Corruption risk - the effect on international competitiveness : a study of Norwegian multinational companies

Masteroppgave (MSc) in Master of Science in International Management, Handelshøyskolen BI, 2014Corruption is a debated topic among actors in the international business environment, particularly as stringent anti-corruption legislations pose restrictions on how companies can legally operate. Corruption is by many leading economists regarded as a worldwide challenge and an impediment to economic growth and development. Norway has taken an active role in the international fight against corruption, and this thesis asks whether this could affect Norwegian multinational companies’ (MNCs) competitiveness. This thesis examines how the risk of corruption affects Norwegian multinational companies’ international competitiveness. To limit the scope, the thesis asks the following sub-questions: (1) how is the inherent risk of corruption considered? (2) How is the inherent risk of corruption managed? A qualitative study has been conducted on five Norwegian multinational companies, operating in the BRIC countries (Brazil, Russia, India, China). The MNCs operate in different industries and represent a combination of private/public and privately owned companies. The research found that the MNCs consider the inherent risk of corruption to be high. The MNCs respond to the identified risk by implementing strict internal procedures for corruption risk management. However, despite these procedures, certain MNCs recognize that they are unable to reduce the risk to an acceptable level, leading to risk aversion. The implementation of anti-corruption procedures, as a result of identified risk, is found to affect the MNCs’ international competitiveness negatively in two ways. On one hand, it requires a considerable amount of resources that might affect the companies’ profitability. On the other hand, risk aversion may force the MNCs to exclude certain markets due to the identified corruption risk. These consequences are, however, argued to be short term. On a long-term basis, the anti-corruption procedures are assumed to contribute to international competitiveness. If anti-corruption laws continue to proceed towards a global standard, it is argued to cause equal competitive conditions for all multinational actors

Diabetic retinopathy : from glycation to clinical aspects

Non-enzymatic formation of Advanced Glycation End products is observed in the human body and accelerated in disease such as diabetes and its complications. The range of functionally and structurally different AGEs makes it difficult to point out the most pathogenic AGE. However, hydroimidazolone (MG-H1) is the quantitatively dominating AGE-modification in vivo and forms when arginine reacts with the α-oxoaldehyde methylglyoxal, in itself capable of provoking oxidative stress. We used immunoassay as method of detection of levels of MG-H1. Also other compounds were cross-sectionally measured in different body compartments of different patients with type 1 and type 2 diabetes and related to extent of diabetic eye disease; diabetic retinopathy (DR). In addition, a clinical method for classification of retinal photographs was applied on an epidemiological follow-up study determining cumulative incidence of proliferative diabetic retinopathy (PDR) in 294 patients diagnosed with diabetes type 1 in Norway in the period between 1973 and 1982. Compared to those without retinopathy, we found increased serum levels of MG-H1 in both type 1 and type 2 diabetic patients with retinopathy. Serum levels of MG-H1 were increased in PDR compared to NPDR (diabetes mellitus type 2). Vitreous levels of MG-H1 were a) increased in type 2-diabetic patients compared to age-matched controls due to leakage from serum, and b) increased in PDR compared to NPDR in type 2-diabetic patients, originating from the vasculature due to breakdown of the inner blood-retinal barrier (iBRB). The growth factor VEGF was increased in vitreous fluid of patients with diabetes type 2. Even higher levels were found in PDR. This increase in VEGF was not due to a spill-over effect from the circulation, even though the iBRB is disrupted, supporting that it is produced intraocularly. Patients with type 1 diabetes of 24 years duration and retinopathy staged from fundus photographs had 89.1% cumulative incidence for DR. 10.5% of these have PDR. Intervention can be made on modifiable risk factors, combined with regular screening for diabetic retinopathy. The positive association between retinopathy and hydroimidazolone in both type 2 and type 1 diabetes remains to be causally investigated

