Manzur Kader | Karolinska Institutet (original) (raw)
Papers by Manzur Kader
Journal of the International AIDS Society, 2010
Study DesignA prospective cross-sectional survey.ObjectiveThe study aimed to examine the Knowledg... more Study DesignA prospective cross-sectional survey.ObjectiveThe study aimed to examine the Knowledge, Attitudes, and Practices (KAP) of people living with Spinal cord injury (SCI) towards COVID-19 and their psychological status during in-patient rehabilitation in Bangladesh.SettingThe Centre for the Rehabilitation of the Paralyzed (CRP) and the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), two tertiary level hospitals in Dhaka, Bangladesh.MethodsFrom July to September 2020, a prospective, cross-sectional survey of SCI subjects, 13-78 years of age, carried out in two SCI rehab centers in Bangladesh. Data has been collected by face to face interview through a pretested, and language validated questionnaire on KAP and Depression, Anxiety, Stress (DASS). Ethical approval and trial registration obtained prospectively. As all the patients were previously living with Spinal cord injury (SCI), therefore, all the patients admitted/ attend SCI rehab centers were cons...
BMJ
Objectives To assess whether male elite football players are at increased risk of alcohol related... more Objectives To assess whether male elite football players are at increased risk of alcohol related disorders compared with men from the general population, and whether such an increased risk would vary on the basis of calendar year of the first playing season in the top tier of competition, age, career length, and goal scoring abilities. Design Nationwide cohort study. Setting Sweden, 1924-2020. Participants 6007 male football players who had played in the Swedish top division, Allsvenskan, from 1924 to 2019 and 56 168 men from the general population matched to players based on age and region of residence. Main outcome measures Primary outcome was alcohol related disorders (diagnoses recorded in death certificates, during hospital admissions and outpatient visits, or use of prescription drugs for alcohol addiction); secondary outcome was disorders related to misuse of other drugs. Results During follow-up up to 31 December 2020, 257 (4.3%) football players and 3528 (6.3%) men from th...
Sports
This is a cross-sectional study that examined the association between fitness trainers’ education... more This is a cross-sectional study that examined the association between fitness trainers’ educational qualifications and experience, and the risk of their trainees’ musculoskeletal pain. The study included 1177 trainees (aged 15–60 years) from 74 fitness centers in Bangladesh. Data were collected by using the Nordic musculoskeletal questionnaire, including potential confounders such as demographic factors (e.g., age, occupation), and training-related factors (e.g., workout knowledge, overweight lifting). Multiple logistic regression was performed for a binary outcome (pain—yes or no), and a generalized linear model was fitted for the ordinal outcome (pain—sites of the body). The trainers’ lower experience (no or ≤1 year) was associated with higher odds of their trainees’ musculoskeletal pain (OR: 2.53, 95% CI: 1.18–5.44) compared to trainers with >5 years of experience; however, no association was found between the trainers’ education and the risk of their trainees’ musculoskeletal...
BMC Nutrition, Aug 22, 2022
Background Literature shows that people with spinal cord injury (SCI) experience lower quality of... more Background Literature shows that people with spinal cord injury (SCI) experience lower quality of life (QoL) comparing to their non-disabled peers. Factors contributing QoL in people with SCI are understudied in developing countries like Bangladesh. Objective To investigate factors contributing QoL in people with spinal SCI in Bangladesh Methodology A cross-sectional study was conducted using data from a convenience sample of 75 participants (56 male, mean age 32.4 years, range 18-60 years) with SCI after completing rehabilitation from Centre for the Rehabilitation of the Paralyzed (CRP), Savar, Dhaka between March 2015 to May 2015. QoL was measured using interviewer administered Bengali version of Short-Form Health Survey-36 (SF-36). Stepwise multiple linear regression was used to predict QoL (total SF-36 score) in relation to age, sex, marital status, employment status, family income, living area (urban or rural), injury duration, cause of lesion (traumatic or non-traumatic) and injury severity as complete or incomplete and paralysis type (tetraplegia or paraplegia). Results Stepwise regression showed complete injury was the most important factor associated with QoL (adjusted R2= 0.14, standardized beta = -0.37, p < 0.001) followed by the unemployment (adjusted R2= 0.09, standardized beta = -0.25, p = 0.014) and being tetraplegic (adjusted R2= 0.04, standardized beta = -0.22, p = 0.030). Conclusion The results demonstrate severity of injury and unemployment were the significant predictors of QoL in people with SCI in Bangladesh. These findings have important implications for providing targeted strategies as part of rehabilitation and follow up for people with SCI.
