bluuebunny/crossref_metadata_2025 huggingface dataset:
A Formal Exchange Reaction between Ketones and Vinyl Ethers with Solid Catalysts
Authors: Oliver-Meseguer Judit , Leyva-Pérez Antonio , Mingueza-Verdejo Paloma , Cerón-Carrasco Jose Pedro
Published: November 2023

The formal exchange of functional groups in internal positions of two different molecules is of interest in synthetic chemistry, as a simple retrosynthetic strategy. Here the formal exchange reaction between internal α-methylene ketones and vinyl ethers, retaining the original C–O bonds is presented. This process offers a new route for the synthesis of vinyl ethers in one step from ketones, including 1,3-diketones, under mild reaction conditions. Besides, the reaction is catalyzed by reusable cheap solids and can be carried out in flow for 20 days without signs of catalyst depletion. Combined experimental and computational mechanistic studies unveil the key role of carbonyl–enol equilibria.
Unawareness of Primary Aldosteronism as a Common Cause of Hypokalemia
– Insights from the IPAHK+ Trial (Incidence of
Primary Aldosteronism in Patients with Hypokalemia)
Authors: Gruber Sven , Stasi Evangelia , Pion Antonio Boan , Steiner Regula , Erlic Zoran , Bornstein Stefan R. , Sudano Isabella , Reincke Martin , Beuschlein Felix
Published: November 2023

Hypokalemia plays an important role in the diagnosis and management of primary
aldosteronism (PA). While the hypokalemic variant of the disease accounts for
about one third of all cases, little is known about the incidence of PA in
hypokalemic populations. The IPAHK+ study is an epidemiological,
cross-sectional trial to provide evidence on the incidence of PA in hypokalemic
patients from a university hospital outpatient population. Recruitment of
outpatients with hypokalemia≤3 mmol/l is carried out on
a continuous referral-basis through an automated data delivery system. Up to an
interim data closure, 66 patients underwent the study protocol. The mean age of
the participants was 52.9±1.5 years with an equal sex ratio of 1:1 women
to men, a mean potassium value of 2.78±0.31 mmol/l
[1.8;3.0] and a prevalence of arterial hypertension of 72.7%. PA was
diagnosed in 46.6% of all participants, all of whom had a history of
hypertension. Incidence of PA increased continuously with decreasing potassium
levels with proportions of 26.7%, 50% and 57.1% in the
subgroups of 3.0 mmol/l (n=15),
2.8–2.9 mmol/l (n=22)
and≤2.7 mmol/l (n=21), respectively. Prior to
testing, 59.1% of all patients presented at least with one plausible
other cause of hypokalemia. The incidence of PA in the investigated outpatient
population was more than 4 out of 10 and inversely correlated with baseline
potassium levels. Moderate or severe hypokalemia, regardless of its cause,
should therefore prompt evaluation for PA in hypertensive individuals.
Normotensive hypokalemic PA was not observed in this cohort.
Low-Cost, Durable Sheepskin Uterine Model for Obstetric Hemorrhage Emergency Simulation
Authors: Lunardhi Alicia , Stohl Hindi Elaine , Betson Lance , Saad Christina
Published: November 2023

Objective Postpartum hemorrhage is a common obstetrical emergency. Because the majority of cases respond to conservative medical therapies, trainees have limited clinical experience with hemostatic sutures or placement of a Bakri intrauterine balloon for refractory postpartum hemorrhage. Simulations provide an invaluable adjunct to resident education to learn and practice these hemostatic techniques. We aimed to create a low-cost, reproducible simulation model to prepare residents for uterine atony interventions such as B-Lynch, Bakri balloon placement, and uterine artery ligation.

Study Design Using low-cost supplies, a reusable, life-sized recent postpartum uterus was constructed from pieces of sheepskin and sewn together with various expired suture. The sheepskin material allowed for repeated, secure placement of B-Lynch and O'Leary sutures and Bakri balloons, as well as offering the required compressibility to simulate a boggy uterus. Finally, sections of a red robin catheter were incorporated along the lateral lower borders of the model to simulate blood vessels for practicing uterine artery ligations.

Results The model was used about 50 times over the span of 3 years to practice uterine hemostatic suturing. Residents found this model lifelike, accurate in size, and multifunctional for practicing these various techniques. The sheepskin material proved to be very resistant to repeated suturing, and also provided strong suture pull through strength. The durability of the sheepskin material demonstrates that this model can be used for repeated simulations or individual practice.

Conclusion The sheepskin uterus model provides trainees a realistic, low-cost, reproducible, simulation of a hypotonic uterus and allows for multiple modalities for managing postpartum hemorrhage.

