Artificial intelligence (AI) is increasingly being applied in breast cancer care, yet its use across the post-diagnosis phase remains poorly mapped. This scoping review aimed to identify and categorise AI applications in post-diagnosis breast cancer care, encompassing treatment planning, treatment delivery, follow-up and surveillance, survivorship, and palliative care. Following JBI methodology and PRISMA-ScR reporting guidelines, four databases (MEDLINE, EMBASE, CINAHL, and Web of Science) were searched, identifying 3784 records. After screening and full-text assessment, 54 studies published between 2016 and 2024 were included. Machine learning was the predominant technology (81%), followed by generative AI (7%), conversational agents (6%), traditional natural language processing (4%), and data mining (2%). Follow-up and surveillance were the most represented care stage (48%), driven primarily by recurrence prediction models. Most applications were provider-focused (83%), while patient-facing tools accounted for 17% of studies and relied on either conversational agents or generative AI. No studies addressed palliative care. The evidence base was predominantly retrospective (70%) and concentrated in high-income countries (74%). Future research should prioritise prospective evaluation in clinical workflows, address unsupervised patient use of generative AI, and ensure equitable development across diverse populations and care settings.

Abstract Background/Aims Arthritis places a growing global burden on both physical and mental health. Systematic reviews suggest that yoga, an ancient mind-body discipline, shows promise in easing symptoms and improving well-being. Despite this potential, few people with arthritis take it up. No prior synthesis has explained what drives some patients to embrace yoga while others avoid it. Therefore, this systematic review aimed to address that gap by synthesising existing evidence to uncover the barriers and facilitators that shape yoga practice in arthritis care. Methods JBI methodological guidance for qualitative systematic reviews was followed. MEDLINE, Embase, CINAHL Plus, PsycInfo, AMED, and Web of Science were searched to identify published studies, and ProQuest Dissertations and Theses for unpublished studies. Databases were searched from inception to 07 November 2024 without language restrictions. Two reviewers independently conducted study screening, methodological quality assessment, and data extraction. Data were synthesised using a meta-aggregative approach. Results Of 1330 identified records, nine articles, representing eight studies, were included. All studies were conducted in high-income countries (the USA, UK, and New Zealand), with a majority of female participants. Methodological quality ranged from moderate to high; six studies met at least seven of the ten quality assessment criteria. A total of 112 findings were extracted from the articles and grouped into 20 categories based on similarity in meaning. These were formulated into five synthesised findings: (i) Yoga, arthritis, and the body: the anticipated and experienced impacts of yoga on physical well-being influenced yoga practice; (ii) Yoga, arthritis, and the mind: levels of motivation and perceived impact on mental well-being influenced yoga practice; (iii) Yoga, arthritis, and the mind-body impact: yoga’s mind-body benefits supported coping with arthritis and encouraged continued practice; (iv) Yoga, arthritis, and session accessibility and structure: factors related to session accessibility and structure influenced engagement with yoga; and (v) Yoga, arthritis, and the session environment: a supportive social environment in yoga sessions impacted yoga practice. Conclusion This systematic review synthesised a range of barriers and facilitators to yoga practice among people living with arthritis. People recognise yoga’s physical, mental, and mind-body benefits, yet barriers related to accessibility, session structure, and social environment often limit participation. Importantly, facilitators outweighed barriers, suggesting strong potential for yoga to be integrated into arthritis care. For clinicians, the next step may be to actively support safe, accessible, and culturally sensitive yoga options by signposting patients to credible arthritis-specific yoga programmes. For patient organisations, a next step might be to work with yoga providers to adapt sessions for physical limitations and to encourage social and peer support within group settings to boost engagement. Future clinical pathways could consider embedding yoga as a complementary option alongside conventional treatments. Disclosure I. Biswas: None. P. Egwumba: None. C. Evans: None. K. Kumar: None. S. Lewis: None. K. Chattopadhyay: None.

