bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of health care technology
Authors: Banta H David , Luce Bryan R 
Published: November 2023

Abstract
In the past, use of technology has received relatively little attention either from policy-makers or researchers. Regulatory programmes and explicit decisions within health care systems have tended to focus on the adoption stage. However, the recent focus on outcomes research in the USA is beginning to change this situation. Adoption and use of technology have been separated into two chapters; for several reasons. One is that no general relationship between adoption and use has been observed. Obviously, technology must be acquired to be used. How ever, adopted technologie are used at very different rates. Availability of a technology has been observed to increase use in the case of laboratory services and surgery (25). On the other hand. many pieces of equipment tend to be used under capacity.
Financial costs and their evaluation
Authors: Banta H David , Luce Bryan R 
Published: November 2023

Abstract
It is this background that has given health care technology assessment its primary impetus. During the 1970s, most policy-makers expected technology assessment to be helpful in containing co ts. Gradually, they have realized that costs mu t be contained by financial means, such as budgets and prospective payment. The issue for the 1980s has become choice: how does a society deter mine how to spend its limited resources? Technology assessment seems definitely useful in aiding such choices.
The assessment of prevention
Authors: Banta H David , Luce Bryan R 
Published: November 2023

Abstract
Historically speaking, assessment of preventive activities is well-established. One of the first assessments on record is that of John Snow, who investigated the origin of a cholera epidemic in London in 1854. One of the first randomized clinical trials was that of pertussis (whooping cough) vaccine, organized by Bradford Hill (454). As cost-effectiveness analysis began to be used in the health field, many of the earliest analyses were of preventive interventions. In the period preceding 1984, about a quarter of all cost-effectiveness analyses concerned prevention.
Medical technology in the UK
Authors: Spiby Jackie , Stocking Barbara 
Published: November 2023

Abstract
The UK consists of four countries: England, Wales, Scotland, and Northern Ireland. There are some differences in the administrative arrangements for health service provision among the countries, but none that has a major impact on policies concerning the introduction and use of medical technology. The UK has a population of 55 million people and currently spends about 6.1 per cent of its gross national product on health care. The 1989 government expenditure on the National Health Service (NHS) was £23.25 billion.
The population and individual strategies
Authors: Fowler Godfrey 
Published: November 2023

Abstract
Health care is not the sole, nor indeed the main, determinant of a nation’s health. A variety of factors—political, social, economic, legislative, and many others—contribute substantially; health measures are only supplementary and those directed at individuals are generally of relatively marginal importance. Historically in developed countries, and currently in developing ones, improvements in economic and social circumstances which influence conditions of life have a major influence on health. They include nutrition, clean water supplies, safe sewage disposal, and living conditions generally. During the present century, an important adverse effect on health world-wide has been tobacco smoking; although this is subject to some control in developed countries and its prevalence is declining, world-wide the epidemic continues to escalate.
Preparing the practice
Authors: Lawrence Martin 
Published: November 2023

Abstract
Prevention of cardiovascular disease (CVD) is a major task for any general practice. Many of the practice staff are involved—-whether receptionists making appointments and giving results, nurses doing health check clinics, or doctors making management decisions. Unless the practice is well prepared and organized, the whole exercise is likely to fail. It is much better to take a little longer to plan well and to prepare everyone involved before embarking on a programme of CVD prevention than for a start to be made piecemeal, or by individuals without adequate consultation.
Chest injury
Authors: Guly H R 
Published: November 2023

Abstract
It is important to differentiate between: (1) low velocity injury which is likely to cause an injury to the chest wall only; (2) a more severe crushing injury which may cause asphyxia in addition to the chest injury; and (3) the high velocity injury which may damage mediastinal structures and cause significant pulmonary contusion. With a low velocity injury the exact mechanism will differentiate between the injury which is unlikely to have caused more than a single rib fracture (which may not even require an X-ray) and the rather greater force which may have caused multiple rib fractures.
Forearm and wrist injuries
Authors: Guly H R 
Published: November 2023

