techniques in patients experiencing an acute exacerbation of chronic obstructive pulmonary disease: a systematic review. Chron Respir Dis. 2010; 7(1):9-17. 14. Jones AP, Rowe BH. Bronchopulmonary hygiene physical therapy for chronic obstructive pulmonary disease and bronchiectasis. Cochrane Database Syst Rev. 2000; (2):Cd000045. 15. Tang CY, Taylor NF, Blackstock FC. Chest physiotherapy for patients admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease (COPD): a systematic review. Physiotherapy. 2010; 96(1):1-13. 16. Andrews J, Sathe NA, Krishnaswami S, McPheeters ML. Nonpharmacologic airway clearance techniques in hospitalized patients: a systematic review. Respir Care. 2013; 58(12):2160-86. 17. Dobler CC, Morrow AS, Farah MH, Beuschel B, Majzoub AM, Wilson ME, et al. Nonpharmacologic Therapies in Patients With Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review With Meta-Analysis. Mayo Clinic proceedings. 2020; 95(6):1169-83. 18. Daynes E, Jones AW, Greening NJ, Singh SJ. The Use of Airway Clearance Devices in the Management of Chronic Obstructive Pulmonary Disease. A Systematic Review and Meta-analysis of Randomized Controlled Trials. Ann Am Thorac Soc. 2021; 18(2):308-20. 19. Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020. Available from https://synthesismanual.jbi.global. 20. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021; 372:n71. 21. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. 22. Tricco A, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine. 2018; 169. Appendix I: Search strategy Medline via PubMed: Searched April 26th, 2023 #1 Pulmonary Disease, Chronic Obstructive[Mesh] OR “Chronic Obstructive Lung Disease*” OR “Chronic Obstructive Pulmonary Disease*” OR “Chronic Obstructive Airway Disease*” OR “COPD” OR “COAD” OR “Chronic Airflow Obstruction*” OR “emphysema” or “bronchitis” 150,630 records retrieved #“physiotherap*” OR “physical therap*” OR “airway* clearance” OR “sputum clearance” OR “mucus clearance” OR “lung clearance” OR “tracheobronchial clearance” OR “mucociliary clearance” OR “sputum clearence” OR “bronchopulmonary hygiene” OR “pulmonary hygiene” OR “lung hygiene” OR “oscilat*” OR “PEP” OR “positive expiratory pressure” OR “Flutter” OR “Acapella” OR “Cornet” OR “Quake” OR “Aerobika” OR “Threshold” OR “TheraPEP” OR “intermittent positive pressure breathing” OR “IPPB” OR “IPV” OR “intrapulmonay percussive ventilation” OR “HFCWO” OR “High Frequency Chest Wall Oscillation” OR “autogenic drainage” OR “ELTGOL” OR “slow expiration with glottis opened in lateral posture” OR “Expiration Lente Totale Glotte Ouverte” OR “ACBT” OR “active cycle*” OR “postural drainage” OR “gravity-assisted drainage” OR “percussion” OR “clapping” OR “vibration” OR “shaker” OR “shaking” OR “Physical Therapy Modalities” OR “AFE” OR “simeox” 555,225 records retrieved #3 #1 AND #2 5,474 records retrived

This paper is a comprehensive study that looks into the impact of dynamic informed consent on patient data privacy, ownership, trust, and willingness to disclose. The study includes a systematic review of existing literature to identify and evaluate relevant studies that have been published on the topic. The review process is thorough and systematic, with pre-determined inclusion and exclusion criteria used to ensure that only high-quality studies are included in the review. The study's findings indicate that dynamic informed consent has a significant effect on patient data privacy, ownership, trust, and willingness to disclose. Dynamic informed consent, in particular, was found to increase patient trust and willingness to disclose personal health information. Furthermore, dynamic informed consent improves patient understanding of their data privacy rights and ownership, according to the study. The paper provides useful information about the potential benefits of dynamic informed consent for patients and healthcare providers. The study emphasizes the significance of utilizing dynamic informed consent in healthcare settings to improve patient data privacy, ownership, trust, and willingness to disclose. Overall, the paper adds to the growing body of literature on the application of dynamic informed consent in healthcare.

Suicide is a leading cause of death among females of reproductive age, with a 5.5-7.4% mortality rate between the ages of 15-44 years (National Center for Health Statistics (U.S.), 2022). A 2006 review paper indicated that individuals are more likely to make a suicide attempt the week before the onset of menses and the week of menses onset (Saunders & Hawton, 2006). Albeit comparisons between groups, a post-mortem study of females indicated that 54.46% of females who died by suicide were menstruating at the time of death, compared to the 6.75% of females who died by other causes of death (Dogra et al., 2007). In another study, researchers indicated reproductive females in states of low estrogen and low progesterone (menstrual phase, amenorrhea, and menopause) were more likely to have increased suicide intent, and specifically in an emergency room setting reproductive females were more likely to make an attempt during their menstrual week (Baca-Garcia et al., 2010). A recent paper indicated that 34% of individuals with PMDD have a lifetime history of suicide attempts, indicating a relationship between individuals who experience this predisposition to emotional hormone sensitivity are at risk for a suicide attempt (Eisenlohr-Moul et al., 2022). Despite evidence for large individual differences in emotional hormone sensitivity, there are no studies prospectively exploring whether greater emotional hormone sensitivity is linked to suicide attempt history. Given the cross-sectional data suggesting greater suicide attempt risk in the weeks surrounding menses, the present study aims to examine whether there is a correlation between degree of cyclical mood change (i.e., emotional hormone sensitivity) and previous lifetime suicide attempt (vs. ideation only) in females. If this association is observed, it would suggest that emotional reactivity to the menstrual cycle serves as a risk factor for not only suicidal ideation, but also suicide attempt, and would support further research aimed at identifying the causes of (and potential treatments for) these emotional symptom changes as a method of suicide prevention.

The current study is the primary paper resulting from the Love Together, Parent Together project. Study components (method, procedures, comprehensive measurement) can be found on the project page. In short, participants completed baseline assessments, at which point they were randomized to L2P2 vs. waitlist control. All participants completed three writing sessions (once every 4 weeks) which included brief surveys and a written summary of a recent conflict (and for the intervention group, the L2P2 program), followed by 1-week post-intervention, 1-month follow up, and 3-month follow up surveys. The current paper will present on the two-arm (treatment vs. waitlist) pilot RCT assessing the primary feasibility and secondary clinical objectives. Primary feasibility goals: steady enrolment rates; recruitment of a diverse sample in terms of sociocultural identity factors, and in the mild-moderate risk range as it relates to pandemic-related stress, and relationship distress; retention, adherence, and uptake; and program acceptability. Secondary clinical goals include a preliminary evaluation of treatment effects by examining group differences in the primary outcome to be used in a future main RCT (specifically, couples' relationship quality).

Stroboscopic visual training has carried out a series of tests in many aspects, such as attention, visual sensitivity, predictive time ability, visual motor response speed, visual memory and so on. However, the improvement boundary of stroboscopic vision training is not clear yet.Therefore, this paper provides a systematic review of the relevant literature on the impact of visual cognitive function after stroboscopic visual training. The purpose of this paper is to further clarify the mechanism of stroboscopic visual training, and to provide a theoretical basis for its application in sports training.

