bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure measurement
Authors: Armstrong Bruce k. , White Emily , Saracci Rodolfo 
Published: November 2023

Abstract
Epidemiology is a comparatively new science. Its methods were first developed when the study of diseases due to infectious organisms was its main focus. The measurement of exposure was then grounded in microbiology, and most epidemiologists had substantial training or experience in this discipline. Interest in non-microbiological determinants of disease was commonly confined to the more readily measurable host factors such as age, sex, race, etc. Measurement of the microbiological determinants was simplified by the possibility of isolation and culture of a specific organism from the presumed agent of disease, the short interval that commonly separated exposure from onset of clinical symptoms, and the possibility of serological documentation of exposure that had occurred in the distant past.
The design of questionnaires
Authors: Armstrong Bruce k. , White Emily , Saracci Rodolfo 
Published: November 2023

Abstract
For our purposes, a questionnaire can be defined as a tool designed to elicit and record, or guide the elicitation and recording of, recalled exposures from subjects of an epidemiological study. It contains questions to be put to the subject, and may also include answers to those questions from which the subject must choose those which are appropriate to him or her. The objectives of questionnaire design are:
These objectives are potentially in conflict, and any questionnaire usually represents a compromise among them. For example, it may be necessary to trade off some ease in processing and analysis against ease in completion by the interviewer or the subject. Similarly, the addition of some questions essential to the objectives of the study, for example questions about sexual behaviour in a study of the aetiology of cancer of the cervix, may make a questionnaire more difficult for an interviewer to administer and more threatening to the respondent. Judgement must be exercised in making
The personal interview
Authors: Armstrong Bruce k. , White Emily , Saracci Rodolfo 
Published: November 2023

Abstract
In epidemiology, an interview is’ a structured procedure with a scientific purpose by means of which the respondent [subject of research], through a series of questions or presented stimuli, is induced to give verbal information.’ (Scheuch 1967). The personal interview, whether face-to-face or by telephone, is the commonest method of collecting data on exposure in epidemiological studies.
Measurements in the human body or its products
Authors: Armstrong Bruce k. , White Emily , Saracci Rodolfo 
Published: November 2023

Abstract
An exposure always leaves a trace, either transient or permanent, in the exposed subject. As a result, the exposure can sometimes be measured directly in the subject’s internal environment: in cells, body fluids, or body products. These measurements are commonly described as ‘biological measurements’ or measurements of ‘biological markers’, although the measurement procedures, in most cases, do not make use of biological properties but are, rather, chemical or physical in nature.
The Evaluation of National Health Systems
Authors: Cumper George E 
Published: November 2023

Abstract
As the demand for health care grows faster than the finance available, many developing countries (and some developed ones) are forced to evaluate their health systems, and even reorganize them. This needs more than an endorsement of international health policies and the accumulation of evaluations of individual projects. It needs the use of all available data on health system performance and a comparison with the standards the system is meant to meet: these standards relate not only to biomedical matters, but to administration, resource use and public demand. This requires a good understanding of the structure and working of the system, and of how the evaluator's results may be applied. This book is based particularly on experience in the Caribbean and the countries of south east Asia.
The follow-up study
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel 
Published: November 2023

Abstract
A cluster of disease often initiates a case-control study, but a clustering of diseases could easily escape notice. Good record keeping or registers are often very helpful; but experience, intuition, or chance may play a role. You have a problem and you need a solution. You have a group of diseases and you look for a cause. Epidemiological principles may also be applied if you have a new work process which might influence the health of the workers or a potential cause of harm and you need to know if it will influence the health of the workers. It is necessary to find out whether a particular exposure damages workers’ health. In this case you have an exposure-a number of people are exposed. The problem is: does it damage the workers’ health? In the Kentucky example, it would have been possible to identify a group of workers exposed to vinyl chloride and study new diseases occurring in the study period: a control group, which might be non-exposed workers from the same factory would be needed.
An ‘occupational ‘flu ‘ epidemic
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel 
Published: November 2023

Abstract
April 15 1965; a phone call from a more than desperate manager to a department of occupational health was the beginning of the end of a puzzling situation that nearly spelled disaster for the relatively small factory that was the scene of this ‘drama’. Twenty years ago, just after the Second World War, the father of the present manager, together with two of his brothers, set up a small plant where various kinds of metal cans were manufactured. Through hard work this family business prospered and developed into a small factory, with half a dozen or so unskilled workers. However, the demand for metal cans diminished, and it was thought worthwhile to change to a new technology. A second workshop was opened in which ‘plastic’ boxes were produced. The ‘plastic’ base material was delivered in large sheets to be cut and moulded. The manager himself and three new unskilled workers spent a week learning the technical procedures in a large factory in Germany, and production started at the end of February 1965. Initially everything went smoothly and the productivity of the workmen was considered quite good. Then things went wrong.
A small cluster of spontaneous abortions
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel 
Published: November 2023

