A critical and systematic literature review of epistemic justice applied to healthcare: recommendations for a patient partnership approach.

Invalidation from healthcare practitioners is an experience shared by many patients, especially those marginalized or living with contested conditions (e.g., chronic pain, fibromyalgia, etc.). Invalidation can include not taking someone's testimony seriously, imposing one's thoughts, discrediting someone's emotions, or not perceiving someone's testimony as equal and competent. Epistemic injustices, that is, the disqualification of a person as a knower, are a form of invalidation. Epistemic injustices have been used as a theoretical framework to understand invalidation that occurs in the patient-healthcare provider relationship. However, to date, the different recommendations to achieve epistemic justice have not been listed, analyzed, nor compared yet. This paper aims at better understanding the state of the literature and to critically review possible avenues to achieve epistemic justice in healthcare. A systematic and critical review of the existing literature on epistemic justice was conducted. The search in four databases identified 629 articles, from which 35 were included in the review. Strategies to promote epistemic justice that can be applied to healthcare are mapped in the literature and sorted in six different approaches to epistemic justice, including virtuous, structural, narrative, cognitive, and partnership approaches, as well as resistance strategies. These strategies are critically appraised. A patient partnership approach based on the Montreal Model, implemented at all levels of healthcare systems, seems promising to promote epistemic justice in healthcare.

The study of ableism in population health: a critical review.

Over the past three decades, health equity has become a guiding framework for documenting, explaining, and informing the promotion of population health. With these developments, scholars have widened public health's aperture, bringing systems of oppression sharply into focus. Additionally, some researchers in disability and health have advocated for utilizing socially grounded frameworks to investigate the health of disabled people. Yet, naming ableism, much less operationalizing it for the empirical study of health, remains scant. This paper critically reviews the study of ableism as a social determinant of disabled people's health within population health research. First, we provide an orientation to the present state of this literature by looking to the past. We briefly trace a history of traditional approaches to studying disability and health and alternatives that have emerged from critiques of the individualized lens that has dominated this work. Next, we delineate the operation of ableism across social levels. We characterize how ableism has been studied in population health in terms of levels of analysis (intrapersonal, interpersonal, institutional, and structural) and measures of interest. To conclude, we discuss hinderances to and promising avenues toward population health research that advances health equity for disabled people.

A guide to critical appraisal of quality improvement reports.

Quality improvement (QI) has become an integral part of healthcare. Despite efforts to improve the reporting of QI through frameworks such as the SQUIRE 2.0 guidelines, there is no standard or well-accepted guide to evaluate published QI for rigor, validity, generalizability, and applicability. User's Guides for evaluation of published clinical research have been employed routinely for over 25 years; however, similar tools for critical appraisal of QI are limited and uncommonly used. In this article we propose an approach to guide the critical review of QI reports focused on evaluating the methodology, improvement results, and applicability and feasibility for implementation in other settings. The resulting Quality Improvement Critical Knowledge (QUICK) Tool can be used by those reviewing manuscripts submitted for publication, as well as healthcare providers seeking to understand how to apply published QI to their local context.

From bench to policy: a critical analysis of models for evidence-informed policymaking in healthcare.

Background: The use of research evidence in policy making is a complex and challenging process that has a long history in various fields, especially in healthcare. Different terms and concepts have been used to describe the relationship between research and policy, but they often lack clarity and consensus. To address this gap, several strategies and models have been proposed to facilitate evidence informed policy making and to identify the key factors and mechanisms involved. This study aims to critically review the existing models of evidence informed policy making (EIPM) in healthcare and to assess their strengths and limitations. Method: A systematic search and review conducted to identify and critically assess EIPM models in healthcare. We searched PubMed, Web of Science and Scopus databases as major electronic databases and applied predefined inclusion criteria to select the models. We also checked the citations of the included models to find other scholars' perspectives. Each model was described and critiqued each model in detail and discussed their features and limitations. Result: Nine models of EIPM in healthcare were identified. While models had some strengths in comprehension, flexibility and theoretical foundations, analysis also identified limitations including: presupposing rational policymaking; lacking alternatives for time-sensitive situations; not capturing policy complexity; neglecting unintended effects; limited context considerations; inadequate complexity concepts; limited collaboration guidance; and unspecified evidence adaptations. Conclusion: The reviewed models provide useful frameworks for EIPM but need further improvement to address their limitations. Concepts from sociology of knowledge, change theory and complexity science can enrich the models. Future EIPM models should better account for the complexity of research-policy relationships and provide tailored strategies based on the policy context.