Key Points
Ownership of ESG characteristics
Authors: Bateman Mark E. , Goldberg Lisa R.
Published: November 2023

A portfolio can be viewed as the collection of the businesses, policies and practices of constituent companies. We measure investors’ Ownership of this collection. Ownership metrics aggregate an assortment of company specific Environmental, Social and Governance (ESG) characteristics to the portfolio level, and they can inform investment and engagement decisions. Relative to a benchmark, investor Ownership is active and satisfies a zero-sum property, which underscores the distinction between Ownership and impact. Ownership of ESG characteristics may be interpreted as ascribing ethical responsibility, but that conclusion and any decisions that result from it belong to the investor.
Does culture matter? Corporate reputation and sustainable satisfaction in the Chinese and German banking sector
Authors: Damberg Svenja , Liu Yide , Ringle Christian M.
Published: November 2023

Corporate reputation is important for all types of banks across the world, despite these countries differing culturally. Building on an extended corporate reputation model, we identify the key drivers of customer-based reputation and sustainable customer satisfaction in two culturally different countries, namely China and Germany. We also consider two reputation dimensions—perceived competence and likeability—and their effects on the target construct. Empirical data from 625 German and 734 Chinese commercial bank customers allow us to estimate the corporate reputation model with the partial least squares structural equation modeling (PLS-SEM) method, and by substantiating the relationships by means of a necessary condition analysis (NCA) and a predictive power analysis. By comparing the two countries’ results, we identify their cultural differences. Overall, we confirm the model’s relevance for the two cultures, finding that banks’ perceived attractiveness is the most important driver of both cultures’ customer-perceived bank reputation. By means of an importance-performance map analysis, we identify a large overlap between the two cultures’ set of important constructs, likeability’s much greater importance in Germany, and the perceived quality construct’s relevance in both countries. We contribute to research and scientific knowledge about corporate reputation models by identifying the similarities in and differences between two countries’ markets with respect to the banking sector, all of which have implications for international banks’ management.
The Covid-19 pandemic in Ghana: exploring the discourse strategies in president Nana Addo’s speeches
Authors: Kwame Abukari , Makarova Veronika , Hudu Fusheini , Petrucka Pammla M.
Published: November 2023

Communication during a crisis can affect crisis management and health outcomes. Only a few studies in Africa have examined political leaders’ speeches on Covid-19 pandemic preventive and restrictive lockdown measures. The purpose of this study is to examine the discourse strategies employed in President Nana Addo’s speeches delivered to Ghanaians on the measures taken to combat the coronavirus. The first ten speeches of Nana Addo since the inception of Covid-19 were selected, coded, and examined using content thematic analysis. The analysis of these speeches identified five main themes to capture the discourse strategies which President Nana Addo used. The strategies captured in the thematic analysis included framing Covid-19 as a war, encouraging nationalism and patriotism, showing appreciation and gratitude, threatening sanctions, and using religious values. These strategies were reinforced by using religious, moralizing, and national identity legitimation discourses to justify measures the government had put in place to minimize the impact of Covid-19 and improve healthcare response. Also, the historical, social, and political contexts of Ghana and elsewhere were invoked in Nana Addo’s speeches to legitimize the government’s response to Covid-19. In conclusion, we highlight the implications of these strategies on crisis communication and management.
Near-field radiative heat transfer between nanoporous GaN films
Authors: Han 韩 Xiaozheng 晓政 , Zhang 张 Jihong 纪红 , Liu 刘 Haotuo 皓佗 , Wu 吴 Xiaohu 小虎 , Leng 冷 Huiwen 惠文
Published: November 2023

Photon tunneling effects give rise to surface waves, amplifying radiative heat transfer in the near-field regime. Recent research has highlighted that the introduction of nanopores into materials creates additional pathways for heat transfer, leading to a substantial enhancement of near-field radiative heat transfer (NFRHT). Being a direct bandgap semiconductor, GaN has high thermal conductivity and stable resistance at high temperatures, and holds significant potential for applications in optoelectronic devices. Indeed, study of NFRHT between nanoporous GaN films is currently lacking, hence the physical mechanism for adding nanopores to GaN films remains to be discussed in the field of NFRHT. In this work, we delve into the NFRHT of GaN nanoporous films in terms of gap distance, GaN film thickness and the vacuum filling ratio. The results demonstrate a 27.2% increase in heat flux for a 10 nm gap when the nanoporous filling ratio is 0.5. Moreover, the spectral heat flux exhibits redshift with increase in the vacuum filling ratio. To be more precise, the peak of spectral heat flux moves from ω = 1.31 × 1014 rad⋅s−1 to ω = 1.23 × 1014 rad⋅s−1 when the vacuum filling ratio changes from f = 0.1 to f = 0.5; this can be attributed to the excitation of surface phonon polaritons. The introduction of graphene into these configurations can highly enhance the NFRHT, and the spectral heat flux exhibits a blueshift with increase in the vacuum filling ratio, which can be explained by the excitation of surface plasmon polaritons. These findings offer theoretical insights that can guide the extensive utilization of porous structures in thermal control, management and thermal modulation.
Emergence of OXA-48-producing Enterobacter hormaechei in a Swiss companion animal clinic and their genetic relationship to clinical human isolates
Authors: Donà Valentina , Nordmann Patrice , Kittl Sonja , Schuller Simone , Bouvier Maxime , Poirel Laurent , Endimiani Andrea , Perreten Vincent
Published: November 2023

Background

Enterobacter hormaechei producing the carbapenemase OXA-48 was identified repeatedly in infections in companion animals hospitalized at a Swiss veterinary clinic where OXA-48-producing Klebsiella pneumoniae was previously reported.

