Conceptualization, operationalization, and measurement of machine companionship: a scoping review

BackgroundArtificial intelligence (AI) is often heralded as a potential disruptor that will transform the practice of medicine. The amount of data collected and available in health care, coupled with advances in computational power, has contributed to advances in AI and an exponential growth of publications. However, the development of AI applications does not guarantee their adoption into routine practice. There is a risk that despite the resources invested, benefits for patients, staff, and society will not be realized if AI implementation is not better understood.ObjectiveThe aim of this study was to explore how the implementation of AI in health care practice has been described and researched in the literature by answering 3 questions: What are the characteristics of research on implementation of AI in practice? What types and applications of AI systems are described? What characteristics of the implementation process for AI systems are discernible?MethodsA scoping review was conducted of MEDLINE (PubMed), Scopus, Web of Science, CINAHL, and PsycINFO databases to identify empirical studies of AI implementation in health care since 2011, in addition to snowball sampling of selected reference lists. Using Rayyan software, we screened titles and abstracts and selected full-text articles. Data from the included articles were charted and summarized.ResultsOf the 9218 records retrieved, 45 (0.49%) articles were included. The articles cover diverse clinical settings and disciplines; most (32/45, 71%) were published recently, were from high-income countries (33/45, 73%), and were intended for care providers (25/45, 56%). AI systems are predominantly intended for clinical care, particularly clinical care pertaining to patient-provider encounters. More than half (24/45, 53%) possess no action autonomy but rather support human decision-making. The focus of most research was on establishing the effectiveness of interventions (16/45, 35%) or related to technical and computational aspects of AI systems (11/45, 24%). Focus on the specifics of implementation processes does not yet seem to be a priority in research, and the use of frameworks to guide implementation is rare.ConclusionsOur current empirical knowledge derives from implementations of AI systems with low action autonomy and approaches common to implementations of other types of information systems. To develop a specific and empirically based implementation framework, further research is needed on the more disruptive types of AI systems being implemented in routine care and on aspects unique to AI implementation in health care, such as building trust, addressing transparency issues, developing explainable and interpretable solutions, and addressing ethical concerns around privacy and data protection.

Background: This paper has identified a gap in the extant Human Resource higher education literature in relation to the use of sustainable e-learning pedagogy. As such, a scoping review has been undertaken to draw conclusions to help narrow this gap. This review is timely, given the rise in e-Human Resource practices in organisations. Introduction: For Human Resource e-learning to be truly sustainable, consideration also needs to be given to the broader driving forces impacting its long-term viability in university provision. The objectives of this paper are focused on exploring the interdisciplinary nature of the context, challenges, benefits, and future directions of sustainable e-learning in tertiary education. Design: the methodological design is based upon the PRISMA extension for scoping reviews. Discussion: this scoping review also considers the emerging e-learning sustainability issues at the university level to determine if a full systematic literature review would be beneficial in the long term. Conclusions: this paper offers conclusions to support Human Resource researchers and educators who wish to push the boundaries of sustainable e-learning research. Future Direction: this paper also points to the speed of advances in AI and the need to move from a uni-generational to a multi-generational sustainable e-learning focus.

There is a growing global concern about the impact of tobacco smoke on our lungs. Therefore, it is important to identify, detect, and measure this impact to better understand it. However, it is also important to recognize that traditional methods such as questionnaires and observing smoking behaviour can have biases. With advances in technology, new methods for identifying smoking behaviour have emerged. A review paper, based on existing literature, investigates the role of technology—especially AI and ML—in understanding how tobacco smoke exposure affects the human respiratory system. This review follows the guidelines established by Joanna Briggs for review papers. The literature search was thorough, covering major databases like PubMed, Scopus, and Web of Science, using keywords such as "detection methods," "AI," "environmental sensors," and focusing on studies from 2020 to July 2025. Out of 36 articles identified, after removing duplicates and screening titles and abstracts, 9 articles remained that met the full-text review and inclusion criteria. These articles discuss detection techniques involving wearable sensors, ambient sensors, and predictive algorithms that enable continuous monitoring for accurate detection of tobacco exposure. Scientific evidence confirms the link between tobacco smoke exposure and respiratory diseases, including COPD, along with their symptoms and decreased lung function. Advances in AI and sensor technologies hold promise for the detection and identification of tobacco use and related diseases, including tobacco-related respiratory conditions.

