Digitale transformasjoner og soft skills: En studie av syv virksomheter i Oslo-regionen.

Funn fra vårt kvalitative studie indikerer at soft skills har stor betydning i gjennomføring av digitale transformasjoner. Kommunikasjon, endringsvilje, empati, eierskap, samarbeidsevne, og læringsvilje blir ansett som de viktigste soft skills hos både ledere og medarbeidere i en digital transformasjon. Alle de seks soft skills anses som gjennomgående viktig i en digital transformasjon. Enkelte soft skills fant vi hadde større betydning før og under i en endringsprosess. Soft skills i den siste fasen viser seg å være av mindre betydning og overlappende med de to foregående fasene i en slik prosess. Våre funn indikerer også at kultur er en viktig faktor i en digital transformasjon, og er en forutsetning for å realisere soft skills. I denne oppgaven ønsket vi å utvikle et taksonomi av de seks viktigste soft skills i digitale transformasjoner. Vi så på hvordan og når soft skills blir viktig i en slik prosess, og hvordan de kan utnyttes for å optimalisere en digital transformasjon. På bakgrunn av dette utviklet vi følgende problemstilling: Hvordan blir soft skills viktig i digital transformasjon? Soft skills og digital transformasjon er begge begreper med mange definisjoner og tidvis uklar betydning, og vi ønsket derfor å kartlegge det vesentlige i dem ved å gjennomføre en kvalitativ undersøkelse. For å best mulig svare på problemstilling utviklet vi følgende forskningsspørsmål: F1: Hva er soft skills? F2: Hvilke soft skills er viktige i digital transformasjon? F3: Hvordan kan bedrifter utnytte soft skills for å optimalisere digital transformasjon? For å svare på problemstilling og forskningsspørsmål, valgte vi å gjennomføre semistrukturerte dybdeintervju med respondenter som har implisitt kjennskap og direkte erfaringer knyttet til tema

Quality of life among patients undergoing bariatric surgery: associations with mental health- A 1 year follow-up study of bariatric surgery patients

Background: Preoperative mental health seems to have useful predictive value for Health Related Quality of Life (HRQOL) after bariatric surgery. The aim of the present study was to assess pre- and postoperative psychiatric disorders and their associations with pre- and postoperative HRQOL. Method: Data were assessed before (n = 127) and one year after surgery (n = 87). Psychiatric disorders were assessed by Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II). HRQOL was assessed by the Short Form 36 (SF-36) questionnaire. Results: Significant improvements were found in HRQOL from preoperative assessment to follow-up one year after surgery. For the total study population, the degree of improvement was statistically significant (p values < .001) for seven of the eight SF-36 subscales from preoperative assessment to follow-up one year after surgery. Patients without psychiatric disorders had no impairments in postoperative HRQOL, and patients with psychiatric disorders that resolved after surgery had small impairments on two of the eight SF-36 subscales compared to the population norm (all effect sizes < .5) at follow-up one year after surgery. Patients with psychiatric disorders that persisted after surgery had impaired HRQOL at follow-up one year after surgery compared to the population norm, with effect sizes for the differences from moderate to large (all effect sizes ≥ .6). Conclusion: This study reports the novel finding that patients without postoperative psychiatric disorders achieved a HRQOL comparable to the general population one year after bariatric surgery; while patients with postoperative psychiatric disorders did not reach the HRQOL level of the general population. Our results support monitoring patients with psychiatric disorders persisting after surgery for suboptimal improvements in quality of life after bariatric surgery

Multidisciplinary intervention in patients with musculoskeletal pain: a randomized clinical trial

