427 research outputs found
Cell phone-supported cognitive behavioural therapy for anxiety disorders : a protocol for effectiveness studies in frontline settings.
No full textThe resulting protocol (NCT01205191 at clinicaltrials.gov) for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.Original Publication: Joakim Ekberg, Toomas Timpka, Magnus Bång, Anders Fröberg, Karin Halje and Henrik Eriksson, Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings., 2011, BMC medical research methodology, (11), 3. http://dx.doi.org/10.1186/1471-2288-11-3 Copyright: BioMed Central http://www.biomedcentral.com/</p
Health Information System Implementation : A Qualitative Meta-analysis
No full textHealthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered, as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations. We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and, most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and not a predictive theory.The original publication is available at www.springerlink.com:Bahlol Rahimi, Vivian Vimarlund and Toomas Timpka, Health Information System Implementation: A Qualitative Meta-analysis, 2009, Journal of medical systems, (33), 5, 359-368.http://dx.doi.org/10.1007/s10916-008-9198-9Copyright: Springer Science Business Mediahttp://www.springerlink.com
Temaledare: lnformationstekniken och folkhemmet
No full textMånga historiker menar att en av de främsta förebilderna för modernt hälsoarbete var ombyggnaden av Londons vattenförsörjning och fysiska infrastruktur i samband med industrisamhällets uppbyggnad under 1800- talet. Erfarenheterna ledde efter hand fram till formuleringen av "The Public Health Act" i England 1848. Trots detta i dras Sverige över 150 år senare i flera utredningar slutsatsen att det saknas bevis för nyttan av samhälleliga insatser för att förebygga sjukdom och ohälsa. Kanske har betydelsen av underliggande strukturer underskattats. Under det senaste decenniet har samhällets infrastrukur utökats genom avancerad elektronisk kommunikation och andra typer av individnära datortekniker (Timpka 2000). Modern informationsteknik (IT) i form av datornät och distribuerad teknik för insamling av hälsodata ger därför idag nya möjligheter att genomföra och påvisa resultat från folkhälsoarbete. Det är inget som motsäger att anpassning av IT i syfte att befrämja folkhälsan skulle kunna betyda lika mycket i ett befolkningsperspektiv som anpassningen av den fysiska infrastrukturen i slutet av förra seklet
Elicitation of Pandemic Coping Strategiesamong Health Care Workers: ContextualAdaptation of a Mental Models Method
No full textThe aim of this study is to develop and formatively evaluate a method of eliciting health care workers' understanding of pandemics and their forecasted behaviors during an outbreak. Qualitative methods were used for the evaluation. The results demonstrate that it was possible to identify specific points during the subject interviews when the health care worker seemed to turn from provision of frank data on self-efficacy to that of speculation. Considering this observation, the re-designed method allowed collection and analysis of data critical for pandemic planning. The results imply that more reliable predictions of health care workers' behavior during a pandemic are possible, albeit sensitive to elicit. Use of realistic mental exercises can provide important insights into the level of pandemic preparedness, but these methods will require additional research to reliably differentiate between prediction and speculation.Joakim Ekberg, Toomas Timpka and Elin A. Gursky, Elicitation of Pandemic Coping Strategies among Health Care Workers: Contextual Adaptation of a Mental Models Method, 2009, Journal of Homeland Security and Emergency Management, (6), 1, 78.http://www.bepress.com/jhsem/vol6/iss1/78/Copyright: Berkeley Electronic Presshttp://www.bepress.com
Risk of injury in elite football played on artificial turf versus natural grass : a prospective two-cohort study.