Background:Effective doctor-patient communication is fundamental to safe, high-quality health care and is a core competency across undergraduate and postgraduate medical education. Communication skills training (CST) has traditionally relied on workforce-intensive methods such as role-play and standardized patient encounters, which face increasing pressure from rising student numbers, constrained faculty capacity, and growing clinical workloads. Digital technologies offer scalable, flexible alternatives, yet the extent, educational design, and strength of evidence supporting digital CST remain unclear. Objective:This study aimed to comprehensively map the digital technologies used for CST in undergraduate and postgraduate medical education, examine the reported outcomes in the context of educational theory, and identify gaps relevant for future research and clinical practice. Methods:This scoping review followed Joanna Briggs Institute (JBI) methodology and is reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Four electronic databases (Medline, Embase, CINAHL, ERIC) were searched from inception to January 5, 2026. Eligible studies examined any digital technology used to support active, 2-way CST for undergraduate or postgraduate medical learners. Passive learning approaches were excluded. Data were synthesized descriptively. To support structured interpretation of heterogeneous outcomes, interventions were mapped to Kolb's experiential learning cycle to examine learning processes and to Kirkpatrick's evaluation model to assess depth of educational and translational impact. Results:A total of 11,179 records were identified, of which 121 studies met the inclusion criteria. Most studies were published within the past decade (92/121, 76%) and were conducted in North America and Europe (93/121, 76.9%), with 58.7% (71/121) of studies focusing on undergraduate learners. Recording-based tools (51/121, 41.8%), live stream platforms (33/121, 27%), and virtual patient simulators (32/121, 26.2%) were the most used digital technologies. General communication and history taking was the most frequent topic taught. Only 28.1% (34/121) of studies used validated objective outcome measures. Educationally, digital interventions overwhelmingly supported early stages of experiential learning (120/121, 99.2%), with almost no progression to abstract conceptualization or active experimentation. Outcome evaluation was similarly limited in depth; most studies assessed outcomes at Kirkpatrick Levels 1 and 2. Few studies evaluated behavior change in clinical practice (6/121, 5%) or patient-level outcomes (1/121, 0.8%). A small but growing subset of studies incorporated artificial intelligence, primarily within virtual patient simulators, showing promising but methodologically limited evidence. Conclusions:Although digital CST interventions show promise for supporting early-stage learning outcomes, the evidence is constrained by weak study designs, inconsistent use of validated measures, and minimal real-world evaluation. Current technologies support only initial phases of experiential learning, with no evidence of progression to competency development or translation into improved patient care. For educators investing in digital CST, these technologies should be integrated thoughtfully within broader curricula rather than treated as standalone solutions, accompanied by evaluation extending to clinical outcomes. Future research that prioritizes robust comparative designs evaluating whether digital training meaningfully improves clinical communication and patient care is warranted.

BACKGROUND AND OBJECTIVES:The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews (ScRs) (PRISMA-ScR) was published in 2018 to provide reporting guidance. A substantial increase in published ScRs in recent years coupled with the omission or lack of engagement of interest-holders, including patients and public partners, as research partners throughout its development necessitate updating PRISMA-ScR. Important methodological advancements have emerged since PRISMA-ScR 2018, including automation and data extraction, which need to be incorporated into this update and reflected in new reporting items. Aligned with PRISMA 2020, this ScR underpins the update by identifying potential new reporting items for consideration from recent studies related to reporting guidance and the evaluation of reporting completeness in ScRs. METHODS:The protocol for this review was published and registered with the Open Science Framework and in a peer-reviewed journal. We conducted database searches in MEDLINE, Embase, and Cochrane Methodology Register and gray literature searches guided by the Canada's Drug Agency Gray Matters tool. Retrieved sources were screened in duplicate to assess eligibility. Included studies underwent data extraction with one extractor and one verifier. We summarized results and proposed additional PRISMA-ScR reporting items. RESULTS:Of the 8265 records screened, 43 unique documents (13 overviews of ScRs and 30 guidance documents) were included and extracted. Thirty-seven potential reporting items for ScRs were identified; these will be evaluated in a subsequent Delphi survey to inform the PRISMA-ScR update. The most common additional items were related to objectives (67.4%), eligibility criteria (62.8%), search strategy (51.2%), data collection process (53.5%), and results of synthesis (51.2%). Newly identified items included reporting the inclusion criteria using a suitable framework (e.g., Population, Concept, and Context), reporting protocol deviations in the final ScR, and visually presenting results along with relevant text to support the visuals. CONCLUSION:This ScR highlights gaps in existing PRISMA-ScR reporting guidance and provides additional reporting items for consideration and potential inclusion in an updated guideline. When aligned with the latest methodological advancements and involving interest-holders, including patients and public partners, the updated guideline will enhance the transparency and robustness of ScRs. PLAIN LANGUAGE SUMMARY:The goal of this project is to update the reporting guideline for ScRs. The reporting guideline is called PRISMA-ScR. ScRs collect and summarize information from many studies addressing a broad research question. They are useful because they help researchers see what is already known. They also find gaps in knowledge and inform what research should be conducted next. ScRs also help health-care workers, leaders, and policy makers make informed decisions. PRISMA-ScR is a guide to help researchers clearly explain the methods they used to conduct their ScR. Clear reporting of the methods used is important so readers can judge the quality of the review and know if they can be confident in the results. It allows other researchers to repeat the study to check if the results are reliable. Health professionals also use the information to guide patient care and healthcare planning. An update to PRISMA-ScR is needed for several reasons. 1. ScRs are not always reported in a clear or consistent way. This can make them hard to understand or use. 2. The original guideline from 2018 did not include patients or public partners. In this project, patients and public partners are involved throughout the entire process. Their experiences and perspectives help make the guideline more useful and relevant. 3. New methods for doing ScRs have been developed since 2018. The guideline needs to reflect these changes. To support the guidance update, researchers looked at current guidelines. They also completed a new ScR. They found 47 research papers that suggested 37 new reporting items. These items suggest there may be gaps in the existing guidelines. As a result, the new reporting items will be considered as part of the PRISMA-ScR update.