Abstract
At a small factory close to a town in a rural area, about 40 women were mainly engaged in sewing men’s shirts. The work was monotonous and badly paid. Previously, most women only stayed in the job for a short period of time and left when other work opportunities presented. However, because of a high rate of unemployment among unskilled women in the area, these 40 women had been at the factory from two to ten years. They knew each other well, not only because they worked together, but also because most of them lived within a short distance of the factory in a sparsely populated area. Thirty-two of the women were under 45 years of age. One day the factory nurse was contacted personally by one of the women. She told her that she and her husband had been trying to have a child for some time. When she had finally become pregnant, she had lost the child after about three months. She had discussed the matter with some of the other women at the work place, and three others reported that they had also had a spontaneous abortion within the last two years.
An historical perspective
Authors: Elwood Harold 
Published: November 2023

Abstract
Anencephalus and spina bifida are known to have occurred in ancient times. A mummified anencephalic human fetus discovered in a sarcophagus at Hermopolis on the Nile was demonstrated at a meeting of the Academy of Sciences in Paris by Etienne Saint-Hilaire (1826). It was found in the catacombs of that city in the area where sacred animals, the ape and ibis, normally were buried according to the religious beliefs of ancient Egypt (Fig. 1.1). Brothwell and Powers (1968) note that the embalmer followed the usual methods of mummification, attempting to remove the brain via an opening made through the nose, and apparently the significance of the deformities in the head and neck region posteriorly were not noticed. This specimen was acquired by the King of Prussia and formed part of the collection of the Berlin Museum which was later destroyed by one of the Allied Forces' bombing raids during the Second World War (Powers 1978). The earliest post-Renaissance description of an anencephalic is probably that by Lycosthenes (1557) and another is included in the register prepared by Ambrosinus (1642) of a collection of specimens of monstrosity assembled by Aldrovandus. Taruffi (1891) wrote that the term 'anencephaly' was used by Schlegal in 1812 and after this date the term 'anencephalus' became more widely adopted. Further details of various historical aspects are given by Warkany (1959, 1971) and Lemire et al. (1978).
Fetal loss
Authors: Little Julian , Elwood Mark 
Published: November 2023

Abstract
Almost all epidemiological studies of anencephalus and spina bifida are based on the recorded prevalence at birth, counting only livebirths and legally accepted stillbirths, defined by a minimum estimated gestational age, currently 20 or 28 weeks in most countries. The number of such affected births is the number of embryos or fetuses in which the defects occur (the true incidence) minus the number of fetuses lost as spontaneous or induced abortions before the legal gestational limit, and the prevalence rate at birth (the proportion of all births which are affected) depends on the incidence rate of the defect and the ratio of the abortion rates in affected and unaffected pregnancies. To know to what extent prevalence at birth reflects incidence, it is necessary to calculate prevalence rates at different stages of gestation.
Maternal age and reproductive history
Authors: Elwood Mark , Little Julian 
Published: November 2023

Abstract
The literature on maternal age and parity has been regarded as ‘very confusing’ (Elwood J.M. and Elwood J. H. 1980, p. 181). This is still the situation and in at least one way the confusion has increased. In earlier work from developed countries, using data predominantly from the 1950s to the 1970s, variations in the prevalence at birth of neural tube defects by maternal age and parity could be taken to represent to a large degree biological processes, and coherent hypotheses to explain the variations could be considered. In the more recent data from the 1980s, the extent to which such variations reflect sociological rather than biological effects has increased and brings another complex element into the interpretation. With the wide availability of effective contraceptive methods since the 1960s, and the dramatic increase in induced abortion since the 1980s, the biological meaning of a birth at a particular age or a particular birth order is more questionable. Methodological limitations also exist. Data sets which are large enough to allow the separation of the effects of variables such as age and parity are usually based on routine birth certificate and vital statistical systems, which are restricted to the consideration of legally registered stillbirths and livebirths, and often have no information on other important factors such as social class. More detailed data sets may allow the consideration of spontaneous and induced abortions and relevant other factors but are often too small to separate the effects of related variables. The associations seen between the frequency of a defect and characteristics such as maternal age or parity on a population basis may differ from those seen in studies of individual mothers because of confounding factors: studies allowing the consideration of events linked by sibships are therefore particularly useful.
Socio-economic status and occupation
Authors: Little Julian , Elwood Harold 
Published: November 2023

