Current research projects | ISAC

Research projects conducted in the Injuries' Social Aetiology and Consequences group at the Department of Public Health Sciences.  

Digital Health 

mHealth for Burn Diagnostic and Care in South Africa. Knowledge-Based Partnership

Participants from ISAC: Lucie Laflamme, Marie HasselbergJohan LundinLisa BlomAnders KlingbergConstance Boissin, Lee Wallis                                                                                          

Collaboration between ISAC members and Stellenbosch University, Division of Emergency Medicine (South Africa).

Burn injuries are a leading cause of premature death worldwide, and they are largely attributable to poor living conditions.Timely care is of paramount importance to the reduction of burn mortality and morbidity. In resource-poor settings, appropriate and timely care can be safeguarded through mobile information communication technologies (mHealth).

In this partnership between two academic institutions we aim to develop and implement an interactive mobile phone-based consultation system to supply healthcare staff with burn diagnosis and care advice in the Western Cape Province (South Africa). We intend to use mobile phones as a tool for communication between grass root health staff and experts.

Through our academic and professional activities in the field of injury control and prevention, the partners are strongly committed to the improvement of health and safety in South Africa in particular and in the African region in general.

Ultimately, the system could inspire similar applications in trauma care, in South Africa, and in the region. Systems of that kind could not only supply and improve injury care but also decrease substantially costs and inequalities in health care provision.

Grant from MMW - Marianne and Marcus Wallenberg Stiftelse (2013-2017)
Grant from Sida - Swedish International Development Cooperation Agency (2012-2013) 

Recent publications

Image-based teleconsultation using smartphones or tablets: qualitative assessment of medical experts.
Boissin C, Blom L, Wallis L, Laflamme L
Emerg Med J 2017 Feb;34(2):95-99

Gender differences in burns: A study from emergency centres in the Western Cape, South Africa.
Blom L, Klingberg A, Laflamme L, Wallis L, Hasselberg M
Burns 2016 Nov;42(7):1600-1608

A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care.
Wallis L, Fleming J, Hasselberg M, Laflamme L, Lundin J
PLoS ONE 2016 ;11(2):e0147253

Can We Trust the Use of Smartphone Cameras in Clinical Practice? Laypeople Assessment of Their Image Quality.
Boissin C, Fleming J, Wallis L, Hasselberg M, Laflamme L
Telemed J E Health 2015 Nov;21(11):887-92

A review of primary and secondary burn services in the Western Cape, South Africa.
Rode H, Rogers A, Numanoglu A, Wallis L, Allgaier R, Laflamme L, et al
S. Afr. Med. J. 2015 Sep;105(10):853-7

Photograph-based diagnosis of burns in patients with dark-skin types: the importance of case and assessor characteristics.
Boissin C, Laflamme L, Wallis L, Fleming J, Hasselberg M
Burns 2015 Sep;41(6):1253-60

Image-based medical expert teleconsultation in acute care of injuries. A systematic review of effects on information accuracy, diagnostic validity, clinical outcome, and user satisfaction.
Hasselberg M, Beer N, Blom L, Wallis L, Laflamme L
PLoS ONE 2014 ;9(6):e98539

Computer-Assisted Diagnostics for Burns

Lucie Laflamme, Johan Lundin, Fredrik Huss, Lee Wallis, Nikki Allorto, Constance Boissin, Jian Fransén​, Ziad El-Khatib

The project is a collaboration between ISAC members and colleagues from other research groups at the Department of Public Health Sciences and from other univerisities in Sweden (Uppsala University), Finland (University of Helsinki) and South Africa (Stellenbosch University and University of Kwa-Zulu Natal)

An alternative manner to remotely assist in acute burn diagnostic and management decisions is through the use of modern computer vision algorithms or computer-assisted diagnosis (CAD). Should the approach prove to be feasible and accurate, it could benefit not only junior clinicians in specialised units but even those in primary and emergency care services where less severe – but not less challenging – burns are managed. 

The aim of this project is to develop such a CAD system for acute burns, and to assess its acceptance and trust among clinical staff in a diversity of health care settings. 