This article consists of a citation of a published article describing research funded by the Health and Social Care Delivery Research programme under project number NIHR134535, and is provided as as part of the complete record of research outputs for this project. The original publication is available at: https://doi.org/10.1136/bmjopen-2023-079153 The COVID-19 pandemic has led to increased use of digital clinical consultations (phone or video calls) within UK maternity services. This project aimed to review the evidence on digital clinical consultations in maternity systems to illuminate how, for whom and in what contexts, they can be used to support safe, personalised and equitable care. A realist synthesis, drawing on diverse sources of evidence (2010–present) from OECD countries, alongside insights from knowledge user groups (representing healthcare providers and service users). The review used three analytical processes (induction, abduction and retroduction) within three iterative stages (development of initial programme theories; evidence retrieval and synthesis; validation and refinement of the programme theories). Ninety-three evidence sources were included in the final synthesis. Fifteen programme theories were developed showing that digital clinical consultations involve different mechanisms operating across five key contexts: the organisation, healthcare providers, the clinical relationship, the reason for consultation and women. The review suggests that digital clinical consultations can be effective and acceptable to stakeholders if there is access to appropriate infrastructure/digital resources and if implementation is able to ensure personalisation, informed choice, professional autonomy and relationship-focused connections. The review found relatively less evidence in relation to safety and equity. Due to the complexity of maternity systems, there can be ‘no one-size fits all’ approach to digital clinical consultations. Nonetheless, the review distills four ‘CORE’ implementation principles: C—creating the right environment, infrastructure and support for staff; O—optimising consultations to be responsive, flexible and personalised to different needs and preferences; R—recognising the importance of access and inclusion; and E—enabling quality and safety through relationship-focused connections. Service innovation and research are needed to operationalise, explore and evaluate these principles, particularly in relation to safety and equity. CRD42021288702. This publication was funded by the Health and Social Care Delivery Research programme as a part of award number NIHR134535. This article reports on one component of the research award ARM@DA: A Realist Inquiry into Maternity Care @ a DistAnce. For more information about this research please view the award page [https://fundingawards.nihr.ac.uk/award/NIHR134535] https://doi.org/10.1136/bmjopen-2023-079153

INTRODUCTION:This article presents patient and public involvement and engagement (PPIE) work undertaken to explore FGM survivors' and stakeholders' views on reconstructive surgery, potential service models, care pathways, barriers to access and other support needs. The aim was to set research priorities, identify key themes and help inform subsequent research in the field. METHODS:A national research collective was established comprising over 20 stakeholders, including FGM survivors/women with lived experience, healthcare professionals, academics and advocacy groups. The group undertook two discussion workshops with FGM survivors (n = 11 participants), two national stakeholder events (n = 142 attendees) and significant advocacy and partnership-building activities. RESULTS:Key insights were that FGM survivors would value reconstructive surgery to address body image concerns, genital pain and sexual difficulties. Potential barriers to surgery included stigma, safeguarding concerns, lack of awareness and fear. Significant gaps were identified around women's knowledge of clitoral anatomy, FGM types and specialist services. Survivors and stakeholders emphasised the need to complement surgical reconstruction with a comprehensive care pathway including trauma counselling and psychosexual therapy. CONCLUSION:This study highlights the importance of a survivor-led approach to FGM service development, as often the voices of FGM survivors are not included. The exercise demonstrated that, with the right approach, it is possible to engage 'minoritised communities/individuals from the global majority' and communities dispayed considerable willingness to participate in this sensitive research field. It also emphasises an urgent need for accessible, high-quality FGM care informed by the voices of those affected, to improve outcomes and support for FGM survivors in the United Kingdom. PATIENT OR PUBLIC CONTRIBUTION:Women with lived experience of FGM and women from FGM-affected communities, as well as other national stakeholders (including Non Government Organisation's and charities working with FGM survivors, academics, artists and campaigners were involved in the design and conduct of this study, analysis and interpretation of the data and preparation of the manuscript.

