Environment and Health Data in Europe as a Tool for Risk Management Needs, Uses, and Strategies

1990 ◽  
pp. 267-270
Author(s):  
R. M. Stern
Author(s):  
Amy Mizen ◽  
Sarah Rodgers ◽  
Richard Fry ◽  
Ronan Lyons

IntroductionModelling the daily exposure environment provides evidence for policy and practice. However, the dose-response relationship between exposure to food environments and obesity has not been widely investigated. This study investigated whether increased retail food environment (RFE) exposure in children was associated with a larger body mass index (BMI). Objectives and ApproachIndividually tailored environmental exposures were calculated in a GIS for home and school locations, and modelled walking routes to and from school. Exposures were linked to individual level health data in the SAIL databank for a cohort of individuals aged 11-13 years from south Wales who had BMI measurements. A fully adjusted multilevel regression model was fitted to investigate the association of RFE exposure with BMI. Based on the distance individuals lived from school, we investigated differences between children who have the potential to walk to school (“walkers” lived 4.8km). ResultsHome exposure and exposure along the walk to school was significantly greater for children living in deprived catchments, compared with children living in affluent school catchments (t = -5.25, p Conclusion/ImplicationsIncreased BMI was associated with greater RFE exposure along the walk home from school. The findings suggest that the walk home from school should be the focus for developing interventions and policies to discourage unhealthy eating. Research should be undertaken to better understand child purchasing habits.


2004 ◽  
Vol 10 (2) ◽  
pp. 169-182 ◽  
Author(s):  
Samantha Cockings ◽  
Christine E Dunn ◽  
Raj S Bhopal ◽  
David R Walker

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101109
Author(s):  
T Katrien J Groenhof ◽  
A Titia Lely ◽  
Saskia Haitjema ◽  
Hendrik M Nathoe ◽  
Marlous F Kortekaas ◽  
...  

BackgroundMany patients now present with multimorbidity and chronicity of disease. This means that multidisciplinary management in a care continuum, integrating primary care and hospital care services, is needed to ensure high quality care.AimTo evaluate cardiovascular risk management (CVRM) via linkage of health data sources, as an example of a multidisciplinary continuum within a learning healthcare system (LHS).Design & settingIn this prospective cohort study, data were linked from the Utrecht Cardiovascular Cohort (UCC) to the Julius General Practitioners' Network (JGPN) database. UCC offers structured CVRM at referral to the University Medical Centre (UMC) Utrecht. JGPN consists of electronic health record (EHR) data from referring GPs.MethodThe cardiovascular risk factors were extracted for each patient 13 months before referral (JGPN), at UCC inclusion, and during 12 months follow-up (JGPN). The following areas were assessed: registration of risk factors; detection of risk factor(s) requiring treatment at UCC; communication of risk factors and actionable suggestions from the specialist to the GP; and change of management during follow-up.ResultsIn 52% of patients, ≥1 risk factors were registered (that is, extractable from structured fields within routine care health records) before UCC. In 12%–72% of patients, risk factor(s) existed that required (change or start of) treatment at UCC inclusion. Specialist communication included the complete risk profile in 67% of letters, but lacked actionable suggestions in 86%. In 29% of patients, at least one risk factor was registered after UCC. Change in management in GP records was seen in 21%–58% of them.ConclusionEvaluation of a multidisciplinary LHS is possible via linkage of health data sources. Efforts have to be made to improve registration in primary care, as well as communication on findings and actionable suggestions for follow-up to bridge the gap in the CVRM continuum.


2021 ◽  
Vol 11 (8) ◽  
pp. 1061
Author(s):  
Michael Lang ◽  
Daniela Rau ◽  
Lukas Cepek ◽  
Fia Cürten ◽  
Stefan Ringbauer ◽  
...  

