Illness prevalence and symptoms in youth floorball players: a one-season prospective cohort study involving 471 players

ObjectiveTo describe weekly illness prevalence and illness symptoms by sex in youth floorball players during one season.DesignProspective cohort study.SettingPlayers who were registered to play community level floorball during the 2017–2018 season (26 weeks) in two provinces in southern Sweden.Participants471 youth players aged 12–17 years. Mean (SD) age for 329 male players 13.3 (1.0) years and 142 female players 13.7 (1.5) years.Primary and secondary outcome measuresWeekly self-reported illness prevalence and illness symptoms according to the 2020 International Olympic Committee’s consensus recommendations.Results61% of youth floorball players reported at least one illness week during the season, with an average weekly illness prevalence of 12% (95% CI 10.8% to 12.3%). The prevalence was slightly higher among females (13%, 95% CI 11.6% to 14.3%) than males (11%, 95% CI 9.9% to 11.7%), prevalence rate ratio 1.20 (95% CI 1.05 to 1.37, p=0.009). In total, 49% (53% male, 43% female) of illness reports indicated that the player could not participate in floorball (time loss), with a mean (SD) absence of 2.0 (1.7) days per illness week. Fever (30%), sore throat (16%) and cough (14%) were the most common symptoms. Female players more often reported difficulty in breathing/tight airways and fainting, and male players more often reported coughing, feeling tired/feverish and headache. Illness prevalence was highest in the peak winter months (late January/February) reaching 15%–18% during this period.ConclusionsOur novel findings of the illness prevalence and symptoms in youth floorball may help direct prevention strategies. Athletes, coaches, parents and support personnel need to be educated about risk mitigation strategies.Trial registration numberNCT03309904.

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Nurse-led PrEP-RN clinic: a prospective cohort study exploring task-Shifting HIV prevention to public health nurses

BMJ Open ◽

10.1136/bmjopen-2020-040817 ◽

2021 ◽

Vol 11 (1) ◽

pp. e040817

Author(s):

Patrick O'Byrne ◽

Amanda Vandyk ◽

Lauren Orser ◽

Marlene Haines

Keyword(s):

Public Health ◽

Cohort Study ◽

High Risk ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Secondary Outcome ◽

Bivariate Analysis ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Risk Criteria

ObjectiveTo report the results of a nurse-led pre-exposure prophylaxis (PrEP) delivery service.DesignThis was a prospective cohort study conducted from 5 August 2018 to 4 March 2020. It involved manual chart review to collect data. Variables were described using frequencies and percentages and analysed using χ2 testing. Those significant in bivariate analysis were retained and entered into a binary multiple logistic regression. Hierarchical modelling was used, and only significant factors were retained.SettingThis study occurred in an urban public health unit and community-based sexually transmitted infection (STI) clinic in Ottawa, Canada.ParticipantsOf all persons who were diagnosed with a bacterial STI in Ottawa and everyone who presented to our STI clinic during the study period, there were 347 patients who met our high-risk criteria for PrEP; these criteria included patients who newly presented with any of the following: HIV contacts, diagnosed with a bacterial STI or single use of HIV PEP. Further, eligibility could be determined based on clinical judgement. Patients who met the foregoing criteria were appropriate for PrEP-RN, while lower-risk patients were referred to elsewhere. Of the 347 patients who met our high-risk criteria, 47% accepted and 53% declined. Of those who accepted, 80% selected PrEP-registered nurse (RN).Primary and secondary outcome measuresUptake, acceptance, engagement and attrition factors of participants who obtained PrEP through PrEP-RN.Findings69% of participants who were eligible attended their intake PrEP-RN visit. 66% were retained in care. Half of participants continued PrEP and half were lost to follow-up. We found no significant differences in the uptake, acceptance, engagement and attrition factors of participants who accessed PrEP-RN regarding reason for referral, age, ethnicity, sexual orientation, annual income, education attainted, insurance status, if they have a primary care provider, presence or absence of depression or anxiety and evidence of newly acquired STI during the study period.ConclusionsNurse-led PrEP is an appropriate strategy for PrEP delivery.

