Grey Literature Search Research Articles

Operationalising generalism in medical education: a narrative review of international policy and mission documents

ABSTRACT Introduction Despite moves across medical education to increase learning of generalist principles, a lack of clarity about what generalism means and how we should train doctors as ‘generalists’, has remained. This study explores how international, undergraduate and postgraduate, policy and educational mission documents characterise the practice and learning of generalism and how this can inform physician training. Methods A narrative literature review was conducted based on policy and mission documents identified through grey literature searches and a wider systematic review looking at empirical texts. Texts published between 1999 and present and related to ‘generalism’ were eligible for inclusion. Texts were coded and codes were reviewed and grouped into key themes. Results Thirty-four documents were included. Definitions vary: some described generalism as a basic skill, whilst others emphasised expertise. Factors which support learning generalism include: favourable financial outcomes; ageing populations; coordination of multidisciplinary care; demand for doctors with transferable skills; and patient expectations. Barriers to learning about generalism include: preference for specialisation; structure of undergraduate teaching and assessment; and the hidden curriculum. Solutions may include re-imagining generalists and specialists as being on a continuum as well as increasing exposure throughout medical education. Discussion Whilst generalism is consistently positioned as valuable, less clarity exists about how best to operationalise this in medical education. Fundamental ideological and structural changes within teaching curricula and assessment, are necessary to improve generalist learning and to promote sustainable practice. Medical education needs careful, considered planning to ensure workforce expertise is meeting population needs.

RISK FACTORS FOR FALL-RELATED MILD TRAUMATIC BRAIN INJURIES AMONG OLDER ADULTS: A SYSTEMATIC REVIEW

Abstract Mild traumatic brain injuries (mTBI) are commonly undiagnosed, which delays treatment and recovery. About 80% of older adults’ mTBIs stem from falls, yet factors driving fall-related mTBIs are unclear. This study aimed to systematically review risk factors for fall-related mTBIs among older adults. We used the Preferred Reporting Items for Systematic Reviews with Meta-Analysis protocol and the Meta-Analysis of Observational Studies in Epidemiology guidelines (Prospero ID: CRD42023377847). Our scope included prospective studies analyzing risk factors for fall-related mTBI in adults ≥ 60 years. The primary outcome measure was the relative risk for fall-related mTBIs, and secondary outcomes were: fall rate, total falls, and the number of fallers and non-fallers in those with and without a mTBI. On November 4, 2022, we searched: CINAHL Plus, and Health Source: Nursing Academic Edition, Nursing & Allied Health Database, PubMed, SPORTDiscus, and Web of Science. We conducted a grey literature search by examining reference lists of relevant studies. Two authors screened articles, and one author adjudicated any disagreements. Two authors would have assessed the reporting quality using the Strengthening the Reporting of Observational Studies in Epidemiology checklist, and the risk of bias using the Joanna Briggs Institute Prevalence Critical Appraisal tool. The database search yielded 410 articles; after deduplication, 395 titles and abstracts were screened, and 66 articles underwent full-text review. Overall, no studies were eligible. Fall-related mTBIs can have devastating consequences. There is an urgent need to identify risk factors for fall-related mTBIs in older adults to improve screening procedures and therapeutic intervention.

Truth-telling to the seriously ill child - Nurses' experiences, attitudes, and beliefs.

Nurses play an integral role in the care of children hospitalised with a serious illness. Although information about diagnostics, treatments, and prognosis are generally conveyed to parents and caregivers of seriously ill children by physicians, nurses spend a significant amount of time at the child's bedside and have an acknowledged role in helping patients and families understand the information that they have been given by a doctor. Hence, the ethical role of the nurse in truth disclosure to children is worth exploring. A systematic academic database and grey literature search strategy was conducted using CINAHL, Medline Psych Info, and Google Scholar. Keywords used included truth, children, nurse, disclosure, serious illness, and communication. A total of 17 publications of varying types were included in the final data set. As this was a review of the literature, there were no direct human participants. Empirical studies included in the review had received ethics approval. Of the 17 articles included in the review, only one directly reported on the experiences of nurses asked to withhold the truth from patients. Empirical studies were limited to HIV-positive children and children diagnosed with cancer and the dying child. A paucity of literature exploring the experiences, attitudes, and beliefs of nurses with regard to truth-telling to seriously ill children is evident. Little consideration has been given to the role nurses play in communicating medical information to children in a hospital setting. The 17 articles included in the review focused on cancer, and HIV, diagnosis, and end-of-life care. Further research should be undertaken to explore the experiences and attitudes of nurses to clinical information sharing to children hospitalised with a wide range of serious illnesses and in diverse clinical scenarios.

