Accessibility for the visually impaired community in hospitality and tourism: A scoping review

This study identified the current state of knowledge about the Quality of Life (QoL) of siblings of children who are deaf and hard of hearing (DHH), have a vision impairment (VI) or motor impairment (MI). Additionally, factors associated with individual variation in QoL were examined. A scoping review was performed using PsycInfo, ERIC, Web of Science, and CINAHL. Empirical studies with siblings (age 0-18 years) of children who are DHH, have a VI or MI that investigate the QoL of siblings were included. A total of 1746 studies were identified of which 11 met the inclusion criteria. The results showed that QoL has different interpretations and various measurement tools are used. The findings showed both positive and negative outcomes for the QoL of siblings. For example, family cohesion was found as a positive consequence. A negative consequence could be a higher score on problem behavior. Personal and parental characteristics such as age and parental availability were two main factors related to individual variation in QoL. Insight in the factors related to individual variation may help researchers to consider the research perspective. In addition, healthcare providers can use the information to be either aware or intervene on specific factors that are related to the QoL of the children who are DHH, have a VI or MI and their siblings.

The aim of this study was to review the current literature on falls prevention in people with visual impairment and to estimate the applicability of methods of fall prevention for people with visual impairment and intellectual disability. A scoping review was performed according to the Arksey and O’Malley framework. Relevant studies were collected from PubMed, Web of Science, and the Cochrane Register of Controlled Trials (CENTRAL). All records covering the time span from January 1980 until November 2017 were collected. Studies were included if the participants had a visual impairment according to objective ophthalmic assessments, the article described interventions to reduce falls or risk factors for falls, and the study was written in English and published in a peer-reviewed journal. The methodological quality of the studies were determined by consensus of the authors on the PEDro scale. Fifteen articles were included in this scoping review. Three articles focused on screening and intervention programmes, five articles addressed the effectiveness of environmental adjustments, and seven articles involved training programmes for physical improvement. Environmental adjustments emerged as having the best evidence for falls prevention for people with a visual impairment. Physical training programmes improved balance in those with a visual impairment but could not reduce the number of falls. Environmental adjustments also may be effective for persons with a visual impairment and intellectual disability. In addition, multifactorial screening and intervention programmes are recommended as an important new research direction with important clinical implications.

BackgroundIndividuals with sensory impairment (visual and/or hearing) experience health inequalities and increased the risk of medication-related iatrogenic disease compared with the general population. Assistive technologies and tailored strategies could support medication management for individuals with sensory impairment to reduce harm and increase the likelihood of therapeutic benefit. ObjectiveThis scoping review identified assistive technologies and strategies to support medication management of/for people with hearing and/or visual impairment. MethodsStandard scoping review methodology was used to identify studies that evaluated technologies or strategies designed to support people with sensory impairment with independent medicine management. Electronic databases were searched (MEDLINE, Embase, CINAHL, ACM, Cochrane) from inception to 18/07/22. Independent duplicate screening, selection, and data extraction were undertaken. ResultsOf 1231 publications identified, 18 were included, reporting 17 studies, 16 of which evaluated technologies to assist people with visual impairment and one study to assist people with hearing impairment. The range of technologies and devices included: applications for android phones (n = 6); eyedrop-assistance devices (n = 5); audio-prescription labelling/reading systems (n = 2); touch-to-speech devices (n = 2); continuous glucose monitoring system (n = 1); magnifying technology (n = 1). Ten studies tested early-stage prototypes. Most participants could operate the technologies effectively and deemed them to be useful. ConclusionsDespite the increasing number of medicine-related assistive technologies, there has been limited empirical evaluation of their effectiveness for supporting individuals with sensory impairment. Prototypes appear to be useful for people with visual or hearing impairment, however wider ‘real-life’ testing is needed to confirm the benefits of these technologies.