Grant from the Swedish Research Council (2017-2019)

Implementation and evaluation of a smartphone teleconsultation system for acute burn injury care in resource-poor settings

Marie Hasselberg, Lucie Laflamme, Anders Klingberg, Lee Wallis, Hendry R. Sawe

Collaboration between ISAC members and Muhimbili University of Health and Allied Sciences (MUHAS), Department of Emergency Medicine and Stellenbosch University, Division of Emergency Medicine, South Africa .

Purpose and aims

The purpose of this project is to improve the management of, and outcomes from, burn injuries in resource-poor settings using mobile communication technology (mHealth). This, in turn, will contribute to reduce burn-related mortality and morbidity and to the creation of equitable and sustainable development through more accessible, evidence-based and cost-effective burn injury care for all.

This study concerns the care of patients at the point of entry into the health care system, emergency care. The function of emergency care is to provide definitive care for those who do not need admission, or to help patients who are more seriously ill or injured transition safely into the hospital setting. The primary research aim of the project is therefore to assess how mHealth for acute burn injury care can impact on the delivery of emergency care for burns victims, both in terms of clinical management and site of care. Intermediate aims are to assess the clinical quality, clinical outcomes, and the user perspective of the mHealth system.

Grant from the Swedish Research council for a period of 3 years (January 2016 – December 2018).

Strengthening healing processes among paediatric burn victims: a digital storytelling application for smartphones

Mathilde Sengoelge, Ashley van Niekerk, Lucie Laflamme, Lisa Blom, Roxanne Jacobs, Nancy Hornsby

'Long-term physical and psychosocial sequelae from burns pose special challenges to the health care sector, victims and their relatives. Burn victims, especially children, experience high levels of social anxiety and strain trying to integrate into community life. Furthermore, long-term psychosocial recovery depends greatly on successful integration early on after discharge. 

In this project we plan to create a digital story prototype to strengthen paediatric burn victims in their recovery process. Digital storytelling integrates a mixture of digital images, text, audio narration, and music to tell a story that in this case is focused on enabling individual resilience, coping and social integration after hospital discharge. Due to its multimodal mode of communication, it reaches chilen by using the whole spectrum of communication and thereby emerges as a promising intervention in pediatric trauma care.

This joint partnership will support new collaborations to venture into digital storytelling as an accessible, low-cost and child-friendly tool to benefit paediatric burn victims reintegrating into the community. 

Grant from the Swedish Foundation for International Cooperation in Research and Higher Education (STINT), jointly led between ISAC members and University of South Africa-South African Medical Research Council. 

Road traffic Injuries 

Road Traffic Injury Prevention and Care in Tanzania 

Marie Hasselberg, Lucie Laflamme

A collaboration between ISAC members, Umeå University and Muhimbili University of Health and Allied Sciences

The overall aim of this research-training programme is to build sustainable research capacity to advance knowledge about mechanisms and dynamics of road traffic injuries in Tanzania. A series of complementary research projects address individual, social and environmental risk factors of road traffic injuries and the provision of care after an injury.

The number of road traffic injuries has increased rapidly in Tanzania since the 1990s and both mortality and morbidity data show that they contribute to a substantial part of death and burden of disease in the country. An increased understanding of the burden and circumstances of road traffic injuries in the specific context of Tanzania will allow for more targeted interventions. 

Grant from Sida - Swedish International Development Cooperation Agency (2016-2019)

Children and Youth Encounters with Traffic - Interplay Between Environment, Mobility and Injury Risk at Various Ages

Marie HasselbergLucie LaflammeUzma Khan

Traffic is an important factor in young people's lives, facilitating or impeding their independent mobility. It can help them move around on their own, but it can also pose an obstacle and a risk to them. In the worst case, traffic may cost them their lives; traffic injury is still the number one cause of death among children and adolescents in Sweden and in many other countries in the world. 

We have a series of different projects in the area.

We conduct research in Sweden and other countries (e.g., Pakistan and Iran) on the gender and socioeconomic distribution of road traffic injuries among a variety of road users (motor vehicle riders, motorcyclists, bicyclists, and pedestrians).

We investigate the individual and contextual mechanisms susceptible to explain those associations.

Children independent mobility is also one of our focuses.

We have initiated studies on the consequences on individuals of road traffic injuries and the various manners in which they can be measured.

