Storage of vitamin D in adipose tissue and associations between vitamin D related genetic variants and diabetes, myocardial infarction, cancer, death, and low bone mineral density. Results from a high-dose vitamin D study and the Tromsø Study

Paper I of this thesis is not available in Munin. Paper I: Martinaityte, I., Kamycheva, E., Didriksen, A., Jakobsen, J., Jorde, R., (2017). Vitamin D Stored in Fat Tissue During a 5-Year Intervention Affects Serum 25-Hydroxyvitamin D Levels the Following Year. Available in The Journal of Clinical Endocrinology & Metabolism, 102(10): 3731–3738. Cholecalciferol (vitamin D) is a biologically active substance, which acts in both skeletal and non-skeletal metabolic pathways, and is stored most in adipose tissue. Its active metabolite 1,25-dihydroxyvitamin D (1,25(OH)2D), bound to the vitamin D receptor (VDR), regulates gene expression and initiates rapid responses in the cells that regulate bone and adipose tissue homeostasis, lead to anti-diabetic, anti-atherosclerotic, and anti-carcinogenic effects. Furthermore, low vitamin D levels are associated with diverse negative health outcomes. Nevertheless, the clinical relevance of storage of vitamin D and its metabolites in adipose tissue as well as clinical effect of vitamin D supplementation has not yet been established. In our project, we found that vitamin D supplementation for 3–5 years maintains sufficient serum 25-hydroxyvitamin D (25(OH)D) levels in 1 year after cessation, likely due to the storage of vitamin D in subcutaneous adipose tissue (which decreased by half during the follow-up). 25(OH)D in adipose tissue was measured in smaller amounts, and probably is important for local vitamin D actions. In addition, we identified the gene variation rs7968585, related to VDR, to be associated with type 2 diabete,s and possibly with myocardial infarction. Finally, we found that the single nucleotide polymorphism (SNP) rs6013897 in the gene involved in the degradation of 25(OH)D and synthesis of 1,25(OH)2D was associated with total hip bone mineral density (BMD), and that the estrogen receptor related SNP rs4870044 was a risk factor for both forearm and total hip BMD in a population from Tromsø, Northern Norway. We also evaluated predictors for BMD, and, surprisingly, serum 25(OH)D levels were not among them, possibly due to generally sufficient vitamin D levels in our study population

Leveraging employee creativity through high performance work systems:a multilevel perspective

Research has looked at single rather than a configuration of human resource management (HRM) practices to influence creativity so it is not yet clear how these practices synergistically facilitate creativity and organisational performance. I address this significant but unanswered question in a three-part study. In Study 1, I develop a high performance work system (HPWS) for creativity scale. I use Study 2 sample to test the validity of the new scale. In Study 3, I test a multilevel model of the intervening processes through which branch HPWS for creativity influences creativity and branch performance. Specifically, at the branch level, I draw on social context theory and hypothesise that branch HPWS for creativity relates to climate for creativity which, in turn, leads to creativity, and ultimately, to profit. Furthermore, I hypothesise environmental dynamism as a boundary condition of the creativity-profit relationship. At the individual level, I hypothesise a cross-level effect of branch HPWS for creativity on employee-perceived HPWS. I draw on self-determination theory and argue that perceived HPWS for creativity relate to need satisfaction and the psychological pathways of intrinsic motivation and creative process engagement to predict creativity. I also hypothesise climate for creativity as a cross-level moderator of the intrinsic motivation-creativity and creative process engagement-creativity relationships. Results of hierarchical linear modeling (HLM) indicate that ten out of the fifteen hypotheses were supported. The findings of this study respond to calls for HPWS to be designed around a strategic focus by developing and providing initial validity evidence of an HPWS for creativity scale. The results reveal the underlying mechanisms through which HPWS for creativity simultaneously influences individual and branch creativity leading to profit. Lastly, results indicate environmental dynamism to be an important boundary condition of the creativity-profit relationship and climate for creativity as a cross-level moderator of the creative process engagement-creativity

Delighting the Customer: Creativity-Oriented High-Performance Work Systems, Frontline Employee Creative Performance, and Customer Satisfaction

Drawing on self-determination theory, we proposed and tested a cross-level model of how perceived creativity-oriented high-performance work systems (HPWS) influence customer satisfaction. Data were obtained from frontline employees (FLEs), their managers, and branch records of two organizations (retail bank and cosmetics) in Lithuania. Results of multilevel structural equation modeling analyses revealed partial support for our model. Although perceived creativity-oriented HPWS related to creative performance at the individual level, this effect was mediated solely by need satisfaction and not by creative process engagement nor by a serial mediation of both variables as we hypothesized. However, as we did hypothesize, average branch creative performance related to branch customer satisfaction. We interpret our findings as underscoring the utility of perceived creativity-oriented HPWS in fostering FLEs’ creative performance and ultimately, customer satisfaction

