Aim/Purpose: The primary use of electronic health records (EHRs) is in the care of the individual patient. Secondary research uses employ information in EHRs for purposes beyond that of care of the individual. Secondary research uses may broadly be divided into studies which focus on improving care and treatment of individuals and those which aim to increase knowledge about disease causes, associations and prevalence at a population level. This paper provides a review of studies that have used EHRs to increase knowledge at a population level. It examines the methods used, types of research conducted, difficulties and challenges faced and implications for future research and mental health research in particular. Method: A review was undertaken based on a search for peer-reviewed and recently (i.e. since 2005) published articles with full-text available online. Findings/Results: The studies which have used EHRs to increase knowledge have predominantly involved; (1) data mining to identify biomarkers and gene–disease associations, (2) epidemiological research using linked/merged health records and (3) surveillance, prediction and alerts for diseases/illnesses. The principal methodological challenges identified were data quality, discrepancies/inconsistencies in data and interoperability of EHRs. Conclusions: Despite the challenges faced in secondary usage of EHRs, significant research has been undertaken and researchers have proposed and tested various approaches to address methodological issues. The study methods employed in other fields of medical research can be extrapolated to study issues of significance to mental health using EHRs.

The increased adoption of digital systems in the maritime domain has led to concerns about cyber resilience, especially in the wake of increasingly disruptive cyber-attacks. This has seen vessel operators increasingly adopt Maritime Security Operation Centers (M-SOCs), an action in line with one of the cyber resilience engineering techniques known as adaptive response, whose purpose is to optimize the ability to respond promptly to attacks. This research sought to investigate the domain-specific human factors that influence the adaptive response capabilities of M-SOC analysts to vessel cyber threats. Through collecting interview data and subsequent thematic analysis informed by grounded theory, cyber awareness of both crew onboard and vessel operators emerged as a pressing domain-specific challenge impacting M-SOC analysts' adaptive response. The key takeaway from this study is that vessel operators remain pivotal in supporting the M-SOC analysts' adaptive response processes through resource allocation towards operational technology (OT) monitoring and cyber personnel staffing onboard the vessels.