Hearing and vision impairments are common globally. They are often considered separately in research, and in planning and delivering services. However, they can occur concurrently, termed dual sensory impairment (DSI). The prevalence and impact of hearing and vision impairment have been well-examined, but there has been much less consideration of DSI. The aim of this scoping review was to determine the nature and extent of the evidence on prevalence and impact of DSI. Three databases were searched: MEDLINE, Embase and Global Health (April 2022). We included primary studies and systematic reviews reporting the prevalence or impact of DSI. No limits were placed on age, publication dates, or country. Only studies where the full text was available in English were included. Two reviewers independently screened titles, abstract, full texts. Data were charted by two reviewers independently using a pre-piloted form. The review identified 183 reports of 153 unique primary studies and 14 review articles. Most evidence came from high-income countries (86% of reports). Prevalence varied across reports, as did age groups of participants and definitions used. The prevalence of DSI increased with age. Impact was examined across three broad groups of outcomes—psychosocial, participation, and physical health. There was a strong trend towards poorer outcomes for people with DSI across all categories compared to people with one or neither impairment, including activities of daily living (worse for people with DSI in 78% of reports) and depression (68%). This scoping review highlights that DSI is a relatively common condition with substantial impact, particularly among older adults. There is a gap in evidence from low and middle-income countries. There is a pressing need for a consensus position on the definition(s) of DSI and standardisation of reporting age groups to enable reliable estimates to be ascertained and compared and responsive services developed.

Hearing and vision impairments are common globally. They are often considered separately in research, and in planning and delivering services. However, they can occur concurrently, termed dual sensory impairment (DSI). The prevalence and impact of hearing and vision impairment have been well-examined, but there has been much less consideration of DSI. The aim of this scoping review was to determine the nature and extent of the evidence on prevalence and impact of DSI. Three databases were searched: MEDLINE, Embase and Global Health (April 2022). We included primary studies and systematic reviews reporting the prevalence or impact of DSI. No limits were placed on age, publication dates, or country. Only studies where the full text was available in English were included. Two reviewers independently screened titles, abstract, full texts. Data were charted by two reviewers independently using a pre-piloted form. The review identified 183 reports of 153 unique primary studies and 14 review articles. Most evidence came from high-income countries (86% of reports). Prevalence varied across reports, as did age groups of participants and definitions used. The prevalence of DSI increased with age. Impact was examined across three broad groups of outcomes-psychosocial, participation, and physical health. There was a strong trend towards poorer outcomes for people with DSI across all categories compared to people with one or neither impairment, including activities of daily living (worse for people with DSI in 78% of reports) and depression (68%). This scoping review highlights that DSI is a relatively common condition with substantial impact, particularly among older adults. There is a gap in evidence from low and middle-income countries. There is a pressing need for a consensus position on the definition(s) of DSI and standardisation of reporting age groups to enable reliable estimates to be ascertained and compared and responsive services developed.

To describe the prevalence, diagnoses and aetiologies of visual impairment in children with developmental delay (DD) in a Danish county with a population of 618 000 citizens. We carried out a cross-sectional study in Copenhagen County of children aged 4-15 years with profound to borderline DD (IQ <or= 80). Children were located through school psychologists or paediatric clinics. The number of children with DD was estimated using the capture-recapture method. A total of 1126 children fulfilled the inclusion criteria, corresponding to 97.7% of the estimated number of children with DD in the county. Ophthalmological examinations were performed in 923 children. The prevalence of visual impairment was 10.5% in the study group and 22.4% in those with an IQ <or= 50. The diagnoses were predominantly cerebral visual impairment, optic atrophy, retinal dystrophies and congenital nystagmus. The aetiology of visual impairment was prenatal in 54 children, perinatal in 29 children and postnatal in seven children. Visual impairment is highly increased in children with DD and is correlated to low IQ.

Background/Objectives: Sleep problems are highly prevalent among children with vision impairment and can negatively affect physical, emotional, and cognitive development. There is a need to identify and evaluate effective interventions in this population. This scoping review aimed to map the range of sleep challenges experienced by these children and to summarise the interventions evaluated to date. Methods: Systematic searches were performed in Embase, Medline, and Web of Science Core Collection. Screening was completed in Covidence, and data extraction and descriptive analysis were conducted using Microsoft Excel (version 2510) and IBM SPSS Statistics (version 30). Narrative synthesis was used to summarise findings. Results: Fifteen studies were included, over half of which were case reports. The vast majority (14/15) were conducted in high-income countries, leaving a significant evidence gap for low- and middle-income settings. Reported sleep challenges included delayed sleep onset, non-24-h sleep-wake disorder, early morning waking, and fragmented sleep. Interventions were predominantly pharmacological (11/15), with melatonin the most frequently evaluated. Across studies, melatonin demonstrated short-term effectiveness in improving sleep latency, duration, and parent-reported quality, though prescribing practices, dosages, and availability varied. Other pharmacological options, such as tasimelteon and vitamin B12, were rarely reported. Non-pharmacological strategies were evaluated in only a small number of studies and included behavioural interventions, structured routines, and activity-based therapies. These showed potential benefit but remain under-researched. Conclusions: Overall, the evidence base is small, heterogeneous, and methodologically limited. Further research is needed to develop and carefully test non-pharmacological approaches, and to compare them directly with pharmacological treatments, to provide families and clinicians with effective and sustainable options.