Acta neurologica Scandinavica, 2018
This study aimed to investigate how the use and perceived unmet need of mobility devices (MD) in ... more This study aimed to investigate how the use and perceived unmet need of mobility devices (MD) in people with Parkinson's disease (PD) evolve over a 3-year period. The study reports baseline assessments (n = 255) and comparisons for participants with complete data at baseline and the 3-year follow-up (n = 165). Structured questions addressed the use and perceived unmet need of various MDs indoor and outdoor (eg, canes, wheeled walkers, and manual and powered wheelchairs). McNemar tests were used to investigate differences over time. In the total sample at baseline, 30% and 52% of the participants reported using MDs indoors and outdoors, respectively. Among those with complete data also at the 3-year follow-up, the proportion of participants using MDs increased significantly (P < .001) from 22% to 40% for indoors and from 48% to 66% for outdoors, with transition of MD toward more assistive potential (ie, wheeled walker and manual wheelchair). Wheeled walkers were the most commo...
Spinal cord, Mar 2, 2017
Cross-sectional study. To identify socio-demographic and injury-related factors that contribute t... more Cross-sectional study. To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25-43) years and 5 (2-10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0-100; a high score indicates greater activity limitations and participation restrictions). Independent variables included soc...
The Gerontologist, 2015
In older populations both fallers and non-fallers report fear of falling and activity avoidance. ... more In older populations both fallers and non-fallers report fear of falling and activity avoidance. Previous studies have shown that fear to fall can lead to activity avoidance, and has a negative impact on balance, gait, mobility, social activity, mental health and independence. Worldwide research on fear of falling has taken a flight in the past years and even populations challenging to enroll are currently being studied. This warrants connecting international research findings in search for sustainable prevention strategies to tackle fear of falling. During this symposium new, international findings from four innovative research studies will be presented. The presenters from the US, Sweden, Germany and The Netherlands will address respectively: 1) awareness, beliefs, and actions regarding falls and fear of falling in community-living older adults, 2) fall-related activity avoidance in people aging with Parkinson's disease and the relationship with disease severity, fear of falling and falls, 3) life space in vulnerable nursing home residents and associations with motor, cognitive and psychological outcomes, including concerns about falling, and 4) a multicomponent program on concerns about falls and the identification of the least and most promising components. Dr. Desphande, our discussant from Canada / US, will reflect on the presented outcomes. The audience will be invited to interact with the presenters and discussant during the symposium in order to share evidence and opinions, and to take meaningful steps in research and practice related to reducing fear of falling in older populations.
Journal of Parkinson's disease, 2017
While walking difficulties are common in people with Parkinson's disease (PD), little is know... more While walking difficulties are common in people with Parkinson's disease (PD), little is known about factors that independently contribute to their perceived walking difficulties. To identify factors that independently contribute to perceived walking difficulties in people with PD. This study involved 243 (62% men) participants; their mean (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A postal survey preceded a home visit that included observations, clinical tests, questions and questionnaires that were administered as a structured interview. Perceived walking difficulties (dependent variable) were assessed with the self-administered generic Walk-12 (Walk-12G, scored 0-42, higher = worse). Independent variables included personal (e.g., age and general self-efficacy) and social environmental factors (e.g., social support and living situation) as well as disease-related factors including motor (e.g., freezing of gait (FOG) and postural instability...
Violence and Gender, 2014
Acta paediatrica (Oslo, Norway : 1992), Jan 31, 2015
Household food insecurity (HFI) is insufficient access to nutritionally safe and adequate foods t... more Household food insecurity (HFI) is insufficient access to nutritionally safe and adequate foods to meet the dietary needs for an active and healthy life. We examined the prevalence and determinants of HFI in Bangladeshi children under five with diarrhoea. This study included 365 children (55% boys) who had diarrhoea in the two weeks before the 2011 Bangladesh Demographic Health Survey (BDHS-2011). The Household Food Insecurity Access Scale (HFIAS) was used to assess HFI and Pearson's chi-square test and binary logistic regression analysis were used to investigate the association between HFI and multilevel factors. The prevalence of HFI among children under five with diarrhoea in the two-week prior to the BDHS-2011 survey was 48%. HFI was significantly higher among the children of uneducated mothers, who were two times more likely to experience HFI, with an adjusted odds ratio (OR) of 2.14 and children who were from the lowest socioeconomic status families, who were more than sev...
