bluuebunny/crossref_metadata_2025 huggingface dataset:
Chosen Peoples
Authors: Smith Anthony D
Published: November 2023

Unto thy seed I have given this land.’ From the moment of God’s covenant with Abraham in the Old Testament, the idea that a people are chosen by God has had a central role in shaping national identity. Chosen Peoples argues powerfully that sacred belief remains central to national identity, even in an increasingly secular, globalized modern world. In this important new study, Anthony D. Smith goes in search of the deep Judeo-Christian roots of the many manifestations of national identity. This rich and timely contribution to current debates about nationalism explains the complex historical reasons behind often violent modern conflicts around issues of land, culture, religion, and politics. Tracing the development of individual nations over many centuries, it offers fascinating insights into the religious and cultural foundations of countries such as Great Britain, the United States, Israel, France, and Germany. The argument draws on a wide range of examples from historic landscapes in Ireland, Switzerland and Egypt, myths of Arthurian Britain, Holy Russia, and Byzantium, through memories of a ‘Golden Age’, to the modern commemoration of the ‘Glorious Dead’, and of victims of war.
The Nation as a Sacred Communion
Authors: Smith Anthony D
Published: November 2023

Exile, it is often said, is the nursery of nationalism. If so, then the yearning for the homeland has a long history. In Psalm 1 37, we see the Jews by the rivers of Babylon, complaining of the humiliations heaped on them by their captors: For there they that led us captive required of us songs, And they that wasted us required of us mirth, saying, Sing us one of the songs of Zion. How shall we sing the Lord’s song in a strange land? From afar, we tend to visualize the homeland with sharper outlines and more golden hues. The nation of our dreams is imagined through native verse and song, in what Benedict Anderson calls ‘unisonance’, ‘the echoed physical realization of the imagined community’, where ‘Nothing connects us all but imagined sound’. At such moments, the community is perceived as pure, noble, solidary (Anderson 1991: 145).It is usual to see in nationalism a modern, secular ideology that replaces the religious systems found in premodern, traditional societies. In this view, ‘religion’ and ‘nationalism’ figure as two terms in the conventional distinction between tradition and modernity, and in an evolutionary framework that sees an inevitable movement whether liberating or destructive-from the one to the other.
Election and Covenant
Authors: Smith Anthony D
Published: November 2023

Whence comes the myth of the sacred communion of the people, and of the essential goodness of the authentic nation? The first place where one might look for an answer would be the ideal of fraternity proclaimed, along with those of liberty and equality, in the French Revolution. Here there seems to be a novel vision of the nation, one in which its collective will stands above and apart from individual interests and purposes, and which, because of the nation’s general and disinterested nature, commands the assent of its citizens. Beneath the factions, parties, and selfish interests, we can discern the rhythms and contours of a pure and authentic community that is the original and undying nation. As the Abbe Sieyes put it in Nations on earth must be conceived as individuals outside the social bond, or as is said, in the state of nature. The exercise of their will is free and independent of all civil forms. Existing only in the natural order, their will, to have its full effect, only needs to possess the naturalcharacteristics of a will. (cited in Cobban 1963: i. 165, emphasis in original)Undoubtedly, in the form in which it is stated, this vision of the essential nature of the nation was most clearly and boldly enunciated
Introduction
Authors: Rachels James
Published: November 2023

DARWIN wrote these words in 1838, twenty-one years before he was to publish The Origin of Species. He would go on to support this idea with overwhelming evidence, and in doing so he would bring about a profound change in our conception of ourselves. After Darwin, we can no longer think of ourselves as occupying a special place in creation—instead, we must realize that we are products of the same evolutionary forces, working blindly and without purpose, that shaped the rest of the animal kingdom. And this, it is commonly said, has deep philosophical significance.

The religious implications of Darwinism are often discussed. From the outset, churchmen have worried that evolution is incompatible with religion. Whether their concern is justified is still debated, and I will have a good bit to say about this. But Darwinism also poses a problem for traditional morality. Traditional morality, no less than traditional religion, assumes that man is ‘a great work’. It grants to humans a moral status superior to that of any other creatures on earth. It regards human life, and only human life, as sacred, and it takes the love of mankind as its first and noblest virtue. What becomes of all this, if man is but a modified ape?
Health economics research in developing countries: an overview
Authors: Lee Kenneth , Mills Anne , Hoare Geoffrey
Published: November 2023

Those responsible for the planning, delivery, and evaluation of health and health-related services increasingly recognize that systematic approaches are necessary, in the face of limited and often shrinking resources for health, to make the inevitable difficult choices. In the developing world, this recognition has been longer established than elsewhere, and sharpened by recent and continuing economic difficulties. Economics, which is concerned with issues of choice related to production, exchange, and consumption, provides a ready vehicle for the consideration of how best to use scarce resources for the production of health. Certainly, the potential contribution that techniques of economic analysis can bring to the improvement of health is being given much attention, and rightly so
Total sales of tobacco products, 1870-1989
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

