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Abstract Background Although anthracycline-related cardiotoxicity is widely studied, only a limited number of echocardiographic studies have assessed cardiac function in breast cancer survivors (BCSs) beyond ten years from anthracycline treatment, and the knowledge of long-term cardiorespiratory fitness (CRF) in this population is scarce. This study aimed to compare CRF assessed as peak oxygen uptake (V̇O2), cardiac morphology and function, and cardiovascular (CV) risk factors between long-term BCSs treated with anthracyclines and controls with no history of cancer. Methods The CAUSE (Cardiovascular Survivors Exercise) trial included 140 BCSs recruited through the Cancer Registry of Norway, who were diagnosed with breast cancer stage II to III between 2008 and 2012 and had received treatment with epirubicin, and 69 similarly aged activity level-matched controls. All the participants underwent blood sampling, blood pressure measurements, echocardiography and cardiopulmonary exercise testing from October 2020 to August 2022. Results BCSs were aged 59 ± 6 years and had received a cumulative dose of 357 (243 to 366) mg/m2 of epirubicin on average 11 ± 1 years before inclusion. There was no difference between BCSs and controls with respect to peak V̇O2 (27.6 ± 5.4 mL/kg/min vs. 27.1 ± 5.4 mL/kg/min, P = 0.25), 2D left ventricular ejection fraction (57 ± 3% vs. 57 ± 3%, P = 0.43), left ventricular global longitudinal strain (-20.5 ± 1.0% vs. -20.6 ± 1.0%, P = 0.46) or the proportion with N-terminal pro-brain natriuretic peptide ≥ 125 (22% vs. 20%, P = 0.93). The proportions with hypertension, dyslipidemia or diabetes did not differ between the groups. Conclusion We found that CRF, cardiac function, and CV risk profile in BCSs examined a decade after treatment with anthracyclines were similar to that in women with no history of cancer. Trial registration clinicaltrials.gov (NCT04307407) https://clinicaltrials.gov/ct2/show/NCT04307407 .

Abstract Background Atresia of the infrarenal inferior vena cava (IVC) is associated with thrombophilia and antithrombin (AT) deficiency (ATD) due to homozygosity for the so-called Budapest 3 variant, c.391C > T, in the gene, SERPINC1. Case presentation We report on a father and his two sons that had severe thrombosis at a young age. One son had absence of, and the other had very gracile infrarenal IVC. The father had gracile vena iliaca. All had significant collateral building. AT activity was determined with four different methods and varied between moderately reduced and borderline normal values, depending on the method. While all were heterozygous for c.391C > T, the father was also heterozygous for a variant of uncertain significance in SERPINC1. Conclusions The findings support the association between c.391C > T in SERPINC1, thrombophilia, and atresia of the IVC system and indicate that even heterozygosity for c.391C > T may contribute to such anomalies. ATD detection was hampered by the varying sensitivity of methods used for AT activity measurement.

Abstract Background Monitoring self-reported suicide attempts (SA) with nationally representative surveys is important to initiate suicide prevention strategies. The aim of the study was to assess the prevalence of SA and compare deliberate self-harm, (DSH), mental health, drug misuse and traumas between SA and non-suicide attempters (NSA). Methods In this cross-sectional survey of a representative sample (N=1757) of the Norwegian population, we compared people with self-reported SA (n=54) to NSA (n=1703) regarding sociodemographic data, mental health problems, drug misuse and exposure to trauma. Results The prevalence of SA was 3.1 %. There was a higher proportion of welfare recipients and more deliberate self-harm, mental health problems, drug misuse and traumas in the SA group compared to NSA. Conclusion This national study confirms the association between suicide attempt and deliberate self-harm, mental health problems, drug misuse and traumas.