Sykepleiers kunnskap og vurdering av postoperative smerter

Bakgrunn En vanlig følge av et kirurgisk inngrep er smerter. Sykepleieren skal observere, kartlegge, vurdere og behandle smerter til postoperative pasienter. Smerte er en subjektiv opplevelse, og kan dermed være utfordrende å vurdere. I tillegg er smerte et symptom, som gir viktig informasjon om pasientens tilstand. Sykepleieren har en viktig funksjon til postoperative pasienters smerte, og trenger kunnskap, erfaringer og ferdigheter for å gi god smertelindring. Hensikt Hensikten med oppgaven er å undersøke hvordan sykepleiere bruker sine kunnskaper om smertelindring ved vurdering av postoperativ smerte. Metode Metoden som er benyttet i oppgaven er litteraturstudie, med en kvalitativ tilnærming på problemstillingen. Studien har inkludert tre kvalitative artikler, samt to kvantitative for å underbygge resultatene fra de kvalitative artiklene. For å besvare oppgaven har vi brukt resultatene fra forskningsartiklene, Katie Eriksson teori om pleielidelse, relevant faglitteratur og egne refleksjoner. Resultater Resultatene trakk frem flere faktorer rundt kartlegging av postoperative smerter. Dette dreide seg om hvordan sykepleiere observerer pasienten, og betydningen av å tolke smerter. Det var viktig å forklare pasientene bruken av smertekartleggingsverktøy. Å spørre pasientene om beskrivelser gav mer informasjon, enn å spørre om et tall. Samarbeid med andre sykepleiere, profesjoner og pårørende var gode ressurser. Sykepleiere trenger kunnskap og erfaring innen postoperative smerter for å gi god smertelindring. Funn viser at kunnskaper om postoperative smerter kunne vært bedre, samt at fagutvikling anses som viktig. Både sykepleierens og pasientens holdninger har betydning i vurdering og behandling av postoperative smerter. Nøkkelord: Postoperativ, smerte, kartlegging, observasjon og vurdering, sykepleie, pleielidelse, kunnskap, erfaring, holdning.Background A common consequence of a surgical procedure is pain. Nurses must observe, map, assess and treat pain for postoperative patients. Pain is a subjective experience, and can thus be challenging to assess. In addition, pain is a symptom, which provides important information about the patient's condition. The nurse has an important function for postoperative patients' pain, and needs knowledge, experience and skills to provide good pain relief. Purpose The purpose of the thesis is to investigate how nurses use their knowledge of pain relief when assessing postoperative pain. Method The method used in the thesis is a literature study, with a qualitative approach to the problem. The study has included three qualitative articles, as well as two quantitative ones to substantiate the results from the qualitative articles. To answer the question, we have used the results from the research articles, Katie Eriksson's theory of nursing suffering, relevant scientific literature and our own reflections. Results The results highlighted several factors surrounding the mapping of postoperative pain. This was about how nurses observe the patient, and the importance of interpreting pain. It was important to explain to patients the use of pain mapping tools. Asking patients for descriptions provided more information than asking for a number. Collaboration with other nurses, professions and relatives were good resources. Nurses need knowledge and experience in postoperative pain to provide good pain relief. Findings show that knowledge about postoperative pain could have been better, and that professional development is considered important. Both the nurse's and the patient's attitudes are important in the assessment and treatment of postoperative pain. Keywords: Postoperative, pain, mapping, observation and assessment, nursing, nursing suffering, knowledge, experience, attitude

Idégrunnlaget for byromsutvikling i Oslos utsatte områder – tiltak, mål og konsekvenser

