Mobile teleconsultations in acute burn care : acceptance and user-experience among emergency care providers in resource-poor settings

Background: Burn injuries are a global health problem with severe consequences for those affected and nearly 95% of all burns occur in low- and middle-income countries (LMICs). While minor burns can be treated locally such as at the emergency department, severe burns need transfer to a specialist burns centre. However, non-specialists often lack the training and experience to accurately diagnose and manage burns. While smartphones have been shown to be feasible for remote consultations between frontline providers and burns specialists, barriers may impede successful uptake. Aims: The aims of the thesis were to deepen the knowledge about referral patterns of patients with burns in resource poor settings, and to study perceptions and experiences among emergency staff’s use of smartphones as a diagnostic support to improve the assessment, initial care and referrals of patients with burns. Methods: Study I was a retrospective case study of 871 paediatric patients with burns at a trauma unit in Cape Town. Demographic, injury characteristics, and disposition was used to determine whether patients were referred according to local criteria. Study II was a mixedmethods study of the usability of a smartphone app (the Vula app) for burn injury consultations. Twenty-four emergency doctors and four burns specialists were enrolled in the study. A think-aloud study was conducted with all participants and their interaction with the app was video-recorded and later analysed using content analysis. The twenty-four emergency doctors also completed a usability questionnaire. Study III was a qualitative study where semi-structured interviews were conducted with 15 doctors regarding their experiences using the Vula app for burn consultations and referrals. The interview-guide and thematic analysis were informed by the Normalisation Process Theory. In Study IV, fifty-nine frontline health workers completed a questionnaire to assess their intention to use the Vula app. The questionnaire and the analysis were informed by the technology acceptance model (TAM). Results: Study I. Most referred patients fulfilled the referral criteria. However, of those treated and discharged from the trauma unit, 8 out of 10 children also fulfilled the criteria for referral. In Study II, the usability test and questionnaire showed that the doctors perceived the Vula app to be easy to use and useful. However, some problems were identified mainly related to navigation, and understanding of meaning of icon’s terminologies. Some users also said that predefined options in the app limited their ability to express their clinical findings. Study III revealed several barriers and promotors for successful integration of the Vula app. Promotors included the already prevalent practice of using smartphones, that it was easy to use and the learning opportunity that the app offered. Barriers to successful integration included; inconsistent use of the app across specialities and lack of information, policies and infrastructure to support the users. In Study IV, almost all health professionals used smartphones in their work and were positive towards using Vula. Access to wireless internet and access to smartphones was mentioned to be a barrier. Conclusions: Identifying patients with burns who are in need of referral is challenging. Mobile teleconsultations is therefore a way of assisting with diagnosis and initial management. The Vula app was easy to use and perceived to be useful, but several barriers need to be addressed for the app to become an integrated part of the practice in emergency care. In settings with considerably fewer resources, these barriers will likely be even more important to address prior to implementation

All Aboard: ERP Implementation as Participatory Design

Following a previous description of Enterprise Resource Planning (ERP) implementations as participatory design (Pries-Heje & Dittrich, 2009), this paper explores the case of a medium-sized, family-owned manufacturing company and its endeavors with changing their current ERP system. The case was selected on the premise of it being perceived a success by the involved stakeholders. Through a series of interviews and analysis of secondary material, the case covers the period between 1995 and 2010. As the results show, several instances of user involvement and participation can be found throughout the case. According to the respondents, this is seen as one of the central elements of the success. This is discussed in relation to previous findings and a call for future research into ERP implementation is presented

Carpe Diem -En studie i användandet av realtids BI

Bakgrund: Information har länge varit en viktig resurs för företagen och Business Intelligence har gjort det möjligt för dem att analysera stora mängder data. En annan resurs som företagen värdesätter är tid och på senare år har tekniken möjliggjort att BI-systemen inte bara kan hantera stor mängder data utan även göra det på kort tid, eller i realtid. Frågeställning: Vad räknas in i begreppet realtids BI? Kan realtids BI användas för att skapa tidsbaserade konkurrensfördelar? Syfte: Kartlägga begreppet Realtids BI samt identifiera möjliga användningsområden för denna inom den tidsbaserade konkurrensteorin. Metod: Vi har använt oss av en kvalitativ metod där vi intervjuat konsulter och leverantörer inom Business Intelligence. Resultat och slutsatser: Studien visar att det inte finns någon klar definition av realtids BI, men två huvudspår har identifierats. (1) Realtidsanalys med innebörden att data finns tillgänglig för analys när användaren så kräver, samt (2) att realtidsdata uppdateras i nära realtid, vilket kan variera från några sekunder upp till ett par timmar. Dessa två spår inom realtids BI finner användningsområde inom olika områden av den tidsbaserade konkurrensteorin. Realtidsanalys kan användas för att uppnå den externa tidsprestationen i det att företaget snabbare kan identifiera rådande marknadstrender och har då möjligheten att snabbare uppdatera sitt produktutbud. Realtidsdatabaserad BI har sitt främsta användningsområde inom den interna tids-prestationen genom att stödja operativt beslutsfattande och arbete

The relevance in Annual reports -Studying the use of annual reports in the credit and investment decision

Background: The adoption of the mandatory use of IFRS as accounting principles for all listed companies in the European Union in 2005 have triggered a debate about the usefulness of the financial statements prepared in accordance with these regulations. Voices have been raised, both in favor of these regulations and against them. Purpose: The purpose of this bachelor’s thesis is to describe the use of the annual report in the analytical processes of investors and lenders. Furthermore, an evaluation is made whether annual reports made in accordance with IFRS meet the IASB framework quantitative characteristic of relevance for investors and lenders. Method: The empirical findings in this thesis were obtained through qualitative interviews. Interviews were conducted with representatives for both lenders and investors. Conclusion: For lenders, the annual report lacks the timeliness needed to be of relevance in the decision making process. The annual report, however, is valuable for the credit analyst in that it provides reliable audited information with which they can confirm the information previously obtained. The investment analyst has the same problem with the timeliness issue as the creditor. Furthermore, the investment analysts feel that the annual report provides information lacking in quality due to the fair value valuation method. The conclusion can be drawn that from the investor’s perspective, the annual report lacks relevance in the decision making process

Dental fear/anxiety and dental behaviour management problems in children and adolescents : a review of prevalence and concomitant psychological factors

OBJECTIVES: The objectives of this article were to examine the literature published from 1982 to 2006 and to evaluate prevalence of dental fear and anxiety (DFA) and dental behaviour management problems (DBMP) in children and adolescents, and their relationships to age, sex, general anxiety, temperament, and general behavioural problems. METHODS: A broad search of the PubMed database was performed using three combinations of search terms. RESULTS: A large proportion of the identified articles could not be used for the review owing to inadequate endpoints, measures or poor study design. Thirty-two papers of acceptable quality were identified and reviewed. The prevalence of both DFA and DBMP were estimated to 9%, with a decrease in prevalence with age. DFA/DBMP were more frequent in girls. DFA/DBMP were related to general fear and both internalizing and externalizing behavioural problems, although these relationships were not clear-cut. Temperament was related to both DFA and DBMP but with different temperamental characteristics, while general behavioural problems mainly correlated with DBMP. CONCLUSIONS: DFA/DBMP are common, and several psychological factors are associated with the development of these problems. In order to better understand these relationships, a number of issues concerning design of research and measurement of DFA/DBMP have to be dealt with