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Objectives: The aim of this article is to review and synthesize the evidence on end-of-life in burn intensive care units. Methods: Systematic scoping review: Preferred Reporting Items for Systemic Reviews exten- sion for Scoping Reviews was used as a reporting guideline. Searches were performed in 3 databases, with no time restriction and up to September 2021. Results: A total of 16,287 documents were identified; 18 were selected for analysis and syn- thesis. Three key themes emerged: (i) characteristics of the end-of-life in burn intensive care units, including end-of-life decisions, decision-making processes, causes, and trajectories of death; (ii) symptom control at the end-of-life in burn intensive care units focusing on patients’ comfort; and (iii) concepts, models, and designs of the care provided to burned patients at the end-of-life, mainly care approaches, provision of care, and palliative care. Significance of results: End-of-life care is a major step in the care provided to critically ill burned patients. Dying and death in burn intensive care units are often preceded by end-of-life decisions, namely forgoing treatment and do-not-attempt to resuscitate. Different dying trajec- tories were described, suggesting the possibility to develop further studies to identify triggers for palliative care referral. Symptom control was not described in detail. Palliative care was rarely involved in end-of-life care for these patients. This review highlights the need for early and high-quality palliative and end-of-life care in the trajectories of critically ill burned patients, leading to an improved perception of end-of-life in burn intensive care units. Further research is needed to study the best way to provide optimal end-of-life care and foster integrated palliative care in burn intensive care units.

Understanding how dietary fat is perceived by the senses is crucial in developing public health strategies aimed at curbing excessive fat intakes. Olfaction is one of several sensory modalities contributing to fat perception in foods, yet the nature and extent of its involvement is relatively unclear. A systematic scoping literature review was conducted to identify and summarise relevant evidence on the contribution of olfaction to dietary fat perception in humans and rodents and highlight relevant knowledge gaps. The review was carried out in accordance with the PRISMA methodology, using combinations of olfaction-, fat- and perception-related search terms. Following searches in Scopus, Web of Science and PubMed databases, 42 articles were ultimately included. Overall, findings are consistent with the notion that olfaction plays a role in the perception of dietary fat in rodents and humans. Rodents can perceive dietary fat via olfactory cues, and this ability may affect their preference for fat-containing feed. Humans can detect, discriminate, and identify fat and its constituents solely by olfaction, even when embedded within a complex food matrix. Food fat content can modulate the perception of various fat- and non-fat olfactory qualities, depending on the food matrix and odorant physio-chemical properties. On the other hand, the presence of fat-related odours can modify the perception of olfactory and non-olfactory sensory qualities (e.g., mouthfeel). Several knowledge gaps were identified, namely, the role of fat-related odours in eating behaviour, the nature of chemical signals underlying olfactory fat perception and factors governing sensitivity to fat-related odours.

Purpose The alignment between the labour market and initial vocational education and training (IVET) is placing always more importance on technical knowledge and skills, whilst metacognitive competences such as critical thinking and media literacy are increasingly neglected. In the context of IVET, this results in authors and practitioners paying always more attention to how to devise possible training interventions, with the double aim of implementing their educational pathways and enhancing students’ critical thinking and media literacy. This paper aims to report the state of the art concerning such processes of enhancement in IVET students. Design/methodology/approach The study adopted the method of systematic scoping review to address the research questions on how to enhance critical thinking and media literacy in the context of IVET. Findings The paper presents the analyses of the n = 19 contributions collected. Then, it proposes an initial conceptualization of the dimensions of critical thinking and media literacy. Moreover, by combining evidence from various contributions, the review proposes implications for educational practices and strategies. Around these pieces of knowledge, further avenues of research and practice are proposed. Research limitations/implications This study contributes to the literature on critical thinking and media literacy in the context of IVET by advancing initial comprehensive conceptualizations of the two dimensions. Moreover, the study advances initial practical implications for teachers and trainers for the development of training interventions. Originality/value The originality of the present review rests in its proposal of definitions of critical thinking and media literacy; moreover, it widens the discussion of practices on how to enhance such metacognitive competences. Indeed, the study identifies the teaching and training practices meant to enhance critical thinking and media literacy and proposes applied implications in the context of IVET.

This is a systematic scoping review protocol which seeks to analyze the evidence base on women’s experiences of stigma due to genital fistula including experiences across stigma domains, the different manifestations and levels of stigma severity, documenting consequences, coping strategies, responses or mechanisms and stigma resistance, and identify areas where additional research is necessary. This review is currently being conducted by the study team listed. Please cite this protocol in any published work resulting from its use.

PurposeThe coronavirus disease 2019 (COVID-19) pandemic highlighted the necessity of practicing Evidence-based Management (EBMgt) as an approach to decision-making in hospital settings. The literature, however, provides limited insight into the process of EBMgt and its contextual nuances. Such insight is critical for better leveraging EBMgt in practice. Therefore, the authors' aim was to integrate the literature on the process of EBMgt in hospital settings, identify the gaps in knowledge and delineate areas for future research.Design/methodology/approachThe authors conducted a systematic scoping review using an innovative methodology that involved two systematic searches. First using EBMgt terminology and second using terminology associated with the EBMgt concept, which the authors derived from the first search.FindingsThe authors identified 218 relevant articles, which using content analysis, they mapped onto the grounded model of the EBMgt process; a novel model of the EBMgt process developed by Sahakian and colleagues. The authors found that the English language literature provides limited insight into the role of managers' perceptions and motives in EBMgt, the practice of EBMgt in Global South countries, and the outcomes of EBMgt. Overall, this study’s findings indicated that aspects of the decision-maker, context and outcomes have been neglected in EBMgt.Originality/valueThe authors contributed to the EBMgt literature by identifying these gaps and proposing future research areas and to the systematic review literature by developing a novel scoping review method.

Background Complex interventions in health care are characterized by multiple interacting components as well as by numerous nonlinear interactions with the social systems within which they are being implemented. The process of developing, evaluating and implementing complex interventions is therefore challenging. Established guidance such as the MRC (Medical Research Council) framework for developing and evaluating complex interventions refers to process evaluations as an integral part of the development of complex evidence-based interventions. Even though the need for process evaluations is recognized, the realization of such approaches is challenging because methodological instruction is sparse, and the phenomenon of interest is complex. A number of theoretical approaches indicating how to conduct process evaluations of complex interventions in health care exist, but a systematic and comprehensive overview of these is missing. Thus, the objective of the systematic scoping review described herein is to provide an overview and analysis of theoretical approaches suitable for the planning and conducting of process evaluations. Methods The design and conduct of this review will follow the procedures of a systematic scoping review. The search strategy will be developed following the BeHEMoTh (Behaviour of interest; Health context; Exclusions; Models or Theories) template which has been conceptualized for structured reviews of theory. The systematic search of the MEDLINE (via PubMed), CINAHL (via EBSCO) and PsycInfo (via EBSCO) electronic databases will be complemented by “hand searching” techniques. Study selection, data extraction, and data analysis will be performed by tandems of two researchers independently of each other. Divergent decisions and judgements between the two researchers will be discussed by the whole review team. Discussion The findings from this scoping review will provide an overview and comparison of theoretical approaches suitable for process evaluations of complex interventions in health care. The review results will support researchers in choosing the theoretical approach that best fits the respective focus of their process evaluation study. Systematic review registration This study has been registered with PROSPERO (International Prospective Register of Systematic Reviews) under registration number CRD42020211732.

