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Objective: The objective of this scoping review is to chart and appraise the available evidence regarding prevention in musculoskeletal care in the chiropractic, osteopathic and physiotherapy (COP) professions. Introduction: Prevention or maintenance is common practice in COP but the extent and quality of their evidence is currently not known. Inclusion criteria: The review is intended to include papers that assess preventative strategies for musculoskeletal pain or disability delivered through interactions between a patient and a COP clinician and used in or outside the treatment room. Prospective, retrospective, observational studies, case-control studies and trials will be sought. This review will exclude papers regarding general physical activity, or regarding prevention of cardiovascular or metabolic conditions. Methods: The online searches will be conducted on OVID Medline, AMED, Index To Chiropractic Literature, and PEDro. Reference lists of included papers will be screened for relevant papers. To ensure a broad and rigorous search, a team of experts with systematic searches for review will be involved regarding the search string. Papers not available in English or French will be excluded. There will be no limit placed upon date of publication, any significant findings related to the age or developments in the literature will be acknowledged. Data will be screened, appraised and extracted in duplicate by at least two blinded reviewers. Results will be tabulated and narratively synthesised.

Objective : Nowadays, the number of cancer survivors continues to grow. Physical activity is effective in increasing their quality of life. There is a paucity of systematic reviews focusing only on the effects of aerobic exercise on cancer survivors’ quality of life and there are few information about the most effective exercise intensity. The aim of this review is to investigate the effects of supervised aerobic training on the quality of life in cancer survivors. Additionally, the effect size of different training intensities will be presented. The hypothesis is that aerobic exercise will increase the quality of life and the most effective exercise intensity will be moderate to vigorous Data source: Literature search was perform using Medline/Ovid and Scopus on the 6th February 2020. This study was subsequently updated to include studies published between the second week of February 2020 (6th February) and the fifth week of September 2020 (29th September). Two authors independently screened the papers based on the titles and abstract, and when appropriate based on the full text. The Preferred Reporting Items for Systematic Reviews (PRISMA) statement was followed. Study selection : Inclusion criteria were: adult cancer survivors, supervised (by professionals) aerobic exercise only, validated questionnaires to assess quality of life. The articles had to be written in English or French. Results: 10 papers were included. All studies, with the exception one, found significant improvements in quality of life. There was no correlation between the improvements and the exercise intensity. Conclusion: The present review demonstrated the effectiveness of aerobic exercise in improving quality of life in cancer survivors. Influence of exercise intensity is yet to be found.

Increasing evidence has suggested that individual vulnerability to dysregulated eating behaviours can be linked to variation in cortical activity, particularly within the prefrontal cortex (PFC), and connectivity between brain regions (Lowe et al., 2019); the PFC is a brain region often implicated in cognitive control and self-regulation. PFC-mediated regulatory processes are thought to play a crucial role in regulating consumptive behaviours by downregulating cravings and/or the immediate rewards associated with consuming hyperpalatable calorie-dense foods. On these accounts, individual vulnerability to dysregulated eating behaviours (i.e., excessive consumption) are thought to be associated to variation in prefrontal activity in response to food cues and other cues that trigger excessive consumptive behaviours. Given the hypothesized association between cortical activity in the lateral PFC and food cravings and consumptive behaviours, a growing number of experimental and clinical studies have employed non-invasive neuromodulation methods (1) to assess the causal relationship between cortical activity in the lateral PFC, and other hypothesize brain regions, and food cravings and consumption, and (2) as a treatment for obesity and eating disorders (bulimia nervosa, binge-eating disorder, and anorexia nervosa). The later involves the repeated administration of a neuromodulation method over the course of weeks to months. Briefly, neuromodulation methods refer to a set of neuroscience tools that are used to induce temporary changes, either excitatory or inhibitory, in localized neuronal populations under the stimulation site. The repeated administration of these methods, over time, are thought to induce long-term changes in brain functionality and connectivity, resulting in long-term changes to behaviours, thoughts, mood, and actions. Within the neuromodulation family, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are the main modalities, but other methods (e.g., transcranial alternate current stimulation (tACS)) exist within the literature. Within the context of dietary behaviours, a growing body of evidence has suggested that methods used to increase brain activity, primarily within the lateral PFC, can decrease food cravings and the consumption of calorie-dense foods in healthy and clinical populations (e.g., patients with obesity or bulimia nervosa). Likewise, studies that have used inhibitory methods have demonstrated that decreasing activity within the same regions have resulted in increased self-reported food cravings and the consumption of appetitive calorie-dense foods. However, the findings from these studies are mixed, and therefore, questions regarding the effectiveness of these methods as an experimental and clinical research tool remain. To this end, we will conduct a systematic review and meta-analysis that will determine: (1) the effect size for acute administration of neuromodulation across individuals with and without eating pathologies across the weight spectrum; (2) the effectiveness of excitatory and inhibitory methods in healthy and clinical populations; (3) the effectiveness of treatment studies in modulating food cravings and food consumption. Although, recent systematic reviews and meta-analyses on this topic have been published, these studies were limited by small sizes (less than 10 papers) or have focused on substance abuse in general (i.e., food, drugs, alcohol). Given the rapid increase in papers within this area, there is a need for an updated and more comprehensive review and meta-analysis. The current review will achieve this using more advanced methods (i.e., multilevel meta-analytic methods to account for repeated outcomes within studies). In addition, we will look at the effect size estimate for inhibitory and excitatory stimulation, and healthy and clinical populations separately.

Introduction Pain is an unpleasant sensory and emotional experience associated with, or similar to, that associated with actual or potential tissue damage that causes suffering and reduces the quality of life. The perception of pain is individual and depends on the emotional, cognitive state, circumstances, and factors such as memory, attention, language, and expectations.1,2 It is important to assess pain in its multidimensional context, to manage it with pharmacological and non-pharmacological approaches, and to reassess it. Treatment must be patient-centered and consider its current presentation, professional clinical judgment, potential risks, and benefits. Adequate pain management should be a priority in the quality of care in health institutions.2,3 Patient-controlled analgesia (PCA) is a method that consists of self-administration of analgesic doses for pain treatment. PCA pumps are computerized systems, programmed for individual use. The effectiveness of PCA in controlling pain is proven, as it improves patient satisfaction, reduces opioid consumption, and as a need for nursing care. The prescriber defines the drug, usually, morphine or another opioid, orders the dose, demand, dose range, and block as proposed by the guidelines of the Current American Pain Society. The term PCA goes beyond the pump, as it encompasses a whole process that includes the patient, nurse, pharmacist, and doctor. Therefore, if any component is failing, security is compromised. Be careful with patient selection, education, proper prescription, and patient monitoring, the method becomes safer and more effective.4-8 Patient safety practice reduces the likelihood of drug-related adverse events, defined as health care complications that may be due to errors or an adverse reaction.9 Unsafe health care causes serious damage to the health of patients, in addition to serious damage financially and loss of confidence in the health system.10 Security is closely related to high-quality care since it produces the best health results.9 It is essential to think about pain as an adverse event when it is undertreated, poorly controlled, and due to surgical, drug, and diagnostic interventions. The creation of protocols that stand out from the contexts where pain management may fail is a way to identify risk factors and integrated approaches to prevention and control. Adequate pain management is one of the aspects associated with ensuring patient safety, which aims to reduce the risk of unnecessary damage associated with health care. According to the WHO, investments in a safe care practice can generate related savings and the best results for patients. Promote proactive risk management implying how a process can fail, identifying risk trends to explore mandatory mitigations to reduce risk before bad results occur. 11,12,13 Studies estimate that clinical incidents related to PCA occur more commonly in surgical services and are more associated with drugs provided via PCA.5 Such a process involves several components, as doses must be prescribed, prepared, administered and their effects monitored. The administration was the stage most marked by errors: rates, configuration, dose, medication, solution, interruption, and violation of the policy or protocol. Failures in monitoring, in responding to the patient's clinical condition, documents, labeling, knowledge and skills, equipment, communication, and selection of patients.5 Therefore, incident analysis is the first step for the risks to be identified and managed, allowing the building security improvement practices in ACP, as it is a highly error-prone process.6 There are publications involving some primary studies on risk management and safety measures in the use of the patient-controlled analgesia pump. Preliminary research was carried out on the bases: PROSPERO, MEDLINE (PubMed), JBI Database of Systematic Reviews and Implementation Reports. No scoping or systematic reviews were found on the topic. A scoping review can identify research gaps in the scope of actions to promote safety. In this sense, it was decided to conduct a scoping review, guided by the methodology proposed by the Joanna Briggs Institute for Scoping Reviews.14 A review will aim to map the available evidence on the risks of adverse events associated with the PCA technique and to identify patient safety actions. This review seeks to answer the following question: What is the evidence about the risks of adverse events and safety actions in the use of PCA (patient-controlled analgesia). Review question(s) The research question was guided by the PCC strategy (P: population, C: concept, and C: context). The “P” Corresponds to patients using ACP pumps (population),“ C ”to the risks of adverse events and safety actions (concept), and“ C ”to hospitals (context). This review seeks to answer the following question: What is the evidence about the risks of adverse events and safety actions in the use of PCA (patient-controlled analgesia). Inclusion criteria Participants This review will consider studies that include adult patients, 18 years or older, using PCA pumps regardless of sex, diagnosis, type, and severity of pain. Concept This review will consider studies that explore the risks of adverse events and safety actions. Context This review will consider studies that performed on hospitalized patients, regardless of geographic region and level of care. Types of sources The information source will be “open” to provide greater sensitivity and, consequently, a broad mapping that includes all existing literature and all types of evidence. To this end, it will consider quantitative, qualitative, and mixed methods study designs, reviews, experimental, quasi-experimental, observational, descriptive, and analytical studies, in addition to theses, texts, and opinion articles. Do not limit the language restriction and data publishing limitations. Methods The proposed scoping review will be conducted following the JBI methodology for scoping reviews 14. The choice for this method is due to its main objectives: mapping available evidence, analyzing gaps in existing literature, identifying, reporting, and discussing as main related characteristics to a concept. From this synthesis, it will be possible to develop a review with a broader scope on security actions for the safe handling of ACP, and, in the future, it may contribute to the construction of a systematic review. Search strategy The search strategy will take place in three stages. An initial limited search at MEDLINE via Pubmed and at CINAHL via Ebsco was undertaken to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles were used to develop a full search strategy for MEDLINE via Pubmed (see Appendix I). The keywords and research expressions identified were: “patient-controlled analgesia”, “Risk management” and “Patient safety”. The search strategy, including all identified keywords and index terms, will be adapted for each included information source. In the second step, a complete search will be performed in all databases included using all keywords and index terms identified in the initial search. The search will be adapted for each included information source. Appendix I contains a detailed search strategy for MEDLINE (PubMed). The third step will be screened for additional papers in the reference lists of all publications included in the review, and to obtain more information, if necessary, the reviewers appear in contact with the authors of the included materials. There will be no language restriction or publication date A librarian will be contacted to refine the strategy. The databases to be searched include MEDLINE (Medical Literature Analysis and Retrieval System Online / PubMed); EMBASE (Elsevier); CINAHL (Cumulative Index to Nursing and Allied Health Literature / EBSCOhost); CENTRAL (The Cochrane Central Register of Controlled Trials The Cochrane Library); LILACS (Scientific and Technical Literature of Latin America and the Caribbean / VHL - Virtual Health Library); SCOPUS; Web of Science; Capes Portal (Coordination for the Improvement of Higher Education Personnel); Academic Google; TRIP (Turning Research into Practice) database. Sources of unpublished studies and gray literature to be searched include sites of pain and patient safety organizations such as The Agency for Healthcare Research and Quality; The Institute for Healthcare Improvement; NICE (National Institute for Health and Care Excellence); The Institute for safe medication practices and other sources such as ProQuest Dissertations and Theses Database. Study/Source of evidence selection Following the search, all identified records will be collated and uploaded into EndNote (Clarivate Analytics, PA, USA), and duplicates removed. Following a pilot test, titles and abstracts will then be screened according to the inclusion criteria with the support of Rayyan, a web and mobile app for systematic reviews that makes it possible to include and exclude citations imported from EndNote independently and blinded by two reviewers.15 The full text of the selected citations will be evaluated in detail about the inclusion criteria. The reasons for excluding full-text articles that do not meet the inclusion criteria will be recorded and reported in the scoping review. Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion or with a third reviewer. There will be no analysis of the methodological quality of the sources of evidence because it is a scoping review. The research results will be reported in full in the final scope review and presented in a flow chart of Preferred Reporting Items for Systematic Reviews and Meta-analyzes for Scope Reviews (PRISMA-SCR).16 Data extraction Data will be extracted from papers included in the scoping review by two independent reviewers using a data extraction tool developed by the reviewers. The data extracted will include specific details about the adult patients using PCA pumps, risk management, safety actions, and the hospital institution relevant to the review question. A draft extraction tool is provided with the objective and question of review (see Appendix II). The draft data extraction tool is preliminary, so it can be modified and revised as necessary during the process of extracting data if new relevant information is identified during the reading of the publications. Modifications will be detailed in the full scoping review. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. A pilot test will be carried out on publications for what is necessary to familiarize reviewers with the instrument. Data analysis and presentation The extracted data will be presented in tabular and diagrammatic form for scope review. A narrative summary will accompany the tabulated and mapped results and describe how they relate to the research objective and question. These tools will elucidate the different contexts of PCA use, types of errors, and associated risks, in addition to actions for risk management and the promotion of patient safety. The risks to be listed may involve aspects related to the pump, patient, prescriber, pharmacist, nursing, and medication such as errors in programming, operation, and configuration of the PCA pump, drug selection, dose and blocking periods, patient choice, and monitoring. References 1. Raja SN et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. International Association for the Study of Pain. 2020;00(00):1-7. 2. Williams AC, Craig KD. Updating the definition of pain. 2016;157(11):2420–3. 3. Baker DW. Statement on pain management: understanding how Joint Commission standards address pain. Jt Comm Perspect 2016;36(6):10–2. 4. D’Arcy Y et al. Keep your patient safe during PCA. Nursing 2008. 2007; 38(1):50-5. 5. Clinical Excellence Commission. Clinical Focus Report Patient Controlled Analgesia [Internet]. Sidney South; 2013 [cited 2020 Nov 11]. Available from: https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0009/259209/patient-safety-report-pca-web.pdf 6. San Diego Patient Safety Council. Patient Controlled Analgesia (PCA) Guidelines of Care [Internet]. San Diego; 2009 [cited 2020 Nov 22]. Available from: https://www.hqinstitute.org/post/patient-controlled-analgesia-pca-guidelines-care. 7. Institute for safe medication practices. Safety Issues with PCA Part I - How Errors Occur [Internet]. Horsham; 2003 [cited 2020 Nov 22]. Available from: https://www.ismp.org/resources/safety-issues-pca-part-i-how-errors-occur. 8. Morello RT, Lowthian AJ, Barker AL, McGinnes R, Dunt Dm, Brand C. Strategies for improving patient safety culture in hospitals: a systematic review. BMJ Qual Saf. 2013;22: 11-18. 9. World Health Organization. Patient Safety Global action on patient safety [Internet]. WHO; 2018 [cited 2020 Nov 22]. Available from: https://apps.who.int/iris/handle/10665/327526. 10. Chorney JM, McGrath P, Finley GA. Pain as the neglected adverse event. CMAJ 2010;182(7):732. 11. Sheikh A, Kumar ND, Kelley E, Kieny MP, Donaldson LJ. The third global patient safety challenge: tackling medication-related harm. WHO 2017;95:546-54A. 12. World Health Organization. Patient Safety [Internet]. WHO; 2019 [cited 2020 Nov 21]. Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety. 13. Yarmohammadian MH, Abadi TNB, Tofighi S, Esfahani SS. Performance improvement through proactive risk assessment: Using failure modes and effects analysis. J Edu Health Promot 2014; 3:28. 14. Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis [Internet]. JBI; 2020 [cited 2020 Nov 21]. Available from: https://synthesismanual.jbi.global.https://doi.org/10.46658/JBIMES-20-01. 15. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan — a web and mobile app for systematic reviews. BioMed Central. (2016); 5:210. 16. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. The PRISMA-ScR Statement. Ann Intern Med. 2018;169(7):467-73. Appendix I: Search strategy The search was conducted in MEDLINE (via Pubmed) in November 2020. Search #1 Query: “Analgesia, Patient-Controlled” [MESH] OR “Analgesia, Patient Controlled” [tw] OR “Patient-Controlled Analgesia” [tw] OR “Patient Controlled Analgesia” [tw] Records retrieved: 6,590 Search #2 Query: “Risk Management” [MESH] OR “Management, Risk” [tw] OR “Management, Risks” [tw] OR “Risks Management” [tw] OR “Reporting, Hospital Incident” [tw] OR “reporting, Hospital Incident” [tw] OR “reporting, Hospital Risk” [tw] OR “Hospital Risk Reporting” [tw] OR “hospital risk reporting” [tw] OR “Reporting, Hospital Risk” [tw] OR “Risk Reporting, Hospital” [tw] OR “risk reporting, Hospital” [tw] OR “incident reporting, Hospital” [tw] OR “Incident Reporting, Hospital” [tw] OR “hospital incident reporting” [tw] OR “Voluntary Patient Safety Event Reporting” [tw] OR “Hospital Incident Reporting” [tw] OR “Incident Reporting” [tw] OR “incident reporting” [tw] OR “Reporting, Incident” [tw] OR “reporting, Incident” [tw] Records retrieved: 311,735 Search #3 Query: “Patient Safety” [MESH] OR “Patient Safeties” [tw] OR “Safeties, Patient” [tw] OR “Safety, Patient” [tw] Records retrieved: 21,663 Search #4 Query: Search #1 AND #2 AND #3 Records retrieved: 1,766 Appendix II: Data extraction instrument A. Responsible for extraction B: Bibliographic data Year of publication C: Study Type Place Objective D: Population Patient profile Type of pathology Medicinal characteristics Pump characteristics E: Concept Adverse events (errors or adverse reactions) Risk stage Security actions F: Context Hospital institution G: References Relevant bibliographic

Background The World Health Organization (WHO) declared the 2019 novel coronavirus (SARS-CoV-2) a pandemic on March 11, 2019. Recent findings from a pooled analysis suggested a prominent increase in D-dimer levels as a predictor of adverse outcomes was persistently seen in coronavirus disease 2019 (COVID-19) suggesting the presence of underlying coagulopathy (Lippi). There is an increasing evidence that severe COVID-19 may have a potential impact on thromboembolism risk but the nature and extent of these abnormalities is not clear. We plan to conduct a scoping review of coagulopathy and thrombosis risk associated with COVID-19 infection with the aim of providing an overview of the current knowledge on this topic. Methods A literature search will be conducted using a single search engine through PubMed using the Medical subject headings (MeSH) COVID, coronavirus, coagulopathy, disseminated intravascular coagulation, thrombosis, deep vein thrombosis, pulmonary embolism, venous thromboembolism and hemostasis, through Boolean operators. Additional references are retrieved from included papers and from the guidelines of the International Society on Thrombosis and Haemostasis (ISTH), and Thrombosis United Kingdom (UK). Broad screening will be conducted according to title. Subsequently, all relevant abstracts are reviewed. In the end, all potentially included articles will be reviewed in full length. Two reviewers (FAA, SC) separately will assess the potentially included papers to verify eligibility. Discrepancies are resolved by a consensus or by a third reviewer (ALL). There is no language restriction. Translation of included papers from Chinese to English will be conducted with the use of Google Chrome’s built-in translation tool. Inclusion Criteria 1- Study design: randomized control trials (RCTs), observational cohort studies (prospective or retrospective), case-control studies or case series. 2- Participants: adult patients with hospitalized COVID-19 infection 3- Participants should have been assessed for thrombosis or coagulopathy Study outcome The study outcome is a descriptive assessment of thromboembolism incidence and risk including deep venous thrombosis (DVT)/pulmonary embolism (PE), thromboprophylaxis strategy, risk of Disseminated Intravascular Coagulation (DIC) in COVID-19 infections, and the role of coagulation markers in predicting the severity and mortality of the disease. Study potential limitations This is a rapidly evolving issue. Data may be change in the near future.

Systematic review Review title. Does the filling technique and the type of sealer affect the incidence of postoperative pain in endodontic treatment? A systematic review of clinical trials. Anticipated or actual start date. DD/MM/YY- 03/02/2020 Anticipated completion date. DD/MM/YY - 30/11/2020 Stage of review at time of this submission. Review stage Started Completed Preliminary searches Yes Yes Piloting of the study selection process Yes Yes Formal screening of search results against eligibility criteria Yes Yes Data extraction No No Risk of bias (quality) assessment No No Data analysis No No Named contact. Emilio Carlos Sponchiado Junior spemilio@ufam.edu.br Named contact address Piracicaba Dental School- State University of Campinas (UNICAMP) , Av. Limeira, 901 - Areião, Piracicaba – São Paulo, Brazil. Organizational affiliation of the review. Piracicaba Dental School- State University of Campinas (UNICAMP) 1.Emilio Carlos Sponchiado Junior. Federal University of Amazonas and Piracicaba Dental School (UNICAMP) 2. Walbert de Andrade Vieira. Piracicaba Dental School (UNICAMP) 3. Juliana Vianna Pereira. Federal University of Amazonas and Piracicaba Dental School (UNICAMP) 4. Adriana de Jesus Soares. Piracicaba Dental School (UNICAMP) Funding sources/sponsors. There is no funding involved in the present systematic review Conflicts of interest. None Review question. Does the filling technique and the type of sealer (Interventions) affect the incidence of postoperative pain (Outcomes) in endodontic treatment? (Population) A systematic review of clinical trials. (Study design) Searches. The main databases searched was PubMed (including MEDLINE), Scopus, Embase, SciELO, Web of Science, Cochrane Library and LILACS. Each article will be assessed carefully and in detail. In case of missing information, the authors will be contacted by e-mail. After the formal search strategy, the reference lists of the eligible article will be searched for eventually missing articles. The search was performed on February 3, 2020. There wasn't any restrictions on the language or publication period. These are some terms that was used: (postoperative pain or endodontic pain or postoperative endodontic pain) and (root canal obturation or root canal sealer or root canal filling). OpenThesis, OpenGrey, REBEC and Clinical Trials base was searched for grey literature. Condition or domain being studied. This systematic review will investigate whether different obturation techniques and different sealers will influence the incidence of postoperative pain in patients undergoing endodontic treatment. Intervention(s), exposure(s). Clinical trials comparing different filling techniques and/or different type of sealers with or without overfilling that evaluated the occurrence of postoperative pain after endodontic treatment. Comparator(s)/control. Other root canal sealers and/or other obturation techniques Types of study to be included. Randomized clinical trials (RCTs) or Controlled Clinical Trials (CCTs) were considered. Participants/population. The inclusion criteria were as follows: Study participants will be adults (age 18–65 years) who underwent endodontic treatment; Participants received conventional RCT or CCT. There were no limitations on gender, ethnicity, or socio-economic status of the participants; type of endodontic diagnosis; Outcome variables included the prevalence of pain, pain intensity, or the need for analgesics; The follow-up time was at least 6h after therapy. The exclusion criteria were as follows Patients who were pregnant, immunocompromised, on medication or hypersensitive to anti-inflammatory drugs, or patients with occlusal disorders or any type of periodontitis or endodontic complications, since these conditions would interfere with the analysis of the presence of pain after endodontic treatment. The inclusion criteria were as follows: Study participants will be adults (age 18–65 years) who underwent endodontic treatment; Participants received conventional RCT or CCT. There were no limitations on gender, ethnicity, or socio-economic status of the participants; type of endodontic diagnosis; Outcome variables included the prevalence of pain, pain intensity, or the need for analgesics; The follow-up time was at least 6h after therapy. The exclusion criteria were as follows Patients who were pregnant, immunocompromised, on medication or hypersensitive to anti-inflammatory drugs, or patients with occlusal disorders or any type of periodontitis or endodontic complications, since these conditions would interfere with the analysis of the presence of pain after endodontic treatment. Studies characterized as case reports, case series, review papers, letters to the editor, monographs, conference papers, or in vitro studies. Main outcome(s). The primary outcome was the analysis of the occurrence of postoperative pain after endodontic treatment. Additional outcome(s). If apical Overfilling affect the incidence of postoperative pain; total amount of analgesics consumed in mg or number or capsules. Data extraction The papers will be screened independently by two reviewers. At first, they will screen the articles by title and abstract. Secondly, full text-papers will be retrieved and selected based on the inclusion criteria. Disagreements between the two reviewers will be resolved by discussion with a third reviewer. Data extraction will also be carried out independently by two reviewers. Data extraction forms will be used to record the following information: (a) authors and year of publication; (b) study design; (c) country; (d) participants sample size; (e) age group and sex (f) endodontic diagnosis; (g) tooth types; (h) endodontic treatment; (i) technique of obturation; (j) type of sealers; (l) extrusion of material filling; (m) evaluation method; (n) evaluation interval; (o) occurrence and pain intensity. Risk of bias (quality) assessment. This systematic review will be carried out following the Cochrane Handbook for the Systematic Reviews of Interventions and the preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines To Assess the quality of the included studies using the Cochrane risk of bias assessment tool for seven domains. For this, each domain will be divided into three categories: low risk of bias, unclear risk of bias, and high risk of bias. The studies will be classified as low risk of bias if all domains were evaluated to be of low risk, as moderate risk bias if one or more domains were evaluated to be of unknown risk, or as high risk if any domain was evaluated as high risk. These procedures will be performed blind (unknown authorship) to avoid conflicts of interest. Disagreements between the two reviewers will be resolved by discussion with a third reviewer Strategy for data synthesis. In case of homogeneous data, will include meta-analysis of the selected papers in which effect measures and 95% of CIs or standard deviation are reported or can be extracted. Data from eligible studies will be either dichotomous (occurrence of pain) or continuous (pain intensity and amount of analgesics consumed). The outcomes will be summarized by calculating the Hedge’s g standardized mean difference (continuous data) and the risk ratio (dichotomous data). The random effects models will be employed. Heterogeneity wil be assessed using the I² statistics. Potential publication bias will be tested for using the funil plot. The level of significance for all tests was 5%. Analysis of subgroups or subsets. Depending on the number of included studies, subgroup analysis will be performed to evaluate: Subgroup analysis will be carried out according to technique obturation group, type of sealers and with or without apical overfilling. Type of review Systematic Review of Intervention and Meta-analysis Language and Country English / Brazil Keywords. endodontic, postoperative pain, root canal obturation, root canal sealer Current review status. Review Ongoing Other Registers PROSPERO acknowledgement of receipt [169255]