Chronic illnesses (CIs) are increasingly prevalent among children/young people (CYP) globally. For migrant CYP with CIs, achieving a stable life in a new country can be particularly challenging due to additional barriers such as cultural and language differences, unsafe living conditions, and discrimination. While migration can sometimes improve healthcare access by introducing new models of care and ways of understanding health, these advantages are often outweighed by obstacles that hinder access to essential services. This review aimed to map the global evidence on post-migration experiences and outcomes of CYP with CIs and to identify priorities for research, policy, and practice to improve their care. A scoping review was conducted following JBI guidelines. We searched seven online databases, including MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL, Social Science Collection, and Web of Science, up to February 2024. Data were synthesised using a socio-ecological model, and four young migrants living with sickle cell disease in the UK contributed to the review through a Patient and Public Involvement Advisory Group. Of the 58 included papers, most focused on migration to high-income countries, particularly the USA, and used institutional records or case studies. Few studies provided detailed information about migration status or reason for migration, often using proxies like parental country of birth or language spoken. The socio-ecological model revealed disparities in health status, treatment access, and health outcomes for migrant CYP with CIs. Key challenges were language, communication, costs, bureaucracy, family dynamics, coordination issues, resource constraints, and socio-political influences. Significant gaps included a lack of intersectional analyses (e.g. accounting for ‘race’ and citizenship) and limited qualitative research capturing the lived experiences of migrant CYP with CIs. Migrant CYP with CIs face significant health disparities shaped by individual, social, and systemic factors. Addressing these challenges requires intersectional and qualitative research, alongside collaboration with policymakers, practitioners, and communities, to inform more equitable healthcare policies and practices.

The global burden of arthritis is high and increasing. Systematic reviews suggest that yoga, an ancient mind-body discipline, may help in arthritis treatment. This systematic review aimed to synthesise the barriers and facilitators to yoga practice in people with arthritis. JBI methodological guidance for qualitative systematic reviews was followed. MEDLINE, Embase, CINAHL Plus, PsycInfo, AMED, and Web of Science were searched to identify published studies, and ProQuest Dissertations and Theses for unpublished studies. Databases were searched until 07 November 2024, with no language restrictions. Study screening, assessment of methodological quality, and data extraction were completed independently by two reviewers. Data were synthesised using a meta-aggregative approach. Of 1330 identified records, nine articles, representing eight studies, were included in the review. All studies were conducted in high-income countries (the USA, UK, and New Zealand), with a majority of female participants. Methodological quality ranged from moderate to high; six of the eight studies met at least seven of the ten quality assessment criteria. 112 findings were extracted from the articles and grouped into 20 categories based on similarity in meaning. These were formulated into five synthesised findings: (i) Yoga, arthritis, and the body: the anticipated and experienced impacts of yoga on physical well-being influenced yoga practice; (ii) Yoga, arthritis, and the mind: levels of motivation and perceived impact on mental well-being influenced yoga practice; (iii) Yoga, arthritis, and the mind-body impact: yoga’s mind-body benefits supported coping with arthritis and encouraged continued practice; (iv) Yoga, arthritis, and session accessibility and structure: factors related to session accessibility and structure influenced engagement with yoga; and (v) Yoga, arthritis, and the session environment: a supportive social environment in yoga sessions impacted yoga practice. Each synthesised finding revealed a range of barriers and facilitators to yoga practice in people with arthritis. Within the included studies, there appeared to be more facilitators than barriers, suggesting that yoga could be a valuable addition to arthritis treatment. Future interventions to support yoga practice in this group should promote these facilitators and address the barriers to ensure successful implementation. PROSPERO registration number: CRD42023483350.