The use of tobacco spread from America to other countries during the sixteenth century. The first factories making cigarettes by machine were set up in Havana in 1853, in London in 1856, and in the USA in 1872. However, during the nineteenth century, tobacco for pipes and chewing, and tobacco for cigars and snuff, accounted for virtually all the tobacco sold. From 1895 sales of manufactured cigarettes increased rapidly, so that by 1919 they comprised more sales by weight than all other forms of tobacco combined. Filter cigarettes, although available from the 1930s, did not become popular until the 1960s when they quickly replaced plain cigarettes. Hand-rolled cigarettes have accounted for only about 6 per cent of total annual cigarette sales by weight during the last 30 years.
Consumption of tobacco products per person and per smoker, 1870-1988
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

As TAC data have not been provided after 1987 and the GHS does not collect data on the annual weight of tobacco consumed, these data will not be available in the future unless steps are taken to obtain the information. If they are not it will represent an important gap in our knowledge of national smoking habits.
Manufactured cigarettes: trends in type and yields, market shares
Authors: Wald Nicholas , Nicolaides-Bouman Ans
Published: November 2023

The first major change to occur in the type of manufactured cigarettes was the switch from plain to filter cigarettes, which began in the 1950s, gathered momentum in the 1960s, and has continued to the present. The original filter cigarettes were unventilated (without perforations in the tip), and these still account for the majority of the filter market. During the 1970s, ventilated filters (with perforations in the tip) were introduced. The subsequent rise in the market share of ventilated filter cigarettes was due both to the introduction of new ventilated brands, and to the change of some existing brands from unventilated to ventilated filters. By 1988 the market shares of unventilated filter, ventilated filter, and plain cigarettes were estimated to be 52, 46, and 2 per cent respectively.
Measurements in the environment
Authors: Armstrong Bruce k. , White Emily , Saracci Rodolfo
Published: November 2023

Environmental agents include physical, chemical, and biological components or contaminants of the general environment (soil, air, water), the local environment (home, workplace, recreational sites), or the personal environment (food, drinks, cosmetics, drugs). Frequently, exposure to these agents is unknown or unsensed by the exposed individual. Under these circumstances, the exposure as such cannot be recalled or recorded by the study subject, so it can only be documented through measurements in the environment. In other circumstances measurements in the environment represent an alternative or a complementary approach to questioning the subject.
The results of evaluation
Authors: Cumper George E
Published: November 2023

It is axiomatic that the results of the evaluation of a national health system are to be measured not in terms of the document it produces, but in terms of the favourable changes it generates in health, and particularly in health care. If this is a falsehood, it is one which no one in the field of health planning and administration dares to contradict. Yet experience suggests that this generalization is eminently contradictable. The shelves of health ministries and of international agencies are well provided with evaluation reports which have not led to change (at least directly). Evidently getting implemented the suggestions for change which arise from evaluation is not the easiest part of the evaluator’s task. This is the kind of difficulty with which this chapter mainly deals. But it will also be suggested that a national evaluation which leads immediately to no traceable change is not entirely wasted.
Searching for Causes of Work-Related Diseases
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel
Published: November 2023

This book is an introductory text for those people who need to know more about the scientific principles behind the study of the causes of disease occurence. As most people spend a large part of their lives at work, and as some people may be at risk of being exposed to harmful substances at high levels, workers protection should have a high priority. Studies in the workplace can help to identify causes of occupational diseases, and the outcome of such investigations should be applied when the effects of protective action are evaluated. In searching for occupational causes of diseases, epidemiological principles should be used, even at the factory level. Applying strict logical principles to the collection of data concerning worker's experience with ill-health ensures that a useful insight is gained into the causes of disease, and that data are obtained in a format suitable for subsequent larger-scale studies.
Case study of infertility in males
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel
Published: November 2023

In 1977 a chemical factory manufactured fertilizers and pesticides for agricultural and household use. In the latter process, workers mixed, diluted, and repacked technical-grade pesticides obtained from chemical manufacturers. Some 100 different chemicals were used in the formulation of approximately 200 different products, including organophosphorus compounds, halogenated hydrocarbons and carbamates. Since 1962 the company had established a special Agricultural Chemical Division with 39 employees: three supervisors, 24 production workers, four maintenance mechanics, two clerks, and six laboratory workers. Thirty-six of the group were men. exposed workers was compared with unexposed. The cohort of exposed workers was identified as far back in time as possible according to available records. Such studies are often referred to as historical or retrospective follow-up studies. Non-respondents are frequent in many epidemiological studies including the present one where only 142.
Lung cancer mortality among workers exposed to chromate pigments
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel
Published: November 2023