A scoping review will be conducted in order to summarise the available evidence on digital health and multidisciplinary management of obesity including overweight. Studies will be selected if the obesity management is based on nutrition education, promotion of regular physical activity and/or psychological support through digital health. The PRISMA-ScR checklist (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review) will be followed. - Hypotheses and objectives Obesity is a multifactorial disease. Multidisciplinary approaches based on nutrition education, promotion of regular physical activity and/or psychological support provide an optimal management of obesity (1-4). As digital health enables people to manage their own health, digital health technologies might sustainably help to take charge of obesity (5, 6). - The objective of the scoping review is to summarise the available evidence on multidisciplinary management of obesity through digital health, based on nutritional, exercise and/or psychological support. - Design Plan: + Study type: Scoping review. + Study design: Scoping review based on a systematic search of evidence. The evidence will include observational (i.e. cross-sectional, case-control studies and cohorts) and experimental (i.e. randomised controlled trials or non-randomised trials) studies. - Sampling Plan: + Existing Data: The present study corresponds to the first research conducted by our group in this domain. + Explanation of existing data: Understanding on the existing data has been limited to exploratory non-systematic searches of reviews and studies using PubMed. + Data collection procedures: ++Eligibility criteria: Studies published in English since January 1st 2000 will be considered. Studies will be selected if they consider the management of obesity as a disease through digital health in humans. Eligible studies will have information on the multidisciplinary management of obesity, including overweight, through nutrition education, physical activity promotion and/or psychological support through digital health technologies. Original research will be eligible. Brief reports, reviews and commentaries will be considered as a potential source of references not found in our systematic search. The age range of inclusion will be between 6 and 64 years old: children (6-12 years), adolescents (13-18 years), adults (19-44 years) and people at middle age (45-64 years) having overweight or obesity. ++Exclusion criteria: Children and adults with normal weight (without overweight or obesity), Children < 6 years, Elderly people (≥ 65 years), Studies targeting the management of other chronic diseases than obesity as primary outcome (e.g. cardiovascular disease, diabetes, cancer, hypertension…). In these studies, obesity is not considered as a disease, but as a risk factor of the other chronic diseases, Pregnancy, Articles published languages other than English, “Grey” literature (reports, doctoral theses, conference contributions, book chapters, editorials), unless they will be used to identify potential references. ++Systematic search: 1. An exhaustive systematic search of the literature will be performed through the following selected databases: PubMed covering all records from Medline, as well as in-processing publications, Scopus covering all records from PsycINFO and Web of Science, in addition to Medline records. If needed we will contact colleagues working on the topic of interest to ask to them for potential relevant material. 2. Joanna Briggs Manual: The scoping review will be performed according to the Joanna Briggs Manual: 2.1. Identification of key words An initial limited search in 20 previously published papers will be performed. This will enable us to identify the main keywords and synonyms associated with the topic. These keywords will be extracted from the title, abstract and the main text of the selected articles. A snowball search will be performed, based on the references cited in the selected papers. The 20 most significant studies will be selected from the snowball search. A MeSH (Medical Subject Headings) terms search will also be conducted. 2.2. - Execution of systematic search: The systematic final search will be conducted, in the selected databases, based on the combination of the selected keywords. The search strategy will have the following structure: “keywords for obesity” AND “keywords for digital health” AND “keywords for nutritional education OR promotion of physical activity OR psychological support”. The full electronic search strategy will be presented in the appendix of the final manuscript. ++Data charting process: The open access online software CADIMA (JKI—Julius Kühn-Institut, vers. 2.1.3 - Feb 2020) will be used to conduct the systematic search. +++ Papers selection: The literature search will be uploaded from the PubMed and Scopus databases into the software CADIMA as a bibliographic citation file that will be registered in RIS (Research Information Systems) format. The search results will then be combined. The duplicated studies will be detected and eliminated. In order to select the papers that will be included in the scoping review, the recorded papers will be screened. The screening of the identified references will be performed at the level of the title, abstract and the full text. Two independent researchers will work on the pre-selection and selection of the studies and a third researcher will act as a mediator for agreement of the selection. The titles, abstracts and texts should mention the multidisciplinary management of obesity through digital health, based on nutrition education, promotion of regular physical activity and/or psychological support. The following selection criteria will be applied to define the eligibility of a study: ++++ Population: Human 6-64 years, having overweight or obesity, no pregnant. ++++ Intervention/Exposure: Digital technologies to manage obesity including overweight, based on a multidisciplinary approach including nutrition education, promotion of physical activity and/or psychological support. ++++ Study Design: Observational studies (cross sectional studies, case-control, and cohorts) or interventional studies (randomized controlled trials and non-randomized controlled trials). A consistency check will be performed on a random sample of the selected references in order to assess the inter reviewer agreement, following the application of the selection criteria. +++ Data extraction: The following information will be extracted from the selected papers: ++++Study information: Specific Objective of the study (feasibility, efficacy or efficiency) Study design Study location and country (school, workplace…) Study duration (weeks) Study / Weight management program's name Type of digital health technology used (internet-based weight loss program, mobile application…) Name of the digital health technology used (MyFitnessPal, Lose it!....) ++++Target population: Adults / Children / Parent-child dyad (yes, no) Sample size Gender (N, %) Age (minimum, maximum) Dropout (N, %) ++++ Approaches: Nutritional intervention / Digital health-Nutritional intervention / Physical activity intervention / Digital health- Physical activity intervention / Psychological support intervention / Digital health- Psychological support intervention / Control Group / Dropout. - Study outcomes: + Feasibility, efficacy and/or efficiency + Anthropometric, biological, clinical, nutrition-physical activity and psychological related outcomes. - Data presentation: The presentation of the data and the results will include the description of the study selection process through a flow diagram based on the PRISMA for scoping review checklist, as well as a bibliographic reference list for each database after elimination of the duplicates, the results of the consistency check. The main findings will be presented in tables and supplementary material. - Co-authors contributions: HS conceptualized the study and coordinated the review. AB and SSFDC performed the systematic search. SSFDC, GRM and B Leners performed the papers selection and data extraction. HS acted as a mediator for agreement of the studies selection and data extraction. SS advised the team on the scoping review process. SSFDC and HS drafted the manuscript. AB, GF, SS, B Lefebvre and TB provided further input to the manuscript. All authors critically revised the manuscript for important intellectual content, and approved the final version. - Acknowledgement: We acknowledge Coralie Dessenne, Documentation Officer at the Luxembourg Institute of Health, for her support, especially her advice advising on the literature search. - References: 1. Bischoff SC, Damms-Machado A, Betz C, Herpertz S, Legenbauer T, Low T, et al. Multicenter evaluation of an interdisciplinary 52-week weight loss program for obesity with regard to body weight, comorbidities and quality of life--a prospective study. Int J Obes (Lond). 2012; 36: 614-24. 2. Yumuk V, Tsigos C, Fried M, Schindler K, Busetto L, Micic D, et al. European Guidelines for Obesity Management in Adults. Obesity facts. 2015; 8: 402-24. 3. Yumuk V, Fruhbeck G, Oppert JM, Woodward E, Toplak H. An EASO position statement on multidisciplinary obesity management in adults. Obesity facts. 2014; 7: 96-101. 4. Ross MM, Kolbash S, Cohen GM, Skelton JA. Multidisciplinary treatment of pediatric obesity: nutrition evaluation and management. Nutr Clin Pract. 2010; 25: 327-34. 5. World Health Organisation. WHO Guideline: recommendations on digital interventions for health system strengthening. 2019. 6. Castelnuovo G, Simpson S. Ebesity - e-health for obesity - new technologies for the treatment of obesity in clinical psychology and medicine. Clin Pract Epidemiol Ment Health. 2011; 7: 5-8.

Claim paragraph (from the sourcing sheet): We selected the claim that the number of deaths from COVID-19 is significantly associated with the decision to issue the stay-at-home order. This reflects the following statement from the paper’s abstract: “We also observed a clear dose-response relationship in the Cox model: the larger the number of cases, or deaths, the higher the probability that the stay-at-home order will be made.” The claim was tested by using a Cox regression analysis, in which all data for eligible states was used, but those states that had not issued the order by the time of the analysis were censored. The Cox regression curves show that the number of deaths from COVID-19 is significantly associated with the probability of declaring the state-at-home order (hazard ratio (HR) = 1.68, p < 0.00001). The focal test in the original paper is: The Cox regression curves show that the number of deaths from COVID-19 is significantly associated with the probability of declaring the state-at-home order (hazard ratio (HR) = 1.68, p < 0.00001).

Data were collected from children with a sex chromosome trisomy and/or autism, and their families. Families completed two questionnaires (the Children's Communication Checklist and the Pediatric Symptom Checklist) and took part in a telephone interview using the 3Di-sv autism assessment. Children completed a test battery including five novel language tasks and a nonverbal matrix reasoning task. The test battery could be completed remotely or with a researcher. Where a researcher met with the young person, a conversation sample was collected. The data are reported in Wilson & Bishop (2020). Does the autism phenotype differ when selecting groups by neurodevelopmental versus genetic diagnosis? A comparison between autism and sex chromosome trisomy. This paper considers the results for the language battery and 3Di across groups. Scripts relevant to this paper are MainAnalysis.R and MakePlots.R. Alongside the analyses reported in this paper, we developed a new measure to assess the conversation samples collected from young people involved in the project. This new measure is called the Observational Assessment of Conversation Scale (OACS): see OACS.docx for the rating scale and OACS.csv for the associated data. This analysis has not been formally written up for publication.

Introduction Spasticity is the root cause of the functional limitations in cerebral palsy and it can be countered by various methods. Selective dorsal rhizotomy (SDR) is a procedure in which afferent fibers are ablated near the posterior root of the spinal cord leading to reduction of efferent excitation which thereby reduces spasticity. This involves identification of the rootlets during surgery through intraoperative electrical stimulation so that only those rootlets are ablated which contribute maximally to spasticity (1). Also, several functions have been reported to have improved post SDR which cannot be explained by traditional neural pathways like speech, cognition, upper limb function and visual attention (2). Earlier studies have shown the development of spinal deformities post SDR (3–5). Various other transient and non-transient side effects or complications have been reported in literature (6–8). The literature lacks a concise overview regarding the various possible complications which can occur secondary to SDR. The aim of this study is to systematically review the literature regarding the various possible complications post-SDR and present them concisely. Material and methods The current systematic review will be performed following PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analysis). The protocol of the review will be registered on PROSPERO and Open Science Framework. A literature search using PubMed (http:// www. ncbi.nlm.nih.gov/pubmed), Embase (http:// www. elsevier.com/online- tools/embase) and Google Scholar will be done focusing on outcomes and complications of selective dorsal rhizotomy in cerebral palsy. The keywords ‘outcome’, ‘result’, ‘complication’, ‘selective posterior rhizotomy’, ‘functional posterior rhizotomy’ and ‘selective dorsal rhizotomy’ will be used. The search strategy [((outcome) OR (result) OR (complication)) AND ((selective posterior rhizotomy) OR (functional posterior rhizotomy) OR (selective dorsal rhizotomy))] will be used. The search will also be replicated using the appropriate MeSH terms. The following filters will be used to obtain the probable article candidates: humans and English, French and German. Additional articles will be identified through the ‘related articles’ feature. All bibliographies will be checked for further probable studies for inclusion. The full text will be obtained after the screening of the title and abstract. Final selection of the articles will be done and any disagreement on the process was resolved by a group discussion of the three authors (PK, SB, DM). Studies on SDR in cerebral palsy will be included. The studies to be included were to have used SDR for management of spasticity in patients of cerebral palsy. The long-term complications of SDR mentioned in the articles will be included in this study with special emphasis on spinal deformities. Exclusion criteria will be studies with less than 5 cases, technical notes, review articles, conference abstracts, conference papers, conference reviews, data papers, and editorials. Full texts of the eligible studies will be retrieved and data extracted in Microsoft Excel sheets. The studies will be graded according to Oxford Centre for Evidence- Based Medicine. References 1. Steinbok P, Reiner A, Beauchamp RD, Cochrane DD, Keyes R. Selective Functional Posterior Rhizotomy for Treatment of Spastic Cerebral Palsy in Children. Pediatr Neurosurg. 1992;18(1):34–42. 2. Mittal S, Farmer JP, Al-Atassi B, Montpetit K, Gervais N, Poulin C, et al. Impact of selective posterior rhizotomy on fine motor skills. Long-term results using a validated evaluative measure. Pediatr Neurosurg. 2002 Mar;36(3):133–41. 3. Peter JC, Hoffman EB, Arens LJ, Peacock WJ. Incidence of spinal deformity in children after multiple level laminectomy for selective posterior rhizotomy. Childs Nerv Syst. 1990 Jan 1;6(1):30–2. 4. Steinbok P, Hicdonmez T, Sawatzky B, Beauchamp R, Wickenheiser D. Spinal deformities after selective dorsal rhizotomy for spastic cerebral palsy. J Neurosurg. 2005 May;102(4 Suppl):363–73. 5. Ravindra VM, Christensen MT, Onwuzulike K, Smith JT, Halvorson K, Brockmeyer DL, et al. Risk factors for progressive neuromuscular scoliosis requiring posterior spinal fusion after selective dorsal rhizotomy. J Neurosurg Pediatr. 2017 Nov;20(5):456–63. 6. Bolster EA, van Schie PE, Becher JG, van Ouwerkerk WJ, Strijers RL, Vermeulen RJ. Long-term effect of selective dorsal rhizotomy on gross motor function in ambulant children with spastic bilateral cerebral palsy, compared with reference centiles. Dev Med Child Neurol. 2013 Jul;55(7):610–6. 7. Nordmark E, Josenby AL, Lagergren J, Andersson G, Strömblad LG, Westbom L. Long-term outcomes five years after selective dorsal rhizotomy. BMC Pediatr. 2008 Dec;8(1):54. 8. Sitthinamsuwan B, Phonwijit L, Khampalikit I, Nitising A, Nunta-aree S, Suksompong S. Comparison of efficacy between dorsal root entry zone lesioning and selective dorsal rhizotomy for spasticity of cerebral origin. Acta Neurochir (Wien). 2017 Dec;159(12):2421–30.

Over 150 million Americans receive health insurance through an employer or union. Most employers rely on insurance companies to act as agents and negotiate prices with hospitals and other health care providers and both design and administer benefits. While this contracting structure should create incentives to constrain costs, recent empirical work has highlighted both the wide variability in prices paid by employer plans and the high level of prices relative to Medicare and other public payers. Hospital and insurer markets are imperfectly competitive, and several recent studies have modeled hospital prices as equilibrium outcomes of bargaining between hospitals and insurers; Ho and Lee (2017) also link hospital price setting to insurer market structure and bargaining over premiums between insurers and employers. However, little existing work has examined how insurer monopoly power with employers leads to monopsony power in the hospital market. If negotiating prices requires substantial effort (i.e., transaction costs), then insurers with monopoly power in the insurance market may be unwilling or unable to exploit their monopsony power in bargaining with hospitals. Relatedly, existing literature has only briefly examined how the structure of hospital-insurer contracts explains pricing patterns. Hospital-insurance contracts range from contracts that specify a multiplier of Medicare rates, contracts that use a discounted rate of billed charges, and contracts that separately negotiate different prices for different procedures. The characteristics of hospitals, employers, and insurers that use these various contracting forms is not known, and the literature on insurer-hospital bargaining has not incorporated variation in the form of insurer-hospital contracts into structural models. Finally, while the existing literature finds that many physician contracts are based on a percentage of Medicare, the influence of Medicare payments on hospital prices paid by private insurers has only rarely been examined. Cooper et al. (2019) documented that percentage-of-Medicare contracts are less common among hospitals than among physicians. We will follow the approach of Clemens & Gottlieb (2017) and examine how administrative updates to Medicare payment rates influence private insurance prices for inpatient and outpatient hospital care. 1.1.1. Overview In this project, we will use a multi-state, multi-payer database of hospital claims to provide new evidence on how hospital prices paid by private insurers are determined across a broader cross-section of US hospital markets and payers than has previously been examined. The ultimate goal of this study is to develop and estimate a structural model of hospital-insurer bargaining that is capable of explaining price variation observed within hospital markets, individual hospitals, and hospital-insurer pairs as an equilibrium outcome of hospital-insurer bargaining. Our modeling approach will build on the framework developed by Gowrisankaran, Nevo, Town (2015), and related papers, but extend their model to incorporate data on the form of hospital-insurer contracts, perhaps by allowing for transaction costs associated with insurer bargaining that depend on the contract form. In order to inform this modeling effort, we have also planned a number of descriptive analyses that are pre-specified in this analysis plan. Many of our initial analyses will focus on basic descriptive statistics characterizing the degree of variation in hospital prices and the associations between hospital prices and factors such as hospital market structure, insurer market structure, and employer characteristics, as in Cooper et al. (2019). We will also use a new method for inferring hospital contract structure from claims data to describe the prevalence and correlates of Medicare-based, charge-based, and other contract forms, as well as associations between contract form and price. After describing the extent of cross-sectional variation in hospital prices and the relative importance of variation across hospitals, within hospitals across insurers, and within hospital-insurer pairs across employers, we will also use linear regression models to describe the association between prices and market structure while controlling for hospital, insurer, employer, and market characteristics. Finally, we will follow previous studies (Cooper et al. (2019) for hospitals and Clemens and Gottlieb (2017) for physicians) and reexamine the relationship between Medicare payments and private hospital prices. Contributions Many of our initial descriptive analyses are intended to replicate or reexamine those conducted in several recent studies on hospital prices, particularly Cooper et al. (2019) and Craig, Ericson and Starc (2018). Compared to these papers and other studies that have described variation in hospital prices, an innovation of our study is the use of a unique claims database with unprecedented breadth in terms of the scope of payers included and geographic diversity. In contrast to the HCCI data used by Cooper et al. (2019), which contain claims from three of the five largest nationwide insurers, our data include claims from some BCBS insurers. We also use all-payer claims database (APCD) data from seven states, which captures fully-insured business in the small group market, including smaller insurance carriers that are not captured in more widely used multi-payer commercial claims datasets such as Marketscan or HCCI. While Craig, Ericson, and Starc (2018) analyze a broad range of payers using data from the Massachusetts APCD, our claims database includes employers in several states, providing us with many more hospital markets and, potentially, greater cross-sectional variation in market structure with which to examine hospital price determination. Finally, we will provide new evidence on the role of contract structure as a mechanism explaining hospital price variation. 1.1.2. Research Questions 1. What is the effect of the contracting form on the hospital-insurer negotiated prices? 2. How does contract form and hospital prices vary with the degree of employer, insurer, and provider market power? 3. Describe variation in hospital prices across wider set of payers and health care markets than in previous literature • Within a hospital market and within a hospital, how do prices and contract form differ between small payers in the competitive fringe and large, multi-state insurers examined in the previous literature 4. Describe variation in payer-hospital contract form (% Medicare vs. % of Charges). Does variation in contract form reflect frictional costs (e.g., costly bargaining effort paid by insurer)? 5. How do employer characteristics affect insurer-hospital bargaining outcomes, including contract form and hospital price. • Employer characteristics include firm size, industry, ASO vs. fully-insured, firm concentration (relative to local labor market) 6. Do hospital responses to payment changes vary with hospital market structure? When do payment reductions result in a) hospital cost savings/greater efficiency vs. b) reduced profits with no change in efficiency c) cost-shifting to other payers? • Treat Medicare updates as exogenous payment changes?

Introduction: Individuals experiencing chronic musculoskeletal pain often report episodes of ‘brain fog.’ The associated impairments in cognitive abilities may further limit engagement in daily activities. Currently, symptoms, assessment methods, and potential management strategies remain understudied and ill-defined. Inclusion criteria: This review will include both peer-reviewed and non-peer reviewed sources including quantitative and qualitative experimental studies, thesis papers, and review papers, addressing cognitive functioning in persons,18-65, with chronic pain as a primary feature of their condition. We will exclude papers not published in English, sources with or incomplete data such as conference abstracts and sources which the full text cannot be obtained after reasonable efforts. Methods: We will systematically search the Medline, PyscINFO, Embase and CINAHL databases from inception using a formal keyword search constructed with inputs from a health librarian. Initially titles, abstracts will be dual screened to confirm the eligibility criteria. Studies meeting the criteria will proceed to full-text review, followed by data extraction, where two reviewers will process information. The data extraction form will be developed incorporating recommended categories (Aromataris & Munn, 2020) and pilot tested on a purposeful sampling of different study designs. We will report summary statistics including frequencies and percentages to describe the data set obtained (e.g. study designs, specific pain populations, interventions and outcomes). Qualitative content description methods will also be employed to generate a summary of the definitions and taxonomies used to describe ‘brain fog’. Results will then be presented in narrative, table and graph forms. Inspired by the Levac, Coloquhon and O’Brien (2010) elaboration of scoping review methods, we will also seek input on results and conclusions by health care professional and persons living with pain.