Abstract
The theoretical background for the concept of social class and related indicators of relative position within society, together with a comprehensive review of measures of social class and a comparison of indicators used in epidemiological studies, have been documented by Liberatos et al. (1988). In epidemiological studies, indicators have been based on occupation, education, income, composite measures, and area of residence. In studies of neural tube defects in the British Isles, the social class measure used in virtually all studies has been based on occupation, classified according to the Registrar General's system (OPCS 1970, 1980). The classification was originally devised by Stevenson, statistician at the General Register Office, London, in 1911. The system divides the occupations of individuals into five social classes depending on the degree of skill involved and the social position implied.
Diet
Authors: Elwood Mark , Elwood Harold , Little Julian 
Published: November 2023

Abstract
Several aspects of the epidemiology of anencephalus and spina bifida may be interpreted as consistent with a dietary aetiology. The most important results are those of the randomized trial of dietary supplementation, which has shown a major protective affect of folic acid supplementation in high risk women (MRC Vitamin Study Research Group 1991). These results became available as this work was going to press, and are discussed at the end of this chapter and further in Chapter 20. We will here review the studies related to diet which have led up to this trial. Many dietary hypotheses have been suggested; Table 15 .1 shows the main areas and the types of study which are relevant to each.
Smoking and osteoporosis
Authors: Law Malcolm 
Published: November 2023

Abstract
The mineral density of bone is a useful simple index of its propensity to fracture. This chapter reviews 13 studies that have compared bone mineral density in cigarette smokers and non-smokers. In women who are 8 years or more post-menopausal, and in older men, bone density is lower in smokers than non-smokers, by about half a standard deviation (i.e. about one-eighth of the range of bone density in the population). In women who are pre-menopausal or less than 5 years post-menopausal, bone density is similar in smokers and non-smokers. These observations, and measures of the rate of bone loss in one study, indicate that smoking does not have an important influence on peak bone density but is associated with an increased rate of subsequent bone loss. It is likely that smoking directly causes this faster bone loss, as confounding with other determinants of bone density, or other sources of bias, appear unlikely. Of the possible mechanisms for this effect of smoking, the lower body weight of smokers is partly responsible, but an important action independent of body weight is likely. In women, the earlier menopause of smokers can be no more than a minor factor, and the effects of smoking in inhibiting oestrogen synthesis and inducing the selective production of inert metabolites appears irrelevant to the effect of smoking on the rate of bone loss, as the former action seems confined to pre-menopausal women, and the latter to post-menopausal women. The effects of smoking on other hormones, notably androstenedione and cortisol, could be important.
Health systems—a critical analysis of existing and suggested models
Authors: Ellencweig Avi Yacar 
Published: November 2023

Abstract
Health systems are characterized by many complex interactions. The complexity of these interactions permits the creation of innumerable varieties of policies, delivery mechanisms and control mechanisms. Perhaps, the only axiomatic statement that can unify all health systems and their subdivisions would be that they differ from each other. Those differences are not due to chance alone, rather they are rooted in the organization of societies. Societal determinants and attributes which have shaped each system and geared it into its present pattern can be described in several ways as shown in the next section.
Assessing the outcomes of health systems
Authors: Ellencweig Avi Yacar 
Published: November 2023

Abstract
The unequivocal ultimate goal of any health system is the improvement of the health of populations of a given region or country. For overall goals, there is general agreement with the World Health Organization ‘Health for all’ policy. However, at the population level, definitions of health outcomes, methods for outcome measurement, and the cause and effect relationships between factors and their effects on outcomes are characterized by confusion and disagreement. As we already mentioned in Chapter 2, there is disagreement about both the definition of health and the boundaries of the health system. In systems where there is a comprehensive welfare strategy, health is only one dimension in a multifaceted array of social networks. Thus, positive health outcomes depend not only on the health system but on society’s success in the general social and psychological arenas. This relationship reflects the WHO definition of health, in which social and psychological well-being are equal to physical health. Nevertheless, in many countries there are narrower boundaries for the national social systems, for health, welfare, and education, and thus they are strictly separated. Because in some countries the social systems are interrelated, and in some strictly separated, it is not feasible to standardize these boundaries. The picture is made even more complex by the modern definitions of health in which factors shaping up health outcomes but external to the health care system, are emphasi?’.ed. These factors are societal norms, environmental factors and biological phenomena. (See for example De Miguel 1975; Alan Dever 1980; Blum 1981).
Cross-national comparisons—correlating input factors and determinants of process with outcomes
Authors: Ellencweig Avi Yacar 
Published: November 2023