Abstract
There are a variety of ways in which the forearm can be injured, including falling or becoming caught in machinery, but the history of a blow with a heavy stick or similar object to the ulna aspect of the forearm (e.g. when the forearm has been raised for protection against assault) should suggest the possibility of an isolated fracture of the shaft of the ulna (nightstick fracture).
Ankle injury
Authors: Guly H R 
Published: November 2023

Abstract
The commonest mechanism of injury at the ankle is an inversion injury and it is easy to fall into the trap of assuming that every ankle injury has been caused in this way. However, there are other mechanisms of injury which occur at this site and there are two injuries which would be missed much less frequently if a proper history was taken. Ruptured Achilles tendon has been noted above under the heading of calf injuries (Chapter 28) but it may also be misdiagnosed as a sprained ankle by the careless. The other injury commonly missed is the fractured calcaneum. The clue to this injury is that it is usually caused by a fall directly on to the heel.
Genetic aspects of diabetic nephropathy
Authors: Bilous R W , Mauer, S M , Viberti G C 
Published: November 2023

Abstract
Both insulin and non-insulin dependent diabetes mellitus (IDDM and NIDDM) are recognized as having a large genetic component in their pathogenesis. Identical twin studies (Barnett et al. 1981) and later HLA analysis in IDDM patients provided early evidence (Cudworth and Festen stein 1984). More detailed genetic analysis has demonstrated specific abnormalities in some NIDDM patients (Leahy and Boyd 1993).Because diabetic nephropathy is known to affect a minority (albeit sizeable) of IDDM and NIDDM patients (approximately 25% cumulative incidence after 25 years duration in both types of diabetes) (Ballard et al. 1988; Hasslacher et al. 1989), there has been a considerable interest in trying to identify genetic factors in the individual predisposition to renal complications.
Sickle cell anaemia and renal disease
Authors: Morgan Stephen H 
Published: November 2023

Abstract
Human single-gene disorders have been the subject of intense genetic research for almost a century and have resulted in many hostorical advances leading to the evolution of ‘molecular genetics’ as a science. In 1949, Pauling suspected that an abnormal haemoglobin was the cause of sickle-cell anaemia (Pauling et al. 1949) and this was subsequently confirmed by Ingram (1956) who found a single amino acid substitution (valine for glutamic acid at position 6 of the beta globin chain) altering the haemoglobin polypeptide sequence. This was the first demonstration, in any organism, that a mutation in a structural gene could produce such an alteration in an amino acid sequence.
Cystinuria
Authors: Jaeger Philippe 
Published: November 2023

Abstract
Cystinuria is an inherited disorder characterized by defective renal and intestinal transport of cystine as well as of arginine, lysine, and ornithine, the dibasic amino acids. Save the fact that cystine is the least soluble amino acid, cystinuria would have remained an experimental model to study transepithelial amino acid transports in man. Because of poor solubility of cystine, how ever, it is one of the disorders to look for in patients with renal stone disease (Halperin and Thier 1980; DeFronzo and Thier 1986 a, b).
Wilms’ tumour
Authors: Mitchell Christopher D 
Published: November 2023

Abstract
Wilms’ tumour, the most common genito-urinary malignancy of childhood, is a triphasic embry onal neoplasm consisting of varying proportions ofblastema, stroma, and epithelium. It develops from proliferation of the metanephric blastema, possibly in the absence of normal stimulation from the metanephric ducts, to produce differentiated tubules and glomeruli. Although the specific histological appearance was described by Max Wilms in 1899, the eponym is now loosely applied to virtually any malignant tumour arising in the kidney in childhood, some of which are pathologically, clinically, and probably genetically distinct.
Writing reports
Authors: Montague Alan , Hopper Andrew 
Published: November 2023