Trauma is the leading cause of pediatric mortality, potential years of life lost, and a significant medical cost in the developed world. (1,2) In addition, children have a higher incidence of mortality compared with adults. Mortality in children with traumatic hemorrhagic shock is 50% compared to 20-25% reported in adults. (3,4) Estimates indicate that there are 1,000 preventable traumatic deaths after injury in children per year in the US due to inadequate or delayed care. Recent retrospective and prospective observational studies indicate that resuscitation practices (appropriate blood product ratios and tranexamic acid (TXA) use) can dramatically reduce mortality in children with traumatic hemorrhagic shock. (5,6) Due to these alarming statistics, resuscitation and hemostatic strategies are a key target for standardization and subsequent investigation. However, clinical trial design surrounding this topic would be very difficult due to not only the lack of standardization in resuscitation approaches, transfusion strategies, utilization of hemostatic monitoring and adjuncts, but also the lack of agreed upon critical definitions and common data elements for study. To address these challenges, we organized a multidisciplinary team of highly engaged international experts and key stakeholders to develop consensus statements on best practice based on the current literature, consensus statements on research priorities, and methods of dissemination and implementation of the conference proceedings. Consensus statements will be developed via a highly structured process to include using the Delphi Method. A panel of 21 international experts (USA, Canada, Europe, Israel) that represent trauma surgery, transfusion medicine/hematology, anesthesia, critical care, and emergency medicine will form the consensus committee. The conference will also lead to the generation of a multidisciplinary research network focused on improving outcomes for children with traumatic hemorrhagic shock. Aim 1: Review the current state of the art for the management of pediatric traumatic hemorrhagic shock. To achieve this aim, one full day of lectures will be used to review and discuss in detail current knowledge in the biology of traumatic hemorrhagic shock, methods to monitor shock and its consequences, hemorrhage control methods, and resuscitation practice patterns and outcomes in this population. Lectures will also include the importance of collecting common data elements, structure of a pediatric trauma resuscitation research network, and the Delphi Method for consensus statement generation. Aim 2: Develop evidence-based informed consensus statements for the management of pediatric traumatic hemorrhagic shock. To achieve this aim, we will use the Delphi Method process to create consensus recommendations for best practices for the management of pediatric traumatic hemorrhagic shock. Specific topics for discussion will include the use of tourniquets, prehospital blood use, transfusion and hemostatic adjunct strategies, hemostasis monitoring, airway and blood pressure management. Aim 3: Develop a consensus statement on research priorities. To achieve this aim, consensus statements will be developed that describe the mission and goals for a pediatric trauma resuscitation research network. Consensus statements will also be generated on specific research topics that need to be prioritized for the development of clinical trials. Recognizing the paucity of literature on many important topics in pediatric traumatic shock resuscitation, current knowledge gaps and research priorities in this population will be identified that will be critical to improving patient care. Aim 4: Develop a robust dissemination and implementation methods for consensus statements generated and for the results of future trials. To achieve this aim, we will collaborate with experts in the field of dissemination and implementation to develop methods that are optimal for the pediatric trauma community. Methods will include publishing a supplement in Pediatric Critical Care that summarizes the conference proceedings. Other methods such as the development of decision support tools, and the use of video conferencing and social media venues will be explored. The use of the dissemination and implementation tools established during the conference will be incorporated by the newly formed pediatric trauma resuscitation research network to change practice based on the evidence it generates. This network will begin multi-institutional collaboration to study generated research questions and maintain its framework and momentum with regular conference calls and yearly meetings. Consensus Methods: A “medical consensus” is a public statement on a particular aspect of medical knowledge that is generally agreed upon as an evidence-based, state-of-the art knowledge by a representative group of experts in that area. (20) A specific method to commonly used to establish consensus is the Delphi Method. To begin the process of developing consensus, the planning committee has agreed upon important topics (listed in agenda) that the consensus committee will discuss with the goal of generating consensus statements. Lectures during day 1 of the conference will cover these topics in detail to inform the discussion within the consensus committee. In addition, the planning committee will collect the current literature on consensus topics in a systematic approach and share as a pre-meeting packet to the consensus committee for review at least one month prior to this meeting. Members of the planning committee will perform scoping and systematic reviews with formal guidance from library science experts (UAB Library Services). Searches for all literature pertinent to the consensus statements, will use a Boolean approach that will take into account the keywords in the PICOS domains (21, 22): P (population), I (intervention), C (comparator), O (outcome), S (study design). In each instance, the librarian will search at least in PubMed, Medline and the Cochrane Library. Thereafter, two members of the consensus committee will independently select relevant papers through Covidence software. Retained papers will be used to write the first draft of one or multiple summaries and a first draft of recommendation(s) for the topics by the primary lecturer on the topic, using the GRADE methodology. (23-27) Although we will not be publishing formal systematic reviews, identical search methods and methodology to select the relevant literature will be carried out to provide the most relevant, current literature on which to base our consensus statements and discussion. The consensus statement development will be initially drafted by the faculty lecturer on the topic and will then be voted on by all members of the consensus committee utilizing the RAND/UCLA Appropriateness Methodology, a method developed to combine the best available scientific evidence with the collective judgement of the experts. All experts rate the consensus statement on a Likert scale (1=disagreement, 9=strong agreement). The highest and lowest scores are discarded followed by calculation of the median and range. The median value determines how the recommendation is categorized: agreement (median=7-9), equipoise (median=4-6), or disagreement (median=1-3). The range (remaining lowest and highest values) determines if the recommendation is “strong” or “weak.” (28) If there is not agreement, those not in agreement can aid discussion to amend statement to facilitate agreement until voting can occur on the adjusted statement. If there is not consensus after three votes, the faculty lecturer will moderate discussion to develop changes from audience feedback to attempt to gain consensus. If after 5 total cycles of voting, there is no consensus, we will publish consensus could not be obtained. Two hours will be allotted for each topic.

A proof-of-concept training study of the effect of corporal control on cognitive function using the Geography of Corporal Consciousness (GEOCOCO) Method. ___ What role does the body play in cognition? What tools does the body give us to think? How does the specific way in which we use our body to relate with the space around us shape our cognitive abilities? Research has shown that cognitive and motor function in human beings is interrelated. This association can be understood evolutionarily in the context of bipedalism, where the human being’s upright posture and its requirement of complex and sophisticated movement served as a basis for the evolution of the neocortex. For example, Leisman et al. suggest that human postural muscles were the main conduit for motor and cognitive binding (1). From an ontogenetic perspective, there is evidence that delays in achieving motor developmental milestones impact cognitive function in children (2,3) and adolescents (4) especially in visuospatial working memory, and executive functions like inhibition and switching. Diamond (2000) also showed an interrelation and coactivation of the cerebellum and prefrontal cortex in both cognitive and motor functions (5). In both children (6) and adults (7) there is some evidence that physical aerobic activity for as little as 15 minutes can improve the brain’s plasticity and lead to better cognitive performance (though see Ciria et al., 2023 (8)). There is also extensive research on gesture, language, and cognition (9,10) suggesting that gesture was the primary modality for language evolution (11), and that it can shape and structure thought with performance on cognitive tasks becoming poorer when participants were not allowed to gesture (12). The discovery of mirror neurons and the human mirror neuron system, that are engaged whilst performing an action as well as when seeing another individual performing that same action (13), suggest that