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Can delirium research activity impact on routine delirium recognition? A prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-023386 ◽

2018 ◽

Vol 8 (10) ◽

pp. e023386 ◽

Cited By ~ 2

Author(s):

Carly Welch ◽

Thomas A Jackson

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

University Teaching ◽

Secondary Outcome ◽

Research Activity ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Improve Patient ◽

Discharge Summaries

ObjectiveTo assess if ongoing delirium research activity within an acute admissions unit impacts on prevalent delirium recognition.DesignProspective cohort study.SettingSingle-site tertiary university teaching hospital.Participants125 patients with delirium, as diagnosed by an expert using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition reference criteria, were recruited to a prospective cohort study investigating use of informant tools to detect unrecognised dementia. This study evaluated recognition of delirium and documentation of delirium by medical staff.InterventionsThe main study followed an observational design; the intervention discussed was the implementation of this study itself.Primary and secondary outcome measuresThe primary outcome was recognition of delirium by the admitting medical team prior to study diagnosis. Secondary outcomes included recording of or description of delirium in discharge summaries, and factors which may be associated with unrecognised delirium.ResultsDelirium recognition improved between the first half (48%) and second half (71%) of recruitment (p=0.01). There was no difference in recording of delirium or description of delirium in the text of discharge summaries.ConclusionDelirium research activity can improve recognition of delirium. This has the potential to improve patient outcomes.

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Meniscal tear outcome Study (METRO Study): a study protocol for a multicentre prospective cohort study exploring the factors which affect outcomes in patients with a meniscal tear

BMJ Open ◽

10.1136/bmjopen-2020-038681 ◽

2020 ◽

Vol 10 (7) ◽

pp. e038681

Author(s):

Imran Ahmed ◽

Mike Bowes ◽

Charles E Hutchinson ◽

Nicholas Parsons ◽

Sophie Staniszewska ◽

...

Keyword(s):

Cohort Study ◽

Research Ethics ◽

Outcome Measures ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Meniscal Tear ◽

Ethics Committee ◽

Secondary Outcome ◽

Research Ethics Committee ◽

Baseline Characteristics

IntroductionThis study is designed to explore the baseline characteristics of patients under 55 years of age with a meniscal tear, and to describe the relationship between the baseline characteristics and patient-reported outcome measures (PROMs) over 12 months. Research has highlighted the need for a trial to investigate the effectiveness of arthroscopic meniscectomy in younger patients. Before this trial, we need to understand the patient population in greater detail.Methods and analysisThis is a multicentre prospective cohort study. Participants aged between 18 and 55 years with an MRI confirmed meniscal tear are eligible for inclusion. Baseline characteristics including age, body mass index, gender, PROMs duration of symptoms and MRI will be collected. The primary outcome measure is the Western Ontario Meniscal Evaluation Tool at 12 months. Secondary outcome measures will include PROMs such as EQ5D, Knee Injury and Osteoarthritis Outcome Score and patient global impression of change score at 3, 6 and 12 months.Ethics and disseminationThe study obtained approval from the National Research Ethics Committee West Midlands—Black Country research ethics committee (19/WM/0079) on 12 April 2019. The study is sponsored by the University of Warwick. The results will be disseminated via peer-reviewed publication.Trial registration numberUHCW R&D Reference: IA428119. University of Warwick Sponsor ID: SC.08/18–19

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Study protocol for the ABERRANT study: antibiotic-induced disruption of the maternal and infant microbiome and adverse health outcomes — a prospective cohort study among children born at term

BMJ Open ◽

10.1136/bmjopen-2019-036275 ◽

2020 ◽

Vol 10 (6) ◽

pp. e036275

Author(s):

Maryse Volery ◽

Valentin Scherz ◽

William Jakob ◽

Diane Bandeira ◽

Vanessa Deggim-Messmer ◽

...

Keyword(s):

Antibiotic Resistance ◽

Cohort Study ◽

Breast Milk ◽

Health Outcomes ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Intestinal Microbiome ◽

Metagenomic Sequencing ◽

Adverse Health Outcomes ◽

Registration Number

IntroductionThere is compositional overlap between the maternal intestinal microbiome, the breast milk microbiome and the infant oral and intestinal microbiome. Antibiotics cause profound changes in the microbiome. However, the effect of intrapartum and early-life antibiotics on the maternal intestinal and breast milk microbiome, and the infant oral and intestinal microbiome, and whether effects are only short term or persist long term remain uncertain.Methods and analysesIn this prospective cohort study, we will use metagenomic sequencing to determine: (1) the effect of intrapartum antibiotics on the composition of the breast milk, and the infant oral and intestinal microbiome, including the development and persistence of antibiotic resistance; (2) the effect of antibiotic exposure in the first year of life on the composition of the infant oral and intestinal microbiome, including the development and persistence of antibiotic resistance; (3) the effect of disruption of the infant oral and intestinal microbiome on health outcomes and (4) the compositional overlap between the maternal intestinal microbiome, the breast milk microbiome and the infant oral and intestinal microbiome.Ethics and disseminationThe ABERRANT study has been approved by the commission cantonale d’éthique de la recherche sur l’être humain (CER-VD) du Canton de Vaud (#2019–01567). Outcomes will be disseminated through publication and will be presented at scientific conferences.Trial registration numberNCT04091282.