Qualitative research (QR) take advantage of a wide range of methods and theoretical frameworks to explore people's beliefs, perspectives, experiences, and behaviours and has been applied to many areas of healthcare. The aim of this review was to explore how QR has contributed to the field of perioperative anesthesiology.We performed a systematic scoping review of published QR studies pertaining to the field of perioperative anesthesiology in three databases (CINAHL, Pubmed, and Embase), published between January 2000 and June 2018. We extracted data regarding publication and researchers' characteristics, main study objectives, and methodological details. Descriptive statistics were generated for each data extraction category.A total of 107 articles fulfilled our inclusion criteria. We identified 13 main research topics addressed by the included studies. Topics such as "patient safety," "barriers to evidence-base medicine," "patient experiences under local/regional anesthesia," "training in practice," "experiences of care," and "implementation of changes in clinical practice" were commonly tackled. Others, such as "interprofessional communication", "work environment," and "patients'/healthcare professionals' interactions" were less common. Qualitative research was often poorly reported and methodological details were frequently missing.Qualitative research has been used to explore an array of issues in perioperative anesthesiology. Some areas may benefit from further primary research, such as interprofessional communication or patient-centred care, while other areas may deserve a detailed systematic knowledge synthesis. We identified suboptimal reporting of qualitative methods and their link to study findings. Increased attention to quality criteria and reporting standards in QR is called for.RéSUMé: OBJECTIF: La recherche qualitative (RQ) tire parti d’un large éventail de méthodes et de cadres théoriques afin d’explorer les croyances, perspectives, expériences et comportements des individus. Elle a été appliquée à de nombreux domaines des soins de santé. L’objectif de cette revue était d’explorer comment la RQ a contribué au domaine de l’anesthésiologie périopératoire. SOURCES: Nous avons effectué une revue systématique de portée des études de RQ publiées entre janvier 2000 et juin 2018 dans le domaine de l’anesthésiologie périopératoire dans trois bases de données (CINAHL, Pubmed et Embase). Nous avons extrait les données concernant les caractéristiques de publication et des chercheurs, les principaux objectifs de l’étude et les détails méthodologiques. Des statistiques descriptives ont été générées pour chaque catégorie d’extraction de données. RéSULTATS PRINCIPAUX: Au total, 107 articles ont répondu à nos critères d’inclusion. Nous avons identifié 13 principaux sujets de recherche abordés par les études incluses. Des sujets tels que la « sécurité des patients », les « obstacles à la médecine fondée sur des données probantes », « les expériences des patients sous anesthésie locale/régionale », la « formation en pratique », les « expériences de soins » et la « mise en œuvre de changements dans la pratique clinique » étaient couramment abordés. D’autres thèmes, tels que la « communication interprofessionnelle », « l'environnement de travail » et les « interactions patients/professionnels de la santé » étaient moins courants. La recherche qualitative était souvent mal rapportée et les détails méthodologiques faisaient souvent défaut. CONCLUSION: La recherche qualitative a été utilisée pour explorer un éventail de questions en anesthésiologie périopératoire. Certains domaines pourraient bénéficier d’autres recherches primaires, telles que la communication interprofessionnelle ou les soins centrés sur le patient, tandis que d’autres domaines mériteraient une synthèse systématique détaillée des connaissances. Nous avons identifié une communication sous-optimale des méthodes qualitatives et de leur lien avec les résultats de l’étude. Il est nécessaire de porter une attention accrue aux critères de qualité et aux normes de communication en RQ.

Objectives: To review and synthetize the evidence on end-of-life in burn intensive care units about (i) the characteristics of end-of-life in burn intensive care units, (ii) the symptom control provided to burned patients facing dying and death in this context, and (iii) the concept, models and designs of the care provided. Methods: Systematically conducted scoping review, following Arksey and O'Malley's framework. Preferred Reporting Items for Systemic Reviews extension for Scoping Reviews was used as a reporting guideline. Searches were performed in three databases, with no time restriction and up to September 2021. Results: 16,287 documents identified; thirteen (13) selected for analysis and synthesis. Three key themes emerged: (i) characteristics of the end-of-life in burn intensive care units, including end-of-life decisions, decision-making processes, causes and trajectories of death; (ii) symptom control at the end-of-life in burn intensive care units focusing on patients’ comfort; and (iii) concepts, models, and designs of the care provided to burned patients at the end-of-life, mainly care approaches, provision of care and palliative care.Significance of Results: End-of-life care is a major step in the care provided to critically ill burned patients. Dying and death in burn intensive care units are often preceded by end-of-life decisions, namely forgoing treatment, and do-not-attempt to resuscitate. Different dying trajectories were described, suggesting the possibility to develop further studies to identify triggers for palliative care referral. Symptom control was not described in detail. Palliative care was rarely involved in end-of-life care for these patients. This review highlights the need for early and high-quality palliative and end-of-life care in the trajectories of critically ill burned patients, leading to an improved perception of end-of-life in burn intensive care units. Further research is needed to study the best way to provide optimal end-of-life care and foster integrated palliative care in burn intensive care units.