Objective To report and compare psychological distress as symptoms of anxiety, depression and post-traumatic stress among intensive care units’ (ICU) nurses, physicians and leaders at 12 months after the baseline survey (spring 2020), during the COVID-19 pandemic in Norway. Furthermore, to analyse which baseline demographic and COVID ICU-related factors have a significant impact on psychological distress at 12 months.Design Prospective, longitudinal, observational cohort study.Setting Nationwide, 27 of 28 hospitals with COVID ICUs in Norway.Participants Nurses, physicians and their leaders. At 12 month follow-up 287 (59.3%) of 484 baseline participants responded.Primary and secondary outcome measures Symptoms of anxiety and depression using the Hopkins Symptoms Checklist-10 (HSCL-10). Symptoms of post-traumatic stress using the post-traumatic stress disease checklist for the Diagnostic and Statistical Manual of Mental Disorders 5 (PCL-5).Demographics (included previous symptoms of anxiety and depression) and COVID ICU-related factors (professional preparations, emotional experience and support) impacting distress at 12 months.Results Psychological distress, defined as caseness on either or both HSCL-10 and PCL-5, did not change significantly and was present for 13.6% of the participants at baseline and 13.2% at 12 month follow-up. Nurses reported significantly higher levels of psychological distress than physicians and leaders. Adjusted for demographics and the COVID ICU-related factors at baseline, previous symptoms of depression and fear of infection were significantly associated with higher levels of anxiety and depression at 12 months. Previous symptoms of depression, fear of infection and feeling of loneliness was significantly associated with more symptoms of post-traumatic stress.Conclusion One year into the COVID-19 pandemic 13.2% of the ICUs professionals reported psychological distress, more frequently among the nurses. Fear of infection, loneliness and previous symptoms of depression reported at baseline were associated with higher levels of distress. Protective equipment and peer support are recommended to mitigate distress.Trial registration number ClinicalTrials.gov. Identifier: NCT04372056.

Individuals with psychosocial disabilities face substantial barriers that hinder their equal participation in working life, such as discrimination and lack of self-determination. A method developed to increase work integration and self-determination for persons experiencing mental illness is Individual Placement and Support (IPS), which embraces the zero-exclusion principle. This entails that service users themselves should decide when they want to engage in work (re-)integration and that professionals should not, based on their professional assessments, exclude anyone. The study reveals that managers in healthcare and employment services experience practitioners’ adherence to a professionalism logic, which hinders self-determination because professionals make pre-assessments to determine who is job ready. However, managers made use of the zero-exclusion principle to promote self-determination and challenge the dominant professionalism logic. Additionally, findings indicate that managers observed a gradual shift in perceptions about job readiness and referrals to IPS over time as practitioners gained experience with the zero-exclusion principle.

Purpose – The article compares the effect of European Union (EU)-Russian sanctions imposed in 2014 with the influence of fluctuating oil prices on Danish trade. Design/methodology/approach – In this paper annual import and export trade data between Denmark and 152 countries from the period 2002–18 were computed in STATA/SE 16.1 using the Gravity model to evaluate the effect of economic sanctions and the price of oil. Findings – Results showed that the impact from the fall of oil price exceeded the negative effect from sanctions on Danish export. Additionally, the analyses suggest that the fall in oil price had a negative effect on Danish import. Even so, Danish import significantly increased due to growth in supplies of energy resources from Russia. Originality/value – This study explains the overlapping effects of EU-Russian sanctions and fluctuating oil prices on Danish trade. This methodology can be expanded to encompass multiple countries using the two-sided Gravity model.

A negative association between cardiorespiratory fitness and measures of arterial stiffness is demonstrated in this study of 86 industrial workers. Because former results have shown increased pulse wave velocity in shift workers exceeding that of day workers, the present results present implications for shift workers' future macrovascular and microvascular health. Objective: Previously, we have found increased carotid-to-femoral pulse wave velocity (cfPWV) among shift workers compared to day workers in industry, and a decline in maximal oxygen uptake (V̇O2max) in all 86 workers. Methods: Utilizing all available measurements in 2018, 2021, and 2022, this study investigated associations between V̇O2max and measures of arterial stiffness. Using a mixed model approach, we analyzed the cross-sectional association between all V̇O2max (outcome) and measures of arterial stiffness (covariates). Results: We observed a significant association between V̇O2max and cfPWV of −1.59 (95% confidence interval [CI], −3.03 to −0.16), and between augmentation pressure (AP) and augmentation index (Aix) of −0.32 (95% CI, −0.58 to −0.06) and −0.12 (95% CI, –0.23 to −0.005), respectively. Conclusions: We found a significant negative association between cardiorespiratory fitness and measures of arterial stiffness. The former and present results pose challenges for shift workers' future macrovascular and microvascular health. [ABSTRACT FROM AUTHOR]