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Adherence to childhood cancer treatment: a prospective cohort study from Northern Vietnam

BMJ Open ◽

10.1136/bmjopen-2018-026863 ◽

2019 ◽

Vol 9 (8) ◽

pp. e026863

Author(s):

Bui Ngoc Lan ◽

Anders Castor ◽

Thomas Wiebe ◽

Jacek Toporski ◽

Christian Moëll ◽

...

Keyword(s):

Cohort Study ◽

Cancer Treatment ◽

Childhood Cancer ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Cox Model ◽

Secondary Outcome ◽

Northern Vietnam ◽

Family Decision ◽

Treatment Abandonment

ObjectivesGlobal incidence and attention to childhood cancer is increasing and treatment abandonment is a major cause of treatment failure in low- and middle-income countries. The purpose of this study was to gain an understanding of factors contributing to non-adherence to treatment.DesignA prospective cohort study with 2 year follow-up of incidence, family-reported motives and risk factors.SettingThe largest tertiary paediatric oncology centre in Northern Vietnam.ParticipantsAll children offered curative cancer treatment, from January 2008 to December 2009.Primary and secondary outcome measuresFamily decision to start treatment was analysed with multivariable logistic regression, and family decision to continue treatment was analysed with a multivariable Cox model. This assessment of non-adherence is thereby methodologically consistent with the accepted definitions and recommended practices for evaluation of treatment abandonment.ResultsAmong 731 consecutively admitted patients, 677 were eligible for treatment and were followed for a maximum 2 years. Almost half the parents chose to decline curative care (45.5%), either before (35.2%) or during (10.3%) the course of treatment. Most parents reported perceived poor prognosis as the main reason for non-adherence, followed by financial constraints and traditional medicine preference. The odds of starting treatment increased throughout the study-period (OR 1.04 per month (1.01 to 1.07), p=0.002), and were independently associated with prognosis (OR 0.51 (0.41 to 0.64), p=<0.0001) and travel distance to hospital (OR 0.998 per km (0.996 to 0.999), p=0.004). The results also suggest that adherence to initiated treatment was significantly higher among boys than girls (HR 1.69 (1.05 to 2.73), p=0.03).ConclusionsNon-adherence influenced the prognosis of childhood cancer, and was associated with cultural and local perceptions of cancer and the economic power of the affected families. Prevention of abandonment is a prerequisite for successful cancer care, and a crucial early step in quality improvements to care for all children with cancer.

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Determining universal processes related to best outcome in emergency abdominal surgery: a multicentre, international, prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2014-006239 ◽

2014 ◽

Vol 4 (10) ◽

pp. e006239 ◽

Cited By ~ 7

Author(s):

Aneel Bhangu ◽

J Edward Fitzgerald ◽

Stuart Fergusson ◽

Chetan Khatri ◽

Hampus Holmer ◽

...

Keyword(s):

Cohort Study ◽

Abdominal Surgery ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Outcome Measure ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Perioperative Mortality ◽

Acute Surgery ◽

Emergency Abdominal Surgery

IntroductionEmergency abdominal surgery outcomes represent an internationally important marker of healthcare quality and capacity. In this study, a novel approach to investigating global surgical outcomes is proposed, involving collaborative methodology using ‘snapshot’ clinical data collection over a 2-week period. The primary aim is to identify internationally relevant, modifiable surgical practices (in terms of modifiable process, equipment and clinical management) associated with best care for emergency abdominal surgery.Methods and analysisThis is a multicentre, international, prospective cohort study. Any hospital in the world performing acute surgery can participate, and any patient undergoing emergency intraperitoneal surgery is eligible to enter the study. Centres will collect observational data on patients for a 14-day period during a 5-month window and required data points will be limited to ensure practicality for collaborators collecting data. The primary outcome measure is the 24 h perioperative mortality, with 30-day perioperative mortality as a secondary outcome measure. During registration, participants will undertake a survey of available resources and capacity based on the WHO Tool for Situational Analysis.Ethics and disseminationThe study will not affect clinical care and has therefore been classified as an audit by the South East Scotland Research Ethics Service in Edinburgh, Scotland. Baseline outcome measurement in relation to emergency abdominal surgery has not yet been undertaken at an international level and will provide a useful indicator of surgical capacity and the modifiable factors that influence this. This novel methodological approach will facilitate delivery of a multicentre study at a global level, in addition to building international audit and research capacity.Trial registration numberThe study has been registered with ClinicalTrials.gov (Identifier: NCT02179112).