Preventive Medicine, 2015
are gratefully acknowledged for critically reading the manuscript.
ISRN pediatrics, 2013
Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public heal... more Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14-45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). ...
International Journal of Medicine and Public Health, 2013
Background: Betel nut (BN) or areca nut (AN) chewing habits on its own or with other ingredients ... more Background: Betel nut (BN) or areca nut (AN) chewing habits on its own or with other ingredients including chewing tobacco are highly prevalent in many South East Asian countries as well as among the migrants from these countries residing around the world. The major alkaloid arecoline in the BN has been found to carcinogenic and to be associated with a range of health risks, including negative effects on pregnancy outcomes. Pregnancy imposes stress on folate stores because of increased requirements for growth of maternal tissues, fetus, and placenta. Folate defi ciency during pregnancy is a major public health concern as is associated with many adverse health outcomes including neural tube defects, low birth weight, preterm birth, and delayed maturation of the nervous system, growth retardation, and megaloblastic anemia. Objective: To investigate any association between BN consumption and folate status among pregn ant women in rural Bangladesh. Materials and Methods: Data of 730 pregnant women aged 14-50 years from the Maternal and Infant Nutrition Intervention in Matlab (MINIMat) trial in Bangladesh were included in this study. Logistic regression analysis and analyses of covariance (ANCOVA) were used. Results were adjusted for potential confounders. Results and Interpretation: Two-third (63%) of the women consumed BN and 17% had folate defi ciency. The women who consumed BN combined with chewing tobacco were 2.57 times more likely to have folate defi ciency (OR2.57; 95% CI1.23-5.36; P0.012;) and the women who consumed BN 2-3 times/day were 2.51 times more likely to develop folate defi ciency among users (OR 2.51; 95% CI1.07-5.92; P0.035). Mean serum folate levels were signifi cantly lower among BN users as compared to nonusers. Conclusion: The results suggest that betel nut consumption combined with chewing tobacco is associated with lower serum folate level and folate defi ciency among pregnant women in rural Bangladesh. Strategies are needed for prevention and control of betel nut consumption in order to prevent adverse health outcomes.
North American Journal of Medical Sciences, 2014
Background: Little is known about how parental gender equality early in their children lives can ... more Background: Little is known about how parental gender equality early in their children lives can infl uence daughters' decision to use contraceptive pills. Aim: The study aimed at exploring whether maternal working time and paternity leave in Sweden during the fi rst two years of their daughters' lives is associated with the use of oral contraceptives when they are adolescents or young adults. Materials and Methods: The study population was selected from a cohort of all Swedish fathers and mothers who had their fi rst child together between 1988 and 1989 (n = 57,520 family units). Multivariate logistic regression was used to estimate the association. Results: Mothers' longer working time was mildly associated with daughters' oral contraceptive pill use, though no clear trend was observed. Longer paternity leave periods (>30 days) were not associated with use of oral contraceptives among their daughters, but 1-30 day periods showed a mild positive association. Conclusion: For maternal working time, there seems to be an association, but trends by working hours are not clear. There is no clear association between paternity leave during the fi rst two years of their daughters' life and the use of oral contraceptives when they are adolescents and young adults.
Journal of the International AIDS Society, 2010
Study DesignA prospective cross-sectional survey.ObjectiveThe study aimed to examine the Knowledg... more Study DesignA prospective cross-sectional survey.ObjectiveThe study aimed to examine the Knowledge, Attitudes, and Practices (KAP) of people living with Spinal cord injury (SCI) towards COVID-19 and their psychological status during in-patient rehabilitation in Bangladesh.SettingThe Centre for the Rehabilitation of the Paralyzed (CRP) and the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), two tertiary level hospitals in Dhaka, Bangladesh.MethodsFrom July to September 2020, a prospective, cross-sectional survey of SCI subjects, 13-78 years of age, carried out in two SCI rehab centers in Bangladesh. Data has been collected by face to face interview through a pretested, and language validated questionnaire on KAP and Depression, Anxiety, Stress (DASS). Ethical approval and trial registration obtained prospectively. As all the patients were previously living with Spinal cord injury (SCI), therefore, all the patients admitted/ attend SCI rehab centers were cons...
