Whole systems approach to obesity

解决肥胖问题的全系统方法

基本信息

  • 批准号:
    2272659
  • 负责人:
  • 金额:
    --
  • 依托单位:
  • 依托单位国家:
    英国
  • 项目类别:
    Studentship
  • 财政年份:
    2019
  • 资助国家:
    英国
  • 起止时间:
    2019 至 无数据
  • 项目状态:
    已结题

项目摘要

In the UK two thirds of adults, a quarter of 2-10-year olds and third of 11-15-year olds are overweight or obese. The harmful effects of obesity are not only felt by individuals, through worsened health risks, but also financially to the wider economy. The way we live of lives has a major impact on our health, however, there is increasing recognition that the circumstances in which live also impacts on our health - it impacts on the opportunities we must make healthy choices. While individual behaviour does matter, the reality is that our health is impacted by behavioural, social, economic and environmental factors. The most comprehensive investigation into obesity and its causes [Foresight] described obesity as a complex problem that requires action from individuals and society across multiple sectors. Because of this paradigm shift, obesity is now viewed through a social lens (oppose to a medical one), and it is generally accepted that lifestyle (i.e. individual), environmental, economic and social factors contribute to the consequences of obesity. However, with almost 10 years since the publication of Foresight, most of the research informing this ongoing policy debate fails to consider the interplay between these domains. Insightful analyses have considered these factors in isolation; this proposal will extend the utility of current evidence and understanding by jointly considering environmental, behavioural, economic and social determinants of obesity.The need for effective weight management programmes - which encourage strong participant engagement and demonstrate positive health-related improvement is critical. However, participant dropout, and consequent programme attrition, challenges programme effectiveness, in child weight management, for example, attrition ranges from 8-83 %. Higher participant attendance is associated with greater weight loss and health-related benefits in contrast to those with lower attendance or those who dropout. Of concern to policy makers and programme commissioners (those funding the programmes), dropout and attrition compromise the economic effectiveness of WM programmes. Policy makers have engaged with the idea that individual, social, economic and environmental factors contribute to obesity. However, almost all the research evaluating weight management interventions fails to consider this interplay and focus on individual factors.In addition, Public Health England have acknowledged the need to understand all the factors that contribute to obesity and have committed to 'support local authorities to deliver a whole systems approach to tackle obesity'. The objectives of this PhD align to this commitment, as the key outcome will be a quantitative whole systems approach to modelling public health measures to determine what factors are associated with obesity, and how they inter-relate at the local and individual levels. Research Aims:- To create new knowledge and understanding about the drivers of obesity and engagement in weight management programmes, these factors need to be brought together within an integrated framework: the primary objective of this PhD is to use agent-based modelling to simulate environmental, behavioural, economic and social determinants of obesity and engagement in weight management programmes, at the local level. - The methodological approach (agent based modelling) will inform policies to affect change from a whole systems perspective. Understanding the complex and interacting systems that result in an obesogenic environment is the necessary start, hopefully leading to the adoption of a whole system approach to address obesity at the local level. This will be the first UK based study to investigate the quantitative relationships as part of a wider 'system', with a whole system approach driving its development.
在英国,三分之二的成年人、四分之一的2-10岁儿童和三分之一的11-15岁儿童超重或肥胖。肥胖的有害影响不仅会通过恶化的健康风险对个人产生影响,而且还会对更广泛的经济产生财政影响。我们的生活方式对我们的健康有重大影响,然而,人们越来越认识到,生活的环境也影响我们的健康——它影响我们必须做出健康选择的机会。虽然个人行为很重要,但现实情况是,我们的健康受到行为、社会、经济和环境因素的影响。对肥胖及其原因的最全面的调查将肥胖描述为一个复杂的问题,需要个人和社会在多个部门采取行动。由于这种模式的转变,现在人们从社会的角度(而不是从医学的角度)来看待肥胖,人们普遍认为生活方式(即个人)、环境、经济和社会因素导致了肥胖的后果。然而,在《预见》出版近10年后,大多数为正在进行的政策辩论提供信息的研究都没有考虑到这些领域之间的相互作用。有洞察力的分析孤立地考虑了这些因素;该提案将通过联合考虑肥胖的环境、行为、经济和社会决定因素,扩大现有证据和理解的效用。必须制定有效的体重管理规划,鼓励参与者积极参与,并证明健康方面的积极改善。然而,参与者的退出,以及随之而来的项目减员,挑战了项目的有效性,例如,在儿童体重管理方面,减员率在8- 83%之间。与出勤率较低或辍学的人相比,出勤率较高的人体重减轻和健康方面的益处更大。政策制定者和方案专员(那些为方案提供资金的人)关心的是,辍学和自然减员损害了妇女管理方案的经济效益。政策制定者已经接受了个人、社会、经济和环境因素导致肥胖的观点。然而,几乎所有评估体重管理干预措施的研究都没有考虑到这种相互作用,而是关注个体因素。此外,英国公共卫生部承认有必要了解导致肥胖的所有因素,并承诺“支持地方当局提供一套完整的系统方法来解决肥胖问题”。该博士学位的目标与这一承诺一致,因为关键成果将是一种定量的整体系统方法,用于对公共卫生措施进行建模,以确定与肥胖相关的因素,以及它们在地方和个人层面上如何相互关联。研究目的:为了创造关于肥胖和参与体重管理计划的驱动因素的新知识和理解,这些因素需要在一个综合框架内汇集在一起:本博士的主要目标是使用基于代理的建模来模拟环境,行为,经济和社会决定因素肥胖和参与体重管理计划,在地方层面。-方法方法(基于代理的建模)将从整个系统的角度通知影响变化的政策。了解导致肥胖环境的复杂和相互作用的系统是必要的开始,希望能导致采用整个系统的方法来解决地方层面的肥胖问题。这将是第一个以英国为基础的研究,将定量关系作为更广泛的“系统”的一部分进行调查,并采用整体系统方法推动其发展。

项目成果

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其他文献

吉治仁志 他: "トランスジェニックマウスによるTIMP-1の線維化促進機序"最新医学. 55. 1781-1787 (2000)
Hitoshi Yoshiji 等:“转基因小鼠中 TIMP-1 的促纤维化机制”现代医学 55. 1781-1787 (2000)。
  • DOI:
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    0
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LiDAR Implementations for Autonomous Vehicle Applications
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    2021
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    0
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生命分子工学・海洋生命工学研究室
生物分子工程/海洋生物技术实验室
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吉治仁志 他: "イラスト医学&サイエンスシリーズ血管の分子医学"羊土社(渋谷正史編). 125 (2000)
Hitoshi Yoshiji 等人:“血管医学与科学系列分子医学图解”Yodosha(涉谷正志编辑)125(2000)。
  • DOI:
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Effect of manidipine hydrochloride,a calcium antagonist,on isoproterenol-induced left ventricular hypertrophy: "Yoshiyama,M.,Takeuchi,K.,Kim,S.,Hanatani,A.,Omura,T.,Toda,I.,Akioka,K.,Teragaki,M.,Iwao,H.and Yoshikawa,J." Jpn Circ J. 62(1). 47-52 (1998)
钙拮抗剂盐酸马尼地平对异丙肾上腺素引起的左心室肥厚的影响:“Yoshiyama,M.,Takeuchi,K.,Kim,S.,Hanatani,A.,Omura,T.,Toda,I.,Akioka,
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