The use profile of antimicrobial drugs in neonatal intensive care units: A scoping review protocol.

BackgroundOlder adults with dual sensory impairment (DSI/combined hearing and visual impairment), are more likely to obtain poorer scores on cognitive tests. Whether these results are due to poor cognitive function or inappropriate or absent adaptation of test administration for sensory impaired older adults is unclear. Given that this population is at higher risk of developing dementia, e.g., due to Alzheimer’s disease, ensuring optimal test administration is imperative to provide adequate cognitive care. Therefore, we mapped the existing scientific literature on various cognitive measures/tools that have been used to screen or assess cognitive impairment in older adults with DSI.MethodA scoping review was conducted using the Arksey and O’Malley framework (2005). Scientific articles were searched across eleven databases (CINAHL, Embase, Global Health, Mednar, OAIster, OpenGrey, PsycEXTRA, PsycINFO, PubMed, Web of Science, and WorldWideScience). The inclusion criteria were: the articles considered and/or measured cognitive function, in individuals with DSI, aged 65 and older. Extracted data included sample cognitive status, cognitive measure type (objective or subjective), reported cognitive domains evaluated by the measure, psychometric properties as well as reported, if any, sensibility measures during administration.ResultOf 11,595 articles retrieved, fifty‐six (n = 56) met the inclusion criteria. All but five (n=5) studies employed an objective measure of cognitive function. The most commonly used cognitive test in studies with older adults with DSI is the Mini‐Mental State Examination (1975) with almost 1/3 of the studies reporting its use (n=17). More importantly, none of the studies in this scoping review used cognitive tests that were adapted for vision and hearing impairment, highlighting that optimal cognitive assessment in DSI is neglected.ConclusionMost objective cognitive tests include vision‐ and hearing‐dependent items and require functional vision and/or hearing for both the administration and the execution of these tests. Our study confirmed the use of commonly used standardized tests, initially validated in a healthy population, to measure the cognitive function of older adults with DSI. Identifying these generally utilized tools is the first step to developing optimal adaptations in their administration for this vulnerable population.

Human papillomavirus (HPV) is the most common cause of cervical cancer in women. However, among adolescent boys, initial exposure to HPV is associated with a higher risk of developing oropharyngeal and oral cancers compared with girls. Notably, the incidence of oropharyngeal cancer has been rising sharply in high-income countries, yet HPV vaccination coverage among adolescent boys remains suboptimal. Therefore, understanding the perceptions of adolescent boys and their parents regarding HPV vaccination in high-income countries is crucial for the development of effective public health strategies. This scoping review aims to explore the perceptions of adolescent boys and their parents regarding HPV vaccination and investigate the facilitating factors and barriers influencing HPV vaccination. The method framework of Arksey and O'Malley, the Joanna Briggs Institute, as well as the recommendations of Levac will be used to conduct the scoping review. This scoping review will be reported in accordance with the PRISMA extension for scoping reviews checklist. A systematic literature search will be performed on Ovid-MEDLINE, CINAHL, Cochrane CENTRAL, Ovid-Embase, PsycINFO and Web of Science. Two reviewers will independently perform the study selection and data extraction. Identified studies will be extracted using a customised extraction template on Covidence and analysed descriptively using narrative synthesis. The review commenced in April 2024 and will be completed in July 2025. Formal ethical approval is not required, as primary data will not be collected for this study. The findings will be disseminated through publication in a peer-reviewed journal. This protocol has been registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/M5NH2).

