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- Mendez, D. Y., et al.
(författare)
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Characterization of data-driven clusters in diabetes-free adults and their utility for risk stratification of type 2 diabetes
- 2022
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Ingår i: Bmc Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The prevention of type 2 diabetes is challenging due to the variable effects of risk factors at an individual level. Data-driven methods could be useful to detect more homogeneous groups based on risk factor variability. The aim of this study was to derive characteristic phenotypes using cluster analysis of common risk factors and to assess their utility to stratify the risk of type 2 diabetes. Methods Data on 7317 diabetes-free adults from Sweden were used in the main analysis and on 2332 diabetes-free adults from Mexico for external validation. Clusters were based on sex, family history of diabetes, educational attainment, fasting blood glucose and insulin levels, estimated insulin resistance and beta-cell function, systolic and diastolic blood pressure, and BMI. The risk of type 2 diabetes was assessed using Cox proportional hazards models. The predictive accuracy and long-term stability of the clusters were then compared to different definitions of prediabetes. Results Six risk phenotypes were identified independently in both cohorts: very low-risk (VLR), low-risk low beta-cell function (LRLB), low-risk high beta-cell function (LRHB), high-risk high blood pressure (HRHBP), high-risk beta-cell failure (HRBF), and high-risk insulin-resistant (HRIR). Compared to the LRHB cluster, the VLR and LRLB clusters showed a lower risk, while the HRHBP, HRBF, and HRIR clusters showed a higher risk of developing type 2 diabetes. The high-risk clusters, as a group, had a better predictive accuracy than prediabetes and adequate stability after 20 years. Conclusions Phenotypes derived using cluster analysis were useful in stratifying the risk of type 2 diabetes among diabetes-free adults in two independent cohorts. These results could be used to develop more precise public health interventions.
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- Lornudd, C., et al.
(författare)
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A champagne tower of influence : An interview study of how corporate boards enact occupational health and safety
- 2021
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Ingår i: Safety Science. - : Elsevier B.V.. - 0925-7535 .- 1879-1042. ; 143
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Tidskriftsartikel (refereegranskat)abstract
- The board of directors is responsible for governing organizations, including firms’ occupational health and safety (OHS). However, empirical research addressing how boards of directors enact OHS responsibility is scarce. In this study, we explored how boards of directors describe how their board acts to take responsibility for OHS. A secondary aim was to analyze whether those actions represent governance according to the agency theory and/or the stewardship theory. The empirical material consisted of 34 interviews with board members and chief executive officers in large private companies from four industries: trade, construction, manufacturing, and health/social care. Using Boardman and Lyon's framework for OHS governance, we conducted a hybrid thematic analysis. The findings deepen and broaden the current understanding of the role that the board of directors may play in OHS governance in private companies. The boards’ actions for taking responsibility for OHS both represent governance in line with the agency theory and stewardship theory. However, the boards’ actions also underpin a behavioral view of corporate OHS governance. This suggests an influence on the organization that starts with actions in the boardroom and, like champagne in a glass tower, trickles down from the executive directors to other layers of the organization.
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