Children's participation rights and the role of pediatric healthcare teams: A critical review.

AIM: A critical review examined how childrens participation rights as represented in the United Nations Convention on the Rights of the Child inform the work of pediatric teams in healthcare settings. METHODS: We systematically searched peer-reviewed literature on the enactment of child participation rights, within the context of pediatric teams. Articles were evaluated using the LEGEND (Let Evidence Guide Every New Decision) tool. Data extraction and analysis highlighted themes and disparities between articles, as well as gaps. A total of 25 studies were selected. RESULTS: We reviewed studies from around the globe, with the majority of papers from the UK. Qualitative and mixed methods approaches were administered. The following observations were made: (1) limited language of children's rights exists in the literature, (2) lack of information regarding the composition of pediatric healthcare teams and how they work with children, (3) children's perspectives on what constitutes good interactions with healthcare providers are replicated, (4) minimal references to theory or philosophical underpinnings that can guide practice. CONCLUSION: Explicit references to children's participation rights are lacking in the literature which may reflect the absence of rights language that could inform pediatric practice. Descriptive understandings of the tenets of pediatric interprofessional team composition and collaboration are necessary if we are to imagine the child as part of the team along with their family. Despite these shortcomings, the literature alludes to children's ability to discern desirable interactions with healthcare providers.

The impact of virtual reality on the psychological well-being of hospitalised patients: A critical review.

Background and objectives: Improving hospitalised patients' psychological well-being (PWB) is relevant to their recovery and overall quality of life. Virtual Reality (VR) holds the potential to emerge as a novel tool for increasing the PWB of hospitalised patients. This study critically reviewed existing research concerning the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The primary aim of this study was to evaluate the efficacy and practical applicability of VR in enhancing the PWB for hospitalised patients dealing with serious illnesses. Methodology: In the initial search, the authors identified 106 sources that provided valuable insights into the broader field of VR, PWB, and the influence of VR on the psychological functioning of hospitalised patients. However, only eight articles were selected for the critical review, following the SALSA method. The SALSA method comprises the following steps: (S) Search, (AL) Appraisal, (S) Synthesis and (A) Analysis. Data extracted from these eight articles were subjected to reflexive thematic analysis, through which patterns were identified to examine the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The thematic analysis process involves data gathering and familiarisation, code identification, and formulating and refining various themes to produce a thematic analysis report. Results: The themes that emerged from the analysis were (i) positive psychological effects (with sub-themes including the effectiveness of VR in improving psychological symptoms, its role as an equivalent or adjunctive treatment, and symptom reduction), (ii) perceptions and the adoption of novel technology, (iii) characteristics that influence the effectiveness of VR, and (iv) statistical and practical applicability and diversity of VR. Conclusion and recommendation: The use of VR to increase the PWB of hospitalised patients is a relatively recent innovation. Nevertheless, the themes identified in this study indicate that the use of VR within the context of hospitalised patients can benefit their psychological functioning, ultimately contributing to an improvement in their overall PWB. Further in-depth studies are needed to provide a comprehensive conclusion on the potential benefits of VR on the PWB of hospitalised patients dealing with serious illnesses.

Time to put aside the false dichotomy between personality disorders and psychotic symptoms.

Unlike internalizing and externalizing symptoms, psychotic symptoms (e.g., hallucinations, delusions) are manifestations of personality disorders (PDs) that are more controversial and poorly understood. This leaves clinicians with very little guidance for clinical practice, especially for diagnosis. What is more, most reviews have focused strictly on the links between psychotic symptoms and the categorically defined borderline PD, which contrasts with the growing movement that emphasizes a dimensional perspective (especially in psychology). Thus, the objectives of this critical review will be to (a) expose typical cases where PDs and psychotic symptoms might cooccur; (b) assess the state of scientific knowledge surrounding PD and psychotic symptoms; and (c) provide clinicians and researchers with recommendations to keep the field moving forward. We conclude that researchers and clinicians should move past the false "PD or psychosis" dichotomy since they often cooccur, avoid (as far as possible) making psychotic symptoms an exclusion criterion in PD research to enhance ecological validity, and consider dimensional PD diagnosis as a potential unifying solution to the dilemma posed by this cooccurrence.

A critical review of the role of manual therapy in the treatment of individuals with low back pain.

