bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking and oestrogen-related sites. Data from American Cancer Society Studies
Authors: Garfinkel Lawrence , Boffetta Paolo 
Published: November 2023

Abstract
Data from two American Cancer Society prospective studies-Cancer Prevention Study I, 1959-72 (CPS I), and Cancer Prevention Study II, 1982-6 (CPS ]])-were used for an analysis of cigarette smoking and oestrogen-related sites of cancer. Smoking and cancer of the colonrectum and of the gall bladder and biliary passage were also evaluated. Smoking was negatively related to endometrial cancer in both CPS I and CPS II, and increased the risk of cervical cancer in CPS I (RR 1.41, 95 per cent CJ 1.20-1.65) and in CPS II (RR 2.27, 95 per cent CJ 1.27-3.74). Breast cancer and ovarian cancer were not related to smoking. Colon-rectum cancer was negatively related in CPS I (RR 0.89, 95 per cent CJ 0.82-0.98) but positively related in CPS II (RR 1.16, 95 per cent CJ 0.99-1.37). Cancer of the biliary passages was related to smoking in CPS I (RR 1.81, 95 per cent CJ 1.19-2.63) but too few deaths in smokers occurred in CPS II to see if there was any relationship. Adjusting for known risk factors did not substantively change the relative risk ratios.
Smoking and inflammatory bowel disease
Authors: Logan Richard F A 
Published: November 2023

Abstract
Despite considerable research, the aetiology of inflammatory bowel disease (IBD) remains disappointingly obscure. For both diseases, the most widely accepted hypothesis broadly involves an infective agent(s) which triggers an abnormal immune response (Kirsner and Shorter 1982). Until recently the only environmental factor that had been demonstrated with any consistency was increased refined sugar consumption by patients with Crohn’s disease (Persson et al. 1987).
Smoking and endogenous sex hormones in men and women
Authors: Barrett-Connor Elizabeth 
Published: November 2023

Abstract
Studies of endogenous hormone levels have confirmed that cigarette smoking can have important hormonal effects. Circulating levels of the adrenal hormones androstenedione and dehydroepiandrosterone sulphate have repeatedly been found to be elevated in smokers. Oestradiol and oestrone levels do not appear to be related to smoking in women, but may be increased in men who smoke. The data regarding testosterone are variable. The net effect of these changes may be that smoking has an androgenic influence in women and an oestrogenic influence in men.
Supplying the system—analysis of manpower, physical resources, and socio-economic development
Authors: Ellencweig Avi Yacar 
Published: November 2023

Abstract
The modular approach is illustrated by the macro-model of health systems as shown in Chapter 2. Those modules of a health system that enable it to operate and that fuel its activities are its inputs. In this chapter we shall examine the content and significance of these input modules which include both resources and the socio-economic environment as discussed at the end of Chapter 2.
New horizons for systems outcomes: effectiveness, efficiency, equity, and quality
Authors: Ellencweig Avi Yacar 
Published: November 2023

Abstract
In Chapter 7 we delineated the concept and measurement of outcomes related to the health status of the population. We primarily discussed implications for better health, selecting only those variables measurable in the context of a population. In fact, all the health status measures described in Chapter 7 could be examined in the absence of a health care system. However, since health care systems are designed to provide their own effects on health status, it is appropriate to study the health systems outcomes, that is, how health care systems were successful in mobilizing their resources and in optimizing their processes for better health. Here we suggest four concepts for the measurement of the outcomes of a health care system: effectiveness, efficiency, equity, and quality. We shall explore possible definitions for these four concepts and consider their relevance to our discussion. After we elaborate on each concept, we suggest appropriate indicators for it.
Limitations of cross-national and cross-regional comparisons of health systems
Authors: Ellencweig Avi Yacar 
Published: November 2023

