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Refereed/Peer-reviewed Background: There is a recognized need for evidence to inform breast cancer screening guidelines and services for transgender people, who face barriers to accessing appropriate and inclusive health care. Aims: This review summarized evidence for breast cancer risk and screening guidelines in transgender individuals, including the potential impact of gender-affirming hormone therapy (GAHT); factors that may influence screening decision-making and behaviors; and considerations for providing culturally safe, high-quality screening services. Methods: A protocol was developed based on the Joanna Briggs Institute scoping review methodology. Searches were performed in Medline, Emcare, Embase, Scopus, and the Cochrane Library for articles reporting information on the provision of culturally safe, high-quality breast cancer screening services for transgender people. Results: We identified 57 sources for inclusion: 13 cross-sectional studies, 6 case reports, 2 case series, 28 review or opinion articles, 6 systematic reviews, 1 qualitative study, and 1 book chapter. Evidence on rates of breast cancer screening among transgender people and the association between GAHT and breast cancer risk was inconclusive. Factors negatively associated with cancer screening behaviors included socioeconomic barriers, stigma, and lack of health provider awareness of transgender health issues. Breast cancer screening recommendations varied and were generally based on expert opinion due to the lack of clear evidence. Considerations for providing culturally safe care to transgender people were identified and mapped to the areas of workplace policies and procedures, patient information, clinic environment, professional conduct, communication, and knowledge and competency. Discussion: Screening recommendations for transgender individuals are complicated by the lack of robust epidemiological data and clear understanding of the role GAHT may play in breast cancer pathogenesis. Guidelines have been developed based on expert opinion and are subsequently not uniform or evidence based. Further work is required to clarify and consolidate recommendations.

Scoping reviewers often face challenges in the extraction, analysis, and presentation of scoping review results. Using best-practice examples and drawing on the expertise of the JBI Scoping Review Methodology Group and an editor of a journal that publishes scoping reviews, this paper expands on existing JBI scoping review guidance. The aim of this article is to clarify the process of extracting data from different sources of evidence; discuss what data should be extracted (and what should not); outline how to analyze extracted data, including an explanation of basic qualitative content analysis; and offer suggestions for the presentation of results in scoping reviews. Refereed/Peer-reviewed

The Australian Royal Commission into Aged Care Quality and Safety made 148 recommendations to reform Australian aged care. The recommendations concerning the sector's workforce are integral to ensuring that the widespread neglect and failures characterising the sector be addressed and prevented. This paper discusses several of the Commission's recommendations in relation to issues that we see as foundational for ensuring sustained success of urgent sector-wide reform. We focus on mandated staffing levels and skills mix, attraction and retention, education and training, staff registration, and funding transparency and accountability. Refereed/Peer-reviewed

The Royal Commission’s recommendation for nursing home minimum time standards and the Australian Government’s response do not support best practice resident care. We recommend that higher mandated minimum staffing levels and skills mix should be phased in by mid-2026. What is known about the topic? The Australian Government has not committed to fully implementing the Commission’s recommendations for mandated minimum staff time standards. What does this paper add? We highlight issues with the Commission’s recommendations and the Australian Government’s response where they do not support sufficient minimum time to provide best practice care. What are the implications for practitioners? Mandated evidence-based minimum staffing levels and skills mix should be phased in by mid-2026 to support best practice care.

Objective The objective of this review is to provide an overview of the existing evidence regarding nurse-initiated protocols in the emergency department management of pediatric oncology patients with fever and suspected neutropenia. Introduction Febrile neutropenia in pediatric oncology patients poses a significant burden of increased morbidity and mortality. Prompt, efficient emergency care and rapid antibiotic administration within 60 minutes of presentation to hospital is required to prevent clinical deterioration and reduce rates of intensive care admission and mortality. Efficient emergency department care delivery is impacted by modern day challenges, such as increasing user-demand, limited resources, and lack of flow. In response to this, to expedite care provision, practice guidelines have been developed to include nurse-initiated protocols that guide nurses to initiate specific predetermined investigations and interventions for patients meeting certain criteria. Febrile neutropenic pediatric patients may be a specific group that can benefit from nurse-initiated protocols due to the time-critical nature of required care. Inclusion criteria The scoping review will consider literature that reports on nurse-initiated protocols in the management of pediatric febrile oncology patients with suspected neutropenia in the emergency department setting. Methods JBI methodology for scoping reviews will guide the review process. English-language literature from 2000 to present will be searched in Embase, MEDLINE, Scopus, Emcare, CINAHL Plus, and gray literature in Google Scholar, Open Grey, and Theses Global. Critical appraisal will not be performed. A tabular and accompanying narrative summary of the information will present extracted evidence aligned to the review's objective and questions.

Problem Lactational mastitis is a common condition amongst breastfeeding women. It is associated with decreased breastfeeding rates and often treated with antibiotics. Background The anti-inflammatory effects of probiotics have been identified as a potential treatment or prevention strategy for lactational mastitis leading to increased commercial and public interest. Despite the marketing of probiotics to women, evidence is still emerging as to its efficacy. Aim/Methods This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to identify and examine the evidence around probiotic consumption and lactational mastitis. The review addressed the question; what is the evidence regarding probiotic consumption and human lactational mastitis? Studies were critically appraised using the Joanna Briggs Institute checklist for randomised control trials (RCTs). Findings Five RCTs met the inclusion criteria; three concerned probiotic consumption for the treatment of mastitis, two for the prevention of mastitis. All reported a lower incidence of mastitis in the probiotic groups. Discussion Although potentially promising results were reported across all studies there were significant methodological limitations concerning; appropriately described baseline characteristics, study hypotheses, lack of power calculations, definitional issues, and potential conflicts of interest. Conclusion Probiotics may have utility for the treatment or prevention of lactational mastitis. However only a few studies with significant limitations have been published to date. Well designed and conducted studies are needed before evidence-based recommendations can be made for use of probiotics in the treatment or prevention of lactational mastitis.