action may be the way we understand other humans and learn by imitation. Motivated by these phenomena, the Embodied Cognition approach suggests that cognitive processes cannot be separated from the body and the wider world in which they function. Embodied Cognition offers that the body has three functions with regard to cognition (14). The first is to act as a constraint, whereby bodily characteristics can aid or limit cognition. The second is as a distributor, where the body is seen as sharing the load of cognitive functions and cognitive systems are seen to include non-neural parts of the body (non-brain) and beyond-the-body environment as well. The third function of the body is to act as a regulator ensuring that cognition and action are coordinated in space and time (14). Following both the body as a distributor and body as a regulator proposals, the present study examines the cognitive consequences of learning to execute a particular motor act (to carry out a free-hand drawing task), when learning requires precise awareness of the body and its movement in relation to its surroundings during that motor act. Through a test –– training –– post-test design using the Geography of Corporal Consciousness (GEOCOCO) Method, we study this specific aspect of corporal consciousness and its effect on cognitive function, which has not been studied extensively by the existing literature, especially in the neurotypical adult population. GEOCOCO is a method developed with the intention of working on motor skills through corporally gestated drawings which involves the freehand execution of straight and curved lines on paper. The method was developed by Mr. Jaime Refoyo who then collaborated with Dr. Jaume Guilera, a doctor who suggested that patients with motor coordination difficulties could benefit from exercises based specifically on this methodology. Their study of the execution of GEOCOCO lines in the context of existing literature in the field of motor and cognitive processes indicated that the execution of said lines requires attention, fine and gross motor skills, response inhibition, estimation of time and space, motor pattern sequencing, visuospatial analysis and memory, metacognition, and awareness of the body’s position in space. For example, in order to execute a single line freehand, a GEOCOCO student has to simultaneously attend to roughly 20 inputs such as the specific position, orientation and pressure of different parts of the body towards the body itself and in space, the weight in each point of contact of the body with the table or floor, the grip of the pencil, the force executed while moving the pencil against the paper, the speed and rhythm of movement, and others. Thus executing a straight line in GEOCOCO requires one’s full attention and it is impossible to carry out any other task simultaneously or even to think about anything other than the correct execution of the line by aligning the body, pencil, paper and the space around as the technique requires. Studies using dual-task paradigms offer evidence suggesting that there are significant attentional demands for postural control (15) and that postural control employs visual-spatial processing (16). In the case of GEOCOCO, this attentional load also inhibits mechanisms that would divert attention away from the execution of the present line, including other lines already drawn on the paper. Drawing the line necessitates an implementation of a specific and precise motor sequence in which the timing of the action is equally important. Mr. J. Refoyo and Dr. Guilera used the method earlier to work individually with an autistic child and with a child with Attention Deficit Hyperactivity Disorder (ADHD) over a period of two years with positive results. Anecdotal evidence of their work suggested that both children performed better on a visuospatial memory task –– the Rey-Osterrieth Complex Figure Drawing Test –– at the end of the training. There was also anecdotal evidence for transfer of learning to other motor skills and tasks. For example, the parent of one child reported that her son was able to independently tie his own shoelaces one day, which he had never been able to do before. Based on Refoyo’s previous work with the GEOCOCO method, the theoretical basis of its practice (detailed below), and its unique requirement of motor consciousness, this study is a first attempt at a formal study of the effect of receiving a GEOCOCO training on performance on a variety of cognitive control and perceptual abilities in the neurotypical adult population – specifically, attention, visuospatial orientation, proprioception, and visuospatial memory. Three types of stimuli are used in the work done in GEOCOCO – verbal (spoken instructions regarding the correct execution of lines), spatial (geometrical problems arising during the execution of the exercises) and object (how to hold the pencil, how to position the body in relation to the table and the floor). The three stimuli are combined for the correct execution of tasks done in GEOCOCO. If the goal of GEOCOCO is executing a perfectly straight line freehand for example, what is unique about the method is that the line drawn is only possible through the precise coordination of body parts that allows for the execution of a movement that results in the line. The line is a trace of the body’s movement and the precision of the line is a reflection of the precision of the coordination of the full body to carry it out. The straight and curved lines drawn in this manner are the tools used to solve different geometric problems proposed by the instructor. If the solution of a problem requires a line drawn in a different orientation, the student would need to reposition their entire body (arms, legs, pelvis) in order to be able to execute the new line. Unlike regular drawing, in which one would simply have to make a change in the angle of the wrist, or rotate the paper, here a thought (decision or choice) requires a unified action of the entire body. If it’s not possible for the body to be in a suitable position to execute the line, it is possible that the geometric problem, however simple, cannot be solved. In this way, the GEOCOCO method aims at involving the body as a whole and directly implicating it in thought.

The aim of this review is to examine existing research on the topic of professional carers’ discussion of grief and loss with parents caring for children with life-limiting neurodevelopmental disabilities (LLNDD’s). Of particular interest is the timing of these discussions, and whether these occur early in the child’s life or towards the end of life. Summary Parents experience a range of emotional reactions when their child is diagnosed with a life-limiting condition, including grief and loss responses (Machin, 2014; Guerin and Sheehan, 2017). Children with LLNDD’s may have long periods of relative stability interspersed with episodes of acute, potentially life-threatening illness and complications (Eiser,1993). Parents live with the constant awareness of their child’s shortened lifespan, though little is known about professional support for dealing with such challenging emotions. A preliminary search of relevant articles identified that studies of professional carers’ discussion of grief and loss primarily focus on the end-of-life phase in tertiary settings. While the benefits of initiating these discussions during the earlier stages of the child’s trajectory have been noted (Carr, 2021; Kochen et al., 2019), evidence for this is unclear. Findings from bereavement literature suggest that lack of preparedness for death is associated with increased bereavement risk (Aoun et al., 2012). Neurodevelopmental disabilities comprise a diverse group of diseases that all have dysfunction of the nervous system in common. They may vary over time and include a broad range of severity and complexity (Morris et al., 2013). The term “life-limiting neurodevelopmental disability” refers to a condition of neurodevelopmental origin for which there is currently no cure, and which is likely to lead to the child dying prematurely (Sutherland et al., 1994). For the purposes of the current review, the definition proposed by Together for Short Lives (2017) will be used. Life-limiting conditions are defined as “those for which there is no reasonable hope of cure and from which children or young people will die. Some of these conditions cause progressive deterioration rendering the child increasingly dependent on parents and carers”. Key Review Questions The scoping review aims to address four research questions: 1. What is known from research of professional carers’ discussion of aspects of grief and loss with parents caring for a child with a LLNDD? 2. How common are these discussions? 3. To what end do these discussions take place? 4. At what point(s) in the child’s lifespan do these discussions occur? 