No full textOBJECTIVE: To compare injury risk in elite football played on artificial turf compared with natural grass. DESIGN: Prospective two-cohort study. SETTING: Male European elite football leagues. PARTICIPANTS: 290 players from 10 elite European clubs that had installed third-generation artificial turf surfaces in 2003-4, and 202 players from the Swedish Premier League acting as a control group. MAIN OUTCOME MEASURE: Injury incidence. RESULTS: The incidence of injury during training and match play did not differ between surfaces for the teams in the artificial turf cohort: 2.42 v 2.94 injuries/1000 training hours and 19.60 v 21.48 injuries/1000 match hours for artificial turf and grass respectively. The risk of ankle sprain was increased in matches on artificial turf compared with grass (4.83 v 2.66 injuries/1000 match hours; rate ratio 1.81, 95% confidence interval 1.00 to 3.28). No difference in injury severity was seen between surfaces. Compared with the control cohort who played home games on natural grass, teams in the artificial turf cohort had a lower injury incidence during match play (15.26 v 23.08 injuries/1000 match hours; rate ratio 0.66, 95% confidence interval 0.48 to 0.91). CONCLUSIONS: No evidence of a greater risk of injury was found when football was played on artificial turf compared with natural grass. The higher incidence of ankle sprain on artificial turf warrants further attention, although this result should be interpreted with caution as the number of ankle sprains was low.Original Publication:Jan Ekstrand, Toomas Timpka and Martin Hägglund, Risk of injury in elite football played on artificial turf versus natural grass: a prospective two-cohort study, 2006, British journal of sports medicine, (40), 12, 975-80.http://dx.doi.org/10.1136/bjsm.2006.027623Copyright: BMJ Publishing Grouphttp://group.bmj.com/</p
Information system needs in health promotion: Case study of Safe Community program using requirements engineering methods
No full textObjectives: To explore the need for information system support in health promotion programs. Methods: The international Safe Community program was used as the setting for a case study. The 14 Safe Communities active in Sweden during 2002 were invited to participate. 13 of them accepted. A questionnaire containing questions about computer usage and a critical incident technique instrument was distributed to all practitioners involved in the programs either at a municipality office or a county council (n=202). The Voice of the Customer Table method was used to transform the critical incident data into needs for information system support. Descriptive statistics were used to analyze data on computer usage. Results: Sharing of management information, creating social capital for safety promotion, and injury data recording were found to be key areas that need to be further supported by computer-based information systems in safety promotion practice. 90% (111/123) of the respondents reported having access to a personal computer workstation with standard office software. The interest in using more advanced computer applications was low among the practitioners, and there was considerable need for technical user support. Conclusions: Areas where information systems can be used to make health promotion practice more efficient were identified, and patterns of computers usage were described. These results can be used to guide future information systems development projects in health and safety promotion.The final, definitive version of this paper has been published in: Health Informatics Journal, (14), 3, 183-193, 2008.Toomas Timpka, Christina Ölvander and Niklas Hallberg, Information system needs in health promotion: Case study of Safe Community program using requirements engineering methods.http://dx.doi.org/10.1177/1081180X08092829. by SAGE Publications Ltd, All rights reserved. http://www.sagepub.com
Time for Medicine and Public Health to Leave Platform X [Elektronisk resurs]
No full textFor more than 50 years, digital technologies have been employed for the creation and distribution of knowledge in health services. In the last decade, digital social media have been developed for applications in clinical decision support and population health monitoring. Recently, these technologies have also been used for knowledge translation, such as in the process where research findings created in academic settings are established as evidence and distributed for use in clinical practice, policy making, and health self-management. To date, it has been common for medical and public health institutions to have social media accounts for the dissemination of novel research findings and to facilitate conversations about these findings. However, recent events such as the transformation of the microblog Twitter to platform X have brought to light the need for the social media industry to exploit user data to generate revenue. In this viewpoint, it is argued that a redirection of social media use is required in the translation of knowledge to action in the fields of medicine and public health. A new kind of social internet is currently forming, known as the "fediverse," which denotes an ensemble of open social media that can communicate with each other while remaining independent platforms. In several countries, government institutions, universities, and newspapers use open social media to distribute information and enable discussions. These organizations control their own channels while being able to communicate with other platforms through open standards. Examples of medical knowledge translation via such open social media platforms, where users are less exposed to disinformation than in general platforms, are also beginning to appear. The current status of the social media industry calls for a broad discussion about the use of social technologies by health institutions involving researchers and health service practitioners, academic leaders, scientific publishers, social technology providers, policy makers, and the public. This debate should not primarily take place on social media platforms but rather at universities, in scientific journals, at public seminars, and other venues, allowing for the transparent and undisturbed communication and formation of opinions.</p
Proactive health computing