What is known and Objective: Scoping reviews are a valuable evidence synthesis methodology. They can be used to map the evidence related to any topic to allow examination of practice, methods, policy and where (and how) future research could be undertaken. As such, they are a useful form of evidence synthesis for pharmacy clinicians, researchers and policymakers to review a broad range of evidence sources. Comment: This commentary presents the most comprehensive and up to date methodology for scoping reviews published by Joanna Briggs Institute (JBI). This approach builds upon two older approaches by Arksey and O'Malley, and Levac. To assist reviewers working in the field of pharmacy with planning and conducting scoping reviews, this paper describes how to undertake scoping reviews from inception to publication with specific examples related to pharmacy topics. What is new and conclusion: The JBI scoping review methodology is a valuable evidence synthesis approach to the field of pharmacy and therapeutics. This approach can assist pharmacy clinicians, researchers and policymakers to gain an understanding of the extant literature, to identify gaps, to explore concepts, characteristics and to examine current practice. Refereed/Peer-reviewed

People who identify as lesbian, gay, bisexual, or transgender (LGBT) may experience differences in outcomes or experiences across the cancer pathway compared to the general population. This chapter describes the cancer trajectory of people who identify as LGBT in Australia and New Zealand, drawing on available evidence regarding cancer risk factors, HPV vaccination, cancer screening, cancer incidence, treatment, and survivorship experiences, and importantly, substantial gaps in knowledge are highlighted. Though gains are being made in terms of social and legal equality for LGBT people in both Australia and New Zealand, there are ongoing areas of disparity that may leave LGBT people vulnerable an increased level of some cancer risk factors, as well as inferior cancer-related experiences and outcomes. Greater inclusivity of LGBT people in population-level data collection is urgently needed to address gaps in knowledge regarding cancer risk factors and participation in preventive health care, incidence, and outcomes, with research also required to understand and address disparities in experiences of LGBT people as they navigate each step of the cancer pathway, from screening to survivorship or end-of-life care.

Background Paediatric oncology patients with fever and suspected neutropenia are at risk of developing life-threatening systemic infection. Prompt Emergency Department assessment, early intervention and antibiotic administration within 60 minutes of hospital presentation is now recognised as the required standard of care. Nurse-initiated protocols have been implemented in emergency departments to facilitate timely care for a variety of patient groups, yet little is known about their feasibility in this population. Aim To provide an overview of the existing evidence regarding nurse-initiated protocols in the emergency management of paediatric oncology patients with fever and suspected neutropenia. Methods This scoping review followed the JBI methodological guidance for conducting scoping reviews. Comprehensive, systematic searches were conducted in Embase, Medline (Ovid), Scopus, Emcare (Ovid), CINAHL Plus, Google Scholar, Open Grey, and Theses Global. Findings Of the 768 studies imported for screening, 504 were excluded at title and abstract screening, and 39 studies were assessed for eligibility at full-text screening. Fourteen studies met the inclusion criteria and were included for review. Important findings included the identification of; sources of delay in care, the key features of nurse-initiated protocols, and the outcomes, barriers and facilitators of the protocols. Through the effective streamlining of care provision, communication, and increased nursing autonomy via nurse-initiated protocols, improvements in time to care initiation, investigations and antibiotic delivery was demonstrated. Barriers are related to insufficient nursing staff knowledge, technical skill, parental opposition and institutional inexperience in protocol initiation. With appropriate institutional support, multidisciplinary involvement, family engagement and ongoing education the successful implementation of nurse-initiated protocols was facilitated. Discussion/Conclusion The available evidence is limited to primary quality improvement projects. Further high quality-research is required before definitive recommendations for practice can be made, however, evidence suggests that nurse-initiated protocols may be an effective strategy to improve the emergency department care of paediatric oncology patients presenting with fever and suspected neutropenia.

Objective: The objective of this scoping review is to identify and report upon evidence (such as guidance) or tools regarding methodological quality or risk of bias of scoping reviews. Introduction: Scoping reviews have gained popularity in recent years but have been criticized for variations in their approaches. This scoping review will examine evidence on the methodological quality of scoping reviews, as well as identify and describe potential tools to inform the development of a tool for appraising the quality of scoping reviews. Inclusion criteria: The scoping review will include all documents reporting on the development, evaluation, or conduct of tools addressing the critical appraisal or risk of bias of scoping reviews. The literature search will seek evidence published from 2005 onwards, corresponding with the publication of Arksey and O’Malley's framework for scoping reviews. Methods: The search strategy will aim to locate both published and unpublished documents utilizing a three-step search strategy. An initial search of PubMed has identified keyword and MeSH terms. A second search of PubMed, Embase, and CINAHL will follow. Google and Google Scholar will be searched for difficult-to-locate and unpublished literature. Authors will endeavor to consult with relevant methodologists through the authors’ professional networks, social media accounts, and professional newsletters to obtain materials that can be considered for inclusion. Documents will be independently screened, selected, and extracted by two researchers and the data will be presented in tables. Refereed/Peer-reviewed

Objective: This scoping review aims to identify and map the outcomes reported from evaluations that measure the effectiveness and acceptability of palliative care programs and interventions in residential aged care facilities. Introduction: As the population ages, there is increasing attention on implementing new interventions and programs to improve palliative care in residential aged care facilities. However, there is no standard evaluation for intervention implementation. Mapping the outcome measures used in evaluations of diverse palliative care interventions in residential aged care facilities has not been explored recently. Inclusion criteria: This review will consider studies involving older adults (aged 50 and above) in any country living and receiving care in residential aged care facilities. This review will exclude literature that focused on other age groups and people receiving palliative care in other care settings, such as hospitals, palliative care inpatient units, sheltered housing, cancer centers, own homes, and hospices. Methods: This scoping review will follow the JBI methodology for scoping reviews. This scoping review will identify both published and unpublished (eg, gray literature) primary studies, as well as reviews. The databases to be searched for published studies will include MEDLINE, Emcare, ProQuest, Embase, PsycINFO, Web of Science, Scopus, and the Cochrane Library. The search will be limited to evidence published in English from 2008 to the present. Visual, tabular, and accompanying narrative summaries will be used to present the results. Refereed/Peer-reviewed