Background: Burnout is frequent among intensive care unit (ICU) healthcare professionals and may result in medical errors and absenteeism. The COVID‐19 pandemic caused additional strain during working hours and also affected off‐duty life. The aims of this study were to survey burnout levels among ICU healthcare professionals during the first year of COVID‐19, describe those who reported burnout, and analyse demographic and work‐related factors associated with burnout. Methods: This was a national prospective longitudinal cohort study of 484 nurses, physicians and leaders working in intensive care units with COVID‐19 patients in Norway. Burnout was measured at 6‐ and 12‐month follow‐up, after a registration of baseline data during the first months of the COVID epidemic. The Copenhagen Burnout Inventory (CBI), was used (range 0–100), burnout caseness defined as CBI ≥50. Bi‐ and multivariable logistic regression analyses were performed to examine baseline demographic variables and work‐related factors associated with burnout caseness at 12 months. Results: At 6 months, the median CBI score was 17, increasing to 21 at 12 months (p =.037), with nurses accounting for most of the increase. Thirty‐two per cent had an increase in score of more than 5, whereas 25% had a decrease of more than 5. Ten per cent reported caseness of burnout at 6 months and 14% at 12 months (n.s.). The participants with burnout caseness were of significantly lower age, had fewer years of experience, reported more previous anxiety and/or depression, more moral distress, less perceived hospital recognition, and more fear of infection in the bivariate analyses. Burnout was the single standing most reported type of psychological distress, and 24 out of 41 (59%) with burnout caseness also reported caseness of anxiety, depression and/or post‐traumatic stress disorder (PTSD) symptoms. Multivariate analysis showed statistically significant associations of burnout caseness with fewer years of professional experience (p =.041) and borderline significance of perceived support by leader (p =.049). Conclusion: In Norway, a minority of ICU nurses, physicians and leaders reported burnout 1 year into the pandemic. A majority of those with burnout reported anxiety, depression and/or PTSD symptoms combined. Burnout was associated with less years of professional experience. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine if maximal oxygen uptake (V˙O2max), resting heart rate (RHR), and self-reported leisure- time moderate to vigorous physical activity (MVPA) changed over a 3-year follow-up (FU) among industrial workers. Methods: We assessed cardiorespiratory fitness (CRF) August 2018 and August 2021. The last 17–18 months coincided with the COVID-19 pandemic. Data from 86 participants were collected; demographics by questionnaire and cardiovascular outcomes from medical examination: V˙O2max, RHR, and fat mass (%). Workers reported on their leisure-time MVPA twice. To assess changes in health outcomes we applied a linear mixed model, adjusting for baseline (BL) age, sex, pack-years, shift work, and a 5-month plant shutdown. Further, we adjusted for actual age instead of BL age. Results: V˙O2max decreased from 39.6 mL/kg/min at BL to 34.0 at FU, a reduction of 5.6 mL/kg/min (95%CI, −7.6, −3.7). Adjusted for actual age, the corresponding figure for V˙O2max was 5.4 mL/kg/min, (95%CI, −7.4, −3.4), an annual loss of 4.6%. RHR increased from 61.3 to 64.4 beats per minute (95%CI, 0.8, 5.4). Self-reported MVPA decreased by 43.9 min/week, (95%CI, −73.5, −14.4). Conclusions: We observed a decrease in V˙O2max, an increase in RHR and a decrease in self-reported MVPA, suggesting physical inactivity during the COVID-19 pandemic.

Aim: To assess changes in blood pressure (BP) and arterial stiffness among 84 rotating shift and 25 dayworkers (control subjects) at two industrial plants during a 4-year follow-up, and to assess changes in outcome variables among shift workers at the two plants after a reduction in the number of night shifts during the last year of follow-up in one of the plants. Methods: We collected demographic data using a questionnaire, examined systolic and diastolic blood pressure (sBP, dBP), central systolic and diastolic aorta pressure (cSP, cDP), augmentation pressure (AP), central pulse pressure (cPP), and pulse wave velocity (PWV). We registered sleep quality. The last 4–14 months of follow-up one plant implemented a 12-week shift plan reducing the total number of night shifts and consecutive night shifts from 16.8 to 14 and from 7.2 to 4. To assess differences in change of outcomes between study groups we applied linear mixed models. Results: The dayworkers were older, more hypertensive, reported less sleep disturbance, and smoked/snuffed less than the shift workers did. The adjusted annual increase in PWV was 0.34 m/s (95%CI, 0.22, 0.46) among shift workers and 0.09 m/s (95%CI, −0.05, 0.23) in dayworkers, yielding a significant difference of change of 0.25 m/s (95%CI, 0.06, 0.43). No significant differences were found between the two groups of shift workers in any cardiovascular disease (CVD) outcome during the last year of follow-up. Conclusions: Shift work in industry is associated with arterial stiffness, reflecting an increased risk of future CVD. No significant changes in arterial stiffness were identified as a consequence of a small reduction in the number of night shifts and consecutive night shifts.