Despite improvements in diagnosis and treatment, multiple sclerosis (MS) is the leading neurological cause of disability in young adults. As a chronic disease, MS requires complex and challenging management. In this context, eHealth has gained an increasing relevance. Here, we aim to summarize beneficial features of a mobile app recently implemented in clinical MS routine as well as beyond MS. PatientConcept is a CE-certified, ID-associated multilingual software application allowing patients to record relevant health data without disclosing any identifying data. Patients can voluntarily share their health data with selected physicians. Since its implementation in 2018, about 3000 MS patients have used PatientConcept. Initially developed as a physician–patient communication platform, the app maps risk management plans of all current disease modifying therapies and thereby facilitates adherence to specified monitoring appointments. It also allows continuous monitoring of various PROs (PatientReportedOutcomes), enabling a broad overview of the disease course. In addition, various studies/projects currently assess monitoring, follow-up, diagnostics and telemetric evaluations of patients with other diseases beyond MS. Altogether, PatientConcept offers a broad range of possibilities to support physician–patient communication, implementation of risk management plans and assessment of PROs. It is a promising tool to facilitate patient-tailored management of MS and other chronic diseases.


Author(s):  
Lora Fleming ◽  
Niccolò Tempini ◽  
Harriet Gordon-Brown ◽  
Gordon L. Nichols ◽  
Christophe Sarran ◽  
...  

Big data refers to large, complex, potentially linkable data from diverse sources, ranging from the genome and social media, to individual health information and the contributions of citizen science monitoring, to large-scale long-term oceanographic and climate modeling and its processing in innovative and integrated “data mashups.” Over the past few decades, thanks to the rapid expansion of computer technology, there has been a growing appreciation for the potential of big data in environment and human health research. The promise of big data mashups in environment and human health includes the ability to truly explore and understand the “wicked environment and health problems” of the 21st century, from tracking the global spread of the Zika and Ebola virus epidemics to modeling future climate change impacts and adaptation at the city or national level. Other opportunities include the possibility of identifying environment and health hot spots (i.e., locations where people and/or places are at particular risk), where innovative interventions can be designed and evaluated to prevent or adapt to climate and other environmental change over the long term with potential (co-) benefits for health; and of locating and filling gaps in existing knowledge of relevant linkages between environmental change and human health. There is the potential for the increasing control of personal data (both access to and generation of these data), benefits to health and the environment (e.g., from smart homes and cities), and opportunities to contribute via citizen science research and share information locally and globally. At the same time, there are challenges inherent with big data and data mashups, particularly in the environment and human health arena. Environment and health represent very diverse scientific areas with different research cultures, ethos, languages, and expertise. Equally diverse are the types of data involved (including time and spatial scales, and different types of modeled data), often with no standardization of the data to allow easy linkage beyond time and space variables, as data types are mostly shaped by the needs of the communities where they originated and have been used. Furthermore, these “secondary data” (i.e., data re-used in research) are often not even originated for this purpose, a particularly relevant distinction in the context of routine health data re-use. And the ways in which the research communities in health and environmental sciences approach data analysis and synthesis, as well as statistical and mathematical modeling, are widely different. There is a lack of trained personnel who can span these interdisciplinary divides or who have the necessary expertise in the techniques that make adequate bridging possible, such as software development, big data management and storage, and data analyses. Moreover, health data have unique challenges due to the need to maintain confidentiality and data privacy for the individuals or groups being studied, to evaluate the implications of shared information for the communities affected by research and big data, and to resolve the long-standing issues of intellectual property and data ownership occurring throughout the environment and health fields. As with other areas of big data, the new “digital data divide” is growing, where some researchers and research groups, or corporations and governments, have the access to data and computing resources while others do not, even as citizen participation in research initiatives is increasing. Finally with the exception of some business-related activities, funding, especially with the aim of encouraging the sustainability and accessibility of big data resources (from personnel to hardware), is currently inadequate; there is widespread disagreement over what business models can support long-term maintenance of data infrastructures, and those that exist now are often unable to deal with the complexity and resource-intensive nature of maintaining and updating these tools. Nevertheless, researchers, policy makers, funders, governments, the media, and members of the general public are increasingly recognizing the innovation and creativity potential of big data in environment and health and many other areas. This can be seen in how the relatively new and powerful movement of Open Data is being crystalized into science policy and funding guidelines. Some of the challenges and opportunities, as well as some salient examples, of the potential of big data and big data mashup applications to environment and human health research are discussed.


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