5. What gaps exist in the body of primary research literature relating to professional carers’ discussion of aspects of grief and loss with parents following diagnosis of their child with a LLNDD? Objective To explore the factors associated with professional carers’ discussion of aspects of grief and loss with parents caring for a child with LLNDD’s. Primary Investigator Elaine Brennan, B.A. (Hons) Social Policy, MSW, C.Q.S.W., MSc Loss and Bereavement Other Investigator(s) Prof. Suzanne Guerin, BA, PhD Participating Institution(s) School of Psychology, University College Dublin Contact Details for Public/Scientific Enquiries Postal Address: Elaine Brennan c/o Prof. Suzanne Guerin, School of Psychology, Newman Building, University College Dublin, Belfield, Dublin 4, Ireland. E-Mail Addresses: elaine.brennan3@ucdconnect.ie suzanne.guerin@ucd.ie Telephone Number: 00353877759240 (Elaine Brennan) Countries involved Ireland Funding The primary researcher who is a PhD candidate registered with the School of Psychology, University College Dublin, was awarded the Mc Kenna Scholarship funded by LauraLynn Ireland’s Children’s Hospice. Search Strategy The PCC framework (Peters et al., 2020) developed by the Joanna Briggs Institute (JBI) for the conduct of scoping reviews was selected for this study in order to identify the main concepts in the review questions and objectives and to inform the search strategy. Using the PCC mnemonic the main concepts were identified as follows: • Population: Parents of children with life-limiting neurodevelopmental disabilities as defined above (Sutherland et al.,1994; Together for Short Lives, 2017) • Concept: The review is interested in the extent to which professional carers initiate discussion of aspects of grief and loss with parents, with a particular interest in the timing of these discussion. • Context: The review will focus on the period following diagnosis and throughout the child’s lifespan. Studies in all settings of paediatrics including hospitals, community-based services and hospices will be included. Databases The following electronic databases will be searched using the same string of search terms: PsycINFO, CINAHL and PubMed. The search described below will be run on all three identified databases on the same day and results uploaded first to Endnote and then to Covidence software for removal of duplicates and screening. Search terms Search terms were identified based on existing reviews and following initial searching of three relevant databases to examine the terminology, synonyms and keywords used to describe the relevant concepts. The search terms developed for the PsycINFO database are provided below, with adaptations based on the specifics of the other databases. PsycINFO Database Search String: “life limiting neurodevelopmental disabil*” OR “neurodevelopmental disorders” OR "life limiting condition" OR "life limiting illness" OR “complex care need" OR "progressive disabil*" OR "life-threatening condition” OR "chronic illness" OR “chronic disease” OR “disease progress*” OR “end of life” OR (DE “Disease Progression”) OR (DE “Critical Illness”) OR (DE “Chronically Ill Children”) AND child* OR kid* OR infant* OR toddler* OR pre-school* OR youth* OR “young person” OR adolescen* OR p#ediatric OR teen* OR student* OR pupil* OR ( DE "Preschool Students") OR (DE "Pediatrics”) AND parent* OR mother* OR maternal OR father* OR paternal OR famil* OR caregive* OR (DE "Parents") OR (DE "Mothers") OR (DE "Fathers") OR (DE "Family") OR (DE "Caregivers") AND Death OR Grief OR Loss* OR "palliati* care" OR dying OR coping OR bereave* OR griev* OR mourn* OR terminal* OR "child mortality" OR adaptat* OR “end of life care” OR (DE "Death and Dying") OR (DE "Grief") OR (DE "Coping Behavior") OR (DE "Palliative Care") OR (DE "Adaptive Behavior") OR (DE" Bereavement") OR (DE "Child Death") Information Sources All types of empirical studies published in peer-reviewed journals will be included. This will include quantitative research, qualitative research, and mixed methods studies. Study designs that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, qualitative description and action research will be included. The search will be exhaustive of all years of records and countries of publication. Searching will be confined to peer-reviewed articles published in the English language. Inclusion Criteria 1. Articles reporting studies relating to children with life-limiting neurodevelopmental disabilities in line with the definition proposed by Together for Short Lives (2017). 2. Articles reporting discussions of grief and loss by professional carers’ with parents of children with LLNDD at the time of diagnosis and throughout the child’s lifespan. 3. The study gathers the views of professional carers or gathers the views of parents reporting their engagement with professionals on this issue. 4. Studies that include parents of children with other life-limiting conditions if the findings relating specifically to children with life-limiting neurodevelopmental disability can be extracted and synthesised separately or if the majority of the sample meet the first criterion. 5. Articles reporting primary, empirical research. 6. Research articles published in peer-reviewed journals in the English language. 7. Children are defined as persons from birth to 18 years. Exclusion Criteria 1. Articles reporting secondary research (e.g. systematic reviews, meta analyses), conference abstracts, theoretical/conceptual papers, book chapters (unless peer-reviewed and presenting primary empirical research), opinion pieces, protocols. 2. Articles reporting discussions by professional carers’ with parents of children with life-limiting diagnoses that do not explicitly report on discussions with parents of children with life-limiting neurodevelopmental disabilities. 3. Studies reporting on professional carers’ discussions with parents of children over the age of eighteen years. Data Screening Screening of all results will be undertaken in two phases. First, a Title and Abstract screening by two reviewers to identify articles that may meet the eligibility criteria. Relevant articles will be screened at Full Text review using the same eligibility criteria. A pilot screening will be undertaken by two members of the research team on the first 50 title and abstract records generated by a search of the all three databases in order to test and refine the inclusion and exclusion criteria. Understanding of inclusion and exclusion criteria will be discussed and clarified among the three members of the research team to ensure consistent application, recognising that some criteria can only be established at full text level. All records with a Yes/Yes and Yes/Maybe determination will be brought forward for full text screening. No/No and No/Maybe determinations will lead to exclusion from full text screening. Any Yes/No conflicts will be resolved based on the review determination of the third member of the research team. A pilot screening of a sample of full texts will be undertaken by two members of the research team on the first 10 full text records generated by the Title & Abstract screening in order to test and refine the inclusion and exclusion criteria and to identify reasons for exclusion to be added to Covidence. All articles identified to progress to Full Text screening will be reviewed by two reviewers, using the original inclusion and exclusion criteria and with disagreements resolved as per the Title and Abstract Screening. Contact will be made with study authors as required, in order to clarify aspects of studies being considered for inclusion. Data Extraction Data extraction will be completed on each article identified for inclusion in the data extraction stage following full text screening to map the characteristics of included studies. The template developed will be piloted by two reviewers on a sample of 10% of papers to ensure consistent extraction of data and maximising relevance to research question. The template will be modified and revised as necessary during the process of extracting data from each included evidence source. Modifications will be detailed in the scoping review. Remaining data extraction will be completed by the primary reviewer, with double extraction on a sample of articles to allow for calculation of rates of agreement. Primary Outcomes A descriptive summary of data extracted relating to professional carers’ discussions of aspects of loss and grief with parents caring for a child with life-limiting neurodevelopmental disability, including details about the population, concepts, study methods and key findings. Secondary Outcome An identification of the gaps in primary research relating to the discussion by professional carers’ of aspects of grief and loss with parents caring for children with life-limiting neurodevelopmental disability. Assessment of Methodological Quality The Mixed Methods Appraisal tool (Hong et al, 2019) will be used to appraise the quality of studies at the data extraction stage to inform synthesis and interpretation of results. A risk of bias assessment is not required in scoping reviews as the purpose is not to interpret results for clinical practice. Data Synthesis The information gathered in the extraction and analysis stage will be included in a descriptive summary of the main results and will describe how the results relate to the review objective and question. Thematic synthesis (Braun and Clarke, 2022) will guide the process of summarising data. Extracted data will be mapped into particular categories based on the PCC framework and an explanation provided for each category. Results and limitations of the review will be discussed in the context of current literature, gaps in the literature and implications for future research. Reporting of Results The results will be reported in full in the final scoping review and presented using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) (Tricco et al., 2018). Dissemination Plan Conference presentations (to professionals and parents). Summary of findings disseminated via social media and sent to relevant bodies (LauraLynn, Disability Service providers) with a request that they consider dissemination. Updated record including summary of findings will be submitted to Research Registry on completion of the study. Journal article publication. Stage of review at time of submission Searches of identified databases have been completed. References Aoun, S.M., Breen, L.J., O'Connor, M., Rumbold, B. and Nordstrom, C. (2012). A public health approach to bereavement support services in palliative care. Australian and New Zealand journal of public health, 36 (1), pp. 14-16. Braun, V. & Clarke, V. (2022). Thematic analysis: a practical guide. Los Angeles:Sage. Eiser, C. (1993). Growing Up With A Chronic Disease: The Impact on Children and Their Families. London: Jessica Kingsley Publishers. Hong, Q.N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.P., Griffiths, F., Nicolau, B. and O’Cathain, A. (2019). Improving the content validity of the mixed methods appraisal tool: a modified e-Delphi study. Journal of clinical epidemiology, 111, pp.49-59. Kochen, E.M., Jenken, F., Boelen, P.A., Deben, L.M.A., Fahner, J.C., van den Hoogen, A., Teunissen, S.C.C.M., Geleijns, K., Kars, M.C., Grief, T.A. and Boelen, L. (2020).When a child dies: a systematic review of well-defined parent-focused bereavement interventions and their alignment with grief- and loss theories. BMC palliative care, 19(1), pp. 28-28. Machin, L. (2014). Working with loss and grief: a theoretical and practical approach, Second Edition. Los Angeles: Sage. Morris, C., Janssens, A., Tomlinson, R., Williams, J. & Logan, S. (2013). Towards a definition of neurodisability: a Delphi survey. Developmental medicine and child neurology, 55( 12), pp.1103-1108. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12 Sutherland, R. Hear, J. Baum, D. Elston, S. (1994). Definitions in paediatric palliative care. Health Trends 25,pp.148-150. Together for Short Lives (2017). Children's palliative care definitions. Retrieved from http://www.togetherforshortlives.org.uk/professionals/childrens_palliative_care_essentials/definitions. Tricco AC, Lillie E, Zarin W, et al . (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine https://doi.org/10.7326/M18-0850

Title: Financial Activities and Errors Among Patients with Dementia Authors: Madhumitha Manivannan, Winston Chiong, MD PhD Research Questions: Descriptive/exploratory: Investigate current financial activities of patients with dementia For people with dementia, financial errors due to either their own mismanagement or to abuse by others can have devastating personal and family consequences. Studies show that financial mismanagement is often the earliest sign of cognitive decline, well before patients and their families are aware of reduced cognitive capacity. Furthermore, patients with dementia often continue to handle finances despite receiving a diagnosis of dementia, indicating high vulnerability to mismanagement and errors. One gap in the current literature is in characterizing the extent to which patients with dementia continue to engage in real-world activities, as a risk factor for financial mismanagement and abuse. Do different dementia syndromes have characteristic types of financial errors? Different dementia syndromes target specific neural systems that may be reflected in susceptibility to different types of error (e.g. amnestic errors in Alzheimer’s disease versus impulsive decisions in frontotemporal dementia). Understanding these differences might help providers better counsel and support patients with dementia and their families in mitigating risks associated with specific errors. Hypotheses: Primary Aim Hypotheses Hypothesis a Financial mistakes due to being too gullible or trusting and wasteful or too careless with money are more prevalent in patients with frontotemporal dementia than in patients with Alzheimer’s Disease. Hypothesis b Financial mistakes due to trouble with memory are more prevalent in patients with Alzheimer’s disease than in patients with frontotemporal dementia. Secondary Aims (Exploratory) -We will examine the prevalence of financial mistakes among patients with primary progressive aphasia due to the reasons listed in hypotheses a and b (above). Sampling Plan Existing Data: The “parent” projects we are recruiting our participants from include the UCSF ADRC (Alzheimer’s Disease Research Center) and the UCSF Frontotemporal Dementia: Genes, Images, and Emotions program (funded by the Parent Project Grant [PPG]). Behavioral data have been collected on both a Qualtrics platform as well as paper versions of the financial activities questionnaire. Behavioral data has been reviewed to assess enrollment numbers in disease categories and tailor future recruitment strategies. At the time of this pre-registration, all data from bvFTD and PPA participants have been collected. We are continuing to enroll AD participants to reach our target enrollment numbers. No analyses have been conducted on collected data. Data Collection Procedures: Participants will be recruited from one of two “parent” projects, the ADRC or the PPG, with continuing clinical, neuropsychological and neuroimaging data collection. As part of enrollment in one of the two aforementioned projects, subjects undergo extensive neurological and neuropsychological evaluations, neuroimaging, and clinical interviews and will be diagnosed by a team of neurologists, neuropsychologists, and nurses using consensus research criteria for Alzheimer’s disease, bvFTD, and primary progressive aphasia. Inclusion criteria will mirror those in each of the three parent projects: subjects will be fluent in English and will not have a history of another cognitive or neurological disorder. Questionnaires are completed by participants' family caregivers, who are co-enrolled in longitudinal research with patients as informants. Initially, some questionnaires were distributed to caregivers as paper copies; later, these questionnaires were transferred to Qualtrics. Caregivers were provided with tablet computers during patients' in-person visits and guided to answer the questionnaire. For some caregivers, if collection could not be accomplished during the in-person visit, then the Qualtrics instrument was e-mailed for completion at home. Sample Size: Our target sample size is 150. We plan to enroll 50 patients with frontotemporal dementia, 50 patients with Alzheimer’s Disease, and 50 patients with primary progressive aphasia. Sample Size Rationale: Chiong et al.’s study (2014) of differences in financial decision-making among patients with Alzheimer’s Disease and frontotemporal dementia reported moderate effect sizes for a dissociation between cognitive versus affective aspects of decision-making4. Hypothesis a: Applying standard power calculations based upon effect sizes observed in Chiong et al. (2014), two-sided alpha = 0.05 level tests based on 50 subjects in each group will have 43% power to detect observed differences in errors reflecting interpersonal solicitation, 93% power to detect observed differences in errors reflecting excessive spending, and 99% power to detect observed differences in errors reflecting decreased sensitivity to losses. As question 9 and 10 relate to all three of these factors, we expect the power of our combined item to fall somewhere between the above values. Hypothesis b: Applying standard power calculations based upon effect sizes observed in Chiong et al. (2014), two-sided alpha = .05 level tests based on 50 subjects in each group will have 88% power to detect observed differences in errors reflecting memory. Variables Measured Variables: Financial Activities Questionnaire In this questionnaire, caregivers of patients with dementia answer questions related to the patient’s current financial activities, past financial errors, and different types of financial errors. Questions 1-6 ask about the kinds of financial decision-making the patient participated in both before and after they had problems with memory or cognition. Question 7 allows respondents to elaborate on their answers to 1-6. Questions 8-13 ask about the types of financial errors the patient has made in the past year, e.g. mistakes due to memory problems, being too trusting, or worrying too much. Question 14 allows respondents to elaborate on their answers to 8-13. All multiple choice questions have answer choices of ‘Yes,’ ‘No,’ or ‘I did not know them well enough to answer.’ Analysis plan: For our primary aims, we will run multiple logistic regression with respondents' answers to question 9 and 10 (mistakes due to being too trusting/gullible, and mistakes due to wasteful or careless with money, respectively) as outcome variables for hypothesis a and using question 11 (mistakes due to impaired memory) as the outcome variable for hypothesis b. The model will include predictors for patient’s age, gender, and educational attainment as demographic variables. References: Pérès, K., Helmer, C., Amieva, H., Orgogozo, J. M., Rouch, I., Dartigues, J. F., & Barberger-Gateau, P. (2008). Natural history of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study. Journal of the American Geriatrics Society, 56(1), 37–44. https://doi.org/10.1111/j.1532-5415.2007.01499.x Triebel, K. L., Martin, R. C., Nabors, L. B., & Marson, D. C. (2009). Medical decision-making capacity in patients with malignant glioma. Neurology, 73(24), 2086-2092. Widera, E., Steenpass, V., Marson, D., & Sudore, R. (2011). Finances in the older patient with cognitive impairment:“He didn't want me to take over”. Jama, 305(7), 698-706. Chiong, W., Hsu, M., Wudka, D., Miller, B. L., & Rosen, H. J. (2014). Financial errors in dementia: testing a neuroeconomic conceptual framework. Neurocase, 20(4), 389-396.

This is a protocol of a scoping review that will be conducted to systematically identify and map the existing literature about the use of compensation with patients who have had a stroke by rehabilitation professionals. The review’s methodology will follow guidelines from the Joanna Briggs Institute (JBI). Papers published in peer review journals of all methodologies and designs will be identified by searching six databases and within the reference list of the included studies until the end of Feb 2023. Included papers will be categorized by their type of evidence resource and design among other characteristics, and will be presented descriptively. We hope to identify research gaps and future research directions.