The number of low back pain (LBP) cases is projected to increase to more than 800 million by 2050. To address the substantial burden of disease associated with this rise in prevalence, effective treatments are needed. While clinical practice guidelines (CPG) consistently recommend non-pharmacological therapies as first-line treatments, recommendations regarding manual therapy (MT) in treating low back pain vary. The goal of this narrative review was to critically summarize the available evidence for MT behind these recommendations, to scrutinize its mechanisms of action, and propose some actionable steps for clinicians on how this knowledge can be integrated into a person-centered approach. Despite disparate recommendations from CPG, MT is as effective as other available treatments and may be offered to patients with LBP, especially as part of a treatment package with exercise and education. Most of the effects of MT are not specific to the technique. MT and other interventions share several mechanisms of action that mediate treatment success. These mechanisms can encompass patients' expectations, prior experiences, beliefs and convictions, epistemic trust, and nonspecific contextual effects. Although MT is safer than opioids for patients with LBP, this alone is insufficient. Our goal is to encourage clinicians to shift away from outdated and refuted ideas in MT and embrace a person-centered approach rooted in a comprehensive biopsychosocial framework while incorporating patients' beliefs, addressing illness behaviors, and seeking to understand each patient's journey.

Definitions and Measurement Tools for Assessing Parental Reactions to LGB People Coming Out: A Critical Review.

Parental responses to young people's coming out as lesbian, gay or bisexual (LGB) are a crucial experience in identity formation and subsequent mental health outcomes. However, how parents react to coming out varies and remains relatively imprecise in the literature. The aim of the present critical review was to explore and discuss the different definitions and measurement tools used in studies assessing perceived parental reactions to the coming out of LGB people aged 18 years and over. Following PRISMA guidelines, a review of 14 selected articles was carried out to examine the different tools used. Then, based on this selection of articles, a review of the different proposed definitions of parental reactions was carried out. Analysis revealed that the Perceived Parental Reactions Scale emerged as the most widely used and most appropriate international scale for capturing the diversity of perceived parental reactions. Then, parental responses were often addressed in a dichotomous manner, focusing primarily on acceptance or rejection. Future studies will need to consider a more nuanced approach to understanding parental reactions to coming out.

Clinical indications for carbon-ion radiotherapy in the UK: A critical review.

INTRODUCTION: Carbon-ion radiotherapy (CIRT) has unique radiobiological properties that cause increased radiobiological effect and tumour control, especially with hypoxic tissues. This critical review aimed to evaluate clinical response to CIRT across all published tumour sites to establish if there is a clinical need for a CIRT centre in the UK. METHODS: A critical review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature searching was undertaken in November 2022 within the PubMed, Science Direct, SCOPUS and Web of Science databases using the term 'carbon ion radiotherapy' in the title, abstract or author keywords. RESULTS: After critical appraisal, data was extracted from 78 primary study papers. Strong evidence supported use of CIRT for chondrosarcoma, chordoma, nasopharyngeal, non-small cell lung cancer (NSCLC), oral cavity, prostate, rectal and salivary gland tumours. Further research is needed to strengthen the evidence base for some other tumour types. CONCLUSION: The UK's incidence and mortality rates suggest a clinical need for CIRT for chondrosarcoma, chordoma, NSCLC, oral cavity, prostate, and rectal tumours. There is a need to improve survivorship amongst pancreatic, liver, and oesophageal cancer patients. Data published relating to CIRT for these tumours is promising but of lower quality and more research is needed in these areas. IMPLICATIONS FOR PRACTICE: The clinical response to CIRT for certain tumours suggests the need for a carbon-ion centre in the UK. Demand for further research [phase III trials] has been identified, giving the UK opportunity to establish a research centre, with opportunity to treat, contributing to world-renowned research whilst improving patient outcomes.

Pesticide residues in animal-derived food: Current state and perspectives.

Pesticides are widely used in the cultivation and breeding of agricultural products all over the world. However, their direct use or indirect pollution in animal breeding may lead to residual accumulation, migration, and metabolism in animal-derived foods, posing potential health risks to humans through the food chain. Therefore, it is necessary to detect pesticide residues in animal-derived food using simple, reliable, and sensitive methods. This review summarizes sample extraction and clean-up methods, as well as the instrumental determination technologies such as chromatography and chromatography-mass spectrometry for residual analysis in animal-derived foods, including meat, eggs and milk. Additionally, we perspectives on the future of this field. This information aims to assist relevant researchers in this area, contribute to the development of ideas and novel technical methods for residual detection, metabolic research and risk assessment of pesticides in animal-derived food.