Workers involved in the manufacture of zinc and lead chromate pigments drew the attention of the occupational physician to several fatal cases of lung cancer among their co-workers. The occupational physician in charge of this small plant (92 workers) first noted that all the cases were smokers and considered that the condition was not related to occupation. In 1974 two new cases and in 1976 a third one changed that point of view and the physician decided to consult the Institute of Occupational Medicine to set up a study to determine if an occupational hazard was involved. All 251 workers who had worked for six months or more in the plant between 1958 and 1978 were included in the study. Occurrence and dates of death were obtained from the plant or death registers or both. Causes of death could not be obtained from death certificates in the country where the study was conducted and were therefore obtained from families, physicians, hospitals, or pathologists.
Geographical variation
Authors: Little Julian , Elwood Mark
Published: November 2023

The ascertainment of neural tube defects has been discussed in Chapter 3; some of the major conclusions are reviewed here. Anencephalus is a gross malformation, obvious to simple inspection, and is incompatible with survival beyond a few hours or days. Therefore its recording in hospital records, birth records, or death and stillbirth certificates will be reasonably accurate. Such equivalence will not hold for spina bifida or any other major defect. Data on anencephalus may be inaccurate because of variations in terminology, particularly in earlier periods; examples of death certificates coded as Ȉmonstrosityȉ which in turn was usually counted as anencephalus, were given by Elwood J.M. and Elwood J. H. (1980, p. 77). However, data based on livebirths alone, excluding stillbirths, will be grossly inaccurate; in Canada it was shown that the proportion of cases of anencephalus classified as stillbirths has varied greatly over time, and so data on time trends based only on livebirths are misleading (Elwood J.M. and Elwood J. H. 1980, p. 76). Mortality data thus give a good measure of the frequency of anencephalus in births and stillbirths, but do not, of course, include earlier abortuses. Special recording systems are needed to include induced abortions, and the frequency in earlier pregnancy is discussed further in the section on fetal loss. In more recent years, the frequency of antenatal diagnosis and induced abortion has had a large effect on the frequency at birth.
Distribution by sex
Authors: Elwood Mark , Little Julian
Published: November 2023

In most communities, anencephalus and spina bifida are seen more frequently in females than in males. The possibility that this female excess is attributable to a phenotypic feature of the malformations themselves has been considered, but chromosomal studies have confirmed that phenotypically female anencephalics are genotypically female (Polani 1959; Polani and Claireaux 1957; Nakano 1973). Sex distribution may be presented as the sex ratio, namely the ratio of the numbers of male to female cases, or as the proportion of all cases which are male or female. A proportion is simpler to handle statistically than a ratio and so we have expressed sex distribution as the ‘male proportion’, or the male percentage.
Associations between neural tube defects and multiple pregnancy
Authors: Little Julian , Elwood Mark
Published: November 2023

Associations between twinning and neural tube defects may provide clues to the aetiology of these defects. Two general issues can be raised. If neural tube defects were of predominantly genetic aetiology, monozygotic (MZ) twins would be expected to be concordant for the defects more frequently than dizygotic (DZ) twins, because of their greater genetic similarity. If neural tube defects were caused by an abnormal intrauterine environment, it would be expected that if one member of a dizygotic (DZ) twin pair were affected, the other would be affected more often than a non-twin sibling because of the common environment.
Genetic models
Authors: Little Julian , Nevin Norman
Published: November 2023

Certain features of the epidemiology of neural tube defects are consistent with a genetic component in their aetiology. First, concordance rates for neural tube defects are significantly higher in twin pairs of like sex than in twin pairs of unlike sex (Chapter 11). Thus, it is likely that monozygotic twins are concordant for these defects more frequently than dizygotic twins, indicating a genetic component to the aetiology. However, possible associations between zygosity, sex type and intrauterine survival make this conclusion tentative. Second, the increased risk among siblings, the offspring of parents with spina bifida and among half siblings (Chapter 16), is also consistent with a genetic component. Although familial aggregation of disease could be due to shared environmental factors, Khoury et al. (1988) have shown that even with a complete correlation in exposure among siblings, environmental risk factors associated with relative risks of less than ten, as is the case for all risk factors for neural tube defects, lead to an increase of risk in siblings of the order of twice that in the general population. Under a purely environmental model, the 2-5 per cent observed sibling and recurrence risk for neural tube defects could only be explained by a teratogen which increased risk approximately one-hundredfold and which exhibited a considerable degree of familial aggregation. Such a teratogen has not been identified, so a genetic component in the aetiology of these defects may be inferred. We review studies of the possible modes of inheritance of neural tube defects.
Effects of cigarette smoking on ‘hormone-related’ diseases in a Southern California retirement community
Authors: Ross Ronald K , Bernstein Leslie , Paganini-Hill Annlia , Henderson Brian E
Published: November 2023

The associations of cigarette smoking with several sex-hormone related disorders were investigated in a cohort study conducted in a large retirement community near Los Angeles, California. Post-menopausal women who smoked cigarettes had a lowered risk of endometrial cancer, especially when smoking at the time of last menstrual period was considered. There was no relationship between smoking and breast cancer but smokers had an increased risk of hip fracture. In men the data suggested a weak link between smoking and prostatic hyperplasia requiring surgical treatment and cancer of the prostrate, although there was no consistent relationship with amount smoked or duration of smoking.
Smoking and Parkinson’s disease
Authors: Marmot Michael
Published: November 2023

