Public Health Observatories: a learning community model to foster knowledge transfer for sustainable cities

[EN] A Public Health Observatory (PHO) is a platform to provide “health intelligence” as a service for a specific population. The World Health Organization (WHO) identifies the primary purposes of PHOs as “monitoring health situations and trends, including assessing progress toward agreed-upon health-related targets; producing and sharing evidence; and, supporting the use of such evidence for policy and decision making” For the purposes of the PULSE project, create an observatory to function as a unique point of access to the PULSE technology for people both inside and outside the project consortium.Specifically, we create a platform for e-learning and knowledge sharing that it can be easily navigated by lay persons that are interested in learning about or participating in the PULSE project. We targeted specifically policymakers, clinicians, as well as leaders and citizens in other cities. As a concept, it reflects the principles participation, sustainability, and collaboration across sectors and levels of government The Observatory leverages on the Health in All Policies (HiAP) framework. HiAP is a cross-sectoral approach to public policy that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity.PULSE project has been founded by the European Union’s Horizon 2020 research and innovation programme, and it is documented in the grant agreement No 727816. Specifically. PULSE has been founded under the call H2020-EU-3.1.5. in the topic SCIPM-18-2016-Big Data supporting Public Health policies. More information on http://www.project-pulse.euVito, D.; Ottaviano, M.; Cabrera, MF.; Teriús Padrón, JG.; Casella, V.; Bellazzi, R. (2020). Public Health Observatories: a learning community model to foster knowledge transfer for sustainable cities. En 6th International Conference on Higher Education Advances (HEAd'20). Editorial Universitat Politècnica de València. (30-05-2020):1383-1390. https://doi.org/10.4995/HEAd20.2020.11285OCS1383139030-05-202

Propuesta de marco tecnológico para la autogestión de enfermedades crónicas afectadas por la exposición a factores de calidad del aire usando el paradigma de Internet de las Cosas

Hoy en día, las grandes ciudades se encuentran afectadas por altos niveles de contaminación del aire. El tráfico vehicular, el transporte público ineficiente, y las calefacciones, entre otros, son las fuentes de contaminantes que más afectan a la salud. Aproximadamente, el 80% de los países del mundo, no cumple con los estándares de calidad del aire establecidos. Por otro lado, las enfermedades crónicas representan el 70% de las muertes a nivel mundial. Las enfermedades cardiovasculares, respiratorias, y neurodegenerativas repercuten en el gasto sanitario europeo en 115 billones de euros anuales. Estudios recientes muestran la estrecha relación entre las enfermedades crónicas y la contaminación ambiental, en donde las partículas contaminantes afectan directamente al pulmón, el cerebro y el corazón. Para el tratamiento de la cronicidad, existen programas que ayudan a los pacientes a autogestionar su enfermedad lo que permite empoderarlos en el control de su salud desde sus hogares y contribuye descargar a los sistemas sanitarios al reducir el número de ingresos por emergencia y visitas a hospitales por parte de estos pacientes. Sin embargo, estos programas no contemplan el factor calidad del aire como parte de contenido programático para preparar a sus pacientes, debido a la falta de tecnología que permita ayudar al paciente a gestionar su exposición a alto niveles de contaminación. Es por ello por lo que esta tesis doctoral tiene como objetivo principal proponer un marco tecnológico para la autogestión de enfermedades crónicas afectadas por la exposición a factores de calidad del aire usando el paradigma de Internet de las Cosas. La definición del marco tecnológico toma como referencia en el Modelo Innovative Care of Chronic Conditions, creado por la Organización Mundial de la Salud, el cual ofrece una hoja de ruta para mejorar la forma en la que las enfermedades crónicas son prevenidas o tratadas y el Chronic Diseases Self-Management Program, el programa de autogestión de enfermedades crónicas más difundido y utilizado. Para la validación de esta propuesta se han diseñado, desarrollado y evaluado soluciones tecnológicas IoT para tres escenarios planteados en los cuales un paciente hace uso de la tecnología para autogestionar su condición crónica. Estos escenarios son: (1) dentro de un entorno inteligente por medio de distintos sensores, (2) en interiores o exteriores con tecnología portable o vestible, y (3) en una ciudad inteligente usando tecnología móvil. Adicionalmente, el marco tecnológico ha sido validado por potenciales usuarios y un panel de expertos multidisciplinar especialistas en Epidemiología Ambiental, Medicina Preventiva y Salud Pública, Medio Ambiente y Salud, Medicina Legal y Forense, Medicina familiar, Oncología, Cardiología y Neumología. Las contribuciones originales de esta tesis doctoral incluyen: (1) Definición del nicho de innovación; (2) Un marco tecnológico para la autogestión de enfermedades crónicas partiendo de la detección de niveles de contaminación en el aire; (3) Diseño y desarrollo de prototipos para la autogestión de calidad del aire en entornos domóticos y con dispositivos IoT portables o vestibles y tecnología móvil para cada uno de los escenarios planteados; y (4) Evaluación y validación del marco tecnológico. ----------ABSTRACT---------- Nowadays, major cities are affected by high levels of air pollution. Vehicular traffic, inefficient public transport, charcoal heating, among others, are the sources of pollutants that most affect health. Approximately 80% of the world's countries do not meet established air quality standards. On the other hand, chronic diseases account for 70% of deaths globally. Cardiovascular, respiratory and neurodegenerative diseases have an impact on European health spending by 115 billion Euros per year. Recent studies show the close relationship between chronic diseases and air pollution, where polluting particles directly affect the lung, brain and heart. For the treatment of chronicity, there are programs that help patients to self-manage their disease which allows to empower them in the control of their health from their homes reducing the number of emergency admissions and visits to hospitals by these patients. However, these programs do not consider air quality factor as part of programmatic content to prepare their patients due to the lack of technology that allows to help the patient manage their exposure to high levels of pollution. That is why this doctoral thesis has as its main objective to propose a technological framework for the self-management of chronic diseases affected by exposure to environmental factors of air quality using the paradigm of the Internet of Things. The definition of the technological framework is based on the Innovative Care of Chronic Conditions Model, created by the World Health Organization, which offers a roadmap to improve the way in which chronic diseases are prevented or treated, and the Chronic Diseases Self-Management Program, the most widespread and used patient program. For the validation of this proposal, IoT technological solutions have been designed, developed and evaluated in three scenarios in which a patient will make use of technology to self-manage their chronic condition. These scenarios are: (1) within a smart environment; (2) indoors or outdoors with portable or wearable technology; and (3) in a smart city using mobile technology. Additionally, the technological framework has been validated by potential users and a panel of multidisciplinary experts specialized in Environmental Epidemiology, Preventive Medicine and Public Health, Environment and Health, Legal and Forensic Medicine, Family Medicine, Oncology, Cardiology and Pulmonology. The original contributions of this doctoral thesis includes: (1) Definition of the innovation niche; (2) A technological framework for the self-management of chronic diseases based on the detection of levels of pollution in the air; (3) Design and development of prototypes for the self-management of air quality in home automation environments and with portable or wearable IoT devices and mobile technology for each of the scenarios proposed; and (4) Evaluation and validation of the technological framework