Misogynistic Extremism: A Scoping Review

BackgroundArtificial intelligence (AI)–powered analysis of electrocardiograms (ECGs) is reshaping cardiac diagnostics, offering faster and often more accurate detection of conditions such as arrhythmias and heart failure. However, growing evidence suggests that algorithmic bias, defined as performance disparities across patient subgroups, may undermine diagnostic equity. These biases can emerge at any stage of the AI life cycle, including data collection, model development, evaluation, deployment, and clinical use. If unaddressed, they risk exacerbating health disparities, particularly in underrepresented populations and low-resource settings. Early identification and mitigation of such bias are essential to ensuring diagnostic equity.ObjectiveThis scoping review protocol outlines a structured approach to mapping the evidence on algorithmic bias in AI-enabled ECG interpretation. Following the population-concept-context framework and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidance, the planned review will systematically identify and categorize reported sources and types of bias, examine their effects on diagnostic performance across demographic and geographic subgroups, and document mitigation strategies applied throughout the AI life cycle. By synthesizing how bias and fairness considerations are handled in this field, this review aims to clarify existing evidence, highlight key gaps, and inform future efforts toward equitable and clinically trustworthy application of AI in cardiology.MethodsWe will conduct a comprehensive literature search across 5 electronic databases (PubMed, Embase, Cochrane CENTRAL, CINAHL, and IEEE Xplore) and gray literature sources. Eligible studies will include original research (2015-2025) evaluating the performance of AI-based ECG models across different subgroups or reporting on bias mitigation strategies. Two reviewers will independently screen studies, extract data using a standardized form, and resolve disagreements through consensus. This review will follow the PRISMA-ScR reporting framework.ResultsAt the time of submission, study identification and screening has been completed. Database searches conducted in August and September 2025 yielded 430 records, with an additional 18 records identified through other sources. After duplicates removal, 398 unique records remained. Title and abstract screening led to the exclusion of 250 records, and 148 articles proceeded to full-text review. Following full-text assessment, 110 articles were evaluated for eligibility, of which 38 studies met the inclusion criteria and were included in the qualitative synthesis. The study selection process is summarized in a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. Data extraction was conducted between November and December 2025.ConclusionsThis review will be the first to comprehensively map the landscape of algorithmic bias in AI-powered ECG interpretation. By identifying patterns of inequity and evaluating proposed solutions, it will provide actionable insights for developers, clinicians, and policymakers aiming to promote fairness in AI-enabled cardiac care.International Registered Report Identifier (IRRID)PRR1-10.2196/82486

IntroductionCOVID-19 vaccines are crucial for preventing severe illness from the virus. Despite their effectiveness; vaccine hesitancy, unequal access, and economic disparities hinder vaccination programs across Africa, posing significant challenges in Ethiopia.MethodThis scoping review followed the methodological guidelines outlined in the Joanna Briggs Institute Reviewer's and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) checklist and explanation to ensure transparency. To analyze the data, we developed tailored search strategies for key databases [HINARI, PubMed, Cochrane, African Journals Online (AJOL), and Science Direct] and gray literature sources. These strategies combined controlled vocabulary and relevant keywords. A descriptive thematic analysis was then employed to identify and categorize the various findings within the included studies. The results are presented in a narrative format, summarizing the key themes and providing a clear and comprehensive overview of the current evidence base.Results and recommendationsA review of 34 Ethiopian studies revealed significant COVID-19 vaccine hesitancy, with rates exceeding 50% in over 40% of the studies. The lowest hesitancy was found in adults from Addis Ababa (19.1%), while the highest rates were seen among healthcare workers in Oromia (69.7%) and pregnant women in Southwest Ethiopia (68.8%). Factors contributing to vaccine hesitancy in Ethiopia include being female, having only primary education, residing in rural areas, younger age, limited knowledge about the vaccine, reduced trust in authorities, and misperceptions about the risk of the virus. To address this challenge effectively, policymakers should prioritize interventions that build public trust, enhance awareness of the vaccine's benefits, and counter misinformation.