Objectives

To determine the genetic relatedness of animal and human E. hormaechei strains collected in Switzerland during 2017–22 and their mobile genetic elements.

Methods

Hybrid assemblies for phylogenetic and comparative analysis of animal (n = 9) and human (n = 25) isolates were obtained by sequencing with Illumina, PacBio and Oxford Nanopore Technologies. Antimicrobial susceptibility was tested by broth microdilution.

Results

The animal strains were identified as E. hormaechei subsp. xiangfangensis ST114 (n = 6) and ST418 (n = 2), and E. hormaechei subsp. hoffmannii ST78 (n = 1). Human E. hormaechei belonged to subspecies steigerwaltii (n = 10), xiangfangensis (n = 13), hoffmannii (n = 1) and hormaechei (n = 1), with a heterogeneous ST distribution differing from the animal strains, except for two ST114. Core-gene SNP analysis confirmed the clonality of the animal ST114 and ST418 isolates (0 to 10 SNPs), and close relatedness of animal and human ST114 strains (80–120 SNPs). The strains harboured the blaOXA-48 gene on ca. 63 kb IncL-type plasmids (n = 27); on ca. 72 kb IncL plasmids co-harbouring blaCTX-M-14 (n = 2); and on ca. 150–180 kb IncFIB (n = 4) or hybrid IncFIB/IncL (n = 1) plasmids. The blaOXA-48-harbouring plasmids and the blaDHA-1-carrying ISCR1 element in one animal ST114 and both ST418 clones were likely acquired from previously spreading K. pneumoniae strains.

Conclusions

Common ecological niches favour the spread of plasmid-borne carbapenemases among Enterobacterales and the emergence of MDR E. hormaechei clones.
Minimally invasive management of sleeve gastrectomy collection with a nasobiliary drainage tube
Authors: Sidhu Tejminder S , Jhamb Shaurya , Welch Christine , Whiting Scott
Published: November 2023

A staple line leak is a feared complication of sleeve gastrectomy. Endoscopic methods have superseded surgical management of small leaks, however large collections often require surgical intervention. Here, we describe endoscopic management of large collection adjacent to the staple line with an 8Fr nasobiliary tube.
The impact of malaria control on the economic development of Nepal
Authors: Mills Anne
Published: November 2023

Throughout the hours of daylight the Terai is safe enough. It is the evening that man may not spend in this beautiful park. Sundown in the Terai has brought to an end more attempted raids into Nepal and has buried more political hopes than will ever be known. The English learnt their lesson early, for within forty years of Plassey a column − moving to the help of hard-beset Nepal − withered and retreated before the miasma of this paradise. The English had been told of its dangers, but they had to learn from experience what all India had known and feared for centuries ... The tribe of the Tharus alone − an indigenous race of the Terai, fit only to act as carters − are immune ... Perhaps after all this zone is only affected by an unusually virulent form of the fever, but of its mortal effect there is no question. The records of Nepal and of the Indian army are crowded with the names of its victims. This local pestilence is known far and wide as awal, a name which hums an undertone of death throughout the chronicles of Nepal. Between October and March its teeth are drawn.
The determinants of hospital costs: an analysis of Ethiopia
Authors: Bitran-Dicowsky Ricardo , Dunlop David W
Published: November 2023

The problem of financing health care in poor countries has become increasingly acute since Alma Ata. In the context of health financing, hospitals are viewed with scepticism as facilities which are not cost-effective in the provision of primary health-care services.
Introduction
Authors: Cumper George E
Published: November 2023

In this sceptical world, few things are universally accepted as good. Salvation is judged irrelevant by a secular society; motherhood is an indulgence to be controlled through family planning; even apple pie may contain harmful additives. Only health commands universal respect, as an aim for ourselves and a benefit to be conferred on others. Socialist governments routinely allot health services a generous share of the state budget; revolutionary regimes give a high priority to health campaigns; conservative countries complain about the increasing costs of health care, without questioning the need for its expansion by conventional or ‘alternative’ means.
Micro-evaluation: who needs it?
Authors: Cumper George E
Published: November 2023

People responsible for the allocation of resources to and within the health sector obviously need criteria to guide them in their work. Their professional backgrounds may be various: doctors, professional administrators, accountants, bankers. The extent of their responsibility, too, may vary from management of a single institution to oversight of national and international programmes. In the last two decades a range of techniques has become available to help them evaluate single projects and programmes, referred to broadly as cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) (see, for example Drummond 1980; Drummond et al. 1987; but see also Elzinga 1981). It is argued here that these techniques are not sufficient for evaluation of health care systems at the national level. But to keep the argument in perspective, it is necessary to emphasize that these techniques do meet real needs, even though these are not the needs of the health system evaluator.
Epidemiology and Control of Neural Tube Defects
Authors: Elwood J Mark , Little Julian , Elwood J Harold
Published: November 2023

