Showing papers by "Toomas Timpka published in 2002"
TL;DR: A high psychiatric morbidity and a need for psychiatric interventions in this war-wounded refugees group 8 years after arrival in Sweden are suggested.
Abstract: The complex nature of recent wars and armed conflicts has forced many war-injured persons into exile. To investigate their long-term mental health, three instruments for assessing mental health (HSCL-25, PTSS-10, and a Well-Being scale) were presented to 44 war-wounded refugees from nine different countries 8 years after arrival in Sweden. The prevalence of psychiatric symptoms was high and corresponds to findings in previous studies of refugee patient populations. A lower level of mental health was associated with higher education, unemployment, and poor physical health. The findings suggest a high psychiatric morbidity and a need for psychiatric interventions in this refugee group. Methodological issues to be considered in research on sequels of war traumas are discussed.
90 citations
TL;DR: After introduction of an injury prevention program based on the WHO Safe Community model, the relative risk for child injury in the intervention community decreased significantly more than in a control community exposed only to national injury prevention programs.
Abstract: Objectives: To evaluate the outcome of the World Health Organization (WHO) Safe Community model with respect to child injuries.Study design: A population based quasiexperimental design was used. Cross sectional pre-implementation and post-implementation data were collected in intervention (Motala municipality) and control (Mjolby municipality) areas, both in Ostergotland county, Sweden.Results: The total relative risk of child injury in the intervention community decreased more (odds ratio 0.74; 95% confidence interval (CI) 0.68 to 0.81) than in a control community exposed only to national level injury prevention programs (0.93; 95% CI 0.82 to 1.05). The relative risk of moderately (abbreviated injury scale (AIS) 2) severe injury in the study area was reduced to almost a half (odds ratio 0.49; 95% CI 0.41 to 0.57), whereas the risk of minor (AIS 1) injuries decreased only slightly (odds ratio 0.89; 95% CI 0.80 to 0.99). The risk of severe or fatal (AIS 3–6) injuries remained constant.Conclusions: After introduction of an injury prevention program based on the WHO Safe Community model, the relative risk for child injury in the intervention community decreased significantly more than in a control community exposed only to national injury prevention programs.
54 citations
TL;DR: The main task appears to be to coordinate the different visions and in particular clarify them, as well as to establish the impact that these visions would have on the forthcoming ICT application.
Abstract: There are numerous challenges to overcome before information and communication technology (ICT) can achieve its full potential in process‐oriented health‐care organizations. One of these challenges is designing systems that meet users’ needs, while reflecting a continuously changing organizational environment. Another challenge is to develop ICT that supports both the internal and the external stakeholders’ demands. In this study a qualitative research strategy was used to explore the demands on ICT expressed by managers from functional and process units at a community hospital. The results reveal a multitude of partially competing goals that can make the ICT development process confusing, poor in quality, inefficient and unnecessarily costly. Therefore, from the perspective of ICT development, the main task appears to be to coordinate the different visions and in particular clarify them, as well as to establish the impact that these visions would have on the forthcoming ICT application.
29 citations
TL;DR: Both the MMPI and the DMTm results were interpreted as suggesting that a cognitive coping strategy program be considered for rehabilitation, indicating that univariate approaches is not sufficient when investigating factors of importance for disability.
Abstract: Objectives: To compare personality features of fibro-myalgia patients with those of a disease control group with regional pain.Methods: A group of 33 women with fibromyalgia [FMS-group] was compared on the Minnesota Multiphasic Personality Inventory [MMPI] and the Defense Mechanism Technique modified [DMTm] with 31 women [C-group] without this diagnosis who had localized chronic pain in their neck, shoulder, and/or low back areas and were very similar in chronological age, intelligence, and basic personality patterns.Results: As hypothesized the FMS-group scored higher than the C-group on the MMPI-scales of Hypochondriasis, Depression, and Hysteria. They also scored higher on Admission of symptoms, Psych-asthenia, Anxiety, Schizophrenia, Social introversion, and a number of nonclinical subscales. The differences were not found to be due to differences in pain intensity. The only statistically significant difference in DMTm between the groups was that of FMS patients more often reporting the projected self...
24 citations
TL;DR: This investigation uses case study methods to explore ethical obstacles originating in the shared use of geographic health information in public health programs and how this affects the design of information systems.
23 citations
TL;DR: Smart homes promise to make the lives of elderly people more comfortable and safe, and the potential for using these technologies to promote safety and prevent injury among old people is especially important.