BACKGROUND Adverse childhood experiences (ACEs) are potentially traumatic events such as abuse, neglect, and household dysfunction that occur in the first eighteen years of life (Felitti et al., 1998). Research has found robust dose-response relationships between ACEs and many negative physical and psychosocial health outcomes (Kessler et al., 2010; Petruccelli, et al., 2019). The deleterious effects of ACEs can also be transmitted across generations through mechanisms such as maternal mental health, parenting practices, epigenetics, and socio-economic disadvantage (Merrick, et al., 2020; Scorza et al., 2020; Herbell & Bloom, 2020; Mersky, et al., 2021). However, not all individuals who are exposed to ACEs experience negative outcomes, in part because they may also be exposed to protective factors such as positive childhood experiences (PCEs) that can build resilience and buffer the negative effects of ACEs (Bethell, Jones, Gombojav, et al., 2019). Examining ACEs and PCEs jointly is important because it provides researchers with a more comprehensive understanding of the impact of ACEs and the interactions between ACEs and PCEs. It also allows researchers to better target the needs of people exposed to ACEs and develop effective prevention and intervention strategies and promote positive health and psychosocial outcomes. Although ACEs affect people from all communities, racially marginalized groups have higher prevalence rates of ACEs (Maguire-Jack et al., 2020). One study indicated that mean ACE scores are higher among Hispanics, non-Hispanic Blacks, and American Indians compared to non-Hispanic Whites and Asians (Mersky et al., 2021). Asian Americans comprise the fastest-growing racial minority group in the U.S., but few studies have reported ACE or PCE prevalence rates in Asian American populations (Bethell, Jones, Gombojav, et al., 2019; Crouch et al., 2019). Of those studies that have, Asian Americans appear to have the lowest prevalence of ACEs compared to other racial/ethnic groups (Bethell, Davis, Gombojav, et al., 2017). However, low ACE prevalence rates may mask substantial social, economic, and educational disparities across Asian Americans that could have effects on health. Most studies depict Asian Americans as a homogeneous sociocultural group, when in fact, Asian Americans represent over 20 different ethnic groups. Asian Americans often face model minority stereotyping and are viewed as the most prosperous and well-educated ethnic group in the U.S. (Shih, Chang, & Chen, 2019). This false narrative of Asian Americans obscures the understanding of diversity among this population. An assessment of the current knowledge of ACEs and PCEs prevalence and impact is imperative for beginning to evaluate the scope and severity of these phenomena in Asian American populations. A preliminary search did not identify any types of reviews about ACEs or PCEs in Asian American populations. A scoping review is indicated due to the exploratory nature of this review, in light of the limited research evidence on the topic. The objective of this scoping review is to assess the available evidence about the prevalence and impact of ACEs and PCE in Asian American populations. REVIEW QUESTIONS 1. What is known about the prevalence of adverse childhood experiences (ACEs) in Asian American populations? 2. What is known about the prevalence of positive childhood experiences (PCEs) in Asian American populations? 3. What is known about the impact of ACEs on Asian Americans’ physical and mental health and psychosocial outcomes such as educational attainment, criminal justice involvement, and socioeconomic status? 4. What is known about the impact of PCEs on Asian Americans’ physical and mental health and psychosocial outcomes such as educational attainment, criminal justice involvement, and socioeconomic status? KEYWORDS Adverse childhood experiences; Asian-American; health disparities; positive childhood experiences ELIGIBILITY CRITERIA Participants Individuals self-identified as Asian Americans aged zero to end of life living in the U.S.. Based on U.S. Census definition, Asian-Americans are persons “having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent” (U.S. Census Bureau, n.d.). The review includes all Asian American populations regardless of immigration status. Concept This review seeks to assess the state of the science regarding the prevalence and impact of ACEs and PCEs in Asian American populations. Studies will be included if they used ACE or PCE measures that captured cumulative adverse events or protective factors. Studies that only examine one domain of adversity, such as maltreatment or separation from caregivers, will be excluded. Context This review will assess studies that examined ACEs and PCEs in Asian Americans, including as a sub-sample within a larger study. This review will include national and state-level samples, community samples, and clinical samples. Studies will not be excluded based upon setting. Types of Sources This scoping review will consider quantitative and qualitative studies reporting on the prevalence of ACEs or PCEs or on the impact of ACE or PCEs. This will include any experimental or quasi-experimental study designs and observational study designs. Gray literature, including dissertations, reports, and white papers, will be included. Systematic reviews and meta-analyses will be excluded. METHODS The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) scoping review guideline for scoping reviews (Peters, et al., 2020) and publicly available in the Open Science Framework (OSF). Search Strategy An initial search of PubMed, CINAHL, PsycINFO, and Web of Science was conducted to identify keywords, search terms, and to develop a full search strategy. The review will conduct searches in five databases including PubMed, Embase, CINAHL, PsycINFO, and Web of Science. Advanced search techniques such as Medical Subject Headings (MeSH), truncation, proximity searching, and phrase searching will be used to capture the concept of adverse and positive childhood experiences. Appendix 1 describes the complete strategy for each database. Study Selection Following the search, all identified citations will be exported from the search databases into Covidence, a web-based software platform for researchers to collaborate on primary screening and data selection for research review projects. Duplicated citations are deleted by Covidence automatically or manually by two reviewers if missed by Covidence. Two levels of screening for the study selection will be established. At the first level, two reviewers will independently review titles and abstracts of all publications obtained from the electronic databases search. Citations deemed relevant by both reviewers will be included in full text review. Discrepancies between reviewers will be resolved by discussion between reviewers to reach consensus. At the second level, the full text of each relevant citation will be assessed by two reviewers independently using established criteria to determine eligibility for inclusion. Reasons for exclusion of citations will be recorded and reported in the scoping review. Any discrepancies between the assessments of the two reviewers will be resolved through discussion and consensus, or with an additional reviewer if needed. The results of the search, screening, and inclusion process will be reported in full in the scoping review using a PRISMA-ScR flow diagram (Page, et al., 2021). Data Extraction Data will be extracted from included sources by two independent reviewers using a standardized and detailed Excel spreadsheet. The following variables will be abstracted: • Authors • Year of publication • Type of publication • Location and setting • Study design • Study aim • Participant characteristics (e.g., mean age, ethnicity, gender) • Sample size • Measurement tools used to measure ACEs/PCEs and outcome variables • Type/category of ACEs and/or PCEs measured • ACE and/or PCE prevalence • Results for outcomes of interest Any discrepancies between the extraction results of the two independent reviewers will be resolved through discussion or with an additional reviewer if necessary. Data Analysis and Presentation Studies will be divided into two broad categories for analysis: ACEs/PCEs prevalence estimates and impact of ACEs/PCEs. Quality of selected publications will be critiqued using the JBI appraisal tools. Details of selected publications including quality of the evidence will be summarized and synthesized in tables within the paper. A narrative summary will accompany the tabulated results and will describe how the results relate to the review objectives. Funding None Conflicts of Interest Neither Wenyi Chen nor Emily Hoppe have a conflict of interest in this project.

Authors Dr Edelweiss Aldasoro 1 edelweissaldasoro@integratedcarefoundation.org Lydia O’Sullivan 2,3 lydia.osullivan@ucdconnect.ie Áine O’Brien 4 aineobrien2018@gmail.com Dr Clíona McGovern 2 cliona.mcgovern@ucd.ie Dr Maeve Nolan 5 maeve.nolan@nrh.ie Professor Áine Carroll 1, 2,5 aine.carroll@nrh.ie 1 International Foundation for Integrated Care 2 School of Medicine, University College Dublin 3 Health Research Board-Trials Methodology Research Network 4 School of Health Sciences, National University of Ireland, Galway 5 National Rehabilitation Hospital, Dun Laoghaire Corresponding author: Dr Edelweiss Aldasoro International Foundation for Integrated Care Annexe Offices, Linton Road, Oxford, OX2 6UD, England Title Protocol for a Rapid Systematic Review: How can an ethical decision-making tool compliment and assist healthcare decisions in a pandemic? Abstract The COVID-19 pandemic has placed unprecedented pressures on healthcare systems throughout the world. There is a move from patient centred provision to practices primarily guided by considerations of public health well-being. Asked to respond to this crisis in an equitable, reasonable and proportionate way, the adherence of health services personnel to a ‘duty of care’ continues to alter in response to the evolving impact of this pandemic. Unique and challenging ethical issues have been raised as a direct result of COVID-19. These include prioritising access to health care resources, conflicts for health care workers weighing up work obligations and family responsibilities and the implementation of measures to reduce the spread of the disease, while protecting the rights of the individual to free movement. The objective of this rapid review is to identify and assess the available international literature regarding ethical frameworks and decision making to inform the development of a comprehensive ethical framework in Ireland. This framework will aim to support health care professionals, administrators and managers when making decisions regarding the allocation of limited healthcare resources in emergency situations, such a pandemic. Keywords Ethics; Ethical framework; Scarce resources; Pandemic; COVID-19; Coronavirus Introduction Rationale for this Rapid Review The COVID-19 pandemic has placed unprecedented pressures on healthcare systems throughout the world 1 2. In Ireland, as in many neighbouring European countries, there is a move from patient centred provision to practices primarily guided by considerations of public health well-being. Asked to respond to this crisis in an equitable, reasonable and proportionate way, health services personnel adherence to a ‘duty of care’ continues to alter on a realisation of impact of this pandemic. Drawn from experiences in Italy and Spain, such pandemics are catastrophic on healthcare systems, outstripping resources (i.e. protective equipment), and creating a shortage of personnel and of life-saving equipment 3 4. Faced with increasing number of patients requiring acute care, ethical decisions are being made on how to allocate resources and to identify patients who have the most favourable chance of survival. Unique and challenging ethical issues have been raised as a direct result of COVID-19. These include prioritising access to health care resources, obligations of health care workers considering risk to their own health and the implementation of measures to reduce the spread of the disease, while protecting the rights of the individual to free movement. In this context front-line clinicians (including administrators/managers) are looking for ethical decision-making tools that provide key-knowledge sharing opportunities and compliment clinical decisions on patient care pathways; as speedily – but proportionately and fairly; as possible. However, it is recognised that presently no national collaborative effort is taking place to determine appropriate practices or protocols for use in Ireland. This challenging situation calls for an ethical framework and decision-making tool to guide healthcare professionals, administrators and managers when allocating scare resources, such as manpower, personal protective equipment, ventilators etc. Given the unprecedented and emerging nature of the COVID-19 pandemic, there are currently no published systematic reviews summarising the available literature on this subject. Objective of the review The objective of this rapid review is to identify and assess the available international literature regarding ethical frameworks and decision making to inform the development of a comprehensive ethical framework in Ireland. This framework will aim to support health care professionals, administrators and managers when making decisions regarding the allocation of limited healthcare resources in emergency situations, such a pandemic. PICO Problem: In a context of acute healthcare resource limitation , how should limited health resources be rationed or fairly allocated in the healthcare setting? Context includes e.g. national emergency, epidemic, pandemic. Limitations include manpower and healthcare equipment etc. Intervention(s): An ethical framework to support decision-making processes to ensure that the maximum benefit is gained from the available resources in a fair and equitable manner. Comparator(s): Not applicable for this review. Outcome(s): 1. Maximise the protection of patient’s rights to healthcare. 2. Minimise the risk of treatment withdrawal based on unethical reasoning. 3. Support for healthcare professionals, administrators and managers making difficult decisions regarding resource allocation. Methods A rapid systematic review methodology was selected given the time sensitive nature of this project. Rapid reviews have been shown to identify and evaluate the relevant evidence similar to a full systematic review. This Rapid Review protocol was compiled following consultation with the Cochrane COVID-19 Rapid Review Workflow and protocol template. The protocol was reviewed for completeness and transparency using the PRISMA-P Checklist 5. The protocol is not eligible for registration on the PROSPERO database, as the question of interest is an ethical framework, and not a clinical outcome for participants. Eligibility Criteria Articles will be included if they meet the following Inclusion/Exclusion Criteria. Inclusion Criteria: papers will be included if they contain at least two of these three concepts: • Acute Resource Limitation or similar • Rationing / Allocation / Decision-making or similar • Ethical perspective Exclusion Criteria: papers with the following concepts will be excluded if they contain one or more of these concepts: • Accident and Emergency Services • In-flight emergencies • Clinical research taking place during humanitarian emergencies • Ethics in clinical research • Communication strategies • Informed consent • Other clinical emergencies which are not outbreaks/disasters/pandemics • No abstract • Books which were not open access No limits with regard to language will be applied. All study type and article types will be considered, including exploratory qualitative studies, reflective studies, opinion pieces, philosophical pieces. Information Sources Medline, EMBASE and Google Scholar have been selected as the electronic databases. A search of references, relevant Grey Literature, including LitCovid will be also undertaken. National and International Ethical Frameworks which the authors were aware of will also be included. Due to time constraints, authors of individual papers will not be contacted to collect additional information or to request full text of papers. Search Strategy Following an initial scoping search and consultation with an experienced Health Sciences Librarian, the following search terms were agreed upon and will be used to search within the title or abstract: Search string Key words 1 ((“Coronavirus” OR “Covid19” OR “epidemic” OR “outbreak” OR “pandemic“ OR “humanitarian emergency” OR “catastrophes” OR “disaster”) 2 (“Resources” OR “Resource Allocation” OR “Rationing” OR “Shortage” OR “Personal Protective Equipment” “Ventilator” OR “Triage” OR “Withholding”) 3 (“Ethics” OR “Morality” OR “Ethical framework” OR “Health equity” OR “Decision making”). 4 1 AND 2 AND 3 5 Limit Jan 2000 to 6th April 2020 No limits with regard to language will be applied. For Medline and EMBASE, the following limits will be applied: • Humans • Time period January 2000 to 6th April 2020 Within Google Scholar, the first 200 entries will be included. Study Records Data Management and Selection Process All identified papers will be exported to Zotero and duplicates will be excluded. All remaining papers will be imported to Rayaan to undergo review. Two blinded members of the team (LOS and AOB) will independently screen Titles and Abstracts of all of the papers according to the above Inclusion and Exclusion Criteria using Rayaan. Once Title/Abstract screening is complete, a third member of the team (EA) will resolve discrepancies in the screening decisions. Due to time constraints, three members of the team (EA, LOS, AOB) will each review a portion of the full texts. Papers will be excluded if: • The full text is not available • Doesn’t contain any principles relevant to an ethical framework • The topic relates solely to triage procedures in pandemics/disasters • The topic relates to legal aspects, rather than ethical ones • They contains only a case study / case studies • They only give a brief summary of the main ethical approaches, with no details • The topic relates only to pandemic planning Data Items Data extraction will be completed using a customised data extraction form. Due to time constraints, three members of the team (EA, LOS, AOB) will each extract following data from a portion of the papers selected for analysis: • Lead author • Year of publication of paper • Ethical principles relevant to an ethical framework • Synonyms of the named ethical principle • Related ethical principles • Example(s) of a scenario where the ethical principle applies The screening and selection process will be reported in the form of the PRISMA 2009 Flowchart. Outcomes and Prioritisation The following outcomes will be sought using a qualitative review of the selected papers: • Ethical principles which apply in pandemic situation where resources are scarce • Ethical frameworks already in place for pandemic situations where resources are scarce • Examples of scenarios where these ethical principles or frameworks apply • Examples of how the identified ethical principles relate to or clash with each other No outcome (ethical principle or framework)) will be prioritised over another. Risk of bias in individual studies Due to the nature of this Rapid Review (qualitative review of ethical principles and guidelines), no formal risk of bias assessment will be conducted. Data Synthesis Following data extraction, a constant comparative approach will be employed to evaluate the data. A group consensus will then be sought regarding the appropriateness and applicability of the identified ethical principles and frameworks. Meta-bias(es) Not applicable Confidence in cumulative Evidence Not applicable Data Availability Data will be made available upon request. Reporting Guidelines Not applicable. Author Contributions EA: Data curation; Formal analysis; Investigation; Methodology; Project Administration; Writing – Original Draft Preparation LOS: Data curation; Formal analysis; Investigation; Methodology; Project Administration; Writing – Review and Editing AOB: : Data curation; Formal analysis; Investigation; Methodology; Project Administration; Writing – Review and Editing CMcG: Conceptualization; Project Administration; Methodology; Funding Acquisition; Writing – Review and Editing MN: Conceptualization; Project Administration; Methodology; Writing – Review and Editing AC: Conceptualization; Project Administration; Methodology; Funding Acquisition; Writing – Review and Editing Competing Interests The authors of this Rapid Review have no competing interests to disclose. Grant Information This Rapid Review will be supported by funding from the National Rehabilitation Hospital, Dun Laoghaire. The National Rehabilitation Hospital had no role in the development of this protocol. Acknowledgements The Rapid Review Team would like to acknowledge Mr Diarmuid Stokes, Health Sciences Librarian who provided guidance on the search strategy. The Rapid Review Team also acknowledge the Cochrane COVID-19 Rapid Review Workflow and their protocol template, both of which were used for reference and guidance when writing this protocol. References 1. Emanuel EJ, Persad G, Upshur R, et al. Fair Allocation of Scarce Medical Resources in the Time of Covid-19. New England Journal of Medicine 2020 doi: 10.1056/NEJMsb2005114 2. Prevention CDC. Strategies for optimizing the supply of N95 respirators. Atlanta, USA, 2020. 3. Vergano M, Berolini G, A G. Clinical Ethics Recommendations for the Allocation of Intensive Care Treatments, in Exceptional, Resources-Limited Circumstances: Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care, 2020. 4. Mounk Y. The extraordinary decisions facing Italian doctors: The Atlantic, 2020. 5. Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 2015;4(1):1. doi: 10.1186/2046-4053-4-1

Aims and objectives: This systematic review aims to systematically investigate the available models for COVID-19 lockdown exit scenarios and to synthesise the potential strategies for exiting COVID-19 lockdown. The specific objectives of this review are to: (1) identify which models have been developed for COVID-19 lockdown exit scenarios; (2) investigate differences between available models; (3) synthesise the potential strategies for exiting COVID-19 lockdown. Methods: We will search MEDLINE and EMBASE through Ovid for published studies. We will search two major preprint databases, namely Arxiv and medRxiv for unpublished studies. We will also search Google Scholar, GitHub and the reference lists of included papers for additional studies or models. We will include primary modelling studies that investigated population level COVID-19 lockdown exit strategies. Two reviewers will independently screen the titles and abstracts of identified studies against eligibility criteria. Full-text papers of potentially relevant studies will be assessed by two independent reviewers. Data extraction and risk of bias assessment will be performed independently by two reviewers. A pre-piloted data extraction form will be used to extract data. Summary of overall evidence will be presented in tables and graphs. We will undertake a detailed critical narrative synthesis of the models and lockdown exit scenarios.

Soccer is played throughout the calendar year around the world. Therefore, variations in environmental conditions such as temperature or high altitude should be considered in preparation for, and during, elite team sport competition. We aimed to systematically review observational and quasi-experimental studies which have been specifically designed to quantify the effects of temperature or high altitude on in-match physical performance. A search of electronic databases (Web of Science, Scopus, SPORTDiscus, PubMed/MEDLINE) was conducted, initially resulting in 19,424 papers being identified as relevant. Following sifting in relation to the eligibility criteria, 12 papers were deemed directly relevant. The studies included scored 6-9 (on a 0-9 scale) on quality assessment in a previously utilized scale. The major outcome variables relevant to the current review were total distance (m), high speed running (m) and high-speed runs (count). Standardized effect sizes (ES) were heterogeneous across studies for total distance (ES: -0.96 to -0.14) and high-speed running (ES: -0.69 to 0.12) for 1000 m vs sea-level, time spent in the environment being a putative factor for heterogeneity. Heat had mainly detrimental effects on performance, but again ES were variable across studies (ES: -1.25 to 0.26), dependent on temperature intensity. Given the small number of studies available, and large heterogeneity across studies in effect sizes and sample sizes, more research needs be conducted on team sport performance in these environmental conditions, with specific attention on standardizing outcomes, study reporting and broadening the approaches of studies to guide future decision making in professional sporting environments.

Given the increasing frequency with which biomarkers are being used in alcohol intervention studies, we believe it is an appropriate time to undertake a review of the literature to characterize the types of biomarkers being used, how they are being used, and in what contexts they are being used. This review will take the form of a scoping review, which, unlike a systematic review, is not designed to answer a narrow question through formal qualitative evidence synthesis or meta-analysis, but rather to address exploratory research questions and provide a summary of the literature as well as existing gaps in knowledge on a topic. We aim to provide a narrative overview and map concepts related to the use of biomarkers in alcohol intervention studies. Specifically, the review aims to address the following questions: 1. Which biomarkers have been used in alcohol intervention studies to measure alcohol consumption? 2. What are the characteristics of intervention studies that have included alcohol biomarkers (study designs, country/context, populations, interventions, outcomes)? 3. How were biomarkers used in study and, if a comparison between self-reported and biomarker-obtained alcohol consumption was conducted, did the inclusion of biomarkers change the inference of findings in the study based on self-reported alcohol outcomes? Inclusion and Exclusion Criteria: Studies included in the review will be peer-reviewed papers published in the scientific literature or studies that are ongoing (as evidenced by registration on ClinicalTrials.gov or NIH Reporter) that meet the following criteria: • Studies that were published or in progress between January 1, 2000 and March 31, 2021. • The study pilots or evaluates through experimental, quasi-experimental, or non-experimental designs an intervention that aims, at least in part, to reduce unhealthy alcohol use. • Alcohol consumption is a stated primary or secondary outcome of the study. • The study includes an alcohol biomarker as a primary or secondary method for measuring alcohol consumption. We will exclude studies that use biomarkers for purposes other than evaluating alcohol consumption in the context of an intervention (e.g., biomarker validation studies, observational or epidemiologic studies of alcohol consumption that do not involve an intervention). The search of the literature will proceed with the following steps: • We will conduct searches in the following academic databases: o Medline/Pubmed o PsycInfo o Cochrane Central o Embase o CINAHL o Lilacs o NIH Reporter o Clinicaltrials.gov • Searches will include all possible combinations of search terms in the following three categories: biomarker/biosensor type, alcohol use, and intervention. Searches will be done in the title, abstract, and/or full text of articles. • After searching all of the above databases with each combination of the terms, we will record the total number of records (titles and abstracts) that were identified. • Using Covidence, all duplicates will be removed from the list. • Two independent reviewers will conduct a review of all studies in the list. The initial screening will consist of evaluating the TITLE and ABSTRACT (if available) of the documents that resulted from the search. Discrepancies will be resolved through discussion or, if necessary, by a third reviewer. Reviewers will classify studies as “yes” if the title and abstract describe an alcohol intervention study (i.e., an intervention study in which alcohol was a stated primary or secondary outcome) and the use of an alcohol biomarker/biosensor. Studies will be labeled “maybe” if they describe an alcohol intervention study but do not mention biomarker/biosensor in the abstract/title. Studies will be marked “no” if they are not an alcohol intervention study. • We will retain all articles classified as “yes” or “maybe” for full text review. Two independent reviewers will screen the full text of retained articles based upon the full eligibility criteria. Full text review screening will similarly be completed using Covidence software. Reviewers will meet to discuss any discrepancies. If needed, a third reviewer will resolve discrepancies that were not resolved through discussion. • Once the list of included full texts from the searches is finalized, two independent reviewers will search the reference lists of all included studies and include any additional eligible articles. Discrepancies will be resolved through discussion or by a third reviewer, if needed. • The review results will be shared with the full investigator team and additional articles may be included based on investigator input and knowledge of known papers or studies that are relevant and that meet eligibility criteria. • The search strategy will be documented and summarized using the PRISMA Sc-R flow chart Data extraction and analysis: Two independent reviewers will extract data from included articles. Discrepancies will be resolved through discussion or by a third reviewer, if necessary. The types of information to be extracted includes (but will not be limited to): author/year, study design, intervention type, biomarker/biosensors used, alcohol outcome method (other than biomarker/biosensor), country/context, population, description of how biomarker/biosensor was used and result of using biomarker/biosensor.

BACKGROUND: Stigma is a barrier for help-seeking, mental health service access, and contributes to the mental health treatment gap. Because the mental health treatment gap is greatest in low- and middle-income countries, it is vital to identify effective strategies to reduce stigma in these countries. To date, there has been a lack of synthesis of findings from attempts to reduce stigma related to mental disorders within China. OBJECTIVE: Conduct a scoping review that will clarify what attempts are currently being done to reduce stigma related to mental disorders in China, how effective are these attempts and identify any critical gaps in current knowledge about this important issue. DESIGN: Based on the results of a pilot study aimed at refining the search strategy, screening criteria, and data extraction form, we will search three Chinese and six English academic databases for relevant peer-review papers, theses, dissertations, and government reports published from 1 January 2000 to 10 March 2022. Data will be extracted from eligible papers by two independent reviewers.

BACKGROUND: Factors influencing the implementation of communication partner training (CPT) with familiar partners of people with aphasia (PWA) have previously been documented using disparate approaches. To date there has been no synthesis of these factors using a common theoretical framework. Investigating CPT implementation factors using a common theoretical framework may further our understanding of universal barriers and guide future development of tailored, theoretically informed implementation strategies. AIMS: (1) To determine the perceived and/or observed barriers and facilitators to implementing CPT with familiar partners of adults with aphasia; (2) to map extracted barriers and facilitators to a common theoretical framework; (3) to synthesize extracted barriers and facilitators; and (4) to identify potential implementation strategies to address the most frequently identified barriers and facilitators. METHODS & PROCEDURES: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, CINAHL, Web of Science) were systematically searched in April 2021. Empirical qualitative and/or quantitative research studies reporting barriers/facilitators to speech-language therapists (SLTs) implementing CPT with familiar partners of adults with aphasia were included. The search was limited to English or French articles with no date limit applied. Methodological quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). A framework and content analysis was then conducted to extract and synthesize the implementation factors in alignment with the Theoretical Domains Framework (TDF), followed by a theoretically informed mapping exercise to identify potential implementation strategies. RESULTS & MAIN CONTRIBUTION: The database searches yielded 2115 studies. Following screening, 17 studies were included in the review. Overall, the included studies had good methodological quality. Extracted implementation factors were classified as barriers, facilitators or mixed (i.e., both) and aligned with 13 of the 14 TDF domains, plus two additional domains: 'carer perspectives on the CPT intervention' and 'patient/carer characteristics'. Synthesized data revealed eight key theoretical domains: Environmental context and resources; Social influences; Beliefs about consequences; Skills; Memory, attention and decision-making; Knowledge; Beliefs about capabilities; and Reinforcement. Within each domain, the research team identified common categories and developed illustrative examples of theoretically informed implementation strategies. CONCLUSIONS & IMPLICATIONS: This systematic review and theory-informed synthesis of previously reported CPT implementation factors enabled the identification of key barriers to SLTs delivering this best practice. This led to proposed implementation strategies that should be validated, refined and evaluated in future research involving stakeholders who have contextual understanding of implementing CPT. WHAT THIS PAPER ADDS: What is already known on the subject CPT of familiar partners of PWA is an effective intervention that is inconsistently used in clinical settings. Factors influencing CPT implementation have previously been identified, but using disparate approaches and frameworks. A synthesis of these factors articulated around a common framework is currently not available. What this paper adds to existing knowledge This paper provides a theory-informed synthesis of previously reported barriers and facilitators to SLTs implementing CPT with familiar partners of PWA. It highlights key factors influencing the uptake of this best practice and includes suggestion of implementation strategies to address them. What are the potential or actual clinical implications of this work? The key influencing factors and proposed implementation strategies reported in this paper may support stakeholders in the future design of tailored and theoretically informed implementation strategies aiming to improve the delivery of familiar CPT in their setting.