The Socioeconomic Impact of Diseases of Working Equids in Low and Middle-Income Countries: A Critical Review.

Working equids provide a crucial contribution to the livelihoods and food security of communities in low- and middle-income countries (LMICs). Nevertheless, they are a neglected category within animal health policies and interventions of governmental and non-governmental institutions. This critical review aims to assess the socioeconomic impact of diseases of working equids in LMICs. By highlighting the implications of diseases on working equid welfare, human wellbeing and livelihoods, this review seeks to sensitise policymakers within governments and international organisations to develop policies and interventions aimed at protecting the health of working equids and, consequently, the health and livelihoods of their dependent communities. Twenty relevant publications were identified through the search of five databases (CAB Abstracts, Web of Science Core Collection, BIOSIS, EMBASE and Scopus), backward citation searching and screening of indexes of proceedings and Special Issues retrieved from the database search. The review findings show that diseases of working equids have detrimental socioeconomic effects. However, this subject is under-researched and restricted to few diseases and geographical settings. Considering the complexity of the issue, this review demonstrates that the 'One Health' approach represents an opportunity to clarify the link between equid health, human wellbeing and livelihoods, facilitating the translation of research into policy.

Art Therapy Interventions for Syrian Child and Adolescent Refugees: Enhancing Mental Well-being and Resilience.

PURPOSE OF REVIEW: This critical review primarily aims to conduct a comprehensive assessment of recent studies conducted within the past 3 years, with a specific focus on the use of art therapy within Syrian child and adolescent refugee populations. The central objective of this inquiry is to explore the impact of art therapy interventions and provide critical insights into their effectiveness in enhancing the mental well-being and resilience of these young refugees. RECENT FINDINGS: Recent research conducted within the past 3 years highlights the effectiveness of art therapy as an intervention strategy within Syrian child and adolescent refugee populations. These studies emphasize that art therapy offers a safe and supportive space for these young refugees to express emotions, process trauma, and improve their psychological well-being. It has shown promise in mitigating trauma-related challenges and fostering resilience among this group of refugee populations. Furthermore, art therapy plays a crucial role in preserving cultural identities and has proven to be versatile and adaptable to various artistic modalities. These findings underscore the potential of art therapy as a valuable tool for supporting the mental well-being and resilience of Syrian children and adolescent refugees, warranting further exploration and integration into their care and support programs. Recent studies on the use of art therapy within Syrian child and adolescent refugee communities reveal its potential as a powerful intervention strategy for enhancing mental well-being and resilience in this vulnerable population. The review identifies six key themes, highlighting the therapeutic benefits and versatility of art therapy. As we move forward, these findings offer promising future directions for research and practice in art therapy with this specific group of refugees, emphasizing the need for continued exploration and integration of this approach in supporting Syrian child and adolescent refugees.

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

Indigenous communities are disproportionately exposed to contaminated sites, and this poses unique challenges as many Indigenous peoples consider land as an integral part of their culture and economy. This scoping review aimed to identify and map information on contaminated sites and Indigenous peoples in Canada and the United States, namely (1) the relationship between contaminated sites and Indigenous peoples and their land and food systems; (2) strategies, challenges, and successes for contaminated sites assessment and management on Indigenous land; and (3) Indigenous leadership and inclusion in contaminated site assessment and management. We followed a PRISMA-ScR (Transparent Reporting of Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews) checklist to collect data that could be categorized into these three objectives. Between October 2021 and July 2023, information from three data streams was retrieved: a systematic literature search; a grey literature search; and federal site data retrieval (Canada's Federal Contaminated Sites Inventory, USEPA's contaminated sites databases, including Superfund). This search yielded 51 peer-reviewed articles, 21 grey literature articles, and 11 404 federal site records, evidencing the contamination of the lands of 875 Indigenous communities and the presence of 440 different contaminants or contaminant groups. The body of information was categorized into three themes within the above objectives: Objective 1: Indigenous communities and geographic patterns; Contaminated sites, sources, and media; Contaminated sites and Indigenous lands; Contaminated sites and Indigenous food systems; Contaminated sites and the health of Indigenous peoples; Objective 2: Site management and classification processes; Health risk assessment; Risk management; Long-term management; and Objective 3: Collaborative research, Collaborative site management; Traditional knowledge and contaminated sites. Results highlighted a need to prioritize holism, efficiency, and Indigenous leadership in site assessment, management, and research, including a focus on community-specific approaches to site assessment and management; a reconceptualization of risks that privileges Indigenous epistemologies; and greater collaboration between stakeholder networks. Integr Environ Assess Manag 2023;00:1-24. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Application of industry 4.0 enablers in supply chain management: Scientometric analysis and critical review.