Abstract
Criminal proceedings are the commonest occasion for a medico-legal report in the form of a factual description of injuries, requested by the police. Victims, their solicitors, and others may approach doctors for reports to aid civil claims for compensation. These too are usually essentially factual, but the opinion of the doctor may also be required making the report an ‘expert’ report.
Mouse models of polycystic kidney disease
Authors: McDonald Ruth A , Avner Ellis D 
Published: November 2023

Abstract
Experimental studies in a variety of model systems have identified three major factors of potential pathophysiological significance in tubular cyst formation and enlargement: (1) tubular epithelial hyperplasia in response to a variety of physical or chemical stimuli, or cell cycle control abnormalities; (2) altered tubular epithelial cell metabolism and transport leading to intratubular fluid accumulation; and (3) extracellular matrix abnormalities leading to increased tubular wall compliance or alteration of the tubular microenvironment (Avner 1993; Avner et al. 1990).
Tuberous sclerosis complex
Authors: Torres Vicente E 
Published: November 2023

Abstract
Tuberous sclerosis complex (TSC) is an autosomal dominant disease that affects all tissues with the possible exception of the peripheral nervous system, meninges, and skeletal muscles. The term ‘tuberous sclerosis complex’ is preferred to tuberous sclerosis because it emphasizes the multiplicity of organs involved. Some of the lesions are so characteristic that they are considered diagnostic for the disease.
Von Hippel-Lindau disease
Authors: Michels Virginia 
Published: November 2023

Abstract
Von Hippel-Lindau (VHL) disease is an autosomal dominant disorder character ized by central nervous system (CNS) and/or retinal haemangioblastomas, visceral cysts, renal cancer and, less frequently, pheochromocytoma, and pancreatic cancer. Patients with VHL disease usually present with CNS or visual symptoms (Melmon and Rosen 1964). However, as physicians become more aware of the value of family screening and as diagnostic technology advances, a greater number of asymptomatic patients will be detected. In clinical series the age of onset of symptoms has ranged from 4 (Fill et al. 1979) to 65 years (Melmon and Rosen 1964).
Cloning strategies and genetics of type 1 autosomal dominant polycystic kidney disease
Authors: Germino Gregory 
Published: November 2023

Abstract
It has been nearly 40 years since Dalgaard concluded his landmark study with this observation. Sadly, renal failure remains a common outcome for those inheriting the disease gene. Despite the development of diagnostic tools that now allow identification of such individuals long before they become symptomatic, our therapeutic armamentarium is limited to treatments for the associated complications (hypertension, infection, pain). Aggressive control of blood pressure has many laudatory benefits, possibly including the delay of renal failure in hypertensive individuals, but there are no data proving that it significantly affects the underlying disease process.
Progression to renal insufficiency
Authors: Ritz Eberhard , Zeier Martin , Waldherr Rudiger 
Published: November 2023

Abstract
Since the reputed first description of polycystic kidney disease post-mortem by Eustachio Fine in 1986, the disease was viewed, until recently, as leading inexorably to end-stage renal failure. This view may have to be modified, however, in the light of recent observations that indicate that previous estimates have been too negative as a result of ascertainment bias (Churchill et al. 1984). In the seminal paper of Dalgaard (Dalgaard 1957) all the 173 patients who had come to autopsy had suffered fromuraemia unless they had died as a result of subarachnoid haemorrhage or urological complications.
How will I know if I have kidney disease?
Authors: Cameron Stewart 
Published: November 2023

Abstract
When the patient dies the kidneys may go to the pathologist, but while he lives the urine is ours. It can provide us day by day, month by month, and year by year with a serial story of the major events going on within the kidney. The examination of the urine is the most essential part of the physical examination of any patient with Bright’s disease.
Artificial kidneys and dialysis
Authors: Cameron Stewart 
Published: November 2023