Neural tube defects, spina bifida, anencephalus, and encephalocoele, are among the commonest severe congenital abnormalities in most countries. The last decade has seen many advances, including the use of antenatal diagnosis by chemical and ultrasound methods, population screening, and many new findings in epidemiology, culminating in the demonstration of the protective effect of folic acid on recurrences. The progress in both antenatal diagnosis and in aetiological research on neural tube defects has been particularly dramatic, and may well anticipate developments in regard to other congenital abnormalities. Primary prevention now appears as an attainable goal. This book presents a critical review of the extensive findings of epidemiological studies, discusses several methodological issues of wider relevance such as ascertainment, seasonal variation, ethical and legal issues. As well as providing a unique resource in regard to neural tube defects, much of the material is relevant to those with wider interests in the prevention, antenatal diagnosis, and control of major diseases.
Ethnic origin and migration
Authors: Little Julian , Elwood Mark
Published: November 2023

The striking variations in the prevalence at birth of anencephalus and spina bifida in different places throughout the world have been discussed in Chapter 4. We now attempt to separate the effect of the geographical factor from the effects of person related characteristics, particularly the ethnic origin of the parents. To some extent the geographical factor represents environmental and ethnic origin genetic influences, but this is an over-simplification. An ethnic subgroup may have a characteristic disease pattern either because of genetic homogeneity or because of specific environmental influences such as dietary habits. Differences in disease frequency between migrants and the population from which they come (sedentes) may be due to the influence of the new environment, but also may arise from both social and genetic differences between those who migrate and those who do not (selective migration). Selective outbreeding and intermarriage between different ethnic groups will change the gene pool but this process takes several generations. Thus, comparisons between migrants and their descendants, their source populations (sedentes), and the populations of the areas into which they have moved, are of interest in view of genetic effects, effects of selective migration, and the influences of the changed environment, mediated by the lifestyle of the migrant group.
Risks in siblings and other relatives
Authors: Little Julian
Published: November 2023

The most important established risk factor for neural tube defects is a prior history of an affected stillbirth or liveborn baby. In this chapter, we examine the variations in risks in siblings and other relatives, and consider factors affecting this variation.
Cigarette smoking and the incidence of endometrial cancer
Authors: Weiss Noel S
Published: November 2023

A lower risk of endometrial cancer among cigarette smokers than among non-smokers has been noted in 10 of 11 studies. The negative association has been particularly strong in recent smokers, which would be predicted if smoking were to exert an effect by interfering in some way with the action of oestrogens in endometrial carcinogenesis. The observed difference between smokers and non-smokers has generally been somewhat greater in post-menopausal than in pre-menopausal women, and greater in users than in non-users of post-menopausal oestrogens. Thus, if cigarette smoking does prevent some women from developing endometrial cancer, it is likely to do so in ways other than by reducing ovarian production of oestrogens.
Influence of nicotine and other components of tobacco smoke on oestradiol metabolism
Authors: Michnovicz Jon J , Bradlow H Leon , Fishman Jack
Published: November 2023

The oxidative metabolism of oestradiol, particularly C-2 hydroxylation, is significantly enhanced by cigarette smoking in humans. The biochemical mechanism for this metabolic induction may help to explain the anti-oestrogenic effect of smoking on various hormone-dependent diseases in humans. Therefore, it is of considerable interest to know which chemicals in tobacco smoke have the capacity to alter oestrogen metabolism. This paper reviews the various mammalian P450 drug metabolizing isozymes capable of catalysing 2-hydroxylation and the factors influencing their activity. Current research strongly indicates that the polycyclic aromatic hydrocarbons in cigarette smoke are primarily responsible for induction of the cytochrome P450 isozymes (P45OI) that perform oestradiol 2-hydroxylation, although other constitutive isozymes may be active in the non-induced individual. While nicotine has the capacity in some experimental systems to induce P450 metabolism, isozymes other than those in the P450I family are more likely to be affected. Further research into the effects of cigarette smoking on oestradiol metabolism should help to develop strategies that reduce the risk of hormone-dependent diseases without the adverse consequences of smoking.
Consumers, producers, and government
Authors: Cohen David R , Henderson John B
Published: November 2023

Among other things, micro-economic theory attempts to explain consumers’ demand, producers’ supply, and whether or not there is any justification for the government intervening in the freely made choices of consumers or suppliers. This chapter concentrates on the last of these issues. Consider the following example: Joe Brown has just bought a new motorcycle and is now considering the pros and cons of buying (and wearing) a crash helmet. Wanting to be a rational informed consumer, he gathers all the evidence on motorcycle safety, determines the statistical risk of injury or death with and without a helmet, and, after also determining the types of injuries possible and their consequences, decides not to wear a helmet. In many countries such a decision is considered unacceptable. If an individual will not voluntarily demand a helmet, the law can, and in most places does, compel him or her to wear one.
Case studies in secondary prevention
Authors: Cohen David R , Henderson John B
Published: November 2023