Background Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term disability and reduced quality of life. The scientific literature on effects of treatment for musculoskeletal pain is inconclusive. Purpose The purpose of this study is to compare a multidisciplinary intervention (MI), including use of the novel Interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET), with a brief intervention (BI), on effects on mental and physical symptoms, functioning ability, use of health services and coping in patients sick-listed due to musculoskeletal pain. Method Two hundred eighty-four adults aged 18–60, referred to a specialist clinic in physical rehabilitation, were randomized to MI or BI. Patients received a medical examination at baseline and completed a comprehensive questionnaire at baseline, 3 months and 12 months. Results Both groups reported improvements in mental and physical symptoms, including pain, and improved functioning ability at 3 and 12 months, but the MI group improved faster than the BI group except from reports of pain, which had a similar course. Significant interactions between group and time were found on mental symptoms (anxiety (p < 0.05), depression (p < 0.01), somatization (p < 0.01)) and functioning ability (p < 0.01) due to stronger effects in the MI group at 3 months. At 3 and 12 months, the MI group reported significantly less use of health services (general practitioner (p < 0.05)). At 12 months, the MI group reported better self-evaluated capability of coping with complaints (p < 0.001) and they took better care of their own health (p < 0.001), compared to the BI group. Conclusion The results indicate that the MI may represent an important supplement in the treatment of musculoskeletal pain.publishedVersio

Fatigue and Depression in Sick-Listed Chronic Low Back Pain Patients

Objective: The relationship between fatigue and pain has been investigated previously, but little is known about the prevalence of substantial fatigue in patients sick-listed for chronic low back pain (CLBP) and about how fatigue is associated with depression, pain, and long-term disability. The aims of the study were to examine the prevalence of substantial fatigue; associations between fatigue, depression, and pain; and whether fatigue predicted long-term disability. Methods: Five hundred sixty-nine patients participating in a randomized controlled trial and sick-listed 2–10 months for LBP were included in the study. Cross-sectional analyses were conducted to investigate the prevalence and independent associations between fatigue, depression, pain, and disability, while longitudinal analyses were done to investigate the association between fatigue and long-term disability. Results: The prevalence of substantial fatigue was 69.7%. Women reported significantly more fatigue than men (t = −3.6, df = 551; P < .001). Those with substantial fatigue had higher pain intensity (t = −3.3, df = 534; P = 0.01), more depressive symptoms (t = −10.9, df = 454; P < 0.001), and more disability (t = −7.6, df = 539; P < 0.001) than those without substantial fatigue. Musculoskeletal pain and depression were independently associated with substantial fatigue. In the longitudinal analyses, fatigue predicted long-term disability at 3, 6, and 12 months' follow-up. After pain and depression were controlled for, fatigue remained a significant predictor of disability at 6 months' follow-up. Conclusions: The vast majority of the sick-listed CLBP patients reported substantial fatigue. Those with substantial fatigue had more pain and depressive symptoms and a significant risk of reporting more disability at 3, 6, and 12 months. Substantial fatigue is disabling in itself but also involves a risk of developing chronic fatigue syndrome and long-term disability

Return to work in patients with chronic musculoskeletal pain: multidisciplinary intervention versus brief intervention: a randomized clinical trial

Objective: This randomized clinical trial was performed to compare the effect of a new multidisciplinary intervention (MI) programme to a brief intervention (BI) programme on return to work (RTW), fully and partly, at a 12-month and 24-month follow-up in patients on long-term sick leave due to musculoskeletal pain. Methods: Patients (n = 284, mean age 41.3 years, 53.9 % women) who were sick-listed with musculoskeletal pain and referred to a specialist clinic in physical rehabilitation were randomized to MI (n = 141) or BI (n = 143). The MI included the use of a visual educational tool, which facilitated patienttherapist communication and self-management. The MI also applied one more profession, more therapist time and a comprehensive focus on the psychosocial factors, particularly the working conditions, compared to a BI. The main features of the latter are a thorough medical, educational examination, a brief cognitive assessment based on the non-injury model, and a recommendation to return to normal activity as soon as possible. Results: The number of patients with full-time RTW developed similarly in the two groups. The patients receiving MI had a higher probability to partly RTW during the first 7 months of the follow-up compared to the BI-group. Conclusions: There were no differences between the groups on full-time RTW during the 24 months. However, the results indicate that MI hastens the return to work process in long-term sick leave through the increased use of partial sick leave. Trial Registration: http://www.clinicaltrials.gov with the registration number NCT01346423.publishedVersio