Parkinson ‘s disease is a degenerative disorder of the substantianigra characterized by a dramatic improvement after treatment with the dopamine precursor L-dopa. Cigarette smoking is inversely related to the risk of Parkinson ‘s disease, and this appears to be a genuine protective effect. If smoking is, in fact, protective of Parkinson ‘s disease then one would expect not only that patients with Parkinson ‘s disease would be less likely to be smokers but also that they would have a lower risk of smoking-related cancers, which indeed they do.
Increased oxidative metabolism of oestrogens in male and female smokers
Authors: Michnovicz Jon J , Fishman Jack
Published: November 2023

The metabolism of oestradiol in humans is principally oxidative, and involves two competing pathways, C-2 and C-16a hydroxylation. Oestradiol 2-hydroxylation generates peripherally inactive catechol oestrogens, and increased activity of this enzyme in smokers could contribute to a hypo-oestrogenic state. Using an in-vivo radiometric technique cigarette smoking in both men and women has been found to be associated with significant induction of 2-hydroxylation, and no change in l 6a-hydroxylation. Increased 2-hydroxylation measured radiometrically is accompanied by enhanced urinary excretion of 2-hydroxyoestrone, the end product of the enzyme reaction. The ratio of urinary 2-hydroxyoestrone to oestriol ([20HEY[E3]) is roughly proportional to the increase in 2-hydroxylation. Furthermore, elevated 2-hydroxylation increases gradually with greater levels of smoke exposure, as judged by serum cotinine levels, suggesting that even breathing other people ‘s smoke may be sufficient, in some individuals, to alter oestrogen metabolism. These studies shed light on the environmental factors capable of modulating hormone metabolism, and may help in developing strategies to reduce the risk/or oestrogen-dependent diseases in humans.
Analysing Health Systems
Authors: Ellencweig Avi Yacar
Published: November 2023

This book explores the methods and approach necessary to investigate the setting up and running of a health system. It will enable the reader to begin to investigate his own health system, and compare and contrast it with other systems. The continual monitoring of change allows for the detection and identification of longitudinal trends within and across systems, and evolution in systems can then occur. Looking at systems can furnish alternative ideas, and help to establish new models of care. The book presents a modular approach to analysing health care systems, and the author explains how this can be put to practical use. Topics are discussed at both conceptual and operational levels, and methods of applying the approach are outlined. Case histories illustrate the use of the modular approach in `real life' situations. An appendix of terms and concepts is provided to facilitate use.
Assessment of needs—population needs and their measurement
Authors: Ellencweig Avi Y Acar
Published: November 2023

To analyse the process of health care requires that we consider the recipients of health care. The needs of these recipients are likely to be presented in the form of health needs. Their needs can then be translated into the demand for health services. Needs can be regarded as the ‘difference between observed and ideal levels of health’ (Kalimo 1979, p. 64). Need is thus an egalitarian concept because it reflects what is desirable, while demand for health care is a libertarian concept because ‘liberty is seldom equally divided’ (Boulding 1966).
Preparation for the process— analysis of health care organization
Authors: Ellencweig Avi Yacar
Published: November 2023

The organization of health care systems is a crucial element in our analysis. Unfortunately, studying complex organizational patterns is also complex, often cumbersome, and sometimes ambiguous. Because of this complexity, the analysis requires a step-by-step consideration of several organizational dimensions.
Occupational Health in Developing Countries
Authors: Jeyaratnam J
Published: November 2023

This book discusses the occupational health concerns of countries with minimal resources. Extensive industrial and agricultural growth is taking place in many of these countries, resulting in an urgent need for the provision of appropriate and accessible health care to the working population. The contributors are international experts in occupational health.
Preventive behaviour: a closer look
Authors: Cohen David R , Henderson John B
Published: November 2023

Price, income, and advertising are all factors which are expected to alter the demand for any good be it preventive, hazardous, or neutral in terms of its effect on health. Thus there is no reason why the demand for screening cannot be analysed in the same framework as the demand for shoes, as was seen in the previous chapter. Estimates of the price, income, and advertising elasticities of demand for screening are valuable pieces of information.
Community-based health programmes in Indonesia: the challenge of supporting a national expansion
Authors: Berman Peter
Published: November 2023

It is now well over a decade since Indonesia launched its first official, government-sponsored community health worker (CHW) scheme. Although Indonesia’s efforts violate most of the conventional wisdom on CHW programmes, they comprise one of the largest and longest running efforts in the world. In the last 12 years, hundreds of thousands, some estimate millions, of community health, nutrition, and family-planning workers have been trained. Most of these citizens work as volunteers, receiving no monetary compensation and often no compensation at all. They provide or participate in a fairly comprehensive package of basic services, yet they receive a bare minimum of training, preparation, and support for their tasks. In a public health system characterized by fairly low cost-efficiency, they are one of the most cost-efficient components. There are major doubts about their efficacy, but few observers feel they make no contribution to health improvement.
France
Authors: Lachaud Claire , Rochaix Lise
Published: November 2023