BMJ
Objectives To assess whether male elite football players are at increased risk of alcohol related... more Objectives To assess whether male elite football players are at increased risk of alcohol related disorders compared with men from the general population, and whether such an increased risk would vary on the basis of calendar year of the first playing season in the top tier of competition, age, career length, and goal scoring abilities. Design Nationwide cohort study. Setting Sweden, 1924-2020. Participants 6007 male football players who had played in the Swedish top division, Allsvenskan, from 1924 to 2019 and 56 168 men from the general population matched to players based on age and region of residence. Main outcome measures Primary outcome was alcohol related disorders (diagnoses recorded in death certificates, during hospital admissions and outpatient visits, or use of prescription drugs for alcohol addiction); secondary outcome was disorders related to misuse of other drugs. Results During follow-up up to 31 December 2020, 257 (4.3%) football players and 3528 (6.3%) men from th...
Sports
This is a cross-sectional study that examined the association between fitness trainers’ education... more This is a cross-sectional study that examined the association between fitness trainers’ educational qualifications and experience, and the risk of their trainees’ musculoskeletal pain. The study included 1177 trainees (aged 15–60 years) from 74 fitness centers in Bangladesh. Data were collected by using the Nordic musculoskeletal questionnaire, including potential confounders such as demographic factors (e.g., age, occupation), and training-related factors (e.g., workout knowledge, overweight lifting). Multiple logistic regression was performed for a binary outcome (pain—yes or no), and a generalized linear model was fitted for the ordinal outcome (pain—sites of the body). The trainers’ lower experience (no or ≤1 year) was associated with higher odds of their trainees’ musculoskeletal pain (OR: 2.53, 95% CI: 1.18–5.44) compared to trainers with >5 years of experience; however, no association was found between the trainers’ education and the risk of their trainees’ musculoskeletal...
BMC Nutrition, Aug 22, 2022
Background Literature shows that people with spinal cord injury (SCI) experience lower quality of... more Background Literature shows that people with spinal cord injury (SCI) experience lower quality of life (QoL) comparing to their non-disabled peers. Factors contributing QoL in people with SCI are understudied in developing countries like Bangladesh. Objective To investigate factors contributing QoL in people with spinal SCI in Bangladesh Methodology A cross-sectional study was conducted using data from a convenience sample of 75 participants (56 male, mean age 32.4 years, range 18-60 years) with SCI after completing rehabilitation from Centre for the Rehabilitation of the Paralyzed (CRP), Savar, Dhaka between March 2015 to May 2015. QoL was measured using interviewer administered Bengali version of Short-Form Health Survey-36 (SF-36). Stepwise multiple linear regression was used to predict QoL (total SF-36 score) in relation to age, sex, marital status, employment status, family income, living area (urban or rural), injury duration, cause of lesion (traumatic or non-traumatic) and injury severity as complete or incomplete and paralysis type (tetraplegia or paraplegia). Results Stepwise regression showed complete injury was the most important factor associated with QoL (adjusted R2= 0.14, standardized beta = -0.37, p < 0.001) followed by the unemployment (adjusted R2= 0.09, standardized beta = -0.25, p = 0.014) and being tetraplegic (adjusted R2= 0.04, standardized beta = -0.22, p = 0.030). Conclusion The results demonstrate severity of injury and unemployment were the significant predictors of QoL in people with SCI in Bangladesh. These findings have important implications for providing targeted strategies as part of rehabilitation and follow up for people with SCI.
Acta neurologica Scandinavica, 2018
This study aimed to investigate how the use and perceived unmet need of mobility devices (MD) in ... more This study aimed to investigate how the use and perceived unmet need of mobility devices (MD) in people with Parkinson's disease (PD) evolve over a 3-year period. The study reports baseline assessments (n = 255) and comparisons for participants with complete data at baseline and the 3-year follow-up (n = 165). Structured questions addressed the use and perceived unmet need of various MDs indoor and outdoor (eg, canes, wheeled walkers, and manual and powered wheelchairs). McNemar tests were used to investigate differences over time. In the total sample at baseline, 30% and 52% of the participants reported using MDs indoors and outdoors, respectively. Among those with complete data also at the 3-year follow-up, the proportion of participants using MDs increased significantly (P < .001) from 22% to 40% for indoors and from 48% to 66% for outdoors, with transition of MD toward more assistive potential (ie, wheeled walker and manual wheelchair). Wheeled walkers were the most commo...