Pediatric keratoconus (KC) causes progressive deformation of the cornea of children and adolescents, leading to progressive loss of vision and need for rehabilitation(1). Its epidemiology is still poorly understood. However, the need for its reporting is now increased due to new treatments allowing halting of the disease and prevention of the worse outcomes such as the need for penetrating keratoplasty and its associated morbidity and high cost, irreversible loss of vision and amblyopia. There are few systematic reviews on keratoconus, even fewer on pediatric KC(2).Objectives: The authors objective was to perform a systematic review on pediatric KC epidemiology, discuss the studies reporting data on pediatric keratoconus (prevalence, incidence, age distribution) and current diagnostic and screening efforts. The scoping review methodology was favored due to it being the most adequate for summarizing findings from a body of knowledge that is heterogeneous in methods and disciplines (Tricco et al., 2018). The PRISMA-ScR methodology and checklists were used in the elaboration of the manuscript(3). Eligibility Criteria The inclusion criteria are: English language, publication between August 7th 1998 and August 7th 2019 (20 years), studies on the epidemiology of pediatric keratoconus. Sources of evidence The search strategy was performed in the PubMed-MEDLINE database and Cochrane Database of Systematic Reviews and included eight combinations of these MeSH terms: keratoconus; child; incidence; prevalence; pediatrics; adolescent; epidemiology. The included articles were in the English language, with available abstracts, published between August 7th 1998 and August 7th 1998 (20 years) in the PubMed-MEDLINE database. Charting Methods “A flowchart of the article selection process will be provided as per PRISMA-ScR recommendations.” The included studies will be charted in Excel 2019, in order to summarize research methodologies, describe the included populations and demographic characteristics. Expected Results The authors expect to systematically summarize the existing literature, report the methodology of the current epidemiological studies and describe the gathered information. Pediatric keratoconus (KC) is a disease of the eye which causes progressive deformation of the cornea of children and adolescents. KC is bilateral and asymmetric, and its progression may lead to acute corneal hydrops – corneal edema due to breaks in the corneal Descemet membrane with subsequent scarring of the cornea(4). Keratoconus is usually considered to be more severe in the pediatric population (5). Pediatric KC causes a shifting myopic and astigmatic refractive error. Uncorrected refractive error is of severe concern in children due to the possible development of amblyopia, which is an irreversible reduced vision due to inadequate development of the visual brain pathways(Wallace et al., 2007). Traditionally, mild pediatric KC treatment has been based on rehabilitation with glasses and contact lenses. However, severe cases with corneal opacities and highly irregular and curved corneas may require surgery such as intracorneal rings segments, penetrating keratoplasties or deep anterior lamellar keratoplasties(4,7–15). Penetrating keratoplasty (PK) is associated with high costs and brings some morbidity, including the need for reoperations, intraoperative complications, need for visual rehabilitation with glasses and contact lenses, close follow-up visits, and more severe complications such as infectious disease. Furthermore, PK is difficult to be performed in the young due to need of post-operative manipulation, eye rubbing tendencies, poor compliance, increased risk of rejection and increased inflammatory response(7,8,12,16–22). Pediatric KC’s epidemiology has gained importance, due to the possibility of alteration of KC’s natural history through corneal crosslinking(1,23,32,24–31). The development of corneal crosslinking allows for earlier intervention with a possible change in the course of the disease, allowing the prevention of complications and stabilization of corneal anatomy(19,22,32,38–43). In addition, corneal CXL appears to be a cost-effective treatment compared to conventional treatment with PK(44). CXL is based on the application of riboflavin and ultraviolet light on the cornea, which causes strengthening of the cornea due to increase of collagen crosslinks. Pediatric KC is a global healthcare concern and it may be more common than previously reported(19,22,32,38–43). Its epidemiology is still poorly understood, however it is fundamental to policy decisions regarding possible pediatric KC screening programs. Therefore, the authors objective is to conduct a systematic scoping review on pediatric KC: define the disease, describe the studies reporting epidemiological data (prevalence, incidence), its clinical features and screening programs. The authors found that due to the breadth of the purposed review and the significant knowledge gaps, a scoping review was the most appropriate tool to report the information. Methods: The scoping review methodology was favored due to it being the most adequate for summarizing findings from a body of knowledge that is heterogeneous in methods and disciplines (Tricco et al., 2018). The PRISMA-ScR methodology and checklists were used in the elaboration of the manuscript. The scoping review proposal will be included in the OSF database (https://osf.io/), and registration information will be presented in the final manuscript. The eligibility criteria are: English language, publication between 07th of August 7th 1998 and August 7th 2019 (20 years), studies on epidemiological features of pediatric keratoconus, on pediatric KC`s clinical features, and those reporting/proposing screening programs. The information sources are PubMed-MEDLINE database and Cochrane Database of Systematic Reviews and keyword combinations of these MeSH terms: keratoconus; child; incidence; prevalence; pediatrics; adolescent; epidemiology. The included articles will be those in English language, with available abstracts, published in the last twenty years, the last search was conducted on August 7th, 2019. Authors of the included articles will be contacted if needed to clarify information. Pertinent references of the included articles will also be listed in the final references. Duplicate references will be excluded. One reviewer will decide the inclusion of articles based on the title and abstract initially. References out of the scope of the review will be excluded. Two other reviewers will analyze the resulting lists and may propose alterations. In case of divergence, a consensus will be reached to decide inclusion. The included articles will be reviewed in full text and their results charted by one author in Excel 2019, in order to summarize research methodologies, describe the included demographic characteristics. The resulting chart will be reviewed by the other two authors. The proposed data chart will be tested by the team on ten articles before its ample use. The studies will be critically analyzed according to the proposed methodology, corresponding results and risk of bias. A flowchart of the processing of the search results included studies, excluded studies, and reasoning will be provided, following PRISMA-ScR recommendations. Synthesis of the information will be done using the charted data using Excel 2019 software and narrative description, resulting in tables and charts to be presented in the manuscript. References: 1. Godefrooij DA, Soeters N, Imhof SM, Wisse RPL. Corneal Cross-Linking for Pediatric Keratoconus: Long-Term Results. Cornea [Internet]. 2016 [cited 2019 Jul 8];35(7):954–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27027921 2. McAnena L, Doyle F, O’Keefe M. Cross-linking in children with keratoconus: a systematic review and meta-analysis. Acta Ophthalmol [Internet]. 2017;95(3):229–39. Available from: http://files/5281/McAnena et al. - 2017 - Cross-linking in children with keratoconus a syst.pdf 3. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and ExplanationThe PRISMA-ScR Statement. Ann Intern Med [Internet]. 2018 Oct 2;169(7):467–73. Available from: https://doi.org/10.7326/M18-0850 4. Buzzonetti L, Ardia R, Petroni S, Petrocelli G, Valente P, Parrilla R, et al. Four years of corneal keratoplasty in Italian paediatric patients: indications and clinical outcomes. Graefes Arch Clin Exp Ophthalmol. 2016;254(11):2239–45. 5. Naderan M, Jahanrad A, Farjadnia M. Prevalence of Eyelid Laxity and its Association with Ophthalmic Findings and Disease Severity in Patients with Keratoconus. Eur J Ophthalmol. 2017;27(6):670–4. 6. Wallace DK, Chandler DL, Beck RW, Arnold RW, Bacal DA, Birch EE, et al. Treatment of Bilateral Refractive Amblyopia in Children Three to Less Than 10 Years of Age. Am J Ophthalmol [Internet]. 