Gingival crevicular fluid (GCF) and oral fluid have emerged as promising diagnostic tools for detecting biomarkers. This review aimed to evaluate the existing literature on using oral fluids as a source of biomarkers for bone turnover diseases affecting the jawbone. A comprehensive search strategy was executed between August 2014 and August 2024 across five major databases (Web of Science, EBSCOhost Dentistry & Oral Sciences Source, Cochrane Library, Scopus, and PubMed) and grey literature sources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was applied. The screening was facilitated using Rayyan at rayyan.ai and Endnote X20 software tools, culminating in the evaluation of 14,965 citations from databases and 34 from grey literature. Following rigorous scrutiny, 37 articles were selected for inclusion in this review, encompassing diseases such as periodontitis, medication-related osteonecrosis of the jaw (MRONJ), and osteoporosis. The quality of the included observational studies was assessed using the Revised Risk of Bias Assessment Tool for Non-Randomized Studies (RoBANS 2). Interleukin-1 beta (IL-1β), sclerostin, osteoprotegerin (OPG), and interleukin-34 (IL-34) emerged as significant biomarkers in GCF, and they were mainly from periodontitis and osteoporosis. Osteocalcin (OC), IL-1β, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), OPG, and matrix metalloproteinase-9 (MMP-9) were significant in oral fluid or saliva, and they were from periodontitis, MRONJ, and osteoporosis. These findings underscore the potential use of oral fluids, which are regarded as non-invasive tools for biomarker identification in bone turnover. Many biomarkers overlap, and it is important to identify other specific biomarkers to enable accurate diagnosis of these conditions.

The objective of this review was to map the extent of literature on models and frameworks of reflective clinical supervision for midwives that embed concepts of cultural safety and trauma-informed practice, identifying key characteristics and knowledge gaps to guide future research. Reflective clinical supervision is gaining momentum as a potential strategy to support the well-being of midwives and improve quality of care. However, it is not routinely offered by maternity services, and evidence of established practice models is scarce. Additionally, a culturally safe midwifery workforce is a global priority, as culturally unsafe care contributes to poorer outcomes for First Nations mothers and babies. However, it is not known how models of reflective clinical supervision embed cultural safety and trauma-informed principles, particularly for midwives caring for First Nations women. This scoping review considered peer-reviewed original literature and gray literature that described models or frameworks of reflective clinical supervision for midwives. The context of the search was global midwifery practice; therefore, no geographical or date limitations were applied. Eligible settings included all systems in which midwives operate. A scoping review was conducted in accordance with the JBI methodological guidance and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A search strategy was adapted for each database and information source including APA PsycINFO (EBSCOhost), CINAHL (EBSCOhost), MEDLINE (EBSCOhost) and Cochrane Library. Sources of unpublished studies and gray literature searched included ProQuest Dissertations and Theses, Google and Google Scholar, and targeted searching of relevant government and health service websites. The search did not apply date or geographical limitations. The search was conducted between October 11, 2024, and November 18, 2024. After a pilot test of the screening process, data were extracted and analyzed using basic inductive qualitative content analysis. Data are presented narratively and in tabular and figure formats. Nineteen sources were included in the scoping review consisting of both primary research and clinical practice guidelines published between 2005 and 2024. Much of the literature originated from Australia (n=9) and the remainder from England, Ireland, New Zealand, Scotland, and Wales. Ten different models and frameworks of reflective clinical supervision used in midwifery were described, with no one-size-fits-all model of reflective clinical supervision identified. This scoping review identified 6 key characteristics of effective midwifery models of reflective clinical supervision: functions, guided reflection, safe reflective environment, session structure, trusting alliance, and supervisor characteristics. Cultural safety or trauma-informed practices for midwives were not embedded in any of the included models or frameworks. This review found that most models of reflective clinical supervision used for midwives were implemented in both nursing and midwifery contexts, with only a few models specific to midwifery contexts. Further research is needed to explore how the principles of cultural safety and trauma-informed practice are applied in reflective clinical supervision for midwives, especially those supporting First Nations women. OSF https://osf.io/vf73w.

Introduction:General practitioners (GPs) strive to use a patient centered approach to achieve shared decision making by integrating clinical evidence, clinical judgement, and patient priorities. In order to achieve this standard of care, GPs require relevant, up to date and high quality evidence. Currently there is a gap in the literature regarding the role of GP professional organisations internationally in producing and publishing evidence based guidance and clinical guidelines for GPs. This protocol outlines a scoping review to identify what evidence-based guidance is produced by general practitioner professional organisations internationally in terms of topic content, the structure and methods used to develop guidance and ways of disseminating this guidance, to support general practice clinical decision making.Methods:This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. Two researchers will search electronic databases (Medline, Embase, Cochrane Library and Scopus), grey literature sources and contact international GP professional organisations directly to identify appropriate studies for inclusion. Key information will be categorised and classified to generate a summary of the methods used internationally to develop and implement evidence-based guides for general practitioners and a narrative synthesis will be conducted.Conclusions:This scoping review will examine current practice internationally regarding the role of General Practice professional organisations in producing and publishing clinical guidelines and evidence based guidance to support general practitioner’s clinical decision making to benefit patient care.