Abstract: Smart homes promise to make the lives of elderly people more comfortable and safe. Today, there is a significant interest from industry and policy makers in developing these technologies. In theory, the emerging technologies make it possible to provide a new range of services. So far, however, the goal has often been to develop new services for young people rather than assisting old people to improve their quality of life. Especially important is the potential for using these technologies to promote safety and prevent injury among old people because this group is at home more than the other age groups. Networked devices can collect data from sensors and aid decision-making on intervention and other measures. Furthermore, these devices can instruct and remind individuals about safety-related issues.
22 citations
TL;DR: The results of the case study suggest that when time and effort are invested in allowing healthcare staff to participate in information system development processes, the benefits can well exceed the costs throughout the life cycle of the project.
Abstract: Objectives: The aim of this paper is to build a theoretical framework for analysis of when decisionmakers should use end-user participation as a form of insurance for unforeseen consequences of implementing information systems in healthcare organizations. Method: Data were collected in a case study of an information system development project in a small clinical setting. During the initial phase, the future end-users of the system were allowed to actively influence the system design and test every new tool that was considered for implementation. Results: The results of the case study suggest that when time and effort are invested in allowing healthcare staff to participate in information system development processes, the benefits can well exceed the costs throughout the life cycle of the project. Risk-averse decision-makers fearing negative secondary consequences of a HIS, with regard to clinical work flow, will always adopt measures to prevent future failures, if they can find a possibility of shifting these risks. Therefore, they calculate the present discounted value of the effects accrued over time to the unit and predict the amount of resources they are willing to pay to acquire an insurance (such as design participation) that will protect the organization from future losses. Conclusions: End-user participation in the design process can be the key positive influence on the quality of the service and, thereby, organizational effectiveness. Investments in broad design participation can, consequently, be a productive activity that transforms potential current income into future benefits.
20 citations
TL;DR: The overall injury incidence during youth bandy games is low, but the injuries that occur cause extensive absences from the only four months long bandy season, which can be recommended for consideration when physical exercise is to be promoted among school-age children in countries with a winter climate.
Abstract: Purpose: Bandy, with a century-long tradition in northern Europe, is a winter team-sport similar to ice hockey. To investigate the occurrence of injuries during competitive youth bandy games, injur ...
13 citations
TL;DR: The results show that UCMs can provide a visualization of the system's functionality and in combination with PAR provide a sound basis for gathering requirements in inter-organizational settings and are found useful in generating intuitive requirements by the creation of use cases.
Abstract: Objectives: To evaluate Use Case Maps (UCMs) as a technique for Requirements Engineering (RE) in the development of information systems with functions for spatial analyses in inter-organizational p ...
11 citations
TL;DR: The results suggest that a main reason for discordance was that the elderly women feared "losing face" by reporting some diseases, followed by diseases of the gastrointestinal system.
Abstract: Objectives: To compare the chronic diseases mentioned by elderly women in an interview study with those documented in their respective medical records. Methods: The prevalence of positive diagnoses, overall agreement, and the kappa-coefficient were calculated for each group of diagnoses. Results: The lowest overall agreement was observed for psychiatric diseases, followed by diseases of the gastrointestinal system. Poor chance-adjusted agreement was found concerning diseases of the gastrointestinal system and diseases of the skin. Conclusions: The results suggest that a main reason for discordance was that the elderly women feared »losing face« by reporting some diseases.
10 citations
Proceedings Article•
01 Jan 2002TL;DR: It is argued that, in large and distributed Participatory Design projects, the DISC-method can be suitable to aid participant selection and create a shared understanding of the current situation while preserving the democratic and multi-disciplinary character of participatory Design.
Abstract: Basing our findings on experience from a participatory system development process in the Swedish project Distance Supported Learning for Local Knowledge Needs (DLK) we present and discuss the DISC-method for participatory scenario creation. We argue that, in large and distributed Participatory Design projects, the method can be suitable to aid participant selection and create a shared understanding of the current situation while preserving the democratic and multi-disciplinary character of Participatory Design.
TL;DR: A minimal data set for capturing users' voices on problems experienced by public health professionals in their daily work and opinions about how these problems can be solved and can be used both as the basis for formulating the requirements of ISs forpublic health professionals and to create an understanding of the use context.
TL;DR: In this paper, the authors explored the use of activity theory in an organisational context where the subject is of marked collective nature, in an information systems development project for the Swedish National Trade Union Confederation (LO).
Abstract: Activity Theory has, in recent years, been criticised for not paying enough attention to the notion of individual versus collective subjects. It has also been pointed out that even though the Activity theoretical framework can beneficially be used in the development of information systems, actual attempts to apply it to concrete projects are only occasional. This study explores the use of Activity Theory in an organisational context where the subject is of marked collective nature, in an information systems development project for the Swedish National Trade Union Confederation (LO). Both implications of the study as regards the specific trade union application, and more general implications of applying Activity Theory to studies of entire organisations and for system development, are discussed.