bluuebunny/crossref_metadata_2025_split huggingface dataset:
United Kingdom
Authors: O’Donnell Owen , Propper, Carol , Upward Richard 
Published: November 2023

Abstract
This chapter presents evidence on departures from equity in the finance and delivery of health care in the UK. Following the methodology proposed in this volume, we examine equity in the finance and the delivery of health care separately and thus do not examine the net redistributive impact of the UK health care system. On the finance side, we review the progressivity of the finance of health care in the UK. Since health care in the UK is primarily financed from taxation, the analysis is predominantly an assessment of the progressivity of general taxation. On the delivery side, we examine the extent to which the allocation of health care in Britain is consistent with the National Health Service (NHS) policy objective of ‘equal treatment for equal need’. Previous studies of this issue in the UK have yielded contradictory results. Le Grand (1978), using data from the 1972 General Household Survey, found evidence of substantial inequity in favour of the middle classes. Collins and Klein (1980), using data from the same survey but for a later year (1974), could find no evidence of inequity. We have argued elsewhere that, in part, these conclusions may reflect methodological differences between the studies (O’Donnell and Propper 1991 a).
Health, health expenditures, and equity
Authors: Culyer A J 
Published: November 2023

Abstract
What motivates studies dealing with the interpersonal (or interfamily, interhousehold, interclass) distribution of income, wealth, health, and so on? They seem usually to have been undertaken so as to enable judgements to be made (by either their authors or their readers) of the ‘fairness’, ‘justice’, or ‘equity’ of such distributions with respect to some benchmark distribution (which need not, of course, be an equal distribution). It seems reasonable to ask two fundamental questions to do with their motivation. The first is: ‘What is the ethical theory that underlies the study?’ This issue is examined elsewhere in the present volume by Alan Williams (Chapter 16) and I shall not examine it further here other than to note that, because there is more than one ‘ideology’ serving as justi¬ fication (e.g., utilitarian, desert-based, Rawlsian) it would be in general helpful (although no doubt rather complicated) if studies were to be so conducted as to enable equity judgements to be made from a variety of viewpoints or ideologies (rather than that only of the authors-if they have one). When one is confident of there being a consensus amongst the trageted readership, this desideratum is less compelling, of course. The second question is: ‘Why study the distribution of whatever entity it is that has been studied?’ In the case of the present volume, there are two entities-health care expenditures on the one hand, and health care payments on the other. In this section I shall explore some reasons why it may be interesting to examine the distribution of health expenditures. That of payments will be discussed subsequently.
Equity and health care policy: the American experience
Authors: Davis Karen 
Published: November 2023

Abstract
The US is the only major industrialized nation without a national health plan that assures universal access to health care services. Rather, it has a mixed public-private approach to the financing of health care services. Public programmes finance health care for elderly, disabled, and some groups of poor people. Employers voluntarily provide private health insurance to the majority of workers and their dependents.
Equity in the distribution of health care: the British debate
Authors: Grand Julian Le 
Published: November 2023

Abstract
In 1978, I published an article in Economica on the distribution of public expenditure on health care in England and Wales (Le Grand 1978). The article compared the distribution of illness with the distribution of public expenditure and arrived at the conclusion that, once the distribution of illness was taken into account, the distribution of public spending favoured the higher social groups. In other words, contrary to its stated intentions, the British National Health Service (NHS) was not providing equity in at least one interpretation of that term, equal treatment for equal need. Rather, it was providing more treatment per person ill for the better-off.
Wound dressings
Authors: Thomas S , Leigh I M 
Published: November 2023

Abstract
For centuries, man has applied a variety of substances to his wounds to stem bleeding, ease pain, or provide protection for newly formed tissue. Many of these agents were simple absorbents that were used to remove exudate and produce a dry wound, an essential prerequisite for rapid and uneventful healing - or so it was believed. It was not until the work of George Winter, in the early 1960s, that this view was chal lenged and the advantages of moist wound healing finally became recognized.
Decentralization
Authors: Collins Charles 
Published: November 2023