Introduction: General practitioners (GPs) strive to use a patient centered approach to achieve shared decision making by integrating clinical evidence, clinical judgement, and patient priorities. In order to achieve this standard of care, GPs require relevant, up to date and high quality evidence. Currently there is a gap in the literature regarding the role of GP professional organisations internationally in producing and publishing evidence based guidance and clinical guidelines for GPs. This protocol outlines a scoping review to identify what evidence-based guidance is produced by general practitioner professional organisations internationally in terms of topic content, the structure and methods used to develop guidance and ways of disseminating this guidance, to support general practice clinical decision making.Methods: This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. Two researchers will search electronic databases (Medline, Embase, Cochrane Library and Scopus), grey literature sources and contact international GP professional organisations directly to identify appropriate studies for inclusion. Key information will be categorised and classified to generate a summary of the methods used internationally to develop and implement evidence-based guides for general practitioners and a narrative synthesis will be conducted.Conclusions: This scoping review will examine current practice internationally regarding the role of General Practice professional organisations in producing and publishing clinical guidelines and evidence based guidance to support general practitioner’s clinical decision making to benefit patient care.

Introduction: General practitioners (GPs) strive to use a patient centred approach to achieve shared decision making by integrating clinical evidence, clinical judgement, and patient priorities. This protocol outlines a scoping review to identify what evidence-based guidance is produced by general practitioner professional organisations internationally to support general practice clinical decision making. Methods: This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. Two researchers will search electronic databases (Medline, Embase, Cochrane Library and Scopus), grey literature sources and contact international GP professional organisations directly to identify appropriate studies for inclusion. Key information will be categorised and classified to generate a summary of the methods used internationally to develop and implement evidence-based guides for general practitioners and a narrative synthesis will be conducted. Conclusions: This scoping review will identify the role of GP professional organisations in generating, endorsing and/or disseminating evidence-based guidance for supporting general practitioner’s clinical decision making to benefit patient care.

Communication and Marketing Management in Patient Safety within Healthcare Organizations: A Scoping Review

Sound therapy methods have seen a surge in popularity, with a predominant focus on music among all types of sound stimulation. There is substantial evidence documenting the integrative impact of music therapy on psycho-emotional and physiological outcomes, rendering it beneficial for addressing stress-related conditions such as pain syndromes, depression, and anxiety. Despite these advancements, the therapeutic aspects of sound, as well as the mechanisms underlying its efficacy, remain incompletely understood. Existing research on music as a holistic cultural phenomenon often overlooks crucial aspects of sound therapy mechanisms, particularly those related to speech acoustics or the so-called "music of speech." This study aims to provide an overview of empirical research on sound interventions to elucidate the mechanism underlying their positive effects. Specifically, we will focus on identifying therapeutic factors and mechanisms of change associated with sound interventions. Our analysis will compare the most prevalent types of sound interventions reported in clinical studies and experiments. Moreover, we will explore the therapeutic effects of sound beyond music, encompassing natural human speech and intermediate forms such as traditional poetry performances. This review adheres to the methodological guidance of the Joanna Briggs Institute and follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist for reporting review studies, which is adapted from the Arksey and O'Malley framework. Our search strategy encompasses PubMed, Web of Science, Scopus, and PsycINFO or EBSCOhost, covering literature from 1990 to the present. Among the different study types, randomized controlled trials, clinical trials, laboratory experiments, and field experiments were included. Data collection began in October 2022. We found a total of 2027 items. Our initial search uncovered an asymmetry in the distribution of studies, with a larger number focused on music therapy compared with those exploring prosody in spoken interventions such as guided meditation or hypnosis. We extracted and selected papers using Rayyan software (Rayyan) and identified 41 eligible papers after title and abstract screening. The completion of the scoping review is anticipated by October 2024, with key steps comprising the analysis of findings by May 2024, drafting and revising the study by July 2024, and submitting the paper for publication in October 2024. In the next step, we will conduct a quality evaluation of the papers and then chart and group the therapeutic factors extracted from them. This process aims to unveil conceptual gaps in existing studies. Gray literature sources, such as Google Scholar, ClinicalTrials.gov, nonindexed conferences, and reference list searches of retrieved studies, will be added to our search strategy to increase the number of relevant papers that we cover. DERR1-10.2196/54030.