Det er knyttet ulike idealer til den gode byen, og hvilken rolle det offentlige rommet har i forankringen av dette. Mange av byens nye offentlige rom utvikles som del av privatinitierte utbyggingsprosjekter, og er helt eller delvis i privat eie. Denne masteroppgaven ser i stedet på utvikling av byrom i de områdene hvor den private investeringsviljen mangler, og kommunen selv må initiere prosjektene. Hva er idegrunnlaget og idealene bak utvikling og oppgradering av offentlig rom i det som forstås som Oslos mest ‘utsatte’ områder? Jeg tar utgangspunkt i en forståelse av det offentlige rommet som et romlig objekt, bestående av fysiske og sosiale materialer i ulik skala. Gjennom en undersøkelse av to eksempelområder gjøres en analyse av hvilke ideer som knyttes til sammenheng mellom fysiske tiltak og sosiale effekter. De kommunale områdesatsingene gjøres med mål om økt deltakelse i lokalsamfunn og storsamfunn. Det undersøkes på hvilken måte byrommet relaterer seg til dette målet, med utgangspunkt i en forståelse av det offentlige rommet som del av ulike sosio-romlige systemer. Gjennom studien beskrives ideer knyttet til sammenheng mellom lokalsamfunnets sosiale og fysiske egenskaper, og negativ utvikling i lokalsamfunn. Videre beskrives hvilke typer tiltak som anbefales for å skape en ønsket utvikling og materialitet i det offentlige rommet. På bakgrunn av analysen vises det til at byromsoppgraderingene kan forstås som en korrektiv praksis, hvor bestemte sosiale og fysiske materialer settes sammen for en ønsket programmering av byrommet. Kommunen viser til mål om mangfold og bred inkludering av ‘alle’, men forståelsen av inkludering og mangfold er - i likhet med forståelsen av den gode byen - relativ og knyttes til ulike sosio-romlige idealer. Studien viser at det kan ses en kommunal vektlegging av tradisjonelle lokalsamfunnsverdier i de utsatte områdene, hvor byromsprosjektene knyttes til mål om tilhørighet, trivsel og fellesskap.The notion of what makes a good city, and the role public space has in securing this, is related to different political ideals. Many new public spaces are developed as part of privately initiated development projects, and are wholly or partially privately owned. This master's thesis instead looks at the development of urban spaces in those areas where the private interest to invest is lacking, and the municipality itself must initiate projects. What ideas and ideals justify the development of public space in what is viewed as Oslo's most 'vulnerable' areas? I develop an understanding of public space as a spatial object, consisting of physical and social materials in different geographical scales. By studying two different case areas, I analyze ideas related to the connection between physical measures in public space and social effects. The urban regeneration projects (‘områdesatsinger’) implement goals of increased participation in local community and society at large. I examine how development of public space relates to these goals, building on an understanding of public space as part of different socio-spatial systems. The study describes different ideas of the connection between socio-spatial materials and negative development in local communities, and what types of measures are recommended to create a desired development and materiality in public space. Based on this, the study shows that the practice of revitalizing urban space in vulnerable areas can be seen as being corrective, where certain social and physical materials are put together for a desired programming of the urban space. The municipality describes goals of diversity and inclusion of ‘everyone’, but the understanding of inclusion and diversity – just as the notion of the good city – is relative, and related to different soico-spatial ideals. The study shows what can be seen as an emphasis on traditional community values in vulnerable areas

Sykepleiers kunnskap og vurdering av postoperative smerter

Bakgrunn En vanlig følge av et kirurgisk inngrep er smerter. Sykepleieren skal observere, kartlegge, vurdere og behandle smerter til postoperative pasienter. Smerte er en subjektiv opplevelse, og kan dermed være utfordrende å vurdere. I tillegg er smerte et symptom, som gir viktig informasjon om pasientens tilstand. Sykepleieren har en viktig funksjon til postoperative pasienters smerte, og trenger kunnskap, erfaringer og ferdigheter for å gi god smertelindring. Hensikt Hensikten med oppgaven er å undersøke hvordan sykepleiere bruker sine kunnskaper om smertelindring ved vurdering av postoperativ smerte. Metode Metoden som er benyttet i oppgaven er litteraturstudie, med en kvalitativ tilnærming på problemstillingen. Studien har inkludert tre kvalitative artikler, samt to kvantitative for å underbygge resultatene fra de kvalitative artiklene. For å besvare oppgaven har vi brukt resultatene fra forskningsartiklene, Katie Eriksson teori om pleielidelse, relevant faglitteratur og egne refleksjoner. Resultater Resultatene trakk frem flere faktorer rundt kartlegging av postoperative smerter. Dette dreide seg om hvordan sykepleiere observerer pasienten, og betydningen av å tolke smerter. Det var viktig å forklare pasientene bruken av smertekartleggingsverktøy. Å spørre pasientene om beskrivelser gav mer informasjon, enn å spørre om et tall. Samarbeid med andre sykepleiere, profesjoner og pårørende var gode ressurser. Sykepleiere trenger kunnskap og erfaring innen postoperative smerter for å gi god smertelindring. Funn viser at kunnskaper om postoperative smerter kunne vært bedre, samt at fagutvikling anses som viktig. Både sykepleierens og pasientens holdninger har betydning i vurdering og behandling av postoperative smerter. Nøkkelord: Postoperativ, smerte, kartlegging, observasjon og vurdering, sykepleie, pleielidelse, kunnskap, erfaring, holdning.Background A common consequence of a surgical procedure is pain. Nurses must observe, map, assess and treat pain for postoperative patients. Pain is a subjective experience, and can thus be challenging to assess. In addition, pain is a symptom, which provides important information about the patient's condition. The nurse has an important function for postoperative patients' pain, and needs knowledge, experience and skills to provide good pain relief. Purpose The purpose of the thesis is to investigate how nurses use their knowledge of pain relief when assessing postoperative pain. Method The method used in the thesis is a literature study, with a qualitative approach to the problem. The study has included three qualitative articles, as well as two quantitative ones to substantiate the results from the qualitative articles. To answer the question, we have used the results from the research articles, Katie Eriksson's theory of nursing suffering, relevant scientific literature and our own reflections. Results The results highlighted several factors surrounding the mapping of postoperative pain. This was about how nurses observe the patient, and the importance of interpreting pain. It was important to explain to patients the use of pain mapping tools. Asking patients for descriptions provided more information than asking for a number. Collaboration with other nurses, professions and relatives were good resources. Nurses need knowledge and experience in postoperative pain to provide good pain relief. Findings show that knowledge about postoperative pain could have been better, and that professional development is considered important. Both the nurse's and the patient's attitudes are important in the assessment and treatment of postoperative pain. Keywords: Postoperative, pain, mapping, observation and assessment, nursing, nursing suffering, knowledge, experience, attitude