Aim: To develop evidence-based recommendations for provision of culturally safe, high-quality services for breast cancer screening for transgender people. Design: The scoping review will follow the JBI methodological guidance for scoping reviews. Methods: A search using MEDLINE (PubMed), Embase (Ovid), Scopus, the Cochrane Library, including the Cochrane Methodology Register, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and the World Health Organization, Australia Government Department of Health and Google Scholar will be undertaken. The review will include people of any age and ethnicity defined in the source of evidence as transgender. The review will include individuals who have used gender-affirming interventions or not and sources of evidence that report information relevant to the provision of culturally safe, high-quality breast cancer screening services for transgender people. English language sources of evidence published from database inception with information from any country will be eligible for inclusion. Sources will be screened for inclusion by three independent reviewers. Results will be extracted using a purpose-built tool and presented in relation to the review questions and objective in the final report using tables, figures and corresponding narrative. Project funding was approved by the Australian Government Department of Health in June 2020. Discussion: There are a range of factors that impact on the equity of health access and outcomes for people who are not cisgender. Transgender people are at risk of breast cancer but there is relatively little evidence about how their risks may or may not differ substantially from cis-gendered individuals and little guidance for health providers to ensure inclusive, culturally safe, high-quality breast cancer screening services for both transgender males, transgender females and gender diverse people who may not identify as male or as female. Impact: It is important to provide culturally safe, high-quality services for breast cancer screening for transgender people. Refereed/Peer-reviewed

Two thousand and twenty was a challenging year for all, however it was also a year of many successes for the Australian Journal of Advanced Nursing, attributable in no small part to the contributions of authors, peer reviewers and readers. Here, we discuss some of our achievements to date, including publication of four quarterly issues through our relaunched website, and highlight new journal sections and plans to expand on resources for support and guidance to authors. We also introduce a guest editorial by professors Juanita Sherwood, Roianne West and colleagues who signal the beginning of a developing community of practice as First Nations nurses and midwives, educators, practitioners and researchers. The year gone has shown us all how important it is that we share our knowledge and experience, and so we look forward to supporting another year of challenge and accomplishment for nursing and midwifery both in Australia and beyond.

Refereed/Peer-reviewed

Refereed/Peer-reviewed Objective: The objective of this review is to identify and map the tools and approaches used for reflection as a learning strategy for nurses and nursing students in clinical settings. Background: Several types of reflection interventions exist to develop nurses' reflective competencies in clinical practice. This scoping review mapped the available literature on the use of reflection in the education of nurses and nursing students in clinical settings. Three questions guided the review: i) What tools and approaches for reflection have been reported? ii) What levels of reflection have been identified (low/descriptive, middle/application, or high/evaluative)? iii) What outcomes of reflection have been reported? Inclusion criteria: Studies investigated nursing students or nurses working in clinical settings involved in patient care, and described reflective interventions and definitions of reflection, descriptions of the contents reflected on, measurement instruments, and outcomes of interventions. Methods: MEDLINE (PubMed), Emcare (Ovid), MEDLINE (Ovid), ERIC (ProQuest), CINAHL (Ovid), and Web of Science databases were searched for full-text studies published in English, Danish, Swedish, or Norwegian. Studies from any country and published from 2007 to September 2020 were eligible for inclusion. The review followed the JBI methodology for scoping reviews and was based on an a priori protocol. Two independent reviewers assessed studies against the inclusion criteria and extracted data. Inclusion for review was determined according to the pre-determined eligibility criteria and consensus between researchers. Data were extracted using a standardized data extraction table and results were summarized narratively with accompanying tables. Results: Seventeen articles were included; nine quantitative studies and eight qualitative studies. Findings are presented separately due to varying study designs and outcomes. Most studies used physical tools and reflective dialogues in clinical settings. Some tools included specific questions for participants to reflect on, while others included open questions or no questions. Reflective approaches included lectures, workshops, or reflection with supervisors or peers in clinical settings. None of the 17 studies included the same combination of tools and approaches. Measurement of reflection was varied across articles, and there was a lack of standardization in how reflection outcomes were classified. Conclusions: Interventions, tools, approaches, and the measurement of nurses' reflection in clinical settings are highly varied, and none of the included studies had the same combination of elements. The studies indicate that reflection skills are achieved potentially according to the tools and approaches used, and the foci for reflection. There is little agreement among the research community on how best to assess the measurement and quality of reflection. It is recommended that future studies are explicit on the classification of low-, middle-, and high-level reflection according to standardized criteria.

Scoping reviews are an increasingly common approach to evidence synthesis with a growing suite of methodological guidance and resources to assist review authors with their planning, conduct and reporting. The latest guidance for scoping reviews includes the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews. This paper provides readers with a brief update regarding ongoing work to enhance and improve the conduct and reporting of scoping reviews as well as information regarding the future steps in scoping review methods development. The purpose of this paper is to provide readers with a concise source of information regarding the difference between scoping reviews and other review types, the reasons for undertaking scoping reviews, and an update on methodological guidance for the conduct and reporting of scoping reviews.Despite available guidance, some publications use the term ‘scoping review’ without clear consideration of available reporting and methodological tools. Selection of the most appropriate review type for the stated research objectives or questions, standardised use of methodological approaches and terminology in scoping reviews, clarity and consistency of reporting and ensuring that the reporting and presentation of the results clearly addresses the review’s objective(s) and question(s) are critical components for improving the rigour of scoping reviews.Rigourous, high-quality scoping reviews should clearly follow up to date methodological guidance and reporting criteria. Stakeholder engagement is one area where further work could occur to enhance integration of consultation with the results of evidence syntheses and to support effective knowledge translation. Scoping review methodology is evolving as a policy and decision-making tool. Ensuring the integrity of scoping reviews by adherence to up-to-date reporting standards is integral to supporting well-informed decision-making.

Problem There is ongoing debate regarding the impact of, and relationship between, technological innovation and staffing levels and skills mix in aged care. Some commentators suggest that mandating minimum staffing levels and skills mix will undermine the sector’s ability to increase productivity via technological innovations. Aim This paper aims to stimulate scholarly debate regarding staffing levels, skills mix, and technological innovation in aged care. Methods As a discussion paper providing a scholarly and political critique of current policy issues affecting nurses and aged care, no reporting guideline has been followed. Findings Staffing and skills mix in aged care has risen as a prominent, divisive issue. Some commentators suggest that productivity is hampered by mandating minimum staffing levels and skills mix by interfering with the uptake of innovation and technology. While technological innovation has led to many opportunities for better outcomes, we argue that without at least enough of the right kind of staff in aged care, technology and innovation alone cannot be relied upon to facilitate the dignified, person-centred care that older people deserve. Discussion We argue that staffing levels and skills mix need not be opposed to the implementation of innovations in aged care and that a focus on productivity and efficiency risks dehumanising the sector even further. Conclusion By maximising labour potential in aged care, and enabling a sector that supports a suitably sized and skilled workforce to care for older people, we are supporting a workforce that is ready and able to leverage opportunities offered by innovations in ways that do not dehumanise our older people.