IntroductionHospital-based nurses and midwives play a pivotal role in promoting, protecting and supporting breastfeeding. However, variation in preservice education, in-service training and institutional policies contributes to inconsistent breastfeeding support across healthcare systems. Given the global push toward improving breastfeeding outcomes and the centrality of skilled nursing support, this scoping review protocol aims to systematically map the breadth, characteristics and reported outcomes of breastfeeding education and training initiatives targeting hospital-based nurses and midwives.Methods and analysisThis scoping review will be conducted in accordance with the methodological framework developed by Arksey and O’Malley and advanced by the Joanna Briggs Institute (JBI). A systematic search will be conducted across major databases including OVID Medline, CINAHL, Scopus and Web of Science, as well as grey literature sources. Studies will be selected using the Population–Concept–Context (PCC) framework, focusing on breastfeeding-related education and training interventions designed for nurses and midwives in hospital settings. Two independent reviewers will screen all titles, abstracts and full texts, extract data using a standardised tool and resolve discrepancies via discussion or third-party consultation. The extracted data will be analysed using descriptive statistics and thematic synthesis to identify trends, gaps and directions for future research. The literature search will be conducted between August and October 2025.Ethics and disseminationThis scoping review involves the analysis of existing literature and does not require ethical approval. The findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Results will be disseminated through peer-reviewed publication and presentations at nursing and maternal–child health conferences to inform educators, hospital administrators and policy makers involved in breastfeeding support and clinical education.

The objective of the review is to chart clinical signs and symptoms presented by solid organ recipients when serum levels of tacrolimus are supratherapeutic. Tacrolimus is the worldwide standard immunosuppressive agent used in post-solid organ transplantation. However, this narrow-index therapeutic drug can lead to acute toxicity at supratherapeutic serum levels (≥20 ng/mL). This clinical scenario evolves dynamically, making its diagnosis and urgent treatment difficult for transplant teams, while its sequelae are potentially serious and even fatal. Studies on solid organ recipients (heart, lung, kidney, liver) who had tacrolimus serum levels of ≥20 ng/mL and are aged ≥18 years will be considered for inclusion. There will be no limits on the care setting or geographic location. Studies on other types of transplants or studies where tacrolimus serum levels are not reported will be excluded. This review will follow the JBI methodology for scoping reviews, and the results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The following databases will be searched: MEDLINE (Ovid), Web of Science, Scielo (BIREME), LILACS (BVS), Embase (Ovid), CINAHL (EBSCOhost), Scopus, Cochrane CENTRAL, and the Cochrane Database of Systematic Reviews. Gray literature sources will also be searched. No date or language limits will be applied. Reports will be independently screened by 2 researchers. Signs and symptoms presented by patients during acute toxicity will be extracted from studies using a modified JBI data extraction tool. Data will be analyzed using descriptive statistics and the results presented in tabular and graphical formats, accompanied by narrative summaries. OSF osf.io/f7tzu/.

Background: Actions focused on age-friendly environments contribute to promote and maintain older people’s functional ability and may enable them to contribute to their communities and enjoy life. As such, age-friendly practices require collaboration between diverse stakeholders across multiple sectors responsible for natural, built, and social environments, which can be particularly relevant during public health emergencies when socio-ecological vulnerabilities become more salient and may disproportionally affect older people. This paper presents a protocol for a scoping review aiming to investigate the breadth of evidence concerning the development, implementation, and evaluation of age-friendly practices during the COVID-19 pandemic. The protocol sets out the objectives, methods, and dissemination plans for the review.Methods: The scoping review will be conducted in line with the Joanna Briggs Institute (JBI) scoping review methodology. We will search databases (PubMed, Web of Science, Embase, CINAHL, Scopus, PsychNet) and grey literature sources. Publications relating to practices across the 8 domains of the World Health Organization’s age-friendly cities and communities’ framework will be included. A tabular data extraction tool will be used to facilitate a narrative synthesis of results.Ethics and dissemination: Ethical approval is not required as the methods proposed for this scoping review consist of collecting publicly available data. Findingswill be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) and submitted to a journal for academic dissemination. Lay dissemination plans include an infographic and a blog-style article presenting our core results.Conclusion: The publication of this protocol allows for transparency in the systematic process of a scoping review focused on age-friendly practices during COVID-19.Findings emerging from the scoping review will provide insights into the evidence available regarding age-friendly activities during COVID-19 and may inform future age-friendly practices during public health emergencies and beyond.