General practitioners' opinions on how to improve treatment of mental disorders in primary health care. Interviews with one hundred Norwegian general practitioners

<p>Abstract</p> <p>Background</p> <p>Improvements in treatment of mental disorders are repeatedly called for. General practitioners (GPs) are responsible for the majority of treatment of mental disorders. Consequently, we interviewed GPs about their opinions on how treatment of mental disorders in primary health care contexts could be improved.</p> <p>Methods</p> <p>Among GPs affiliated within the Norwegian reimbursement system, we approached 353, and made contact with 246 GP's. One-hundred of these agreed to participate in our study, and 95 of them expressed opinions on how to improve treatment of mental disorders. The telephone interviews were based on open-ended questions, responses were transcribed continuously, and content analysis was applied. Results are presented both as frequency tables of common responses, and as qualitative descriptions and quotations of opinions.</p> <p>Results</p> <p>Nearly all (95%) of the GPs had suggestions on how to improve treatment of mental disorders in primary health care. Increased capacity in secondary health care was suggested by 59% of GPs. Suggestions of improved collaboration with secondary health care were also common (57%), as were improvements of GPs' skills and knowledge relevant for diagnosing and treating mental disorders (40%) and more time for patients with mental disorders in GP contexts (40%).</p> <p>Conclusions</p> <p>The GPs' suggestions are in line with international research and debate. It is thought-provoking that the majority of GPs call for increased capacity in secondary care, and also better collaboration with secondary care. Some GPs made comparisons to the health care system for physical disorders, which is described as better-functioning. Our study identified no simple short-term cost-effective interventions likely to improve treatment for mental disorders within primary health care. Under-treatment of mental disorders is, however, also associated with significant financial burdens.</p

A Collaborative Analysis of Individual Participant Data from 19 Prospective Studies Assesses Circulating Vitamin D and Prostate Cancer Risk.

Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and the risk of prostate cancer overall and by tumor characteristics. Principal investigators of 19 prospective studies provided individual participant data on circulating 25(OH)D and 1,25(OH)2D for up to 13,462 men with incident prostate cancer and 20,261 control participants. ORs for prostate cancer by study-specific fifths of season-standardized vitamin D concentration were estimated using multivariable-adjusted conditional logistic regression. 25(OH)D concentration was positively associated with risk for total prostate cancer (multivariable-adjusted OR comparing highest vs. lowest study-specific fifth was 1.22; 95% confidence interval, 1.13-1.31; P trend < 0.001). However, this association varied by disease aggressiveness (P heterogeneity = 0.014); higher circulating 25(OH)D was associated with a higher risk of nonaggressive disease (OR per 80 percentile increase = 1.24, 1.13-1.36) but not with aggressive disease (defined as stage 4, metastases, or prostate cancer death, 0.95, 0.78-1.15). 1,25(OH)2D concentration was not associated with risk for prostate cancer overall or by tumor characteristics. The absence of an association of vitamin D with aggressive disease does not support the hypothesis that vitamin D deficiency increases prostate cancer risk. Rather, the association of high circulating 25(OH)D concentration with a higher risk of nonaggressive prostate cancer may be influenced by detection bias. SIGNIFICANCE: This international collaboration comprises the largest prospective study on blood vitamin D and prostate cancer risk and shows no association with aggressive disease but some evidence of a higher risk of nonaggressive disease

Multidisciplinary Intervention in Patients with Musculoskeletal Pain: a Randomized Clinical Trial