Background: Several studies have discussed the importance of self-compassion in reducing anxiety, stress, and negative emotions for oneself. However, little research has been undertaken regarding the effectiveness of including self-compassion and outcomes for parents and their children. Aim and objective:To examine and explore the research evidence for the influence of self-compassion education and training upon parents and families.Methods: This systematic review will utilize the Joanna Briggs Institute (JBI) systematic review methodology. A three-stage comprehensive search of at least five electronic databases including Medline, Embase, PsychoInfo, Emcare and Cochrane library, as well as Grey literature,will be conducted. Two independent reviewers will review the title and abstract of each paper to determine inclusion; all included papers will be appraised using the standardized critical appraisal instruments for evidence of effectiveness developed by JBI. This review will consider studies that include parents, mothers, fathers, family/families and expectant parents.Studies investigating education or training will be included, i.e., programs, workshops, seminars or sessions provided by all health care professionals/health and social workers/counsellors, psychologists, nurses, midwives, meditation practitioners, and mindfulness trainers.In addition, this review will consider studies that evaluate or measure any type of self-compassion education or training, i.e., programs, workshops, seminars, sessions targeted for parents, mothers, fathers, family/families or expectant parents.Self-compassion education or training may be provided face-to-face, one-to-one, group work, webinar, digital or online,programs, workshops, parental education classes or simulation classes, seminars, sessions.This review will include any randomized controlled trials, quasi-experimental studies, cohort studies and case-controlled studies, before and after studies, and mixed-method studies.Studies will only be considered if they include the following outcome measures: measuring self-compassion (self-kindness, common humanity, mindfulness), fear of compassion and any outcome for health and wellbeing of parents/families,and these will be reported in a column in the summary table of all included studies. Results:The review outcomes will be reported on both continuous and dichotomous scales, where possible findings will be pooled for reporting using JBI tools. Conclusions: The findings of this systematic review will guide further research on developing, designing, facilitating and evaluating self-compassion education and training programs, workshops, sessions for parents and families.PROSPERO registration: This systematic review title is registered at the International Prospective Register of Systematic Reviews: CRD42021225021.

Review question What is the association and impact of maternal behavioural and psychosocial disorders on infantile and childhood anaemia? Searches Relevant published studies will be sought from electronic journal databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, LILACS, BVS, and the Cochrane Library) from 01/01/1990 to 01/08/2020. The search strategy is composed of a broad range of terms related to (i) maternal health, pregnancy and puerperium (population); (ii) behavioural and psychosocial disorders among mothers including DSM-5 and ICD-11 classified disorders and behavioural-related conditions (exposure); and (iii) measures of neonatal and infantile anaemia including specifically iron-deficiency anaemia and methods used for diagnosis during the neonatal and childhood period (outcomes). Relevant terms will be identified using both free text and controlled vocabulary (see search strategy). The search strategy and its tailoring across journal databases will be constructed. In addition to the electronic database searches, we will seek other relevant studies by hand searching the bibliographies of relevant articles and searching for articles citing relevant papers. The literature search will be updated prior to the final synthesis in order to include new relevant papers. Types of study to be included The review will include studies that: a) Evaluated the association between maternal behavioural & psychosocial disorders and the iron-deficiency anaemia diagnosed in neonates and children until 59 months of age. Including its effects on the cognitive, executive function and development competences of children born at term (>37 weeks of pregnancy) and/or children born weighting >2500 g and 2500 g and 10% of relevant articles from preliminary searches. Strategy for data synthesis A summary of the main characteristics and results from each of the studies included in the review will be presented, as well as their methodological quality. This description will be conducted separately for each of the outcomes of interest when possible in a narrative synthesis of results. Analysis of subgroups or subsets N/A Contact details for further information Dr Elaine C. Flores e.flores@qmul.ac.uk Organisational affiliation of the review Institute of Population Health Science, Queen Mary University of London, London, UK Review team members and their organisational affiliations Dr Elaine C. Flores. Institute of Population Health Science, Queen Mary University of London, London, UK Mg Marco Barboza. Pontificia Universidad Católica del Perú, Lima, Perú Dr Doreen Montag. Institute of Population Health Science, Queen Mary University of London, London, UK Type and method of review Scoping review, Mapping review Funding sources/sponsors This review will be conducted as part of the Medical Research Council – MRC grant number MR/S024654/1 and by the Fondo Nacional de Desarrollo Científico, Tecnológico y de Innovación Tecnológica – FONDECYT, grant number 033-2019 The funders had no involvement in the design of the scoping review, and will have no input in the execution, synthesis, interpretation, reporting, and publication of the review. Subject index terms Behavioural conditions, mental disorders, psychosocial disorders, mental health, maternal health, iron deficiency anaemia, child; humans; infant, newborn; neurodevelopment

Background: The collection and use of the patient feedback data for the codesign and improvement of rehabilitation services is paramount for a person-centered and better Patient Experience (Px) with rehabilitation care. Aim: To map and characterize the literature on patient engagement and on the use of Px feedback for codesigning or improving rehabilitation services. Eligibility: We include English-language, peer-reviewed (all time) and grey literature (last 5 years) on initiatives that engage patients, family members, patient representatives, or overall Px feedback (quantitative or qualitative) for informing or evaluating service development, codesign, or quality improvement (QI) activities in physical rehabilitation services. The Appendix 1, supplementary file, details key working definitions. Reports that address only collecting, assessing, or monitoring, Px data, i.e., without a reported use of these data for service improvement purposes, are excluded. We include every study type, including quantitative, qualitative or mixed-methods research, case studies, and data-based QI reports, but we exclude study protocols, perspectives, narrative reviews, letters, and broadly papers without designated methods or results being reported. Two independent reviewers (TJ, BS) will conduct the title-and-abstracts screenings and the full-text reviews after an initial review for calibration, the latter with up to two rounds afterwards toward consensus with a third reviewer (AD or AH) resolving any remaining disagreements. Sources: The search includes keyword searches in five databases of the peer-reviewed literature (PubMed/Medline, CINAHL, Rehabdata, Scopus, and Web-of-Science – Core Collection). The Appendix 2, supplementary file, provides the detailed search strategy for each scientific database. Specifically for the grey literature, we will also conduct keyword searches in Greylit and ProQuest database (dissertations & theses), in a generic search engine (i.e., Google), and in key websites (e.g., Institute for Healthcare Improvement, Beryl Institute – including its Patient Experience Journal). The search strategy also includes snowballing from the initially included papers (e.g., citation- and author-tracking) and from the references lists of included articles. Finally, a minimum of two key informants (e.g., academic and field experts) will be supplied with a preliminary list of inclusions and asked about other potential inclusions. Data Extraction: We will extract the study aim, biographic details (e.g., publication year, journal) and methodological features, such as study design, rehabilitation setting, country, participants (type and numbers), study outcomes measures, and analytical approaches. We will also extract key data for the type of Px feedback used, patient engagement methods, interventions, outcomes of interest, primary results, stated implications, recommendations, and any reported limitations. The extractions will be performed by one experienced reviewer (TJ), fully confirmed by another (BS or JS). Analysis: Descriptive statistics will be used to quantify and map the distribution of the literature per characteristic type and methodological features and a conventional content analysis will be used to synthesize the study aims, engagement procedures, results reported, stated implications, recommendations for further studies, and finally the reported direction for future research and the study limitations.

Correlation between gifts from pharmaceutical companies to French medical academics and their scientific productivity patterns: a protocol for a retrospective study using the French Transparency in Healthcare Alexandre Scanff1, Ioana Cristea2,3, Pierre Etienne Savourat1, Thomas Clément1, Benjamin Bastian1, Marion Taburet1, Alain Braillon4, Florian Naudet, Professor1,* 1: Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d’Investigation Clinique de Rennes), France 2: Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, St.Republicii 37, 400015 Cluj-Napoca, Romania 3: University of Pavia, Department of Brain and Behavioral Sciences, 27100 Pavia, IT 4: Alcohol Treatment Unit, University Hospital, 80054 Amiens CEDEX 1. France * : corresponding author ; orcid.org/0000-0003-3760-3801 ; mail floriannaudet@gmail.com ; twitter handle /naudetflorian The scientific impact of academics is appraised with their ability to produce knowledge. Funding, promotion of individuals and survival of their team depends on their publication records and some quantitative citations metrics. Many projects such in genomics [1] can only be conducted in collaboration and new ideas often arise by conversations with colleagues. Collaboration driven by industrialists may also have an impact on researchers' productivity at the price of potential financials conflicts of interest (COIs). Prolific academics are often identified and pushed by industrialists as "Key Opinion Leaders" on the ground of their publication records, lectures, and their participation on different groups [2]. For example, in the field of oncology, financial COIs were correlated with metrics of academic reputation and success [3]. And indeed, committees hiring academics use indicators such as scientific productivity (i.e. number of published papers) and quality. For quality, two proxies are generally used: a) the journal impact factor (JIF) and b) the Hirsch Index (h-index), corresponding to the largest number h of papers one has published that have been cited at least h times. [4] We aim to investigate the relationship presently used measures of academic success (publications/citations/h-index) with the potential financial COIs. Methods Study design and participants The project will be based on a protocol that will be registered on the Open Science Framework prior any data collection. In France, academic duties require both an active clinical activity and a research activity. While clinical skills are only evaluated qualitatively, assessment of research activity entails publication metrics, which are easy to quantify and investigate. This study will be conducted and reported to the Standards for Reporting Diagnostic Accuracy. [5] One researcher will identify all French Medical Professors and associated professors (and their academic discipline) from lists of the different universities and the “annuaire santé” that also details sex and medical specialty (i.e. academic discipline). Then we will extract from online databases (e.g. Google Scholar, Web of Science, Scopus) the year of their first paper (an indicator of seniority) and quantitative indicators of productivity for the 2014-2019 period (h-index over the period, number of papers and number of citations). For each academic, the amount of money declared by the industry during the 2014-2019 period will be extracted from the French database registering all direct gifts (e.g., meals or congress-related hotel, and travel costs) perceived by healthcare players. This open access database was created in 2012 (https://www.transparence.sante.gouv.fr/) and the industry is required by law to report. We will use only the “advantage” table, comprising all industry funding which in theory is not associated with a contractual obligation of the recipient. Two more tables exist, which report “conventions” and “remunerations” when there is a contractual obligation for the recipient, but reporting the monetary value was not mandatory and poorly implemented during the all the study period, and thus the amount is almost-always lacking. An automatic search will be developed, possibly completed by manual checks to explore the possibility of misidentification. Ethics We are seeking the opinion of an ethics committee, namely that of the CNGE Ethics Committee. The procedure toward protection of persons has been validated by the Data Privacy Officer of Rennes 1 University. In view of the large number of subjects studied, we cannot afford to contact all of them. Moreover, this step would risk adding a social desirability bias to the results of our study that may invalidate the study results. Data collected are not considered as sensitive data by the French law. In addition, general information will be made publicly available on the Reither website (https://www.reither.org/) detailing the protocol, the use that will be made of the data, with a contact information (Pr Florian Naudet: floriannaudet@gmail.com). This information will also be detailed in the thesis references once it has been published to indicate to the interested parties the right of access to any data concerning them. Indexes The f-index will be defined as the sum of gifts received by each academic in the 2014-2019 period (meals, and/or travel/accommodation expenses). The gold standard used for the purpose of the study will be high scientific productivity defined for an academic as an h-index over the period 2014-2019 in the top quartile of h-indexes in the group analysed and in subgroups defined by all academic discipline for subgroup analyses. As no gold standard exists but institutions need to take decisions under constraints of limited time and budgets, we opted for this standard. It reflects the fact that in the current system effectively only a few top researchers can expect promotion. Outcomes and analysis First, a descriptive analysis will be performed, consisting of numbers and percentages for categoric outcomes, and means, standard-deviations for quantitative outcomes. Then, Pearson’s correlations will be used to explore the association between indicators and several characteristics of the academics, after logarithmic transformation (index value+1), if needed. Receiver Operating Characteristic (ROC) curves will be drawn by plotting sensitivity vs. one minus specificity and the optimal threshold will be determined according to Youden’s J measure. The main outcome for this study will be the diagnostic properties (sensitivity, specificity, positive predictive value, negative predictive value) of the f-index to objectively reflect high scientific productivity. [6] Finally, to account for possible variations according to subspecialty, subgroup analyses (f-index, h-index, correlation between f-index and h-index, optimal threshold) will be explored by academic discipline separately. 95% confidence intervals for test parameters will be estimated by bootstrap procedure. An exploratory analysis of the effect of sex and year of first paper on the f-index will be realized by linear mixed model, using a random intercept for academic speciality. REFERENCES: 1. Lehner T, Senthil G, Addington AM. Convergence of advances in genomics, team science, and repositories as drivers of progress in psychiatric genomics. Biological psychiatry 2015;77(1):6-14. 2. Moynihan R. Key opinion leaders: independent experts or drug representatives in disguise? bmj 2008;336(7658):1402-03. 3. Lammers A, Edmiston J, Kaestner V, et al. Financial Conflict of Interest and Academic Influence Among Experts Speaking on Behalf of the Pharmaceutical Industry at the US Food and Drug Ad-ministration's Oncologic Drugs Advisory Committee Meetings. Mayo Clinic proceedings 2017;92(7):1164-66. doi: 10.1016/j.mayocp.2017.04.014 [published Online First: 2017/07/10] 4. Hirsch JE. An index to quantify an individual’s scientific research output. Proc Natl Acad Sci U S A 2005;102:16569–72. doi:10.1073/pnas.0507655102 5. Bossuyt PM, Reitsma JB, Bruns DE, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ 2015;351:h5527. doi:10.1136/bmj.h5527 6. Perkins NJ, Schisterman EF. The Inconsistency of “Optimal” Cut-points Using Two ROC Based Criteria. Am J Epidemiol 2006;163:670–5. doi:10.1093/aje/kwj063

The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR) Checklist. Search will be conducted in Medline (PubMed), Scopus, CINAHL, Embase, Cochrane Library, and Web of science. Gray literature sources to be searched include ProQuest, MedNAR, OpenGrey, PEDRo, Google Scholar, and clinicaltrial.gov.in. Inclusion Criteria includes Children above two years to 17 years 11 months 29 days with developmental or neuromotor disability having poor head & trunk control ability. This review will include randomized controlled trial, non-randomized trial, quasi-experimental trial, and systematic reviews. Articles published other than in the English language will be excluded. This scoping review will include articles on physiotherapy and technology-based interventions in a variety of settings, such as outpatient, inpatient, and community settings, globally. Following the search, all identified records will be collated and uploaded into Zotero and duplicates will be removed. Following a pilot test, titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant papers will be retrieved in full and their citation details imported into the Rayyan QCRI (Qatar Computing Research Institute, Doha, Qatar), which is a web application that allows de-duplication, screening, and administration of important screening statistics among reviewers, after the search from all the sources. The full text of selected citations will be assessed in detail against the inclusion criteria by two independent reviewers. Reasons for exclusion of full-text papers that do not meet the inclusion criteria will be recorded and reported in the scoping review. Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion or with a third reviewer. The results of the search will be reported in full in the final scoping review and presented in a PRISMA-ScR flow diagram. The data coding tool will be developed and used to code data from the papers included in the scoping review. The retrieved data will include specific details about the “participants”, “concept”, “context”, “study methodology”, and “important findings” relevant to the review questions. The draft data extraction tool will be updated and revised as needed by piloting the tool prior to the data extraction process. If additional or missing data from included studies are required, the authors of the publications will be contacted. In this circumstance, the studies will be included in the review and appropriate limitations will be indicated if the authors do not respond within two weeks. Tables and visual representations will be used to present the data. A narrative summary will be presented to conclude the scoping review, explaining the results in relation to the review questions and objectives.

Objective: To discover what is known about music therapy and the mental health of healthcare workers, and the outcomes that have been reported. Introduction: Music therapy has been documented to improve mental health. This scoping review aims to assess the extent the literature examines music therapy and healthcare workers’ mental health and what outcomes have been reported. Inclusion criteria: This scoping review will consider experimental, quasi-experimental, and qualitative studies and systematic reviews that include healthcare workers in all healthcare settings and geographic locations caring for patients at the time of the study. It will consider studies that examine music therapy and the mental health of healthcare workers and the reported and observed outcomes. Methods: Published and unpublished primary studies, reviews, and text and opinion papers published in English will be included in the search strategy across nine databases. After duplicates are removed, two independent reviewers will screen titles and abstracts against the inclusion criteria for the review and then assess the full text of selected citations against the inclusion criteria, recording any reasons for exclusion. Data will be extracted from papers included in the scoping review by two independent reviewers using a data extraction tool developed by the reviewers. The authors will determine how to present the extracted data after analysis, but the data will be presented in either a diagrammatic or tabular format that aligns with the objective and question of the scoping review and accompanied by a narrative summary. Keywords: Complimentary Alternative Medicine; Healthcare Worker; Music Therapy; Outcome

In the current available literature there are various papers published surrounding the use of iron in reduced ejection fraction heart failure with iron deficiency patients, but these papers vary greatly in their interventions used as well as their objectives sought. This heterogeneity in the literature gives rise to questions about what the most efficient and safe way to replete a patients iron with HFrEF and iron deficiency is, as well as what benefits these patients will see based on the different therapeutic alternatives. This scoping review aims to identify the current literature surrounding this topic and also identify gaps in the literature for future studies to be performed in.

Objective: The objective of this scoping review is to describe the alternative statistical methods used to evaluate hospital services using routinely collected observational data in Australia. Introduction: The Australian Federal Government has encouraged the use of routinely collected hospital data in research to improve population health outcomes, and to increase the effectiveness and efficiency of the health system. These data have been incorporated in comparative analyses of patient outcomes across different hospitals and time periods to measure performance or evaluate interventions. Due to acknowledged limitations inherent in routinely collected hospital data, these analyses depend on robust statistical risk-adjustment techniques to control for differences in the case mix of patient cohorts. In the past decade, the range of available statistical methods that can be used to balance groups in observational studies has increased, some incorporating modern machine learning techniques. It is unclear, however, to what extent these newer methods have been incorporated into comparative analyses of hospital outcomes dependent on routinely collected data. Inclusion criteria: The review will consider papers that used statistical adjustment for balancing patient cohorts in Australian studies of hospital outcomes. The review will be limited to analyses in cardiology over the last 10 years and will include studies that considered difference in groups of hospital patients across time or between institutions. Methods: Databases, including PubMed, Medline, Embase, Cinahl and Econlit will be searched. The search will be restricted to the last 10 years of published articles incorporating Australian hospital data and will also be restricted to papers in English only. Two reviewers will screen titles and abstracts, followed by full text screening of selected articles. Data extraction will be conducted using a customised template. Included studies will be summarized using narrative synthesis structured around the types of study designs, and the different types of statistical methods used.