Objective: The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). Introduction: Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. Methods: Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. Results: The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues, such as when a scoping review is (or is not) appropriate, and how to extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. Conclusions: The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned. Refereed/Peer-reviewed

Objective: The objective of this scoping review is to identify and examine the available evidence of domestically trained international nursing students’ and new graduates’ experiences of transition to the nursing workforce. Introduction: International students’ workforce transition experiences are attracting researchers globally. One under-researched area relates to the workforce transition experiences of domestically trained international nursing students and new graduates. This scoping review will focus on identifying studies that examine factors that can directly or indirectly affect experiences of workforce transition. Inclusion criteria: This review will consider studies that include domestically trained international nursing students enrolled in an undergraduate/baccalaureate nursing program (outside their country of origin) and new graduates within their first year of completing an undergraduate/baccalaureate nursing program (outside their country of origin). Participants may be either employed or not employed in the host country’s nursing workforce. Studies that include participants from any other nursing programs will be excluded. Methods: The JBI approach for conducting and reporting scoping reviews will be followed. The review will include both published and unpublished literature. Research from 2000 onward that is available in English will be included.Searches will be conducted in MEDLINE, Scopus, Emcare, ERIC, PsycINFO, ProQuest Central, ProQuest Dissertations and Theses Global, and ScienceDirect. An assessment of methodological quality will be included, with results presented in the final report. One reviewer will carry out the data extraction process independently and will be checked by another reviewer. Data will be presented in tabular form accompanied by a narrative summary that aligns with the objective of this scoping review. Refereed/Peer-reviewed

Objective: The objective of this scoping review is to identify and examine the evidence on probiotic consumption and its effect on human lactational mastitis. Introduction: Lactational mastitis is a painful, inflammatory condition of the breast tissue commonly occurring among breastfeeding women. It can lead to decreased breastfeeding rates which then may lead to poorer maternal and newborn outcomes. There is growing interest and research on the use of probiotics to prevent or treat this condition following promising, but equivocal, evidence from studies of probiotics in relation to animals and other human conditions. Inclusion criteria: Women of any age are eligible if they are planning a pregnancy, pregnant, breastfeeding or expressing post-childbirth. There will be no exclusion based on comorbidity, previous history, or current diagnosis or treatment of lactational mastitis. All probiotic species and strains and all dosages, preparations and timing/scheduling of probiotic administration will be eligible for inclusion. All concepts regarding the use of probiotics and its effect on lactational mastitis will be included, and all types of research will be considered. Non-human studies will be excluded. Methods: This scoping review will follow the JBI methodology for the conduct and reporting of scoping reviews. Sources of evidence published in English from the year 2000 to present will be included. The search will include the Cochrane Library, Scopus, Embase and Emcare, in addition to gray literature. A critical appraisal will be performed and the results will be presented in the final review. A tabular and accompanying narrative summary of the information will be provided. Refereed/Peer-reviewed

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in Wuhan, Hubei province, China in 2019 as the cause of a cluster of pneumonia cases later confirmed to be the COVID-19 disease (World Health Organization (WHO) 2020a). A novel coronavirus, SARS-CoV-2 is similar to other human and animal viral pathogens including some of those which cause the common cold and is most similar to severe acute respiratory syndrome (SARS/ SARS-CoV-1). The SARS-CoV-2 virus has spread to many countries and was declared a pandemic by the World Health Organization (WHO) on 30 January 2020 (World Health Organization (WHO) 2020b) The individuals most at-risk of infection are those in close contact with patients with COVID-19 which includes health and aged care staff. Governments, employers, local, national, and global health and aged care agencies and organisations including those that represent and advocate for health and aged care workers, such as international and national nursing associations, recommend and provide guidance regarding the use of personal protective equipment (PPE), both directly related to the current COVID-19 pandemic and more broadly around infection prevention and control. A lack of consistency regarding PPE policy and recommendations has been discussed recently by Chughtai and colleagues in an editorial which focussed particularly upon differences in the recommended type/level of PPE, policies on extended use and reuse, and the importance of respiratory protection programs (Chughtai et al., 2020). In this paper, we focus more specifically on recommended processes for the use of PPE, particularly donning and doffing practices; and discuss the issue of inconsistent recommendations and messaging leading to confusion, concern, avoidable errors, and most seriously, increased risk of contamination and infection for both health and aged care staff, as well as patients and community members.

BACKGROUND In 2014, JBI Database of Systematic Reviews and Implementation Reports published a comprehensive methodology for the conduct and reporting of scoping reviews based on previous frameworks and guidance. Further work on scoping review methodology and particularly reporting is needed. To assist with refinements to the methodology, this survey was undertaken to evaluate users' experiences of following the process methodology. An electronic survey was generated to explore authors' experiences with the methodology and to seek feedback on the stages of scoping review development. METHOD An online survey administered using Qualtrics - a secure survey platform - was distributed through invitations to a total of 51 registered users in the Joanna Briggs Database of Systematic reviews and Implementation reports. We analysed the questionnaire data using descriptive statistics. The qualitative data were grouped together, and free text comments were inductively themed and coded by the authors. RESULTS Thirty-one participants completed the survey (response rate of 61%). The majority of the participants identified themselves as researchers (55%) followed by educators (25%). Most participants were university employees (77%) and only 10% were based in hospitals. Forty-two percent of the participants reported that the scoping review they had been involved with had taken between 6 and 12 months, and 32% of participants spent over a year completing their reviews. Eighty-seven percent of participants stated that their scoping reviews led to further work such as developing a systematic review, a basis for a grant application, formation of a part of students' doctoral studies, and informing further work in a research project. Some of the limitations listed by the participants were the lack of examples in each section of the methodology, especially in the inclusion criteria, and presentation of the results sections. CONCLUSION The overall evaluation by the participants of the JBI scoping review methodology highlighted the need for additional detailed guidance for inclusion criteria and presentation of the results. Provision of clear examples for each step was also requested for future improvement.

