Sozial- und Präventivmedizin
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With some 30,000 dependent persons, opiate addiction constitutes a major public health problem in Switzerland. The Swiss Federal Office of Public Health (FOPH) has long played a leading role in the prevention and treatment of opiate addiction and in research on effective means of containing the epidemic of opiate addiction and its consequences. Major milestones on that path have been the successive "Methadone reports" published by that Office and providing guidance on the care of opiate addiction with substitution treatment. ⋯ The RAND Appropriateness Method proved to be an accepted and appreciated method to assess the appropriateness of methadone maintenance treatment for opiate addicts. In the next step, the results of the expert panel process must now be combined with those of the Swiss and international literature reviews and the survey of current attitudes and practices in Switzerland, to be synthesized into formal practice guidelines. Such guidelines should be disseminated to all concerned, promoted, used and rigorously evaluated for compliance and outcome.
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It was examined whether the rate of hospital admissions change after transition into unemployment. ⋯ For myocardial infarction the findings may reflect increased morbidity, for occupational diseases they may reflect a decrease following ceasing expositions at the workplace. For the remaining diagnostic groups decreasing health care utilisation may apply without morbidity having changed.
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Biography Historical Article
Statistical methods in epidemiology: Karl Pearson, Ronald Ross, Major Greenwood and Austin Bradford Hill, 1900-1945.
The tradition of epidemiological study through observation and the use of vital statistics dates back to the 18th century in Britain. At the close of the 19th century, however, a new and more sophisticated statistical approach emerged, from a base in the discipline of mathematics, which was eventually to transform the practice of epidemiology. This paper traces the evolution of that new analytical approach within English epidemiology through the work of four key contributors to its inception and establishment within the wider discipline.
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Biography Historical Article
Changing images of John Snow in the history of epidemiology.
Ever since the end of the 19th century, the story of John Snow and his investigations into the contagiousness of cholera has fascinated epidemiologists. Several different lessons have been extracted from the interpretation and reinterpretation of Snow's work--according to prevailing insights. The story of John Snow continues to evolve, even into the 21st century.
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Biography Historical Article
The changing assessments of John Snow's and William Farr's cholera studies.
This article describes the epidemiological studies of cholera by two major British investigators of the mid-nineteenth century, John Snow and William Farr, and it asks why the assessments of their results by contemporaries was the reverse of our assessment today. In the 1840s and 1850s Farr's work was considered definitive, while Snow's was regarded as ingenious but flawed. ⋯ A major change in thinking about disease causation was needed before Snow's work could be widely accepted. William Farr's later studies contributed to that acceptance.