Abstract
Until now, we have focused on presenting the various modules that make up a health system. After examining the conceptual basis for each module, we identified indicators for measuring the phenomena in each module and also examined how these phenomena change over time. Deliberately, we avoided the crucial question: did we choose and use indicators appropriately? This chapter is aimed at answering this question, and we shall do that in a two-stage process. First we shall examine it methodologically. We shall consider methodological problems and how they affect the use of the modular approach in cross-national comparisons. Then, by suggesting possible remedies, we shall attempt to solve these methodological problems.
Integration of modules into a comprehensive model—a three-country example
Authors: Ellencweig Avi Yacar 
Published: November 2023

Abstract
In Chapter 10 we applied our model to multi-country comparisons using a small number of modules. Alternatively, we can compare a few countries on a broad basis using a larger number of modules. In Chapter 11, we shall explore the potential for the comparability over a broad range among three different representative health systems. We have chosen the Canadian health system as an example of a fully developed national health system. The Israeli health system is an example of a developed national health system which in some areas faces the problems of developing nations. The Nigerian health system is an example of the health system of a developing nation.
Health, Prevention and Economics
Authors: Cohen David R , Henderson John B 
Published: November 2023

Abstract
Prevention is better than cure, it is said, but is it more efficient? In the quest for improvements in health and life expectancy, and reductions in the growth of health care costs, attention has focused on the cost-effectiveness of preventive over curative medicine. Economics adds an essential dimension to the analysis of prevention policy that extends far beyond the study of comparative costs. The aim of this book is to give, for the first time, a comprehensive overview of the economics of prevention. It examines the scope of economics; the impact of the economy on avoidable ill-health, and of prevention on the economy; the economic rationale for provision of preventive services and regulation of hazardous activities; the cost-benefit approach and the nature of efficiency in prevention; the practice of economic appraisal; economic influences on the demand for hazardous commodities and screening services; theories of preventive behaviour; national prevention programme budgeting and priority setting; and the potential contribution of health economics.
Health, prevention and economics
Authors: Cohen David R , Henderson John B 
Published: November 2023

Abstract
Prevention is currently fashionable, and in some ways this is unfortunate. Being fashionable is not conducive to rational debate: it disposes people to take up extreme positions. Some argue that prevention is always better than cure, that it alone in the realm of health care is deserving of greater priority, or even that curative care could be dispensed with if only greater efforts were devoted to prevention. Others argue that prevention is ineffective, that trying to change behaviour is futile and elitist, or that the sacrifices involved are too great. This book tries to stand back from heated arguments and unreasoned positions. Its aim is to help to inform the more tempered and rational debate that is replacing them.
Towards a prevention strategy
Authors: Cohen David R , Henderson John B 
Published: November 2023

Abstract
For over a decade there have been explicit policy statements calling for a shift of emphasis away from treatment and cure and toward prevention as part of a new health strategy. Both the UK and the US governments, for example, have espoused an overall, comprehensive prevention policy as the way forward in trying to reduce morbidity and mortality (Department of Health and Social Security 1977; Department of Health, Education, and Welfare 1980). With so much having been said, it is reasonable to ask why more hasn’t been done.
Equity in the finance of health care: methods and findings
Authors: Doorslaer Eddy Van , Wagstaff Adam 
Published: November 2023

Abstract
For reasons indicated in the previous chapter, the analysis of equity in the finance of health care starts from the premise that payments for health care ‘ought to be positively related to ability to pay, rather than to the receipt of care. This chapter summarizes the evidence on the progressivity of health care finance in 10 OECD countries. Evidence is presented on the progressivity of each country’s financing system overall, as well as on the progressivity of each of its constituent parts. The chapter begins with a brief overview of the principal differences between the health care financing systems of the countries concerned. It then outlines the methods used to measure progressivity, as well as the data, variable definitions and incidence assumptions used in the empirical analysis. The chapter then goes on to discuss the principal findings of this part of the project. The final section contains a summary and discussion.
United States
Authors: Gottschalk Peter , Wolfe Barbara 
Published: November 2023