No full textIn an analysis departing from the global health situation, the foundation for a change of paradigm in health informatics based on socially embedded information infrastructures and technologies is identified and discussed. It is shown how an increasing computing and data transmitting capacity can be employed for proactive health computing. As a foundation for ubiquituos health promotion and prevention of disease and injury, proactive health systems use data from multiple sources to supply individuals and communities evidence-based information on means to improve their state of health and avoid health risks. The systems are characterised by:being profusely connected to the world around them, using perceptual interfaces, sensors and actuators,responding to external stimuli at faster than human speeds,networked feed-back loops, andhumans remaining in control, while being left outside the primary computing loop.The extended scientific mission of this new partnership between computer science, electrical engineering and social medicine is suggested to be the investigation of how the dissemination of information and communication technology on democratic grounds can be made even more important for global health than sanitation and urban planning became a century ago. Copyright © 2001 Elsevier Science B.V.</p
Professional ethics for infectious disease control: moral conflict management in modern public health practice
No full textObjectives: Despite scientific evidence that confirms their effectiveness, use of vaccines and microbiological mass testing during the COVID-19 pandemic has been associated with social and moral controversies. In this commentary, it is suggested how such conflicts originating from moral/normative imperatives can be managed in infectious disease control. Study design: This was a commentary analysis. Methods: A case example of scientific and public debate regarding infectious disease control and policy-making during the early pandemic response is first presented. The case is used to characterize how conflicts arising from moral constraints occurred during the COVID-19 pandemic. These features are thereafter used as a basis for outlining a strategy for moral conflict prevention and management. Results: A challenge for infectious disease control throughout the pandemic was how to manage persuasive initiatives originating from social forces competing with science for influence. Purposively maneuvered information distributed through social media and internet websites could predispose population factions to contest legitimate (evidence and legally based) pandemic response measures. During the pandemic, fact-based criticism of professionals responsible for infectious disease control was mixed with a critique of their moral standards and intentions so as to diminish effectiveness and credibility. Such blending could be curtailed if infectious disease control professionals are made accountable for public health decisions made in the light of prevalent scientific evidence and legislation. Conclusions: If the infectious disease control community would embrace the international code of medical professional ethics, this would help to deal with moral conflicts, especially ones arising from external threats, in modern public health. (c) 2023 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Funding Agencies|Swedish Research Council [VR 2021-05608, VR 2022-05608]; Research Council of Southeast Sweden [ALF-936190]; Region Ostergotland; [FORSS-940915]</p
Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory
No full textBackground: Computerized provider order entry (CPOE) systems have been introduced to reduce medication errors, increase safety, improve work-flow efficiency, and increase medical service quality at the moment of prescription. Making the impact of CPOE systems more observable may facilitate their adoption by users. We set out to examine factors associated with the adoption of a CPOE system for inter-organizational and intra-organizational care. Methods: The diffusion of innovation theory was used to understand physicians and nurses attitudes and thoughts about implementation and use of the CPOE system. Two online survey questionnaires were distributed to all physicians and nurses using a CPOE system in county-wide healthcare organizations. The number of complete questionnaires analyzed was 134 from 200 nurses (67.0%) and 176 from 741 physicians (23.8%). Data were analyzed using descriptive-analytical statistical methods. Results: More nurses (56.7%) than physicians (31.3%) stated that the CPOE system introduction had worked well in their clinical setting (P andlt; 0.001). Similarly, more physicians (73.9%) than nurses (50.7%) reported that they found the system not adapted to their specific professional practice (P = andlt; 0.001). Also more physicians (25.0%) than nurses (13.4%) stated that they did want to return to the previous system (P = 0.041). We found that in particular the received relative advantages of the CPOE system were estimated to be significantly (P andlt; 0.001) higher among nurses (39.6%) than physicians (16.5%). However, physicians agreements with the compatibility of the CPOE and with its complexity were significantly higher than the nurses (P andlt; 0.001). Conclusions: Qualifications for CPOE adoption as defined by three attributes of diffusion of innovation theory were not satisfied in the study setting. CPOE systems are introduced as a response to the present limitations in paper-based systems. In consequence, user expectations are often high on their relative advantages as well as on a low level of complexity. Building CPOE systems therefore requires designs that can provide rather important additional advantages, e. g. by preventing prescription errors and ultimately improving patient safety and safety of clinical work. The decision-making process leading to the implementation and use of CPOE systems in healthcare therefore has to be improved. As any change in health service settings usually faces resistance, we emphasize that CPOE system designers and healthcare decision-makers should continually collect users feedback about the systems, while not forgetting that it also is necessary to inform the users about the potential benefits involved.Original Publication:Bahlol Rahimi, Toomas Timpka, Vivian Vimarlund, Srinivas Uppugunduri and Mikael Svensson, Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory, 2009, BMC MEDICAL INFORMATICS AND DECISION MAKING, (9), 52, .http://dx.doi.org/10.1186/1472-6947-9-52Licensee: BioMed Centralhttp://www.biomedcentral.com/. On the day of the defence date the original title of this article was "Adoption of computerized provider order entry systems: An organization-wide study based on diffusion of innovations theory"
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