Background In the face of fragile health care systems in resource scarce settings, health care for the elderly faces ethical challenges that need much attention. Very little attention is given to ageing research in Sub-Saharan Africa despite the rapidly growing number of older adults and their significance in communities, for example, in taking care of younger kin and thus shaping the future generation [1]. Care needs of older people in sub-Saharan Africa are higher than those in developed countries. For example, in South Africa, more than 45% of people aged 75 and older require assistance with daily activities, while 20% of older persons in the same age group in Switzerland require assistance [2]. Although the ageing of people could be beneficial to society in general, due to, for example, the social capital of older people and the accumulated wealth across longer life-course [3], the health care needs associated with ageing bring a challenge to healthcare systems with insufficient resources. Generally speaking, old age care in east Africa is in its underdeveloped state. The growth of older population in the region, combined with the rapid change and development in terms of culture and economy, bring more complex ethical questions not only on the ways health care services are provided, but also on how administrations and policies address care issues for the older population. Although there are strong traditional family and community supports for older people, many still suffer as traditional support structures weaken mainly because of the growth of industrialisation. Family support dwindles when a supporter, for example, dies or migrates to cities or other countries [4, 5]. A pilot search conducted on 13 June 2020 shown that there were neither protocols nor finalised reports of systematic/scoping reviews on ethical issues in old age care in east Africa. The most relevant papers that we could identify after searching five databases - African-Wide Information, AgeLine, CINAHL, MEDLINE and Google Scholar – include one systematic review protocol on the effectiveness of interventions for dementia in low- and middle-income countries [6], one systematic review of qualitative studies on end of life care in sub-Saharan Africa [7], and one protocol for a scoping review of age-related health conditions among geriatric populations in sub-Saharan Africa [8]. However, none of these articles specifically focus on ethical aspects of elder care. Therefore, seeking evidence on ethical issues in old age care in east Africa warrants further exploration. The purpose of this scoping review is to explore existing evidence addressing the various ethical issues in connection with elder care in the region of east Africa, which consists the following 18 countries according to the UN Statistics Division: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Réunion, Rwanda, Seychelles, Somalia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe [9]. The scoping review, as its protocol is prepared beforehand, complies with what Peters et al. state: ‘as with all systematic reviews, an apriori scoping review protocol must be developed prior to undertaking the review itself’ [10]. It is anticipated that the results of this scoping review will inform governments and policy makers of the ethical issues in old age care in east Africa. Methods We will conduct a scoping review of the literature to capture evidence about ethical issues in the care of older people in east Africa who are 60 years old and above. The United Nations agreed to refer as geriatric populations those who are 60 and above in Africa whereas age 65 will be used to define geriatric populations in high income countries [11]. Scoping reviews are conducted mainly to identify the types of available evidence on emerging topics and to analyse the knowledge base [12]. Therefore, this methodology proves suitable for this work. We will apply Arksey and O’Malley’s scoping review framework consisting of five stages: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing and reporting the results [13]. We will follow a transparent and rigorous search strategy with support from experienced librarians. For reviews such as ours, using the support from qualified librarians is strongly recommended as they have the skills necessary for designing and executing sensitive search strategies that researchers may not have [13]. We will pilot the search strategy to test the appropriateness of search terms and databases. Four reviewers will be involved in this scoping review to reduce error and increase reliability in the review process [10, 12]. Eligibility criteria Inclusion criteria Articles that will be included in this scoping review will have to meet the following criteria: - Written in English - Peer-reviewed journal articles - Published in any year until July 2020 - Focus on people aged 60 or older from east Africa - Address ethical issues in connection with the provision of formal and/or informal health care to older people - Focus on one, some or all of east African countries (Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Réunion, Rwanda, Seychelles, Somalia, Uganda, United Republic of Tanzania, Zambia and Zimbabwe) Exclusion criteria Articles will be excluded if they have any of the following characteristics: - If they do not exclusively focus on people/participants aged 60 and above - If they do not exclusively focus on east African countries - If they do not exclusively focus on formal or informal care of the old - If their full text cannot be obtained - If they are not available in English - If they are not peer-reviewed journal articles Literature search The approach to searching for evidence for this scoping review will follow the same three-step method recommended in standard JBI (Joanna Briggs Institute) systematic reviews [14], and the search strategy will be comprehensive in order to identify as may literature as possible [10]. First, we will undertake an initial search of selected databases and analyse index terms and text words contained in titles and abstracts. We will gather and identify the keywords by searching MeSH terms and subject headings on the databases, searching on the internet (google, Wikipedia and Google Scholar) and incorporating expert comments. We will break down our research question – what are the ethical issues in the care of older persons in east Africa – into broad keywords and Medical Subject Headings (MeSH) terms such as “older people” or “older adults” or “senior citizens” and “east Africa”. We will develop a search strategy for each database with a combination of free text and controlled vocabulary. Our strategy in developing and using search keywords will be kept broad and flexible in order to increase the chance of getting relevant papers. Our topic is broad and we will be less specific when searching studies in order not to miss relevant information; “the whole point of scoping the field is to be as comprehensive as possible in identifying primary studies” [13]. Second, we will use all identified keywords and index terms to search the following databases: Africa-Wide Information, AgeLine, CINHAL, MEDLINE, APA PsycInfo, SCOPUS and SocINDEX. Third, the reference list of all identified papers will be searched for additional evidence. At this stage, we will also search additional web-based platforms such as Google to identify more literature. Study selection The evidence selection process will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist [15]. First, all eligible articles will be uploaded into Endnote X9 software. Then the first author (KMM) will identify and remove duplicates. Two of the authors (KMM, TW) will then perform a preliminary screening based on titles and abstracts to identify and exclude those papers that do not meet the eligibility criteria. Any disagreements regarding study eligibility of the selected articles will be discussed between the two reviewers until consensus is reached. If consensus could not be reached, a third reviewer will arbitrate. Then, two reviewers (JS, BE) will independently review the full-text articles to determine their eligibility. If there are discrepancies between the results and if the discrepancies cannot be resolved by discussion and consensus, a third reviewer will interfere to take the final decision. The degree or percentage of agreement between reviewers will be calculated and reported. At the end, references of the articles deemed eligible will be screened to identify any further relevant evidence. Data charting Data from the articles will be extracted using a proforma the first author prepared. The charting form will remain flexible and be updated as necessary throughout the charting process. The extracted data will include the following information (Table 1) Table 1: Categories of information to be extracted from the data Author/s, date and title Publication type Country/location of study Objective Design and methods Sample (study population) Main Findings Recommendations for future research (if any) REC/IRP approval Remarks by reviewers (if any) Collating, summarizing and reporting the results A table consisting of the results will be presented. A narrative report will be produced to summarise the presented data. Data will be described in connection with the research question and in relation to the objectives of the scoping review. Discussion This scoping review aims to identify and discuss ethical issues in the care of older people in east Africa. This review will be the first to identify and map ethical issues in old age care in east Africa. This scoping review will contribute to understandings of the ethical issues arising in relation to providing elderly care in the African context. It has a potential to create greater awareness into the growing complexities of geriatric care in today’s rapidly evolving and globalising world. The results of this review will also identify areas requiring further investigation. Some limitations in this scoping review are anticipated. Studies will be omitted if they include participants of all ages including older people aged 60 or above. Studies which, for example, operationally define older people as adults aged 50 years and above will be excluded. A typical example of such articles is the WHO’s study on global ageing and adult health (WHO SAGE) among selected low- and middle-income countries [16]. Similarly, studies that include all African countries including those in east Africa will be excluded. These may result in the exclusion of important articles that could bring more insight into the research inquiry. Additionally, studies will be omitted if they are not available in English. Lastly, the lack of critical appraisal of included articles will prohibit commenting on the reliability of extracted data. References 1. Aboderin, I.A.G. and J.R. Beard, Older people's health in sub-Saharan Africa. The Lancet, 2015. 385(9968): p. e9-e11. 2. WHO, Towards long-term care systems in sub-Saharan Africa: WHO series on long-term care. 2017, World Health Organisation: Geneva, Switzerland. 3. Gebremariam, K.M. and R. Sadana, On the ethics of healthy ageing: setting impermissible trade-offs relating to the health and well-being of older adults on the path to universal health coverage.(Report). International Journal for Equity in Health, 2019. 18(1). 4. Lemma, S., Experiences and practices of old age home care and support to the Elderly Living in the Institutions: Assessment at Three Selected Institutions in Addis Ababa. 2014, School of Social Work, Addis Ababa University. 5. Teka, A. and M. Adamek, “We Prefer Greeting Rather Than Eating:” Life in an Elder Care Center in Ethiopia. Journal of Cross-Cultural Gerontology, 2014. 29(4): p. 389-404. 6. Salcher-Konrad, M., et al., Effectiveness of interventions for dementia in low- and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis. BMJ Open, 2019. 9(6). 7. Gysels, M., et al., End of life care in sub-Saharan Africa: a systematic review of the qualitative literature. BMC Palliat. Care, 2011. 10. 8. Naidoo, K. and J. van Wyk, Protocol for a scoping review of age-related health conditions among geriatric populations in sub-Saharan Africa. Syst. Rev., 2019. 8(1). 9. UN, United Nations Standard Country or Area Codes for statistical Use, D.O.E.a.S.A.S. Division, Editor. 1999: New York, United States of America. 10. Peters, D.J.M., et al., Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 2015. 13(3): p. 141-146. 11. Kowal, P., L. Wolfson, and J. Dowd, Creating a minimum data set on ageing in sub-Saharan Africa. NCD Prevention and Surveillance, 2000. 9. 12. Munn, Z., et al., Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med. Res. Methodol., 2018. 18(1). 13. Arksey, H. and L. O'Malley, Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 2005. 8(1): p. 19-32. 14. Aromataris, E. and D. Riitano, Constructing a search strategy and searching for evidence. A guide to the literature search for a systematic review. Am J Nurs, 2014. 114(5): p. 49. 15. Tricco, A.C., et al., PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of internal medicine, 2018. 169(7): p. 467-473. 16. Arokiasamy, P., et al., Chronic Noncommunicable Diseases in 6 Low- and Middle-Income Countries: Findings From Wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (SAGE). Am J Epidemiol, 2017. 185(6): p. 414-428.

Objective: The objective of this scoping review is to understand the extent and type of evidence in the literature about effective delivery and implementation of virtual placements in physical therapy programs in Canada to inform clinical curriculum, and academic program policy and processes. In addition, we aim to summarize how virtual placements have been implemented globally in the clinical education of physical therapy students. This review will provide physical therapy programs in Canada with a summary of the current research about achievement of entry-to-practice competencies by physical therapy students during virtual placements. Introduction: During the COVID-19 pandemic, virtual clinical placements were adopted by academic programs to facilitate physical therapy student progression through their academic programs to meet program level outcomes and accreditation requirements. Like many other examples of the uptake of technology to meet work, leisure and health care needs during COVID-19, virtual placements using technology are likely to remain in use to some extent following the pandemic. Increased enrolment in physical therapy academic programs, implications of an increasingly aging demographic, and shift in clinical care practice behaviours are examples of factors to sustain some use of virtual placements for clinical education training, necessitating evidence-informed consideration of effectiveness of virtual placement for student achievement of competencies. Inclusion criteria: Population of interest include physical therapy students. Any physical therapy student, patient care clinical education supervised by a registered health discipline professional (i.e., PT, OT, SLP/Aud) and virtual video and/or audio communication technology intervention, hybrid/virtual exposures or situations focused on this population in any of the following study designs: literature reviews, primary studies, programmatic quality improvement initiatives, reports, and policy and position papers will be included. Any studies including in-person clinical training only during placement; clinical health professional education/development (i.e., not related to patient care); study protocol for virtual placement research, or not physical therapy will be excluded. Conference abstracts, commentaries and editorials will also be excluded. Methods: The search strategy includes electronic databases and grey literature. The following databases will be searched, adapting search terms according to each database subject heading terminology and syntax requirements: PubMed (MEDLINE), CINAHL, PsycINFO, EMBASE, and SCOPUS (ProQuest Nursing and Allied Health). The search will be limited to studies published after 2000. The review will be written in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR; Tricco et al., 2018) transparent reporting of scoping reviews recommendations. The review protocol will be registered with the Open Science Framework (https://osf.io). This scoping review will consider both experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies and interrupted time-series studies. In addition, analytical observational studies including prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies will be considered for inclusion. This review will also consider descriptive observational study designs including case series, individual case reports and descriptive cross-sectional studies for inclusion. Qualitative studies will also be considered that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, qualitative description, action research and feminist research. In addition, systematic reviews that meet the inclusion criteria will also be considered, depending on the research question. Text and opinion papers will also be considered for inclusion in this scoping review.

Introduction Patients evaluating symptoms and deducing the necessity and urgency of seeing a physician is a core moment in medical care. A novelty in this process is the plethora of artificial intelligence-based or algorithm-based tools such as symptom checker apps (SCA) that are spreading on the market. They might have the most immediate affect on emergency care and primary care as those parts of health services that are directly accessible for patients. To date, it remains unclear, how SCA and similar tools are transforming working worlds of health care professionals, which work-related psychosocial demands and resources (Bakker et al. 2003) are connected to this transformation and how this is related to perceived stress for health care professionals (GDA 2014). Objectives This scoping review aims to systematically explore the existing knowledge on the impacts of symptom checkers or similar services on health care professionals in general practice and to identify gaps in knowledge. The following question was formulated: What is known from the literature about the impact of SCA and similar tools on health care professionals in general practice, especially with regards to work content and work organization, professional-patient-interaction/relationship, their professional self-image, job satisfaction, and perceived stress? Inclusion criteria Articles concerning the impacts of SCA and similar tools on health care professionals in general practice will be included. We will follow the PCC scheme (population – concept – context) (Peters et al. 2015) to define inclusion and exclusion criteria. Population: The relevant population of our scoping review is health care professionals, not patients, without focus on specific countries. Concept: We will apply “impact of symptom checkers and similar tools” as relevant concept. We will include studies that focus on any artificial intelligence-based or algorithm-based SCA or similar services and tools offering self-diagnosis/pre-diagnosis that were designed for (potential) patients. We will exclude all health apps/services that do not provide patients’ self-diagnosis such as diagnostics apps for clinicians, nurses and veterinary surgeons; diagnostics apps with scan-technology or sensors; non diagnostic m-health applications (e.g. symptom monitoring, self-management of conditions, disease-management, medical decision making, telemedicine, medical information and coaching; motivation, fitness). Impacts will not be restricted to but can include work content/work, organization/service use, job satisfaction of health care professionals, perceived stress of health care professionals, professional–patient relationship and communication, professional self-image. We will exclude studies e.g. regarding diagnostic accuracy or accuracy of disposition, costs and cost-effectiveness, clinical effectiveness, safety, or patients’ usage of new technologies. Context: We will focus on general practice as relevant context. We will include empirical studies, reviews and publications that discuss the topic in general as well as discussion papers, editorials, book chapters etc. To be included in the scoping review, the publication should be published 2000-2021, should be in English, German, French, Turkish or Russian language, and the full text paper should be obtainable. Methods The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews (Peters et al. 2015). As we expect limited research with regards to our specific research interest, we have conceptualized the search strategy rather open. The following databases will be searched as they showed to be the most promising after preliminary testing: PubMed (Medline) and CINAHL. Search strings consisting of search terms and MeSH terms will be built and the titles and abstracts in the respective databases will be searched accordingly. Titles and abstracts will be screened against the background of the inclusion criteria. The reference lists of sources included will be screened to identify additional literature. To ensure quality control, the whole process will be conducted and constantly discussed by two independent reviewers. Duplicates will be removed in the literature management programme Citavi and the software Rayyan will be used to screen the sources. Key information of the data will be charted and managed in Microsoft Excel and results will be synthesized in text, tables, and graphics. Conflict of Interest The authors declare that there is no conflict of interest. Literature Bakker AB, Demerouti E, de Boer E, Schaufeli WB. Job demands and job resources as predictors of absence duration and frequency. J. Vocat. Behav. 2003, 62, 341–356. Gemeinsame Deutsche Arbeitsschutzstrategie (GDA). Occupational Safety and Health in Practice. Recommendations for Implementing Psychosocial Risk Assessment; Management of the GDA Mental Health Working Programme, c/o Federal Ministry of Labour and Social A_airs: Berlin, Germany, 2014. Peters MDJ, Godfrey CM, McInerney, Khalil H, Parker D, and Baldini Soares C. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015. 13(3):141-146.

Authors: Arunnee Jaitieng1 Nisachon Bubpa 2 1. Department of Family and Community Health Nursing, Faculty of Nursing, Khon Kaen University, Thailand 2. Department of Family and Community Health Nursing, Faculty of Nursing, Khon Kaen University, Thailand Abstract Objective: This protocol is for a scoping review. The objective of this scoping review is to provide an overview of the existing health literacy tools that have been validated to measure health literacy related to COVID-19 19 among aged 15 years and older. Introduction: Health literacy is the key concept tool for the prevention and control of COVID-19. People have called to access information and decision to apply and adapt their behavior to care for themselves and their family members. Therefore, it is essential to provide an overview of the existing health literacy tools to measure health literacy. Inclusion criteria: This scoping review will consider studies with examined validity of a health literacy tool related to COVID-19 among aged 15 years and older. Methods: The proposed review will be conducted by following the JBI methodology for scoping reviews. The search strategy aims to find all types of papers both published and unpublished studies. The databases to be searched will include; CINAHL Complete, PubMed, Scopus, Web of Science, ProQuest Nursing & Allied Health, and Thai Journals Online (ThaiJO). The search for unpublished studies will include OpenGrey (a European repository). Studies published in English, and Thai, and studies that were carried out between 2019 and 2021 will be considered for inclusion. Retrieved papers will be screened for inclusion by two reviewers. Data will be extracted and presented in matrix form, mapping, and a narrative.

Authors Purvi Jain1 Beatrice Tenchini1 Ciarán Kenny1 1. Trinity College Dublin, Ireland Abstract Objective: The objective of this scoping review is to understand the extent and type of evidence on different rehabilitative vocal adduction exercises and their effect on swallow physiology, in adults with typical or disordered swallowing. An account of the proposed principles of rehabilitation and outcome measures will be reported. Introduction: In healthy individuals, airway protection during swallowing involves closure of the larynx at multiple levels, including adduction of the true vocal folds and approximation of the false vocal folds (Vose & Humbert, 2019). Different exercises to improve glottic closure during swallowing have been reported in dysphagia research. This review aims to map the evidence on vocal adduction exercises and their physiological effects in swallowing rehabilitation. Inclusion criteria: All published studies in adults (age>=18years) with healthy swallowing and/or dysphagia investigating vocal adduction exercises and their effects on swallow physiology will be included in this review, with no restrictions on time, language or setting. Selected studies must instrumentally measure impact on swallow function, as this provides more valid and quantitative evidence of the physiological effects of the exercises. Methods: The Joanna Briggs Institute methods and PRISMA-ScR guidelines will be used to inform this review. Electronic databases (MEDLINE (PubMed), EMBASE (Ovid), CINAHL (EBSCO) and Web of Science) and grey literature will be searched from inception to March 2022 inclusive, to find studies on vocal adduction exercises and swallowing rehabilitation. Articles will be assessed by two independent reviewers, utilizing a three-step search strategy, to meet the following criteria: (1) exercises targeting vocal cord adduction (2) physiological outcomes measured instrumentally during swallowing, and (3) in typical healthy adults or persons with dysphagia. The resulting evidence map will be reported in tabular form along with a narrative summary. Introduction Vocal fold adduction is a crucial line of defense for airway protection during swallowing. The true and false vocal folds prevent aspiration by restricting entry of material into the lower airway and contribute to the forceful ejection of any material that has already penetrated the laryngeal vestibule (Voce & Humbert, 2019). While compensatory strategies for laryngeal adduction during swallowing are well documented (Logemann, 1983), no comprehensive review has been conducted describing the use or efficacy of vocal adduction exercises in swallowing rehabilitation. Rehabilitative exercises, are intended to change and improve the swallowing physiology in force, speed or timing, with the goal of being able to produce a long-term effect, as compared to compensatory interventions used for a short-term effect (Langmore & Pisenga, 2015). Based on the shared anatomical, physiological, and neurophysiological underpinnings of the voice and swallow mechanism, different rehabilitative exercises targeting glottic closure have been studied to find impact on swallowing function. The complex and heterogenous nature of these studies makes it imperative for a scoping review to map the existing evidence in dysphagia literature. No past or currently underway literature reviews on this topic were identified from our preliminary search. This exploratory project aims to assess the extent of the body of published literature and identify key concepts and knowledge gaps related to vocal adduction exercises for swallowing rehabilitation in healthy adults and, or persons with dysphagia, to apprise clinical practice and future research. Review question Primary questions: What exercises target vocal adduction for swallowing rehabilitation and what are their effects on swallowing physiology in adults with typical swallowing and, or dysphagia? Secondary questions: (1) What are the proposed principles of rehabilitation, and (2) what outcome measures have been reported, in the selected studies? Keywords Dysphagia; Exercise; Rehabilitation; Vocal Adduction; Larynx Eligibility criteria Participants Persons (age>=18years) with healthy swallowing and/or dysphagia are included. Those with typical swallowing are included to examine proof of principle. Those with dysphagia help to generalise results across sampled populations. Paediatric populations will be excluded from the review due to structural and functional differences in body systems and rehabilitative practice. Concept Studies investigating rehabilitative exercises for vocal adduction, that instrumentally examine their effects on swallow function are included in this review. The earlier definition of rehabilitative exercise (Langmore & Pisenga, 2015) is used to guide the review. Instrumental assessment is considered a more valid and reliable way of visualising and assessing movement patterns of swallowing-related structures to formulate inferences regarding the long-term effect of the rehabilitative exercise on physiologic function and integrity of deglutition, as compared to non-instrumental evaluations (e.g. clinical bedside swallow exam, patient reported outcome measures, quality of life, etc). Context Articles published from inception to March 2022, inclusive, will be selected. Randomised control trials (RCT), non-RCTs, cohort studies, case control studies and case series type of studies will be included. Literature reviews will be excluded from the study, but screened for original articles in their reference lists. No restrictions on culture, gender, ethnicity, language, time or setting will be applied to increase the reviews’ comprehensiveness. Gray literature will be manually searched to cover a wide and inclusive range of evidence and reduce publication bias. Types of Sources No restrictions are imposed on study design or quality (PRISMA-ScR; Tricco et al., 2018). This scoping review will consider both experimental and observational study designs, including individual case reports. In addition, systematic reviews that meet the inclusion criteria will also be screened for original articles in their reference lists. Gray literature consisting of text and opinion papers like letters to the editor will also be considered for inclusion in this scoping review to cover a wide and inclusive range of evidence and reduce publication bias. Methods The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews (Peters et al., 2020). Search strategy An initial limited search of PubMed and Embase will be undertaken to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles will be used to develop a full search strategy for PubMed database, in an iterative process, and adapted for each included database and/or information source. The reference list of all included sources of evidence will be screened for additional studies. No limitations on publication date or language are applied. The databases to be searched include MEDLINE (PubMed); EMBASE (Ovid); CINAHL (EBSCO); Web of Science. All included sources of grey literature evidence like conference papers, letters to the editor, dissertations and theses will be included in the appendix. Study/Source of Evidence selection Following the search, all identified citations will be collated and uploaded into Covidence systematic review online software, Veritas Health Innovation, Melbourne, Australia, for deduplication. Following a pilot test on a sample of 25 titles and abstracts, search results will be screened by PJ and BT independently for assessment against the eligibility criteria for the review, once 75% agreement is achieved. Reasons for exclusion of sources of evidence will be recorded and reported in the scoping review. Any disagreements that arise between the reviewers will be resolved through discussion with the third reviewer. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flow diagram will guide the reporting of results of the search and the study inclusion process. Data Extraction A data extraction charting form will be developed by the primary reviewer in collaboration with the supervisor on Microsoft Excel, based on the research objectives, and examination of ten percent of the full texts identified as eligible for charting. The two reviewers will independently pilot the charting form on ten percent of the selected articles, discuss the results and continuously update the data-charting form in an iterative process. Disagreements will be resolved in collaboration with the research team through discussion. This is in an attempt to ensure the recommendations of data charting are met; that all relevant data is captured, keeping in mind the research aims and allow for the creation of a descriptive summary of results (Arksey & O’Malley, 2005). If necessary, authors of papers will be contacted to request missing or additional data, where required. Critical appraisal will not be carried, because this study focuses on literature synthesis. The data extracted will include details about the participants, concept, context, study methods and key findings relevant to the review questions. The final charting form with clear definitions of each item will be attached. Any study information reviewers feel may be of relevance for interpreting outcomes will be included in a comment box and discussed between reviewers following conclusion of the data charting phase. Data items that are not considered as possibly useful towards answering the research questions before beginning the charting may be added if they present as reoccurring themes. Amendments to the data charting form will be reported. Data Analysis and Presentation A descriptive numerical analysis and qualitative thematic analysis will be done by the first author, presenting findings in a narrative format with tabular and visual representation, in relation to the primary and secondary review questions (Levac et al., 2010). Broadly, the results will be classified under main conceptual categories of rehabilitative vocal adduction exercises, patient populations, physiological effects on swallow function, principles/rationale for rehabilitation and outcome measures. Acknowledgements This literature review is being carried out as a part of the Master’s degree in Clinical Speech and Language Studies, dissertation project, at Trinity College Dublin, for the academic year 2021-2022, under the supervision of Dr. Ciarán Kenny. Funding The project received no professional or institutional funding as it is undertaken as part of the Master’s degree project at Trinity College Dublin. Conflicts of interest The authors report no conflicts of interest. References Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory and Practice, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616 Ekberg O Closure of the laryngeal vestibule during deglutition. Acta Oto Laryngol. 1982;93:123–9. https://www.ncbi.nlm.nih.gov/pubmed/7064688 El Sharkawi, A., Ramig, L., Logemann, J. A., Pauloski, B. R., Rademaker, A. W., Smith, C. H., Pawlas, A., Baum, S., & Werner, C. (2002). Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. Journal of neurology, neurosurgery, and psychiatry, 72(1), 31–36. https://doi.org/10.1136/jnnp.72.1.31 Kawasaki A, Fukuda H, Shiotani A, Kanzaki J. Study of movements of individual structures of the larynx during swallowing. Auris Nasus Larynx. 2001;28:75–84. https://www.ncbi.nlm.nih.gov/pubmed/11137367 Khalil, H., Peters, M., Godfrey, C. M., McInerney, P., Soares, C. B., & Parker, D. (2016). An Evidence-Based Approach to Scoping Reviews. Worldviews on evidence-based nursing, 13(2), 118–123. https://doi.org/10.1111/wvn.12144 Langmore, S. E., & Pisegna, J. M. (2015). Efficacy of exercises to rehabilitate dysphagia: A critique of the literature. International journal of speech-language pathology, 17(3), 222–229. https://doi.org/10.3109/17549507.2015.1024171 Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: advancing the methodology. Implementation Science, 5(1), 69. https://doi.org/10.1186/1748-5908-5-69 Logemann JA, Pauloski BR, Rademaker AW, Kahrilas PJ. Oropharyngeal swallow in younger and older women: videofluoroscopic analysis. J Speech Lang Hear Res. 2002;45:434–45. [PubMed: 12068997] Peters M. D. J., 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 Peters, M. D. J., Godfrey, C. M., Khalil, H., McInerney, P., Parker, D., & Soares, C. B. (2015). Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare, 13(3), 141–146. https://doi.org/10.1097/XEB.0000000000000050 Steele C. M. (2012). Exercise-based approaches to dysphagia rehabilitation. Nestle Nutrition Institute workshop series, 72, 109–117. https://doi.org/10.1159/000339999 Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., Lewin, S., … Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of internal medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850 Troche, M. S., Okun, M. S., Rosenbek, J. C., Musson, N., Fernandez, H. H., Rodriguez, R., Romrell, J., Pitts, T., Wheeler-Hegland, K. M., & Sapienza, C. M. (2010). Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial. Neurology, 75(21), 1912–1919. https://doi.org/10.1212/WNL.0b013e3181fef115 Vose, A., & Humbert, I. (2019). "Hidden in Plain Sight": A Descriptive Review of Laryngeal Vestibule Closure. Dysphagia, 34(3), 281–289. https://doi.org/10.1007/s00455-018-9928-1

Background and rationale Previous research suggests that repeated exposure to sweetness is linked to a maintained or increased liking for sweet taste (Pepino & Mennella 2005; Beauchamp & Moran 1982; Beauchamp & Moran 1984). Further, more frequent exposure to sweet foods was associated with a higher preference for sweetness at age 4 and 5 years (Vennerod et al. 2017). However, this relationship was only found when liking was tested with foods of the same flavour profile (Beauchamp & Moran 1984). When having been fed sugared water in infancy, at age two, children liked sweetened water more than children who have not been fed sweetened water in infancy. However, this group difference was not found when sweetness liking was measured using a fruit-flavoured beverage (Beauchamp & Moran 1984). Therefore, it is not clear yet whether repeated exposure to sweetness influences sweetness liking in general or only enhances liking for the specific taste or flavour the child has been exposed to. In a recent systematic review including findings from studies with adults and children, equivocal evidence for the presence and possible direction of sweetness exposure and sweetness liking was found (Appleton et al., 2018). As taste preference is one driver for building food preferences, further research is needed in the field to investigate the relationship between sweetness exposure and general sweetness liking (Schwartz et al. 2011; Panis 2014). An individual’s first year of life plays a special role regarding experiential influences on eating behaviour and food preferences. The child goes through a transition phase from in utero-feeding, over milk feeding to table food (Nicklaus 2017). It is assumed that eating behaviour rooted early in life is maintained during childhood and predicts eating behaviour until adulthood (Nicklaus 2017). Not only repeated exposure may be related to sweetness liking, but also individual differences as a result of genetics (Nicklaus 2017; Panis 2014). Due to that, it is important to evaluate sweetness liking and exposure longitudinally in addition to the assessment at different time points. Assessment of sweetness liking before the beginning of complementary feeding makes it possible to investigate liking at a time point with low variability in the diet. During the milk feeding period babies only consume breast or formula milk. Thus, we may assume that the exposure to sweetness is comparable between babies during that time (Schwartz et al, 2010). That reduces the variability of sweetness exposure and makes it possible to compare sweetness liking after similar exposure to sweetness. Previous research has already examined the same dataset which will be used for this study (Schwartz et al. 2009; Schwartz et al. 2011; Schwartz et al. 2017; Schwartz et al. 2013; Schwartz et al. 2010; Yuan et al. 2016). Regarding sweetness exposure and liking, preliminary analyses with a subset of participants showed that between 3-12 months of life, the acceptance of sweet taste varied increasingly between children (Schwartz et al. 2009), which could be an indicator for the impact of inter-individual differences in sweetness exposure on sweetness liking. Further, in another paper, at the beginning of complementary feeding, a higher sweet taste acceptance was related to a higher acceptance of foods with sweet taste (Schwartz et al. 2011). However, during the first 12-20 months, the acceptance of sweet, salty, sour and umami taste decreased with only sweetness being accepted at 20 months of age (Schwartz et al. 2017), which could be an indicator for developmental influences on sweetness liking and stresses the importance of assessing sweetness liking longitudinally. In another paper, sweetness was preferred over water at 6 and 12 months of age and no relationship was found between the duration of exclusive breastfeeding and sweetness acceptance at this age (Schwartz et al. 2013). However, Yuan et al. (2016) found that a breastfeeding duration of 6 months or less was associated with a higher sweetness exposure during 3-12 months of age and the initiation of complementary feeding earlier than at 6 months of age was found to be related to a higher sweetness exposure at 3-12 months. This is in line with Schwartz et al.’s (2010) finding that the exposure to sweetness increased sharply at the beginning of complementary feeding. Based on these findings, it is unclear whether there is a relationship between sweetness exposure and sweetness liking during a child’s first 12 months of life and how sweetness liking develops during those months.