The steps that young people and suicide prevention professionals think the social media industry and policymakers should take to improve online safety. A nested cross-sectional study within a Delphi consensus approach

IntroductionConcerns exist about the relationship between social media and youth self-harm and suicide. Study aims were to examine the extent to which young people and suicide prevention professionals agreed on: (1) the utility of actions that social media companies currently take in response to self-harm and suicide-related content; and (2) further steps that the social media industry and policymakers could take to improve online safety.MethodsThis was a cross-sectional survey study nested within a larger Delphi expert consensus study. A systematic search of peer-reviewed and grey literature and roundtables with social media companies, policymakers, and young people informed the questionnaire development. Two expert panels were developed to participate in the overarching Delphi study, one of young people and one of suicide prevention experts; of them 43 young people and 23 professionals participated in the current study. The proportion of participants “strongly agreeing”, “somewhat agreeing”, “neither agreeing nor disagreeing”, and “somewhat disagreeing” or “strongly disagreeing” for each item were calculated; items that achieved =>80% of agreement from both panels were strongly endorsed.ResultsThere was limited consensus across the two groups regarding the utility of the safety strategies currently employed by companies. However, both groups largely agreed that self-harm and suicide-related content should be restricted. Both groups also agreed that companies should have clear policies covering content promoting self-harm or suicide, graphic depictions of self-harm or suicide, and games, pacts and hoaxes. There was moderate agreement that companies should use artificial intelligence to send resources to users at risk. Just over half of professionals and just under half of young people agreed that social media companies should be regulated by government. There was strong support for governments to require schools to educate students on safe online communication. There was also strong support for international collaboration to better coordinate efforts.DiscussionStudy findings reflect the complexity associated with trying to minimise the risks of communicating online about self-harm or suicide whilst capitalising on the benefits. However, a clear message was the need for better collaboration between policymakers and the social media industry and between government and its international counterparts

Identifying Existing Evidence to Potentially Develop a Machine Learning Diagnostic Algorithm for Cough in Primary Care Settings: Scoping Review.

Primary care is known to be one of the most complex health care settings because of the high number of theoretically possible diagnoses. Therefore, the process of clinical decision-making in primary care includes complex analytical and nonanalytical factors such as gut feelings and dealing with uncertainties. Artificial intelligence is also mandated to offer support in finding valid diagnoses. Nevertheless, to translate some aspects of what occurs during a consultation into a machine-based diagnostic algorithm, the probabilities for the underlying diagnoses (odds ratios) need to be determined. Cough is one of the most common reasons for a consultation in general practice, the core discipline in primary care. The aim of this scoping review was to identify the available data on cough as a predictor of various diagnoses encountered in general practice. In the context of an ongoing project, we reflect on this database as a possible basis for a machine-based diagnostic algorithm. Furthermore, we discuss the applicability of such an algorithm against the background of the specifics of general practice. The PubMed, Scopus, Web of Science, and Cochrane Library databases were searched with defined search terms, supplemented by the search for gray literature via the German Journal of Family Medicine until April 20, 2023. The inclusion criterion was the explicit analysis of cough as a predictor of any conceivable disease. Exclusion criteria were articles that did not provide original study results, articles in languages other than English or German, and articles that did not mention cough as a diagnostic predictor. In total, 1458 records were identified for screening, of which 35 articles met our inclusion criteria. Most of the results (11/35, 31%) were found for chronic obstructive pulmonary disease. The others were distributed among the diagnoses of asthma or unspecified obstructive airway disease, various infectious diseases, bronchogenic carcinoma, dyspepsia or gastroesophageal reflux disease, and adverse effects of angiotensin-converting enzyme inhibitors. Positive odds ratios were found for cough as a predictor of chronic obstructive pulmonary disease, influenza, COVID-19 infections, and bronchial carcinoma, whereas the results for cough as a predictor of asthma and other nonspecified obstructive airway diseases were inconsistent. Reliable data on cough as a predictor of various diagnoses encountered in general practice are scarce. The example of cough does not provide a sufficient database to contribute odds to a machine learning-based diagnostic algorithm in a meaningful way.