Abstract
There can be few ideals more dear to the proclamations of politicians and health managers alike than that of decentralization. It is quite clear that the policy formulation and implementation of PHC cannot be conducted through a centralized bureaucratic machinery in a top-down fashion. There are, however, some important issues surrounding decentralization. In this chapter we shall face up to and try to answer a number of challenging questions.
Strengthening district management
Authors: Collins Charles 
Published: November 2023

Abstract
This book has been building up to this point—the district and its management. In Chapters 2 and 3, the relevance of decentralization to the PHC strategy was highlighted along with the importance of developing managerial capacity at both the central and district level. Chapters 4-6, concentrated on developing management and organizations from a national perspective. We should now focus on the district level in this and the next chapter. Firstly, the basic and often recognized characteristics of the district health system will be identified. This will be followed by a checklist of issues for the formulation and implementation of a district health management strengthening programme (HMSP). Secondly, and in the next chapter, we shall examine the scope for district management strengthening in three areas—planning, community participation, and human resources.
Considering adoption
Authors: Furedi Ann 
Published: November 2023

Abstract
Adoption is the least common solution to unplanned pregnancy nowadays, probably because it involves all the stresses of pregnancy and labour but with none of the joys of motherhood after the birth. The claim that today adoption is seen as the least socially acceptable solution to unplanned pregnancy is probably true. A study of the attitudes of single mothers conducted in the late 19 70s showed that of 36 unmarried, pregnant young women, only one said she would choose adoption, while 18 dismissed adoption immediately as in tolerable. Abortion, single parenting, or getting married were, by far, the preferred choices. Today, it is probably even less acceptable to most women. In 1991 just 1 ll 5 babies under one year old were adopted. When this figure is compared to the 12 641 adoption orders granted in respect of babies under one year old in 1968, it is clear how attitudes to adoption have altered.
Prevention for individuals and the ‘high-risk’ strategy
Authors: Rose Geoffrey 
Published: November 2023

Abstract
Illness is a personal and not a collective event: it happens to individuals, and statistics mislead by presenting only the totals. According to recent World Health Organization reports, covering 56 of the world’s populations, annual deaths from lung cancer numbered 471434 (nearly all preventable). What this really means is that there werw 1+1+1+1 ... etc. individuals, each of whom suffered severe personal distress. The objective of preventive medicine is the avoidance of a series of individual misfortunes, and so it is natural to believe that preventive action should be targeted on the individuals at risk.
An overview of the treatment of functional somatic symptoms
Authors: Sharpe Michael , Bass Christopher , Mayou Richard 
Published: November 2023

Abstract
In this chapter we offer an overview of the treatment of patients with functional somatic symptoms with the aim of providing an introduction and context for the chapters that follow. We discuss where patients should be treated, who should treat them, and how they should be treated. A review of the different forms of therapy available is preceeded by a consideration of non-specific aspects of treatment. The chapter concludes with an outline of practical management.
The patient with medically unexplained symptoms: making the initial psychiatric contact
Authors: House Allan 
Published: November 2023

Abstract
Dr House points out that the patient’s initial contact with a psychiatrist has to be very carefully managed. He stresses the importance of eliciting the patient’s attitudes to psychiatric referral, as well as exploring the beliefs and assumptions that influence each patient’s understanding of his or her illness.
The importance of acknowledging the reality of the patient’s physical symptoms during the assessment interview is emphasized, as is the need for a flexible, empathic style of interviewing. In tandem with the ‘illness history’ Dr House encourages the adoption of a developmental approach, during which those experiences that might lead the patient to express distress in somatic terms are explored. Finally, the key role of family attitudes and beliefs is described and the importance of interviewing family members emphasized.
Chronic pelvic pain
Authors: Glover Lesley , Pearce Shirley 
Published: November 2023

Abstract
In this chapter Drs Glover and Pearce begin by describing the prevalence of pelvic pain and the associated cost to health services. An aetiological model of pelvic pain is outlined in which pathophysiological processes in the pelvis (which include abnormal venous congestion) interact with psychological factors to produce the sensation of pelvic pain. A preoccupation with disease explanations for the pain, increased attention to the somatic sensations, and the acquisition of ‘pain behaviours’, may all then act to perpetuate a syndrome of chronic pelvic pain.
The management of patients with functional somatic symptoms in the general hospital
Authors: Bass Christopher , Sharpe Michael , Mayou Richard 
Published: November 2023

