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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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Prenatal growth in humans and postnatal brain maturation into late adolescence

TL;DR: Using over 1,000 brain scans, across three independent samples, this work links subtle differences in prenatal growth, within ranges seen among the majority of human pregnancies, to protracted surface area alterations that preferentially impact later-maturing associative cortices important for higher cognition.
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Precision medicine in cardiology

TL;DR: The cardiovascular research and clinical communities are ideally positioned to address the epidemic of noncommunicable causes of death, as well as advance the understanding of human health and disease, through the development and implementation of precision medicine.
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A Strategy for Comparing the Contributions of Environmental Chemicals and Other Risk Factors to Neurodevelopment of Children

TL;DR: A method for comparing the relative contributions of different risk factors provides a rational basis for establishing priorities for reducing neurodevelopmental morbidity in children.
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Are Racial Disparities in Preterm Birth Larger in Hypersegregated Areas

TL;DR: Living in a hypersegregated MA had a more pronounced association with PTB among older Black women, and racial disparities in PTB were larger in hyperSegregated areas among older mothers, suggesting residential segregation may be an important social determinant of racial birth disparities.
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The Working Healthy Project: a worksite health-promotion trial targeting physical activity, diet, and smoking.

TL;DR: The results suggest that among a cohort of participants in a worksite health promotion study, there were significant health behavior changes across two risk factors over time, and suggest that further investigation of multiple risk factor worksitehealth promotion is warranted.
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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