Contaminated sites and Indigenous peoples in Canada and the United States: A scoping review.

Indigenous communities are disproportionately exposed to contaminated sites, and this poses unique challenges as many Indigenous peoples consider land as an integral part of their culture and economy. This scoping review aimed to identify and map information on contaminated sites and Indigenous peoples in Canada and the United States, namely (1) the relationship between contaminated sites and Indigenous peoplesand their land and food systems; (2) strategies, challenges, and successes for contaminated sites assessment and management on Indigenous land; and (3) Indigenous leadership and inclusion in contaminated site assessment and management. We followed a PRISMA-ScR (Transparent Reporting of Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews) checklist to collect data that could be categorized into these three objectives. Between October 2021 and July 2023, information from three data streams was retrieved: a systematic literature search; a grey literature search; and federal site data retrieval (Canada's Federal Contaminated Sites Inventory, USEPA's contaminated sites databases, including Superfund). This search yielded 51 peer-reviewed articles, 21 grey literature articles, and 11 404 federal site records, evidencing the contamination of the lands of 875 Indigenous communities and the presence of 440 different contaminants or contaminant groups. The body of information was categorized into three themes within the above objectives: Objective 1: Indigenous communities and geographic patterns; Contaminated sites, sources, and media; Contaminated sites and Indigenous lands; Contaminated sites and Indigenous food systems; Contaminated sites and the health of Indigenous peoples; Objective 2: Site management and classification processes; Health risk assessment; Risk management; Long-term management; and Objective 3: Collaborative research, Collaborative site management; Traditional knowledge and contaminated sites. Results highlighted a need to prioritize holism, efficiency, and Indigenous leadership in site assessment, management, and research, including a focus on community-specific approaches to site assessment and management; a reconceptualization of risks that privileges Indigenous epistemologies; and greater collaboration between stakeholder networks. Integr Environ Assess Manag 2024;20:1306-1329. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

The changing epidemiology of preterm labour and delivery: A systematic literature review

AbstractObjectiveTo identify and synthesize epidemiologic data for preterm labour (PTL) and preterm birth (PTB).MethodsA systematic search, with protocol registered in PROSPERO, was implemented in MEDLINE and EMBASE and supplemented by web‐based and grey literature searches. Observational, population‐based studies in the United States, Canada, United Kingdom, France, Germany, Spain, and Italy, published in English between 2012 and 2022 were considered for inclusion. Estimates by country were reported and stratified by gestational age, birth plurality, and race/ethnicity, data permitting.ResultsTen publications and nine grey literature reports were included. Epidemiologic estimates of PTL were reported for the United Kingdom and France: PTL was diagnosed in 2.2% of pregnancies and preceded 50% of PTBs. PTB rates were reported for the United States, Canada, United Kingdom, France, and Spain. Among live births in these countries, annual PTB incidence ranged from 5.9% (Spain, 2020) to 10.2% (United States, 2019). Most countries reported the PTB incidence by gestational age; reports by birth plurality or race/ethnicity were scarce. PTB rates for Germany or Italy were not identified.ConclusionsWhile PTBs were well‐reported overall and by gestational age, how rates varied by plurality, race/ethnicity and etiology is unclear. Epidemiologic estimates for PTL, a leading cause of PTB, were rarely reported in the literature. Population‐based research is needed to understand the burden of PTL and for decision making regarding the management of this condition.