Purpose Virtual rehabilitation (VRehab) offers alternatives to traditional therapy, overcoming barriers like distance, cost, and clinician access. This scoping review examines how digital avatars are used in adult rehabilitation and their impact on health outcomes. Materials and methods We systematically searched Medline, Embase, CINAHL, Web of Science, Engineering Village, IEEE Xplore, and ACM Digital Library. After screening 3,877 unique titles and abstracts and 190 full-text studies, 45 studies were included. Data were charted on study characteristics, health outcomes, avatar features, ethics, AI, and co-design. Results Avatars were most used in stroke (48.8%) and amputee rehabilitation (15.5%), primarily for motor function, gait, and pain. Most employed humanoid avatars on screens or mobile devices, providing real-time feedback. Many reported improved function, adherence, or engagement, though few used advanced AI, privacy measures, or co-design. Standardized assessments were rarely applied. Conclusions Avatar-based rehabilitation shows promise to enhance health outcomes and engagement. Further work should explore long-term effects, ethics, privacy, AI-driven personalization, and integration with health systems.

ChatGPT, as the pioneer of advanced generative AI tools, has triggered scholarly discussions about the potential use of such AI technologies in interdisciplinary fields. With a focus on the surge of AI-related preprints since the introduction of ChatGPT by OpenAI, the study investigated what the surge implies for AI literature, particularly in terms of credibility and quality. A scoping review was initially conducted to study the characteristics of the AI-related preprints in the Web of Science (WoS) database and also in five (5) preprint platforms (ArXiv, MedRxiv, SocArxiv, SSRN, and Research Square). The publication date range was set at January 01, 2023 to September 08, 2023. This was followed up by an interpretive phenomenological analysis (IPA) of the perceptions of experts in the AI field about the preprints. Employing a scoping review of AI-related preprints across six databases and a qualitative analysis of 15 AI experts’ opinions, our study reveals concerns about the research accuracy, quality, and credibility of preprints, and advocates for a robust evaluation and high-quality assurance process to promote open science objectives during their dissemination. Specifically, 45,918 AI-related preprints were found in the six preprint databases or repositories across different fields. The nine themes from the IPA showed that preprints can be of value. However, experts advocated for the safe and responsible use of AI-related preprints, involving such tenets as maintaining ethical integrity and high-quality work on the part of authors and establishing sound AI-content guidelines from publishers and editors. Future studies are recommended to investigate the impact of preprints on decision-making processes in educational research and practice.

Ben Goertzel argues that humans operate within paraconsistent ethics. There are two arguments: 1. Moral para-consistency viewed primarily as resulting from deeply rooted tensions between individuation and self-transcendence (or autopoiesis versus evolutionary fitness). 2. Paraconsistency due to human cognitive limitations (we would need massively stronger cognitive functions to handle our lives consistently). This is directly relevant for AI since advanced humanoid AIs and AGIs should follow paraconsistent norms for easier human-AI interactions. This is also indirectly relevant, in a broader ontological framework, where Goertzel analyzes paraconsistent foundations for quantum probability, programming, and concept formation. Paraconsistence in these domains does not seem to result from weakness of human cognitive functions, manifestly in quantum physics. Those paraconsistencies seem relationally veridical. Yet, in his explanations of ontological paraconsistency, Goertzel 2021a follows Weber in focusing on sorties kind of problems; this creates an impression that the issues of fuzziness are the gist of Goertzel’s paraconsistent approach to AI. Yet, this is more of a heuristic start for Goertzel. Paraconsistency is not always at the boundaries, but at the core of nimble complex systems. We argue that, at least in ethics, paraconsistency is primarily based on alternative objectives or sources of value (following Goertzel’s argument 1; also Ross, Haidt, Dancy, Sen); ethical problems based upon vagueness in boundary conditions, though important and interesting, are less central to the metaethical dimension of paraconsistency, and therefore to the logical make-up of future AIs.KeywordsParaconsistent ethicsParaconsistent AGINon-homogenous moral spaceBen GoertzelAmartya Sen

We mapped key concepts and identified 4 fundamental nursing interventions for patients with neurogenic bowel dysfunction due to complete spinal cord injury (SCI). A scoping review was conducted according to the recommendations of the Joanna Briggs Institute. Searches were performed in PubMed, LILACS, CINAHL, COCHRANE, and SCOPUS electronic databases. We use searched the gray literature using the Google Scholar search engine. We formulated a question to guide the search, based on the participants, concept, and context format: "What are the key manual nursing interventions performed in patients with neurogenic bowel dysfunction resulting from complete spinal cord injury?" We included nursing intervention strategies that may be performed by health professionals, patients, or caregivers. Two reviewers independently participated in the selection; disagreements were resolved by a third reviewer and 5 experts. Thirteen studies conducted between 1998 and 2019 were selected; 5 were randomized clinical trials. Four main interventions were identified for conservative management of neurogenic bowel dysfunction in patients with complete SCI. They were digital-anal stimulation, manual extraction of feces, abdominal massage, and strategies used to stimulate the gastrocolic reflex. Research suggests that each of these interventions, administered alone or in combination, supports bowel evacuation in patients with a complete SCI. Each of these interventions may be performed by a nurse, and taught to the patient and/or lay caregiver. An individualized bowel management program for patients with neurogenic bowel dysfunction due to SCI is necessary to ensure regular bowel evacuation, preserve fecal continence, and support dignity and health-related quality of life. The conservative interventions identified in this scoping review should be incorporated in protocols or guidelines for management of neurogenic bowel dysfunction in this vulnerable population.