Abstract
In this chapter we propose that patients with functional somatic symptoms are best managed by a combination of improvements in routine care by medical and surgical teams and greater provision of specialist care by psychiatrists and clinical psychologists. These improvements would, however, require better training for all those involved. Although some initial increase in resources would be required, significant savings from the reduction of the inappropriate and ineffective use of existing hospital and primary care resources could be expected. Both clinical experience and evaluative research suggest opportunities for improved outcomes for many patients.
Alternative and complementary treatments
Authors: Bass Christopher , Mayou Richard 
Published: November 2023

Abstract
The two forms of non-conventional medicine, complementary, and alternative treatment are described and the reasons patients consult non-orthodox practitioners are outlined. It is suggested that the increased interest in non-conventional therapies is in part a consequence of dissatisfaction with orthodox medicine and, by implication, the training of doctors.
The efficacy of alternative treatments is reviewed and the evidence for most but not all therapies is found to be unconvincing. For example, some of the manipulative therapies may be effective but others such as iridology and reflexology appear to be useless.
Psoriatic arthritis and spondylitis: a clinical approach
Authors: Espinoza L R , Cuellar M L 
Published: November 2023

Abstract
Psoriatic arthritis (PsA) can be defined as a chronic inflammatory disorder affecting the musculoskeletal system in psoriatic patients. This definition encompasses a broad spectrum of clinical articular manifestations, including monoarthritis, distal interphalangeal inflammatory joint involvement, asymmetric and symmetric polyarthritis, and axial or spondylitic involvement (Espinoza et al. 1992a).
The eye in spondyloarthritis
Authors: Rosenbaum James T 
Published: November 2023

Abstract
Many internists tend to be intimidated by having to evaluate eye disease and, conversely, many ophthalmologists are daunted by the differential diagnosis of systemic illness. Consequently, a knowledge of the ocular manifestations of reactive arthritis and ankylosing spondylitis requires either an exceptional rheumatologist or an exceptional ophthalmologist. The eye is commonly involved in spondyloarthropathy and is vital with regard to both theoretical and therapeutic considerations. This chapter reviews the clinical manifestations of this eye disease, its treatment, and its possible aetiology.
Mechanisms of arthritis associated with chronic intestinal inflammation
Authors: Bocker Ulrich , Sartor R Balfour 
Published: November 2023

Abstract
Peripheral arthritis and spondylarthritides are part of a characteristic spectrum of systemic inflammation which accompanies numerous forms of clinical and experimental intestinal inflammatory disorders (Table 14.1) (Sartor and Lichtman 1994). These extraintestinal manifestations, which include arthritis, hepatobiliary inflammation, erythema nodosum, pyoderma gangrenosum, and uveitis, occur in approximately 20-30% of patients with Crohn’s disease, ulcerative colitis, and jejunoileal bypass for obesity (Lichtman and Sartor 1994), but are relatively infrequent in the other clinical conditions listed in Table 14.1.
Neurological disorders with a pigmentary retinopathy
Authors: Baraitser Michael 
Published: November 2023

Abstract
Abstract: Strictly speaking, Bardet-Biedl is separate from Laurence-Moon syndrome. The difference is that patients with Laurence-Moon syndrome are spastic, thin, and do not have polydactyly. Both conditions present with retinal dystrophy, mental handicap, and hypogenitalism. Bardet-Biedl syndrome the commoner of the two, is variable in its manifestations. Seventy per cent of cases have polydactyly which, when present, might only affect one limb. Syndactyly and brachydactyly are very common (Green et al., 1989).
Myoclonus and myoclonic epilepsy
Authors: Baraitser Michael 
Published: November 2023

Abstract
Myoclonic epilepsy is different from myoclonus and the EEG is helpful in differentiating between the two Myoclonus is defined as a brief contraction of a muscle or a group of muscles. It might be. Benign and barely perceptible; Severe, causing a sudden fall; Atypical, as in Lennox-Gastau syndrome.
Muscle disease
Authors: Baraitser Michael 
Published: November 2023