Closing the birth registration gap for Every newborn facility birth: literature review and qualitative research

ABSTRACT Background Birth registration is vital to provide legal identity and access to essential services. Worldwide, approximately 166 million children under five years (just under 25%) are unregistered, yet >80% of all births occur in health facilities in most low- and middle-income countries (LMIC). Objectives This study, conducted in association with UNICEF, aims to review facility-based birth registration initiatives, and provide recommendations to close the gap between facility birth and birth registration rates in LMIC. Methods A literature review covering published and grey literature was conducted to identify facility-based initiatives to increase birth registration rates. Semi-structured in-depth interviews were conducted by audio-call with six key global stakeholders to identify additional initiatives, and further insights for barriers and enablers to close the gap. Results Academic databases and grey literature search yielded 21 studies meeting pre-specified inclusion criteria. Nine barriers preventing birth registration were identified and grouped into three themes: health system, governmental, and societal barriers. Facility-based birth registration initiatives resulted in an increase in birth registration rates. Importantly, health promotion within communities also increased demand for birth registration. In-depth interview respondents provided further detail and supported data found in literature review. Synthesis of the literature and stakeholder interviews noted enablers including inter-sectoral collaboration between health sector and civil registration ministries e.g., placing civil registration offices in health facilities or allowing medical doctors to act as registrars. Conclusion Facility-based birth registration initiatives can increase birth registration rates in LMIC. Initiatives need to address both supply and demand side of birth registration to improve facility-based birth registration rates. A multi-sectoral approach within governments, and alignment with multiple stakeholders is vital.

Physical measures of physical functioning as prognostic factors to predict outcomes in low back pain: Protocol for a systematic review

Background Low back pain (LBP) is a highly prevalent condition that substantially impairs individuals’ physical functioning. This highlights the need for effective management strategies to improve patient outcomes. It is, therefore, crucial to have knowledge of physical functioning prognostic factors that can predict outcomes to facilitate the development of targeted treatment plans aiming to achieve better patient outcomes. There is no synthesis of evidence for physical functioning measures as prognostic factors in the LBP population. The objective of this systematic review is to synthesize evidence for physical measures of physical functioning as prognostic factors to predict outcomes in LBP. Methods The protocol is registered in the International Prospective Register of Systematic Reviews and reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Prospective longitudinal observational studies investigating potential physical prognostic factors in LBP and/or low back-related leg pain population will be included, with no restriction on outcome. Searches will be performed in MEDLINE, EMBASE, Scopus, CINAHL databases, grey literature search using Open Grey System and ProQuest Dissertations and Theses, hand-searching journals, and reference lists of included studies. Two independent reviewers will evaluate the eligibility of studies, extract data, assess risk of bias and quality of evidence. Risk of bias will be assessed using the Quality in Prognostic Studies (QUIPS) tool. Adequacy of clinical, methodological, and statistical homogeneity among included studies will decide quantitative (meta-analysis) or qualitative analysis (narrative synthesis) focused on prognostic factors and strength of association with outcomes. Quality of cumulative evidence will be evaluated using a modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Discussion Information about prognostic factors can be used to predict outcomes in LBP. Accurate outcome prediction is essential for identifying high-risk patients that allows targeted allocation of healthcare resources, ultimately reducing the healthcare burden. Registration PROSPERO, CRD42023406796.

The Relationship between Subjective Aging and Cognition in Elderly People: A Systematic Review.

There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures.

Healthy lives and well-being for all at all ages: expanding representations of determinants of health within systems dynamics and integrated assessment models

Integrated Assessment Models (IAMs) and System Dynamic Models (SDMs) are starting to incorporate representations of the impact of environmental changes on health and socio-economic development into their modelling frameworks. We use this brief review to provide an overview of how health and well-being are currently represented in IAMs and SDMs. A grey literature search on 12 selected model host websites and their corresponding Wiki pages was conducted. Model descriptions, coverage and publications were then tabulated. Additional potential determinants related to health were then suggested based on emerging environmental health literature. Based on these tabulations, it was determined that many individual health outcomes are not represented and thus not analyzed. Social well-being is not represented at all. Additionally, potentially health relevant determinants such as chemical or metal exposure and water pollution are rarely represented in models. Most models have representations of climate, outdoor air pollution and food availability. Air pollution was the most analyzed determinant, especially in relation to its respiratory effects. We suggest that future modelers incorporate more representations of environmental determinants influencing health, and to analyze all available determinants in relation to a wider array of health outcomes. Perhaps, if and when broader determinants of health are represented in IAMs and SDMs, then a composite of these determinants could be used to determine a population’s ability to achieve elements that also contribute to social well-being.

Oligodontia in the Clinical Spectrum of Syndromes: A Systematic Review.