Abstract
If your kidneys fail, fortunately it is possible to replace their function. One treatment for long-term kidney failure, a new kidney in the form of a kidney transpiant, is dealt with in Chapter 8. This chapter concerns the methods of substituting for absent kidney function in other ways, usually called dialysis, which includes the use of an ‘artificial kidney’. We are fortunate to have such treatments: a number of famous figures of the past, including Disraeli, Brunel, Jean Harlow, and possibly Mozart, died prematurely of renal failure.
Kidney transplantation
Authors: Cameron Stewart 
Published: November 2023

Abstract
By the end of 1993, about 140 000 patients owed their lives to kidney trans plants world-wide, including 64 000 in Europe (12 000 in the UK) and 50 000 in the USA. Every year, 11 000 transplants are done in Europe and almost 10 000 in the USA, of which some 3200 are from living related donors. In addition an unknown number of living donor transplants are done in developing countries-probably another 5000. Despite all the problems which remain unsolved, a successful renal transplant is the most satisfactory treatment for end-stage kidney failure from the medical, psychological, social, and economic points of view. It is now an established form of medical treatment for what was formerly an inevitably fatal condition. This chapter gives you the background to having a kidney transplant, and tells you what you may expect from being considered as a recipient of such a graft, through to the long-term outcomes.
The future
Authors: Cameron Stewart 
Published: November 2023

Abstract
Attempting to predict the future is always a faulty exercise, since the greatest changes are wrought by events, ideas, and especially techniques which are unforeseen, and often unforeseeable. Progress in medicine, which is an art b-ased upon science, always arises from a combination of ideas and techniques. Both transplantation and dialysis are examples of ideas which were present long before the techniques to make them practicable became available (see Boxe,.s 3 and 4 in Chapters 6 and 8). Finally, even when both ideas and technique are present, practical, financial, or political difficulties may stand in the way of application. However, the greatest barrier to progress is often that health professior,.als are unable to unwilling to see things in a new light, or to behave in a new way. Thus progress may sometimes have to await a change in generations.
Responding to changing healthcare systems: adapting prescribing in the new NHS
Authors: Bradley Colin , Blenkinsopp Alison 
Published: November 2023

Abstract
Given that the NHS reforms detailed in the preceding chapter have been implemented and are unlikely to be reversed by any subsequent administration, it is imperative that GPs adapt their practices to take account of these changed circumstances. It is no longer possible for GPs to prescribe for patients as they see fit without regard to the economic consequences of their actions. A major thrust of the new environment created by the reforms is to make doctors bear some financial, as well as clinical, responsibility for their prescribing.
Head Injury
Authors: Gronwall Dorothy , Wrightson, Philip , Waddel Peter 
Published: November 2023

Abstract
The authors, of this book have had many years experience working with head - injured people in both research and rehabilitation roles. The effects of injury are explained in non-technical terms and, where possible, practical ways of overcoming these effects are described. Because they also have many years experience working with organisations formed to help the families of the head-injured, the authors know the main areas of concern that these families have. Beginning with the injury itself, the stages that the patient will go through are described, and the procedures and techniques that will be used to chart progress are explained. As well as these direct effects of the injury on the victim, the book also examines the ways that head trauma can affect families and friends.
Leaiting hospital—what happens now?
Authors: Gronwall Dorothy , Wrightson, Philip , Waddel Peter 
Published: November 2023

Abstract
After the first dreadful days or weeks when you did not know whether your friend or relative was going to live or die, all you wanted was to have him well enough to leave hospital and come home. During that time you spent every waking minute that you could at his bedside, even at first when he was still unconscious, and it was important both for him and for you that you were able to do this. However, it had been a pace that no one could keep up for long. The strain of perhaps rushing home from work, rustling up a quick meal, maybe getting children to bed or finding a babysitter, the long drive to the hospital and the struggle to find a car park, were begillling to take their toll, and you thought it would all be so much easier when he was home again. But now that the time has come for him to leave hospital you realize that it may not be as simple as you tl-10ught, you wonder if it is right for him, and whether or not you will be able to cope. Firstly we need to look at the reasons for the move from hospital and how it works, and secondly, at possible alternatives.
Back to work and study
Authors: Gronwall Dorothy , Wrightson, Philip , Waddel Peter 
Published: November 2023