Many areas of healthcare are exploring the use of digital technologies with the aim of improving and expanding care to service users. In England, maternity care is currently undergoing a digital transformation in line with the National Health Service's (NHS) Long Term Plan, which seeks to enhance care delivery and accessibility through digital tools. However, there is a lack of data on the current use and practice of digital consultations across the country. This project aimed to map and explore how digital clinical consultations are currently being used by NHS maternity care services in England. An online survey was designed to capture data on current practice, guidance and procedures to address potential inequalities. The survey was distributed to each NHS Trust (n = 121) that provides maternity care (specifically to senior maternity care professionals and digital maternity leaders who could provide an overview of how digital consultations were being used where they worked). The survey was open between January and March 2024. 53 completed surveys were received representing 39 different organisations (32% of those currently providing maternity care in England). Quantitative summary statistics indicated that telephone consultations were the most commonly used digital modality across all stages of the maternity care pathway. Thematic analysis identified barriers such as a lack of staff consultation and lack of staff training on the use of digital consultations. It was uncommon for women to be asked about their consultation preferences or assessed for individual needs. In conclusion, the findings reveal significant variation in the use of digital consultations, highlighting a gap between policy intentions and practice. Key areas for improvement in the delivery and implementation of digital consultations include staff training, systems to record women's consultation preferences/needs, and more research to support digital inclusion. The findings of this survey have the potential to have applications beyond maternity care and in different geographical contexts.

Introduction Scoping reviews, mapping reviews and evidence and gap maps (collectively known as ‘big picture reviews’) in health continue to gain popularity within the evidence ecosystem. These big-picture reviews are beneficial for policy-makers, guideline developers and researchers within the field of health for understanding the available evidence, characteristics, concepts and research gaps, which are often needed to support the development of policies, guidelines and practice. However, these reviews often face criticism related to poor and inconsistent methodological conduct and reporting. There is a need to understand which areas of these reviews require further methodological clarification and exploration. The aim of this project is to develop a research agenda for scoping reviews, mapping reviews and evidence and gap maps in health by identifying and prioritising specific research questions related to methodological uncertainties.Methods and analysis A modified e-Delphi process will be adopted. Participants (anticipated N=100) will include patients, clinicians, the public, researchers and others invested in creating a strategic research agenda for these reviews. This Delphi will be completed in four consecutive stages, including a survey collecting the methodological uncertainties for each of the big picture reviews, the development of research questions based on that survey and two further surveys and four workshops to prioritise the research questions.Ethics and dissemination This study was approved by the University of Adelaide Human Research Ethics Committee (H-2024-188). The results will be communicated through open-access peer-reviewed publications and conferences. Videos and infographics will be developed and placed on the JBI (previously Joanna Briggs Institute) Scoping Review Network webpage.

The prevalence of viral hepatitis among people in prisons is higher than in the general population. Screening, treatment and vaccination programmes exist within prisons to reduce the incidence of hepatitis, although lower uptake has often been reported compared to similar programmes outside of prisons. We conducted a systematic review of qualitative evidence to explore the barriers and facilitators to hepatitis B and C reduction programmes in prisons from the perspectives of people in prison, custodial staff and prison healthcare staff. Comprehensive searches of five databases (to November 2023) yielded 28 studies for review inclusion. Four synthesised findings were identified: (i) accurate, up-to-date knowledge of viral hepatitis disease and treatment among people in prison and staff is a facilitator to programme uptake, particularly when imparted by a trusted source; (ii) personal subjective and relative views have a bearing on participation with the programme; (iii) social interactions and relationships both within the community of people in prison and between them and staff groups influence participation in the programmes; and (iv) the organisational structure of the prison and healthcare services within it affect programme participation. Based on these findings, we make recommendations for the adaptation of viral hepatitis programmes to individual custodial settings thereby improving equitable programme access and hepatitis B and C reduction in this complex environment.