2007;144(4):487–96. Available from: http://dx.doi.org/10.1016/j.ajo.2007.05.040 7. Gabrić N, Dekaris I, Vojniković B, Karaman Z, Mravicić I, Katusić J. Corneal transplantation in children. Coll Antropol [Internet]. 2001 [cited 2019 Jul 8];25 Suppl:17–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11817008 8. Gulias-Cañizo R, Gonzalez-Salinas R, Hernandez-Zimbron LF, Hernandez-Quintela E, Sanchez-Huerta V. Indications and outcomes of pediatric keratoplasty in a tertiary eye care center: A retrospective review. Medicine (Baltimore) [Internet]. 2017 Nov [cited 2019 Jul 8];96(45):e8587. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29137083 9. Buzzonetti L, Petrocelli G, Laborante A. Anterior Lamellar Keratoplasty Assisted by IntralaseTM Femtosecond Laser in a Pediatric Patient. J Pediatr Ophthalmol Strabismus [Internet]. 2010;47 Online:e1-4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21214143 10. Mukhtar S, Ambati BK. Pediatric keratoconus: a review of the literature. Int Ophthalmol [Internet]. 2018 Oct [cited 2019 Jul 8];38(5):2257–66. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28852910 11. El-Khoury S, Abdelmassih Y, Hamade A, Slim E, Cherfan CG, Chelala E, et al. Pediatric Keratoconus in a Tertiary Referral Center: Incidence, Presentation, Risk Factors, and Treatment. J Refract Surg (Thorofare, NJ 1995) [Internet]. 2016 Aug 1 [cited 2019 Jul 8];32(8):534–41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27505314 12. Shi W, Jin H, Li S, Liu M, Xie L. Indications of paediatric keratoplasty in north China. Clin Exp Ophthalmol. 2007;35(8):724–7. 13. Bajracharya L, Gurung R, DeMarchis E, Oliva M, Ruit S, Tabin G. Indications for keratoplasty in Nepal: 2005 - 2010. Nepal J Ophthalmol [Internet]. 2013 [cited 2019 Jul 8];5(2):207–14. Available from: http://files/5093/Bajracharya et al. - 2013 - Indications for keratoplasty in Nepal 2005 - 2010.pdf 14. Zaidman GW. The pediatric corneal infiltrate. Curr Opin Ophthalmol [Internet]. 2011 [cited 2019 Jul 8];22(4):261–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21597372 15. Léoni-Mesplié S, Mortemousque B, Touboul D, Malet F, Praud D, Mesplié N, et al. Scalability and severity of keratoconus in children. Am J Ophthalmol. 2012; 16. Rebenitsch RL, Kymes SM, Walline JJ, Gordon MO. The lifetime economic burden of keratoconus: A decision analysis using a markov model. Am J Ophthalmol [Internet]. 2011;151(5):768-773.e2. Available from: http://files/4617/Rebenitsch et al. - 2011 - The lifetime economic burden of keratoconus a dec.pdf 17. Ganekal S, Gangangouda C, Dorairaj S, Jhanji V. Early outcomes of primary pediatric keratoplasty in patients with acquired, atraumatic corneal pathology. J AAPOS [Internet]. 2011 [cited 2019 Jul 8];15(4):353–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21907118 18. Lowe MT, Keane MC, Coster DJ, Williams KA. The outcome of corneal transplantation in infants, children, and adolescents. Ophthalmology [Internet]. 2011 [cited 2019 Jul 8];118(3):492–7. Available from: http://files/5296/Lowe et al. - 2011 - The outcome of corneal transplantation in infants,.pdf 19. Harding SA, Nischal KK, Upponi-Patil A, Fowler DJ. Indications and outcomes of deep anterior lamellar keratoplasty in children. Ophthalmology [Internet]. 2010 [cited 2019 Jul 8];117(11):2191–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20663562 20. Limaiem R, Chebil A, Baba A, Ben Youssef N, Mghaieth F, El Matri L. Pediatric penetrating keratoplasty: Indications and outcomes. Transplant Proc [Internet]. 2011 [cited 2019 Jul 8];43(2):649–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21440785 21. Buzzonetti L, Petrocelli G, Valente P. Amniotic membrane transplantation in corneal melting after anterior lamellar keratoplasty assisted by femtosecond laser in children. Eur J Ophthalmol [Internet]. 2012 [cited 2019 Jul 8];22(3):477–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21971732 22. Majander A, Kivelä TT, Krootila K. Indications and outcomes of keratoplasties in children during a 40-year period. Acta Ophthalmol. 2016;94(6):618–24. 23. Zotta PG, Moschou KA, Diakonis VF, Kymionis GD, Almaliotis DD, Karamitsos AP, et al. Corneal Collagen Cross-linking for Progressive Keratoconus in Pediatric Patients: A Feasibility Study. J Refract Surg [Internet]. 2012 [cited 2019 Jul 8];28(11):793–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23347374 24. Kymionis G, Yoo S, Diakonis V, Kankariya V. Management of pediatric keratoconus - Evolving role of corneal collagen cross-linking: An update. Indian J Ophthalmol [Internet]. 2013 [cited 2019 Jul 8];61(8):435. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23925333 25. Ulusoy DM, Göktaş E, Duru N, Özköse A, Ataş M, Yuvacı İ, et al. Accelerated corneal crosslinking for treatment of progressive keratoconus in pediatric patients. Eur J Ophthalmol [Internet]. 2017 [cited 2019 Jul 8];27(3):319–25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27445064 26. Blackburn BJ, Gu S, Ford MR, de Stefano V, Jenkins MW, Dupps WJ, et al. Noninvasive assessment of corneal crosslinking with phase-decorrelation optical coherence tomography. Investig Ophthalmol Vis Sci [Internet]. 2019;60(1):41–51. Available from: http://files/5293/Blackburn et al. - 2019 - Noninvasive Assessment of Corneal Crosslinking Wit.pdf 27. Soeters N, Van der Lelij A, van der Valk R, Tahzib NG. Corneal Crosslinking for Progressive Keratoconus in Four Children. J Pediatr Ophthalmol Strabismus. 2011; 28. Magli A, Chiariello Vecchio E, Carelli R, Piozzi E, Di Landro F, Troisi S. Pediatric keratoconus and iontophoretic corneal crosslinking: refractive and topographic evidence in patients underwent general and topical anesthesia, 18 months of follow-up. Int Ophthalmol [Internet]. 2016 [cited 2019 Jul 8];36(4):585–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26704375 29. Kalkan Akcay E, Uysal BS, Sarac O, Ugurlu N, Yulek F, Cagil N, et al. The Effect of Corneal Epithelium on Corneal Curvature in Patients with Keratoconus. Semin Ophthalmol. 2015; 30. Viswanathan D, Kumar NL, Males JJ. Outcome of Corneal Collagen Crosslinking for Progressive Keratoconus in Paediatric Patients. Biomed Res Int [Internet]. 2014 [cited 2019 Jul 8];2014:1–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25013757 31. Godefrooij DA, Gans R, Imhof SM, Wisse RPLL. Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking. Acta Ophthalmol. 2016;94(7):675–8. 32. Godefrooij DA, de Wit GA, Uiterwaal CS, Imhof SM, Wisse RPLL. Age-specific Incidence and Prevalence of Keratoconus: A Nationwide Registration Study. Am J Ophthalmol. 2017;175:169–72. 33. Kanavi MR, Javadi MA, Sanagoo M. Indications for Penetrating Keratoplasty in Iran. Cornea [Internet]. 2007 [cited 2019 Jul 8];26(5):561–3. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00003226-200706000-00011 34. Downie LE. The Necessity for Ocular Assessment in Atopic Children: Bilateral Corneal Hydrops in an 8 Year Old. Pediatrics [Internet]. 2014 [cited 2019 Jul 8];134(2):e596–601. Available from: http://files/5295/Downie - 2014 - The necessity for ocular assessment in atopic chil.pdf 35. Kaimbo WK. Corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus in a Congolese child. Bull Soc Belge Ophtalmol. 2002; 36. Barsam A, Brennan N, Petrushkin H, Xing W, Quartilho A, Bunce C, et al. Case-control study of risk factors for acute corneal hydrops in keratoconus. Br J Ophthalmol. 2017;101(4):499–502. 37. Sykakis E, Karim R, Evans JR, Bunce C, Amissah-Arthur KN, Patwary S, et al. Corneal collagen cross-linking for treating keratoconus. Cochrane Database Syst Rev [Internet]. 2015 Mar 24 [cited 2019 Sep 13];(3). Available from: http://doi.wiley.com/10.1002/14651858.CD010621.pub2 38. Adachi W, Mitsuishi Y, Terai K, Nakayama C, Hyakutake Y, Yokoyama J, et al. The association of HLA with young-onset keratoconus in Japan. Am J Ophthalmol [Internet]. 2002 Apr [cited 2019 Jul 8];133(4):557–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11931792 39. Reeves SW, Ellwein LB, Kim T, Constantine R, Lee PP. Keratoconus in the Medicare population. Cornea. 2009;28(1):40–2. 40. Gokhale N. Epidemiology of keratoconus. Indian J Ophthalmol. 2013;61(8):382. 41. Torres Netto EA, Al-Otaibi WM, Hafezi NL, Kling S, Al-Farhan HM, Randleman JB, et al. Prevalence of keratoconus in paediatric patients in Riyadh, Saudi Arabia. Br J Ophthalmol. 2018;102(10):1436–41. 42. Fonn D. Concerned Parents and Patients. Eye Contact Lens Sci Clin Pract [Internet]. 2010;36(2):67. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20216267 43. Xie L, Qi F, Gao H, Wang T, Shi W, Zhao J. Major shifts in corneal transplantation procedures in north China: 5316 Eyes over 12 years. Br J Ophthalmol. 2009;93(10):1291–5. 44. Leung VC, Pechlivanoglou P, Chew HF, Hatch W. Corneal Collagen Cross-Linking in the Management of Keratoconus in Canada: A Cost-Effectiveness Analysis. In: Ophthalmology. 2017.