Incidence of dementia over a period of 20 years in a Norwegian population

INTRODUCTION: In Norway, the prevalence of dementia is higher than in demographically comparable, high income countries, but reliable incidence studies are lacking. This study calculated the incidence of age-specific dementia from 2000 to 2019. METHODS: Participants from The Tromsø Study (n = 44,214) were included. Participants with a dementia diagnosis (n = 2049 cases) were identified. Poisson regression was used to calculate age-specific yearly and 5-year incidence rates from 2000 to 2019. RESULTS: The incidence of dementia has decreased from 2000 to 2019. The trend was highly significant for ages of 60–99 years, and was similar for both sexes. DISCUSSION: The incidence of dementia in North Norway has decreased over the past two decades similar to that in Western countries, indicating that the total prevalence is increasing due to an aging population. This decrease of incidence could introduce a reduction in future estimation of dementia prevalence

How/if the Future Changes the Professional Field of Social Work?

The authors aim to discuss the changes in the professional field of social work, the future scenarios and the role of social work in the future society, and to present the views of social workers themselves on the future and the expected changes. The authors provide an overview of the trends in the development of social work profesion and outline the important changes in the professional field based on litearture review. The paper presents a quantitative survey of social workers in Lithuania, which aimed to uncover their attitudes towards new developments, the impact of technology and social innovation, and the future competences of social work. The results of the study reveal that employees see changes in the field of social work, but that these changes are marginal. Not seeing change and a negative public perception of social work are also associated with a willingness to move to another field of work. Leadership and professionalism of managers and more cohesive teamwork would encourage staff to stay. The study did not show that working for any institution (municipal, governmental, non-governmental, etc.) determines social workers‘ attitudes. Social workers‘ attitudes and evaluations were more influenced by their demographics: place of residence, age, education, but even these correlations were rather weak. A large proportion of respondents were not familiar with the Sustainable Development Goals (SGD2030) or had only participated in a few sustainability initiatives, but the importance of innovations in social work practice was identified by 58% of respondents, compared to 72% of those aged between 18 and 35 years. When talking about the future competences of social work, the traditional micro-level competences of social work are highlighted: empathy, emotional intelligence, interpersonal communication and working with a group, less importance is attached to innovative, managerial or macro-level competences

Work meaningfulness and performance among healthcare professionals:The role of professional respect and participative management

While the existing literature has accumulated much evidence for the impact of formal organizational interventions on employees’ experience of meaningfulness and outcomes, less is known about informal influences from coworkers. Drawing on self-determination theory, we propose a multilevel model that explains how professional respect by coworkers and unit participative management, individually and jointly, influence work meaningfulness, which in turn is associated with task performance and service quality. We tested our model using data from 217 nurse–general practitioner dyads from 27 primary healthcare units in Lithuania. The results showed that professional respect is positively related to work meaningfulness but unit participative management is not. Furthermore, work meaningfulness mediates the relationship between professional respect and performance outcomes. Finally, supporting a synergistic perspective, the impacts of professional respect on work meaningfulness and performance outcomes are stronger when unit participative management is high rather than low

Being open, feeling safe and getting creative: The role of team mean openness to experience in the emergence of team psychological safety and team creativity

Although the effects of openness to experience (OTE) on individual creativity are well-established, research on how such effects unfold in a team context is scarce. Drawing on theories of group norms and uncertainty reduction, we argue that team mean OTE leads to a climate of team psychological safety which, in turn, facilitates team creativity. We test our hypothesis over three independent studies, the first comprising 35 business student project teams, the second based on 28 professional teams from the automotive industry, both conducted in the United Kingdom, and the third comprising 24 healthcare teams in Portugal. As predicted, across all three studies, team mean OTE was positively associated with team creativity via the affective emergent state of team psychological safety. Furthermore, the mediating role of team psychological safety remained significant even when accounting for team OTE variance, alternative motivational and cognitive emergent states, namely team promotion focus (studies 1 and 2) and team exploration climate (study 3), as well as empowering leadership (study 3). Finally, in study 3, we examined the differential impact of the two major facets of OTE, intellect, and openness, and found that intellect, but not openness, was responsible for driving the indirect effects. Further analysis did not support alternative perspectives concerning team OTE variance or the interaction between mean and variance. Our findings not only contribute to theoretical understanding regarding the relationship between team personality composition, specifically OTE, and team creativity but also provide much-needed insight into how such effects unfold. We delineate several practical implications for team design and development