Providing the best possible nutritional care requires accurate and precise communication between healthcare professionals. Developing a Nutrition Minimum Data Set will inform professionals in primary healthcare of which core elements should be documented and facilitate a standardized approach to the documentation of nutritional care. A two-step methodological approach was utilized in this study: (1) a systematic scoping review was conducted to map evidence underpinning the development of a Minimum Data Set and (2) the datasources were categorized using the inductive content analysis approach. A total of 32 items were identified in the datasources. Five categories were inductively derived from the data: (1) physiologic measurements, (2) ability to eat, (3) intake, (4) stress factors and (5) factors which indirectly affect intake and needs. Organizing the documentation following the structure presented in this Minimum Data Set will contribute to a standardized terminology, which may lead to increased quality of documentation, increased continuity of care and improved health outcomes. usc Refereed/Peer-reviewed

ObjectiveThe objective of this scoping review is to systematically map the literature to identify the scope, depth, key concepts and gaps in the evidence regarding care of the patient with invasive meningococcal disease by emergency medical service (EMS) clinicians.DesignScoping review. This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guideline.Eligibility criteriaSources which focused on patients with invasive meningococcal disease (population), where the care of EMS clinicians was the focus (concept), in EMS systems worldwide (context) were eligible for inclusion.Search strategyThis review utilised a comprehensive search strategy including MEDLINE, Embase, Emcare, CINAHL, Scopus, Web of Science, Google Scholar and ‘grey’ literature databases from 1992 to January 2019. The search also included a Google search, a hand-search of relevant journals, screening of reference lists, contact with authors of included sources and use of social media in an attempt to locate all sources of evidence which fit the inclusion criteria of the review. Two reviewers independently screened sources for inclusion.ResultsThe search yielded 1803 unique records, of which 10 were included in the synthesis. No original research papers were identified, with all sources classed as either clinical audit or text and opinion literature. The dominant concept throughout the literature is that early antibiotic therapy is critical in the treatment of invasive meningococcal disease.ConclusionsOverall, there is a very narrow scope and shallow depth of literature on the topic of interest. There are gaps in the evidence regarding the care of the patient with invasive meningococcal disease by EMS clinicians. Despite these shortfalls, current consensus-based guidelines should direct clinical practice. Further research is planned to bridge the gaps in knowledge to support best practice.

Objectives: Scoping reviews are being increasingly used by researchers. The objective of this article was to outline some challenges and potential solutions to improve the conduct and reporting of scoping reviews. Study Design and Setting: The JBI scoping review methodology group consists of 9 experts in the field of scoping reviews. This article summarizes the key issues facing reviewers who conduct scoping reviews and those who use the results from scoping reviews and may engage in consultations during their development. Results: Several key issues have been identified for reviewers as challenges in conducting scoping reviews. Challenges may be faced throughout the conduct of the review, from developing the a priori protocol to finalizing the review report for publication and developing implications or recommendations for research, policy, and practice from the results of the review. Challenges to publishing scoping reviews may stem from a lack of understanding of scoping reviews by journal editors, authors, and peer reviewers to extending the conclusion drawn from these reviews to generate recommendations for practice and policy. Conclusion: By identifying and overcoming challenges to the conduct and reporting of scoping reviews, reviewers may better ensure that scoping reviews are effective in meeting the objectives of scoping reviews. Refereed/Peer-reviewed

The Australian Nursing and Midwifery Federation has published the Australian Journal of Advanced Nursing since 1983. In 2020, the World Health Organization-designated Year of the Nurse and Midwife, we are pleased to introduce the new-look journal along with new guidance for authors for preparing their publications for submission. The Australian Journal of Advanced Nursing will continue the journal’s previous character and aligns and advances the Australian Nursing and Midwifery Federation’s overall strategic objectives as Australia’s largest professional nursing and midwifery organisation. The Australian Nursing and Midwifery Federation’s diverse and dispersed membership works in many sectors including but not limited to public and private health, aged care, schools, tertiary education, research, the community, and disability care across a wide variety of metropolitan, regional, and remote locations. Accordingly, the Australian Journal of Advanced Nursing will seek to showcase and promote a wide variety of original research and scholarly work to inform and empower nurses, midwives, and other healthcare professionals to improve the health and wellbeing of all communities and be prepared for the future. We look forward to working with authors, readers, and our Editorial Board to enhance the reach, readership, and profile of the Australian Journal of Advanced Nursing. https://doi.org/10.37464/2020.371.1

Refereed/Peer-reviewed The impact of COVID-19 has and will be wide-ranging, with implications for people’s health and wellbeing way beyond the direct effects of an infectious respiratory illness. Due to the very real threat of the virus to the health of individuals, government responses to gain control and slow the spread of SARS-CoV-2 in order to protect health care sector capacity has resulted in virtually unprecedented limitations on people’s personal, social, and working lives as well as widespread and lasting economic impacts. Many countries already faced significant challenges related to mental ill health prior to the pandemic. COVID-19 has brought with it new threats to the mental health and wellbeing of people with pre-exiting mental ill health, the health care, maternity care, and aged care workforces, and people in the community with no prior experience or risk factors for mental ill health. Mental health is and will be a pressing issue for a vast number of people across many segments of society and addressing it will take action and cooperation across many contexts and between diverse groups. Now more than ever we need to work collaboratively to help one another – especially our most vulnerable community members who often lack the voice, resources, and platforms to help themselves.