Spinal cord, Mar 2, 2017
Cross-sectional study. To identify socio-demographic and injury-related factors that contribute t... more Cross-sectional study. To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25-43) years and 5 (2-10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0-100; a high score indicates greater activity limitations and participation restrictions). Independent variables included soc...
The Gerontologist, 2015
In older populations both fallers and non-fallers report fear of falling and activity avoidance. ... more In older populations both fallers and non-fallers report fear of falling and activity avoidance. Previous studies have shown that fear to fall can lead to activity avoidance, and has a negative impact on balance, gait, mobility, social activity, mental health and independence. Worldwide research on fear of falling has taken a flight in the past years and even populations challenging to enroll are currently being studied. This warrants connecting international research findings in search for sustainable prevention strategies to tackle fear of falling. During this symposium new, international findings from four innovative research studies will be presented. The presenters from the US, Sweden, Germany and The Netherlands will address respectively: 1) awareness, beliefs, and actions regarding falls and fear of falling in community-living older adults, 2) fall-related activity avoidance in people aging with Parkinson's disease and the relationship with disease severity, fear of falling and falls, 3) life space in vulnerable nursing home residents and associations with motor, cognitive and psychological outcomes, including concerns about falling, and 4) a multicomponent program on concerns about falls and the identification of the least and most promising components. Dr. Desphande, our discussant from Canada / US, will reflect on the presented outcomes. The audience will be invited to interact with the presenters and discussant during the symposium in order to share evidence and opinions, and to take meaningful steps in research and practice related to reducing fear of falling in older populations.
Journal of Parkinson's disease, 2017
While walking difficulties are common in people with Parkinson's disease (PD), little is know... more While walking difficulties are common in people with Parkinson's disease (PD), little is known about factors that independently contribute to their perceived walking difficulties. To identify factors that independently contribute to perceived walking difficulties in people with PD. This study involved 243 (62% men) participants; their mean (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A postal survey preceded a home visit that included observations, clinical tests, questions and questionnaires that were administered as a structured interview. Perceived walking difficulties (dependent variable) were assessed with the self-administered generic Walk-12 (Walk-12G, scored 0-42, higher = worse). Independent variables included personal (e.g., age and general self-efficacy) and social environmental factors (e.g., social support and living situation) as well as disease-related factors including motor (e.g., freezing of gait (FOG) and postural instability...
Violence and Gender, 2014
Acta paediatrica (Oslo, Norway : 1992), Jan 31, 2015
Household food insecurity (HFI) is insufficient access to nutritionally safe and adequate foods t... more Household food insecurity (HFI) is insufficient access to nutritionally safe and adequate foods to meet the dietary needs for an active and healthy life. We examined the prevalence and determinants of HFI in Bangladeshi children under five with diarrhoea. This study included 365 children (55% boys) who had diarrhoea in the two weeks before the 2011 Bangladesh Demographic Health Survey (BDHS-2011). The Household Food Insecurity Access Scale (HFIAS) was used to assess HFI and Pearson's chi-square test and binary logistic regression analysis were used to investigate the association between HFI and multilevel factors. The prevalence of HFI among children under five with diarrhoea in the two-week prior to the BDHS-2011 survey was 48%. HFI was significantly higher among the children of uneducated mothers, who were two times more likely to experience HFI, with an adjusted odds ratio (OR) of 2.14 and children who were from the lowest socioeconomic status families, who were more than sev...
Preventive Medicine, 2015
are gratefully acknowledged for critically reading the manuscript.
ISRN pediatrics, 2013
Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public heal... more Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14-45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). ...