The French health care system was established in 1945 with the clear objective of guaranteeing health for all. Equality of access was therefore a founding principle, but so was the rather more individualistic principle of autonomy of the consumer—freedom of choice. The result is a rather hybrid system which attempts to reconcile solidarity and liberalism through collective financing, coupled with the coexistence of a public and a private sector for the delivery of health care.
Ireland
Authors: Nolan Brian
Published: November 2023

This chapter presents the results of an analysis of equity in the financing and delivery of health care in Ireland, applying the methodology developed in the course of the COMAC-HSR project. The data on which the paper is based come from two large-scale surveys: the Household Budget Survey, carried out by the Irish Central Statistics Office in 1987 (for the financing side), and the Survey of Income Distribution, Poverty and Usage of State Services carried out by The Economic and Social Research Institute in the same year (for the delivery side). The results from an equity perspective presented here can be placed in the context of the Irish health services utilization and financing patterns analysed in detail in Nolan (1991).
Surgical wounds
Authors: Leaper D J , Gottrup F
Published: November 2023

A wound may be defined as the loss of continuity of epithelium, with or without loss of underlying connective tis sue (including muscle, bone, and nerves for example), following injury. The injury may follow direct violence or be inflicted by a non-mechanical injury-which may also be re sponsible for delay in healing. Their may be extensive tissue damage (e.g., contusion or haematoma) with minimal tissue loss.
Authority, hierarchy, and work levels
Authors: Collins Charles
Published: November 2023

So far the analysis has developed agendas for the effective formulation and implementation of decentralization and intersectoral coordination. Attention should now focus on a number of key organizational issues dealing with the internal authority and hierarchy within the ministry of health. All managers working in government health services have to work within hierarchies and forms of authority. The manner in which they are designed can have an important impact on the manager’s effectiveness. Our tasks in this chapter are to look at the following questions.
The Strategy of Preventive Medicine
Authors: Rose Geoffrey
Published: November 2023

This is the central theme of Professor Rose's personal and unique book, in which he presents his ideas drawn from many year of work on preventive medicine strategies. Now in available in paperback, he explores the options for prevention, considering them from various view points - theoretical and scientific, sociological and poitical, practical and ethical. He contrasts the individual and population based strategies for prevention, and offers the concept of health as an issue for populations and not just for individuals. The applications of his ideas are illustrated by a variety of examples ranging from heart disease to alcoholism and roa accidents. Professor Rose, who has pioneered thinking on preventive medicine, hbas written an accessible book which will appeal to a wide range of readers, including clinicians, epidemiologists, public health workers, health service managers, and anyone who is concerned with the wider public issues of health.
What needs to be prevented?
Authors: Rose Geoffrey
Published: November 2023

Those who seek to remedy the world’s ills like to see situations in clear and dichotomous terms: doctors categorize people as sick or healthy, social reformers and politicians focus their concerns on definable minorities and discrete problem areas, moralists identify choices as black or white, evangelists see a world made up of the converted and the heathen, and so on. Any alternative creates indecision and uncertainty. Concern for sick individuals has led to an attractively simple approach to preventive medicine. We wish to reduce the number of sick individuals, who form a clearly definable minority; by implication the majority of the population is normal and should therefore be left in peace. This approach rests on the traditional principle of medical diagnosis which assumes that, with respect to each disease, the world falls into just two classes, namely those who have it and those who do not. Thus if a patient comes to clinic complaining of pain in the belly, the doctor must consider a series of possible diagnoses (peptic ulcer, gastric cancer, gallstones, and so on), and for each there must be a simple judgment, ‘yes’ or ‘no’, implying that each condition is either present or absent. This is the diagnostic process.
The population strategy of prevention
Authors: Rose Geoffrey
Published: November 2023

The high-risk preventive strategy (Chapter 4) is a targeted rescue operation for vulnerable individuals. If a problem is confined to an identifiable minority and if it can be successfully controlled in isolation, then this approach is adequate (although it will need to be maintained for as long as its causes persist), but it is an inadequate response to a common disease or a widespread cause. Mass diseases and mass exposures require mass remedies. A targeted approach may assist but it cannot be sufficient. The population strategy of prevention starts with the recognition that the occurrence of common diseases and expostures reflects the behavior and circumstances of society as a whole. This recognition rests on sociological, moral, and medical grounds.
Concepts, theories, and terminology
Authors: Sharpe Michael , Mayou Richard , Bass Christopher
Published: November 2023