We finally conduct cross-country studies on the share of injuries in general and road traffic injuries in particular in children mortality and morbidity worldwide.

PAIR – Prevent Accidents and Injuries on the Road

Marie HasselbergLucie Laflamme, Abdullah Ali Nasser Al-Maniri

This newly initiated research project deals with the reduction of speeding as a leading risk factor for fatal road traffic injuries in general and in Oman in particular. Its overarching aim is to contribute significantly to the reduction of road traffic injury mortality and morbidity in Oman.

Rooted in a public health and population based approach, potentials for safety improvement are sought in the three domains of primary, secondary and tertiary prevention.

The research questions addressed are multifaceted:

  • What is the importance of speeding as a risk factor of injuries in Oman over time?
  • What are the individual and societal enablers for and obstacles to the adoption of safe practices on the road, including speed reduction?
  • What are the enablers for and obstacles to the creation of safe road infrastructures?
  • What are reasonable objectives/targets that can be set (impact and outcome) for future road traffic safety interventions deployed in Oman

This will be addressed through a series of sub-studies all inspired by the PRECEED-PROCEDE framework developed by Green, and employing a mix of data sources and methodologies.

Grant from: The Research Council of the Sultanate of Oman, Road Safety Research Program

Quality of Life following Injuries

Ritva Rissanen, Marie Hasselberg, Hans-Yngve Berg

Collaboration between ISAC members and colleagues from other divisions of the Department of Public Health Sciences, KI and the Swedish Transport Agency.

In many high income countries the improvement of trauma care has led to a higher survival rate following injury, with an increasing need for both physical and psychological rehabilitation. Whilst the physical impact of injuries are well known the effect of the injury on the individual’s perception of their working capacity, social relationships and financial situation is not as well understood. By focusing on the individual’s self-reported health it is possible to get a broader picture of the impact of the injury on people’s lives.

This research project addresses the short- and long term self-perceived health consequences of injuries. Its overarching aim is to deepen the knowledge about the psychosocial consequences of injury, more specifically in term of Quality of Life (QOL). QoL is a multidimensional construct that considers the “individual's perception of their position in life in the context of the culture value system in which they live and in relation to their goals, expectations, standards and concerns”.

On a long-term scale the knowledge gained from this project will contribute to a deeper understanding of the psychosocial consequences following trauma for various types of injury and allows us to identify the need for and optimize the psychological rehabilitation for those affected by injury.  

Medication and injuries 

Injuries Among the Elderly in Light of their Health Condition

Lucie LaflammeJette MöllerJoel Monárrez-EspinoKarin EngströmKristina Johnell, Christian Rausch

Collaboration between ISAC members and colleagues from other divisions of the Department of Public Health Sciences and other Departments at KI

To date, a range of studies have been conducted on fall injuries and road traffic injuries. More recently, we initiated studies on poisoning

As the association between health condition and injury may vary with age and for different types of injury, focus is placed on injuries among people aged 65 years and over and it is planned to investigate a variety of injury causes.

 

Recent publications

Patterns in health-related behaviours and fall injuries among older people: a population-based study in Stockholm County, Sweden.
Helgadottir B, Moller J, Laflamme L
Age Ageing 2015 Jul;44(4):604-10

Type, number or both? A population-based matched case-control study on the risk of fall injuries among older people and number of medications beyond fall-inducing drugs.
Laflamme L, Monárrez-Espino J, Johnell K, Elling B, Möller J
PLoS ONE 2015 ;10(3):e0123390

CYP2D6-inhibiting drugs and the increased risk of fall-related injuries due to newly initiated opioid treatment--a Swedish, register-based case-crossover study.
Möller J, Laflamme L, Söderberg Löfdal K
Basic Clin. Pharmacol. Toxicol. 2015 Feb;116(2):134-9

Newly initiated opioid treatment and the risk of fall-related injuries. A nationwide, register-based, case-crossover study in Sweden.
Söderberg K, Laflamme L, Möller J
CNS Drugs 2013 Feb;27(2):155-61

Contact

 

Professor

Lucie Laflamme

Phone: +46-(0)8-524 833 62
Organizational unit: Global health (IHCAR)
E-mail: Lucie.Laflamme@ki.se