Background: Scoping reviews are a relatively new approach to evidence synthesis and currently there exists little guidance regarding the decision to choose between a systematic review or scoping review approach when synthesising evidence. The purpose of this article is to clearly describe the differences in indications between scoping reviews and systematic reviews and to provide guidance for when a scoping review is (and is not) appropriate. Results: Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions. Conclusions: Scoping reviews are a useful tool in the ever increasing arsenal of evidence synthesis approaches. Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. Our hope is that with clear guidance available regarding whether to conduct a scoping review or a systematic review, there will be less scoping reviews being performed for inappropriate indications better served by a systematic review, and vice-versa usc Refereed/Peer-reviewed

Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts,theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers,publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews. Refereed/Peer-reviewed

Objectives To explore the cancer care experiences and unmet needs of people who identify as a sexual or gender minority. Methods A qualitative systematic review and meta-synthesis was undertaken based on a registered protocol. Following literature searching and study selection, study quality was examined by using the Critical Appraisal Skill Programme Checklist. Qualitative data were extracted verbatim from included studies and synthesized by using thematic analysis. Results Fifteen studies that included lesbian, gay, and bisexual (LGB) people living with or beyond cancer were included in the review. Studies including gender minorities were not identified. Most of the study participants were sexual minority women with breast cancer or sexual minority men with prostate cancer. Meta-synthesis of 106 individual findings generated 6 overarching themes pertaining to sexual orientation disclosure, experiences and fear of homophobia, positive and negative health-care professional behaviors, heterocentric systems and care, inadequacy of available support groups, and unmet needs for patient-centered care and LGB-specific information. Lesbian, gay, and bisexual people often reported feelings of anxiety, invisibility, isolation, and frustration throughout the cancer care continuum. Conclusions Analysis of the experiences of LGB people with cancer care shows that LGB people face numerous challenges due to their sexual orientation and receive care that does not adequately address their needs. Training and education of health-care professionals are strongly recommended to address some of these challenges and practice gaps. Culturally appropriate care includes avoiding heterosexual assumptions, use of inclusive language, the provision of tailored information, and involving partners in care.

Review question/objective: This scoping review will seek to find answers for the following questions which will focus on the use of reflection in the education of nurses in clinical settings:The review will also extract and map data regarding: i) what outcomes have been found in relation to the use of different tools and approaches (e.g. dialogues, diaries, case studies); ii) how approaches and tools have been implemented as interventions; iii) details of the topic or focus of reflection (e.g. ethical issues, care of older adults etc.); iv) details about the participants involved in reflection activities (e.g. first or second year undergraduate nursing students etc.); and v) barriers/challenges to the use of reflection approaches/tools. Additional details may also be extracted and mapped during the process of the scoping review and this will be explained in the final scoping review report. usc Refereed/Peer-reviewed

Objective The objective of this systematic review was to identify and synthesise existing evidence on the experiences of international nursing students’ and international nursing graduates’ transition to the host country’s nursing workforce. Background International students’ experiences of transition to the host country has been extensively explored by researchers. International students experience unique challenges related to communication and language, socialisation, finance, and temporary student visa. One under-researched area is the experiences of transition for international nursing students and international nursing graduates. This systematic review examined the existing evidence on international nursing students’ and international nursing graduates’ experiences of transition to the host country’s nursing workforce. Inclusion criteria This review considered published and unpublished studies—qualitative, quantitative, mixed methods, evidence syntheses, and grey literature—that included international nursing students enrolled in an undergraduate nursing programme outside their home country and international nursing graduates, either employed or not yet employed in nursing and within their first year of completing an undergraduate nursing programme outside their home country. Methods A three-step search strategy was utilised in this review. The search strategy aimed to find published and unpublished literature in English from January 2000 to April 2020. The databases searched were Ovid Medline, Scopus, Emcare, ERIC, PsycINFO, ProQuest Central, ProQuest Dissertations and Theses Global, JBI Evidence-based Practice Database, and ScienceDirect. Two reviewers independently screened the titles/abstracts and full texts of studies for inclusion and appraised the methodological quality of the included studies. Findings and accompanying illustrations were extracted by one reviewer, assigned a level of credibility, and checked by the others. Results were analysed using JBI’s approach to qualitative meta-aggregation. Results This review included three qualitative papers published between 2011 and 2018. All included studies were appraised as of moderate quality. Sixty-five study findings and nineteen categories were aggregated into the following six synthesised findings: international nursing graduates developed confidence and satisfaction through challenges; personal challenges; clinical challenges; discrimination and justice; academic barriers to success; and what international nursing students liked and wanted. Conclusion The synthesised findings revealed ongoing anxiety, lack of preparedness and role uncertainty that was experienced by international nursing students and international nursing graduates as they transition to the host country’s nursing workforce. They expressed the need for information about professional role expectations, guidance, and support to transition. University transition programmes and services could provide support to address the workforce transition challenges faced by international nursing students and international nursing graduates. Tweetable abstract Systematic review shows international nursing students and international nursing graduates experience anxiety, limited preparedness and role uncertainty when transitioning to the host country’s nursing workforce.

Review objective: The objective of this scoping review is to identify, describe and compare studies investigating patient-reported outcomes (PROs) in esophageal cancer patients following neoadjuvant (preoperative) chemotherapy(CT) and surgery or neoadjuvant chemoradiotherapy (CRT) and surgery.After preliminary searching of the literature and consultation with experts in the fields of esophageal cancer surgery,behavioral science, information systems and scoping review methodology, the following research objectives were defined as follows: To identify, describe and compare the characteristics and timing of PROs, specifically, psychological and somatic quality of life and symptoms, experienced by esophageal cancer patients during and/or followingneoadjuvant CT or CRT. To identify and describe the instruments used to measure PROs in esophageal cancer patients followingneoadjuvant CT or CRT.

Exposure to smoke emitted from wildfire and planned burns (i.e., smoke events) has been associated with numerous negative health outcomes, including respiratory symptoms and conditions. This rapid review investigates recent evidence (post-2009) regarding the effectiveness of public health messaging during smoke events. The objectives were to determine the effectiveness of various communication channels used and public health messages disseminated during smoke events, for general and at-risk populations. A search of 12 databases and grey literature yielded 1775 unique articles, of which 10 were included in this review. Principal results were: 1) Smoke-related public health messages are communicated via a variety of channels, but limited evidence is available regarding their effectiveness for the general public or at-risk groups. 2) Messages that use simple language are more commonly recalled, understood, and complied with. Compliance differs according to socio-demographic characteristics. 3) At-risk groups may be advised to stay indoors before the general population, in order to protect the most vulnerable people in a community. The research included in this review was observational and predominantly descriptive, and is therefore unable to sufficiently answer questions regarding effectiveness. Experimental research, as well as evaluations, are required to examine the effectiveness of modern communication channels, channels to reach at-risk groups, and the ‘stay indoors’ message. Refereed/Peer-reviewed

Review question/objective: The objective of this scoping review is to investigate quality of life (QoL) questionnaires available to pediatric patients following tonsillectomies with or without adenoidectomies for chronic infection or sleep-disordered breathing (SDB). The scoping review will aim to map the components of each QoL questionnaire assessed including frequency of use, age parameters, respondent, domains assessed, format and psychometric properties. Questionnaire format will be summarized into respondent and administrator burden by identifying the number of questions present, scale utilized and time to completion. The scoping review will report on whether psychometric analysis in terms of test reliability and validity was assessed in the included papers as well as the results of those assessments.Specifically, the review question is: what QoL questionnaires are available for pediatric patients following tonsillectomies with or without adenoidectomies for chronic infections or SDB?

