Obesity atlas and methodbox: towards an open framework for sharing public health intelligence workflows.

The large growth in data sources relevant to public health has not been matched by a growth in human resource for producing intelligence to support decisions or generate new insights. There is a need to bring scarce public health expertise into closer alignment with data and data processing methods to support timely public health analysis. The difficulties of developing and sharing this expertise in large organisations such as the UK's National Health Service have long been recognised.

IMPACT: A generalisable system for simulating public health interventions.

Populations are under-served by local health policies and management of resources, partly because of a lack of realistically complex models to enable a wide range of potential options to be appraised. Rising computing power coupled with advances in machine learning and healthcare information now enables such models to be constructed and executed. However, such models are not generally accessible to public health practitioners because they do not have the requisite technical knowledge or skills.

Body mass index in young children and allergic disease: gender differences in a longitudinal study.

Background: The increase in allergic diseases has occurred in parallel with the obesity epidemic, suggesting a possible association.

Objective: We investigated the relationship of body mass index (BMI) up to age 8 years with allergic disease within a birth cohort.

Methods: Children were followed from birth and were reviewed at age 3, 5 and 8 years (n=731; male 406).

Supporting creativity and appreciation of uncertainty in exploring geo-coded public health data.

Background And Objectives: We present a prototype visualisation tool, ADVISES (Adaptive Visualization for e-Science), designed to support epidemiologists and public health practitioners in exploring geo-coded datasets and generating spatial epidemiological hypotheses. The tool is designed to support creative thinking while providing the means for the user to evaluate the validity of the visualization in terms of statistical uncertainty. We present an overview of the application and the results of an evaluation exploring public health researchers' responses to maps as a new way of viewing familiar data, in particular the use of thematic maps with adjoining descriptive statistics and forest plots to support the generation and evaluation of new hypotheses.

User engagement by user-centred design in e-Health.

This paper describes the application of user-centred design (UCD) methods and a user engagement (UE) approach to a case study development of a visualization tool (ADVISES) to support epidemiological research. The combined UCD/UE approach consisted of scenario-based design, and analysis of the users' tasks and mental model of the domain. Prototyping and storyboarding techniques were used to explore design options with users as well as specifying functionality for two versions of the software to meet the needs of novice and expert users.

Elements of a computational infrastructure for social simulation.

Applications of simulation modelling in social science domains are varied and increasingly widespread. The effective deployment of simulation models depends on access to diverse datasets, the use of analysis capabilities, the ability to visualize model outcomes and to capture, share and re-use simulations as evidence in research and policy-making. We describe three applications of e-social science that promote social simulation modelling, data management and visualization.

Beyond atopy: multiple patterns of sensitization in relation to asthma in a birth cohort study.

Rationale: The pattern of IgE response (over time or to specific allergens) may reflect different atopic vulnerabilities which are related to the presence of asthma in a fundamentally different way from current definition of atopy.

Objectives: To redefine the atopic phenotype by identifying latent structure within a complex dataset, taking into account the timing and type of sensitization to specific allergens, and relating these novel phenotypes to asthma.

Methods: In a population-based birth cohort in which multiple skin and IgE tests have been taken throughout childhood, we used a machine learning approach to cluster children into multiple atopic classes in an unsupervised way.

Prescribing errors during hospital inpatient care: factors influencing identification by pharmacists.

Objective: To investigate the prevalence of prescribing errors identified by pharmacists in hospital inpatients and the factors influencing error identification rates by pharmacists throughout hospital admission.

Setting: 880-bed university teaching hospital in North-west England.

Methods: Data about prescribing errors identified by pharmacists (median: 9 (range 4-17) collecting data per day) when conducting routine work were prospectively recorded on 38 randomly selected days over 18 months.

Incident cancer burden attributable to excess body mass index in 30 European countries.

Excess adiposity is associated with increased risks of developing adult malignancies. To inform public health policy and guide further research, the incident cancer burden attributable to excess body mass index (BMI >or= 25 kg/m(2)) across 30 European countries were estimated. Population attributable risks (PARs) were calculated using European- and gender-specific risk estimates from a published meta-analysis and gender-specific mean BMI estimates from a World Health Organization Global Infobase.

Shared genomics: high performance computing for distributed insights in genomic medical research.

The study of the genetics of diseases is entering a new era. Increasingly, genome-wide association studies are being used to identify positions within the human genome that have a link with a disease condition. The number of genomic locations studied means that High Performance Computing (HPC) solutions will have to increasingly be used in the statistical analysis of these data sets.