Abstract
For months everyone involved in the head-injured person’s rehabilitation has been working towards getting him fit enough to go back to work, school, or college. Unfortunately return to work is sometimes botched, in spite of the very best of intentions. There are several ways in which this can happen. The person can be returned to work or school before he has recovered sufficiently to cope with it, often because neither the family nor the employer or school teacher want to hurt his feelings by telling him that it is too early. He can be returned to an inappropriate work or school environment because there has not been sufficient communication between the rehabilitation team, the employer or school, and the head-injured person and his family. Finally, things can go very wrong if there is no system for monitoring the success of the return to work or school trial. By looking at the ways in which return to work or school can go wrong, we can arrive at some general principles which we can use to set up a better system. Remember, however, that in this section we are talking about returning the head-injured person to the employment or study which he was doing at the time of the accident. This is not always possible.
Theory and practice: the special features of psychiatric ethics
Authors: Dickenson Donna , Fulford Bill (Kwm) 
Published: November 2023

Abstract
Psychiatry is something of an ethical paradox1• It is deeply value-laden, so much so that its critics, like the American professor of psychiatry, Thomas Szasz, have argued that it is a moral rather than a medical discipline (Szasz 1960, 1987). Even some supporters regard it as a primitive or pre-scientific branch of medical science (Boorse 1975, 1976). Despite being so value-laden, however, psychiatry has been largely the ‘blind spot’ of bioethics, as one of us has described it elsewhere (Fulford 1993). There are important exceptions, of course, notably the sister volume to this book, Sidney Bloch, Paul Chodoff, and Stephen Green’s Psychiatric Ethics (1999). The first edition of Psychiatric Ethics, published in 1981, was a trail-blazer for the subject.
Diagnosis: rationality, responsibility, and values in psychiatric classification
Authors: Dickenson Donna , Fulford Bill (Kwm) 
Published: November 2023

Abstract
In the last chapter we were concerned with the overall concept of mental disorder. We found that mental disorder is understood in a number of different ways in the context of everyday practice, and that among these different ‘models’, it is important to strike a balance between medical and moral conceptions. In this chapter we move from the general to the specific, from the broad concept of mental disorder to three particular aspects of it which are ethically significant in psychiatric diagnosis: rationality (in Case 4.1, Martin McKendrick); respon sibility (in Case 4.2, Delia Jarrett); and descriptive psychopathology (in Case 4.3, Simon Greer).
The three Rs of research ethics
Authors: Dickenson Donna , Fulford Bill (Kwm) 
Published: November 2023

Abstract
Although this book is primarily a clinical casebook, we felt it important to include a brief consideration of research ethics for two reasons. First, the problems raised by ethics of research illustrate and help to draw together many of the issues that are important in clinical ethics. Second, the gap between clinical work and research is narrowing day by day. More and more clinical training schemes include a research component; and those working in ordinary clinical practice are increasingly expected to carry out research projects. These factors, combined with the growing importance of evidence-based practice, mean that even someone who is not directly involved in research, either as a researcher or as a member of a research ethics committee, must be able to assess the quality of a research proposal in its ethical as well as technical aspects.
Introduction
Authors: Wrightson Philip , Gronwall Dorothy 
Published: November 2023

Abstract
This chapter describes the development of the present concepts of the mechanisms and results of mild head injury. The sequence of organic changes, cognitive impairment, and the reaction to disability is outlined. Early management is important and there is a need for a service that can deal with problems before they become entrenched.
Mild head injury can be defined in a number of ways. Lay people see it as a minor event followed by rapid and complete recovery. In fact in the acute stage there is the possibility of life-threatening complications, and later disabling somatic and cognitive problems may persist and behavioural problems develop. In both cases there is the paradox of an apparently trivial event resulting in an illness with major consequences.