This article describes a novel approach for using EndNote to manage and code references in the conduct and reporting of systematic reviews and scoping reviews. The process is simple and easy for reviewers new to both EndNote and systematic reviews. This process allows reviewers to easily conduct and report systematic reviews in line with the internationally recognized PRISMA reporting guidelines and also facilitates the overall task of systematic or scoping review conduct and reporting from the initial search through to structuring the results, discussion, and conclusions in a rigorous, reproducible, and user-friendly manner. Refereed/Peer-reviewed

Background Invasive meningococcal disease (IMD) is a rare but potentially fatal disease. It can rapidly progress within minutes to hours and carries a significant burden of disease worldwide. The role of emergency medical service (EMS) clinicians in providing early care for the patient with IMD is important, but the literature regarding the pre-hospital phase of care is sparse. Aim The aim of this scoping review is to systematically map the literature to identify the scope, depth and key concepts in the evidence, and to identify gaps in knowledge regarding the care of the patient with IMD by EMS clinicians. Methods A comprehensive electronic search strategy will be used to locate sources of evidence that fit the inclusion criteria of the study. Data will be extracted, charted and reported in accordance with current best practice for scoping reviews. Discussion This protocol provides the framework for the first scoping review to identify the scope, depth and key concepts in the evidence, and to identify gaps in knowledge regarding the care of the patient with IMD by EMS clinicians. The review report will present the current state of knowledge, inform clinical practice guideline development and identify gaps in the evidence requiring further research.

usc AIM: Systematic reviews play an important role in ensuring trustworthy recommendations in healthcare. However, systematic reviews can be laborious to undertake and as such software has been developed to assist in the conduct and reporting of systematic reviews. The Joanna Briggs Institute and its collaborating centres consist of thousands of researchers, academics and clinicians across the globe conducting systematic reviews of various types. To support them in their work, modern software and online tools are required. Our aim was to develop a software program to support systematic reviewers across the globe. Methods:A working party was formed with extensive consultation with members of the Joanna Briggs Collaboration focusing on ideal features of a software program to support systematic reviews. The new systematic review software was built using an agile methodology and designed to be a modern web application. Results:The new systematic review software, the Joanna Briggs Institute System for the Unified Management,Assessment and Review of Information (JBI SUMARI), was successfully developed through an iterative process of development, feedback, testing and review. The software is now available (https://www.jbisumari.org/) and supports the entire systematic review process for different types of systematic reviews. Conclusions:An agile software development approach combined with wide consultation and user testing can facilitate systematic review software design and development. This new software can support systematic reviews and guideline developers to create systematic reviews for a diverse range of questions. Refereed/Peer-reviewed

Review objective and questions: The objective of the review is to map the available evidence to provide an overview of the use of non-invasive thermometers in the general context of health care. The specific questions,in regards to the available international published and unpublished literature, are: What types of non-invasive thermometers have been used? What manufacturers/brand of thermometers have been used? What routes have been used for the thermometers? What thermometers have been used as reference thermometers? What measures of accuracy have been reported in studies comparing different thermometers and routes of temperature measurement? How have included studies reported on comparisons of different thermometers in terms of frequency of thermometer readings, time that temperature is measured and factors affecting accuracy?

Purpose: Methotrexate chemotherapy is associated with various toxicities which can result in the interruption or discontinuation of treatment and a subsequently raised risk of relapse. This umbrella systematic review was conducted to synthesize the results of all existing systematic reviews that investigate the pharmacogenetics of methotrexate-induced toxicity, with the aim of developing a comprehensive reference for personalized medicine. Methods: Databases searched were PubMed, Embase, JBI Database of Systematic Reviews and Implementation Reports, DARE, and ProQuest. Papers were critically appraised by two reviewers, and data were extracted using a standardized tool. Results: Three systematic reviews on methotrexate-induced toxicity were included in the review. Meta-analyses were reported across Asian, Caucasian, pediatric and adult patients for the MTHFR C677T and A1298C polymorphisms. Toxicity outcomes included different forms of hematologic, ectodermal and hepatic toxicities. Results varied considerably depending on the patient groups and subgroups investigated in the different systematic reviews, as well as the genetic models utilized. However, significant associations were found between the MTHFR C677T allele and; hepatic toxicity, myelosuppression, oral mucositis, gastrointestinal toxicity, and skin toxicity. Additionally, limited evidence suggests that the MTHFR A1298C polymorphism may be associated with decreased risk of skin toxicity and leukopenia. Conclusion: This umbrella systematic review has synthesized the best available evidence on the pharmacogenetics of methotrexate toxicity. The next step in making personalized medicine for methotrexate therapy a clinical reality is research on the effectiveness and cost-effectiveness of MTHFR genotype testing to enable the close monitoring of at-risk patients for the timely initiation of rescue therapies. Refereed/Peer-reviewed

Fluoropyrimidine (FU) and platinum-based chemotherapies are greatly complicated by their associated toxicities. This umbrella systematic review synthesized all systematic reviews that investigated associations between germline variations and toxicity, with the aim of informing personalized medicine. Systematic reviews are important in pharmacogenetics where false positives are common. Four systematic reviews were identified for FU-induced toxicity and three for platinum. Polymorphisms of DPYD and TYMS, but not MTHFR, were statistically significantly associated with FU-induced toxicity (although only DPYD had clinical significance). For platinum, GSTP1 was found to not be associated with toxicity. This umbrella systematic review has synthesized the best available evidence on the pharmacogenetics of FU and platinum toxicity. It provides a useful reference for clinicians and identifies important research gaps. Refereed/Peer-reviewed