Abstract
This chapter aims to identify the distributional burdens of paying for health care in the US and the distribution of the beneficiaries of that system. Our focus on who pays and who benefits is motivated by two issues that have dominated discussions in the US in recent years: (1) the lack of universal insurance cover; and (2) the rapid increase in medical care costs that have led to medical expenditures accounting for more than 12 per cent of GNP. The thrust of much of this discussion is that high costs may have led to limited access for those who are not covered by public or private insurance. If it is the (non-elderly) lower-middle class that are caught between having incomes too high for public insurance but too low to afford private insurance then their access is limited by income. Added to this are those with low income not insured by public coverage, who are also likely to be caught. Furthermore, if public insurance is largely financed by the middle class, then they are the ones paying for the services they are the least likely to utilize.
Equity in Health Care: the Role of Ideology
Authors: Williams Alan 
Published: November 2023

Abstract
According to my dictionary an ideology is ‘a body of ideas, usually political and/or economic, forming the basis of a national or sectarian policy’. It usually also has a visionary characteristic, i.e., it is about the nature of a ‘good’ society, and it defines something to strive for, even though we do not expect ever to see it fully attained.
Clinical aspects of healing specialized tissue
Authors: Robson M C , Sampson J A G , Vickery C J , Leaper D J , Irvin T T , Wainwright A M , Smith E J , Whiston R J , Lane, I F , Feneley R C L 
Published: November 2023

Abstract
The skin of man is a large organ comprising a sheet-like investment of the whole body which adapts admirably to its contours and neatly conforms to its movements (1). However, it is more than just the physical exterior of the body being an interface with the environment. It serves as an organ of pro tection, controls the invasion of microorganisms, rations fluid gain or loss, regulates temperature, protects against injury from radiation and electricity, as well as providing immuno logic surveillance (2). At the same time, the skin contains a vasculature and sweating system uniquely adapted to the thermoregulatory demands of the organism, and an extensive neuroreceptor network, which serves as a finely tuned array of complex transducers of environmental information. Each of these functions is specifically related to a cell or areas within the skin.
Health, Primary Health Care, and the management challenge
Authors: Collins Charles 
Published: November 2023

Abstract
In Chapter 1 the need to understand the policy context of management and organizations was stressed. In the absence of universal recipes of good management, we have to understand how different systems of management and organizations are required in different contexts. The policy pursued by an organization is an important factor to be taken into account when developing management and organizations. This book is primarily interested in developing health management and organizations within the context of a Primary Health Care (PHC) policy.
lntersectoral coordination
Authors: Collins Charles 
Published: November 2023

Abstract
The multisectoral approach to health clearly states that, in addition to health services, health status is determined by a range of economic, social, and environmental factors. We might mention education, housing, food production and nutrition, water, sanitation, and income levels. Therefore, when we seek to manage and determine health, we should be concerned with more than the management of health services. Attention should be paid to, for example, the management of water and sanitation services, education, and housing. The health of a population is much more than the concerns of the MoH. It requires the participation of sectors that have health implications and are involved in the broader development tasks. In this chapter we shall look at the links between the management of health services and the management of health related sectors. Our concern is with intersectoral cooperation and coordination for health-the constraints and means for its potential development in management terms.
Considering abortion
Authors: Furedi Ann 
Published: November 2023

Abstract
No woman wants to have an abortion any more than she wants to have any other kind of operation. But just as a tonsillectomy may be considered the best solution for a woman with badly infected tonsils, so for some women an abortion may seem to be the best solution to an unplanned pregnancy. For some women the decision to end an unplanned pregnancy flies in the face of deeply held beliefs and principles, yet they may still feel it to be the only acceptable solution to their personal situation. Few women decide to have an abortion lightly. Even those women who find the very idea of motherhood appalling tend to think again when they discover they are pregnant. After all, most of us grow up believing we are destined to be mothers eventually, and many women take a certain pride in knowing that they are capable of motherhood—even if they do not wish to exercise their capacity for it now.
Considering motherhood
Authors: Furedi Ann 
Published: November 2023

