Hyperglycemia, Assessed by HbA1c, and Future Risk of Venous Thromboembolism -The Tromsø Study

Background: Glycated hemoglobin (HbA1c), a marker of average plasma glucose during the last 8-12 weeks, is associated with future risk of cardiovascular disease (CVD) and all-cause mortality. Objectives: To examine the association between hyperglycemia, assessed by HbA1c, and future risk of VTE in a population based cohort. Methods: HbA1c was measured in 16 156 unique subjects (25-87 years) who participated in one or more surveys of the Tromsø study (Tromsø 4; 1994-95, Tromsø 5; 2001-2, and Tromsø 6; 2007-8). All subjects were followed, and incident VTE events were recorded through December 31, 2010. Results: There were 333 validated first VTE events, of which 137 were unprovoked, during a median follow-up of 7.1 years. HbA1c was not associated with future risk of VTE in analysis treating HbA1c as a continuous variable, or in categorized analyses. The risk of VTE increased by 5% per 1 SD (0.7%) increase in HbA1c (multivariable-adjusted HR 1.05; 95% CI 0.97-1.14), and subjects with HbA1c ≥ 6.5% had 27% higher risk compared to those with HbA1c below 5.7% (multivariable-adjusted HR 1.27; 95% CI 0.72-2.26). There was no significant linear trend for increased risk of VTE across categories of HbA1c (p=0.27). Conclusions: Serum levels of HbA1c were not associated with future risk of VTE in multivariable analysis. Our findings suggest that hyperglycemia does not play an important role in the pathogenesis of VTE

Do Women in Top Management Teams Have an Effect on Company Performance - Evidence from Scandinavia

This paper investigates if a relationship exists between women in TMTs and firm performance for 187 Large- and Mid-Cap firms in Scandinavia for the period 2009-2013. Thereby adding to the scarce international evidence within the gender diversity in TMTs literature. The theoretical simultaneous relationship between performance and gender diversity in TMTs is taken into account and a 2SLS approach is applied. In general, the results from the 2SLS indicate that the inclusion of women in TMTs, as measured by four diversity measures, has a significant impact on firm performance as measured by Tobin’s Q - while having no impact on performance as measured by ROA. Considering the weakness of the instruments employed, panel techniques are also estimated and find no significant effects

Motivasjon og holdninger til HMS og rapportering ombord

Denne oppgaven handler om motivasjon og holdninger til HMS og rapportering ombord. Problemstillingen for oppgaven var: Hvordan påvirker rederiene og kollegaer den enkelte arbeidstakers motivasjon og holdninger til HMS og rapportering ombord? Oppgaven ble begrenset geografisk til fem rederier i nærområdet til skolen, videre ble oppgaven begrenset til å inkludere rederier kun innen tank- og supplynæringen. For å løse oppgaven måtte tilstander ombord kartlegges. Det ble gjort gjennom et spørreskjema som ble sendt ut til båter i de fem aktuelle rederiene. Videre ble det gjort telefonintervjuer med HMS-sjefer i de fem rederiene, og intervjuer med kollegaer ombord. Informasjonen som har kommet frem av spørreskjemaene og intervjuene er grunnlaget for oppgaven. Det ble funnet ut at HMS og rapportering ombord ikke samsvarer helt med bildet som gis fra næringen. Og at det ofte gjøres brudd på regelverk i forbindelse med rapportering og HMS

Cancer patient narratives during cancer outpatient – nurse conversations

Background: Studies have highlighted the significance of cancer patients’ narrative work in order to cope and feel well and find meaning in life. Aim: This article reports a study of whether and how cancer outpatients narrates, and how cancer care nurses contribute to the patients’ narrative work during conversations taking place during planned first time consultations at out-patient clinics. Method: The study was qualitative phenomenological hermeneutic. The data material included recordings of eight patient – nurse meetings taking place as ordinary planned activities at out-patient clinics in Norway. Four female and four male patients, and eight female nurses participated. Transcribed recordings of conversations were content analysed, narrative sequences identified and analysed for how narratives developed and how narrating was encouraged and followed up by nurses. Findings: Results gave insights into narrative contexts and how voices of nursing, medicine, and life world and relational or goal directed communication had implications for patient narrations. Conclusion: The findings of this study of narrations in cancer outpatient – nurse conversations gave insights into nurses’ meaning horizons and communication approaches with implications for practice. There is a need of more research providing insights into the effects of narrative meaning constructions for cancer patients

Lederen som kulturell arkitekt

Masteroppgave i kunnskapsledelse (MKL) - Nord universitet 201

Endocrine-related factors and risk of venous thromboembolism

Even though many environmental and inherited predisposing factors have been associated with venous thromboembolism (VTE), still 30–50% of the events have no obvious provoking factors. There is limited knowledge concerning the association between endocrine-related factors and VTE risk. Therefore we aimed to investigate the relation between hyperglycemia, thyroid function, vitamin D, calcium, parathyroid hormone (PTH), and risk of future VTE in a general population. Our study participants were recruited from the Tromsø study (Tromsø 4; 1994-95, Tromsø 5; 2001-2, and/or Tromsø 6; 2007-8). Two of the papers are based on all three surveys, one paper is based on the fourth and fifth, and one on the fourth survey only. The fourth survey is the largest one, and a total of 27 158 men and women attended. A subset of participants (n=9 056) were further invited to a more extensive second visit. In Tromsø 5 and 6 only subgroups of the municipality of Tromsø were invited. The overall attendance rate went from 77% in Tromsø 4 to 66% in Tromsø 6. Incident VTE events were registered from the date of inclusion until the end of follow-up. Our findings suggest that hyperglycemia does not play an important role in the pathogenesis of VTE, and that obesity is a more important contributor to VTE in subjects with hyperglycemia. TSH within the normal range were not associated with risk of VTE, whereas low and high TSH were associated with a moderately increased risk of VTE. However, the prevalence and the population attributable risk of thyroid dysfunction was low, suggesting that only a minor proportion of the VTE events in the population can be attributed to thyroid dysfunction. Vitamin D status was not associated with VTE risk. Finally, calcium and PTH alone were not associated with future risk of VTE. However, high levels of both calcium and PTH were associated with increased risk of VTE compared to subjects with normal calcium and PTH