Introduction Ostomies are defined as surgically created openings or canals that make a path between the inner of an organ and the outer environment. They are intended to minimize problems that temporarily or permanently disable a segment of the body, seeking to maintain the function of the organ affected by pathologies or trauma. 1,2 Ostomies can be permanent or temporary and, depending on the affected organ, receive different names and specific care. In the present study, the research interest is around eliminatory ostomies with eliminatory function, which are ileostomies and colostomies (ascending, transverse, descending and sigmoid), which are categorized as intestinal ostomies. 3 The national literature regarding the epidemiological data of individuals with ostomies, in general, is still incipient and needs further investigation, however, it is estimated that about one million and 400 thousand surgeries for making ostomies are performed per year in Brazil. According to the Ostomy Associations of America, approximately 100,000 to 130,000 new surgical procedures for making an ostomy are performed in the United States of America (USA), with colostomy being the most made.4,5,6 This data, in particular, is in line with the results of a study carried out in Brazil on the profiles of ostomies in relation to location, which demonstrated a greater predominance of intestinal ostomies, particularly colostomy and ileostomy.7 In this context, it is considered that the increase in the number of neoplasms and gastrointestinal diseases evidenced in the morbidity profile of the population increases the number of people who need intestinal stomas as a therapeutic strategy and, therefore, in view of the risks, there is an increase the susceptibility to complications, namely: hernias, retractions, necrosis, infections, fistulas, more common in colostomy.8 Complications are divided into complications in the ostomy or skin peristomia. In addition, they are also divided in relation to the period of appearance, which can be immediate (within the first 24 hours after the ostomy is made), early (up to 1 week after the ostomy is made) or late (after 1 week, extending up to months after hospital discharge)9,10 Complications related to intestinal stomas are described in the literature in several studies, being frequent in the lives of patients who have newly made stomas. 1,2,11 The rate of complications related to ostomy in the USA is from 21 to 70%.6 In Brazil, an investigation on the perceptions of the quality of care of patients with ostomy, that 71% of patients with ileostomies and 43% of patients with colostomy had complications. 12 Data show rates from 70% to 80% for the development of some complication in patients with ostomies. It is estimated that a person in this condition has the experience of at least one complication up to the second year after confection. 13,14 Complications, in general, are caused by several factors, including the difficulty in self-care in relation to the stoma, the presence of more than one stoma, the high-output stoma. There are also factors related to the approach to surgery, such as emergency surgery, containment sutures, laparoscopic approach, which are more prone to complications. The characteristics of size, shape and height of the stoma influence differently on skin adhesion, which can generate contact with effluents and increase the risk of complications. 13 In addition, in the case of late complications, the presence of comorbidities, especially obesity and high intramuscular pressure, which can result in prolapses and parastomy hernia. 15 In view of this panorama of ostomies and their complications, it is considered that the qualification of nurses and the use of instruments that can help in the early identification of risk factors and in the proper management of complications are essential in improving their professional performance, with potential impact on patient fitness and well-being. 16 After hospital discharge, the specialist nurse is responsible for inspecting the ostomy and the peristomy region to assess aspects of the ostomy in relation to color, shape, size, humidity, presence of exudate or other substances, pain and skin lesions. Thus, the late postoperative period, established one week after surgery, is considered an essential time to monitor the patient and their needs and to minimize and prevent complications.17 When critically reflecting on the care provided by nurses in managing the care of patients with ostomies, in particular with a focus on the management of complications, it is pointed out that nurses, regardless of their specialist status, should provide assistance to this patient in different care settings, in the hospital or out-of-hospital context. Thus, nursing care in the presence of complications should prevent the worsening of the condition of the ostomy, the skin peristomia and its functionality. On the other hand, inadequate management can lead to consequences that worsen the patient's quality of life, bring psychosocial impacts, the need for surgical interventions and the use of complementary materials. 10 Therefore, the absence of follow-up by a qualified professional in the postoperative period can lead the patient to develop peristomia complications and their consequences.13 Therefore, there is a responsibility of health professionals in actions against complications, in view of the reduction of their occurrence and rapid reversal in their validity, aspects that should be enhanced by the presence of professionals prepared for this demand in the services, especially the experts.18 In view of the shortage of specialized professionals in health services, it is assumed that the construction of an assessment instrument, as a health care technology, can help nurses' decision-making in the field of care for patients with functional intestinal ostomy. eliminatory with late complications, guiding nursing care during the management of such complications. In this context, it is assumed that the construction of an assessment instrument will help nurses' decision-making in the field of care for patients with intestinal ostomy with an eliminatory function with complications, helping to guide nursing care during the management of such complications based on scientific evidence. This type of technology has the potential to contribute to knowledge in the area for general practitioners and to directly impact the nursing care provided to clients with this specific need at various levels of health care. Therefore, it is necessary to know the scope of knowledge present in the literature about late complications and the nursing approaches to them, in order to identify and report the scientific evidence that can support the proposition of a health care technology on this topic. Therefore, the objective is: To map the existing knowledge about complications and actions related to nursing therapy in patient care with complications related to intestinal ostomies with eliminatory function. Review questions What are the late complications in eliminatory intestinal ostomies? What is the nursing care for people with late complications in intestinal ostomies with eliminatory function? Population Patients with intestinal ostomies with eliminatory function. Concept Nursing care in the face of late complications of intestinal ostomies with eliminatory function. Context Any context. Type of study We will use primary papers found in predefined databases according to specific eligibility criteria. Furthermore, this scope review will include data found in the grey literature, such as protocols, guidelines, and manuals. Our focus lies in articles that approaches late complications in intestinal ostomies and nursing management to these complications will be considered. For our search in the databases, we will adopt theme-pertinent descriptors and keywords in three languages: Portuguese, English, and Spanish. As for the grey literature, we will search through databanks of theses, and websites of reference entities in the Enterostomal Therapy fields. Languages will also be limited to Portuguese, English, and Spanish, and there will be no time restriction in terms of data production. Yet, whenever there are updates on guidelines/manuals, we will use only the most recent version. Methods This review follows the Joanna Briggs Institute’s (JBI) methodology for scope reviewing, and adopts the 2020 JBI Manual for Evidence Synthesis. 19 Search strategy Firstly, we have searched through databases in order to identify descriptors or keywords for the development of this study (Appendix I). Later on, we will search for scientific papers in these databases: Literature of Latin America and the Caribbean (LILACS), National Library of Medicine (Medline via PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Spanish Bibliographic Index of the Health Sciences (IBECS), SciVerse Scopus (SCOPUS), Embase, and Web of Science. After crossing the descriptors and the keywords in each of the selected bases, we will apply initial filters of “complete text”, “paper”, and language. Appendix II features an example of the strategy that we will use for this scope review. We will search for grey literature evidence in the CAPES Theses and Dissertations Catalogue, in documents available at websites of official institutions, in guidelines and manuals of both national, and international institutions. We will also search in reference entities in the stomatherapy fields in order to find materials on complications and actions related to intestinal ostomies (Appendix III). Study selection We will import every selected paper into the Mendeley Reference Manager, and remove all duplicates. Firstly, we will submit the papers to an exploratory reading of their title and/or abstract by a reviewer, in order to decide whether they fit in the study’s theme and, thus, should be selected. Texts that adhere to the theme of the investigation will be fully read by two reviewers separately, and will be thoroughly analyzed according to the eligibility criteria. Afterwards, we will compare the reviewers’ selections, and, if there is any divergence, we will resolve them by means of consensual discussion, or of a third senior reviewer. Lastly, the studies that have been fully read and excluded for not meeting the inclusion criteria will be counted, and we will systematize the reasons for exclusion in an appendix of the final report. This report will also describe the search process, and the paper selection through the PRISMA Flowchart. Data extraction Data will be extracted by a tool of data collection developed for this review, and two reviewers will participate in this process with the support of the software Microsoft Excel®. Collected data will provide us with information about the studies on drug labelling in Intensive Care, Emergency, and Anesthetic Units. We will control the year of publication, the authorship, the country of publication, the title of the paper, the language, the type of study, the number and the profile of the participants, type of complication, management/care for the complication, results (if applicable). We might contact authors of specific papers if additional information be necessary. Furthermore, we may modify the tool of data collection throughout the investigation, if the analyzed papers highlight the need for additional information (Appendix IV). Data mapping We will present the extracted data in tableaux (Appendix V), and thus characterize, assemble, synthetize, and describe the findings of this review. Hence, after mapping the results, we will correlate them to the goals of this investigation. The information identified will be relevant for understanding which complications occur in the late postoperative period and what actions the nurse can take to manage the complication. Funding There is no funding for this investigation. References 1. MIRANDA SM, Luz MHBA, Sonobe HM, Andrade EMLR, Moura ECC. Caracterização Sociodemográfica e Clínica de Pessoas com Estomia em Teresina. Rev Estima, v. 14, n. 1, 2016. Disponível em: https://www.revistaestima.com.br/estima/article/view/117 2. AZEVEDO C, Faleiro JC, Ferreira MA, Oliveira SP, Mata RF da, Carvalho, EC de. Intervenções de enfermagem para alta de paciente com estomia intestinal: revisão integrativa. Rev Cubana de Enfermería, Vol. 30, Núm. 2,2014. Disponível em: http://www.revenfermeria.sld.cu/index.php/enf/article/view/404 3. LIMA VS, Azevedo NAA, Guimarães JMX, Pereira MM, Neto JA, Souza LM, Pequeno AMC, Sousa MC. Produção de vídeo educacional: estratégia de formação docente para o ensino na saúde. Rev Eletron Comun Inf Inov Saúde. 2019 abr.-jun.;13(2):428-38. http://dx.doi.org/10.29397/reciis.v13i2.1594 4. CERQUEIRA LCN, Cacholi SAB, Nascimento VS da, Koeppe, GBO, Torres, VCP, Oliveira PP. Caracterização clínica e sociodemográfica de pessoas estomizadas atendidas em um centro de referências. Revista Rene. Ed.21, e42145. DOI: 10.15253/2175-6783.20202142145. 2020. 5. BARBOSA MR, Simon BS, Tier CG, Garcia RP, Siniak DS, Rodrigues SO. Profile of people with stomas from a municipal health service in Southern of Brazil. ESTIMA Braz J Enterostomal Ther. 2018; 16:e1318. doi: http://dx.doi.org/10.30886/ estima.v16.465_PT 6. MURKEN DR, BLEIER JIS. Ostomy-Related Complications. Clinic in Colon and Rectal Surgery. Vol. 32, No. 3, 2019. Disponível em: 10-1055-s-0038-1676995.pdf (nih.gov). Acesso em: 10/01/2021. 7. LOPES MV, SILVA VM, ARAÚJO TL. Métodos de pesquisa para validação clínica de conceitos diagnósticos. In: NANDA Internacional Inc; Herdman TH, Carvalho EC, organizadores. PRONANDA - Programa de Atualização em Diagnósticos de Enfermagem - Conceitos Básicos. Porto Alegre: Artmed; 2013. p.85-129. 8. KRISHNAMURTY D, BLATNIK J, MUTCH M. Stoma Complications. Clinics in Colon and Rectal Surgery, 30(3), 193–200. doi:10.1055/s-0037-1598160, 2017. 9. PAULA MAB, CESARETTI IUR. Como cuidar de pessoas com estomias complicadas. In: Estomaterapia em foco e o cuidado especializado. São Caetano do Sul, SP: Yendis Editora, 2014. p.170-182 10. SANTOS VLCG, CESARETTI IUR. Assistência em estomaterapia: cuidando de pessoas com estomia. São Paulo: Editora Atheneu, 2015. 11. MELLOTI LF, Bueno, IM, Silveira GV, Da silva MEN, Fedosse E. Characterization of patients with ostomy treated at a public municipal and regional reference center. J Coloproctol. 2013; 33(2):70–4. Disponível em: http://www.scielo.br/pdf/jcol/v33n2/2237-9363-jcol-33-02-070.pdf. 12. PERSSON E, Gustavsson B, Hellstrom AL, Lappas G, Hultén L. Ostomy patients’ perceptions of quality of care. J ady Nurs. 2005;49(1): 51-58. 13. PINTO IES, Queirós SMM, Queirós CDR, Da Silva CRR, Santos CSVB, Brito MAC. Fatores de risco associados ao desenvolvimento de complicações do estoma de eliminação e da pele periestomal. Revista de Enfermagem Referência. ISSNe: 2182.2883. Serie IV, n°15, p, 155-166. 2017. Disponível em: https://www.redalyc.org/journal/3882/388255693019/html/. 14. Nunes MLG, SANTOS VLCG. Instrumentos de avaliação das complicações na pele periestoma: revisão integrativa. Aquichan. 2018, 18(2):477-491. DOI: 10.5294/aqui.2018. 15. AMBER PC, Kurz NR, Nitschke C, Odeh SF, Moslein G, Zirngibl H. Intestinal Ostomy. Deutsches Ärzteblatt International; Vol. 115; p. 182-7. 2018. Disponível em: https://pubmed.ncbi.nlm.nih.gov/29607805/ 16. Moura RRA, Moraes JT, Guimarães EAA. Avaliação dos serviços de atenção à saúde das pessoas com estomias: estudo de casos múltiplos. Revista Rene. Ed. 19. DOI: 10.15253/2175-6783.20181932961. 2018. 17. Gomes B, Martins SS. A pessoa Estomizada: Análise das Prática Educativas de Enfermagem. Rev Estima, v. 14, n. 3, 2016. Disponível em: https://www.revistaestima.com.br/index.php/estima/article/view/410. 18. Perissotto S, Breder JSC, Zulian LR, Oliveira VX de, Silveira NI da, Alexandre NMC. Ações de enfermagem para prevenção e tratamento de complicações em estomias intestinais: revisão integrativa.ESTIMA, Braz. J. Enterostomal Ther., São Paulo, v17, e0519, 2019. https://doi.org/10.30886/estima.v17.638_PT 19. 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.

Search Strategy The recommendations of the Meta-Analysis of Observational Studies in Epidemiology guidelines (MOOSE) follow in the conduct of this systematic review and meta-analysis. A comprehensive literature search of retrospective and prospective cohort studies conduct in PubMed/MEDLINE, Scopus, Cochrane library, and Web of Science databases, a from database inception to now. The search strategy comprise of “body mass index” OR “Birth weight” AND “Type 1 diabetes” relevant terms. Reference lists from original and review papers investigate to identify additional relevant studies and an email alert service activate in databases to avoid any missing new articles published after our search. Inclusion criteria Studies include if they adhere following inclusion criteria: 1) investigated the association between BMI or birth weight and type I diabetes in a retrospective or prospective study; 2) reported appropriate estimates such as the hazard ratio (HR), risk ratio (RR), or odds ratio (OR) and the corresponding 95% confidence intervals (CI). Studies were excluded if they were conference papers, review papers, editorials, non-human studies, case reports, ecological studies, or letters without sufficient data. Multiple reports for same cohort, cross sectional, case-control, and intervention studies were also excluded. Data extraction and quality assessment Title and abstract screening of searched studies conduct by Two authors, independently. Subsequently, full texts studies assesse, and discrepancies resolve through discussion with a senior author. Relevant data extract according to extraction forms, where the following data extracte: the first authors, year of publication, year of start and finishing studies, study location, cohort name, number of participants, summary estimates and 95% CIs of type I diabetes. Fully adjusted models were used for the meta-analysis. The Newcastle-Ottawa Quality Assessment Scale (NOS) use to assessment of studies quality and Studies were considered with aggregate scores of 0-6 as having low quality and 6.5-9 as having high quality. Statistical analysis All statistical analyses conduct using STATA 14.0 statistical software (Stata Corporation, College Station, Texas, USA). In order to combine risk estimates of type I diabetes in children, DerSimonian and Laird random effects model used.

Background: The herba Houttuynia cordata Thunb. (HC) has anti-inflammatory, antibacterial and antiviral effects. Through nasal irrigation, the related preparation of HC is beneficial for treating rhinosinusitis or promoting recovery after an endoscopic sinus surgery. However, it remains controversial whether nasal irrigation with HC preparation can provide evidence-based clinical benefits for rhinosinusitis patients. Methods: With reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), eight databases are perused to perform a methodical investigation of nasal irrigation with HC preparation and health-related results amongst rhinosinusitis patients. The main research purpose is to determine the influence of PRISMA standards on medical results pertaining to rhinosinusitis patients, including quantitative symptom recording and effective rate. With reference to the Cochrane Handbook, quality assessment of qualified papers is conducted using the Cochrane Risk Assessment Tool. Results: The results will be publicised through a peer-reviewed journal publication. Conclusion: The results of the systematic review will summarise evidences for the efficacy of nasal irrigation with HC preparation in rhinosinusitis treatment. Ethics and dissemination: Since this study involves a methodical investigation of issued medical papers, ethical authorisation and informed patient consent are not necessary.

1 Title Evaluation Tools and Outcome Measures used to assess dysphagia in adults with Disorders of consciousness secondary to Acquired brain injury: A Scoping Review protocol. Scoping review question: “What tools (validated or non-validated) and what outcome measures are used by speech and language therapists during dysphagia screening and assessment in adults with DoC associated with ABI?” 2 Introduction Disorders of consciousness (DoC) are a wide range of conditions whereby patients don't have the ability to interact with the environment(Young, 2012). To be conscious, arousal and awareness must be present and interact with each other, when one of these systems is disrupted, consciousness is impaired (Gosseries et al., 2011). DoC can result from Acquired Brain Injury (ABI) (Young, 2012): a damage to the brain that occurs after birth, not related to congenital disorders, developmental disabilities, or progressive conditions (Eskildsen et al., 2019). Dysphagia is frequent in this population (Mackay et al., 1999) and some components of swallowing impairments are particularly related to consciousness (Bremare et al., 2016; Mélotte et al., 2021). The existence of cognitive and behavioural disabilities in this population has a significant impact on the evaluation (Terré & Mearin, 2007). Therefore, the importance of having an overview of the formal and informal assessment outcome measures and tools used to evaluate deglutition disorders in this population. A preliminary search for existing scoping reviews and systematic reviews on the topic has been conducted in November 2021 in JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, PubMed and Prospero. The aim of the project is to outline and categorize the existing evidence regarding the informal and formal assessment tools and outcome measures useful for speech and language therapists’ management of dysphagia with specific emphasis both in screening and in clinical swallow evaluation in patients with DoC secondary to ABI. The comprehensive overview of the literature may offer useful support for speech and language therapists (SLT) since it would provide an insight of the availability of the tools and measures to choose from when assessing dysphagia in DoC patients after ABI. Additionally, this scoping review may also lay the foundations for a future systematic review to identify the methodological quality of the psychometric properties of the tools and outcome measures identified and to select the most appropriate ones to include in a core outcome set. 3 Eligibility criteria Inclusion criteria - Population Patients with DoC arising from moderate, severe or very severe acquired damage of the brain. Papers should include DOC and patients with moderate, severe or very severe ABI. In the scenario where consciousness is not explicitly mentioned, scales to assess cognitive and behavioural patterns in patients emerging from a coma (e.g. Rancho Los Amigos Level of Cognitive Functioning Scale) or a description of the level of consciousness (LoC) of the patients has to be present. If information about the LoC is missing, the full text will be examined. Patients with tracheostomy are included in the study since it is frequently a necessary procedure in the ICU, especially in patients with TBI (Robba et al., 2020). Excluding patients requiring tracheostomy would dismiss severe/very severe ABI patients limiting the number of eligible papers and foremost the population of interest. However, it is recognised that some features of the dysphagia in the patients may be caused by the presence of the tracheostomy(Skoretz et al., 2020). Exclusion criteria - Population Patients with mild ABI (Glasgow Coma Scale 13-15, post-traumatic amnesia

The aim of the review is to identify evidence of the current impact of extreme weather events (heavy rain, flooding, storms) on the chemicals in the environment, the chemical risk pathways and the populations most at risk. We aim to understand the mechanisms of harm include floods causing risk to health by mobilising toxic substantives, explosions and reactions that then lead to contamination of floodwater with chemicals. Harmful chemicals risks are those assessed as harmful to human health [details]: including POPs, PCBs, heavy metals or sources of chemicals (landfills, hazardous waste sites, mines, acid mine drainage) Justification of time period. We limited our search to papers published in and after year 2000 because a) papers published before this period unlikely to be relevant due changes in managing chemicals, and b) the previous review was ended in 2004.

Introduction : Men who have sex with men (MSM) are disproportionally affected by a number of health conditions which are associated with violence, stigma and discrimination. In recent years, Syndemic Theory provided a framework to explore the interactions of these health disparities on the biological and social levels. Research in this field has been increasing for the past 10 years but methodologies have evolved and sometimes differed from the original concept. The aim of this paper is to provide an overview of the existing literature on Syndemic Theory applied to MSM in order to identify knowledge gaps, inform future investigations and expand our understanding of the complex interactions between avoidable health conditions in a vulnerable population. Methods and analysis : The proposed scoping review will follow the methodological framework developed by Arksey and O’Malley with subsequent enhancements by Levac et al., Colquhoun et al. and Peters and al as well as the PRISMA extension for scoping review. The protocol presented in this paper followed the PRISMA extension for protocols. A systematic search of Medline, PsycInfo, Scopus, Cochrane Central Register of Controlled Trials and ProQuest Sociological Abstracts will be conducted. Reference lists of the included studies will be hand-searched for additional studies. Screening and data charting will be achieved using DistillerSR. Data collating, summarising and reporting will be performed using R and RStudio. Tabular and graphical summaries will be presented, alongside an evidence map and a descriptive overview of the main results. Ethics and dissemination : This scoping review does not require ethical approval. Data and code will be made accessible after manuscript submission. Final results will be disseminated through publication in a peer-reviewed journal and collaboration with grassroots LGBTQI+ organisations.