Abstract
An unplanned pregnancy is not necessarily an unwanted pregnancy, and even those that are initially undesired may become wanted as they progress. It is not possible to generalize about why some women decide to keep their children and others do not. Women’s decisions about pregnancy reflect the broader circumstances of their lives. The fact that, according to a recent report on unplanned pregnancy1, marriage is an important factor in determining whether a woman with an unplanned pregnancy continues it or has an abortion, may reflect the fact that for many couples marriage implies a permanent commitment and consequently a suitable environment into which to bring a child. Often couples marry with the intention of ‘starting a family soon’. An accidental pregnancy in this situation may simply mean bringing such a decision forward.
The objectives of preventive medicine
Authors: Rose Geoffrey 
Published: November 2023

Abstract
Few diseases are the inescapable lot of humanity, for a problem that is common in one place will usually prove to be rare somewhere else. Cervical cancer is twenty times comminer in Colombia than in Israel, 10 per cent of Indian children die before their first birthday whereas in Western countries 99 per cent of babes survive, and according to UK census figures 3.1 per cent of adults in Wales report that they are permanently sick, compared with only 1.2 per cent of residents in southeast England. There is no known biological reason why every population should not be as healthy as the best.
Psychiatric and psychological approaches to the treatment of chronic pain: concepts and individual treatments
Authors: Benjamin Sidney , Main Chris J 
Published: November 2023

Abstract
In the first of two chapters, Dr Benjamin and Dr Main offer observations concerning the treatment of patients with chronic pain, which are relevant to the treatment of the other syndromes described in this book.
Patients with chronic pain (especially those attending pain clinics) may be regarded as having both physical and psychiatric disorder and successful treatment depends on understanding and treating both. Psychological treatment requires the identification of any specific and treatable mental disorder together with behavioural assessment of the ways in which pain and associated disability may be modified. The latter includes a full assessment of the role of care givers.
Dysmorphophobia in plastic surgery and its treatment
Authors: Goodacre Tim E E , Mayou Richard 
Published: November 2023

Abstract
Dr Goodacre and Dr Mayou suggest that the aetiology of dysmorphophobia and the general approach to management has much in common with other functional somatic symptoms. Since Goodacre is a plastic surgeon, their chapter is largely written from a surgical perspective. However, the general principles of management also apply to dysmorphophobia in other settings.
The authors begin by reviewing the psychology of normal appearance and the role of aesthetic surgery in general. It is apparent that many patients, whose appearance is not regarded as abnormal by others, obtain great psychological benefit from surgery. In contrast, a small proportion of patients have a very poor outcome and it is this subgroup who attracted the interest of psychiatrists.
The treatment of somatic symptoms in the elderly
Authors: Pearce Jane , Morris Charles 
Published: November 2023

Abstract
The diagnosis and management of somatic symptoms in the elderly has attracted little attention. However, Drs Pearce and Morris show that there is considerable evidence that such symptoms are at least as common as in younger people and are often associated with considerable disability and use of medical resources.
The high prevalence of physical disease in the elderly makes assessment difficult and means that an interaction of behavioural, physical and psychological factors is extremely common. Presentation and course are also substantially affected by social circumstances and by the reaction of families, friends, and other carers. Adequate assessment and treatment depend upon the giving of full weight both to physical and psychological factors as well as to social influences.
Reactive arthritis and Reiter’s syndrome-the clinical spectrum
Authors: Calin Andrei 
Published: November 2023