INTRODUCTION Globally symphysis fundal height measurement (SFH) is a commonly used method to estimate gestational age globally. Among other methods that are used to estimate the gestational age are the last normal menstrual period (LMP) if it is performed early in pregnancy, early abdominal ultrasound, and New Ballard score which is done on the new born baby after delivery (Rada et al., 2018) SFH measurement is the most used tool to estimate the gestational age and to monitor fatal growth in low and middle income and developing countries where ultrasound services are not always available (Rada et al., 2018). Estimation of gestational age is done to exclude risks such as intrauterine growth retardation (IUGR), multiple pregnancy, polyhydramnios, and oligohydramnios. If the risks are not identified, this may lead to undiagnosed conditions which will then lead to mismanagement. Literature search was done on systematic, scoping, and meta-analysis reviews that were conducted on SFH. Scoping review is regarded as one of the newer review types adapted to clarify the operational definitions and conceptual boundaries of a topic (Peters et al., 2020). Whelan et al. (2022) conducted a systematic review of symphysis fundal height (SFH) measurement in low- and middle-income countries (LMIC). The aim was to look at the methods of SFH measurement and assess the accuracy of SFH in the estimation of gestational age. During this review different databases were searched from January 1980 to November 2021 and the grey literature was included. Inclusion and exclusion eligibility criteria were applied. About 37 out of 1,003 studies that were reporting the comparison between SFH measurement and other methods were included in the study. The findings revealed that SFH is underestimated in comparison with ultrasound, therefore it is not recommended for gestational age aging. Despite these findings SFH measurement is still used worldwide. Goto, (2020) conducted a meta-analysis to assess the diagnostic value of SFH to identify large for gestational age among the two developing African countries. There was no evidence that SFH can estimate low for gestation babies or large babies. (Mabrouk et al., 2022) conducted a scoping review of preterm births in sub-Saharan Africa. Although SFH was among the methods that were used to estimate gestational age, last menstrual period was found to be the most useful method. The literature on SFH measurement shows that it is still used globally and locally especially if the woman is not sure of her menstrual dates and in the absence of ultrasound services. This scoping review will identify the gaps and will map the evidence and rate at which SFH is used to estimate the gestational age. It will also be used to assist in the triaging of patients at risk and their diagnosis thereof. Munn et al. (2018) described the scoping review as “an ideal tool to determine the scope or coverage of a body of literature on a given topic and give a clear indication of the volume of literature and studies available as well as an overview (broad or detailed) of its focus”. Scoping review was introduced to synthesize the evidence of primary research conducted in the health care field. The scoping review may be conducted to summarize and disseminate the findings. It may be undertaken to identify the research gaps and give recommendations necessary for future research Peters et al., (2020). The reviewer has searched PubMed and Google scholar databases for the studies (systematic, scoping, and meta-analysis reviews) conducted on the estimation of gestational age and fetal growth monitoring. The following purposes of conducting the scoping review were reported by (Munn et al., 2018) in their study to describe the guidance for authors when choosing between the systematic and scoping review: a) To identify the types of available evidence in each field b) To clarify key concepts/ definitions in the literature c) To examine how research is conducted on a certain topic or field d) To identify key characteristics or factors related to a concept e) As a precursor to a systematic review INTRODUCTION Globally symphysis fundal height measurement (SFH) is a commonly used method to estimate gestational age globally. Among other methods that are used to estimate the gestational age are the last normal menstrual period (LMP) if it is performed early in pregnancy, early abdominal ultrasound, and New Ballard score which is done on the new born baby after delivery (Rada et al., 2018) SFH measurement is the most used tool to estimate the gestational age and to monitor fatal growth in low and middle income and developing countries where ultrasound services are not always available (Rada et al., 2018). Estimation of gestational age is done to exclude risks such as intrauterine growth retardation (IUGR), multiple pregnancy, polyhydramnios, and oligohydramnios. If the risks are not identified, this may lead to undiagnosed conditions which will then lead to mismanagement. Literature search was done on systematic, scoping, and meta-analysis reviews that were conducted on SFH. Scoping review is regarded as one of the newer review types adapted to clarify the operational definitions and conceptual boundaries of a topic (Peters et al., 2020). Whelan et al. (2022) conducted a systematic review of symphysis fundal height (SFH) measurement in low- and middle-income countries (LMIC). The aim was to look at the methods of SFH measurement and assess the accuracy of SFH in the estimation of gestational age. During this review different databases were searched from January 1980 to November 2021 and the grey literature was included. Inclusion and exclusion eligibility criteria were applied. About 37 out of 1,003 studies that were reporting the comparison between SFH measurement and other methods were included in the study. The findings revealed that SFH is underestimated in comparison with ultrasound, therefore it is not recommended for gestational age aging. Despite these findings SFH measurement is still used worldwide. Goto, (2020) conducted a meta-analysis to assess the diagnostic value of SFH to identify large for gestational age among the two developing African countries. There was no evidence that SFH can estimate low for gestation babies or large babies. (Mabrouk et al., 2022) conducted a scoping review of preterm births in sub-Saharan Africa. Although SFH was among the methods that were used to estimate gestational age, last menstrual period was found to be the most useful method. The literature on SFH measurement shows that it is still used globally and locally especially if the woman is not sure of her menstrual dates and in the absence of ultrasound services. This scoping review will identify the gaps and will map the evidence and rate at which SFH is used to estimate the gestational age. It will also be used to assist in the triaging of patients at risk and their diagnosis thereof. Munn et al. (2018) described the scoping review as “an ideal tool to determine the scope or coverage of a body of literature on a given topic and give a clear indication of the volume of literature and studies available as well as an overview (broad or detailed) of its focus”. Scoping review was introduced to synthesize the evidence of primary research conducted in the health care field. The scoping review may be conducted to summarize and disseminate the findings. It may be undertaken to identify the research gaps and give recommendations necessary for future research Peters et al., (2020). The reviewer has searched PubMed and Google scholar databases for the studies (systematic, scoping, and meta-analysis reviews) conducted on the estimation of gestational age and fetal growth monitoring. The following purposes of conducting the scoping review were reported by (Munn et al., 2018) in their study to describe the guidance for authors when choosing between the systematic and scoping review: a) To identify the types of available evidence in each field b) To clarify key concepts/ definitions in the literature c) To examine how research is conducted on a certain topic or field d) To identify key characteristics or factors related to a concept e) As a precursor to a systematic review a) What is the evidence of studies conducted to estimate the gestational age in single pregnancy using SFH measurement in Africa? b) What are the different methods used to estimate gestational age in single pregnancy in Africa? Scoping review questions Methodology A scoping review protocol will be developed according to the Joanna Briggs Institute (JBI) Manual (Peters et al., 2022). Protocols provide the reviewers with the direction on how to conduct and report the scoping review results. Protocols also specify the inclusion and exclusion criteria, databases and the search strategy that will be adopted (Peters et al., 2022). The reviewer will register the scoping review in JBI to avoid unintended duplication of reviews. When conducting a scoping review, the researcher will follow the steps as described in the (JBI) manual. These steps differ from those that are used when conducting the traditional systematic reviews because the scoping review addresses the broader gaol as opposed to the systematic review (Peters et al., 2022). The number of articles searched will be presented in Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews PRISMA-ScR) checklist. The aim of the PRISMA-ScR is to help readers to understand the relevant items to be reported for scoping reviews (Tricco et al., 2018). Eligibility criteria Scoping review Objective When developing search terms, inclusion, and exclusion criteria, the researcher will apply the Population, Concepts, Context (PCC) framework as indicated in the table below. Table 1 PCC: Search terms and eligibility criteria Variable Description Inclusion criteria Exclusion criteria Population Pregnant women, pregnant mothers or expecting mothers, antenatal patients (A pregnant woman is a woman attending antenatal care clinic with a singleton pregnancy) -Articles written in English language -Studies conducted on singleton pregnancy between 18 and 36 weeks of gestation - SFH and gestational age articles published between 2013 and 2023 -Articles not written in English -Studies not conducted on singleton pregnancy and not between 18 and 36 weeks of gestation -SFH and gestational age studies conducted before 2013 Concept Estimation of gestational age, gestational aging, fetal growth monitoring, symphysis fundal height measurement -Studies conducted in low- and middle-income countries, low socio economic or remote