In this chapter we review the conceptual issues encountered in a discussion of functional symptoms and briefly review the main theoretical standpoints from which functional somatic symptoms have been viewed. We conclude that there is a need for a comprehensive perspective which goes beyond any particular specialist standpoint and which recognizes the common factors underlying the various theoretical approaches.
Cognitive behavioural therapies in the treatment of functional somatic symptoms
Authors: Sharpe Michael
Published: November 2023

In this introductory chapter, Dr Sharpe outlines the historical development of cognitive and behavioural treatment and then discusses the cognitive behavioural model of aetiology. He applies this model to the understanding of functional somatic symptoms and discusses the efficacy of this approach. He concludes with practical guidelines for the treatment of patients with functional somatic symptoms using cognitive behavioural psychotherapy.
Treatment of functional somatic symptoms: psychodynamic treatment
Authors: Guthrie Elspeth
Published: November 2023

In this chapter, Dr Guthrie points out that there are many differences between patients with functional somatic symptoms and those who are usually accepted for psychotherapy in the National Health Service. Although patients with functional somatic symptoms are neither actively seeking psychological help nor psychologically minded, it is often possible to engage them in treatment.
Chest pain and palpitations
Authors: Bass Christopher , Mayou Richard
Published: November 2023

In this chapter Drs Bass and Mayou draw attention to the high prevalence of com plaints of non-cardiac chest pain and benign palpitations in different medical set tings. They also point out the important covariation between these symptoms and other functional complaints and describe the poor outcome in terms of continued symptoms and disability. The contribution of pathological, physiological, and psychological factors to aetiology is reviewed. Emotional disorders (especially symptoms of anxiety and panic) occur in a proportion of patients but many have no conspicuous psychiatric morbidity.
A worldwide overview: the epidemiology of HLA-B27 and associated spondyloarthritides
Authors: Khan Muhammad Asim
Published: November 2023

The discovery of a remarkable association between HLA-B27 and ankylosing spondylitis (AS) and related disorders a quarter of a century ago helped to revitalize interest in the clinical features, pathogenesis, and genetic epidemiology of these disorders, and also broadened our understanding of their clinical spectrum (Khan and van der Linden 1990b, 1990c). The concept of spondyloarthropathies no longer necessarily implies the presence of sacroiliitis or spondylitis, but rather a spectrum that may start with features such as enthesitis, dactylitis, or oligoarthritis on the one hand, and sacroiliitis and spondylitis on the other, that may also be accompanied by certain extra-articular features, including acute anterior uveitis or mucocutaneous lesions.
The bowel and spondylarthritis: a clinical approach
Authors: Mielants H , Veys E M
Published: November 2023

The close relationship between the bowel and the locomotor system (peripheral joints, enthesis, sacroiliac joints, and axial skeleton) is suggested by many clinical observations and several experimental animal models. Gastrointestinal abnormalities can be present in several rheumatological diseases. Among the inflammatory connective tissue diseases, these are largely restricted to scleroderma. In most other rheumatic diseases (for example, rheumatoid arthritis, polyarteritis nodosa, systemic lupus erythematosus, Henoch-Schi:inlein purpura) the intestinal manifestations are either restricted to a systemic arteritis involving intestinal blood vessels or related to drug toxicity.
Animal models of the spondyloarthropathies
Authors: Taurog Joel D
Published: November 2023

The study of the pathogenesis, treatment, and prevention of human disease is invaluably aided by animal models. Animal models of human disease have traditionally been divided operationally into two groups, those occurring spontaneously and those requiring experimental induction. However, diseases occurring in genetically manipulated animals, for example transgenic or ‘gene knockout’ animals, can logically be considered in either of these categories. Ultimately, classification is less important that the utility a particular type of animal or experimental system provides in understanding important aspects of human disease.
Ankylosing spondylitis-the patient’s point of view
Authors: Rogers Fergus J
Published: November 2023

Ankylosing spondylitis (AS) is such a variable condition that every patient’s experience is different. The first major problem encountered by patients worldwide is misdiagnosis. For the young spondylitic patient with a recent disease onset this can become a lonely, painful, and humiliating experience: an ideal sequence of events would be the following: Upon diagnosis the patient is given only a brief description of the disorder, most of which is rapidly forgotten. The primary physician knows little about the condition and either cannot give advice or gives inappropriate advice. This leads some patients to suspect that the doctor is withholding information to protect them against knowledge of an appalling prognosis. The patient is not referred to a patient organization.
Cranial nerves
Authors: Baraitser Michael
Published: November 2023

This syndrome is also called anosmia with hypogonadotropic hypogonadism. The anosmia is due to an agenesis of the olfactory lobes. Cleft lip and palate might be part of the syndrome. Renal agenesis should be sought. A large number of those with the condition are obese. Congenital mirror movements are an interesting associated feature, which points towards a disorder of neuronal outgrowth in the motor system, particularly of the inhibitory callosal fibres (Danek et al.,1992).
Spinal malformations
Authors: Baraitser Michael
Published: November 2023