Objectives/Hypothesis Dysphagia is still a treatment-related morbidity, despite advances in treatment modalities for oral and oropharyngeal squamous cell carcinoma. This systematic review aimed to analyze the effects of swallowing outcomes of patients with oral or oropharyngeal squamous cell carcinoma treated with primary surgery with primary free flap reconstruction, with or without adjuvant therapy, for patients undergoing treatment with curative intent. Study Design A comprehensive search strategy was undertaken across MEDLINE, CINAHL, Embase, and Scopus. Gray literature was sought through Cochrane Central Register of Controlled Trials, MedNar, and ProQuest. Methods Studies included patients with oral cavity or oropharyngeal squamous cell carcinoma treated with primary surgery with primary free flap reconstruction. Swallowing function was the primary outcome, evaluated at 6 months or later following surgery. Methodological quality and data extraction was conducted as per the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and standardized data extraction tool. Results Fifteen articles comprising eight cohort studies and seven case series were included. Postoperative radiotherapy and oropharyngeal resections were demonstrated to be associated with increased dysphagia. Conclusion Advanced tumor-node-metastasis stage and use of adjuvant radiotherapy has been shown to have negative impacts on swallowing function. The majority of patients were able to have gastrostomy tubes removed at 6 months following curative therapy. Larger flap mass for the reconstruction of oral and oropharyngeal defects appeared to improve swallowing outcomes. A protocol for the identification of patients at high and low risk of developing dysphagia is proposed. Level of Evidence N/A. Laryngoscope, 2016

Objective Scoping reviews are used to assess the extent of a body of literature on a particular topic, and often to ensure that further research in that area is a beneficial addition to world knowledge. The aim of this paper reports upon the development of a methodology for scoping reviews based upon the Arksey and O'Malley framework, the Levac, Colquhoun, and O'Brien, and the Joanna Briggs Institute methods of evidence synthesis. Methods A working group consisting of members of the Joanna Briggs collaborating organizations met to discuss the proposed framework for the methodology and develop a draft for the scoping review methodology based on the Arksey and O'Malley framework and the work of Levac et al. This was followed by a workshop attended by other members of the organizations consisting of 30 international researchers to discuss the proposed methodology. Further refinement of the methodology was undertaken as a result of the feedback received from the workshop. Results The development of the methodology focused on five stages of the protocol and review development. These were identifying the research question by clarifying and linking the purpose and research question, identifying the relevant studies using a three-step literature search in order to balance feasibility with breadth and comprehensiveness, careful selection of the studies to using a team approach, charting the data and collating the results to identify the implications of the study findings for policy, practice, or research. Linking Evidence to Action The current methodology recommends including both quantitative and qualitative research, as well as evidence from economic and expert opinion sources to answer questions of effectiveness, appropriateness, meaningfulness and feasibility of health practices and delivery methods. The proposed framework has the potential to provide options when faced with complex concepts or broad research questions.

Background: Evidence-based guidance is needed to inform care provided to mothers and families who experience stillbirth. This paper focuses upon how meaningful and culturally appropriate care can be provided to mothers and families from when they are informed that their baby will be stillborn to many years after the experience. Avoidable suffering may be occurring in the clinical setting. Aims: To promote and inform meaningful and culturally appropriate evidence-informed practice amongst maternity care providers caring for mothers and families who experience stillbirth. Methods: A comprehensive systematic review was conducted which primarily synthesised relevant qualitative research studies. An expert advisory group comprised of stillbirth researchers, clinicians, and parents who have experienced stillbirth provided guidance for the review and the development of implications for practice. Findings: Grieving parents want staff to demonstrate sensitivity and empathy, validate their emotions, provide clear, information, and be aware that the timing of information may be distressing. Parents want support and guidance when making decisions about seeing and holding their baby. Sensitivity, respect, collaboration, and information are essential throughout the experience of stillbirth. Culturally appropriate care is important and may require staff to accommodate different cultural practices. Conclusion: The findings of the review and expert consensus inform the provision of meaningful and culturally appropriate care for mothers and families that have experienced stillbirth. Evidence informed implications for practice are provided to guide the actions, communication, and behaviours of maternity care providers. Refereed/Peer-reviewed

Background: Shared decision making in pregnancy, labour, and birth is vital to woman-centred care and despite strong evidence for the effectiveness of shared decision making in pregnancy care, practical uptake has been slow. Design and Aim: This scoping review aimed to identify and describe effective and appropriate shared decision aids designed to be provided to women in the antenatal period to assist them in making informed decisions for both pregnancy and birth. Two questions guided the enquiry: (i) what shared decision aids for pregnancy and perinatal care are of appropriate quality and feasibility for application in Australia? (ii) which of these decision aids have been shown to be effective and appropriate for Aboriginal and Torres Strait Islander peoples, culturally diverse women, or those with low literacy? Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) was used to conduct the review. Five key databases and selected grey literature sources were examined. English language evidence from Australia, Europe, Canada, United Kingdom, New Zealand, and United States of America produced from 2009 was eligible for inclusion, checked against apriori inclusion criteria, and assessed for quality and usability using the International Patient Decision Aid Standards. Results: From a total of 5,209 search results, 35 sources of evidence reporting on 27 decision aids were included following title/abstract and full-text review. Most of the decision aids concerned decisions around birth (52%, n = 14) or antenatal screening 37% (n = 10). The quality of the decision aids was moderate to high, with most communicating risks, benefits, and choice pathways via a mix of Likert-style scales, quizzes, and pictures or graphs. Use of decision aids resulted in significant reductions in decisional conflict and increased knowledge. The format of decision aids appeared to have no effect on these outcomes, indicating that paper-based are as effective as video- or audio-based decision aids. Eleven decision aids were suitable for low literacy or low health literacy women, and six were either developed for culturally diverse groups or have been translated into other languages. No decision aids found were specific to Aboriginal and Torres Strait Islander peoples. Conclusions and implications for practice: The 27 decision aids are readily adoptable into westernised healthcare settings and can be used by midwives or multidisciplinary teams in conjunction with women. Decision aids are designed to support women, and families to arrive at informed choices and supplement the decision-making process rather than to replace consumer-healthcare professional interaction. If given before an appointment, high quality decision aids can increase a woman's familiarity with medical terminology, options for care, and an insight into personal values, thereby decreasing decisional conflict and increasing knowledge. Refereed/Peer-reviewed