Toomas Timpka | Linköping University (original) (raw)
Papers by Toomas Timpka
Scientific Reports
This research set out to identify pathways from vulnerability and stressors to depression in a gl... more This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18–19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stressors in interaction with structural vulnerability instigate depression. Path modelling using Maximum likelihood estimation was employed for the data analysis. Depression caseness and predisposition were determined using the WHO-5 instrument. Thirty-six percent of the athletes (n = 480) returned complete data. Eighteen percent of the athletes reported lifetime physical abuse, while 11% reported sexual abuse. Forty-five percent of the athletes had recently sustained an injury. The prevalence of depression caseness was 5.6%. Pathways to depression caseness were observed from female sex (p = 0.037) and injury history (p = 0.035) and to predisp...
Orthopaedic Journal of Sports Medicine, Feb 1, 2020
British Journal of Sports Medicine, Mar 11, 2014
ABSTRACT Sports organisations and sportspersons often suffer from an "autonomy-gap&q... more ABSTRACT Sports organisations and sportspersons often suffer from an "autonomy-gap" obstructing implementation of interventions against overuse injuries. This obstruction has been described as the organisation-practice (OP) barrier. To develop an inter-organisational sports safety promotion model targeted at prevention of overuse injuries by identifying initiatives that lastingly will bridge the OP barrier. Participatory action research with focus group interviews using the quality function deployment (QFD) technique. Swedish athletics involving the Swedish Athletics Association (SAA), clubs, athletes, coaches, and other stakeholders in the sport. Representatives of Swedish athletics; officials from different divisions of the SAA, coaches, athletes, medical personal, club representatives and parents to youth athletes (year 1: n=12; year 2: n=35). Sports needs (Voice of Sports), organizational requirements, organizational changes. Organizational facilitators of sports safety promotion targeted at prevention of overuse injuries. An organic sports safety model resulted from the transformation of identified sports needs and organizational requirements into organisational changes. In this model, a dynamic and constantly active organisation-practice membrane reaches across the OP barrier. This organizational membrane consists of an infrastructure supporting continuous exchange of data and information between different actors in athletics. The central component is an Internet-based safety surveillance system covering Swedish athletics as a whole. A 'Safety Forum' is used for safety discussions between athletes, researchers, and SAA representatives, and a 'Coaches' Corner' allows communication between experienced coaches and younger colleagues. An inter-organizational sports safety model facilitating collaboration between sports organisations and sportspersons was developed in the setting of Swedish athletics. The principal feature in the model is an infrastructure supporting continuous exchange of data and information between different actors. Further research is warranted to prospectively evaluate the effectiveness of the novel model in overuse injury prevention.
Sports Medicine, Jun 7, 2023
Frontiers in sports and active living, May 31, 2021
Emerging Infectious Diseases, 2022
Journal of Science and Medicine in Sport, 2021
OBJECTIVES The aim was to describe levels of subjective Health Literacy (HL), and to examine poss... more OBJECTIVES The aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches, parents/caregivers) in Swedish Athletics. DESIGN Cross-sectional. METHODS Data on subjective HL were collected using the Swedish Communicative and Critical Health Literacy (S-CCHL) instrument for mentors and for youth the School-Aged Children (HLSAC) instrument. Questions assessing mentors' literacy on sports injury and return to play were also included. RESULTS The surveys were completed by 159 (91%) mentors and 143 youth athletes (87%). The level of S-CCHL was sufficient in 53% of the mentors. Of youth athletes, 28% reported a high level of HL and the item with least perceived high HL (21%) was critical thinking. Ninety-four percent of the mentors believed that it is quite possible to prevent injuries in athletics and 53% perceived having a very good knowledge about how to prevent injuries. Forty-six percent of the mentors perceived having a very good knowledge of return to sport criteria. CONCLUSIONS The level of health literacy was low with about half of the mentors and one out of three youth athletes having adequate HL levels. Only half of the mentors stated having a good knowledge of various injury prevention strategies. To reduce health consequences in youth sport and enable talent development more work is needed to understand the facilitators and barriers for the uptake of various health promotion and injury prevention strategies.