This chapter reviews economic appraisals of secondary prevention. Secondary prevention is the avoidance of an impending fall in health status through early detection and treatment of incipient disease. Since secondary prevention is also commonly called screening these terms are used interchangeably.
Tackling appraisal
Authors: Cohen David R , Henderson John B
Published: November 2023

The previous two chapters looked at the results of economic appraisals in the areas of primary prevention and screening. Here the issues that have to be tackled to get to the results and the problems that can arise along the way are described in greater depth. The main aim of this chapter is to help the reader understand how questions of efficiency should be appraised so that the better studies can be distinguished and good practice recognized and followed.
Community Health Workers in Tanzania
Authors: Heggenhougen H K , Magari F M
Published: November 2023

Tanzania has a well-earned and long-standing reputation for having developed a comprehensive health care policy, and for attempting to make basic, primary health care (PHC) services available to its total population in both rural as well as urban areas. Already in 1978, 92 per cent of the population were within 10 km, and 70 percent were within 5 km of a health facility. In 1988, the slightly higher proportion of 72 per cent of the population were within 5 km of such a facility. Despite this extraordinary effort to construct anequitably distributed health facilities infrastructure it is, however, still the case that of the country's approximately 8500 villages there are some 5000 without a formal health facility. More than 20 years ago, as now, it was felt that community health workers (CHWs) or wahudumu wa afya vijijini could be trained and deployed in village health posts (VHPs), to provide curative and preventive care at village level, and to assist and complement services provided at the formal government facilities. Both the government, through the Ministry of Health, and voluntary agencies, and a number of donor' agencies (for example, UNICEF, DANIDA, NORAD, SIDA) in different regions of the country, are involved in training and supporting CHW programmes.
The State and democratization in PHC: community participation and the village health worker programme in Zimbabwe
Authors: David Sanders
Published: November 2023

Political independence came to Zimbabwe in 1980, after many years of bitter struggle by the black majority under the leadership of the nationalist parties against white settler colonial rule. The political situation which had developed during 1979, and which persisted throughout the early post-Independence period, as well as the subsequent ebb in the popular mobilization, sets the context for this case study of village health workers (VHWs). The chapter is divided into four main sections. The first examines briefly the health situation before Independence, reviewing both the health (or disease) situation and its social context, as well as colonial health services.
The village context of Honduras’ VHW programme: 1980-84
Authors: Carl Kendall
Published: November 2023

In the early 1970s, Honduras, one of the poorest countries in the Western hemisphere, established a rural-focused innovative, primary health care (PHC) system. The Ministry of Health (MOH) has pursued a policy of encouraging village-level participation in its programme. As a document prepared for Health Sector Planning (Agency for International Development 1977) pointed out: In 1973, the Ministry of Health initiated implementation of a policy of extension of coverage of health and sanitation programs into the rural areas. The program is based on a regionalized system of levels of care ranging from community volunteers, through auxiliary nurse dispensaries, to national hospitals. The overall policy of extension of coverage corresponds to the model of using integrated rural health services to reach the poor majority.
Equity in the delivery of health care: methods and findings
Authors: Wagstaff Adam , Doorslaer Eddy Van
Published: November 2023

In common with the majority of earlier literature on equity in the delivery of health care, the present study starts from the premise that health care ought to be distributed according to need rather than ability to pay. Attention is focused here on the horizontal version of this principle: that persons in equal need ought to treated the same irrespective of their ability to pay. Although this is the main focus of this chapter, evidence is presented first on inequalities in health.
Policy implications of the COMAC-HSR project
Authors: Rutten Frans
Published: November 2023

This chapter considers the results of the COMAC-HSR project reported in Chapters 3 and 4. In the next section current and possible future policies concerning equity in health care are identified and an attempt is made to assess the relevance of the project in this context. Following sections discuss the policy implications of the results reported in Chapters 3 and 4. Finally, we conclude and make recommendations for policy and research.
Denmark
Authors: Christiansen Terkel
Published: November 2023

The pursuit of equity in the area of health care has a long tradition in Denmark as well as in the other Scandinavian countries. A main characteristic of Danish health policy over many years has been ‘equal and free (or almost free) access to various health-related services for all irrespective of economic means and social status’ (Indenrigsministeriet og Sundhedsstyrelsen 1985).
Portugal
Authors: Pereira Joāo , Pinto Carlos Gouveia
Published: November 2023