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Could listening to music during pregnancy be protective against postnatal depression and poor wellbeing post birth? Longitudinal associations from a preliminary prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2017-021251 ◽

2018 ◽

Vol 8 (7) ◽

pp. e021251 ◽

Cited By ~ 3

Author(s):

Daisy Fancourt ◽

Rosie Perkins

Keyword(s):

Mental Health ◽

Cohort Study ◽

Prospective Cohort Study ◽

Postnatal Depression ◽

Prospective Cohort ◽

Depression Scale ◽

Well Being ◽

Secondary Outcome ◽

Confounding Variables ◽

Mental Well Being

ObjectivesThis study explored whether listening to music during pregnancy is longitudinally associated with lower symptoms of postnatal depression and higher well-being in mothers post birth.DesignProspective cohort study.ParticipantsWe analysed data from 395 new mothers aged over 18 who provided data in the third trimester of pregnancy and 3 and 6 months later (0–3 and 4–6 months post birth).Primary and secondary outcome measuresPostnatal depression was measured using the Edinburgh Postnatal Depression Scale, and well-being was measured using the Short Warwick-Edinburgh Mental Well-being Scale. Our exposure was listening to music and was categorised as ‘rarely; a couple of times a week; every day <1 hour; every day 1–2 hours; every day 3–5 hours; every day 5+hrs’. Multivariable linear regression analyses were carried out to explore the effects of listening to music during pregnancy on depression and well-being post birth, adjusted for baseline mental health and potential confounding variables.ResultsListening during pregnancy is associated with higher levels of well-being (β=0.40, SE=0.15, 95% CI 0.10 to 0.70) and reduced symptoms of postnatal depression (β=−0.39, SE=0.19, 95% CI −0.76 to −0.03) in the first 3 months post birth. However, effects disappear by 4–6 months post birth. These results appear to be particularly found among women with lower levels of well-being and high levels of depression at baseline.ConclusionsListening to music could be recommended as a way of supporting mental health and well-being in pregnant women, in particular those who demonstrate low well-being or symptoms of postnatal depression.

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End-stage knee osteoarthritis with and without sarcopenia and the effect of knee arthroplasty – a prospective cohort study

10.21203/rs.3.rs-33924/v4 ◽

2020 ◽

Author(s):

Kevin Ki-Wai Ho ◽

Lawrence Chun-Man Lau ◽

Wai Wang Chau ◽

Queena Poon ◽

Kwong-Yin Chung ◽

...

Keyword(s):

Cohort Study ◽

Muscle Strength ◽

Outcome Measures ◽

Prospective Cohort Study ◽

Knee Arthroplasty ◽

Prospective Cohort ◽

Functional Improvement ◽

Secondary Outcome ◽

End Stage

Abstract Background: Sarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period.Methods: This prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health.Results: Fifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89±7.07 vs. 67.92±6.85; p=0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64±2.64 vs. 28.57±4.04; p=0.01). There was a statistically significant improvement in walking speed (10.24±5.35 vs. 7.69±2.68, p<0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31±5.92 vs. 18.98±6.37 vs. 19.36±7.66; p=0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27±15.98 vs. 20.65±15.24 vs. 16.65±18.13) and SF12v2 (PCS: 33.06±8.55 vs. 38.96±8.01 vs. 40.67±7.93) revealed progressive significant improvement (both comparisons p≤0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities.Conclusions: This study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects.

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Relationships between dipstick proteinuria and risk of hearing impairment among Japanese workers: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-028767 ◽

2019 ◽

Vol 9 (11) ◽

pp. e028767 ◽

Cited By ~ 3

Author(s):

Mitsumasa Umesawa ◽

Mikako Hara ◽

Toshimi Sairenchi ◽

Masanori Nagao ◽

Yasuo Haruyama ◽

...