The supply chain management (SCM) environment is rapidly evolving as a result of the critical role industry 4.0 enablers are playing. Consequently, and to leverage the power of industry 4.0 enablers (I4Es) including; artificial intelligence (AI), machine learning (ML), internet of things (IoT) and big data (BD), researchers and industry practitioners have employed these I4Es to resolve several pain points in supply chain management at all levels, improve operational efficiency, manage demand volatility, tackle cost fluctuations, and make data-driven decisions. Thus, I4Es are working as an evolutionary catalyst for supply chain management in myriads of ways. As such, the application of I4Es in supply chain management (I4Es-in-SCM) research has witnessed tremendous growth over the past years. This study conducted a scientometric analysis and critical review of the I4Es-in-SCM research to monitor trends, visualize the structure of knowledge, identify gaps, and highlight future research avenues. The paper recruited and analysed bibliographic data of 786 papers from Scopus on the application of I4Es-in-SCM research. Analysis showed that the last two decades witnessed a phenomenal growth in research on the application of I4Es-in-SCM, with at least 42 % of all countries making contributions. The analysis showed wider collaboration between countries and noticed a rather significant collaboration among researchers within a given continent. The study also identified the most influential researchers, journals, and countries as well as trending themes and topics in the application of I4Es-in-SCM research. After delineating boundaries of scientific knowledge, the study proffered areas that require further research. The novelty of this study lies in providing a more holistic statistical and visualized analysis of the structure of knowledge, productivity, and scientific collaborations of researchers, journals and countries in the application of I4Es-in-SCM management research. Accordingly, the study outcomes may serve as a useful reference to supply chain academics, early-stage researchers, practitioners, policymakers, and organizations in understanding the structure of knowledge on the application of I4Es-in-SCM research and may constitute a basis for future research.

Physical activity and physical fitness assessments in adolescents and young adults diagnosed with cancer: a scoping review.

PURPOSE: This scoping review describes the assessment methodologies for physical activity (PA) and physical fitness assessments used in studies focusing on adolescents and young adults (AYAs) diagnosed with cancer. METHODS: A search of the literature was conducted in PubMed, CINAHL, Web of Science, and Cochrane Library following the PRISMA-ScR statement. A total of 34 studies were included in this review. RESULTS: PA was primarily assessed via self-reported questionnaires (30/34) either completed in-person (n = 17) or online (n = 13) at different time points and different stages along the cancer trajectory (i.e., from diagnosis onward). A total of 9 studies conducted a physical fitness assessment. CONCLUSIONS: PA and physical fitness measurements are key when trying to describe outcomes, assess for associations, track changes, measure intervention adherence, and test intervention efficacy and effectiveness. Considerable heterogeneity across studies was reported limiting the generation of formal recommendations or guidance for researchers, healthcare providers, and policy makers.

Food allergen analysis: A review of current gaps and the potential to fill them by matrix-assisted laser desorption/ionization.

Food allergy remains a public health, business, and regulatory challenge. Risk analysis (RA) and risk management (RM) of food allergens are of great importance and analysis for food allergens is necessary for both. The current workhorse techniques for allergen analysis (enzyme linked immunosorbent assay [ELISA] and real-time polymerase chain reaction) exhibit recognized challenges including variable and antibody specific responses and detection of species DNA rather than allergen protein, respectively. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) enables protein identification, with potential for multiplex analysis and traceability to the System of International units (SI), aiding global measurement standardization. In this review, recent literature has been systematically reviewed to assess progress in LC-MS/MS and define the potential and benefits of matrix-assisted laser desorption/ionization-time-of-flight MS (MALDI-ToF-MS) technology for allergen analysis. MALDI-ToF-MS of initially intact protein is already applied to verify in silico-derived peptide sequences for LC-MS/MS analysis. We describe the origins of MALDI and its future perspectives, including affinity bead-assisted assays coupled to MALDI. Based on the proliferation of reliable and reproducible MALDI-based clinical applications, the technique should emulate the detection capability (sensitivity) of established allergen detection techniques, whilst reducing technical support and having equivalent multiplexing potential to competing techniques, for example, LC-MS/MS and ELISA. Although unlikely to offer inherent SI traceability, MALDI-based allergen analysis will complement existing MS approaches for allergens. Affinity bead-MALDI appears capable of higher throughput at lower cost per sample than almost any existing technique, enabling repeated sub-sampling as a way to reduce representative sampling issues.

