Notes

Decrease in bromate via drinking water through sulfite/ferric ion systems: Effectiveness and mechanisms.
Both the diagnosis and medical treatment of gender dysphoria (GD)-particularly in children and adolescents-have been the subject of significant controversy in recent years. In this paper, we outline the means by which GD is diagnosed in children and adolescents, the currently available treatment options, and the bioethical issues these currently raise. In particular, we argue that the families and healthcare providers of children presenting with GD currently face two main ethical dilemmas in decision making regarding treatment the pathway dilemma and the consent dilemma.
Hospitals commonly examine patient safety culture and other quality indicators to evaluate and improve performance in relation to quality and safety. A growing body of research has separately examined relationships between patient safety culture and patient experience on clinical outcomes and other quality indicators. However, there is a knowledge gap regarding the relationship between these two important domains. This article describes the protocol for a scoping review of published literature examining the relationship between patient safety culture and patient experience in hospital settings. The scoping review will provide an overview of research into the relationship between patient safety culture and patient experience in hospital contexts, map key concepts underpinning these domains and identify research gaps for further study.

The scoping review will be conducted using the five stages of Arksey and O'Malley's framework identify the research question; identify relevant studies; study selection; chart data; and collate, summarise and report the results. The inclusion criteria will be applied using the Population, Concept and Context Framework. Searches will be conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, Scopus and SciELO databases, without applying date range limits. Hand-searching of grey literature will also be performed to find relevant, non-indexed literature. Data will be extracted using a standardised data extraction form developed by the Joanna Briggs Institute. Both descriptive and thematic analyses will be undertaken to scope key concepts within the body of reviewed literature.

This type of study does not require an ethics review. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.
This type of study does not require an ethics review. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.
The study aimed to examine the association between socioeconomic factors (SEFs) and oral anticoagulation (OAC) therapy and whether it was influenced by changing guidelines. We hypothesised that inequities in initiation of OAC reduced over time as more detailed and explicit clinical guidelines were issued.

Register-based observational study.

All Danish patients with an incident hospital diagnosis of atrial fibrillation (AF), aged ≥30 years old and with high risk of stroke from 1 May 1999 to 2 October 2015 were included. Absolute risk differences (RD) (95% CI) were used to measure the association.

154 448 patients (mean age 78.2 years, men 47.3%).

Education, family income and cohabiting status were the SEFs used as exposure.

A prescription of OAC within -30 to +90 days of baseline (incident AF).

During 2002-2007, the crude RD of initiation of OAC for men with high education was 14.9% (12.8 to 16.9). Inequality reduced when new guidelines were published, and in 2013-2016 the crude RD was 5.6% (3.5 to 7.7). After adjusting for age, the RD substantially reduced. The same pattern was seen for cohabiting status, while inequality was smaller and more constant for income.

Patients with low income, low education and living alone were associated with lower chance of being initiated with OAC. For education and cohabiting status, the crude difference reduced around 2011, when more detailed clinical guidelines were implemented in Denmark. Our results indicate that new guidelines might reduce inequality in OAC initiation and that new, high-cost drugs increase inequality.
Patients with low income, low education and living alone were associated with lower chance of being initiated with OAC. For education and cohabiting status, the crude difference reduced around 2011, when more detailed clinical guidelines were implemented in Denmark. Our results indicate that new guidelines might reduce inequality in OAC initiation and that new, high-cost drugs increase inequality.
Hangeshashinto has been employed for oral mucositis prevention in patients receiving cancer treatment, but the evidence has not been sufficiently robust to guide clinical decision-making. BAY-61-3606 mw This study will therefore be undertaken to assess the effectiveness of Hangeshashinto for preventing oral mucositis in patients with cancer who are receiving treatment.

The databases will include PubMed, Embase, the Cochrane Library, Chinese databases and Japanese databases. The literature will be searched from the databases' inception until May 2021. Other sources, such as potential grey literature, reference lists from included studies and relevant systematic reviews and conference papers, will also be searched. The primary outcome is the incidence of mucositis of any severity, and the secondary outcomes are interruptions to cancer treatment, oral pain and nutritional status. The risk of bias of eligible studies will be assessed using the Cochrane Collaboration's 'risk of bias' tool. Both the Q test and I
statistic will be performed to assess statistical heterogeneity. If I
>50%, sensitivity and subgroup analysis will be conducted. The quality of evidence will be rated according to the Grading of Recommendations, Assessment, Development and Evaluation approach. Egger's test will be used to assess reporting bias.

This systematic review will evaluate only published data; therefore, ethical approval is not required.