Background: Literature suggests an association between shift work and cardiovascular disease (CVD). Limited evidence is available on how a cessation of shift work affects CVD risk factors. Aim: We investigated whether a five-month plant shutdown affected CVD risk factors in 30 industrial shift workers. Methods: We collected demographic data, self-reported data on physical activity (PA) and medical history by questionnaire. Pre- and post-plant shutdown, we measured blood pressure (BP), heart rate, lipids, glycosylated hemoglobin (HbA1c) and C-reactive protein (CRP). Additionally, we collected markers of inflammation, Matrix metalloproteinase-9 (MMP-9), Interleukin-6 (IL-6), Monocyte chemoattractant protein-1 (MCP-1), Tumor necrosis factor-alpha (TNF-α), P-selectin, Interleukin-1 beta (IL-1β), and Interleukin-23 (IL-23). We also examined arterial stiffness (central blood pressure, augmentation pressure, and pulse wave velocity) by means of SphygmoCor® (AtCor Medical Pty Ltd., Sydney, Australia). We monitored sleep by actigraphy prior to and after plant shutdown, with additional registration of sleep quality and assessment of insomnia symptoms. Results: After five months of plant shutdown, we found that HbA1c increased by 1.9 mmol/mol, weight by 1 kg and MCP-1 by 27.3 pg/mL, all unexpectedly. The other markers of inflammation did not change during shutdown, but CRP decreased close to significant levels. There were no changes in lipids during follow-up. Pulse-wave velocity (PWV) was reduced from 8.1 m/s (SD = 1.5) to 7.6 m/s (SD = 1.5), p = 0.03. The workers reported fewer signs of insomnia after shutdown. Conclusions: Our findings suggest that a five-month cessation in shift work increases weight and HbA1c, but also improves insomnia symptoms and reverses arterial stiffening.

Academic interest in the relationship between leaders' personality and subordinates' perception of destructive leadership behavior is increasing. However, results so far have been weak, contradictory, and inconsistent to theory. Here, we examine if using facets of neuroticism, rather than the broader trait, can be more informative and increases the predictive power. Next, we explore the interplay between personality dimensions by examining if the relationship between the facet angry hostility in neuroticism and destructive leadership behavior is moderated by the trait agreeableness. Four hundred and twenty emergent leaders were examined in a military selection context, combining the leaders' self-rated neuroticism (T1) with subordinates' subsequent perception of abusive supervision and laissez-faire leadership in a field exercise two weeks later (T2). The results indicated that using facets instead of the broad factor of neuroticism improved the prediction of examined outcomes. Only some of the facets of neuroticism were related to perceived leader behavior, with specific facets being identified for abusive supervision and laissezfaire leadership, respectively. Further, the relationship between angry hostility and both leadership styles was moderated by agreeableness. [ABSTRACT FROM AUTHOR]

This paper explores labor productivity in Ontario's gold mining industry from 1920 to 1970. The gold produced by a worker is nearly identical in 1920 and 1970, suggesting that the industry experiences no productivity gains over this period. Further, labor productivity in the intervening years was nearly 30% lower than these values, raising concerns about the ability of the industry to remain profitable given a fixed gold price. We look at over 180 different Ontario gold mines comprising nearly the entire industry to determine whether workers become less efficient over time, or whether other factors, such as entry and exit into the industry, declining ore quality, or changes in capital stock, are the primary drivers of this stagnation. This analysis considers the impact of events, such as a sudden 70% rise in the price of gold in 1934, World War II, and the post-war subsidization of the industry on productivity within the industry. [ABSTRACT FROM AUTHOR]