International Journal of Medicine and Public Health, 2013
Background: Betel nut (BN) or areca nut (AN) chewing habits on its own or with other ingredients ... more Background: Betel nut (BN) or areca nut (AN) chewing habits on its own or with other ingredients including chewing tobacco are highly prevalent in many South East Asian countries as well as among the migrants from these countries residing around the world. The major alkaloid arecoline in the BN has been found to carcinogenic and to be associated with a range of health risks, including negative effects on pregnancy outcomes. Pregnancy imposes stress on folate stores because of increased requirements for growth of maternal tissues, fetus, and placenta. Folate defi ciency during pregnancy is a major public health concern as is associated with many adverse health outcomes including neural tube defects, low birth weight, preterm birth, and delayed maturation of the nervous system, growth retardation, and megaloblastic anemia. Objective: To investigate any association between BN consumption and folate status among pregn ant women in rural Bangladesh. Materials and Methods: Data of 730 pregnant women aged 14-50 years from the Maternal and Infant Nutrition Intervention in Matlab (MINIMat) trial in Bangladesh were included in this study. Logistic regression analysis and analyses of covariance (ANCOVA) were used. Results were adjusted for potential confounders. Results and Interpretation: Two-third (63%) of the women consumed BN and 17% had folate defi ciency. The women who consumed BN combined with chewing tobacco were 2.57 times more likely to have folate defi ciency (OR2.57; 95% CI1.23-5.36; P0.012;) and the women who consumed BN 2-3 times/day were 2.51 times more likely to develop folate defi ciency among users (OR 2.51; 95% CI1.07-5.92; P0.035). Mean serum folate levels were signifi cantly lower among BN users as compared to nonusers. Conclusion: The results suggest that betel nut consumption combined with chewing tobacco is associated with lower serum folate level and folate defi ciency among pregnant women in rural Bangladesh. Strategies are needed for prevention and control of betel nut consumption in order to prevent adverse health outcomes.
North American Journal of Medical Sciences, 2014
Background: Little is known about how parental gender equality early in their children lives can ... more Background: Little is known about how parental gender equality early in their children lives can infl uence daughters' decision to use contraceptive pills. Aim: The study aimed at exploring whether maternal working time and paternity leave in Sweden during the fi rst two years of their daughters' lives is associated with the use of oral contraceptives when they are adolescents or young adults. Materials and Methods: The study population was selected from a cohort of all Swedish fathers and mothers who had their fi rst child together between 1988 and 1989 (n = 57,520 family units). Multivariate logistic regression was used to estimate the association. Results: Mothers' longer working time was mildly associated with daughters' oral contraceptive pill use, though no clear trend was observed. Longer paternity leave periods (>30 days) were not associated with use of oral contraceptives among their daughters, but 1-30 day periods showed a mild positive association. Conclusion: For maternal working time, there seems to be an association, but trends by working hours are not clear. There is no clear association between paternity leave during the fi rst two years of their daughters' life and the use of oral contraceptives when they are adolescents and young adults.
Movement Disorders , 2017
Objective: To investigate factors that independently contribute to perceived walking difficulties... more Objective: To investigate factors that independently contribute to perceived walking difficulties in persons with Parkinson’s disease (PD).
Background: Despite that fact that walking difficulties are common in persons with PD, there is limited knowledge regarding the factors are that independently contribute to their perceived walking difficulties in daily life. Such knowledge might facilitate the development of novel interventions that aim at enhancing walking ability in persons with PD.
Methods: The study included 243 persons (62% men) with PD; mean (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A postal survey that included self-administered questionnaires preceded a home visit which included observations, clinical tests and interviews. Dependent variable included perceived walking difficulties, assessed with the self-administered generic Walk-12 (Walk-12G, scored 0-42, higher=worse). Independent variables included personal (e.g., age and general self-efficacy) and socio-environmental factors (e.g., social support and living situation) as well as disease-related factors including motor (e.g., freezing of gait (FOG) and lower extremity functions) and non-motor symptoms (e.g., orthostatic hypotension and cognitive function). Firstly, each independent variable of interest in relation to perceived walking difficulties were examined with simple linear regression analyses; variable with p-value <0.3 were then entered into a multivariable linear regression analysis model.
Results: In multivariable linear regression model, eight significant independent variables (out of 15 variables) explained 56.3% of the variance in perceived walking difficulties. The strongest contributing factor to perceived walking difficulties was FOG (explaining 26%), followed by general self-efficacy, fatigue, PD duration, lower extremity function, orthostatic hypotension, bradykinesia and postural instability.
Conclusion: Personal factors (i.e., general self-efficacy), and both motor and non-motor symptoms (e.g. FOG, PD duration and fatigue) seem to be of importance when addressing perceived walking difficulties in persons with PD. With such knowledge at hand, interventions addressing modifiable factors could be developed, ultimately enhancing walking ability in persons with PD.