The aim of this systematic review was to describe the clinical and genetic features of syndromes showing oligodontia as a sign. The review was performed according to the PRISMA 2020 checklist guidelines, and the search was conducted using PubMed, Scopus, Lilacs, Web of science, Livivo, and EMBASE and supplemented by a gray literature search on Google Scholar and ProQuest, applying key terms relevant to the research questions. The systematic review identified 47 types of syndromes in 83 studies, and the most common was hypohidrotic ectodermal dysplasia, which was reported in 24 patients in 22 studies. Other common syndromes that reported oligodontia included Axenfeld-Rieger syndrome, Witkop's syndrome, Ellis-van Creveld syndrome, blepharocheilodontic syndrome, and oculofaciocardiodental syndrome. The X-linked mode of inheritance was the most reported (n = 13 studies), followed by the autosomal dominant (n = 13 studies). The review describes the main syndromes that may have oligodontia as a clinical sign and reinforces the need for orodental-facial examining for adequate diagnosis and treatment of the affected patients. Molecular analysis in order to better understand the occurrence of oligodontia is imperative.

The “What” and “Why” of (Un)Ethical Evaluation Practice: A Meta-Narrative Review and Ethical Awareness Framework

There is growing recognition of the complex moral and ethical tensions associated with evaluation practice. However, there are scant evidence-informed frameworks for cultivating ethical awareness or informing ethical deliberation across the evaluation landscape. Thus, we aimed to synthesize research evidence on evaluation ethics, and draw on these findings to develop an evidence-informed evaluation ethics framework. Our methodological approach involved, first, conducting a meta-narrative review of empirical studies on evaluation ethics. Specifically, we conducted a systematic peer-reviewed and grey literature search, then identified, extracted, and thematically organize data from 20 studies that meet inclusion criteria. Second, in consultation with an ethicist, we curated findings on ethical concerns within an integrated evaluation ethics framework. Our results illustrate six thematic patterns of research inquiry on evaluation ethics and highlight trends, and gaps. The ethics framework (ACAP) we develop includes four multi-faceted categories. It outlines six Accountabilities (where ethical consideration is owed), illustrates how ethical Concerns can manifest in practice, and outlines diverse stakeholder groups’ Agency over the management of ethical concerns. Critically, it outlines five meta-categories of ethical principles (P) including systematic and transparent inquiry, accordant self-determination, fairness, beneficence and non-maleficence, and reflexive stewardship. Implications for priming ethical awareness, navigating ethical conflicts, and advancing evaluation ethics education and research are discussed.

Vocal tasks for acoustic and/or auditory perceptual analysis for discriminating individuals with and without voice disorders: a systematic review protocol

ObjectiveThe primary objective of the present systematic review is to: (1) identify the current vocal tasks being used for acoustic and/or auditory perceptual analysis to differentiate between individuals with and...

Psychosocial interventions promoting personal recovery in people with schizophrenia: a scoping review protocol

IntroductionPersonal recovery is an important aspect for many individuals diagnosed with schizophrenia, as people can live rich, fulfilling lives despite ongoing symptoms. Prior reviews have found several factors to be...

OP150 An Inventory Of Policy Levers For Influencing Appropriate Care

IntroductionHealthcare reform through appropriate care is a current focus for many jurisdictions. A variety of policy options, or “levers,” are available to decision makers to influence appropriate care. However, these levers are not always identified in advance of developing policy recommendations, and few direct, empirical analyses are available to support their selection. An appropriate care policy lever inventory was developed for health technology assessment (HTA) users in Alberta, Canada, to support HTA scoping and policy development.MethodsRelevant information was identified by a single reviewer through a scoping search of MEDLINE, forward and backward searching, and targeted gray literature searches. An Excel-based inventory was populated with a list of policy levers and their descriptions, policy effectiveness, and implementation considerations. Filters were developed to identify levers based on key characteristics. The inventory was iteratively refined through presentations to and feedback from key user groups.ResultsThe inventory contained 53 policy levers aiming to influence service provision, clinician behavior, fiscal policies, populations or organizations, and patient behavior. The levers varied in how they restrict decision-making. Few levers were considered high impact (>5% change to behavior, utilization, or cost) or well-supported (>10 studies reporting effectiveness). Stakeholders found the inventory information useful, particularly for considering potential levers not frequently utilized within their respective programs. A user guide and case examples were also developed to help users learn to navigate the inventory.ConclusionsAn inventory of policy levers, which can be tailored to specific clinical areas and topics, can be of assistance to healthcare decision makers developing and utilizing HTAs to improve appropriateness of care. With limited indication-specific evidence, policy makers must utilize the broader evidence base on appropriate care policy levers to select and implement strategies that are applicable and transferable to their context. Challenges remain in systematically identifying all relevant literature given the inventory’s breadth, and in updating the inventory to reflect new evidence.