Background:Digital transformation is a key component within the National Health Service Maternity Transformation Programme. The COVID-19 pandemic led to an acceleration of digital innovation, in particular, the use of digital clinical consultations (telephone/video consultations). The ways in which digital clinical consultations can be optimised and utilised alongside the traditional maternity care pathway remains unclear, however, with particular concerns about the potential for digital care to exacerbate inequalities. Objective:To explore how digital clinical consultations can be implemented in a clinically safe, appropriate and acceptable way within UK maternity services? For whom? In what settings? And for what purposes? Design:A realist synthesis combining an evidence review of diverse sources (2010 to the present) from Organisation for Economic Co-operation and Development countries with insights from key stakeholder groups (healthcare professionals, service users and community organisations). Data sources:There were three main sources: (1) published primary and secondary research; (2) grey literature (such as policy documents and maternity safety reports); and (3) stakeholder insights. Methods:A realist synthesis adopts a theory-driven approach which seeks to understand how a complex programme works, for whom and under what circumstances. The review had three iterative phases: (1) refining the review focus and developing initial programme theories; (2) retrieval of evidence for data extraction and analysis (using on a realist logic to identify key contexts, mechanisms and outcomes); and (3) testing and refining the programme theories. Results:The final synthesis included 93 evidence sources (reviews, reports and 77 primary studies), with priority given to UK-focused studies. Study samples included a focus on healthcare professionals (n = 17), women (n = 45, of which 14 focused on vulnerable groups) or both (n = 15). Clinical and safety-related outcomes were reported in 12 studies. Fifteen programme theories were developed. A conceptual framework was produced that illustrates the inter-relationship between key contexts in maternity care through which different interactions activate mechanisms to produce outcomes of interest. The findings suggest that digital clinical consultations can be acceptable and appropriate if implementation includes personalisation and informed choice for women, as well as support and autonomy for staff. The relationship and connection between women and their healthcare professional are proposed as key mechanisms that support safety and engagement in care. Limitations:Some of the evidence lacked details regarding specific settings, interventions or sample characteristics. This limits the extent to which findings can be applied to micro-level contexts. Stakeholder groups contributed key insights to the review at all stages. In spite of efforts to achieve diversity within these groups, there may have been experiences or identities that were missed. Conclusions:Four 'CORE' implementation principles were identified to guide future practice and research: C - Creating the right environment, infrastructure and support for staff; O - Optimising consultations to be responsive, flexible and personalised to different needs and preferences; R - Recognising the importance of access and inclusion; and E - Enabling quality and safety through relationship-focused connections. Future work:Future research should embed equity considerations and should focus on understanding digital clinical consultation within specific maternity systems (like triage/helplines), services (such as specialist outpatient clinics) or groups of women (e.g. with digital literacy or communication needs). Funding:This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research as award number NIHR134535.

Voluntary HIV testing and counselling (VCT) in the workplace could reach population groups who may be at risk for HIV but may not readily seek out testing from other services. We conducted a scoping review to understand (a) the nature of evidence related to initiatives and interventions for vocationally active adults on VCT in occupational settings, and (b) any facilitators and barriers to the delivery of and/or engagement with VCT initiatives/interventions in the workplace. JBI scoping review methodology was followed. The protocol was pre-registered. Included studies focused on vocationally active adults (population), VCT interventions or initiatives (concept), and workplaces in any sector or country (context). The review included studies published after 2000, in English, and of any research design. Studies relating to mandatory workplace HIV screening were excluded. MEDLINE, CINAHL, Scopus, PsycINFO, and the Cochrane Central Register of Control Trials were searched. Sources of grey literature included Google Scholar and governmental and organisational websites. One reviewer screened titles and abstracts; a second reviewer independently screened 10%. Data extraction utilised a modified JBI data extraction tool. We identified 17 studies reporting on 12 workplace VCT interventions (20,985 participants, 15–70 years). Studies were conducted in eight countries between 2001 and 2022. Interventions were delivered in organisations of different types, sizes and sectors. Testing included rapid blood tests and oral fluid self-tests. Where reported, the average on-site HIV testing uptake rate was 63%, and the average linkage to care rate was 86.85%. Views of workers, employers and service providers were largely positive. Barriers included being male, masculinity-driven workplace culture, HIV-related stigma, poor knowledge, low risk perceptions, lack of time and low support. Facilitators included on-site testing for convenience and accessibility, rapid and free tests, organisational, managerial and peer support, and embedding HIV tests within general health checks. Evaluation methods varied, although randomised trial designs were uncommon. Despite the limited number of studies, the workplace appears to be a viable route to the delivery of community-based VCT, albeit barriers should be addressed. Reporting quality of interventions and associated evaluations is variable and could be improved with the use of appropriate checklists.