Five kindred have been described with well-documented syringomyelia, and there have been both recessive and dominant modes of inheritance described (Bentley et al., 1975; Busis and Hochberg, 1985; Colombo and Cislaghi, 1993). The main problem seems to be the possible variable expression of the gene involved, resulting, at one end of the spectrum in syringomyelia with or without syringobulbia, and at the other end, in minor radiological abnormalities such as occipital dysplasia, basilar impression, or Amold-Chiari malformation type I. Patients with syringomyelia might have bulbar weakness, upper limb weakness, and pyramidal tract involvement in the lower limbs. There is mostly a dissociated sensory loss—see also Chiari malformation, below.
Cortical dysplasias
Authors: Baraitser Michael
Published: November 2023

Classification based on Dobyns and Truwit (1995). Lissencephaly (agyria/pachygyria diffuse with abnormally thick cortex and only four layers). Also called lissencephaly type 1: classical: Miller-Dieker syndrome; Lissencephaly sequence; lissencephaly with very small head including a small cerebellum; Cobblestone lissencephaly or lissencephaly type II (a mixture of agyria, pachygyria and polymicrogyria, enlarged ventricles, small brainstem, cerebellun, especially vermis and cerebellar polymicrogyria): Hydrocephalus, agyria, retinal dysplasia (HARD) (seep. 56); the congenital muscular dystrophies (seep. 218);
Craniosynostosis
Authors: Baraitser Michael
Published: November 2023

The previous classification dividing the craniosynostoses into acrocephalysyndactyly and acrocephalypolysyndactyly is no longer useful. The same is probably true for the subdivisions into type I, III, etc. The gene and mutations in the FGFR2 gene have been identified in Apert’s syndrome but the diagnosis is clinically straightforward and gene mutation analysis is not needed for diagnostic purposis. Prenatal diagnosis for the offspring of those who are affected is usually possible given the severe hand and foot syndactyly and ultrasonography is probably all that is needed.
Cerebellar ataxia
Authors: Baraitser Michael
Published: November 2023

Major inroads have now been made by molecular geneticists into the differentiation of the many syndromes of cerebellar ataxia. In general, it is still useful to use age of onset and associated features as a starting point. Congenital onset: cerebellar hypoplasia recessive; cerebellar hypoplasia dominant; cerebellar hypoplasia affecting the granular layer; carbohydrate-deficient glycoprotein syndrome; pontoneocerebellar hypoplasia; Congenital onset affecting especially the vermis: Joubert’s syndrome;
Pyramidal tract disorders
Authors: Baraitser Michael
Published: November 2023

Pure X-linked spastic paraplegia, MASA, and X-linked hydrocephalus due to an acqueduct stenosis, seem to be the result of the mutations of the same gene called Li-CAM. The same mutation in a single family can result in different phenotypes. There are metabolic conditions which must be excluded, especially in single cases. Adrenoleukodystrophy and arginase deficiency are two such conditions.
Metabolic disorders/degenerative diseases of childhood
Authors: Baraitser Michael
Published: November 2023

Synonyms: (Pomes’ disease: Acid maltase deficiency—infantile

Abstract: This condition might initially be diagnosed as Werdnig-Hoffmann disease as the infants are floppy, weak, and areflexic. Unlike Spinal muscular atrophy, type I SMA/1 there might be joint contractures and the muscles appear on palpation to be firm and hypertrophied. Fasciculations might be seen, and swallowing and sucking is usually poor. The heart is enlarged, the myocardium is thick, and the ECG will show giant QRS complexes. Death occurs within the first few years of life.
The Management of Head Injuries
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

Head injuries are commonplace. Though most patients survive, the consequences, both physical and social, can be devastating. The methods of initial assessment and management can have a crucial effect on determining the outcome of the injury, and long-term effects. Only a minority of head-injured patients, however, are cared for by Neurosurgeons. The majority are seen by non-specialists, often junior doctors and nurses, and treated in district hospitals where specialist neurosurgical assistance is unavailable. As a guide for doctors and nurses working in the A & E department, or the Orthopaedic or General Surgical Ward, the emphasis of this book is on the early management of the head-injured patient. New to the second edition are chapters on managing the ‘disturbed’ head injured patient, a chapter of special value to nurses (who often have to deal with this difficult task). A new chapter on anaesthesia and head injuries has also been added, with other chapters significantly revised to reflect the crucial role played by anaesthetists in head injury management. Providing practical advice on the early treatment of minor head injuries, and the management of major head injuries, the book provides advice that will be essential in ensuring effective treatment of these patients.
Limiting violence through good design
Authors: Francis Susan
Published: November 2023