In applied program settings, such as in natural environment control and education, performance ev... more In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the Performance Outcome Scoring Template (POS-T) for assessments with high face-validity in these settings. POS-T puts achievements of individuals or groups in context, i.e. the resulting performance outcome score (POS) reflects a meaningful measure of performance magnitude with regards to internal and external comparisons. Development of a POS is performed in four steps supported by a statistical framework. Software is supplied for creation of scoring applications in different performance evaluation settings. We demonstrate the POS-T by evaluation of CO2 emissions reduction amongst 36 OECD member countries.
Journal of Science and Medicine in Sport, 2020
Journal of Orthopaedic & Sports Physical Therapy, 2020
SYNOPSIS High-quality sports injury research can facilitate sports injury prevention and treatmen... more SYNOPSIS High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting. Meeting participants agreed that the definition of sport injury depends on the research question and context. It was considered essential to be explicit about the goal of the research effort and to use frameworks to illustrate the assumptions that underpin measurement and the analytical strategy. Complex systems were discussed to illustrate how potential risk factors can interact in a nonlinear way. This approach is often a useful alternative to identifying single risk factors. Investigating changes in exposure status over time is important when analyzing sport injury etiology, and analyzing recurrent injury, subsequent injury, or injury exacerbation remains challenging. The choice of statistical model should consider the research question, injury measure (eg, prevalence, incidence), type and granularity of injury data (categorical or continuous), and study design. Multidisciplinary collaboration will be a cornerstone for future high-quality sport injury research. Working outside professional silos in a diverse, multidisciplinary team benefits the research process, from the formulation of research questions and designs to the statistical analyses and dissemination of study results in implementation contexts. This article has been copublished in the British Journal of Sports Medicine and the Journal of Orthopaedic & Sports Physical Therapy. J Orthop Sports Phys Ther 2020;50(5):226-233. doi:10.2519/jospt.2020.9876.
Journal of Science and Medicine in Sport, 2020
BMC Medical Informatics and Decision Making, 2019
British journal of sports medicine, Jan 6, 2018
To examine associations between lifetime sexual and physical abuse, and the likelihood of injury ... more To examine associations between lifetime sexual and physical abuse, and the likelihood of injury within and outside sport in athletes involved in competitive athletics. A cross sectional study was performed among the top 10 Swedish athletics athletes using 1 year prevalence of sports and non-sports injuries as the primary outcome measure. Associations with sociodemographic characteristics, lifetime abuse history and training load were investigated. Data were analysed using simple and multiple logistic regression models. 11% of 197 participating athletes reported lifetime sexual abuse; there was a higher proportion of women (16.2%) than men (4.3%) (P=0.005). 18% reported lifetime physical abuse; there was a higher proportion of men (22.8%) than women (14.3%) (P=0.050). For women, lifetime sexual abuse was associated with an increased likelihood of a non-sports injury (OR 8.78, CI 2.76 to 27.93; P<0.001). Among men, increased likelihood of a non-sports injury was associated with mo...
Scandinavian Journal of Medicine & Science in Sports, 2017
Engaging in competitive sports as a youth can have many health benefits, but recent studies also ... more Engaging in competitive sports as a youth can have many health benefits, but recent studies also report a high risk for injury. The long‐term purpose of this Swedish research program is to develop a framework for safe track and field training for young athletes (aged 12‐15 years). The aim of this study was to establish what is perceived to contribute and cause injuries in youth track and field by compiling the best available experiential knowledge about the underlying factors and use this knowledge to identify appropriate areas to handle these in practical ways. Nine focus group interviews with in total 74 participants and confirming interviews with five individuals were performed in seven Swedish regions. Qualitative research methods were used for data analysis. Injuries in youth athletes were not considered to be strictly the result of individual factors but rather the result of the interactions between factors at different levels. Three major factors emerged as follows: Insuffici...
European journal of public health, Feb 16, 2017
Despite the popularity of the sport, few studies have investigated community-level football injur... more Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female...