Abstract BACKGROUND: Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term disability and reduced quality of life. The scientific literature on effects of treatment for musculoskeletal pain is inconclusive. PURPOSE: The purpose of this study is to compare a multidisciplinary intervention (MI), including use of the novel Interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET), with a brief intervention (BI), on effects on mental and physical symptoms, functioning ability, use of health services and coping in patients sick-listed due to musculoskeletal pain. METHOD: Two hundred eighty-four adults aged 18-60, referred to a specialist clinic in physical rehabilitation, were randomized to MI or BI. Patients received a medical examination at baseline and completed a comprehensive questionnaire at baseline, 3 months and 12 months. RESULTS: Both groups reported improvements in mental and physical symptoms, including pain, and improved functioning ability at 3 and 12 months, but the MI group improved faster than the BI group except from reports of pain, which had a similar course. Significant interactions between group and time were found on mental symptoms (anxiety (p < 0.05), depression (p < 0.01), somatization (p < 0.01)) and functioning ability (p < 0.01) due to stronger effects in the MI group at 3 months. At 3 and 12 months, the MI group reported significantly less use of health services (general practitioner (p < 0.05)). At 12 months, the MI group reported better self-evaluated capability of coping with complaints (p < 0.001) and they took better care of their own health (p < 0.001), compared to the BI group. CONCLUSION: The results indicate that the MI may represent an important supplement in the treatment of musculoskeletal pain.Innlandet Hospital Trust (Norway) funded the study.publishedVersio

Predictors of return to work in patients on sick leave with chronic musculoskeletal pain

Objective: To assess the predictive effect of a multidisciplinary intervention programme, pain, workrelated factors and health, including anxiety/depression and beliefs, on return-to-work for patients sick-listed due to musculoskeletal pain. Design: A randomized clinical study. Methods: A total of 284 patients were randomized to either a multidisciplinary intervention programme (n=141) or to a less resource-demanding brief intervention (n=143). Work participation was estimated monthly from register data for 12 months. Return-to-work was defined as increased work participation in 3 consecutive months. Results: In the adjusted model, return-to-work by 3 months was associated with a multidisciplinary intervention programme (odds ratio (OR)=2.7, 95% confidence interval (95% CI)=1.1–6.9), the factor “belief that work was cause of the pain” (OR=2.2, 95% CI=1.1–4.3), anxiety and depression (OR=0.5, 95% CI=0.2–0.98), and by an interaction between the multidisciplinary intervention and perceived support at work (OR=0.3, 95% CI=0.1–0.9). At 12 months, only duration of sick leave was associated with return-to-work (OR=0.6, 95% CI=0.5–0.8). Conclusion: Multidisciplinary intervention may hasten return-to-work and benefit those who perceive low support at work, but at 12 months only duration of sick leave at baseline was associated with returnto-work

Predictors of return to work in patients on sick leave with chronic musculoskeletal pain

Objective: To assess the predictive effect of a multidisciplinary intervention programme, pain, workrelated factors and health, including anxiety/depression and beliefs, on return-to-work for patients sick-listed due to musculoskeletal pain. Design: A randomized clinical study. Methods: A total of 284 patients were randomized to either a multidisciplinary intervention programme (n=141) or to a less resource-demanding brief intervention (n=143). Work participation was estimated monthly from register data for 12 months. Return-to-work was defined as increased work participation in 3 consecutive months. Results: In the adjusted model, return-to-work by 3 months was associated with a multidisciplinary intervention programme (odds ratio (OR)=2.7, 95% confidence interval (95% CI)=1.1–6.9), the factor “belief that work was cause of the pain” (OR=2.2, 95% CI=1.1–4.3), anxiety and depression (OR=0.5, 95% CI=0.2–0.98), and by an interaction between the multidisciplinary intervention and perceived support at work (OR=0.3, 95% CI=0.1–0.9). At 12 months, only duration of sick leave was associated with return-to-work (OR=0.6, 95% CI=0.5–0.8). Conclusion: Multidisciplinary intervention may hasten return-to-work and benefit those who perceive low support at work, but at 12 months only duration of sick leave at baseline was associated with returnto-work