Background Health care for women with Female Genital Mutilation/Cutting (FGM/C) in the Global North is often described as sub-optimal and focused on maternity care. Specialist FGM/C services have emerged with little empirical evidence informing service provision. The objective of this scoping review is to identify the key features of FGM/C specialist care. Methods The review was conducted in accordance with JBI methodology. Participants: organisations that provide specialist FGM/C care. Concept: components of specialist services. Context: high-income OECD countries. Eligibility criteria included primary research studies of any design from 2012 to 2022, providing a comprehensive description of specialist services. Seven bibliographic databases were searched (MEDLINE, EMBASE, CINAHL, Web of Science, SCOPUS, Cochrane Library and MIC). The components of "specialist" (as opposed to "generalist") services were defined and then applied to an analysis of FGM/C specialist care. FGM/C specialist provision was categorised into primary (essential) and secondary features. Data were extracted and analysed descriptively through charting in tables and narrative summary. Results Twenty-five papers described 20 unique specialist services across eleven high income countries. Primary features used to identify FGM/C specialist care were:-(i) Named as a Specialist service/clinic: 11/20 (55%); (ii) Identified expert lead: 13/20, (65%), either Midwives, Gynaecologists, Urologist, or Plastic Surgeons; (iii) Offering Specialist Interventions: surgical (i.e., reconstruction and/or deinfibulation) and/or psychological (i.e., trauma and/or sexual counselling); and (iv) Providing multidisciplinary care: 14/20 (70%). Eleven services (in Spain, Sweden, Switzerland, Germany, Italy, Netherlands, France, Belgium, and USA) provided reconstruction surgery, often integrated with psychosexual support. No services in UK, Norway, and Australia offered this. Six services (30%) provided trauma therapy only; 25% sexual and trauma therapy; 15% sexual therapy only; 30% did not provide counselling. Secondary features of specialist care were subdivided into (a) context of care and (b) the content of care. The context related to concepts such as provision of interpreters, cost of care, community engagement and whether theoretical underpinnings were described. Content referred to the model of care, whether safeguarding assessments were undertaken, and health education/information is provided. Conclusion Overall, the features and composition of FGM/C specialist services varied considerably between, and sometimes within, countries. Global guidelines advocate that specialist care should include access to deinfibulation, mental health support, sexual counselling, and education and information. The review found that these were rarely all available. In some high-income countries women cannot access reconstruction surgery and notably, few services for non-pregnant women mentioned safeguarding. Furthermore, services for pregnant women rarely integrated trauma therapy or psychosexual support. The review highlights a need for counselling (both trauma and psychosexual) and culturally-appropriate sensitive safeguarding assessments to be embedded into care provision for non-pregnant as well as pregnant women. Further research is needed to extract the features of specialist services into a comprehensive framework which can be used to examine, compare, and evaluate FGM/C clinical specialist care to determine which clinical features deliver the best outcomes. Currently a geographical lottery appears to exist, not only within the UK, but also across the Global North.

OBJECTIVE:This paper describes several automation tools and software that can be considered during evidence synthesis projects and provides guidance for their integration in the conduct of scoping reviews. STUDY DESIGN AND SETTING:The guidance presented in this work is adapted from the results of a scoping review and consultations with the JBI Scoping Review Methodology group. RESULTS:This paper describes several reliable, validated automation tools and software that can be used to enhance the conduct of scoping reviews. Developments in the automation of systematic reviews, and more recently scoping reviews, are continuously evolving. We detail several helpful tools in order of the key steps recommended by the JBI's methodological guidance for undertaking scoping reviews including team establishment, protocol development, searching, de-duplication, screening titles and abstracts, data extraction, data charting, and report writing. While we include several reliable tools and software that can be used for the automation of scoping reviews, there are some limitations to the tools mentioned. For example, some are available in English only and their lack of integration with other tools results in limited interoperability. CONCLUSION:This paper highlighted several useful automation tools and software programs to use in undertaking each step of a scoping review. This guidance has the potential to inform collaborative efforts aiming at the development of evidence informed, integrated automation tools and software packages for enhancing the conduct of high-quality scoping reviews.