The relationship between space and human behaviour is an issue that has been explored in various disciplines over time. Whilst now widely accepted that there is a relationship between them, the extent to which the environment can actually deter mine behaviour is more debatable. Some have tried to link environment and behav iour in a determinstic way, suggesting that physical space can direct behaviour. Many people acknowledge that the design of the environment can influence how people react and how they feel. Indeed, it can support certain work patterns and make others more difficult to achieve. So, the idea that the environment can play a part in limiting violence has currency both in literature and practice.
Attacks on doctors and nurses
Authors: Cembrowicz Stefan , Ritter Sue , Wright Steve
Published: November 2023

Violence in the UK is widespread. A rate of 667 violent offences per 100 000 population was recorded by police in England and Wales in 1997 (Home Office 1998). The British Crime Survey (BCS) found that just over 5% of survey respondents had been victims of violent crime in the previous year (Mirlees-Black et al. 1996). Both of these figures are likely to under-represent the true prevalence of violence. Violence is clearly a major public health problem (Golding 1996; Shepherd and Farrington 1993), and health-service workers are not immune.
Genetics of Stone Forming Diseases
Authors: Strazzullo Pasquale , Vuotto Pietro
Published: November 2023

Nephrolithiasis is a common and heterogeneous disease manifesting itself most commonly during middle age (Preminger 1992). In particular, calcium nephrolithiasis is a health problem and a source of disability in all affluent countries with a reported prevalence between 4 and 10 per cent (Smith 1989).
Economic Evaluation in Health Care
Authors: Drummond Michael , McGuire Alistair
Published: November 2023

To accompany the hugely sccessful Methods for Economic Evaluation of Health Care Programmes 2e, this book is a thorough and rigorous discussion of the methodological principles and recent advances in the rapidly advancing field of theory and practice of economic evaluation in health care. Written by an internationally acclaimed group of authors, the book provides an in-depth discussion of the latest theoretical advances and gives comprehensive reviews of the available literature. The book covers the main areas of economic evaluation, including the methods for measuring costs and outcomes, the collection of data alongside clinical studies, ways of handling uncertainty, discounting and issues relating to the transferability of economic data.
Output measures and valuation in health
Authors: Dolan Paul
Published: November 2023

In all countries throughout the world, there is a considerable degree of government involvement in the market for health care. If governments are going to deploy the resources at their disposal where they will be of greatest benefit, then information on the benefits associated with alternative allocations is required. This raises questions about how benefit is to be defined and measured and how it is to be allocated amongst the population. This chapter addresses these questions from a normative perspective. That is, it is concerned with how health outcomes ought to be measured and with how benefits ought be weighted according to who receives them.
Costing in economic evaluations
Authors: Brouwer Werner , Rutten Frans , Koopmanschap Marc
Published: November 2023

In this chapter the methods related to costing in economic evaluation are discussed. Costing involves identifying, measuring and valuing all resource changes that occur as a certain health care intervention is carried out. The aim is to value the use of scarce resources (materials, drugs, time of physicians, time of patients etc.) that is needed to produce a certain health effect - the outcome of the intervention. Then, we may be able to weigh the sacrifices against the gains of the intervention and thus determine the relative desirability of such an intervention. In Figure 4.1 we indicate which resource uses may in general be distinguished and need to be identified, estimated in quantitative terms and valued monetarily.
Roles of parathyroid hormone-related peptide and the PTH/PTHrP receptor in skeletal development: implications for growth in children with end-stage renal disease
Authors: Jü Harald , Segre Gino V
Published: November 2023

The actions of two distinct peptides, parathyroid hormone (PTH) and PTH-related peptide (PTHrP), are mediated through the PTH/PTHrP receptor (also referred to as PTH1R), a G protein-coupled receptor which signals through at least two different second messenger pathways, adenylate cyclase (AC)/protein kinase A (PKA) and phospholipase C (PLC)/protein kinase C (PKC).1–3 The PTH/PTHrP receptor is most abundantly expressed in kidney, bone, and the metaphyseal growth plate cartilage, and it is thus likely to have a central role in numerous biological actions.4–6 In kidney and bone, the PTH/PTHrP receptor mediates the endocrine actions of PTH, thus enhancing the tubular reabsorption of calcium, promoting the renal excretion of phosphate, and mobilizing calcium (and phosphate) from bone. Together with 1,25(OH)2 vitamin D3 (1,25(OH)2D3), whose production it regulates, PTH is therefore the most important physiological regulator of calcium and phosphorus homeostasis.
Abnormal PTH synthesis, secretion, and metabolism; pathological parathyroid cell growth and apoptosis in chronic renal failure
Authors: Rodriguez Mariano , Drüeke Tilman B
Published: November 2023

Serum calcium and 1,25(OH)2 vitamin D3 (calcitriol) have long been recognized as important regulators of parathyroid cell function. They act by binding to specific receptors, namely the calcium-sensing receptor (CaR) and the vitamin D receptor (VDR) which are expressed abundantly in the parathyroid cell. More recent work has revealed that extracellular phosphate is another element which directly affects parathyroid function. Alterations in the metabolism of calcitriol, calcium, and phosphate may lead to abnormalities in parathyroid cell function.