Primary care nurse's role and educational preparedness in skin cancer screening and early detection: A scoping review.

To identify the available evidence regarding nursing roles in skin cancer screening and early detection and the reported education and training undertaken to do so. Scoping review, reported in accordance with PRISMA-ScR. A database search of Medline, CINAHL, Scopus, Embase, Emcare and JBI was conducted in November 2021. A grey literature search was conducted in February 2022. Searches were updated in August 2023. The data were extracted and synthesized into themes related to nursing roles and education. Of the 2285 identified studies, 54 were included in the review. Nursing roles included screening and early detection, prevention and patient education or counselling. Except for specialized nurse practitioners, nurses working in primary clinical care mostly engage in skin cancer supportive/administrative roles rather than leading collaborators in screening and early detection. The education and training for nurses were identified around themes of didactic education, clinical experience, training in dermoscopy, performance and knowledge assessment and self-efficacy. The roles and responsibilities of nurses working in skin cancer screening and early detection are highly variable, as are the reported training and education programmes. Little research has been conducted to explore this nursing role or the educational requirements needed for proficiency. With appropriate best practice education, it is within most primary care nurses' scope of practice to obtain competence in delivering opportunistic skin cancer screening. While most nurse specialists in dermatology will be proficient in dermoscopy and skin cancer screening, nurses who work in general practice are often underutilized due to a lack of opportunity and a clear pathway to becoming proficient in dermoscopic skin cancer screening. Most nurses involved in skin cancer screening are employed in advanced roles, and only a few studies investigating educational interventions utilized dermoscopy among advanced nurses. With specific training, nurses can work within their full scope of practice and increase access to skin cancer screening and early detection. Adhered to JBI Guidance for Conducting Systematic Scoping Reviews. Open Science Framework, https://doi.org/10.17605/OSF.IO/XUNE6 PATIENT OR PUBLIC CONTRIBUTION: N/A; a literature review.

The development and the use of gender-affirming online resources and games for gender-independent, intersex, non-binary, and transgender (GIaNT) children and youth: A scoping review protocol.

The objective of this scoping review protocol is to review what has been reported on the development and the use of gender-affirming online resources and games for gender-independent, intersex, non-binary, and transgender (GIaNT) youth (aged 9-26). GIaNT youth and their specialized health care needs are mostly exempt from curriculums. There is limited information on the specific online sources available for GIaNT children and youth. The inclusion criteria are sources that include GIaNT children and youth and focus on online spaces and games for the identified population. The Joanna Briggs Institute (JBI) method for scoping reviews has guided the development of this protocol. Databases to be searched include CINAHL, Cochrane, Epistemonikos, ERIC, Gender Studies Database, GenderWatch, LGBTQ+ Source, ProQuest, PyscInfo, and Scopus. Unpublished studies and gray literature searches will be undertaken in ProQuest thesis and dissertation and a limited number of relevant websites. No limit on date or region will be applied. Records will be screened and extracted by two independent reviewers. Results will be presented as tables with accompanying narrative summary. This scoping review protocol will guide the review and mapping of literature on available sources for online spaces and games for GIaNT children and youth.

Imaging Evaluation of Platelet-Rich Fibrin in Post-Exodontic Bone Regeneration: A Systematic Review.