Disengagement from care among people with HIV (PWH) and hepatitis C (HCV) increases the risks of adverse health outcomes and poses significant barriers to achieving global HIV and HCV elimination goals. In accordance with the Joanna Briggs Institute framework, a scoping review was conducted to synthesize and highlight existing gaps in the literature on (dis)engagement in care among PWH and HCV. We searched for original studies on (dis)engagement in care among PWH and HCV in high-income countries using eight electronic databases from inception to May 2023. Our search yielded 4462 non-duplicated records, which were scoped to 27 studies. Definitions of (dis)engagement in care were diverse, with considerable heterogeneity in how retention was operationalized and temporally measured. Studies identified predictors of (dis)engagement to be related to drug and substance use (n = 5 articles), clinical factors (n = 5), social and welfare (n = 4), and demographic characteristics (n = 2). When engagement in care was treated as an exposure, it was associated with HCV treatment initiation (n = 3), achieving sustained virological response (n = 2), and maintaining HIV viral suppression (n = 1). Interventions to improve care engagement among PWH and HCV were limited to five studies using cash incentives (n = 1) and individual case management (n = 4). (Dis)engagement in care is a dynamic process influenced by shifting priorities that may 'tip the balance' towards or away from regularly interacting with healthcare professionals. However, inconsistent definitions render cross-study comparisons and meta-analyses virtually impossible. Further research needs to establish a standardized definition to identify patients at high risk of disengagement and develop interventions that leverage the nested HIV/HCV care cascades to retain and recover patients lost from care.

Chronic Kidney Disease (CKD) has been recognized as one of the main public health problems worldwide, with an estimated global prevalence of 13.4%. Prevention strategies to contain the increase in CKD cases are presented as the best solution, placing Primary Health Care (PHC) with an important role in facing this problem. The Unified Health System (SUS), recognized for its advances, still has difficulties in overcoming the intense fragmentation of health actions and services and qualifying care management. In this context, in 2010, guidelines for the organization of Health Care Networks (HCN) in SUS were published, with the proposal to innovate the process of organizing the health system to produce a positive impact on the population's health indicators. In 2014, the Clinical Guidelines for the Care of Patients with CKD were published in SUS and the criteria for the organization of the Care for People with CKD, which is contained in the Care Network for People with Chronic Diseases. The objectives of this study were to analyze the concept of RAS and carry out an evaluability study (AE) about the implementation of the line of care for the Chronic Kidney Disease. Methodological path: Evaluative research with quantitative and qualitative data. To achieve the first objective, a scope review was carried out and for the evaluability study, the theoretical framework of McLaughlin and Jordan was used. The evaluability study scenario was the Health Region of the Aqufero Guarani, composed of 10 municipalities, covering a population of 945,738 inhabitants. The study was approved by the Research Ethics Committee CEP / CSE-FMRP-USP (CAAE: 58545116.3.0000.5414) Results: 29 key characteristics present in the RAS concept were mapped, which express complementarity in the formation of the RAS concept. Regarding the evaluability study, the Logical Model of the Care of the Person with CKD and a normative evaluation matrix for the implementation of that care in PHC were built.

