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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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The influence of school culture on smoking among pupils

TL;DR: It is hypothesised that school-level educational achievement scores would not be associated with smoking prevalence, but schools providing value-added education given the social background of pupils (authoritative schools) would provide effective support and control, have a relatively strong influence on pupils' lives and beassociated with lower than average smoking prevalence.
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Leveraging social influence to address overweight and obesity using agent-based models: the role of adolescent social networks

TL;DR: Social network dynamics and the strength of peer influence and the proportion of network member (agents) becoming overweight over a simulated year are hypothesized and strengthening peer influence may be a useful strategy in low-obesity populations.
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The fetal origins of adult disease: a narrative review of the epidemiological literature.

TL;DR: It is concluded that much of the research literature on the FOAD-hypothesis finds support for the hypothesis, and should be considered a major insight and constitutes a complement to a focus on genetic and more proximal factors (such as adult lifestyle) as causes of adult disease.
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Influence of family, friend and coworker social support and social undermining on weight gain prevention among adults

TL;DR: Investigation of longitudinal associations between sources of social support and social undermining for healthy eating and physical activity and weight change finds associations are weak in both the positive and the negative.
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Cardiovascular Disease Epidemiology A Journey From the Past Into the Future

TL;DR: In the late 1940s, there were forerunners, but, as always with the birth of creative ideas, there will remain some mystery around the reasons for this explosive development; it led within 30 years to coronary heart disease (CHD) becoming a largely preventable condition.
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.
Journal ArticleDOI

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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