• Background Typically a disorder of the older adult, Myeloproliferative neoplasms (MPNs) are classified as rare, with an incidence rate less than 6 per 100 000 persons per year (Rumi & Cazzola, 2017). There are three main subtypes of MPNs: polycythaemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (MF) (Harrison, et al, 2017). Clinical manifestations vary by subtype but typical symptoms include fatigue, pruritus, night sweats, splenomegaly, abdominal pain and early satiety (Passamonti & Maffioli, 2016). Importantly, PV and ET both convey a high risk of thrombosis and an increased risk of progression to acute myeloid leukaemia (AML) or secondary MF (Mesa & Passamonti, 2016). Patients with a diagnosis of MPN have reduced life expectancy compared with the general population (Paranagama et al, 2018). Research exploring the impact of a diagnosis of MPN on patients has highlighted high symptom burden and reduced quality of life (Harrison et al., 2017). Although symptom burden is highest in myelofibrosis and high-risk patients, lower-risk patients also report symptoms which impact their daily life and ability to work. In addition to physical symptoms, a diagnosis of MPN has been found to affect emotional well-being, with anxiety and depression frequently reported by patients (Walpole, Kelly, Lewis, Gleeson, Cullen & Wochal, 2021). Adolescents and young adults (AYA) can also be diagnosed with the disorder, however research identifying the psychological issues experienced by this population and how these are best managed is limited. a. Review objective and questions: o The objective of this scoping review is to identify and synthesise existing knowledge and identify any knowledge gaps regarding psychological needs of AYA patients with a diagnosis of MPN. o The specific research questions identified as pertinent to the objective are:  What are the psychological issues experienced by AYA patients with a diagnosis of MPN  What psychological interventions for AYAs with a diagnosis of MPN have been utilised  What are the impacts of these interventions  What are the characteristics of AYA patients receiving psychological interventions  Where have the psychological interventions been delivered (e.g. what setting; by what discipline(s), in what countries, etc).  What tools exist for screening/identifying the psychological needs of this patient population b. Searches: o PsychInfo, Medline, CINAHL, Embase, Web of Science, Scopus and the Cochrane Library will be utilised to systematically search for relevant literature. o Gray literature searches along with hand searches of included papers and reference lists of recent, relevant reviews will also be completed. No restrictions will be set according to publication type. The searches will be completed by 19th September 2022. Only studies published in English in the last 2 decades will be included in the scoping review. c. Types of study to be included: Included designs: - Research papers of any methodology - Written in English Excluded designs: - Studies not published in English - Full text not available d. Condition or domain being studied Myeloproliferative neoplasms (MPNs). e. Participants/population Inclusion criteria: Studies whose samples include adolescents and young adults aged 16years old to 39 years old diagnosed with an MPN. Exclusion criteria: Studies which focus on patients under the age of 16 or 40 years or older, with a diagnosis of MPN. f. Intervention(s), exposure(s) Not applicable g. Comparator(s)/control Not applicable h. Main outcome(s) To identify and synthesise existing knowledge and identify any knowledge gaps regarding psychological needs of AYA patients with a diagnosis of MPN. i. Measures of effect Not applicable, the main outcome will be described in a narrative format. j. Additional outcome(s) Not applicable k. Methods This scoping review protocol will follow the PRISMA-ScR (Tricco et al., 2018) checklist. This checklist is an extension of Preferred Reporting Items for systematic reviews and Meta-Analysis (PRISMA) (Page et al., 2021) and builds on the work of Arksey & O’Malley (2005) while also including clarification on the detail required to ensure a robust and transparent framework (Peters et al., 2020). This protocol will be submitted for registration with Open Science Framework (https://osf.io). Any protocol amendments made after acceptance of the submission will be registered via that webpage. (i) Selecting the evidence: The study selection for scoping reviews should be an iterative process to refine the search strategy and provide clarity on study inclusion (Colquhoun et al., 2014). This will be an important component of the literature search to ensure the scoping review objective is achieved. a. Two of the authors (TH, HLR) will screen approximately 5% of titles and abstracts of the papers and as refinement of the inclusion and exclusion criteria unfolds, a further 5% to ensure there is consistency in the screening. b. Once the selected papers have been identified two of the authors will review the full texts, blinded to each other. As by convention (Aromataris & Munn, 2020) if there are any disagreements and or consensus is unable to be achieved on inclusion of a paper, a third author (DGF) with be the adjudicator. (ii) Data charting process, data items and synthesis of results: As noted for scoping reviews, (Colquhoun et al., 2014) the exact determination of variables is an iterative process therefore after the data collection process there may be a change in the variables which will be justified in the actual review. a. A data extraction table will be designed by two authors (TH, HLR) for charting the key information data on the selected articles/studies. In particular, one of the columns will include how this paper aligned with the scoping review objective to ensure clarity of why this was included, as recommended by Peters et al (2020b). To ensure the appropriateness of the data extraction tool the reviewer (TH) and one of the authors (HLR) will independently populate the table/tool with a representative sample of the included articles/papers. Following this, by consensus, the data extraction table design will be agreed upon and used. Data will include author (s), year of publication, country of the study, aims/purpose of the study, population, sample characteristics and size if applicable, details of psychological issues experienced; intervention types; screening tools, comparator as applicable, methods, key findings, and limitations in relation to the overarching question and objectives of this scoping review. This data extraction framework should ensure a quick view summary of how each of the papers answer the overarching objective and or the specific detail of one of the identified questions. l. Results I. Selection of sources of evidence: The selection process of inclusion/exclusion will be entered into a PRISMA flow chart (Page, et al., 2021) to clarify justification of the two categories. This will be a narrative approach, describing the process of inclusion or exclusion of papers and will follow a systematic process of comparison against the inclusion/exclusion criteria and the objective of the scoping review. II. Characteristics of sources of evidence: While the merit and or quality of each specific study is important it is valuable to consider literature that contributes in a substantive way, by citations, to either address the objective or highlight any gaps in the quest to address the objective (Peters et al., 2020b) III. Critical appraisal within sources of evidence: While systematic scoping reviews may not necessarily perform quality appraisal as part of the methods (Tricco et al., 2018), we include the Mixed Methods Appraisal Tool (MMAT) (Hong et al., 2018) as a measure of quality appraisal in order to provide a more transparent overview of the available research evidence. All included articles, papers will be tabulated with specific details for each paper against the identified criteria as described in the data extraction table. IV. Synthesis of result. The findings of the results will be categorised and then summarised as to what information/findings relate to the objective and as a subcategory the questions. m. Discussion The discussion will include a summary of the evidence, including a brief overview of the key concepts, the themes and the types and quality of the relevant literature. This will also include any gaps to address the stated objective of the scoping review. The limitations will be discussed. Finally, a conclusion will be drawn based on the interpretation of the findings specific to the question and objectives to future research. n. Risk of bias (quality) assessment Two review authors (TH and HR) will independently assess the methodological quality of included studies using the Mixed Methods Appraisal Tool (MMAT) (Hong et al 2018). o. Strategy for data synthesis The findings of the results will be categorised and then summarised as to what information/findings relate to the objective and specific scoping review questions. p. Analysis of subgroups or subsets Not applicable q. Contact details for further information Dr Tara Houlihan thoulihan@muh.ie r. Organisational affiliation of the review Mercy University Hospital, Cork, Ireland & University of Limerick, Limerick, Ireland s. Review team members and their organisational affiliations Dr Tara Houlihan, Mercy University Hospital Prof. Dónal G Fortune, University of Limerick Prof. Helen L Richards, Mercy University Hospital/University of Limerick t. Type and method of review Scoping review u. Anticipated completion date 19th September 2022 v. Funding sources/sponsors Not applicable w. Conflicts of interest Not applicable x. Language English y. Country Ireland

Exploring interventions that support the health and wellbeing of refugees and asylum seekers resettled in regional and rural Australia: a scoping review protocol Reviewers: Kate Freire, Shakeh Momartin, Mariano Coello Introduction (not complete) Most research involving refugee populations in Australia has been focused upon those that have resettled in metropolitan areas of Australia. As a result,little is known about what interventions support the health and wellbeing of those who have resettled in regional communities. A preliminary search for existing scoping reviews and systematic reviews on the topic was conducted using the following databases: JBI Evidence Synthesis, Cochrane Library, and PROSPERO. Currently no identified reviews have provided an overview of interventions that support the health and well-being of refugees and asylum seekers settling in regional and rural locations in Australia. Hence, the objective of this review is to examine the current evidence base of interventions that address the health and well-being of humanitarian migrants settling in rural and regional areas. It will aim to identify, map, and summarise key concepts and types of evidence relating to the interventions, including research approaches (e.g., quantitative, mixed method, participatory) and any frameworks that were utilised. In addition, it will identify and summarise any facilitators and barriers to the interventions that have reported. The review will also identify gaps in the research to inform future interventions and research. It is hoped that gaining further insights and reliable evidence on these aspects will assist with the development of future health programs. To address the aim stated above, the following primary research question has been developed: • What interventions have been utilised to support the health and well-being of refugees and asylum seekers who have settled in regional and rural areas in Australia? Two sub-questions have also been identified: • What approaches and frameworks did these interventions utilise? (e.g., participatory etc). • What facilitators and barriers have been reported relating to engagement and success of the intervention? Methods The scoping review will follow guidance from Chapter 11 of the Joanna Briggs Institute Manual for Evidence Synthesis (Peters et al., 2020) and the PRISMA-ScR statement (Tricco et al., 2018). Eligibility of sources Inclusion criteria • Peer-reviewed primary research articles, short communications, systematically conducted reviews, reports of primary or secondary research, theses and dissertations. • Publication Date: 1997 to present (25 years, the actual date the search is conducted to be recorded). • Published in English or a language other than English which is translatable using Google Translate or translatable by colleagues who can read and interpret relevant languages. • Australian regional and rural areas. The Modified Monash Model (MMM) (https://www.health.gov.au/health-topics/rural-health-workforce/classifications/mm) will be used to include all studies that took place in regional and remote areas (MMM 2-7). It is anticipated that some studies won’t the study’s context using the MMM, but there should be enough description to allow a decision between metropolitan areas (MMM 1) and regional, rural, and remote areas (MMM 2-7). • Literature involving people from refugee and refugee-like background, as well as asylum seekers, humanitarian migrants, from both offshore and onshore situations; irrespective of their age, gender, nationality, type of visa or health status. • Literature investigating interventions that support the health and well-being of people from refugee and refugee-like background, and any facilitators and barriers to the interventions. Exclusion criteria • Narrative literature reviews, opinion pieces, editorials, letters/correspondence, conference materials, protocols, guidelines, single case studies, books, eBooks, non-print resources, news articles, magazine articles, pamphlets, trade publications, websites and blogs. • Published or gray literature that has not outlined a research or data analysis method or appropriate eligibility criteria. • Studies that have not obtained ethics approval where it would be appropriate. • Published prior to 1997. • Published in a language other than English that is not translatable using Google Translate, or by colleagues who can read and interpret relevant languages. • Studies that took place in metropolitan areas of Australia (MMM1) and studies that do not provide a description of context that allows the authors to make a judgement between metropolitan areas (MM 1) and regional, rural and remote areas (MMM 2-7). International studies. • Literature in which data for studies in MMM 2-7 locations, is not separable from data pertaining to MMM 1. • Full text is not available. Search strategy design A three-step search strategy has been developed following the recommendations of the JBI Manual for Evidence Synthesis (Peters et al., 2020) and in consultation with a librarian. Firstly, an initial search, using keywords will be conducted of the following two databases: EBSCOhost: CINAHL and ProQuest: MEDLINE. Additional keywords will be identified by analysing of the text words contained in the titles and abstracts of a selection of retrieved papers and their index terms. Subsequently, a second search using all identified keywords will be used to extend the searches of the following databases: • EBSCOhost: Academic Search Complete, CINAHL Plus with Full Text, SocINDEX with Full Text, Education Research Complete, Open Dissertations, ERIC, Psychology and Behavioural Sciences Collection • ProQuest: Health & Medicine Databases (MEDLINE, Health & Medical Collection, Nursing & Allied Health Database, Psychology Database), ProQuest Dissertations & Theses Global • Ovid: Ovid Emcare, APA PsycINFO • Scopus: gray lit • Informit Health Collection • Google Scholar • Google Advanced Search limiting by domain names (e.g., org.au). • The following organisations websites will be searched to see if they have any relevant research or reports: STARTTS, The Australian Red Cross, Australian Refugee Health, Good reason – centre for refugee research at UNSW, Refugee Council of Australia, Australian Government, Department of Home Affairs – immigration and citizenship, NSW Health, Specialist multicultural and refugee health services, UNHCR, World Bank, International Organisation for Migration (OIM), Settlement Services International (SSI). Finally, citation tracking of all papers identified as eligible for the scoping review will be searched for any additional sources. The search is designed to be deliberately broad to ensure all potentially relevant studies are included in the scoping review. Keywords Humanitarian migrant, refugee, refugee-like, asylum seekers, Australia Sample search strategy ‘asylum seekers’ OR refugees OR ‘refugee like’ OR ‘humanitarian migrant’ Filters: geographics to Australia and New Zealand, date range 1997 to current Evidence selection Once duplicates have been removed, initial screening of title and abstracts will be performed by the first reviewer, based upon inclusion and exclusion criteria. Full text screening will be conducted by two reviewers (KF, SM). Discussion with third reviewer (MC) will resolve any disagreements. Data extraction Data extraction will utilise a charting table which will be piloted on two included papers to ensure that all relevant findings are extracted. KF will extract the data; and SM and MC will check her extraction. Any disagreements to be resolve by discussion between three authors. Analysis and presentation of results: Descriptive map and presentation of results. References 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. https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-12 Tricco, AC, Lillie, E, Zarin, W, O'Brien, KK, Colquhoun, H, Levac, D, Moher, D, Peters, MD, Horsley, T, Weeks, L, Hempel, S et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018,169(7):467-473. doi:10.7326/M18-0850.

Authors Jennifer A. Ross1 Sonal N. Shah2 Joshua K. Dodderer3 Tess M. Curran3 Anna C. Dorste4 Michele M. Burns2,5 1. Adolescent Substance Use and Addiction Program (ASAP), Division of Developmental Medicine 2. Division of Emergency Medicine 3. Department of Pediatrics 4. Medical Library 5. Harvard Medical Toxicology Fellowship Boston Children’s Hospital, Boston, MA Introduction: A preliminary search of MEDLINE, the Cochrane Database of Systematic Reviews and PROSPERO was conducted and no current or underway systematic reviews or scoping reviews on the topic were identified. A scoping review methodology was chosen to synthesize all available information, literature, and data on this topic and to highlight gaps in the field. Review Objective: To perform a scoping review of the literature on pediatric poisoning fatalities over 100 years (1900-2000), with the goal of analyzing all cases by age, drug exposure type, and reported drug exposure amounts. The years 1900-2000 were chosen because no existing report has synthesized data from this time period. Keywords: Pediatrics, Toxicity, Poisoning, Fatality, Mortality Concept: The definition of toxic, as utilized in this research project, is exposure to a xenobiotic or other foreign substance. Toxic does not refer to infectious agents, as delineated in the exclusion criteria. Context: Pediatric poisoning fatalities are devastating but largely preventable occurrences. Young children are at high risk of toxic exposures due to their exploratory nature, while adolescents and young adults are at high risk of intentional ingestions due to pediatric mental health concerns and the potential for substance use. In order to implement the appropriate safety regulations and provide education to the community, it is imperative to analyze and describe the circumstances surrounding these fatalities. However, due to the wide variety of substances utilized in poisonings and the lack of a universal reporting system, case reports of these fatalities are scattered throughout the literature. It would be of great benefit to pediatricians, toxicologists, public health officials, and policymakers to be able to reference a comprehensive source of all known cases of pediatric poisoning fatalities. Types of Sources" This scoping review will consider both experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies and interrupted time-series studies. In addition, analytical observational studies including prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies will be considered for inclusion. This review will also consider descriptive observational study designs including case series, individual case reports and descriptive cross-sectional studies for inclusion. Qualitative studies will also be considered that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, qualitative description, action research and feminist research. In addition, systematic reviews that meet the inclusion criteria will also be considered, depending on the research question. Text and opinion papers will also be considered for inclusion in this scoping review. Methods: The proposed scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines. Eligibility criteria: Included are fatalities in children ages 0-18 years resulting from: - Exposures to a xenobiotic - Exposures to a household product - Exposures to toxins secondary to fires including carbon monoxide and cyanide - Iatrogenic exposures during hospitalization or other healthcare settings - Exposures to environmental poisons or envenomations including plants and animal bites/stings - Known adverse effects from pharmaceutical agents Excluded are fatalities in children ages 0-18 years resulting from: - Exposure to second hand smoke - Toxins secondary to food poisoning - Intrauterine exposures - Underlying disease, including cancer and/or infection Search strategy: The search strategy will aim to locate both published and unpublished studies. An initial limited search of PubMed was undertaken to identify articles on the topic. Relevant articles were mined for keywords and relevant controlled vocabulary terms to create a sensitive, comprehensive search strategy of the concepts of “pediatrics,” “poisoning/toxicities,” and “fatalities.” The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles were used to develop a full search strategy for PubMed (see Appendix #1). This strategy was used for translation into the databases below. The databases to be searched include PubMed, Embase, CINAHL, Web of Science, and the Cochrane database. Sources of unpublished studies/ gray literature to be searched include Google Scholar. The reviewers will also hand search relevant reference lists. Please see appendix for a sample search strategy. The remaining strategies are available upon request. There are no language limits. Search limits were set to the publication years 1900-2000. Study/Source of Evidence selection: Following the search, all identified citations will be collated and deduplicated using the validated EndNote deduplication process by Bramer et al. 2016. Deduplicated results will be imported into Covidence systematic review software and independently and blindly reviewed by JR, SS, TC, and JD with MB serving to resolve vote conflicts. After screening initial titles and abstracts against the above criteria, relevant full text citations will be located and uploaded into the software by AD. Full text papers will then be evaluated against the criteria to identify the relevant articles for use in the synthesis. Data Extraction: Data will be extracted from papers included in the scoping review by two or more independent reviewers using the data extraction tool provided by Covidence. The data extracted will include specific details about the participants, concept, context, study methods and key findings relevant to the review objective. Any disagreements that arise between the reviewers will be resolved by a designated reviewer who will only be resolving conflicts (MB). If appropriate, authors of papers will be contacted to request missing or additional data, where required. Conflicts of interest No authors report conflicts of interest except for Michele M. Burns, who is the pediatric toxicology section editor for UpToDate. Appendices Appendix I: Sample Search strategy ((Poisoning[mesh] OR "Poisons"[mesh] OR "Poisons"[pharmacological action] OR "Drug Misuse"[mesh] OR poisoning[Subheading] OR toxicity[Subheading] OR "Drug Overdose"[mesh] OR Toxicology[mesh] OR toxic[tiab] OR toxicity[tiab] OR toxicities[tiab] OR poison[tiab] OR poisons[tiab] OR poisoning[tiab] OR poisonings[tiab] OR overdose[tiab] OR overdosing[tiab] OR overdoses[tiab] OR nontherapeutic[tiab] OR exposure[tiab] OR exposures[tiab] OR "dosing error"[tiab] OR "dosing errors"[tiab]) AND (child[tiab] OR children[tiab] OR infant[tiab] OR infants[tiab] OR newborn[tiab] OR newborns[tiab] OR neonate[tiab] OR neonates[tiab] OR neonatal[tiab] OR pediatric[tiab] OR pediatrics[tiab] OR paediatric[tiab] OR paediatrics[tiab] OR baby[tiab] OR babies[tiab] OR teen[tiab] OR teens[tiab] OR teenager[tiab] OR teenagers[tiab] OR youth[tiab] OR youths[tiab] OR adolescent[tiab] OR adolescents[tiab] OR adolescence[tiab])) AND (Mortality[mesh] OR Death[mesh] OR "Fatal Outcome"[mesh] OR "Drug-Related Side Effects and Adverse Reactions/mortality"[Mesh] OR "Cause of Death"[mesh] OR "Forensic Toxicology"[mesh] OR fatal[tiab] OR fatality[tiab] OR fatalities[tiab] OR death[tiab] OR deaths[tiab] OR mortality[tiab] OR mortalities[tiab] OR "end-of-life"[tiab] OR terminal[tiab] OR morbidity[tiab] OR morbidities[tiab])