Abstract
Dystrophinopathies: Duchenne muscular dystrophy; Becker muscular dystrophy; Congenital muscular dystrophy: Fukuyama muscular dystrophy; occidental type with white matter disease on CT (merosin or alpha-2 laminin deficiency) occidental type with normal scan or white matter disease (merosin positive); HARD; muscle-eye-brain disease; Limb-girdle muscular dystrophy: LGMDlA autosomal dominant; LGMD2A 15q15 calpain 3 related; LGMD2B 2p13; LGMD2C 13q12
Structural Imaging Findings and Macroscopic Pathology
Authors: Hopkins Richard , Lewis Shon 
Published: November 2023

Abstract
From its inception as dementia praecox over a hundred years ago, schizophrenia was considered to be a disorder of the brain (Kraepelin, 1896). There were numerous early attempts to isolate the presumed macroscopic and microscopic pathology (e.g. Alzheimer, 1897; Southard, 1915), mainly inspired by concurrent successes in the neuropathology of general paralysis of the insane. However, research was unable consistently to replicate findings, considerably hindered as it was by a lack of operationalised diagnostic criteria, problems with the selection of brains for analysis, postmortem artefacts, and inadequate controls (see Chapter 14). The diagnostic non-specificity of findings, and the absence of an overall hypothesis also hampered the development of a consensus view.
Hippocampal Pathology
Authors: Arnold Steven E 
Published: November 2023

Abstract
The hippocampal formation has been a region of extensive clinical investigation in schiz ophrenia and also the most commonly studied region in postmortem research (Shapiro, 1993; Arnold and Trojanowski, 1996). There are a number of reasons to justify this. Clinicians have long noted similarities between the symptoms of schizophrenia and those of the schizophrenia-like organic psychoses associated with temporal lobe epilepsy, temporal lobe tumors, and cerebrovascular lesions, herpes encephalitis, and neurodegenerative diseases such as Alzheimer’s disease and frontotemporal degenerative dementias which have particular predilections for the hippocampal region (Davison, 1983). In addition, early clinical neurobiological investigators described enlarged temporal horns in schizophrenia using pneumoencepholgraphy (Jacobi and Winkler, 1929) while electroencephalographers frequently reported abnormal recordings from temporal electrodes (Ellingson, 1954).
Synaptic Pathology
Authors: Honer William G , Young, Clint , Falkai Peter 
Published: November 2023

Abstract
Synapses are a defining characteristic of neurons, and pathology at these sites is proposed to be a mechanism for psychiatric disorders. Studies of neurotransmitters and receptors provide one perspective on synaptic pathophysiology in schizophrenia, however there are other equally informative, complementary approaches to investigate synaptic abnormalities in the disorder. In the past decade, molecular elements of the synaptic complex, both pre and postsynaptic, have been defined in considerable detail. The aims of this chapter are to assess critically the techniques available to study synapses in the human brain, and evaluate the evidence for synaptic pathology in schizophrenia from morphological and molecular vantage points. We conclude with a brief discussion of its potential origins and functional implications.
Cerebral Asymmetry
Authors: Roberts Gareth W , Harrison Paul J 
Published: November 2023

Abstract
Investigation of human brain lateralization began in earnest following Broca’s (1861) report of language distm-bance resulting from injury to the left hemisphere (see Harris (1999) for historical review). Proposals that cerebral asymmetry is relevant to insanitsy can be traced back to Wigan (1844), Crichton Browne (1879), and, more explicitly, to the neuropathol ogist Southard (1915) who stated “the atrophies and aplasias [of schizophrenia], when focal, show a tendency to occur in the left cerebral hemisphere.” Despite these prescient statements, and the stimulus provided by Flor-Henry’s (1969) report that schizophrenia was associated with left-sided foci in temporal lobe epilepsy, it is only in the past 20 years or so that the question has been investigated in any detail. Although no unequivocal answer can be yet given, this chapter reviews a range of evidence which suggests that the neuropathology of schizophrenia is asymmetrical, and considers the implications this has for the nature of the disorder. First, however, we discuss the normal anatomical cerebral asymmetries, since it need not be schizophrenia per se which is lateralized, but rather that the disorder affects these asymmetries.
Initial management of life-threatening wounds
Authors: Wardrope Jim , Edhouse June A 
Published: November 2023