Abstract
Reactive arthropathy and Reiter’s syndrome are two terms that are used more or less interchangeably. The latter defines a triad or more of features, while the former relates to the inflammatory joint process and relationship to infection. In theory, reactive arthropathy may be defined as an inflammatory arthropathy distant in time and place from the original inciting infection, which is usually in the bowel or genitourinary tract. More recently, we have come to suspect that respiratory organisms can also precipitate disease and, of more importance, we accept that the synovial joint is not free of bacterial insult. As discussed elsewhere, there is growing evidence that fragments of organisms and antigenic determinants are found within the joint cavity or synovial tissues. The importance of this phenomenon and the relationship to potential antibiotic therapy remains unclear but of paramount interest and importance.
HLA-B27, ankylosing spondylitis, and the spondyloarthropathies
Authors: Wordsworth Paul , Brown Matthew 
Published: November 2023

Abstract
Ankylosing spondylitis is one of a group of conditions thought to have an autoimmune pathogenesis, which also includes several other rheumatic disorders, such as rheumatoid arthritis and juvenile chronic arthritis. They are characterized by disordered immunological responses, causing tissue-specific inflammation and damage, and by their striking immunogenetic associations (Wordsworth 1995). In 1973 the description of a very strong association between HLAB27, one of the immune response genes, and ankylosing spondylitis (Brewerton et al. 1973a; Schlosstein et al. 1973) prompted enormous interest in the immunogenetics of this condition. The odds ratio for HLA-B27 in ankylosing spondylitis is in excess of 100, and is fairly constant across ethnic groups.
The Practice Skills Seminars
Authors: Hope R A , Fulford, K W M , Yates Anne 
Published: November 2023

Abstract
Introduction This chapter describes the 11 seminars which make up the core of the Practice Skills course. An overview of the tutorials in General Communication Skills is given in Chapter 4. The seminar topics are listed on the next page. For each seminar we provide: setting out: the nature of the seminar its position in the clinical course number of students These describe how the seminar is set up and run, including teaching aids, methods and materials, and a detailed seminar plan. Case vignettes, summaries of the law, etc, as used in the seminar or to take away. The information given on each seminar is intended to be sufficiently comprehensive to allow readers to prepare and deliver their own seminars, picking and choosing from our materials as desired.
Tutorials in General Communication Skills
Authors: Hope R A , Fulford, K W M , Yates Anne 
Published: November 2023

Abstract
This part of the programme was devised by Theo Schofield, William Rosenberg and Tony Hope The Practice Skills Project main teaching consists of two sets of seminars: 1) the Practice Skills Seminars desribed in detail in Chapter 3 of this Manual and, 2) ten small group tutorials which focus on basic communication skills. These two teaching programmes complement each other. Issues of communication are part of the core seminars, and ethical and legal issues arise in the course of the communication skills tutorials. But the focus of the two programmes and the balance of teaching methods are different. In this chapter we outline briefly the content of the communication skills tutorials and the approach to the teaching. Further details are to be found in: Schofield T., Hope T., and Rosenberg W. (1996). Communication in Clinical Practice. Oxford University Press, (in preparation).
Macrocephaly
Authors: Baraitser Michael 
Published: November 2023

Abstract
It is important to know whether the large head has been present from birth, whether it is growing parallel to the centile, or is crossing the centile. Hydrocephalus should be excluded in the latter situation. If the patient has hydrocephalus, then the sex of the child is important. If female, and there is no obvious cause, then recurrence risks are small (2%). If the affected child is male then one should ascertain whether the hydrocephalus is secondary to aqueduct stenosis or not. If it is, the recurrence risks are 12% to male sibs. If not, the risks are small (2-3%).
Paroxysmal disorders
Authors: Baraitser Michael 
Published: November 2023

Abstract
Abstract: This is also called the syndrome of Mount and Reback, who first described the condition in 1940. Attacks can be provoked by alcohol or stress and therefore differ from the kinesigenic group (see below) in which the athetosis or dystonia is provoked by movement. The onset is mostly in childhood and the paroxysms can be severe enough to throw the child to the ground. Attacks can last many hours but short duration attacks have been reported (Demirkiran and Jankovic, 1995). There are some families in which coffee and fatigue have been triggers. The attacks are not influenced by anti-epileptic medication.