A systematic scoping review examining experiential elements and strategies associated with quality participation among children and youth (2- 12 years) with intellectual and developmental disabilities (IDDs).

Introduction: Major depressive disorder (MDD) is a common mental health condition in adolescents. Randomized clinical trials (RCTs) are the gold-standard for assessing the safety and efficacy of interventions in this population. Heterogeneity in the outcomes measured and reported between RCTs limits the ability to compare, contrast, and combine trial results in a clinically meaningful way. There is currently no core outcome set (COS) available for use in RCTs evaluating interventions in adolescents with MDD. We will conduct a systematic scoping review of outcomes reported in adolescent depression RCTs to assess the variability of trial outcomes and to inform the development of a COS for adolescent MDD. Methods and analysis: We will apply methods based on the Joanna Briggs Institute scoping review methods manual. RCTs evaluating any treatment intervention for adolescent MDD published in the last ten years will be located using an electronic bibliographic database search (MEDLINE, PsycINFO, and Cochrane Central Register of Controlled Trials). Title and abstract screening, full-text screening, and data charting of eligible studies will be performed in duplicate. Outcomes identified will be mapped to an outcome domain framework. Data analysis will include summary statistics of the characteristics of the included trials and outcomes. Ethics and dissemination: The results of this review will inform the development of a COS for adolescent MDD. The development and implementation of a COS for RCTs evaluating interventions in adolescents with MDD promises to help reduce variability in trial outcome selection, definition, measurement, and reporting, ultimately facilitating evidence synthesis that will help to identify best treatment practices for adolescents with MDD. Registration details: This protocol was registered prospectively with the Open Science Framework (https://osf.io/xjz9u/).

This project aims to systematically review available guidance on development of clinical practice guidelines (CPG) in the context of management of spinal injuries.

Following acquired brain injury, some patients fail to orient to, attend to, respond to, or report stimuli appearing on the contralesional hemispace, with patients preferring the ipsilesional space despite having intact sensory abilities. Known as unilateral spatial neglect, this disorder is commonplace but highly variable in its symptoms and severity. Although left-sided neglect is diagnosed more frequently than right; left and right-sided neglect are both common. However, as it stands, the current literature predominately focuses on left-sided neglect. Therefore, the potentially different neurological root causes or the behavioural and cognitive consequences of right-sided neglect remains unclear. To our knowledge there has been no systematic review focussing on right-sided neglect. A systematic scoping review can help map the literature specific to right-sided neglect and highlight the characteristics of this disorder. This scoping review aims to map the literature on right-sided neglect following acquired brain injury.

Structured Summary: Limited published literature and media raise serious concerns surrounding atopic dermatitis (AD) and skin infections in both pediatric and adult patients in a Canadian context (Abedi 2019; Asiniwasis et al., 2020; CBC News 2019; Dehaas 2016; Forsey 2014; FNIGC 2012/2018). A retrospective study completed by Jeong et al. (2020) published in BMC identified a high level of antibiotic prescription in adults for skin infections in remote Canadian Indigenous communities, and the authors concluded that, “this population is currently hard to reach and under-represented in standard surveillance systems, and randomized retrospective chart reviews can offer complimentary methodology for monitoring disease burden, treatment, and prevention”. Although Indigenous peoples of North America are unique and diverse in geography, culture and language, they face well documented unique disparities in social determinants of health and health disparity challenges related to social and historical contexts such as residential schools, reserves as legislated segregation, and other government policies (Allan & Smylie, 2015; Waldram, 2006). As a medical dermatologist with an academic interest in dermatology and health disparities, the author (RA) has informally noted a significant gap in inclusion surrounding Indigenous health disparities in skin disease in North American dermatology literature and virtual/in-person continuing medical education events such as conferences, as well as North American clinical trial representation in common inflammatory skin diseases (eg. moderate to severe psoriasis, AD). To date, no unified body of literature exists on North American Indigenous skin disease, thus we chose a systematic scoping review to further explore this topic by providing a ‘lay of the land’. This project involves a systematic scoping review of dermatologic conditions in North American Indigenous peoples using PRISMA-ScR guidelines (Tricco et al., 2018). In keeping with Truth and Reconciliation calls to action (www.trc.ca), our objective is to systematically and formally document dermatologic disease in North American Indigenous peoples, using findings as a launchpoint for discussion, awareness, informing of future research designs, and as a part of the translational research spectrum with the ultimate and hopefully eventual goal of reducing gaps in health disparities. Sources of evidence include a systematic search of North American Indigenous skin disease using MEDLINE, CINAHL, EMBASE, and CENTRAL, with an extended search of guideline repositories of AAD, CDA, AAAI/ACAAI, CSACI, ATS, and CTS and a scoping review of Indigenous representation in Phase II, III, and IV North American clinical trials involving small molecule and biologic therapy in moderate to severe psoriasis and atopic dermatitis. Charting methods include using Rayyan platform and Excel for data entry. Once data is gathered and analyzed, results will be discussed in context of our objectives and research questions. Rationale: We chose a systematic scoping review (ScR) as the topic of North American Indigenous skin disease has not yet been comprehensively reviewed, and includes a sizable, complex and heterogenous nature (TUL, 2021). Other rationales for ScR in this context include detecting gaps in existing literature, clarifying working definitions, and organizing literature from time, location (country and context), and source (Khalil et al., 2016; Temple University Library, 2021). Objectives: To conduct a systematic scoping review using PRISMA-ScR guidelines (Tricco et al., 2018) of North American Indigenous peoples, including all age groups/sex, urban/rural with skin disease. Epidemiological patterns of Indigenous skin disease, co-morbidities and outcomes will be explored. A scoping review of Indigenous representation in North American dermatologic and atopic guidelines and in moderate to severe psoriasis and atopic dermatitis clinical trials in small molecule and biologic therapy will be completed. Research questions include: 1. What is the prevalence/epidemiological patterns of skin disease among North American Indigenous peoples? 2. What kind of research is being done in North American Indigenous Peoples? 3. Frequency of guideline and clinical trial Indigenous representation See detailed attachment for further information. What terminology/language is being used? ADDITIONAL NOTE: Our database search terminology example on MEDLINE is currently being revised as of Feb 2, 2022.