Keyword(s):

Cohort Study ◽

Hearing Impairment ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Health Check ◽

Secondary Outcome ◽

Japanese Workers ◽

Medical Examinations ◽

Urine Testing ◽

Significant Health

ObjectivesHearing impairment is among the most significant health problems, and the number of adults with hearing impairment is increasing worldwide. Therefore, the prevention of hearing impairment is important. Proteinuria appears to be a risk factor for hearing impairment, but no prospective studies have examined the association between proteinuria and hearing impairment risk. This prospective study aimed to clarify the association between dipstick proteinuria and risk of hearing impairment.DesignThis was a prospective cohort study based on annual health check-up data, 2008–2016.SettingData were collected on 7005 employees of a single company who worked in offices and factories throughout Japan.ParticipantsWe analysed data from 5699 subjects (88.6% men) who underwent annual health check-ups twice or more from 2008 to 2016, had no missing data, and were free from hearing impairment at baseline. We regarded the first health check-up as the baseline examination.Primary and secondary outcome measuresHearing tests were performed using audiometry at two frequencies (1 and 4 kHz) during the health check-ups. Defining total moderate hearing impairment as the inability to respond to 30 dB at 1 kHz and/or 40 dB at 4 kHz, we examined the association between dipstick proteinuria at baseline and risk of hearing impairment at final examination.ResultsTotal moderate hearing impairment was noted in 162 (2.8%) subjects. Compared with subjects without proteinuria at baseline, the multivariable adjusted OR (95% CI) was 5.35 (1.87–15.25) for subjects with proteinuria ≥2+, 0.92 (0.40–2.13) for those with proteinuria +/−, and 1.33 (0.63–2.80) for those with proteinuria+ at baseline.ConclusionsSevere dipstick proteinuria was positively associated with risk of hearing impairment in the future. Our results suggest that medical examinations including urine testing are effective for detecting subjects with high risk of hearing impairment.

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Does service heterogeneity have an impact on acute hospital length of stay in stroke? A UK-based multicentre prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-024506 ◽

2019 ◽

Vol 9 (4) ◽

pp. e024506 ◽

Cited By ~ 1

Author(s):

Michelle Tørnes ◽

David McLernon ◽

Max Bachmann ◽

Stanley Musgrave ◽

Elizabeth A Warburton ◽

...

Keyword(s):

Cohort Study ◽

Length Of Stay ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Multiple Linear Regression Model ◽

Hospital Length ◽

Acute Hospital ◽

Hospital Length Of Stay ◽

Secondary Outcome ◽

Hospital Level

ObjectivesTo determine whether stroke patients’ acute hospital length of stay (AHLOS) varies between hospitals, over and above case mix differences and to investigate the hospital-level explanatory factors.DesignA multicentre prospective cohort study.SettingEight National Health Service acute hospital trusts within the Anglia Stroke & Heart Clinical Network in the East of England, UK.ParticipantsThe study sample was systematically selected to include all consecutive patients admitted within a month to any of the eight hospitals, diagnosed with stroke by an accredited stroke physician every third month between October 2009 and September 2011.Primary and secondary outcome measuresAHLOS was defined as the number of days between date of hospital admission and discharge or death, whichever came first. We used a multiple linear regression model to investigate the association between hospital (as a fixed-effect) and AHLOS, adjusting for several important patient covariates, such as age, sex, stroke type, modified Rankin Scale score (mRS), comorbidities and inpatient complications. Exploratory data analysis was used to examine the hospital-level characteristics which may contribute to variance between hospitals. These included hospital type, stroke monthly case volume, service provisions (ie, onsite rehabilitation) and staffing levels.ResultsA total of 2233 stroke admissions (52% female, median age (IQR) 79 (70 to 86) years, 83% ischaemic stroke) were included. The overall median AHLOS (IQR) was 9 (4 to 21) days. After adjusting for patient covariates, AHLOS still differed significantly between hospitals (p<0.001). Furthermore, hospitals with the longest adjusted AHLOS’s had predominantly smaller stroke volumes.ConclusionsWe have clearly demonstrated that AHLOS varies between different hospitals, and that the most important patient-level explanatory variables are discharge mRS, dementia and inpatient complications. We highlight the potential importance of stroke volume in influencing these differences but cannot discount the potential effect of unmeasured confounders.

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