In the late 1970s, together with other southern European countries such as Greece and Italy, Portugal took a decided step to change the financing of its health care from a predominantly social insurance base to a tax-financed National Health Service. An argument put forward at the time was that such a change would lead to both greater equity in the burden of payments borne by different income groups and in the provision of treatment to persons with differential economic resources but similar levels of need. In the 1990s, it is clear that political options with regard to health care financing and delivery have changed. As elsewhere in Europe, greater emphasis is now placed on increasing the relative share of direct payments and insurance contributions vis-a-vis tax financing, and on increasing the scope of competition in the provision of services. These developments have been defended strictly on the grounds of efficiency, namely the bureaucratized nature of an NHS-type system, and its lack of cost-saving and quality-promoting incentives to providers and users. Curiously, the questions of how the burden of payments and incidence of benefits are distributed across income groups have virtually been ignored in the recent public debate. In part, this may reflect the paucity of empirical knowledge on the subject. Apart from preliminary work leading up to this chapter, there are no earlier studies in Portugal which measure the attributes examined here, namely vertical equity in financing and horizon¬ tal equity in the delivery of health care. Our results, and their eventual comparison with those from other countries, can, therefore, go some way to redressing the imbalance in the debate.
History of wound healing
Authors: Leaper D J
Published: November 2023

The history of wound management throughout the development of human society is a fascinating topic, often based on ‘full stops’ of misconception (with disastrous results) but punctuated by remarkable advances made all the more impressive by the lack of scientific background. In the Neolithic period it is known that wounds were inflicted by the early hominids and australopithecines on each other during the hunt for food, or self-preservation. This is clear from the fossil records and from skull trephination that was undertaken, per haps for some unknown ritual, and which was followed by healing (Fig. 2.1) (1).
The future of wound healing
Authors: Harding K G
Published: November 2023

It is only in recent years that interest in the biology and management of wounds has been sustained for a significant period to enable a much better understanding of the subject to be developed. In 1805, in the Edinburgh Medical and Surgical Journal, the treatment of leg ulcers was generally ‘looked upon as an inferior branch of practice; an unpleasant and inglorious task, where much labour must be bestowed and little honour gained (1). The sentiments of that statement held true until fairly recently but even in 1994 Jeffcote spoke of the complexities of healing diabetic foot ulcers and recognized the ‘feeling of critical ignorance of the processes in volved in wound healing’ (2). Both of these examples illustrate the low profile and lack of attention devoted to this important clinical problem and show the need for much greater attention and knowledge to be sought in this subject.
Management and Organization of Developing Health Systems
Authors: Collins Charles
Published: November 2023

The health service is considered as whole in this book, which deals with organizational issues relating to health service provision, including hospitals and personnel management. It includes analysis and discussion of issues of international relevance, particularly health planning, human resource management, information systems, and financial and supplies management. It is ideal for managers with limited health service experience as well as established health professionals. An active approach is encouraged and exercises for individual or group use are included, to provoke further discussion of the concepts and ideas covered.
Strengthening the district: the scope for change
Authors: Collins Charles
Published: November 2023

In this chapter we continue the theme of district health management strengthening. Two basic issues are looked at:

The relationship between organizational structure and associated changes in health management. The principal theme of this book is that of structuring organizations within the context of PHC. However, it has been recognized that an integral process of change has to link structural changes in the organization with associated changes in management processes. This chapter seeks to develop organizational decentralization with further changes in planning, community participation, and human resource management.
Conclusions
Authors: Collins Charles
Published: November 2023

This book carries three major messages.

Firstly, the adherence of national governments to a policy of PHC poses a major challenge to health management and organizations. PHC is a particularly difficult policy to formulate and implement, not least due to the political resistance it engenders. Also, the public sector in many countries is ill-adapted to the managerial and organizational needs of PHC. Secondly, changes in the organizational structure will have an important impact on the development of PHC. Important changes can be made in the organizational structure of the health sector. Particular attention should be paid to decentralization, intersectoral coordination, and the reorientation of bureaucratic systems and structures.
Ankylosing spondylitis: clinical aspects
Authors: Khan Muhammad Asim
Published: November 2023

Ankylosing spondylitis (AS) is a chronic systemic inflammatory rheumatic disorder of the axial skeleton, that is to say the sacroiliac (SI) joints and the spine; the presence of sacroiliitis is its hallmark. Hip and shoulder joints, and less commonly peripheral joints or certain extraarticular structures, may also be involved. Its aetiology is as yet not fully understood, but there is a strong genetic predisposition in association with the histocompatibility antigen HLA-B27. The disease sometimes occurs in association with reactive arthritis (including Reiter’s syndrome), psoriasis, ulcerative colitis, or Crohn’s disease. In such cases it is called secondary AS. Most cases, however, show no evidence of these associated diseases and are classified as primary or uncomplicated AS (Khan 1993, 1997a).
The Oxford Practice Skills Course
Authors: Hope R A , Fulford, K W M , Yates Anne
Published: November 2023