BMC Sports Science, Medicine and Rehabilitation, 2016
British Journal of Sports Medicine, Feb 18, 2020
Socialmedicinsk Tidskrift, 2011
Vaccines
The term hybrid immunity is used to denote the immunological status of vaccinated individuals wit... more The term hybrid immunity is used to denote the immunological status of vaccinated individuals with a history of natural infection. Reports of new SARS-CoV-2 variants of concern motivate continuous rethought and renewal of COVID-19 vaccination programs. We used a naturalistic case-control study design to compare the effectiveness of the BNT162b2 mRNA vaccine to hybrid immunity 180 days post-vaccination in prioritized and non-prioritized populations vaccinated before 31 July 2021 in three Swedish counties (total population 1,760,000). Subjects with a positive SARS-CoV-2 test recorded within 6 months before vaccination (n = 36,247; 6%) were matched to vaccinated-only controls. In the prioritized population exposed to the SARS-CoV-2 Alpha and Delta variants post-vaccination, the odds ratio (OR) for breakthrough infection was 2.2 (95% CI, 1.6–2.8; p < 0.001) in the vaccinated-only group compared with the hybrid immunity group, while in the later vaccinated non-prioritized population, ...
BMC Psychiatry, 2021
Background Recurrence is a problem for many patients who have episodes of depression. In experime... more Background Recurrence is a problem for many patients who have episodes of depression. In experimental settings, hyporeactivity in the Electrodermal Orienting Reactivity (EDOR) test has been observed to be more frequent in these patients. The aim of this study was to investigate the clinical value of this test with regard to a prognosis of episode recurrence in patients hospitalized for depression. Methods The study was performed using a cohort design at a specialized psychiatric clinic in Warsaw, Poland. The primary endpoint measure was relapse or recurrence of depression. Data on electrodermal reactivity measured by the EDOR test, clinical status, and psychiatric history were collected at the clinic. Relapse and recurrence data were collected by clinical interviews 1 year after the EDOR test. The predictive (adjusting for confounders) and comparative (relative to other predictors) performance of electrodermal hyporeactivity was assessed using simple and multiple binary logistic reg...
Scientific Reports
This research set out to identify pathways from vulnerability and stressors to depression in a gl... more This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18–19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stressors in interaction with structural vulnerability instigate depression. Path modelling using Maximum likelihood estimation was employed for the data analysis. Depression caseness and predisposition were determined using the WHO-5 instrument. Thirty-six percent of the athletes (n = 480) returned complete data. Eighteen percent of the athletes reported lifetime physical abuse, while 11% reported sexual abuse. Forty-five percent of the athletes had recently sustained an injury. The prevalence of depression caseness was 5.6%. Pathways to depression caseness were observed from female sex (p = 0.037) and injury history (p = 0.035) and to predisp...
Orthopaedic Journal of Sports Medicine, Feb 1, 2020
British Journal of Sports Medicine, Mar 11, 2014
ABSTRACT Sports organisations and sportspersons often suffer from an "autonomy-gap&q... more ABSTRACT Sports organisations and sportspersons often suffer from an "autonomy-gap" obstructing implementation of interventions against overuse injuries. This obstruction has been described as the organisation-practice (OP) barrier. To develop an inter-organisational sports safety promotion model targeted at prevention of overuse injuries by identifying initiatives that lastingly will bridge the OP barrier. Participatory action research with focus group interviews using the quality function deployment (QFD) technique. Swedish athletics involving the Swedish Athletics Association (SAA), clubs, athletes, coaches, and other stakeholders in the sport. Representatives of Swedish athletics; officials from different divisions of the SAA, coaches, athletes, medical personal, club representatives and parents to youth athletes (year 1: n=12; year 2: n=35). Sports needs (Voice of Sports), organizational requirements, organizational changes. Organizational facilitators of sports safety promotion targeted at prevention of overuse injuries. An organic sports safety model resulted from the transformation of identified sports needs and organizational requirements into organisational changes. In this model, a dynamic and constantly active organisation-practice membrane reaches across the OP barrier. This organizational membrane consists of an infrastructure supporting continuous exchange of data and information between different actors in athletics. The central component is an Internet-based safety surveillance system covering Swedish athletics as a whole. A 'Safety Forum' is used for safety discussions between athletes, researchers, and SAA representatives, and a 'Coaches' Corner' allows communication between experienced coaches and younger colleagues. An inter-organizational sports safety model facilitating collaboration between sports organisations and sportspersons was developed in the setting of Swedish athletics. The principal feature in the model is an infrastructure supporting continuous exchange of data and information between different actors. Further research is warranted to prospectively evaluate the effectiveness of the novel model in overuse injury prevention.
