Predictors of satisfaction with digital follow-up in Norwegian Labor and Welfare Administration: A sequential mixed-methods study

This study examines predictors of satisfaction with digital follow-up among young people in the Norwegian Labor and Welfare Administration (NAV). A total of 1195 young employment seekers were recruited across Norway. Participants completed a cross-sectional online survey comprising demographic questions, general questions on service quality, digital services, and open-ended questions on their experiences with NAV. Using a mixed-methods approach, we developed hypotheses derived from qualitative open-ended text fields and tested these assumptions with quantitative analyses. Results revealed three themes related to satisfaction (information, response time, and impersonal contact), and multiple linear regression identified perceived response time, language comprehension, and information as predictors. Perceived response time was found to be the strongest predictor. We suggest that clients' perceptions of response time may be influenced by their service expectations, and service expectations may be shaped by the application of digital technologies. Hence, clarification of expectations may be of importance in digital follow-up of young people. Finally, this study underscores the importance of clear and understandable information to reduce digital exclusion. We suggest that these changes should occur in collaboration with user-panels.publishedVersio

Benefits and harms of mammography screening

Mammography screening for breast cancer is widely available in many countries. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. This review discusses the benefits and harms of mammography screening in light of findings from randomized trials and from more recent observational studies performed in the era of modern diagnostics and treatment. The main benefit of mammography screening is reduction of breast-cancer related death. Relative reductions vary from about 15 to 25% in randomized trials to more recent estimates of 13 to 17% in meta-analyses of observational studies. Using UK population data of 2007, for 1,000 women invited to biennial mammography screening for 20 years from age 50, 2 to 3 women are prevented from dying of breast cancer. All-cause mortality is unchanged. Overdiagnosis of breast cancer is the main harm of mammography screening. Based on recent estimates from the United States, the relative amount of overdiagnosis (including ductal carcinoma in situ and invasive cancer) is 31%. This results in 15 women overdiagnosed for every 1,000 women invited to biennial mammography screening for 20 years from age 50. Women should be unpassionately informed about the benefits and harms of mammography screening using absolute effect sizes in a comprehensible fashion. In an era of limited health care resources, screening services need to be scrutinized and compared with each other with regard to effectiveness, cost-effectiveness and harms

A pilot study of implementation of endoscopic sleeve gastroplasty (ESG) in Norway

Background and aim - Bariatric surgery is the most effective treatment for obesity but is invasive and associated with serious complications. Endoscopic sleeve gastroplasty (ESG) is a less invasive weight loss procedure to reduce the stomach volume by full-thickness sutures. ESG has been adopted in many countries, but implementation at Scandinavian centres has not yet been documented. We performed a clinical pilot trial at a Norwegian centre with the primary objective to assess the feasibility of the ESG procedure. Patients and methods - We included the first 10 patients treated with ESG at a Norwegian centre in a single-arm pilot study. The eligibility criteria were either a body mass index (BMI) of 40–49.9 kg/m2, BMI 35–39.9 kg/m2 and at least one obesity-related comorbidity, or BMI 30–34.9 kg/m2 and type 2 diabetes. Patient follow-up resembled the scheme used for bariatric surgery at the center, including dietary plans and outpatient visits. Results - All procedures were technically successful except for one patient who had adhesions between the stomach and anterior abdominal wall, related to a prior hernia repair, resulting in less-than-intended stomach volume reduction. Mean total body weight loss (TBWL) after 26 and 52 weeks was 12.2% (95% CI 8.1–16.2) and 9.1% (95% CI 3.3 − 15.0). One patient experienced a minor suture-induced diaphragmatic injury, which was successfully managed conservatively. Conclusions - This first Scandinavian clinical trial of ESG, documenting the implementation of the procedure at a Norwegian center, demonstrated acceptable feasibility and safety, with large variations in individual weight loss during the 52-week follow-up period

Mortality in Norway and Sweden during the COVID-19 pandemic

Background: Norway and Sweden are similar countries in terms of socioeconomics and health care. Norway implemented extensive COVID-19 measures, such as school closures and lockdowns, whereas Sweden did not. Aims: To compare mortality in Norway and Sweden, two similar countries with very different mitigation measures against COVID-19. Methods: Using real-world data from national registries, we compared all-cause and COVID-19-related mortality rates with 95% confidence intervals (CI) per 100,000 person-weeks and mortality rate ratios (MRR) comparing the five preceding years (2015–2019) with the pandemic year (2020) in Norway and Sweden. Results: In Norway, all-cause mortality was stable from 2015 to 2019 (mortality rate 14.6–15.1 per 100,000 person-weeks; mean mortality rate 14.9) and was lower in 2020 than from 2015 to 2019 (mortality rate 14.4; MRR 0.97; 95% CI 0.96–0.98). In Sweden, all-cause mortality was stable from 2015 to 2018 (mortality rate 17.0–17.8; mean mortality rate 17.1) and similar to that in 2020 (mortality rate 17.6), but lower in 2019 (mortality rate 16.2). Compared with the years 2015–2019, all-cause mortality in the pandemic year was 3% higher due to the lower rate in 2019 (MRR 1.03; 95% CI 1.02–1.04). Excess mortality was confined to people aged ⩾70 years in Sweden compared with previous years. The COVID-19-associated mortality rates per 100,000 person-weeks during the first wave of the pandemic were 0.3 in Norway and 2.9 in Sweden. Conclusions: All-cause mortality in 2020 decreased in Norway and increased in Sweden compared with previous years. The observed excess deaths in Sweden during the pandemic may, in part, be explained by mortality displacement due to the low all-cause mortality in the previous year

An analysis of the Birken Group

Summary This thesis is based on the “BØK” courses and “ELE3750 Finansiell Analyse og Verdsettelse”. Our strategic analysis regarding the Birken Group shows that most external factors tend towards favorable trends for the organization. However, consumer’s demand for competitive outdoor sport events may decrease. Our internal analysis shows that the Birken Group has several factors that give them a potential sustainable competitive advantage, but the cost structure prevents them from achieving this. In the financial analysis we see that the net profit margin is decreasing, despite the fact that revenue has tripled over the last 9 years. This is once again due to rapidly increasing costs, which has increase over 5 times in 9 years. The Birken Group has a very low liquidity risk, mainly due to a large cash reserve of approximately 60 million NOK. We also see a plummet in the free cash flow to equity due to a 20 million NOK decrease in the short-term debt item payment in advance. We therefore advice for the Birken Group to reduce the rampant growth of costs and invest parts of the cash reserve to get a higher rate of return on their excess cash, while still maintaining a healthy cash buffer. We also recommend that the Birken Group reduce their dividend payout while their net working capital is fluctuating heavily, which it has for the last few years