Ethics, communication skills, and the law ('practice skills') are important in all aspects of modern health care. Doctors and nurses must be sensitive to the ethical aspects of their work and understand the legal framework within which clinical decisions are made. Well developed skills of communication, with patients, their relatives and other members of the clinical team, are a key feature of good clinical practice Until recently, the important of practice skills has been relatively neglected in health care education. This situation is changing. The UK General Medical Council, for example, has recently identified three aspects as part of the core of the medical course, and the move to degree courses in nursing has led to an increasing focus of practice skills in nurse education. The Oxford Practice Skills Project (OPSP) team have developed a course, within the University of Oxford Clinical School, which covers the teaching of practice skills in an integrated manner. This course is widely recognized as one of the most systematic developments of education in these areas. This manual describes the OPSP course in detail and provides teaching materials. Although developed initially for medical students, it should be helpful to all those involved in teaching ethics, communication skills, and law in health care. Each Seminar is described in detail Tutors' guides are provided Student handouts are included Contains guidelines for introducing 'practice skills' into a busy clinical curriculum Includes over forty case histories for teaching and examination Gives details of many useful sources and resources Details a variety of teaching methods together with their advantages and disadvantages Provides an ethics teaching toolkit for clinical teachers new to this area Readers are welcome to photocopy any part of this manual for their own teaching
The Genetics of Neurological Disorders
Authors: Baraitser Michael
Published: November 2023

Back Cover Copy This third edition of The Genetics of Neurological Disorders incorporates the recent advances in genetics and molecular genetics into this comprehensive classic work. The classification of diseases within the text has been updated in line with the change in practice necessitated by these recent advances. Invaluable for both the geneticist and the neurologist, this book provides up-to-date information about counselling recurrence risks across the wide range of conditions seen by both the adult and paediatric neurologist. Each condition is covered in a way that helps the clinician reach a diagnosis before counselling, and carrier detection and prenatal diagnosis are also discussed for many conditions. Reviews of previous editions: ‘…coherent, well organised, extremely well-documented work…This is a fine book to take to the clinic as well as the library’ New England Journal of Medicine ’No neurologist will care to function from now on without ready access to this book, and it will be consulted by all clinical geneticists. ’ Annals of Human Genetics ’The strength of this book lies in the scholarly treatment of both old and new literature pertaining to familial neurological diseases. This book can heartily be recommended to the clinician seeking information on the genetics of neurological disease. ’ Brain ‘As a comprehensive source of reference it is unrivalled... a unique compilation of great importance which sets out all the current information about genetic elements, markers and calculations of risk. No neurologist can afford to be without a copy close to hand. Journal of Neurology, Neurosurgery and Psychiatry NOT on Back cover - Additional reviews ’This edition has grown by 257 worthwhile pages’ British Medical Journal on 2e ‘The book is very successful indeed, combining a rigorous academic analysis of evidence for any genetic statement with clear English. ‘ Archives of Disease in Childhood on 1e ‘…encyclopaedic coverage of the literature, ranging from major studies of larger populations to single families exhibiting obscure conditions…’ Journal of Nervous and Mental Diseases on 1e ’The book is a comprehensive compendium which presents the facts clearly’
Neuropathology and the Neurodevelopmental Model
Authors: Akil Mayada , Weinberger Daniel R
Published: November 2023

The neurodevelopmental hypothesis of schizophrenia has been in vogue for over a decade following the emergence of several lines of evidence implicating abnormalities of brain development in this disorder. In this chapter, we summarize the evidence suggesting a neurodevelopmental origin of schizophrenia. We then review the neuropathological :findings, asking the question: Are these findings consistent with neurodevelopmental aberrations? Finally, we discuss the limitations of the model and ways it may be refined and tested in the future.
The Management of Wounds and Burns
Authors: Wardrope Jim , Edhouse June A
Published: November 2023

Wound management forms the bulk of the work in Accident and Emergency practice. Although most of these wounds will appear minor and the treatment straightforward for many injuries, the consequences of improper assessment or management can be very serious. Disabling injury may be overlooked, and life threatening infections can follow inappropriate treatment. Accident and Emergency staff must be prepared to begin initial assessment and treatment while surgical help arrives. This new edition of The Management of Wounds and Burns provides practical and authoritative information on all aspects of wound and burn care, taking the reader from initial assessment to the treatment of specific injuries. The care and legal aspects of life-threatening wounds are covered, together with anaesthesia, surgical techniques of wound care, wound infection, and injuries to the hand, face, neck, chest, and abdomen. Throughout , the authors present their guidelines concisely and lucidly, with detailed advice on anatomy, medication, and treatment techniques.
General principles
Authors: Wardrope Jim , Edhouse June A
Published: November 2023

Minor burns and scalds are everyday problems in the A&E department. It is estimated that 150 000 new patients will attend A&E departments each year with a burn injury. The follow up and aftercare of many small burns will take place in the department. Serious burns are less common than minor ones but they are an important cause of mortality and morbidity. In England and Wales during 1996, 442 people died from the effects of fire. Each year, 15 000 patients require admission to hospital.
Minor burns
Authors: Wardrope Jim , Edhouse June A
Published: November 2023