Sports Medicine, Jun 7, 2023
Frontiers in sports and active living, May 31, 2021
Emerging Infectious Diseases, 2022
Journal of Science and Medicine in Sport, 2021
OBJECTIVES The aim was to describe levels of subjective Health Literacy (HL), and to examine poss... more OBJECTIVES The aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches, parents/caregivers) in Swedish Athletics. DESIGN Cross-sectional. METHODS Data on subjective HL were collected using the Swedish Communicative and Critical Health Literacy (S-CCHL) instrument for mentors and for youth the School-Aged Children (HLSAC) instrument. Questions assessing mentors' literacy on sports injury and return to play were also included. RESULTS The surveys were completed by 159 (91%) mentors and 143 youth athletes (87%). The level of S-CCHL was sufficient in 53% of the mentors. Of youth athletes, 28% reported a high level of HL and the item with least perceived high HL (21%) was critical thinking. Ninety-four percent of the mentors believed that it is quite possible to prevent injuries in athletics and 53% perceived having a very good knowledge about how to prevent injuries. Forty-six percent of the mentors perceived having a very good knowledge of return to sport criteria. CONCLUSIONS The level of health literacy was low with about half of the mentors and one out of three youth athletes having adequate HL levels. Only half of the mentors stated having a good knowledge of various injury prevention strategies. To reduce health consequences in youth sport and enable talent development more work is needed to understand the facilitators and barriers for the uptake of various health promotion and injury prevention strategies.
In applied program settings, such as in natural environment control and education, performance ev... more In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the Performance Outcome Scoring Template (POS-T) for assessments with high face-validity in these settings. POS-T puts achievements of individuals or groups in context, i.e. the resulting performance outcome score (POS) reflects a meaningful measure of performance magnitude with regards to internal and external comparisons. Development of a POS is performed in four steps supported by a statistical framework. Software is supplied for creation of scoring applications in different performance evaluation settings. We demonstrate the POS-T by evaluation of CO2 emissions reduction amongst 36 OECD member countries.
Journal of Science and Medicine in Sport, 2020
Journal of Orthopaedic & Sports Physical Therapy, 2020
SYNOPSIS High-quality sports injury research can facilitate sports injury prevention and treatmen... more SYNOPSIS High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting. Meeting participants agreed that the definition of sport injury depends on the research question and context. It was considered essential to be explicit about the goal of the research effort and to use frameworks to illustrate the assumptions that underpin measurement and the analytical strategy. Complex systems were discussed to illustrate how potential risk factors can interact in a nonlinear way. This approach is often a useful alternative to identifying single risk factors. Investigating changes in exposure status over time is important when analyzing sport injury etiology, and analyzing recurrent injury, subsequent injury, or injury exacerbation remains challenging. The choice of statistical model should consider the research question, injury measure (eg, prevalence, incidence), type and granularity of injury data (categorical or continuous), and study design. Multidisciplinary collaboration will be a cornerstone for future high-quality sport injury research. Working outside professional silos in a diverse, multidisciplinary team benefits the research process, from the formulation of research questions and designs to the statistical analyses and dissemination of study results in implementation contexts. This article has been copublished in the British Journal of Sports Medicine and the Journal of Orthopaedic & Sports Physical Therapy. J Orthop Sports Phys Ther 2020;50(5):226-233. doi:10.2519/jospt.2020.9876.