Abstract
In the United Kingdom only 4 per cent of serious injury is due to penetrating trauma. However, all penetrating wounds of the trunk, neck, and face presenting to the A&E department must be regarded as serious. The size and appearance of the skin wound does not give a reliable indication of the severity of the deep damage.
Psychological factors and cancer progression: involvement of neuroimmune pathways and future directions for laboratory research
Authors: Garssen B , Goodkin K 
Published: November 2023

Abstract
Psychological factors may exert their influence on tumour processes through various pathways. One possible pathway is through an effect on health behaviour, and will be discussed in the next chapter. Another more studied, but not necessarily more likely, pathway is via changes in the endocrine and immune systems, and is discussed in this chapter (see also reviews in 1–6). The influence on the immune system can be exerted along two roads. One is directly via the nervous system; the second is through nervous system modulation of the endocrine system, which in tum can regulate immunological activities. In some types of cancer, especially breast cancer and endometrial cancer, tumour growth can also be influenced by hormone levels, which represent a more direct, potential pathway for the effect of psychological factors.
The Urinary Sediment In The Main Diseases Of The Urinary Tract
Authors: Fogazzi Giovanni B , Ponticelli Claudio , Ritz Eberhard 
Published: November 2023

Abstract
Clinical presentation. Minimal change disease (MCD) is mainly a disease of children even though it may also occur in adults. It is characterized by full-blown nephrotic syndrome, i.e. severe proteinuria without hypertension, haematuria or renal failure. Slowly progressing impairment of renal function and appearance of hypertension are exceptional.
Resuscitation
Authors: Currie David G , Ritchie Ewan , Stott Stephen 
Published: November 2023

Abstract
Resuscitation of the head-injured patient is the responsibility of the A&E department, and on no account should a patient be transferred to a specialist unit before resuscitation is complete and the patient stabilized. Hypotension and hypoxia on arrival at Neurosurgery are associated with very high mortality rates. Patients should not be removed from the resuscitation room (e. g. for X-rays) until resuscitation is complete: this may necessitate the use of portable X-ray equipment.
Anaesthesia in head injuries
Authors: Currie David G , Ritchie Ewan , Stott Stephen 
Published: November 2023

Abstract
The anaesthetist is a key member of the team involved in the care of the head-injured patient. The anaesthetist is involved in the transfer of head- injured patients both within the hospital and between hospitals, in the resuscitation of the patient and in anaesthesia for surgical procedures. A thorough understanding of the pathology, physiology, and pharmacology of anaesthetic drugs is required for the safe conduct of these tasks.
The disturbed head-injured patient
Authors: Currie David G , Ritchie Ewan , Stott Stephen 
Published: November 2023

Abstract
Disturbed behaviour is common after head injuries when there is some degree of altered consciousness. Inspection of the Glasgow Coma Scale (See Box 1.3) will show that a minor degree of altered consciousness results in ‘confusion’ even although the patient remains ambulant and able to obey commands. A further deterioration in consciousness results in a verbal response described as ‘inappropriate words’. This commonly means that the patient is abusive and uses offensive language. This is usually a transient phenomenon requiring little active intervention but it is of the greatest importance that those responsible for dealing with head-injured patients realize that this behaviour indicates altered consciousness and not simply antisocial behaviour or drunkenness.
Wilms Tumour and the Wilms Tumour Predisposition Syndromes
Authors: Grundy Richard 
Published: November 2023

Abstract
The molecular genetics of Wilma tumour (WT) has turned out to be far more complex and interesting than originally envisaged (Knudson and Strong 1972). It is now clear that at least six separate genetic loci and loss of genomic imprinting are involved in the predisposition, development, and progression of this fascinating tumour. Wilma tumour is the most common primary renal tumour of childhood affecting approximately 1 in 10,000 children (Birch and Breslow 1995).