Preserving consent-for-consent with feasibility-assessment and recruitment in clinical studies: FARSITE architecture.

Best practice guidance for clinical studies asks investigators to employ the highest possible standards in privacy and consent. When considering the feasibility of a clinical study, issues of privacy extend not only to actual but also to potential study participants. The consent required to access records to determine whether or not an individual might be eligible to participate in a study is sometimes referred to as consent-for-consent.

The high prevalence of unrecognized anaemia in patients with diabetes and chronic kidney disease: a population-based study.

Background: Anaemia occurs early in the course of diabetes-related chronic kidney disease (CKD). There is little evidence about the prevalence of anaemia in people with diabetes. The aim of this study was to assess the prevalence of anaemia, by stage of CKD, in the general diabetic population.

Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study.

Background: Body fat distribution has been cross-sectionally associated with atherosclerotic disease risk factors, but the prospective relation with coronary heart disease remains uncertain.

Methods And Results: We examined the prospective relation between fat distribution indices and coronary heart disease among 24,508 men and women 45 to 79 years of age using proportional hazards regression. During a mean 9.

Cardiorespiratory fitness and body mass index of 9-11-year-old English children: a serial cross-sectional study from 1998 to 2004.

Objective: To examine the changes over time in cardiorespiratory fitness and body mass index (BMI) of children.

Design: Serial cross-sectional, population-based study.

Setting: Primary schools in Liverpool, UK.

Prioritising between direct observation of therapy and case-finding interventions for tuberculosis: use of population impact measures.

Background: Population impact measures (PIMs) have been developed as tools to help policy-makers with locally relevant decisions over health risks and benefits. This involves estimating and prioritizing potential benefits of interventions in specific populations. Using tuberculosis (TB) in India as an example, we examined the population impact of two interventions: direct observation of therapy and increasing case-finding.

Adherence to HAART: a systematic review of developed and developing nation patient-reported barriers and facilitators.

Background: Adherence to highly active antiretroviral therapy (HAART) medication is the greatest patient-enabled predictor of treatment success and mortality for those who have access to drugs. We systematically reviewed the literature to determine patient-reported barriers and facilitators to adhering to antiretroviral therapy.

Methods And Findings: We examined both developed and developing nations.

Measuring children and monitoring obesity: surveys of English Primary Care Trusts 2004-06.

Background: Child obesity has unclear determinants and consequences. A precautionary approach requires best-guess interventions and large-scale surveillance. This study was to determine the current measurement activities and the information systems required for child obesity surveillance.

Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis.

Context: Adherence to antiretroviral therapy is a powerful predictor of survival for individuals living with human immunodeficiency virus (HIV) and AIDS. Concerns about incomplete adherence among patients living in poverty have been an important consideration in expanding the access to antiretroviral therapy in sub-Saharan Africa.

Objective: To evaluate estimates of antiretroviral therapy adherence in sub-Saharan Africa and North America.

Body mass index has risen more steeply in tall than in short 3-year olds: serial cross-sectional surveys 1988-2003.

Objective: To monitor the changing relationship between body mass index (BMI) and height in young children.

Design: Annual cross-sectional surveys using health-visitor-collected routine data 1988-2003.

Setting: Wirral, England.

Impact of specialist care on clinical outcomes for medical emergencies.

General hospitals have commonly involved a wide range of medical specialists in the care of unselected medical emergency admissions. In 1999, the Royal Liverpool University Hospital, a 915-bed hospital with a busy emergency service, changed its system of care for medical emergencies to allow early placement of admitted patients under the care of the most appropriate specialist team, with interim care provided by specialist acute physicians on an acute medicine unit - a system we have termed 'specialty triage'. Here we describe a retrospective study in which all 133,509 emergency medical admissions from February 1995 to January 2003 were analysed by time-series analysis with correction for the underlying downward trend from 1995 to 2003.

Design and implementation of security in a data collection system for epidemiology.

Health informatics can benefit greatly from the e-Science approach, which is characterised by large scale distributed resource sharing and collaboration. Ensuring the privacy and confidentiality of data has always been the first requirement of health informatics systems. The PsyGrid data collection system, addresses both, providing secure distributed data collection for epidemiology.

Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials.

Context: Tumor necrosis factor (TNF) plays an important role in host defense and tumor growth control. Therefore, anti-TNF antibody therapies may increase the risk of serious infections and malignancies.

Objective: To assess the extent to which anti-TNF antibody therapies may increase the risk of serious infections and malignancies in patients with rheumatoid arthritis by performing a meta-analysis to derive estimates of sparse harmful events occurring in randomized trials of anti-TNF therapy.