Background: Internationally, the demand for gender-affirming care has increased exponentially in recent years. The clinical presentation of those seeking care has changed with an increase in transmasculine and non-binary identities and a decrease in the average age of those seeking care. Healthcare navigation remains complicated for this population and warrants further investigation in light of ongoing changes in the field. This paper presents a protocol for a methodological scoping review that aims to systematically map and synthesise the extent and nature of the peer-reviewed, published academic literature on the instruments used to assess factors relating to healthcare navigation and healthcare access for transgender and non-binary individuals seeking gender-affirming healthcare. Methods: This review will search databases (PsychINFO, CINAHL, Medline, and Embase.) and grey literature sources. In line with the methodological framework for scoping reviews, the following six stages will be undertaken: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarising and reporting results and (6) consultation. The PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation will be utilised and reported. The research team will undertake the study as outlined in this protocol and an expert panel of young transgender and non-binary youth will oversee the project through patient and public involvement. Conclusions: This scoping review has the potential to inform policy, practice, and future research through enhanced understanding of the complex interplay of factors that impact healthcare navigation for transgender and non-binary people seeking gender-affirming care. The results from this study will inform further research into healthcare navigation considerations generally and will inform a research project entitled “Navigating access to gender care in Ireland—a mixed-method study on the experiences of transgender and non-binary youth”.

The objective of this review is to map indicators used to evaluate and monitor the implementation of HIV pre-exposure prophylaxis (PrEP) in low- and lower-middle-income countries. Monitoring and evaluation indicators are essential to ensure the effective and equitable implementation of PrEP. However, it remains unclear which indicators are being applied in low- and lower-middle-income countries, where resource limitations and health system barriers may impact PrEP rollout and monitoring. This review will include primary and secondary studies, institutional documents, dissertations, and theses that present indicators related to the evaluation and monitoring of PrEP implementation in low- and lower-middle-income countries. Studies focused exclusively on injectable PrEP will be excluded. This scoping review will follow JBI methodology and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search will be conducted in 5 databases (PubMed, CINAHL, Scopus, Embase, and Biblioteca Virtual em Saúde) and gray literature sources (Google Scholar, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Global, and institutional websites). Studies in any language published from 2010 to the present will be included. Two reviewers will independently extract data using a customized data extraction form developed by the reviewers. The extracted information will be synthesized using a narrative approach, with results presented in tables, charts, graphs, and diagrams. OSF https://osf.io/r8k93/.

BackgroundDigital Health Interventions (DHIs) refers to the utilization of digital and mobile technology to support the health system in service delivery. Over the recent years, advanced computing, genomics, and artificial intelligence are considered part of digital health. In the context of the World Health Organization (WHO) global strategy 2020–2025, digital health is defined as “the field of knowledge and practice associated with the development and use of digital technologies to improve health.” The scoping review protocol details the procedure for developing a comprehensive list of DHIs in Sub-Saharan Africa and documenting their roles in strengthening health systems.Method and AnalysisA scoping review will be done according to the Joanne Briggs institute reviewers manual and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist and explanation. The protocol has been registered at the Open Science Framework (OSF) database at https://osf.io/5kzq7. The review will include DHIs conceptualized/developed/designed, adapted, piloted, deployed, scaled up, and addressing health challenges in Sub-Saharan Africa. We will retrieve data from the global DHI repository-the WHO Digital Health Atlas (DHA)- and supplement it with information from the WHO eHealth Observatory, eHealth Survey (2015), and eHealth country profiles report. Additional searches will be conducted in four (4) electronic databases: PubMed, HINARI-Reasearch4Life, Cochrane Library, and Google Scholar. The review will also include gray literature and reference lists of selected studies. Data will be organized in conceptual categories looking at digital health interventions' distinct function toward achieving health sector objectives.DiscussionSub-Saharan Africa is an emerging powerhouse in DHI innovations with rapid expansion and evolvement. The enthusiasm for digital health has experienced challenges including an escalation of short-lived digital health interventions, duplication, and minimal documentation of evidence on their impact on the health system. Efficient use of resources is important when striving toward the use digital health interventions in health systems strengthening. This can be achieved through documenting successes and lessons learnt over time.ConclusionThe review will provide the evidence to guide further investments in DHIs, avoid duplication, circumvent barriers, focus on gaps, and scale-up successful interventions.