“Patient-Centeredness” (PC) is a theoretical construct made up of a diverse constellation of distinct concepts, processes, practices, and outcomes that have been developed, arranged, and prioritized heterogeneously by different communities of professional healthcare practice, research, and policy. It is bound together by a common ethos that puts the holistic individual at the functional and symbolic center of their care, a quality deemed essential for chronic disease management and health promotion. Several important contributions to the PC research space have adeptly integrated seminal PC conceptualizations to improve conceptual clarity, measurement, implementation, and evaluation in research and practice. This systematic scoping review builds on that work, but with a purpose to explicitly identify, compare, and contrast the seminal PC conceptualizations arising from the different healthcare professional groups. The rationale for this work is that a deeper examination of the underlying development and corresponding assumptions from each respective conceptualization will lead to a more informed understanding of and meaningful contributions to PC research and practice, especially for healthcare professional groups newer to the topic area like pharmacy. The literature search identified four seminal conceptualizations from the healthcare professions of Medicine, Nursing, and Health Policy. A compositional comparison across the seminal conceptualizations revealed a shared ethos but also six distinguishing features: (1) organizational structure; (2) predominant level of care; (3) methodological approach; (4) care setting origin; (5) outcomes of interest; and (6) language. The findings illuminate PC’s stable theoretical foundations and distinctive nuances needed to appropriately understand, apply, and evaluate the construct’s operationalization in contemporary healthcare research and practice. These considerations hold important implications for future research into the fundamental aims of healthcare, how it should look when practiced, and what should reasonably be required of it.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Objectives: This study aimed to explore how the concepts of co‐production and co‐ design have been defined and applied in the context of health and social care and to identify the temporal adoption of the terms. Methods: A systematic scoping review of CINAHL with Full Text, Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, PubMed and Scopus was conducted to identify studies exploring co‐production or co‐design in health and social care. Data regarding date and conceptual definitions were extracted. From the 2933 studies retrieved, 979 articles were included in this review. Results: A network map of the sixty most common definitions and—through exploration of citations—eight definition clusters and a visual representation of how they interconnect and have informed each other over time are presented. Additional findings were as follows: (i) an increase in research exploring co‐production and co‐design in health and social care contexts; (ii) an increase in the number of new definitions during the last decade, despite just over a third of included articles providing no definition or explanation for their chosen concept; and (iii) an increase in the number of publications using the terms co‐production or co‐design while not involving citizens/patients/service users. Conclusions: Co‐production and co‐design are conceptualized in a wide range of ways. Rather than seeking universal definitions of these terms, future applied research should focus on articulating the underlying principles and values that need to be translated and explored in practice. Patient and Public Contribution: The search strategy and pilot results were presented at a workshop in May 2019 with patient and public contributors and researchers. Discussion here informed our next steps. During the analysis phase of the review, informal discussions were held once a month with a patient who has experience in patient and public involvement. As this involvement was conducted towards the end of the review, we agreed together that inclusion as an author would risk being tokenistic. Instead, acknowledgements were preferred. The next phase involves working as equal contributors to explore the values and principles of co‐production reported within the most common definitions

OBJECTIVE: To describe how workload-related exposure variables have been defined in sports injury articles, and to identify the number of workload-related exposure variables included in comparative analyses. U DESIGN: Scoping review. U LITERATURE SEARCH: PubMed, SPORTDiscus, and Scopus were systematically searched on March 13, 2020. Two reviewers independently screened the retrieved literature and selected articles for inclusion. U STUDY SELECTION CRITERIA: Prospective cohort studies using workload-related variables as the primary exposure to sports injury were eligible for inclusion. U DATA SYNTHESIS: The type (eg, distance, balls bowled) and construct of workload-related exposure variables (eg, acute-chronic workload ratio) were extracted and summarized in frequency tables. U RESULTS: A total of 648 articles were identified, and 45 were eligible for inclusion. Workload definition differed greatly, as sports- and workload-related exposure variables could be, but were not limited to, distance, balls bowled, session rating of perceived exertion, accelerations, soreness, and sleep. Within and across articles, authors used different constructs for workload-related exposure variables. For example, distance was represented as total distance, distance per week, distance per 2 weeks, and acute-chronic workload ratio. The number of workload-related exposure variables included in comparative analyses ranged from 1 to 336. U CONCLUSION: Studies used different definitions of workload-related exposure variables. The number of workload-related exposure variables in a single study ranged from 1 to 336. J Orthop Sports Phys Ther 2020;50(10):538-548.

Background There is compelling evidence on the impact of diet as preventative medicine, and with rising health care costs healthcare organizations are attempting to identify interventions to improve patient health outcomes. Objectives The purpose of this systematic scoping review was to characterize existing healthcare organization-based interventions to improve access to fruits and vegetables (F&V) for their patient populations. In addition, we aimed to review the impact of identified interventions on dietary intake and health outcomes. Methods Titles and abstracts were searched in PubMed® (MEDLINE®), Embase®, CINAHL®, and the Cochrane Library® from 1 January 1990 to 31 December 2019. To be selected for inclusion, original studies must have included a healthcare organization and have had a programmatic focus on increasing access to or providing fresh F&V to patients in an outpatient, naturalistic setting. The Effective Public Health Practice Project tool was used to assess study quality in 6 domains (selection bias, study design, confounders, blinding, data collection methods, and withdrawals and dropouts). Results A total of 8876 abstracts were screened, yielding 44 manuscripts or abstracts from 27 programs. Six program models were identified: 1) a cash-back rebate program, 2) F&V voucher programs, 3) garden-based programs, 4) subsidized food box programs, 5) home-delivery meal programs, and 6) collaborative food pantry-clinical programs. Only 6 of 27 studies included a control group. The overall quality of the studies was weak due to participant selection bias and incomplete reporting on data collection tools, confounders, and dropouts. Given the heterogeneity of outcomes measured and weak study quality, conclusions regarding dietary and health-related outcomes were limited. Conclusions Healthcare-based initiatives to improve patient access to F&V are novel and have promise. However, future studies will need rigorous study designs and validated data collection tools, particularly related to dietary intake, to better determine the effect of these interventions on health-related outcomes.

[This corrects the article DOI: 10.3389/fsurg.2023.1102711.]., (© 2023 Enodien, Taha-Mehlitz, Saad, Nasser, Frey and Taha.)

Background: Delirium prevention is crucial, especially in critically ill patients. Nonpharmacological multicomponent interventions for preventing delirium are increasingly recommended and technology-based interventions have been developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview of these interventions for in-hospital delirium prevention and reduction.Objective: This systematic scoping review was carried out to answer the following questions: (1) what are the technologies currently used in nonpharmacological technology-based interventions for preventing and reducing delirium? and (2) what are the strategies underlying these currently used technologies?Methods: A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were eligible if they contained any type of technology-based interventions and assessed delirium-/risk factor-related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form.Results: A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. Our review revealed 8 different technology types and 14 strategies that were categorized into the following 7 pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, (5) provide a sense of security, (6) provide a sense of control, and (7) provide a sense of being connected. For all technology types, significant positive effects were found on either or both direct and indirect delirium outcomes. Several similarities were found across effective interventions: using a multicomponent approach or including components comforting the psychological needs of patients (eg, familiarity, distraction, soothing elements).Conclusions: Technology-based interventions have a high potential when multidimensional needs of patients (eg, physical, cognitive, emotional) are incorporated. The 7 pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the intensive care unit into a healing environment as a powerful tool to prevent delirium.