Blockchain-smart contracts for sustainable project performance: bibliometric and content analyses.

Blockchain-smart contracts have emerged as a new value proposition in improving certain aspects of sustainability in projects. However, there is little knowledge on how smart contracts can be leveraged to stimulate sustainable project performance from the integrated perspective. This study aims to capture the latest research development and applications of smart contracts for sustainable outcomes throughout the project lifecycle. Bibliometric and content analyses were conducted to critically review smart contracts and sustainable project performance. The results show that various new applications of smart contracts for sustainability have become more popular in the architecture, engineering, construction, and operation (AECO) industry. A smart contracts-sustainable project performance framework has been developed to fill up the research gaps for improving each dimension of sustainability and the integrated dimensions of sustainability during the project lifecycle. This study renders important implications for promoting sustainable project performance in the context of the engineering, construction, and operation industry, particularly for the required interdisciplinary research and practice in smart contracts.

Destransición de género: Una revisión crítica de la literatura / Gender detransition: a critical review of the literature

Introducción. La destransición de género es el acto de detenero revertir los cambios sociales, médicos y/o administrativos conseguidos durante un proceso de transición de género. Se trata de un fenómeno emergente de gran interés a nivel clínico y social. Método. Se condujo una búsqueda sistemática en siete bases de datos entre 2010 y 2022, se rastrearon manualmente las referencias de los artículos y se consultaron libros especializados. Se realizó un análisis cuantitativo y de contenido. Resultados. Se incluyeron 138 registros, 37% correspondientes a estudios empíricos y 38,4% publicados en 2021. Se identifican al menos ocho términos para hacer referencia a la destransición, con diferencias en sus definiciones. La prevalencia difiere en función del criterio utilizado, siendo menor para la destransición/arrepentimiento (0-13,1%) que para la descontinuación de la asistencia/tratamiento médico (1,9%-29,8%),y menor para la destransición/arrepentimiento tras cirugía (0-2,4%) que para la destransición/arrepentimiento tras tratamiento hormonal (0-9,8%). Se describen más de 50 factores psicológicos, médicos y socioculturales que influyen en la decisión de destransicionar, así como 16 factores predictores/asociados a la destransición. No se encuentran guías de abordaje sanitario ni legislativo. Los debates actuales se centran en los interrogantes sobre la naturaleza de la disforia de género y el desarrollo de la identidad, el papel de los profesionales con respecto al acceso a los tratamientos médicos y el impacto de las destransiciones sobre la futura accesibilidad a dichos tratamientos. Conclusiones. La destransición de género es una realidad compleja, heterogénea, poco estudiada y escasamente comprendida. Se requiere un abordaje y estudio sistemático que permita comprender su prevalencia real, implicaciones y manejo a nivel sanitario. (AU)

Introduction. Gender detransition is the act of stoppingor reversing the social, medical, and/or administrative changesachieved during a gender transition process. It is an emergingphenomenon of significant clinical and social interest.Methods. We systematically searched seven databasesbetween 2010 and 2022, manually traced article references,and consulted specialized books. Quantitative and contentanalyses were carried out.Results. We included 138 registers, 37% of which were empirical studies and 38.4% of which were published in 2021. Atleast eight terms related to detransition were identified, withdifferences in their definitions. Prevalence estimates differ according to the criteria used, being lower for detransition/regret (0-13.1%) than for discontinuation of care/medical treatment (1.9%-29.8%), and for detransition/regret after surgery(0-2.4%) than for detransition/regret after hormonal treatment (0-9.8%). More than 50 psychological, medical, and sociocultural factors influencing the decision to detransition and16 predictors/associated factors are described. No health orlegal guidelines are found. Current debates focus on the nature of gender dysphoria and identity development, the role ofprofessionals in accessing medical treatments, and the impactof detransition on future access to these treatments.Conclusions. Gender detransition is a complex, heterogeneous, under-researched, and poorly understood reality. Asystematic study and approach to the topic is needed to understand its prevalence, implications, and management from a healthcare perspective. (AU)