BACKGROUND Digital microscopy combined with artificial intelligence (AI) is increasingly being implemented in health care, predominantly in advanced laboratory settings. However, AI-supported digital microscopy could be especially advantageous in primary health care settings, since such methods could improve access to diagnostics via automation and a decreased need for experts on-site. To our knowledge, no scoping or systematic review has previously examined the use of AI-supported digital microscopy in primary health care laboratories, and a scoping review could guide future research by providing insights into the challenges of implementing these novel methods. OBJECTIVE This scoping review aimed to map published peer-reviewed studies on AI-supported digital microscopy in primary health care laboratories to generate an overview of the subject. METHODS A systematic search of the databases PubMed, Web of Science, Embase, and IEEE was conducted on October 2, 2024. The inclusion criteria in the scoping review were based on three concepts: using digital microscopy, AI, and comparison of the results to a standard diagnostic system; and one context, being performed in primary health care laboratories. Additional inclusion criteria were peer reviewed diagnostic accuracy studies in English performed on humans and achieving a sample level diagnosis. The study selection and data extraction were performed by two independent researchers, and cases of disagreement were solved through discussion with a third researcher. The methodology is in accordance with the JBI methodology for scoping reviews. RESULTS A total of 3,403 articles were screened during the article identification process, of which 22 (0.6%) were included in the scoping review. The samples analyzed were as follows: blood (n=12) for blood cell and malaria detection; urine (n=4) for urinalysis and parasite detection; cytology of atypical oral (n=1) and cervical cells (n=2); stool (n=2) for parasite detection; and sputum (n=1) for ferning-patterns indicating inflammation. Both conventional (n=15) and specifically developed methods (n=7) were used in sample preparation. The AI models used were based on both single (n=11) and multiple AI-algorithms (n=11) and all studies except one used convolutional neural networks. The AI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for complete blood counts, malaria detection, identification of stool and genitourinary parasites, screening for oral and cervical cellular atypia, detection of pulmonary inflammation, and urinalysis. The AI-supported digital microscopy had higher sensitivity than manual microscopy in six out of seven (85.7%) studies that used a reference standard that allowed for this comparison. CONCLUSIONS AI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for diagnosing multiple targets in primary health care laboratories and may be particularly advantageous for improving diagnostic sensitivity. However, many shared challenges, ranging from sample preparation to workflow integration, need to be addressed to enable real world implementation. CLINICALTRIAL JMIR Res Protoc 2024;13:e58149 doi:10.2196/58149 INTERNATIONAL REGISTERED REPORT RR2-10.2196/58149

BackgroundDigital microscopy combined with artificial intelligence (AI) is increasingly being implemented in health care, predominantly in advanced laboratory settings. However, AI-supported digital microscopy could be especially advantageous in primary health care settings, since such methods could improve access to diagnostics via automation and a decreased need for experts on-site. To our knowledge, no scoping or systematic review has previously examined the use of AI-supported digital microscopy in primary health care laboratories, and a scoping review could guide future research by providing insights into the challenges of implementing these novel methods.ObjectiveThis scoping review aimed to map published peer-reviewed studies on AI-supported digital microscopy in primary health care laboratories to generate an overview of the subject.MethodsA systematic search of the databases PubMed, Web of Science, Embase, and IEEE was conducted on October 2, 2024. The inclusion criteria in the scoping review were based on 3 concepts: using digital microscopy, AI, and comparison of the results with a standard diagnostic system, and 1 context, being performed in primary health care laboratories. Additional inclusion criteria were peer-reviewed diagnostic accuracy studies published in English, performed on humans and achieving a sample-level diagnosis. The study selection and data extraction were performed by 2 independent researchers (JVB and AS), and cases of disagreement were resolved through discussion with a third researcher (NL). The methodology is in accordance with the Joanna Briggs Institute methodology for scoping reviews.ResultsA total of 3403 papers were screened during the paper identification process, of which 22 (0.6%) were included in the scoping review. The samples analyzed were as follows: blood (n=12) for blood cell and malaria detection, urine (n=4) for urinalysis and parasite detection, cytology of atypical oral (n=1) and cervical cells (n=2), stool (n=2) for parasite detection, and sputum (n=1) for ferning patterns indicating inflammation. Both conventional (n=15) and specifically developed methods (n=7) were used in sample preparation. The AI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for complete blood counts, malaria detection, identification of stool and genitourinary parasites, screening for oral and cervical cellular atypia, detection of pulmonary inflammation, and urinalysis. Furthermore, AI-supported digital microscopy achieved higher sensitivity than manual microscopy in 6/7 (85.7%) studies that used a reference standard that allowed for this comparison.ConclusionsAI-supported digital microscopy achieved comparable diagnostic accuracy to the reference standard for diagnosing multiple targets in primary health care laboratories and may be particularly advantageous for improving diagnostic sensitivity. With further research addressing challenges such as scalability and cost-effectiveness, AI-supported digital microscopy could improve access to diagnostics, especially in expert-scarce and resource-limited settings.