BackgroundFemale genital mutilation (FGM) is a global public health concern. However, reconstructive surgery remains unavailable in many countries.ObjectivesThis scoping review, guided by Joanna Briggs Institute (JBI) principles, explores indications, referral routes, eligibility, care pathways and clinical outcomes of reconstructive surgery for FGM.Search strategyMedical Subject Headings (MeSH) terms and subject headings were searched in EMBASE, MEDLINE, SCOPUS, Web of Science and publicly available trial registers.Selection criteriaAny primary experimental and quasi-experimental study addressing reconstructive surgery for FGM, and its impact on women, published before June 2023.Data collection and analysisAfter removing duplicates from the search results, titles and abstracts were screened and data were extracted. Disagreements were resolved through panel discussion. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagram depicts the search results and inclusion process.Main resultsA total of 40 studies were included. Multidisciplinary teams were involved in 40% (16/40) of the studies, and psychosexual counselling was offered in 37.5% (15/40) of studies. Clitoral reconstruction using Foldes' technique was predominant (95%, 38/40). A total of 7274 women underwent some form of reconstruction. Post-surgery improvement was reported in 94% of the cases (6858/7274). The complication rate was 3% (207/7722 women with reconstruction).ConclusionsFurther research and clinical trials are needed. Although the outcomes suggest improved sexual function and quality of life post-surgery, the evidence remains limited. Advocating surgical reconstruction for survivors of FGM is vital for addressing health disparities and potential cost-effectiveness.

In 1999 Salverson asked how the participatory performance world could attend to the stories and experiences of those navigating the asylum system without reproducing configurations of power that compound individuals in simplistic terms as the 'injured' (51). Despite 'work on the intersections between performance and asylum ha[ving] proliferated' (Cox and Wake, Envisioning Asylum/Engendering Crisis: Or, Performance and Forced Migration 10 Years on. Research in Drama Education: The Journal of Applied Theatre and Performance 23(2): 137–147, 2018, 141) particularly over the last decade, this chapter argues that Salverson's concerns around an 'aesthetic of injury' (1999, 35) remain one of the most pressing representational issues within the field of refugee arts and performance work. To do so it embarks upon an analysis of the ways in which the issue emerged within two Glasgow-based participatory performance projects that formed part of my practice-based doctoral studies fieldwork during 2017–18. This chapter is narrated from the position of Artist-Researcher and puts Salverson's questions in conversation with Thompson's critique of the 'imperative to tell' (Performance Affects: Applied Theatre and the End of Effect. London: Palgrave Macmillan, 2011, 56) and Jeffers' theoretical work on 'bureaucratic performance' and the emergence of the 'endearing refugee' (Refugees, Theatre and Crisis: Performing Global Identities. London: Palgrave Macmillan, 2012, 44). These work as theoretical pillars through which to interrogate how staging suffering consistently arose and was negotiated with as a knotty, uncomfortable issue. As part of this analysis, the chapter reflects upon creative encounters that demonstrate how nuanced and careful practices can responsibily negotiate, and even dismantle, the call for aestheticised injury.

BACKGROUND AND OBJECTIVE:Scoping reviews are a type of evidence synthesis that aims to identify and map the breadth of evidence available on a particular topic, field, concept, or issue, within or across a defined context or contexts. Scoping reviews can contribute to clinical practice guideline development, policy making, reduce research waste by eliminating duplication of research effort, and be a precursor to a systematic review or inform further primary research. This article aims to provide a brief introduction of how to conduct and report scoping reviews. STUDY DESIGN AND SETTING:We will discuss the role and value of scoping reviews within the evidence synthesis ecosystem, the differences and similarities between these reviews and other types of evidence syntheses such as systematic reviews, mapping reviews, evidence and gap maps, and overviews, and how to overcome common challenges often associated in the conduct, reporting, and dissemination of scoping reviews. RESULTS:Scoping reviews have a role in the evidence ecosystem; however, we need to acknowledge their challenges. CONCLUSION:Scoping reviews are a popular form of evidence synthesis, and further research is needed to provide clarity of current methodological challenges.

ObjectivesSystematic reviews have long been seen as critical in the development of trustworthy guidelines. However, as newer synthesis methodologies such as scoping reviews become more common, there is a need to discuss the potential role of these methodologies within guideline development. This article aims to summarize and provide examples of the role of scoping reviews in guideline development.Study design and settingDrawing on the expertise of the JBI scoping review group and guideline developers, this discussion article summarizes five key roles of scoping reviews in guideline development.ResultsGuideline developers can consider using scoping reviews when they need to: 1) know what existing guidelines could be adopted, adapted or adoloped; 2) understand the breadth of evidence that exists on a particular issue and help with the development and prioritization of questions, or identify previous systematic reviews; 3) identify contextual factors and information relevant for a clinical practice recommendation; 4) identify potential strategies for implementation and monitoring and; 5) conduct evidence surveillance and living mapping approaches.ConclusionsScoping reviews conducted and reported according to best-practice guidelines and standards can be used in conjunction with systematic reviews to support the work of guideline developers usefully.