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Sick individuals and sick populations

Geoffrey Rose
- 01 Mar 1985 - 
- Vol. 30, Iss: 3, pp 427-432
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TLDR
Aetiology confronts two distinct issues: the determinant of individual cases, and the determinants of incidence rate: if exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it.
Abstract
Aetiology confronts two distinct issues: the determinants of individual cases, and the determinants of incidence rate. If exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it: they will only identify markers of susceptibility. The corresponding strategies in control are the 'high-risk' approach, which seeks to protect susceptible individuals, and the population approach, which seeks to control the causes of incidence. The two approaches are not usually in competition, but the prior concern should always be to discover and control the causes of incidence.

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Work Addiction, Obsessive-Compulsive Personality Disorder, Burn-Out, and Global Burden of Disease: Implications from the ICD-11

TL;DR: This paper identifies several substantial gaps in the current understanding of the relationships between work addiction, OCPD/APD, burn-out, and the global burden of disease within the context of the WHO’s plan of developing evidence-based guidelines on mental wellbeing in the workplace.
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Chronic pain--is it a public health problem?

TL;DR: It is found that an older adult’s risk of developing disabling pain varies with the deprivation characteristics of the area in which he or she lives, and this area-level variation is only partially explained by the individual risk factor profiles of those individuals who develop disabling chronic pain.
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Periodontal epidemiology: towards social science or molecular biology?

TL;DR: This commentary points out to the limitations of this development and suggests that more emphasis is placed on making the presumed causal disease models explicit, when investigating the relationship between putative determinants and disease.
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Socioeconomic gradients in the effects of universal school-based health behaviour interventions: a systematic review of intervention studies

TL;DR: There is a significant need for more routine testing of the effects of universal school-based interventions on inequality to enable firmer conclusions regarding types of interventions which affect inequality.
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Social and Medical Determinants of Cardiometabolic Health: The Big Picture.

TL;DR: Cardiometabolic health equity in African Americans requires interventions on social determinants to reduce excess risk prevalence of risk factors and social-medical interventions to promote timely access to, delivery of and adherence with evidence-based medicine are needed.
References
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Journal ArticleDOI

Strategy of prevention: lessons from cardiovascular disease.

Geoffrey Rose
- 06 Jun 1981 - 
TL;DR: In this article, two types of preventive measures are proposed; the first consists in the removal of an unnatural factor and the restoration of biological normality as the reduction of intake of saturated fats would be in the case of heart disease; the second does not consist of removing a supposed cause of disease but in adding some other factors in the hope of conferring protection as a high intake of polyunsaturated fat and of long-term medication would be for heart disease.
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A Co-operative trial in the primary prevention of ischaemic heart disease using clofibrate: Report1 from the Committee of Principal Investigators

TL;DR: A double-blind intervention trial to test the hypothesis that the incidence of ischaemic heart disease in middle-aged men can be reduced by lowering raised serum cholesterol levels found men with a substantial reduction of cholesterol concentration, who smoked, and also had above average blood pressure levels showed the most benefit.
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Cardiorespiratory disease and diabetes among middle-aged male Civil Servants. A study of screening and intervention.

TL;DR: In this paper, a screening survey for cardiorespiratory disease and diabetes among 18,403 male Civil Servants aged 40-64 years, representing a 77% response of those eligible.
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How well can we predict coronary heart disease? Findings in the United Kingdom Heart Disease Prevention Project.

TL;DR: Although a group of subjects at high risk can be identified, among whom will be a high proportion of potential victims of heart attack, many subjects will be wrongly classified and highlight the need for research to improve the prediction of the development of coronary heart disease.
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British Regional Heart Study: geographic variations in cardiovascular mortality, and the role of water quality.

TL;DR: A negative relation existed between water hardness and cardiovascular mortality, although climate and socioeconomic conditions also appeared to be important influences.
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