CRD42020216145.
CRD42020216145.
Goal planning is widely recognised as an integral part of mental health service delivery and an important element in supporting recovery. Goal planning identifies priorities for treatment through discussion and negotiation between service users and health practitioners. Goal planning enhances motivation, directs effort, and focuses the development of strategies and treatment options to improve recovery outcomes and promote service users' ownership of the recovery process. While goal planning is a common practice in mental health settings, evidence regarding its impact on treatment outcomes is lacking. This paper outlines a protocol for a systematic review that aims to explore the types of goals planned, experiences of service users and practitioners, and the effectiveness of goal planning as a mental health intervention.

A systematic search will be conducted during March 2021 by searching Medline, CINAHL, Embase, Scopus and PsycINFO electronic databases to answer the following questions (1) What types of 2020220595.
CRD42020220595.
To investigate the incidence of accidental hypothermia (AH) in a nationwide registry and the associated outcomes.

Nationwide retrospective cohort study PARTICIPANTS AND SETTINGS All patients at least 18 years old, admitted to hospitals in Denmark with a diagnosis of AH, with an International Classification of Diseases, 10th edition code of T689, from January 1996 to November 2016. Other recorded diagnoses were included in the analyses.

The primary outcome was 1-year mortality.

During the inclusion period, 5242 patients were admitted with a diagnosis of AH, corresponding to a mean annual incidence of 4.4±1.2 (range by calendar year 2.9-6.4) per 100 000 inhabitants. A total of 2230 (43%) had AH recorded as the primary diagnosis without any recorded secondary diagnoses (primary AH), 1336 (25%) had AH recorded as the primary diagnosis with other recorded secondary diagnoses (AH+2° diagnosis), and 1676 (32%) had AH recorded as a secondary diagnosis with another recorded primary diagnosis (1° diagnosis+AH).1995 to 2016. The diagnosis is associated with a high comorbidity burden and a considerable 1-year mortality. In the high proportion of patients with associated comorbidities, establishing whether AH or the comorbidities are the drivers of mortality remains difficult. This complicates our understanding of AH and makes it difficult to find modifiable factors associated with both AH and outcomes. Future prospective studies are needed elucidate the causal relationship between AH and associated comorbidities.
To examine the association between breastfeeding practice and hospitalisations for infectious diseases in early and later childhood, in particular, to compare exclusive breast feeding 4-5 months with exclusive breastfeeding 6 months or more. Thereby, provide evidence to inform breastfeeding policy.

A register-based cohort study.

A cohort was created by combining the Swedish Medical Birth Register, the National Inpatient Register, the Cause of Death Register, the Total Population Register, the Longitudinal integration database for health insurance and labour market studies, with the Uppsala Preventive Child Health Care database.

37 825 term and post-term singletons born to women who resided in Uppsala County (Sweden) between 1998 and 2010.

Number of hospitalisations for infectious diseases in early (<2 years) and later childhood (2-4 years).

The risk of hospitalisations for infectious diseases decreased with duration of exclusive breastfeeding until 4 months of age. In early childhood, breast feeding was associated with a decreased risk of enteric and respiratory infections. In comparison with exclusive breast feeding 6 months or more, the strongest association was found between no breastfeeding and enteric infections (adjusted incidence rate ratios, aIRR 3.32 (95% CI 2.14 to 5.14)). In later childhood, breast feeding was associated with a lower risk of respiratory infections. In comparison with children exclusively breastfed 6 months or more, the highest risk was found in children who were not breastfed (aIRR 2.53 (95% CI 1.51 to 4.24)). The risk of hospitalisations for infectious diseases was comparable in children exclusively breastfed 4-5 months and children exclusively breastfed 6 months or more.

Our results support breastfeeding guidelines that recommend exclusive breastfeeding for at least 4 months.
Our results support breastfeeding guidelines that recommend exclusive breastfeeding for at least 4 months.
Motor variability is an important feature when performing repetitive movement, and in asymptomatic people functional tasks are typically performed with variable motor patterns. However, in the presence of chronic non-specific low back pain (LBP), people often present with different motor control strategies than those without pain. Movement variability has been assessed using a wide range of variables, including kinetic and kinematic components of motion. This has resulted in a wide range of findings reported in the literature and some contradicting results. Therefore, the aim of this systematic review is to investigate whether the amount and structure of motor variability are altered in people with chronic non-specific LBP, during both repetitive non-functional and functional tasks.

This protocol for a systematic review is informed by Cochrane guidelines and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. MEDLINE, EMBASE, CINAHL, ZETOC, Web of Science, PubMed and Scopus will be searched from their inception to December 2020 along with a comprehensive search of grey literature and key journals.
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