Background Prevalence of chronic gastrointestinal diseases has been rising amongst ethnic minority populations in Western countries, despite the first-generation migrants originating from countries of low prevalence. Differences caused by genetic, environmental, cultural, and religious factors in each context may contribute towards shaping experiences of ethnic minority individuals living with primary bowel conditions. This review aimed to explore the experiences of ethnic minority patients living with chronic bowel conditions. Methods We conducted a systematic scoping review to retrieve qualitative, quantitative, and mixed methods studies from eight electronic databases, and manually searched reference lists of frequently cited papers. Results Fourteen papers met the inclusion criteria: focussing on inflammatory bowel disease, irritable bowel syndrome, and coeliac disease. Core themes were narratively analysed. South Asians had limited understanding of inflammatory bowel disease and coeliac disease, hindered by language and literacy barriers, particularly for older generations, suggesting that culturally relevant information is needed. Family support was limited, and Muslim South Asians referred to religion to understand and self-manage inflammatory bowel disease. Ethnic minority groups across countries experienced: poor dietary intake for coeliac disease and inflammatory bowel disease, cultural conflict in self-managing diet for inflammatory bowel disease which increased anxiety, and there was a need for better quality of, and access to, healthcare services. British ethnic minority groups experienced difficulties with IBD diagnosis/misdiagnosis. Conclusions Cultural, religious, and social contexts, together with language barriers and limited health literacy influenced experiences of health inequalities for ethnic minority patients living with chronic bowel diseases.

Background Molding competent clinicians capable of applying ethics principles in their practice is a challenging task, compounded by wide variations in the teaching and assessment of ethics in the postgraduate setting. Despite these differences, ethics training programs should recognise that the transition from medical students to healthcare professionals entails a longitudinal process where ethics knowledge, skills and identity continue to build and deepen over time with clinical exposure. A systematic scoping review is proposed to analyse current postgraduate medical ethics training and assessment programs in peer-reviewed literature to guide the development of a local physician training curriculum. Methods With a constructivist perspective and relativist lens, this systematic scoping review on postgraduate medical ethics training and assessment will adopt the Systematic Evidence Based Approach (SEBA) to create a transparent and reproducible review. Results The first search involving the teaching of ethics yielded 7669 abstracts with 573 full text articles evaluated and 66 articles included. The second search involving the assessment of ethics identified 9919 abstracts with 333 full text articles reviewed and 29 articles included. The themes identified from the two searches were the goals and objectives, content, pedagogy, enabling and limiting factors of teaching ethics and assessment modalities used. Despite inherent disparities in ethics training programs, they provide a platform for learners to apply knowledge, translating it to skill and eventually becoming part of the identity of the learner. Illustrating the longitudinal nature of ethics training, the spiral curriculum seamlessly integrates and fortifies prevailing ethical knowledge acquired in medical school with the layering of new specialty, clinical and research specific content in professional practice. Various assessment methods are employed with special mention of portfolios as a longitudinal assessment modality that showcase the impact of ethics training on the development of professional identity formation (PIF). Conclusions Our systematic scoping review has elicited key learning points in the teaching and assessment of ethics in the postgraduate setting. However, more research needs to be done on establishing Entrustable Professional Activities (EPA)s in ethics, with further exploration of the use of portfolios and key factors influencing its design, implementation and assessment of PIF and micro-credentialling in ethics practice.

(1) Background: The term 'food literacy' has gained momentum globally; however, a lack of clarity around its definition has resulted in inconsistencies in use of the term. Therefore, the objective was to conduct a systematic scoping review to describe the use, reach, application and definitions of the term 'food literacy' over time. (2) Methods: A search was conducted using the PRISMA-ScR guidelines in seven research databases without any date limitations up to 31 December 2019, searching simply for use of the term 'food literacy'. (3) Results: Five hundred and forty-nine studies were included. The term 'food literacy' was used once in 243 articles (44%) and mentioned by researchers working in 41 countries. Original research was the most common article type (n = 429, 78%). Food literacy was published across 72 In Cites disciplines, with 456 (83%) articles from the last 5 years. In articles about food literacy (n = 82, 15%), review articles were twice as prevalent compared to the total number of articles (n = 10, 12% vs. n = 32, 6%). Fifty-one different definitions of food literacy were cited. (4) Conclusions: 'Food literacy' has been used frequently and broadly across differing article types and disciplines in academic literature internationally. However, agreement on a standardised definition of food literacy endorsed by a peak international agency is needed in order to progress the field.