Protection From Retinopathy and Other Complications in Patients With Type 1 Diabetes of Extreme Duration: The Joslin 50-Year Medalist Study

Objective: To assess complication prevalence and identify protective factors in patients with diabetes duration of $\geq$50 years. Characterization of a complication-free subgroup in this cohort would suggest that some individuals are protected from diabetes complications and allow identification of endogenous protective factors. Research Design and Methods: Cross-sectional, observational study of 351 U.S. residents who have survived with type 1 diabetes for $\geq$50 years (Medalists). Retinopathy, nephropathy, neuropathy, and cardiovascular disease were assessed in relation to HbA$_{1c}$, lipids, and advanced glycation end products (AGEs). Retrospective chart review provided longitudinal ophthalmic data for a subgroup. Results: A high proportion of Medalists remain free from proliferative diabetic retinopathy (PDR) (42.6%), nephropathy (86.9%), neuropathy (39.4%), or cardiovascular disease (51.5%). Current and longitudinal (the past 15 years) glycemic control were unrelated to complications. Subjects with high plasma carboxyethyl-lysine and pentosidine were 7.2-fold more likely to have any complication. Of Medalists without PDR, 96% with no retinopathy progression over the first 17 years of follow-up did not experience retinopathy worsening thereafter. Conclusions: The Medalist population is likely enriched for protective factors against complications. These factors might prove useful to the general population with diabetes if they can be used to induce protection against long-term complications. Specific AGE combinations were strongly associated with complications, indicating a link between AGE formation or processing with development of diabetic vasculopathy

Candesartan Attenuates Diabetic Retinal Vascular Pathology by Restoring Glyoxalase-I Function

This is an uncopyedited electronic version of an article accepted for publication in Diabetes. The American Diabetes Association, publisher of Diabetes, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes in print and online a

Nutritional supplementation for type 2 diabetes: a systematic review

The role of nutritional supplementation is of increasing interest with regard to ocular disease. Randomised controlled trials have demonstrated the effectiveness of supplementation for age-related macular degeneration, and formulations are now being developed for use by people with diabetes and diabetic retinopathy. The aim of this review was to synthesise the evidence for use of nutritional supplementation in type 2 diabetes. MEDLINE and EMBASE databases were searched using a systematic approach. Only double-masked randomised controlled trials were selected. A total of 50 trials were identified as suitable for inclusion. The potential role of alpha-lipoic acid, chromium, folic acid, isoflavones, magnesium, Pycnogenol®, selenium, vitamin C, vitamin E, and zinc in the treatment of type 2 diabetes is discussed. The review of trials identifies positive effects of these nutrients on various outcome measures relating to insulin resistance and cardiovascular factors. Chromium was the most studied supplement, accounting for 16 of the 50 trials. A majority of the trials found a positive effect of chromium on fasting plasma glucose. Isoflavones were found to have a positive effect on insulin resistance and cardiovascular outcome measures, but only when combined with soy proteins. Vitamin E is reported to reduce oxidative stress at levels of 200 mg day-1 or more