The Full Spectrum of Behavioral Activation in Older Adults: A Scoping Review

The prevalence of type 2 diabetes mellitus (T2DM) and associated morbidity and mortality are increasing in sub-Saharan Africa (SSA). To facilitate access to quality care and improve treatment outcomes, there is a need for innovative community care models and optimized use of non-physician healthcare workers bringing diagnosis and care closer to patients' homes. We aimed to describe with a scoping review different models of community-based care for non-pregnant adults with T2DM in SSA, and to synthesize the outcomes in terms of engagement in care, blood sugar control, acceptability, and end-organ damage. We further aimed to critically appraise the different models of care and compare community-based to facility-based care if data were available. We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus, supplemented with backward and forward citation searches. We included cohort studies, randomized trials and case-control studies that reported on non-pregnant individuals diagnosed with T2DM in SSA, who received a substantial part of care in the community. Only studies which reported at least one of our outcomes of interest were included. A narrative analysis was done, and comparisons made between community-based and facility-based models, where within-study comparison was reported. We retrieved 5,335 unique studies, four of which met our inclusion criteria. Most studies were excluded because interventions were facility-based; community care interventions described in the studies were only add-on features of a primarily facility-based care; and studies did not report outcomes of interest. The included studies reported on a total of 383 individuals with T2DM. Three different community care models were identified. 1) A community-initiated model where diagnosis, treatment and monitoring occurred primarily in the community. This model reported a higher linkage and engagement in care at 9 months compared to the corresponding facility model, but only slight reductions of average blood glucose levels at six months compared to baseline. 2) A facility-originated community model where after treatment initiation, a substantial part of follow-up was offered at community level. Two studies reported such a model of care, both had as core component home-delivery of medication. Acceptability of this approach was high. But neither study found improved T2DM control when compared to facility care 3) An eHealth model with high acceptability scores for both patients and care providers, and an absolute 1.76% reduction in average HbA1c levels at two months compared to baseline. There were no reported outcomes on end-organ damage. All four studies were rated as being at high risk for bias. Evidence on models of care for persons with T2DM in SSA where a substantial part of care is shifted to the community is scant. Whereas available literature indicates high acceptability of community-based care, we found no conclusive data on their effectiveness in controlling blood sugar and preventing complications. Evidence from larger scale studies, ideally randomized trials with clinically relevant endpoints is needed before roll-out of community-based T2DM care can be recommended in SSA.

Purpose Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision. Design/methodology/approach This scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings. Findings Three key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3. Research limitations/implications This review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts. Practical implications On hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity. Social implications Service users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care. Originality/value This is the first review to systematically synthesis consumers perspectives on the extent to which service providers are achieving the goal of implementing recovery-orientated practice into their service provision. Despite important policy changes, the findings of this review demonstrate that more work is needed to truly operationalise and translate these principles into practice.

Pediatric patient and family engagement is an active and collaborative process, that involves children, adolescents, and family members with lived experience contributing to the design, implementation, and evaluation of healthcare services. Prior studies have highlighted the patient engagement methods and impact in clinical care, education, and research. However, gaps remain in understanding the commonalities and distinctions of engagement approaches, patient/family partner roles, and outcomes in clinical care, education, and research contexts. Further, research examining the nuances of pediatric patient and family engagement within healthcare delivery, education, and research in pediatric institutions is needed to streamline efforts. This scoping review will identify the commonalities of and distinctions between pediatric patient and family engagement in clinical care, education, and research contexts in pediatric healthcare institutions. A scoping review, conducted in collaboration with a team of adolescent, young adult, and family partners, will allow us to systematically map out key concepts, evidence, and knowledge gaps regarding pediatric patient and family engagement in clinical care, education, and research. We will follow the Joanna Briggs Institute framework in the design and conduct of the review and guidance on engaging knowledge users within scoping reviews. The protocol for this scoping review has been registered with the Open Science Framework database (https://osf.io/63qx5). This study will describe the engagement types, approaches, and outcomes of pediatric patient and family engagement employed within clinical care, education, and research settings, highlighting commonalities and distinctions across contexts. In doing so, it will identify potential opportunities for collaboration and resource-sharing based on the context of engagement and provide needed clarity on streamlining pediatric patient and family engagement approaches within pediatric institutional settings. It is anticipated that the results will produce preliminary evidence of relevance to pediatric institutions seeking to consolidate engagement practices across clinical care, education, and research domains.

ObjectivesMaximising social workers’ contributions to primary care requires clarity about their scope of practice in this context. This scoping review sought to clarify what is known about social work’s scope...

Complex metabolic dysregulation leads to metabolic syndrome (MetS) causing various symptoms such as type II diabetes, central obesity, cardiovascular diseases (CVD), altered glucose metabolism, hypertension, and dyslipidemia, and is thought to be influenced by a number of factors, including migration from rural to urban areas. socioeconomic changes, and a sedentary lifestyle. Therefore, the primary goal of this scoping review was to determine the prevalence of MetS and its components as well as to understand the association between MetS and menopausal symptoms in post-menopausal women. The search strategy included articles that were published from 2010 onwards in MEDLINE/PubMed, Scopus, and Web of Science databases. The eligibility criteria included population, concept and context (PCC) format and based on it, 10 articles were included in this review. The review concluded that in comparison to pre-menopausal women, MetS is more common in post-menopausal women who are likely to experience somatic complaints and positive correlation of vasomotor symptoms with MetS. Hence, post-menopausal women can be counselled regarding menopausal symptoms related to MetS for which appropriate and adequate treatment or measures should be taken.