Occult cancer-related first venous thromboembolism is associated with an increased risk of recurrent venous thromboembolism

Clinical epidemiolog

Genetic variation of platelet glycoprotein VI and the risk of venous thromboembolism

Clinical epidemiolog

Fibrinogen gamma gene rs2066865 and risk of cancer-related venous thromboembolism

Venous thromboembolism (VTE) is a frequent complication in patients with cancer. Homozygous carriers of the fibrinogen gamma gene (FGG) rs2066865 have a moderately increased risk of VTE, but the effect of the FGG variant in cancer is unknown. We aimed to investigate the effect of the FGG variant and active cancer on the risk of VTE. Cases with incident VTE (n=640) and a randomly selected age-weighted sub-cohort (n=3,734) were derived from a population-based cohort (the Tromso study). Cox-regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for VTE according to categories of cancer and FGG. In those without cancer, homozygosity at the FGG variant was associated with a 70% (HR 1.7, 95% CI: 1.2-2.3) increased risk of VTE compared to non-carriers. Cancer patients homozygous for the FGG variant had a twofold (HR 2.0, 95% CI: 1.1-3.6) higher risk of VTE than cancer patients without the variant. Moreover, the six-months cumulative incidence of VTE among cancer patients was 6.4% (95% CI: 3.5-11.6) in homozygous carriers of FGG and 3.1% (95% CI: 2.3-4.7) in those without risk alleles. A synergistic effect was observed between rs2066865 and active cancer on the risk of VTE (synergy index: 1.81, 95% CI: 1.02-3.21, attributable proportion: 0.43, 95% CI: 0.11-0.74). In conclusion, homozygosity at the FGG variant and active cancer yielded a synergistic effect on the risk of VTE.Clinical epidemiolog

Survival after Cancer-related Venous Thrombosis:the Scandinavian Thrombosis and Cancer Study

Patients with cancer have an increased risk of developing venous thromboembolism (VTE), and this combination is reported to result in poorer survival compared with cancer alone. This study aimed to investigate the impact of VTE on the survival of patients with cancer in a general population. The Scandinavian Thrombosis and Cancer (STAC) cohort, a population-based cohort including 144 952 participants without previous VTE or cancer, was used. During follow-up, cancer and VTE incidences were registered. “Cancer-related VTE” was defined as VTE diagnosed in patients with overt or occult cancer. The survival of participants without cancer and/or VTE (“disease-free”) was compared with the survival of participants with cancer and cancer-related VTE. Cox regression models with cancer and VTE as time-varying exposures were performed to calculate hazard ratios for death. Subanalyses were performed across cancer types and stages and VTE type (deep vein thrombosis or pulmonary embolism). During follow-up (mean, 11.7 years), 14 621 participants developed cancer, and 2444 developed VTE, of which 1241 were cancer-related. The mortality rates (per 100 person years) for disease-free participants, VTE only, cancer only, and cancer-related VTE were 0.63, 5.0, 9.2, and 45.3, respectively. Compared with patients with cancer only, the risk of death for patients with cancer-related VTE was increased 3.4-fold. Within all cancer types, the occurrence of VTE increased the mortality risk 2.8- to 14.7-fold. In a general population, patients with cancer with VTE had a 3.4-fold higher mortality risk than patients with cancer without VTE, independent of cancer type

The politics of organizing indigenous sport – cross-border and cross-sectoral complexity

Research Question: The authors studied the complexity surrounding the organization of sport in nations without nationstate status, exploring three research questions: (1) How do representatives of Sámi sport organizations in Finland and Norway perceive and act upon the proposal to reorganize Sámi sport? (2) How do representatives of the Sámi parliaments in Finland and Norway perceive and act upon the proposal to reorganize Sámi sport? (3) How do representatives of the state bureaucracy in Finland perceive and act upon the proposal to reorganize Sámi sport? Research Methods: We interviewed representatives of the Sámi parliaments and Sámi sport in Norway and Finland, an external consultant in Norway and a state official of Finland constituting a total of eight key actor interviews. Results and Findings: The analysis revealed the dominant role of the Norwegian side of Sámi sport, largely based on the institutional power of the Sámi parliament in Norway. In that respect, voluntary sport organizations in both Finland and Norway were reluctant to consider or were even negative towards an ongoing reorganization of Sámi sport since it was initiated by the Norwegian authorities and by the Norwegian Sámi parliament. Implications: Decision-makers in government agencies involved in cross-border and cross-sectoral issues should consider the opinions of all parties involved. Moreover, concerning indigenous groups striving for self-determination in post-colonial contexts, it is important to create a unified voice in matters important to the group as a collective

Análise comparativa de clubes de futebol com escalões de formação de diferentes contextos

ResumoNo decorrer da sua existência e funcionamento os clubes estão sujeitos a influências provenientes do contexto onde estão inseridos, todavia também podem influenciar os sujeitos envolvidos no clube através da sua cultura organizacional. Pelas especificidades dos contextos dos clubes revela-se necessário obter dados sobre a sua cultura e o seu funcionamento para poder perceber os seus efeitos no envolvimento e desenvolvimento dos indivíduos. Para este artigo pretendeu-se a análise e comparação de três clubes de futebol de contextos diferentes, um clube profissional e dois amadores, em que um provém de meio rural e outro de meio urbano. Recorreu-se à observação participante e a entrevistas semiestruturadas para recolher os dados. A AAC-OAF diferencia-se dos clubes amadores pela sua orientação para o esporte de rendimento/espetacularização. Os últimos são suportados no voluntariado, dependendo mais das autarquias e políticas locais e revelam maiores dificuldades na angariação de voluntários, os quais aderem por amizade. A assunção dos cargos dirigentes nos clubes amadores são motivados pelo receio da extinção do clube. A estabilidade financeira da UCE contribui para mudanças na sua cultura e funcionamento organizacional. Todos os clubes demonstram falhas no processo de avaliação na implementação dos programas com vista ao desenvolvimento do jovem atleta, centrando-se esta essencialmente nos resultados desportivos obtidos