Tooth extraction is the most common procedure in dental practice. However, in the long term, it may cause alveolar ridge atrophy. This systematic review aimed to evaluate the role of platelet-rich fibrin (PRF) in post-exodontic alveolar ridge preservation in terms of its effectiveness in the regeneration of bone tissue as assessed by imaging and its efficacy compared to physiological bone healing. The study is presented in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. This systematic review was conducted using electronic databases such as PubMed, Scopus, Web of Science, and Science Direct. The gray literature search was conducted in the New York Academy of Medicine Grey Literature Report. All the studies in this systematic review were randomized controlled trials (RCTs). The risk of bias was performed according to the Cochrane Handbook for Systematic Reviews of Interventions 6.2 (RevMan 6.2). Considering the inclusion and exclusion criteria, we included 17 randomized clinical trials published up to 2022 investigating the efficacy of PRF in post-exodontic bone regeneration. Based on the results of clinical studies, it can be stated that despite not being statistically significant, PRF promotes neoformation and prevents bone loss between three and four months post-extraction.

Monoclonal Immunoglobulin Deposition Disease - a Review of Current and Emerging Data

Introduction Monoclonal immunoglobulin deposition disease (MIDD) is a rare complication of abnormal B and plasma cells, characterized by non-fibrillar, Congo-red negative deposits of monoclonal immunoglobulin molecules. These include light chain (LCDD), heavy chain (HCDD), or combined (LHCDD), and can involve several organs, most notably the kidney. Clone directed treatments for MIDD, including chemotherapy and autologous stem cell transplantation (ASCT), are used to reduce abnormal immunoglobulin deposition and restore organ function. Organ transplantation is considered in select cases. However, data is limited in terms of prognosis, association of MIDD with other hematological disorders, and outcomes in the evolving treatment landscape. Objectives The primary aim of this scoping review is to identify and collate existing data on clinical manifestations, disease associations, and treatment options in MIDD. This will help provide evidence-based recommendations and inform future research. Methods We conducted a literature search through EMBASE, MEDLINE, and CINAHL. Identified studies were imported onto Covidence and screened by two independent reviewers. Primary studies of patients with MIDD were included. Conference abstracts and dissertations were included if they synthesized data on MIDD. Case reports, reviews, and guideline reports were excluded. Outcomes of interest include disease type, risk factors, systemic manifestations, natural history, and prognosis. Data was also collected on disease association, intervention (observation, immunosuppression, chemotherapy, ASCT, organ transplantation, novel agents), and prognostic variables. Standardized scoping review methodology and PRISMA guidelines were used for protocol development. Results A total of 16,673 records were identified through literature search, of which 125 were used. Most studies were case series, with larger retrospective cohort studies providing data on treatment options and transplantation in MIDD. Grey literature search was also performed and yielded no additional results. LCDD was identified as the most common MIDD subtype. Organ involvement was most commonly renal, followed by hepatic and cardiac. Study endpoints included overall survival, renal survival (i.e., time to initiation of renal replacement therapy), hematologic response, and organ response. Biochemical parameters such as serum creatinine and proteinuria were measured. Single organ involvement was more common than multi-organ, and disease response was primarily assessed using laboratory parameters. There was substantial heterogeneity in treatment. These included corticosteroids, plasma exchange, and chemotherapy - typically bortezomib-containing regimens - followed by ASCT in eligible patients. Renal response rates of up to 79% (n=28) were noted in a larger patient cohort. Patients who demonstrated renal response fared better than non-renal responders did (overall survival of 87% vs 60% at 27.3 months, n=255). In patients who underwent ASCT (either as consolidation or in the case of relapse/progression), most patients achieved hematologic CR (71%, n=14). ASCT was relatively well-tolerated, with early transplant-related mortality limited to one patient across 9 studies with data on ASCT (n=69). Patients appeared to have more favorable outcomes with MIDD/MGRS compared to MIDD in the setting of myeloma (VGPR/CR 58.9% vs 47.9%, n=255). Renal response appeared to correlate with deeper hematologic responses. Post renal transplant allograft loss has been noted upon MIDD relapse. Discussion Limited data exists on MIDD and its subtypes. Potential reasons include newer classification schema, low incidence, disease heterogeneity, need for histopathologic diagnosis, and frequently asymptomatic initial course. This scoping review outlines patient characteristics, disease subtypes, and outcomes with treatment options including ASCT and organ transplantation. MIDD appears to respond to chemotherapy and ASCT; however, responses depend on the subtype, associated disease process, and degree of organ involvement. Renal response may have significant prognostic implications. Limitations of this review include a paucity of prospective data, lack of studies using novel plasma cell-directed therapies, and small sample sizes. Further data analysis is ongoing, and emerging prospective data is of interest.