Journal of Science and Medicine in Sport, 2020
BMC Medical Informatics and Decision Making, 2019
British journal of sports medicine, Jan 6, 2018
To examine associations between lifetime sexual and physical abuse, and the likelihood of injury ... more To examine associations between lifetime sexual and physical abuse, and the likelihood of injury within and outside sport in athletes involved in competitive athletics. A cross sectional study was performed among the top 10 Swedish athletics athletes using 1 year prevalence of sports and non-sports injuries as the primary outcome measure. Associations with sociodemographic characteristics, lifetime abuse history and training load were investigated. Data were analysed using simple and multiple logistic regression models. 11% of 197 participating athletes reported lifetime sexual abuse; there was a higher proportion of women (16.2%) than men (4.3%) (P=0.005). 18% reported lifetime physical abuse; there was a higher proportion of men (22.8%) than women (14.3%) (P=0.050). For women, lifetime sexual abuse was associated with an increased likelihood of a non-sports injury (OR 8.78, CI 2.76 to 27.93; P<0.001). Among men, increased likelihood of a non-sports injury was associated with mo...
Scandinavian Journal of Medicine & Science in Sports, 2017
Engaging in competitive sports as a youth can have many health benefits, but recent studies also ... more Engaging in competitive sports as a youth can have many health benefits, but recent studies also report a high risk for injury. The long‐term purpose of this Swedish research program is to develop a framework for safe track and field training for young athletes (aged 12‐15 years). The aim of this study was to establish what is perceived to contribute and cause injuries in youth track and field by compiling the best available experiential knowledge about the underlying factors and use this knowledge to identify appropriate areas to handle these in practical ways. Nine focus group interviews with in total 74 participants and confirming interviews with five individuals were performed in seven Swedish regions. Qualitative research methods were used for data analysis. Injuries in youth athletes were not considered to be strictly the result of individual factors but rather the result of the interactions between factors at different levels. Three major factors emerged as follows: Insuffici...
European journal of public health, Feb 16, 2017
Despite the popularity of the sport, few studies have investigated community-level football injur... more Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female...
BMC Sports Science, Medicine and Rehabilitation, 2016
British Journal of Sports Medicine, Feb 18, 2020
Socialmedicinsk Tidskrift, 2011
Vaccines
The term hybrid immunity is used to denote the immunological status of vaccinated individuals wit... more The term hybrid immunity is used to denote the immunological status of vaccinated individuals with a history of natural infection. Reports of new SARS-CoV-2 variants of concern motivate continuous rethought and renewal of COVID-19 vaccination programs. We used a naturalistic case-control study design to compare the effectiveness of the BNT162b2 mRNA vaccine to hybrid immunity 180 days post-vaccination in prioritized and non-prioritized populations vaccinated before 31 July 2021 in three Swedish counties (total population 1,760,000). Subjects with a positive SARS-CoV-2 test recorded within 6 months before vaccination (n = 36,247; 6%) were matched to vaccinated-only controls. In the prioritized population exposed to the SARS-CoV-2 Alpha and Delta variants post-vaccination, the odds ratio (OR) for breakthrough infection was 2.2 (95% CI, 1.6–2.8; p < 0.001) in the vaccinated-only group compared with the hybrid immunity group, while in the later vaccinated non-prioritized population, ...
BMC Psychiatry, 2021
Background Recurrence is a problem for many patients who have episodes of depression. In experime... more Background Recurrence is a problem for many patients who have episodes of depression. In experimental settings, hyporeactivity in the Electrodermal Orienting Reactivity (EDOR) test has been observed to be more frequent in these patients. The aim of this study was to investigate the clinical value of this test with regard to a prognosis of episode recurrence in patients hospitalized for depression. Methods The study was performed using a cohort design at a specialized psychiatric clinic in Warsaw, Poland. The primary endpoint measure was relapse or recurrence of depression. Data on electrodermal reactivity measured by the EDOR test, clinical status, and psychiatric history were collected at the clinic. Relapse and recurrence data were collected by clinical interviews 1 year after the EDOR test. The predictive (adjusting for confounders) and comparative (relative to other predictors) performance of electrodermal hyporeactivity was assessed using simple and multiple binary logistic reg...