The goal of this doctoral research is to automatically predict difficult words in a text for non-native speakers. This prediction is crucial because good text comprehension is strongly determined by vocabulary. If a text contains too high a percentage of unknown words, the reader is likely to struggle to understand it. In order to provide good support to the non-native reader, we must first be able to predict the number of difficult words. Usually, we do this manually based on expertise or prior vocabulary tests. However, such methods are not practical when we are reading in a computer-based environment such as a tablet or an online learning platform. In these cases, we need to properly automate the predictions. The thesis is divided into three parts. The first part contains a systematic review of the relevant scientific literature. The synthesis includes 50 years of research and 140 peer-reviewed publications on the statistical prediction of lexical competence in non-native readers. Among other things, the analyses show that the scientific scope is divided into two fields of research that have little connection with each other. On the one hand, there is a long tradition of experimental research in foreign language acquisition (SLA) and computer-assisted language learning (CALL). These experimental studies mainly test the effect of certain factors (e.g., repeating difficult words or adding electronic glosses) on learning unrecognized words during reading. On the other hand, recent studies in natural language processing (NLP) rely on artificial intelligence to automatically predict difficult words. Moreover, the literature review points out some limitations that were further studied in this doctoral research. The first limitation is the lack of contextualized measures and predictions. Although we know from research that the context in which a word occurs is an important factor, predictions are often made based on isolated vocabulary tests, among other things. The second limitation is the lack of personalized measures and predictions. Although research in foreign language acquisition has shown that there are many differences among non-native readers, recent studies in artificial intelligence make predictions based on aggregate data. The final limitation is that the majority of studies (74%) focus on English as a foreign language. Consequently, the goal of this doctoral research is a contextualized and personalized approach and a focus on Dutch and French as foreign languages. The second part looks at two measures of lexical difficulty for non-native readers. On the one hand, it investigates how words are introduced in didactic reading materials labeled with CEFR levels. This study introduces a new graded lexical database for Dutch, namely NT2Lex (Tack et al., 2018). The innovative feature of this database is that the frequency per difficulty level was calculated for the meaning of each word, disambiguated based on the sentence context. However, the results show that there are important inconsistencies in how etymologically related translations occur in the Dutch and French databases. Therefore, this difficulty measure does not yet seem valid as a basis for an automated system. On the other hand, it is investigated how non-native speakers themselves perceive difficult words during reading. The perception of difficulty is important to predict because the learner's attention is a determining factor in the learning process (Schmidt, 2001). The study introduces new data for readers of French. An important goal of these data is to make correct predictions for all words in the text, which contrasts with studies in foreign language acquisition that focus on a limited number (Mdn = 22) of target words in the text. Moreover, the analyses show that the data can be used to develop a personalized and contextualized system. The final section looks at two types of predictive models developed on the aforementioned data, namely mixed-effects models and artificial neural networks. The results validate the idea that perceptions of lexical difficulty can be predicted primarily on the basis of "word surprisal", a central concept in information theory. Furthermore, the analyses show that commonly used performance statistics (such as accuracy and F-score) are sensitive to individual differences in rates of difficulty. Because these are therefore not appropriate for comparing predictions for different learners, the D and Phi coefficients are used. Moreover, the results clearly show that a personalized model makes significantly better predictions than a non-personalized model. On the other hand, the results show that a contextualized model can better discriminate difficulty, although these improvements are not always significant for each learner. L'objectif de cette recherche doctorale est la prédiction automatique des mots difficiles dans un texte pour les locuteurs non natifs. Cette prédiction est cruciale car une bonne compréhension d'un texte est fortement déterminée par le vocabulaire. Si un texte contient un pourcentage élevé de mots inconnus, le lecteur aura probablement des difficultés à comprendre le texte. Afin de fournir un bon soutien au lecteur de langue étrangère, nous devons d'abord être en mesure de prédire le nombre de mots difficiles. En général, nous le faisons manuellement en nous basant sur notre expertise ou sur des tests de vocabulaire antérieurs. Cependant, ces méthodes ne sont pas pratiques lorsque nous lisons dans un environnement informatique tel qu'une tablette ou une plateforme d'apprentissage en ligne. Dans ces cas, nous devons automatiser correctement les prédictions. La thèse est divisée en trois parties. La première partie contient un examen systématique de la littérature scientifique pertinente. La synthèse comprend 50 ans de recherche et 140 publications évaluées par des pairs sur la prédiction statistique de la compétence lexicale chez les lecteurs non natifs. Les analyses montrent, entre autres, que le champ scientifique est divisé en deux domaines de recherche peu connectés. D'une part, il existe une longue tradition de recherche expérimentale en matière d'acquisition de langues étrangères (SLA) et d'apprentissage des langues assisté par ordinateur (CALL). Ces études expérimentales testent principalement l'effet de certains facteurs (par exemple, la répétition de mots difficiles ou l'ajout de glosses électroniques) sur l'apprentissage de mots non familiers pendant la lecture. D'autre part, des études récentes sur le traitement du langage naturel (NLP) s'appuient sur l'intelligence artificielle pour prédire automatiquement les mots difficiles. En outre, l'étude de la littérature met en évidence certaines limites qui ont été approfondies dans le cadre de cette recherche doctorale. La première limite est le manque de mesures et de prédictions contextualisées. Bien que la recherche nous ait appris que le contexte dans lequel un mot apparaît est un facteur important, les prédictions sont souvent faites sur la base de tests de vocabulaire isolés, entre autres. La deuxième limite est le manque de mesures et de prédictions personnalisées. Bien que la recherche sur l'acquisition des langues étrangères ait montré qu'il existe de nombreuses différences entre les lecteurs non natifs, des études récentes en intelligence artificielle font des prédictions basées sur des données agrégées. La dernière limite est que la majorité des études (74%) se concentrent sur l'anglais en tant que langue étrangère. L'objectif de cette recherche doctorale est donc une approche contextualisée et personnalisée et une focalisation sur le néerlandais et le français comme langues étrangères. La deuxième partie examine deux mesures de la difficulté lexicale pour les lecteurs non natifs. D'une part, elle étudie la manière dont les mots sont introduits dans les matériels de lecture didactique étiquetés avec les niveaux du CECR. Cette étude introduit une nouvelle base de données lexicale graduée pour le néerlandais, à savoir NT2Lex (Tack et al., 2018). La caractéristique innovante de cette base de données est que la fréquence par niveau de difficulté a été calculée pour le sens de chaque mot, désambiguïsé sur la base du contexte de la phrase. Cependant, les résultats montrent qu'il existe d'importantes incohérences dans la manière dont les traductions étymologiquement liées apparaissent dans les bases de données néerlandaise et française. Par conséquent, cette mesure de difficulté ne semble pas encore valable comme base pour un système automatisé. D'autre part, on étudie comment les locuteurs non natifs perçoivent les mots difficiles pendant la lecture. La perception de la difficulté est importante à prévoir car l'attention de l'apprenant est un facteur déterminant dans le processus d'apprentissage (Schmidt, 2001). L'étude introduit de nouvelles données pour les lecteurs du français. Un objectif important de ces données est de faire des prédictions correctes pour tous les mots du texte, ce qui contraste avec les études sur l'acquisition des langues étrangères qui se concentrent sur un nombre limité (Mdn = 22) de mots cibles dans le texte. De plus, les analyses montrent que les données peuvent être utilisées pour développer un système personnalisé et contextualisé. La dernière section examine deux types de modèles prédictifs développés sur les données susmentionnées, à savoir les modèles à effets mixtes et les réseaux neuronaux artificiels. Les résultats valident l'idée que la perception de la difficulté lexicale peut être prédite principalement sur la base de la "surprise des mots", un concept central de la théorie de l'information. En outre, les analyses montrent que les statistiques de performance couramment utilisées (telles que la précision et le F-score) sont sensibles aux différences individuelles dans les taux de difficulté. Comme ceux-ci ne sont donc pas appropriés pour comparer les prédictions pour différents apprenants, les coefficients D et Phi sont utilisés. De plus, les résultats montrent clairement qu'un modèle personnalisé fait des prédictions nettement meilleures qu'un modèle non personnalisé. D'autre part, les résultats montrent qu'un modèle contextualisé peut mieux discriminer la difficulté, bien que ces améliorations ne soient pas toujours significatives pour chaque apprenant. (LALE - Langues et lettres) -- UCL, 2021

Simulation modeling can be useful to estimate the long-term health and economic impacts of population-based dietary policies. We conducted a systematic scoping review following the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guideline to map and critically appraise economic evaluations of population-based dietary policies using simulation models. We searched Medline, Embase, and EconLit for studies published in English after 2005. Modeling studies were mapped based on model type, dietary policy, and nutritional target, and modeled risk factor-outcome pathways were analyzed. We included 56 studies comprising 136 model applications evaluating dietary policies in 21 countries. The policies most often assessed were reformulation (34/136), taxation (27/136), and labeling (20/136); the most common targets were salt/sodium (60/136), sugar-sweetened beverages (31/136), and fruit and vegetables (15/136). Model types included Markov-type (35/56), microsimulation (11/56), and comparative risk assessment (7/56) models. Overall, the key diet-related risk factors and health outcomes were modeled, but only 1 study included overall diet quality as a risk factor. Information about validation was only reported in 19 of 56 studies and few studies (14/56) analyzed the equity impacts of policies. Commonly included cost components were health sector (52/56) and public sector implementation costs (35/56), as opposed to private sector (18/56), lost productivity (11/56), and informal care costs (3/56). Most dietary policies (103/136) were evaluated as cost-saving independent of the applied costing perspective. An analysis of the main limitations reported by authors revealed that model validity, uncertainty of dietary effect estimates, and long-term intervention assumptions necessitate a careful interpretation of results. In conclusion, simulation modeling is widely applied in the economic evaluation of population-based dietary policies but rarely takes dietary complexity and the equity dimensions of policies into account. To increase relevance for policymakers and support diet-related disease prevention, economic effects beyond the health sector should be considered, and transparent conduct and reporting of model validation should be improved.