Association of soluble tumor necrosis factor receptors 1 and 2 with nephropathy, cardiovascular events, and total mortality in type 2 diabetes

AIMS/HYPOTHESIS: Soluble tumor necrosis factor receptors 1 and 2 (sTNFR1 and sTNFR2) contribute to experimental diabetic kidney disease, a condition with substantially increased cardiovascular risk when present in patients. Therefore, we aimed to explore the levels of sTNFRs, and their association with prevalent kidney disease, incident cardiovascular disease, and risk of mortality independently of baseline kidney function and microalbuminuria in a cohort of patients with type 2 diabetes. In pre-defined secondary analyses we also investigated whether the sTNFRs predict adverse outcome in the absence of diabetic kidney disease. METHODS: The CARDIPP study, a cohort study of 607 diabetes patients [mean age 61 years, 44 % women, 45 cardiovascular events (fatal/non-fatal myocardial infarction or stroke) and 44 deaths during follow-up (mean 7.6 years)] was used. RESULTS: Higher sTNFR1 and sTNFR2 were associated with higher odds of prevalent kidney disease [odd ratio (OR) per standard deviation (SD) increase 1.60, 95 % confidence interval (CI) 1.32-1.93, p < 0.001 and OR 1.54, 95 % CI 1.21-1.97, p = 0.001, respectively]. In Cox regression models adjusting for age, sex, glomerular filtration rate and urinary albumin/creatinine ratio, higher sTNFR1 and sTNFR2 predicted incident cardiovascular events [hazard ratio (HR) per SD increase, 1.66, 95 % CI 1.29-2.174, p < 0.001 and HR 1.47, 95 % CI 1.13-1.91, p = 0.004, respectively]. Results were similar in separate models with adjustments for inflammatory markers, HbA1c, or established cardiovascular risk factors, or when participants with diabetic kidney disease at baseline were excluded (p < 0.01 for all). Both sTNFRs were associated with mortality. CONCLUSIONS/INTERPRETATIONS: Higher circulating sTNFR1 and sTNFR2 are associated with diabetic kidney disease, and predicts incident cardiovascular disease and mortality independently of microalbuminuria and kidney function, even in those without kidney disease. Our findings support the clinical utility of sTNFRs as prognostic markers in type 2 diabetes.

The Role of Gay Spaces for a Gay Destination : Gay Tourism in Gran Canaria

This thesis has the aim to evaluate the role of gay spaces in Gran Canaria as a gay tourists destination with particular reference to gay exclusive resorts. The validation of the gay identity is a key motivation for homosexuals to travel, in order to connect with other homosexuals and experience the gay life that they might not be able to experience at home. Gay spaces have been defined both as liberated areas as well as ghettos, where the homosexuals are, in a way, restrained. The method chosen, a small number of semi- structured interviews with managers of gay exclusive resorts in Maspalomas, the hub of gay life in Gran Canaria, where major LGBT events are held, there is a gay friendly environment, a thriving gay scene and many gay exclusive resorts. In the case of Gran Canaria the gay-specific offer is complementary to the ‘regular’ tourism offer, as they coexist, complement and at times overlap. Nevertheless the gay centric holiday is still predominant amongst gay men, and it is likely to continue to be according to the informants. This is because gay tourists seek freedom and a sense of inclusion that they would not be able to find in mixed environments.

Sponsring av Skid-VM i Falun : En studie av regionala sponsorers vilja att delta isponsornätverket Beyond Skiing

Stora idrottsevenemang är till stor del beroende av de intäkter som kommer från sponsrandeföretag. Inför skid-VM i Falun 2015 startade organisationen Beyond Skiing Foundation ABett projekt i form av ett sponsornätverk. Projektet kom att kallas Beyond Skiing och syftet varatt försöka locka regionala- företag, kommuner och organisationer att sponsra skid-VM.Tanken med sponsornätverket var att ge ett värde till projektets medlemmar som ville varamed och sponsra skid-VM, men som inte ville betala den summa pengar som krävdes för attbli huvudsponsorer till evenemanget.Syftet med denna undersökning är att förklara varför en heterogen grupp sponsorer utspriddaöver en stor region ingick i ett regionalt sponsornätverk. Urvalet bestod av medlemmarna iBeyond Skiing. Vidare gjordes ett urval att medlemmarna skulle vara lokaliserade i Dalarna,men utanför Falun. Anledningen till varför regionala sponsorer utan direkt geografiskkoppling till Falun valdes, var att kopplingen mellan deras sponsring av skid-VM kan påförhand ses som mer komplex och onaturlig jämfört med sponsorer från Falun, eftersomsponsring i mindre skala tenderar att röra samarbeten med sponsrade enheter inom samma ort.Data till studien samlades in genom fem kvalitativa telefonintervjuer. Resultatet indikerar påatt medlemmarna i Beyond Skiing hade tydliga kommersiella mål med sin sponsring av skid-VM och att sponsra endast genom goodwill var i detta fall mindre förekommande. Studien harvisat att sponsringssamarbetes specifika erbjudanden och regionala motiv har varit tvåbidragande orsaker till varför sponsorerna ville sponsra skid-VM. Särskilt nöjda varsponsorerna med nätverksträffarna som Beyond Skiing Foundation anordnade förmedlemmarna inom Beyond Skiing.