Alpha-2-adrenergic receptor agonists for the prevention of delirium and cognitive decline after open heart surgery (ALPHA2PREVENT): protocol for a multicentre randomised controlled trial

INTRODUCTION: Postoperative delirium is common in older cardiac surgery patients and associated with negative short-term and long-term outcomes. The alpha-2-adrenergic receptor agonist dexmedetomidine shows promise as prophylaxis and treatment for delirium in intensive care units (ICU) and postoperative settings. Clonidine has similar pharmacological properties and can be administered both parenterally and orally. We aim to study whether repurposing of clonidine can represent a novel treatment option for delirium, and the possible effects of dexmedetomidine and clonidine on long-term cognitive trajectories, motor activity patterns and biomarkers of neuronal injury, and whether these effects are associated with frailty status. METHODS AND ANALYSIS: This five-centre, double-blind randomised controlled trial will include 900 cardiac surgery patients aged 70+ years. Participants will be randomised 1:1:1 to dexmedetomidine or clonidine or placebo. The study drug will be given as a continuous intravenous infusion from the start of cardiopulmonary bypass, at a rate of 0.4 µg/kg/hour. The infusion rate will be decreased to 0.2 µg/kg/hour postoperatively and be continued until discharge from the ICU or 24 hours postoperatively, whichever happens first.Primary end point is the 7-day cumulative incidence of postoperative delirium (Diagnostic and Statistical Manual of Mental Disorders, fifth edition). Secondary end points include the composite end point of coma, delirium or death, in addition to delirium severity and motor activity patterns, levels of circulating biomarkers of neuronal injury, cognitive function and frailty status 1 and 6 months after surgery. ETHICS AND DISSEMINATION: This trial is approved by the Regional Committee for Ethics in Medical Research in Norway (South-East Norway) and by the Norwegian Medicines Agency. Dissemination plans include publication in peer-reviewed medical journals and presentation at scientific meetings. TRIAL REGISTRATION NUMBER: NCT05029050

Storage of vitamin D in adipose tissue and associations between vitamin D related genetic variants and diabetes, myocardial infarction, cancer, death, and low bone mineral density. Results from a high-dose vitamin D study and the Tromsø Study

Cholecalciferol (vitamin D) is a biologically active substance, which acts in both skeletal and non-skeletal metabolic pathways, and is stored most in adipose tissue. Its active metabolite 1,25-dihydroxyvitamin D (1,25(OH)2D), bound to the vitamin D receptor (VDR), regulates gene expression and initiates rapid responses in the cells that regulate bone and adipose tissue homeostasis, lead to anti-diabetic, anti-atherosclerotic, and anti-carcinogenic effects. Furthermore, low vitamin D levels are associated with diverse negative health outcomes. Nevertheless, the clinical relevance of storage of vitamin D and its metabolites in adipose tissue as well as clinical effect of vitamin D supplementation has not yet been established. In our project, we found that vitamin D supplementation for 3–5 years maintains sufficient serum 25-hydroxyvitamin D (25(OH)D) levels in 1 year after cessation, likely due to the storage of vitamin D in subcutaneous adipose tissue (which decreased by half during the follow-up). 25(OH)D in adipose tissue was measured in smaller amounts, and probably is important for local vitamin D actions. In addition, we identified the gene variation rs7968585, related to VDR, to be associated with type 2 diabete,s and possibly with myocardial infarction. Finally, we found that the single nucleotide polymorphism (SNP) rs6013897 in the gene involved in the degradation of 25(OH)D and synthesis of 1,25(OH)2D was associated with total hip bone mineral density (BMD), and that the estrogen receptor related SNP rs4870044 was a risk factor for both forearm and total hip BMD in a population from Tromsø, Northern Norway. We also evaluated predictors for BMD, and, surprisingly, serum 25(OH)D levels were not among them, possibly due to generally sufficient vitamin D levels in our study population

Incidence of dementia over a period of 20 years in a Norwegian population

Abstract INTRODUCTION In Norway, the prevalence of dementia is higher than in demographically comparable, high income countries, but reliable incidence studies are lacking. This study calculated the incidence of age‐specific dementia from 2000 to 2019. METHODS Participants from The Tromsø Study (n = 44,214) were included. Participants with a dementia diagnosis (n = 2049 cases) were identified. Poisson regression was used to calculate age‐specific yearly and 5‐year incidence rates from 2000 to 2019. RESULTS The incidence of dementia has decreased from 2000 to 2019. The trend was highly significant for ages of 60–99 years, and was similar for both sexes. DISCUSSION The incidence of dementia in North Norway has decreased over the past two decades similar to that in Western countries, indicating that the total prevalence is increasing due to an aging population. This decrease of incidence could introduce a reduction in future estimation of dementia prevalence