Objective: Walking difficulties are one of the earliest signs of disability in people with Parkin... more Objective: Walking difficulties are one of the earliest signs of disability in people with Parkinson's disease (PD). However, few studies have investigated contributing factors to perceived walking difficulties in daily life. This study aimed to investigate which motor aspects that contribute to perceived walking difficulties in people with PD.
Methods: The study involved 243 (62% men) participants; their median (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A postal survey including self-administered questionnaires preceded a home visit, which included observations, clinical tests, questions and questionnaires that were administered as a structured interview. Perceived walking difficulties were assessed by using the self-administered generic Walk-12 (Walk-12G, scored 0-42, higher=worse), which constituted the dependent variable. Independent variables included bradykinesia and postural instability assessed with the motor examination (part III) of the Unified PD Rating Scale (UPDRS) as well as lower extremity function assessed with the timed Chair-Stand Test. An additional variable tapped freezing of gait (FOG) assessed with the self-administered version of the FOG (dichotomous) Questionnaire, item 3. Linear multiple regression analysis was used to identify factors that independently contributed to perceived walking difficulties. Results: The results showed that FOG was the most important motor factor contributing to perceived walking difficulties (explaining 26% of the variance, p < 0.001) followed by lower extremity function (7% of the variance, p = 0.001), postural instability (3% of the variance, p = 0.003) and bradykinesia (1% of the variance, p = 0.033).
Conclusions: The findings highlight the impact of motor aspects on perceived walking difficulties in people with PD. These findings might have important implications for rehabilitation targeting walking ability in people with PD. In order to increase the knowledge further, future studies should include a broader variety factors (e.g., personal factors, environmental aspects, non-motor symptoms) that may contribute to perceived walking difficulties in people with PD.
This study aimed to investigate how fall-related activity avoidance relates to the severity of Pa... more This study aimed to investigate how fall-related activity avoidance relates to the severity of Parkinson's disease (PD), fear of falling and a history of self-reported falls/near falls respectively.The data collection involved 251 participants (median age 70 years, 61% men) who were diagnosed with PD for at least one year. A postal survey was followed by interviews, observations and clinical tests administered at a home visit. Fall-related activity avoidance ranged from 25% in the mildest PD-stage to 75% in the most severe stages. Among those that reported near falls but no falls, 51% reported that they avoided activities due to the risk of falling. Of those that reported a fear of falling, 70 % reported fall-related activity avoidance.After attending this session, participants will be able to: - define a near fall - have an increased understanding about fall-related activity avoidance in people ageing with PD.
AIM To examine how fall-related activity avoidance relates to freezing of gait (FOG), a history o... more AIM
To examine how fall-related activity avoidance relates to freezing of gait (FOG), a history of self-reported falls and concerns about falling in people with Parkinson's disease (PD).
METHOD
This study involved 251 (61% men) participants; their median age and PD duration were 70 and 8 years, respectively. A postal survey that included self-administered questionnaires preceded a home visit which included observations, clinical tests and interviews. Fall-related activity avoidance was assessed with the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE), scored 17-51 (higher = more avoidance) and a dichotomous (Yes/No) question. Participants were classified as freezers/not freezers based on one item in the self-administered version of the FOG Questionnaire. Concerns about falling were assessed with the Falls Efficacy Scale-International (FES-I), scored 16-64 (higher = worse) and categorized into three severity levels. An interview-administered dichotomous (Yes/No) question targeted the history of falls during the past six months, followed by stating the number of incidents.
RESULT
In the total sample, 41 % of the participants reported fall-related activity avoidance; it was more common (P< 0.001) among freezers (57 %) than non-freezers (20 %). There was a significant (P< 0.001) difference in the proportions of participants that reported fall-related activity avoidance in relation to a history of falls: non-fallers (30%), single fallers (50%) and recurrent fallers, i.e. ≥ 2 falls (57%). Fall-related activity avoidance (i.e., mSAFFE scores) correlated strongly (rs, 0.87, P< 0.001) with concerns about falling (i.e., FES-I scores). The participants with high, moderate or low concerns about falling reported 71 %, 21 % and 6% fall-related activity avoidance, respectively (P< 0.001).
CONCLUSION
The findings suggest that fall-related activity avoidance is significantly related to FOG, a history of self-reported falls and concerns about falling in people with PD. In order to investigate factors associated to fall-related activity avoidance, further studies using multivariate analysis are needed.