Abstract
For cross-comparisons of a number of countries there are two main ways in which we can apply our modular approach. One, discussed in Chapter 11, is an in-depth comparison of some of the modules of the health system over a small number of countries. In the other, as discussed in this chapter, we can study the statistical associations among a few of the health system’s modules for a larger number of countries. We can use these statistical associations to link health outcomes with their possible causes. This approach is very attractive because researchers and decision-makers are always intrigued by questions about how health outcomes may have been affected by a health system’s inputs and processes. So, it is not surprising that cross-comparative studies of this kind have been made by researchers in many disciplines. These include historians, epidemiologists, demographers, economists, and health services researchers. All of these have attempted to test the hypothesis that there are significant relationships between the input and processes of health systems, on the one hand, and their outcomes on the other. From an historical perspective, McKeown (1976) examined several factors that can explain the decline in the mortality rate in developed societies, particularly in Britain, over the last two hundred years. After excluding several other factors, he concluded that nutritional levels were a major vehicle for improving the health outcomes of populations. Other factors outside of the health care system like water supply, sanitation, housing, and education, also played important roles in explaining the improvement in health status.
A modular approach to competitive refarm in health systems
Authors: Chinitz* David 
Published: November 2023

Abstract
In Chapters 10 and 11 we used the modular approach to compare health systems in two ways. In one, we dealt with countries which are similar over several modules while diverging widely in one module. In the other, we based our comparison on a larger array of modules, attempting to characterize health systems more completely. For both approaches, we assumed that each module shares the same content validity across various countries.
The biology of healing
Authors: Iocono J A , Ehrlich H P , Gottrup F , Leaper D J 
Published: November 2023

Abstract
Despite great efforts in the study of wound repair, discerning the mechanisms for its control remains far from complete. As late as the early 20th century, poor healing and non-healing wounds were the rule rather than the exception. The additions of aseptic technique, careful observation, and supportive care of wounds markedly improved wound management and outcome. Today, as we prepare to enter the 21st century, clinicians and researchers alike toy with the notions of scarless repair and eradicating the complications of wound healing. Ideas that topical additions or new dressings may close wounds more rapidly and eliminate scarring complications are plentiful.
Zoonoses
Authors: Palmer S R , Soulsby Lord , Simpson D I H 
Published: November 2023

Abstract
Zoonoses are diseases naturally transmissible between vertebrate animals and man including those transmitted by direct contact with infected animals or carcases, by food or water contamination, and by inhalation of infected dust. They are increasingly important in public health issues. This multidisciplinary book is written by international specialists in human and veterinary medicine. Divided into three sections along the lines of bacteriology, parasitology and virology, this book comprehensively covers all zoonoses. Each of the seventy chapters covers the history of the disease, the scientific basis for the control of zoonoses, the microbiology of the causative agent, pathogenesis, clinical features, symptoms and signs, diagnosis, treatment and prognosis. The epidemiology of each disease is described alongside the strategies for prevention and control.
The relation of risk to exposure
Authors: Rose Geoffrey 
Published: November 2023

Abstract
The shape of the dose-effect curve is critical for the planning of control policy. Figure 3.1 illustrates schematically four possibilities, with some examples. Each of the four carries quite different policy implications. In Fig. 3.l(a) exposure is without adverse effects until it reaches a certain high level, beyond which the risk increases rapidly. This applies, for example, to intra-ocular pressure, which can vary over a wide range (‘the normal range’) without any problems, but when it exceeds the critical level there is a rapid rise in the incidence of glaucoma (one of the commonest causes of preventable blindness). It also applies to anemia and its associated symptoms, for there is no evident disadvantage to being mildly anemic and hence there may be no benefit if treatment is given in order to raise a hemoglobin level of, say, 10 g/dl up to the ‘normal’ level of 14.8 g/dl (Elwood 1973). It is generally supposed, though on inadequate evidence, that a curve of this type also describes the relationship between the level of blood alcohol and the risk of involvement in a road traffic accident, and this is the basis for punishing drivers whose levels exceed the ‘legal’ limit whilst condoning lower levels. (Some countries, such as Norway, punish any driver found to have detectable alcohol in the blood, perhaps with the aim of deterrence rather than from any different view on the dose-effect curve.)