countries to obtain the latest information on gestational ageing and the most used methods. -All studies conducted to estimate gestational age using SFH measurement and other methods (Ultrasound, menstrual data) to estimate gestational age or to monitor fetal growth -All studies with SFH measured in successive antenatal visit. Context Africa*, OR African countries* OR developing countries*, OR low resource countries*, OR low- and middle-income countries* -All studies conducted in Africa, developing countries, low resource countries, low- and- middle income countries -All studies conducted in developed countries, high-income countries Search strategy The search strategy will include the keywords symphysis fundal height, gestational age, fetal growth monitoring, estimation of gestational age, gestational aging, Africa, low socio-economic countries, low- middle income countries, developing countries. When searching using the keyworks, the researcher will apply PCC (Population, Concept, Context) framework. The search strategy will also use the index terms when searching the identified databases (Peters et.al, 2020) The literature search will include the studies written in English and conducted between 2013 and 2023. There will be no design limiters during literature search, any study design will be included. During the initial search, the reviewer will screen the titles and abstracts of papers that have been searched using two databases PubMed and EbscoHost. To refine the search terms, key words and MeSH terms will be discussed with the review team (Peters et.al, 2020) In step two the following databases will be searched: UKZN library, Ebscohost, PubMed, CINAHL, Google scholar and Web of Science will be used to search for the relevant articles of primary studies of systematic reviews, and meta-analyses. Grey literature will also be searched in the form of dissertations and theses, and World health organization reports (WHO). In step three the searching of the reference list of the articles included will be done. The key authors of the reviews and primary studies will be contacted should the additional information be required (Peters et al., 2022). The review team, with the help of the subject librarian will apply the eligibility criteria to screen the articles. During literature search, the reviewers will use the Boolean operators OR and AND. To broaden the search, operator OR and truncations will be used. Operator OR will also be used to connect the synonyms for example fetal growth monitoring OR estimation of gestational age. Operator AND will be used to connect the key words for example symphysis fundal height and Africa (Mabrouk et al., 2022). Relevant studies obtained from the search will be imported to the endnote version 20.5. Rayyan software will also be used for the documentation and management of the results (Peters et al., 2022) Query Results Time Search: ((Symphysis fundal height measurement) OR (Fetal growth monitoring)) AND (africa) Filters: Abstract, Free full text, Full text, in the last 10 years 78 05:30:09 Search: (( Africa) AND (Symphysis fundal height measurement)) OR (Fetal growth monitoring) Filters: Abstract, Free full text, Full text, in the last 10 years 1,847 05:28:03 Search: Symphysis fundal height measurement OR fetal growth monitoring AND African countries Filters: Abstract, Free full text, Full text, in the last 10 years 10 05:21:00 Figure 1. Sample of search strategy conducted in April 2023 Process of source selection During the first phase of source selection the review team will remove the duplicates and then will independently screen the titles and abstracts of papers that have been searched. About 15 articles will be piloted and screened by three reviewers who will be functioning independently with Blind On. The agreement level for the piloted articles will be greater than 75 %. Studies which do not meet the inclusion criteria will be excluded (Arksey & O'Malley, 2005). Secondly the inclusion and exclusion criteria will be applied to screen the full text of the papers. PCC framework recommended by the JBI will be adopted when selecting the studies. If new terms, concepts, and sites of evidence are revealed during the review process, searches will be modified (Peters et al., 2022) Data extraction A draft charting table will be developed and used to extract data using the PCC variables. To answer the review questions, the information in table 2 will be included as listed in JBI manual (Peters et al., 2022) Table 2: Draft charting table for the symphysis fundal height measurement in Africa Developing African countries Author/year of study Topic /Country Population Concept Context Methods Relevant results and findings - The reviewers will pilot the charting template on two or three articles to ensure that the required data is added - The reviewers would ascertain if the data extracted is consistent with the review questions and the inclusion criteria, they will also familiarize themselves with the form. - During data extraction process, the reviewers will revise and modify charting of data - Three reviewers will double check the data independently, and the fourth reviewer will be involved to ensure that the consensus is reached. They will focus on the following data: Author(s), year of publication, country of origin (where the study was published or conducted), aims/purpose of the study, study population if applicable, method ology/methods, intervention, type or duration and key findings that relate to the scoping review question/s (Peters et al., 2022) - If there is additional or missing information required, the reviewers will contact the key authors. Collating, summarizing, and reporting results Figures and tables will be used to chart and present the extracted data. The results will be analysed using a descriptive and narrative analysis. During the narrative analysis, the emerging themes will be identified and interpreted. The reviewers will summarize the findings and report how they will be published. The methodologies used, population and the identified gaps will also be reported, including the methods used to estimate gestational age. Dissemination of data will be done through presentation of results at local conference, and they will be submitted to a relevant journal for publication. Quality appraisal The quality of the articles included will be evaluated by using the Mixed Method Appraisal Tool (MMAT) version 18. Five categories of research will be appraised which are: qualitative and quantitative research, randomised controlled trials, non -randomised control trials, and mixed methods studies (Hong et al., 2018). Three independent reviewers will do the quality appraisal. The reviewers will use percentage scores to grade the quality of evidence. The scores will be interpreted as follows: A) ≤50 % - will be graded as low-quality evidence B) 51-75 % - will be graded as average evidence C) 76-100 %- will represent high quality evidence (Maluleke et al., 2021) Discussion This scoping review will evaluate the evidence in the use of SFH measurement in the estimation of gestational age and monitoring of fetal growth. The reviewers will be looking at the different methods that are used in Africa to estimate the gestational age. To evaluate the quality of articles included in the review, the reviewers will use the MMAT. This review will identify gaps in the plotting of SFH and make relevant recommendations. The report will emphasize the importance of SFH measurement since the SFH graph can assist in the triaging of women at risk. The findings from this scoping review will be useful in the development of curriculum for the student midwives (both theory and clinical) and will also inform the stakeholders when developing the policies. References Arksey, H., & O'Malley, L. (2005). Scoping Studies: Towards a Methodological Framework. International Journal of Social Research Methodology: Theory & Practice, 8, 19-32. https://doi.org/10.1080/1364557032000119616 Hong, Q. N., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., Vedel, I., & Pluye, P. (2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Education for Information, 34, 1-7. https://doi.org/10.3233/EFI-180221 Mabrouk, A., Abubakar, A., Too, E. K., Chongwo, E., & Adetifa, I. M. (2022). A Scoping Review of Preterm Births in Sub-Saharan Africa: Burden, Risk Factors and Outcomes. International journal of environmental research and public health, 19(17), 10537. Maluleke, K., Musekiwa, A., Kgarosi, K., Gregor, E. M., Dlangalala, T., Nkambule, S., & Mashamba-Thompson, T. (2021). A Scoping Review of Supply Chain Management Systems for Point of Care Diagnostic Services: Optimising COVID-19 Testing Capacity in Resource-Limited Settings. Diagnostics, 11(12), 2299. https://www.mdpi.com/2075-4418/11/12/2299 Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 143. https://doi.org/10.1186/s12874-018-0611-x Peters, M., Godfrey, C., McInerney, P., Khalil, H., Larsen, P., Marnie, C., Pollock, D., Tricco, A., & Munn, Z. (2022). Best practice guidance and reporting items for the development of scoping review protocols. JBI evidence synthesis, Publish Ahead of Print. https://doi.org/10.11124/JBIES-21-00242 Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119-2126. https://doi.org/10.11124/jbies-20-00167 Rada, S., Gamper, J., González, R., Mombo-Ngoma, G., Ouédraogo, S., Kakolwa, M. A., Zoleko-Manego, R., Sevene, E., Kabanywanyi, A. M., Accrombessi, M., Briand, V., Cot, M., Vala, A., Kremsner, P. G., Abdulla, S., Massougbodgi, A., Nhacolo, A., Aponte, J. J., Macete, E., & Menéndez, C. (2018). Concordance of three alternative gestational age assessments for pregnant women from four African countries: A secondary analysis of the MIPPAD trial [Article]. PloS one, 13(8), 1-13. https://doi.org/10.1371/journal.pone.0199243 Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., . . . Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med, 169(7), 467-473. https://doi.org/10.7326/m18-0850 Whelan, R., Schaeffer, L., Olson, I., Folger, L. V., Alam, S., Ajaz, N., Ladhani, K., Rosner, B., Wylie, B. J., & Lee, A. C. (2022). Measurement of symphysis fundal height for gestational age estimation in low-to-middle-income countries: A systematic review and meta-analysis. PloS one, 17(8), e0272718.

This systematic review is based on preliminary findings collected during an Honors Thesis project by Camille DeMarcus at the University of Arizona. The focus of this project is to expand and refine the data collection from the initial paper. A link to the initial paper will be provided in the protocol.