ABSTRACTBackground: Delayed breast cancer diagnosis in low- and middle-income countries (LMICs) reduces the survival rates. This review identifies the causes of these delays to inform strategies for improving early detection.Methods: This scoping review followed the Arksey and O’Malley framework to explore the factors contributing to delayed breast cancer diagnosis in LMICs. Seven databases, including PubMed, Scopus, Web of Science, Cochrane Library, ProQuest, Embase, and Magiran, were searched for English and Persian studies published between January 2000 and September 2024. The search combined the keywords (e.g., “diagnostic delay,” “missed diagnosis,” “breast cancer,” “late-stage,” “barriers”), using Boolean operators. To focus on LMICs, we applied country filters, where available, and supplemented the search with manual screening of reference lists from the included studies.Results: The initial database search identified 5,313 records. After removing 1,036 duplicates, 4,277 studies were screened based on title, abstract, and country of origin. Of these, 4,217 were excluded for reasons including irrelevance to delayed breast cancer diagnosis, study design, population, setting (e.g., high-income countries), or publication date (outside 2000–2024). The remaining 60 studies met the inclusion criteria and were included in the narrative synthesis. Extracted data were organized and interpreted using the revised Penchansky framework (accessibility, availability, acceptability, affordability, accommodation, awareness). Additional themes included misdiagnosis, competing priorities, and personal factors.Conclusions: Multiple modifiable factors contribute to diagnostic delays in LMICs. Addressing them can accelerate diagnosis, improve outcomes, and reduce harm. Targeted improvements in these areas offer significant potential to enhance breast cancer care and save lives in LMICs.

The World Health Organization (WHO) estimates that 1.5 billion and 2.2 billion people have hearing and vision impairment, respectively. The burden of these non-communicable diseases is highest in low- and middle-income countries due to a lack of services and health professionals. The WHO has recommended universal health coverage and integrated service delivery to improve ear and eye care services. This scoping review describes the evidence for combined hearing and vision screening programs. A keyword search of three electronic databases, namely Scopus, MEDLINE (PubMed), and Web of Science, was conducted, resulting in 219 results. After removing duplicates and screening based on eligibility criteria, data were extracted from 19 included studies. The Joanna Briggs Institute Reviewer Manual and the Preferred Reporting Items for Systematic Reviews and Meta-analyzes (PRISMA) Extension for Scoping Reviews were followed. A narrative synthesis was conducted. Most studies (63.2%) were from high-income countries, with 31.6% from middle-income and 5.2% from low-income countries. The majority of studies (78.9%) involved children and the four studies reporting on adults all included adults above 50 years of age. Vision screening was most commonly performed with the "Tumbling E" and "Snellen Chart," while hearing was typically screened using pure tone audiometry. Studies reported referral rates as the most common outcome with sensitivity and specificity rates not reported in any included articles. Reported benefits of combined vision and hearing screenings included earlier detection of vision and hearing difficulties to support functioning and quality of life as well as resource sharing for reduced costs. Challenges to combined screening included ineffective follow-up systems, management of test equipment, and monitoring of screening personnel. There is limited research evidence for combined hearing and vision screening programs. Although potential benefits are demonstrated, especially for mHealth-supported programs in communities, more feasibility and implementation research are required, particularly in low- and middle-income countries and across all age groups. Developing universal, standardized reporting guidelines for combined sensory screening programs is recommended to enhance the standardization and effectiveness of combined sensory screening programs.

The global incidence of early-onset (EO) cancers-defined as malignancies diagnosed in individuals under the age of 50-has increased significantly over recent decades, particularly in high-income countries. However, epidemiological data from Latin America remain fragmented and underexplored. This study protocol describes a scoping review designed to systematically map and synthesize the available evidence on EO cancer incidence trends in Latin American populations. The review will be conducted in accordance with the JBI Manual for Evidence Synthesis and reported following PRISMA-ScR guidelines. A comprehensive search will be performed across multiple databases (PubMed, Embase, Scopus, LILACS, Cochrane, Web of Science), clinical trial registries, and gray literature sources without language or date restrictions. Studies reporting incidence data on solid tumors diagnosed before age 50 in Latin American countries will be included. Study selection and data extraction will be performed independently by four reviewers using a standardized form. Data will be analyzed through descriptive statistics and qualitative synthesis. The findings aim to highlight incidence patterns by cancer type, population characteristics, and methodological approaches. The final scoping review will present the search results, the study inclusion process, and the data analysis. This review will provide a consolidated epidemiological overview to inform public health policy, improve cancer surveillance, and identify research gaps in the region. This protocol was registered on the Open Science Framework (OSF). The registry number is OSF.IO/TZ67D. This registration ensures the transparency and credibility of our research process, as it provides a public record of our study design and methods.