History—some burning agents will indicate the probability of deep/full-thickness burns. Depth of burn. Thin-walled blisters; red, weeping skin; intact sensation—superficial partial-thickness. Thick-walled blisters, white skin with red punctate areas, sensation intact/blunted—deep partial-thickness.
The Urinary Sediment
Authors: Fogazzi Giovanni B , Ponticelli Claudio , Ritz Eberhard
Published: November 2023

This is the second edition of a full colour reference atlas published first to excellent reviews in 1994. Every renal unit needs to have a reference text of this kind and urine microscopy is an important diagnostic aid in nephrology. After the 'Historical Introduction' by J Stewart Cameron, chapter 1 descibes the methods used to prepare and analyse the urine samples. Chapter 2, which is the most important section of the book, describes with the help of 249 illustrations (over 200 in full colour) the elements of the urinary sediment. Chapter 3 deals with the urinary sediment of the normal subject, while chapter 4 deals with the urinary changes which are observed in the main diseases of the kidney and urinary tract. Chapter 5 describes the changes of the urinary sediment caused by drugs. Chapter 6 is about the interpretation of the urinary findings shown in the previous chapters. Chapter 7 covers the new systems to analyse the urinary sediments. An appendix shows how to adjust the microscope to analyse the urine specimens. The primary audience is practising nephrologists and nephrologists in training, and also those in internal medicine rotating through the renal unit who perform routinely the analysis of the urinary sediment. Clinical pathologists would also find this an attractive and useful book. The illustrations are outstanding and additional clinical information has been added in this new edition. From review from the Lancet of the first edition in comparison with a competing title: 'Every nephrologist knows and teaches that urine microscopy is an important diagnostic aid. What has been urgently needed is a colour guide to the subject.....I preferred the pictures in the European book. They were of high quality, not repetitive and with clear legends...if I wanted to teach myself.. then the European book was well ahead. The latter is also accompanied by an elegant introductory essay by JS Cameron on the history of urine analysis. Every renal unit needs at least one of these books.' The Lancet
Interpretation Of The Urinary Sediment Findings
Authors: Fogazzi Giovanni B , Ponticelli Claudio , Ritz Eberhard
Published: November 2023

Urinary microscopy, integrated with other diagnostic tests, contributes to the diagnosis of the diseases of the urinary tract and is also useful in evaluating their activity and in identifying complications or superimposed conditions. Some main urinary patterns can be identified, which reflect different clinical conditions. These patterns are: the nephrotic sediment; the nephritic sediment; the nephrotic and nephritic sediment; the sediment containing many tubular epithelial cells; the sediment containing bacteria and leukocytes; and the so-called minor urinary abnormalities.
Automated Systems For Urinary Sediment Analysis
Authors: Fogazzi Giovanni B , Ponticelli Claudio , Ritz Eberhard
Published: November 2023

Traditional urinary microscopy requires repeated handling of the sample with consequent possible imprecision. For example, centrifugation can introduce a variable loss of elements, and the preparation of the wet mount, especially when non-standardized procedures are used, can add further error [1, 2]. Imprecision is also caused by irregular cell distribution under the coverslip, which may occur by the entrapment of formed elements by mucus [3]. Furthermore, identification and count of microscopic particles entails the risk of subjectivity, and large differences among observers are possible [4].
Introduction
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

In Scotland, with a population of approximately 5 million people, 80 000 to 90 000 patients are seen each year following injuries to the head. This gives an attendance rate of 1600 to 1800 per 100 000 of the population. The attendance rate in the United States is almost double this figure. Head-injured patients are seen initially by junior doctors in Accident and Emergency (A&E) departments in district general hospitals and teaching hospitals, and by general practitioners in community hospitals. On the basis of this initial assessment approximately 20 000 patients are admitted to hospital annually in Scotland.
Neurological deterioration
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

The effect and outcome of a head injury depends principally on the severity of the initial impact and the extent of the damage thereby caused to the brain. This is the primary brain injury, the clinical results of which may range from a brief period of unconsciousness on the one hand, to prolonged coma on the other.
Radiology
Authors: Currie David G , Ritchie Ewan , Stott Stephen
Published: November 2023

The interpretation of skull X-rays often devolves to relatively junior doctors in the A and E department, often at hours when experienced colleagues are not always available. The finding of a skull fracture is important in its own right, in view of the possible complications of the skull injury. It is also important evidence that the patient has had a head injury when no history of trauma is available—for example, when a patient is admitted in an unconscious state of unknown aetiology.
The causes and prevention of violence
Authors: Farrington David
Published: November 2023

The most basic definition of violence is behaviour that is intended to cause, and that actually causes, physical or psychological injury. The most important violent offences defined by the criminal law are homicide, assault, robbery, and rape.

This chapter is in three sections. This first section reviews basic knowledge about violence: changes over time, measurement and prevalence, continuity from childhood to adulthood, specialization or versatility, and demographic correlates (age, gender, and race). The second section reviews risk factors for violence and presents a theory of violence, while the third section reviews effective prevention programmes.