Background The ongoing Covid-19 pandemic has exposed the extent of pre-existing ethnic inequalities in the health outcomes, access to and experiences of care of people of non-white ethnic backgrounds globally. In the UK, ethnic inequalities in maternal health is the starkest example of how Black and minority ethnic groups experience the health system differently. There remains a four-fold difference in maternal mortality rates between women from Black ethnic backgrounds and white women, and an almost two-fold difference between women from Asian ethnic backgrounds compared to white women1. Ethnic inequalities also persist in severe maternal morbidity with women of Black ethnicity at greater risk of hypertensive disorders in pregnancy than those of White ethnicity 2.The same pattern on ethnic inequalities is also observed in babies. Perinatal mortality i.e. deaths of babies from 20 weeks of gestational age and stillbirths are exceptionally higher in babies of Black ethnicity and those of Asian ethnicity compared with babies of White ethnicity (60% and 43% higher respectively)3. The NHS Long Term Plan sets a target of halving maternity related deaths, stillbirths, neonatal mortality and serious brain injury by 20254. To achieve this, several research projects are investigating the underlying reasons for inequality and to identify what can be done to reduce inequalities between women of different ethnic backgrounds. Some also aim to develop effective interventions to reduce these inequalities. The creation of the NHS Race and Health Observatory (RHO) in May 2020 to support the healthcare system with its work to reduce ethnic inequalities in health presents an opportunity to identify the extent and scope of existing policy interventions; their effectiveness, and gaps in unmet needs5. Existing policies include a specific target to ensure continuity of midwifery care for black and minority ethnic group4. However, lack of cohesiveness across the continuum of care through pregnancy until birth remains a barrier to women’s use of services6. Other attempts to synthesise the evidence on specific antenatal interventions for Black, Asian and Minority Ethnic pregnant women at high risk of poor birth outcomes in the UK does not cover the entire spectrum of how ethnic inequalities persist across maternal and neonatal care78. Moreover, co-producing an evidence map involving stakeholders at a national level to identify factors that contribute to effective policy interventions, for different ethnic minority groups is not yet in place. Aims To systematically map the existing policy interventions to tackle ethnic health inequalities in maternal and neonatal health. Objectives • Examine the scope and efficacy of these interventions. • Critically appraise existing interventions for maternal and neonatal health for Black and ethnic minority communities. • Identify and explore where gaps in provision remain. • Identify areas of good practice and highlight instances where good practice has been effectively or ineffectively spread across maternal and neonatal health system at national and regional levels. • Provide a clear set of recommendations for the RHO for areas to focus future research. Methods A systematic scoping review is a suitable approach to explore broad areas with less distinctive evidence to identify and summarise available interventions and practices. Although several iterations of the MBRRACE-UK report have highlighted ethnic health inequalities in maternal and neonatal health with recommendations for specific interventions targeted at Black and minority ethnic groups, the evidence available on policy interventions linked to these recommendations are sparse. We will therefore follow the “Arksey and O’Malley framework” for conducting scoping reviews and follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews in reporting findings9,10. Active involvement of stakeholders (meaning patients, the public, midwives, health visitors, doctors, health decision makers and funders) ensures quality real-world relevant research is conducted and the needs of the Observatory are met as we identify areas of focus for future research in this area11. Searches and Databases We will search relevant databases including those that specialise in social science (i.e., CINAHL, PubMed, and Medline) and mental health (psychINFO). This will be supplemented by hand searching, examining reference lists of key papers and reports, and identifying grey literature from websites of organisations such as the National Perinatal Epidemiology Unit. We will also search websites of relevant third sector organisations such as the Pregnancy and Baby Charities Working Together, Maternity Action, Tommys, Sands, and Best Beginnings to identify relevant grey literature and conducting forward and backward citation searches of included papers to identify further relevant publications. We will also put out a call for evidence to relevant experts and research groups within the field. Screening Two reviewers will independently screen titles and abstracts and full-texts for relevance. The primary reviewer will screen all titles and abstracts and all selected for full-texts screening. The second reviewer will screen 20% of the search results and articles selected for full-text screening independently. Inconsistencies will be resolved with a third reviewer through a consensus process. Inclusion criteria We will use the Population, Concept and Context (PCC) to guide question development as developed by the Joanna Briggs Institute for scoping reviews12. Using our PCC, we will include studies that report any interventions for maternal and neonatal health regardless of the evaluation status and disaggregate data by ethnic group where the data permits. Table 1 PCC to identify studies for inclusion in review Item Definition Population All pregnant women and/or babies or infants up to age 1 Concept Any intervention targeting pregnant women and/or babies or infants up to age 1 Context Reduce maternal and or neonatal health inequalities Data extraction and risk of bias (quality) assessment Reviewer1 will extract data from included studies using a pre-piloted form. Reviewer 2 will check 20% of data extraction tables. Extracted information will include (i) bibliographic details, (ii) study design, (iii) study participants including details of different ethnic groups, (iv) geographical coverage – i.e. local, regional or national, (v) Comparator, (vi) Adjustment for confounders, (vii) Antenatal or Postnatal care (viii) Framework mapping, (ix) Identified Policy (x) aims and key features of the interventions, (xi) outcomes and outcome measures, (xii) reduction in inequalities, (xiii) main results, and (xiv) main conclusions . We will quality appraise the selected studies using the Liverpool Quality Appraisal Tool. A standardised instrument developed by the University of Liverpool.13 Stakeholder engagement Through the Parent, Patient and Public Involvement and Engagement (PPPIE) network of the NIHR Policy Research Unit in Maternal and Neonatal Health and Care, we will identify nationally representative stakeholders prior to commencing the study to ensure we have lay representation in conducting the searches, identifying care pathways amenable to intervention, narrative synthesis and outputs. We will conduct two online half-day workshops with stakeholders including health professionals working in maternal and neonatal (midwives, health visitors, breastfeeding specialists, doctors), third sector organisations representing various ethnic groups via the Voluntary, Community and Social Enterprise (VCSE) Health and Wellbeing Alliance who share their expertise at the national level with the health and care system with the aim of improving services for all communities. The VCSE is made up of 18 members who represent communities who share protected characteristics or that experience health inequalities and a VCSE coordinator. The first workshop will be conducted in late January/early February for half a day with up to 8 participants to discuss what policy interventions exists locally, regionally and nationally to identify appropriate evidence and ensure all grey literature are captured. This will also allow participants to identify barriers and facilitators to implementation of policies and uptake of interventions which may not be captured in existing literature. The final outcome of this workshop will include visual minutes highlighting the care path way from pre-conception, antenatal, and post-natal period maternal and neonatal health. This workshop will be facilitated by RG and AA who have expertise in stakeholder engagement at the local and national level in maternal health. The second workshop will allow us to present findings of the scoping review and contextualise the policies identified and their implementation. We will also discuss what best practices are in place locally or regionally that can be rolled out nationally. We will present a slide deck of findings and test other project deliverables such as an interactive dashboard. This workshop will also be delivered online for half a day with up to 8 participants in total. Participants will have the opportunity to shape insights and make recommendations on future directions which we will incorporate in the agreed deliverables. Visual minutes mapping the identified interventions, barriers and facilitators and quality of any stakeholder engagement in the rolling out of the policies. Evidence Synthesis For all included studies, we will critically appraise the quality of the intervention, examples of good practices and factors determining uptake and implementation. Where the data permits, we will disaggregate minority ethnic groups to separate entities using the Office for National Statistics 18-level code identification (Table 2)14. We will also identity differences in interventions and implementation across regions of the UK. We will use the guidelines for synthesis of systematic reviews without meta-analysis15. Evidence maps Identified interventions will be classified based on the care pathway for maternal and neonatal health agreed during stakeholder engagement. We will visualise the interventions, their barriers and facilitators across the continuum of care using cross-tabular format, appropriate charts and a conceptual framework that demonstrates relationships between the existing policy interventions. Table 2. ONS ethnicity classification Broad Category Disaggregated group White 1.English/Welsh/Scottish/Northern Irish/British 2. Irish 3. Gypsy or Irish Traveller 4. Any other White background, please describe Mixed/Multiple ethnic groups 5. White and Black Caribbean 6. White and Black African 7. White and Asian 8. Any other Mixed/Multiple ethnic background, please describe Asian/Asian British 9. Indian 10. Pakistani 11. Bangladeshi 12. Chinese 13. Any other Asian background, please describe Black/African/Caribbean/Black British 14. African 15. Caribbean 16. Any other Black/African/Caribbean background, please describe Other ethnic group 17. Arab 18. Any other ethnic group, please describe References 1. MBRRACE-UK -Saving Lives, Improving Mothers’ Care 2020: Executive Summary [Internet]. [cited 2021 Nov 1]. Available from: ttps://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2020/MBRRACE-UK_Maternal_Report_Dec_2020_-_Ex_Summary_v10.pdf 2. Webster LM, Bramham K, Seed PT, Homsy M, Widdows K, Webb AJ, et al. Impact of ethnicity on adverse perinatal outcome in women with chronic hypertension: a cohort study. Ultrasound Obstet Gynecol [Internet]. 2019 Jul 9 [cited 2021 Nov 4];54(1):72–8. Available from: https://onlinelibrary.wiley.com/doi/10.1002/uog.20132 3. Draper ES, Gallimore ID, Smith LK, Fenton AC, Kurinczuk JJ, Smith PW, et al. Maternal, Newborn and Infant Clinical Outcome Review Programme MBRRACE-UK Perinatal Mortality Surveillance Report [Internet]. [cited 2021 Nov 1]. Available from: www.hqip.org.uk/national-programmes. 4. NHS Long Term Plan: Chapter 3: Further progress on care quality and outcomes. A strong start in life for children and young people [Internet]. Available from: https://www.longtermplan.nhs.uk/online-version/chapter-3-further-progress-on-care-quality-and-outcomes/a-strong-start-in-life-for-children-and-young-people/maternity-and-neonatal-services/ 5. Robertson R, Williams E, Buck D, Breckwoldt J. Ethnic health inequalities and the NHS Driving progress in a changing system [Internet]. 2021 [cited 2021 Nov 1]. Available from: www.kingsfund.org.uk 6. Jones E, Lattof SR, Coast E. Interventions to provide culturally-appropriate maternity care services: Factors affecting implementation. BMC Pregnancy Childbirth [Internet]. 2017 Aug 31 [cited 2021 Nov 1];17(1). Available from: https://pubmed.ncbi.nlm.nih.gov/28854901/ 7. Garcia R, Ali N, Papadopoulos C, Randhawa G. Specific antenatal interventions for Black, Asian and Minority Ethnic (BAME) pregnant women at high risk of poor birth outcomes in the United Kingdom: A scoping review. BMC Pregnancy Childbirth [Internet]. 2015 Sep 24 [cited 2021 Nov 1];15(1):226. Available from: http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-015-0657-2 8. Z K. Ethnic health inequalities in the UK’s maternity services: a systematic literature review. Br J Midwifery [Internet]. 2021;29(2). Available from: https://www.britishjournalofmidwifery.com/content/literature-review/ethnic-health-inequalities-in-the-uk-s-maternity-services-a-systematic-literature-review 9. Arksey H, O’Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol Theory Pract [Internet]. 2005 Feb [cited 2021 Nov 7];8(1):19–32. Available from: https://www.tandfonline.com/doi/abs/10.1080/1364557032000119616 10. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation [Internet]. Vol. 169, Annals of Internal Medicine. American College of Physicians; 2018 [cited 2021 Nov 7]. p. 467–73. Available from: https://www.acpjournals.org/doi/abs/10.7326/M18-0850 11. Pollock A, Campbell P, Struthers C, Synnot A, Nunn J, Hill S, et al. Stakeholder involvement in systematic reviews: A scoping review. Syst Rev [Internet]. 2018 Nov 24 [cited 2021 Nov 5];7(1):208. Available from: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0852-0 12. Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol [Internet]. 2018 Nov 19 [cited 2021 Nov 1];18(1):143. Available from: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-018-0611-x 13. Pope D. Liverpool quality assessment tools 2014. Oral Communication. 14. Ethnic group, national identity and religion - Office for National Statistics [Internet]. [cited 2021 Nov 8]. Available from: https://www.ons.gov.uk/methodology/classificationsandstandards/measuringequality/ethnicgroupnationalidentityandreligion#ethnic-group 15. Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. BMJ [Internet]. 2020 Jan 16 [cited 2022 May 5];368. Available from: http://dx.doi.org/10.1136/bmj.l6890http://www.bmj.com/

Parkinson’s Disease (PD) is a neurodegenerative disease of the basal ganglia primarily involving the degeneration of dopamine neurons. Studies have shown that a number of disease processes including neuroinflammation, the clustering and aggregation of the protein -synuclein, as well as the dysfunction of certain organelles such as the mitochondria combine to cause the death of mainly dopaminergic neurons (Bloem et al., 2021) resulting in the classic symptoms of Parkinson’s Disease. There are multiple symptoms of PD and symptoms can be motor or cognitive in nature. Studies have linked dopaminergic neuron death with motor symptoms including bradykinesia, tremor and muscle rigidity (Grosch et al., 2016; Maiti et al., 2017; Surmeier, 2018). Bradykinesia refers to slowed movements, tremor refers to shaking and muscle rigidity refers to the stiffness of muscles (Beradelli et al., 2001; del Rosario Ferreira-Sánchez et al., 2020; Heusinkveld, et al., 2018). In addition to this, a body of evidence has also linked dopamine neuron degeneration in the context of PD to non-motor symptoms such as cognitive impairment (Bloem et al., 2021; Decourt et al., 2021; Wu et al., 2017). Recent reports suggest that in addition to motor and cognitive difficulties people with Parkinson's (PwP) may experience socio-cognitive challenges (Eddy & Cook, 2018). Social cognition difficulties in PD can manifest in a wide range of ways from differences with the ability to recognise the thoughts and feelings of other people to challenges with face perception (Foley et al., 2019; Ricciardi et al., 2017). Over the last 60 years, there has been increasing interest in the recognition of emotions from facial expressions (Bidet-Ildei et al., 2020; Melzer et al., 2019; Tarnowski et al., 2017). Studies show that difficulties with recognising others’ emotions can have a significant and negative impact on PwP’s social relationships, and ultimately on their quality of life (Coundouris et al., 2022; Prenger et al., 2020). PD is diagnosed on the basis of motor symptoms. Currently there are a number of rating scales that can assess what stage of PD an individual is in (Goetz et al., 2008; Hoehn and Yahr, 1967). One of these scales is designed by the International Parkinson and Movement Disorder Society (MDS). These diagnostic criteria can be referred to as the MDS-Unified Parkinson’s Disease Rating Scale (UPDRS) (Goetz et al., 2008; Skorvanek et al., 2015). To be diagnosed with PD, bradykinesia must be present as well as rest tremor and/or muscle rigidity (Marsili et al., 2018). Although motor symptoms are crucial for a diagnosis of PD, non-motor symptoms have also been added into the diagnostic criteria, as there is more awareness surrounding the presence of non-motor symptoms in PD, and how debilitating these can be (Goetz et al., 2008). Non-motor symptoms may include emotion recognition difficulties. The literature suggests that the recognition of negative emotions such as anger and sadness is more difficult for PwP than positive emotions such as happiness. Nevertheless, findings supporting selective difficulties with the recognition of negative emotions in PD are mixed. A review by Argaud et al., collated evidence from 59 papers and made 97 comparisons between typical controls and PwP to surmise whether facial emotion recognition difficulties were seen in PwP, and assessed whether there was evidence of a specific difficulty in each of the six basic emotions. Argaud and colleagues found that the percentage of confirmed difficulties for negative emotions such as anger (44%) and sadness (51%) appear to be higher than the percentage of confirmed deficits for positive emotions such as happiness (27%) and surprise (30%). These percentages refer to the percentage of experiments reviewed that found a facial emotion recognition difficulty in PwP. In line with this, many papers argue that the recognition of angry expressions is particularly impaired in PwP (Clark et al., 2008, Lawrence et al., 2007; Lin et al., 2016, Mioni et al., 2015,). For example, in a study by Lawrence et al., they showed photographs of 10 models displaying six facial expressions (anger, disgust, fear, sadness, happiness and surprise) to 38 participants (17 PwP) and asked them to choose which label (anger, disgust, fear, sadness, happiness and surprise) best related to the photograph they saw displayed. They found that the identification of an angry expression was particularly difficult for PwP who had been temporarily withdrawn from their dopaminergic medication. Thus, illustrating that the recognition of angry expressions was significantly reduced in PwP relative to all other emotions. Surprise and disgust are more controversial, with different papers stating conflicting findings (Clark et al., 2008, Sprengelmeyer et al., 2003). One issue for this field is that studies have typically over-relied on static stimuli (Clark et al.,2008; Lawrence et al., 2007; Lin et al., 2016; Mioni et al., 2015; Sprengelmeyer et al., 2003; Waldthaler et al., 2019). Recent work from our lab has shown that the accurate labelling of others’ facial emotional expression depends on processing both spatial and temporal cues (Sowden et al., 2021). Spatial cues are based on positioning and location of features and temporal cues refer to timing. In addition to this, temporal information has also been found to be important in emotion recognition (Delis et al., 2016). One paper demonstrated that not only are particular movements of the features of the face important, but also the temporal order of these movements (Jack, Garrod and Schyns, 2014). Sowden et al., using point light display stimuli (white dots on a black background in the spatial configuration of the human face), manipulated spatial extent of facial expressions (meaning they changed the coordinates/positioning of the features of the face). This created the impression of spatially reduced and spatially exaggerated facial expressions. They also manipulated the speed of the point light displays of faces that depicted angry, sad and happy emotions. They then investigated if manipulating the speed and spatial extent affected how participants ‘rated’ these emotions on visual analogue scales. They found that increasing the speed of facial expressions increases ratings for happy and angry facial expressions, whereas slowing down the speed of facial expressions inclines people to choose a sad rating (Sowden et al., 2021). Thus, illustrating that in addition to static cues, dynamic cues (such as speed) causally impact on emotion recognition. One study using dynamic stimuli found no significant differences between general controls and PwP in terms of the recognition of the six basic emotions. In this study, which is one of the only so-called dynamic expression recognition in PwP, Coundouris and colleagues used one second videos which began with a neutral stare before progressing into either a high intensity emotion, a low intensity emotion or staying neutral. Following this, participants had to select which emotion each video represented when given a choice between neutral, one of the basic emotions (happiness, surprise, fear, sadness, anger and disgust) or a ‘self-conscious’ emotion (contempt, embarrassment and pride). In contrast to other studies however, they found no significant difference between PwP and general controls in recognising any of the six basic emotions (Coundouris et al., 2022). Dopamine has been implicated in the recognition of facial expressions. In one paper by Sprengelmeyer et al., they found that deficits in facial expression recognition were more pronounced in unmedicated, compared to medicated, PwP. In this study participants were asked to label static facial expression stimuli presented on a computer screen. An Emotion Hexagon was used, which consisted of a series of morphed images. The images were made by ‘blending’ two emotions together in various proportions: 90:10, 70:30, 50:50, 30:70 and 10:90. For example, 90:10 could represent 90% happy and 10% sad (Sprengelmeyer, 1996). The images of the facial expressions were adapted from Ekman and Friesan (1976) and were ordered as follows: happiness – surprise – fear – sadness – disgust – anger (Sprengelmeyer et al., 2003). This order was selected because it groups emotions together which are likely to be confused with one another. It is called an Emotion Hexagon because each of the six emotions, which are grouped in an order as described above, are joined together like a hexagon. These morphed images were individually presented, and participants had to label these images using one of the six basic emotions they thought it represented best. Facial expression recognition for disgust and anger in unmedicated PwP was significantly different from medicated PwP. In a separate study 38 participants were asked to label 60, randomly presented static facial expression stimuli (from Ekman and Friesen, 1976) using one of the six basic emotions they thought it represented best (Lawrence et al., 2007). Lawrence and colleagues found that when PwP were withdrawn from dopamine replacement therapy, the recognition of anger was significantly lower than age-matched controls (Lawrence et al., 2007). These two studies together suggest that dopamine plays a role in the recognition of facial expressions. One point that must be noted is that although we see differences in emotion recognition in PwP, it does not necessarily mean that these differences are due to dopaminergic signalling changes. Currently, there are no mechanisms that explain how dopaminergic signalling changes may influence emotional perception. One recent paper by Schuster and colleagues speculated whether dopamine may affect emotion recognition by influencing temporal perception (Schuster et al., 2022). Therefore, the first study is going to investigate the role of spatial and temporal cues in emotion recognition when PwP are both on and off their dopaminergic medications. To summarise: previous work suggests that PwP experience difficulties with accurately recognising facial expressions of emotion. Preliminary evidence, wherein emotion recognition has been assessed ON versus OFF dopaminergic medication (Lawrence et al., 2007; Sprengelmeyer et al., 2003), suggests that such difficulties may be directly associated with dopaminergic signalling. A second line of work also suggests that such difficulties may be particularly pronounced for negative, as opposed to positive, emotions. To date, however, this literature has largely relied upon static expression stimuli and therefore there is little evidence suggesting that emotion recognition also typically relies upon the processing of dynamic cues, such as movement kinematics (Sowden et al., 2021). To give a brief overview: this study will use a well-validated emotion recognition task (Keating et al., 2021; Sowden et al., 2021). This is the Point Light Faces task which we will run in PwP who are ON and OFF their dopaminergic medication. This will help us to answer important questions such as: what is the role of dopamine in expression recognition? We will also look at positive and negative emotions to further validate whether it is really the case that it is just the negative emotions that are a problem, even when we use dynamic stimuli since this has predominantly been validated in static images (Waldthaler et al., 2019; Lin et al., 2016; Mioni et al., 2015; Clark et al.,2008; Lawrence et al., 2007; Sprengelmeyer et al., 2003). Within this task, we will manipulate speed and spatial extent to investigate which one of those are really feeding into the difficulties seen in PwP. We have a working hypothesis that speed will be especially affected because speed and timing are known to be affected in PwP.

The integration of smartphones into many people’s daily lives provides the unique opportunity to gather high temporal resolution behavioural data in a naturalistic setting. This behavioural data may provide insights into a person’s mental state which could be useful in a clinical context, for example to predict future depressive episodes in patients with Major Depressive Disorder (MDD), or to monitor ongoing symptoms. This review aims to compare the various methods that have been used in digital phenotyping using smartphones, with a focus on studies that include populations with (remitted) MDD. We aim to investigate the current state of digital phenotyping research, in particular to establish what current methods are able to achieve and where subsequent efforts need to be focused to advance the field and achieve models with high clinical utility. We will start by providing an overview and general evaluation of smartphone features that have been correlated with clinically relevant variables such as self-reported symptom scores (e.g. PHQ-9). We will then compare digital phenotyping papers that cover a variety of prediction tasks. We expect to group these papers by prediction goal, for example beginning with papers that predict clinical vs non-clinical labels, and then comparing papers that predict the severity of the disorder or specific symptoms (e.g. using the digital phenotype data to predict symptom severity in the form of questionnaire scores). Finally, papers that predict state at future time points are expected to be evaluated (e.g. using the digital phenotype data to predict a score weeks in advance). Within each grouping of prediction task, the various methods used will be compared, and the successes and limitations of each method will be evaluated.

Objective: This paper describes the current situation of the provision of speech-language services in East Africa. An overview of the educational opportunities, workforce density, communication rehabilitation planning, caseload, and ethical and/or cultural challenges is provided. Method: A narrative review was performed. All papers referring to communication disorders in East African countries were identified from EMBASE, PubMed, ISI Web of Science: Science Citation Index Expanded, and ISI Web of Science: Conference Proceedings Citation Index-Science using the following search terms: speech therapy, speech pathology, speech-language pathology, speech-language rehabilitation, speech-language therapy, logopedics, East Africa, communication disorders, communication difficulties. Two concepts were combined with a Boolean operator 'AND'. Results: At present, there is an alarming shortage of speech-language pathologists in East Africa. This issue is mainly related to the limited availability of educational programs in speech-language pathology. Although more and more universities are beginning to offer such educational programs, the number of available speech-language pathologists is still too low to meet the needs of all children with communication disorders. In addition, speech-language pathologists are often faced with different cultural and ethical obstacles when they provide intervention to East African children with communication disorders. These speech-language pathologists are therefore challenged to take a broader view of their role as a therapist. These alternative roles often include training of other individuals in the context of community-based rehabilitation. Conclusion: In the future, it will be important to carefully consider the development of sustainable learning opportunities in East African contexts. Initiatives, for example, "train-the-trainer" workshops, are needed to support the speechlanguage pathologists. Existing models like the communication disability model can aid to create holistic frameworks for the development of sustainable speech-language services in the East African countries.

Older adults (≥65 years) are the fastest growing population group. Thus, ensuring nutritional well-being of the ‘over-65s’ to optimise health is critically important. Older adults represent a diverse population – some are fit and healthy, others are frail and many live with chronic conditions. Up to 78% of older Irish adults living independently are overweight or obese. The present paper describes how these issues were accommodated into the development of food-based dietary guidelines for older adults living independently in Ireland. Food-based dietary guidelines previously established for the general adult population served as the basis for developing more specific recommendations appropriate for older adults. Published international reports were used to update nutrient intake goals for older adults, and available Irish data on dietary intakes and nutritional status biomarkers were explored from a population-based study (the National Adult Nutrition Survey; NANS) and two longitudinal cohorts: the Trinity-Ulster and Department of Agriculture (TUDA) and the Irish Longitudinal Study on Ageing (TILDA) studies. Nutrients of public health concern were identified for further examination. While most nutrient intake goals were similar to those for the general adult population, other aspects were identified where nutritional concerns of ageing require more specific food-based dietary guidelines. These include, a more protein-dense diet using high-quality protein foods to preserve muscle mass; weight maintenance in overweight or obese older adults with no health issues and, where weight-loss is required, that lean tissue is preserved; the promotion of fortified foods, particularly as a bioavailable source of B vitamins and the need for vitamin D supplementation.

STUDY QUESTION What information and support should be offered to donors, intended parents and donor-conceived people, in general and in consideration of the availability of direct-to-consumer genetic testing and matching services? SUMMARY ANSWER For donors, intended parents and donor-conceived offspring, recommendations are made that cover information needs and informed consent, psychosocial implications and disclosure. WHAT IS KNOWN ALREADY Trends indicate that the use of donor-assisted conception is growing and guidance is needed to help these recipients/intended parents, the donors and offspring, navigate the rapidly changing environment in which donor-assisted conception takes place. STUDY DESIGN, SIZE, DURATION A working group (WG) collaborated on writing recommendations based, where available, on evidence collected from a literature search and expert opinion. Draft recommendations were published for stakeholder review and adapted where relevant based on the comments received. PARTICIPANTS/MATERIALS, SETTING, METHODS Papers retrieved from PUBMED were included from 1 January 2014 up to 31 August 2020, focusing on studies published since direct-to-consumer genetic testing has become more widespread and accessible. The current paper is limited to reproductive donation performed in medically assisted reproduction (MAR) centres (and gamete banks): donation outside the medical context was not considered. MAIN RESULTS AND THE ROLE OF CHANCE In total, 32 recommendations were made for information provision and support to donors, 32 for intended parents and 27 for donor-conceived offspring requesting information/support. LIMITATIONS, REASONS FOR CAUTION The available evidence in the area of reproductive donation is limited and diverse with regards to the context and types of donation. General conclusions and recommendations are largely based on expert opinion and may need to be adapted in light of future research. WIDER IMPLICATIONS OF THE FINDINGS These recommendations provide guidance to MAR centres and gamete banks on good practice in information provision and support but should also be considered by regulatory bodies and policymakers at a national and international level to guide regulatory and legislative efforts towards the protection of donors and donor-conceived offspring. STUDY FUNDING/COMPETING INTEREST(S) The development of this good practice paper was funded by European Society of Human Reproduction and Embryology (ESHRE), covering expenses associated with the WG meetings, the literature searches and dissemination. The WG members did not receive any payment. The authors have no conflicts of interest to declare. DISCLAIMER This document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type. †ESHRE pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.

Preprints allow researchers to make their findings available to the scientific community before they have undergone peer review. Studies on preprints within bioRxiv have been largely focused on article metadata and how often these preprints are downloaded, cited, published, and discussed online. A missing element that has yet to be examined is the language contained within the bioRxiv preprint repository. We sought to compare and contrast linguistic features within bioRxiv preprints to published biomedical text as a whole as this is an excellent opportunity to examine how peer review changes these documents. The most prevalent features that changed appear to be associated with typesetting and mentions of supporting information sections or additional files. In addition to text comparison, we created document embeddings derived from a preprint-trained word2vec model. We found that these embeddings are able to parse out different scientific approaches and concepts, link unannotated preprint–peer-reviewed article pairs, and identify journals that publish linguistically similar papers to a given preprint. We also used these embeddings to examine factors associated with the time elapsed between the posting of a first preprint and the appearance of a peer-reviewed publication. We found that preprints with more versions posted and more textual changes took longer to publish. Lastly, we constructed a web application (https://greenelab.github.io/preprint-similarity-search/) that allows users to identify which journals and articles that are most linguistically similar to a bioRxiv or medRxiv preprint as well as observe where the preprint would be positioned within a published article landscape., Preprints allow researchers to make their findings available to the scientific community before they have undergone peer review This study analyzes the full text content of the bioRxiv preprint repository, identifying field-specific patterns and changes that occur during publication, and providing a search tool that can identify the published papers that are most similar to a given bioRxiv or medRxiv preprint.