This is the preregistration of my planned paper "Using SOFTA-o Alliance Activity to Examine Systemic Dimensions of Multiple Alliances in Home-Based Family Treatment". For this paper, I am making use of an existing dataset which details the results of the System for Observing Family Therapy Alliances (SOFTA; Friedlander et al., 2006) which was used to capture observations of alliances occurring in home-based family treatment sessions. The resulting SOFTA-o sheets contain information about the occurrence of alliance behaviors across the four alliance dimensions "Engagement", "Emotional Bond", "Safety in the Therapeutic Context", and "Shared Sense of Purpose", and per family treatment unit (therapist(s) and clients). Thus far, research using SOFTA-o has focused primarily on alliance formation and maintenance by viewing aggregated scores per dimension. Namely, SOFTA-o deduces global scores ranging between -3 and +3 which reveal the strength of the alliance for each of the four SOFTA alliance dimensions per person and session. In contrast, this study explores the non-aggregated information SOFTA-o reveals about the multiple alliances. Instead of viewing the aggregated global scores alone, this study explores the role of what we will call alliance activity. An individual’s activity on the alliance dimension is represented by the amount of alliance behaviors a person has contributed to this dimension throughout the session. In other words, while the global score is determined by aggregating the positive and negative alliance behaviors to quantify the quality and strength of an alliance dimension, the activity on a dimension reveals how many contributions a person has made to the dimension. This distinction between activity and strength of alliance becomes especially interesting when viewing the global scores between -1 and +1. This is due to the fact that the global scores -1, 0, and +1 are given when both positive and negative behaviors have occurred throughout the session which may effectively cancel each other out. A global score of 0 therefore does not reveal how fixated persons have been on forming the alliance dimension, but only that the accumulated efforts resulted in an overall neutral alliance on the dimension. This is where attention to the alliance activity comes in. The goal of this study is to explore the potential added value of this non-aggregated information SOFTA-o provides. By viewing a person's alliance activity in combination with the alliance dimension's strength, it can help individuals assess the effectiveness of their alliance behaviors. For example, a professional may decide to adjust their interventions if the sessions repeatedly result in low global scores despite high activity by the therapist and clients on this same alliance dimension throughout the sessions. It may mean that it is not a lack of attention to the dimensions per se which is causing the unsatisfactory scores, suggesting that a closer look at the individual alliance behaviors and dynamics throughout the sessions may be warranted. This proposed paper will have a strong methodological focus, expanding the range of applicable analyses in SOFTA's repertoire. To the author's knowledge, there is no other paper looking at alliance activity in combination with SOFTA’s global scores in this way. In order to connect our findings to prior research, we will explore the relationship between a person's role in the family treatment unit and their behavior on the alliance dimensions. Prior studies suggest that a person’s role in the FTU may be related to the strength of the person’s alliance, with for example stronger alliances observed between therapists and parents versus with youth (Welmers-van de Poll et al., 2021a; Wong et al., 2022). We are interested to see whether we find this phenomenon repeated in our dataset as well. More specifically, we will use the proposed methodology to analyze the therapist’s and clients’ systemic alliance behaviors in particular. Despite prior research pointing to the systemic dimensions specifically as predictors of therapy outcome (Friedlander et al., 2018), it seems that alliances are still created largely in a dyadic manner rather than with the group as a whole (Welmers-van de Poll et al., 2021b). This is surprising considering that conjoint family treatment aims to tackle the group’s issues systemically by working with the family unit / system versus the individual. A study by Welmers-van de Poll (2021b) points to especially low contributions of the therapist on the systemic alliance dimensions “Safety in the Therapeutic Context” and “Shared Sense of Purpose” in comparison to the dyadic dimensions. This specific study is, to the author’s knowledge, the only SOFTA-related research to use the number of alliance behavior occurrences (alliance activity) rather than the global scores. Furthermore, findings by Benítez et al. (2020) point out an unequal distribution of contributions by therapist and clients to the strength of the systemic alliance dimensions, with higher global scores on “Shared Sense of Purpose” for the clients than the therapist. This is interesting considering that we generally assume the therapist to play a leading role in managing therapy and shaping alliances (Hartmann et al., 2015). We are interested to see whether looking at the alliance activity can help shed further light on these alliance dynamics at hand. The analyses will be performed primarily by the first author, Andrea Bunge. She has thus far briefly viewed the dataset in order to choose appropriate methods for the analyses. No analyses have been performed at the time of this registration. Literature: Benítez, J. L., Abascal, A., Garrido, M., & Escudero, V. (2020). Building an Expanded Therapeutic Alliance: A Task Analysis with Families Trapped in Parental‐Adolescent Conflict. Family Process, 59(2), Article 2. https://doi.org/10.1111/famp.12435 Friedlander, M. L., Escudero, V., Horvath, A. O., Heatherington, L., Cabero, A., & Martens, M. P. (2006). System for observing family therapy alliances: A tool for research and practice. Journal of Counseling Psychology, 53, 214–225. https://doi.org/10.1037/0022-0167.53.2.214 Friedlander, M. L., Escudero, V., Welmers-van de Poll, M. J., & Heatherington, L. (2018). Meta-analysis of the alliance-outcome relation in couple and family therapy. Psychotherapy (Chicago, Ill.), 55(4), 356–371. https://doi.org/10.1037/pst0000161 Hartmann, A., Joos, A., Orlinsky, D. E., & Zeeck, A. (2015). Accuracy of therapist perceptions of patients’ alliance: Exploring the divergence. Psychotherapy Research, 25(4), 408–419. https://doi.org/10.1080/10503307.2014.927601 Welmers-van de Poll, M. j., Stams, G. j. j. m., van den Akker, A., & Overbeek, G. (2021a). Alliance discrepancies in home-based family treatment: Occurrence, development and the therapist’s perspective. Journal of Family Therapy, 43(4), 642–664. https://doi.org/10.1111/1467-6427.12309 Welmers-van de Poll, M., Stams, G., van den Akker, A., & Overbeek, G. (2021b). Therapists’ Contributions to the Alliance in Home-Based Family Treatment: The Role of Alliance Building Behaviors, Personality, and Clinical Experience. Contemporary Family Therapy, 43, 1–14. https://doi.org/10.1007/s10591-021-09597-3 Wong, N. R., Carta, K. E., Weintraub, M. J., & Miklowitz, D. J. (2022). Therapeutic alliance in family therapy and clinical outcomes among adolescents at risk for mood disorders. Journal of Affective Disorders, 300, 66–70. https://doi.org/10.1016/j.jad.2021.12.088

Background: Timely suicide and self-harm surveillance is crucial to prevention. Impaired registration of suicide and self-harm directly influences knowledge about trends, vulnerability, and the design of suicide prevention and postvention strategies. Most World Health Organization member countries lack good-quality data on suicide and self-harm. Furthermore, most LMCIs countries do not have surveillance systems for suicide or self-harm. Data quality improvement for suicide prevention is one of the Comprehensive Mental Health Action Plan (2013-2030) objectives. Aims: To identify the characteristics of suicide and self-harm surveillance systems in healthcare. Methods: Scoping review following the Joanna Briggs Institute (JBI) recommendations. This review includes searches in Cochrane Central Register of Controlled Trials, Cinahl, Embase, Lilacs (Scientific health information from Latin-American and Caribbean countries), PubMed (US National Library of Medicine), Scopus e WebScience. In addition, Google Scholar and OpenGrey will be searched for grey literature. Will be included studies exploring suicide and self-harm surveillance systems. Eligibility criteria include papers using qualitative, quantitative, or mixed methods with no time or language restrictions. It will be excluded: a) papers regarding euthanasia and assisted suicide; b) papers that do not explicitly describe suicide and self-harm, limiting the comprehension of the study and/or the methodological steps taken by the authors; c) studies that investigate how to notify or report suicide and self-harm in the media or to families and friends. Data will be extracted using the JBI tool and analysed independently by two researchers using content analysis. Results: Results will be presented descriptively according to PRISMa-ScR. Conclusion: Identifying the characteristics of surveillance systems for suicide and self-harm would provide information about the key features of these systems and the gaps for proposing improvements in suicide and self-harm prevention.

Objective: This scoping review aims to summarize the characteristics of blinding assessment in acupuncture RCTs studies and conclude a reference for future acupuncture studies. Methods: Papers will be selceted from PubMed, Embase, Cochrane Library, Web of Science with the related subject word acupuncture or elecrtoacupuncure from January 1, 2013 to December 31, 2022. Data about blinding assessment will be extracted from the eligible papers, and findings will be presented in graphs. A descriptive qualitative approach to analysis will be conducted to form the scoping review.