bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress in the biology of aging
Authors: Finch Caleb E 
Published: November 2023

Abstract
This paper describes some major trends and major gaps in knowledge in biogerontology. In its focus on humans and animals. it cannot be comprehensive. Three areas are growing spectacularly: physiology—pathology, biochemistry—cell biology, and molecular genetics. A major theoretical theme in biogerontology has concerned the possible accumulation of random damage in the genetic apparatus, as hypothesized from various mechanisms by Harmon, Szilard, Medvedev, Orgel, Burnet, and others. However, many types of recent evidence do not support random genomic damage as a prominent cause of age-related dysfunction at either the cell or organ level, though the age-related increase of cancer may involve cumulative effects from mutations over the lifespan. Consequences of limited cell proliferation are another major theme in all three areas, drawing from the finite replication of diploid human fibroblasts in vitro. While many mammalian cells show clonal senescence through a finite number of cell cycles in vitro and in vitro, the role of this phenomenon in age changes in vivo is not generally established. The impaired proliferation of cultured human lymphocytes could be a related phenomenon, and there may also be indirect consequences from limited clonal proliferation during development (e.g. through the inability to replace damaged neurones in the adult brain). Physiological—pathological changes are being analysed from the molecular level upwards. A remarkable diversity of age changes can be manipulated through diet, hormones, and drugs. These laboratory and clinical manipulations provide powerful tests of hypotheses about the many different types of cell and molecular mechanisms in aging. Suffice it to say that few biologists expect a comprehensive theory of biological aging and that most recognize a multiplicity of mechanisms.
Strategy for evaluating a national health system
Authors: Cumper George E 
Published: November 2023

Abstract
In the health field, the term evaluation covers a wide range of activities, from clinical audit in hospitals through cost-benefit and cost-effectiveness analysis of projects to national sector reviews by international agencies. Broadly, it can be defined as the comparison of the performance of an individual or institution with the standards appropriate to its function. Seen as part of the process of management, it carries the implication that any divergence is to lead to corrective action. When applied at the national level, this innocent-sounding definition raises certain difficulties which have to be solved before effective evaluation can take place.
Standards for health system evaluation
Authors: Cumper George E 
Published: November 2023

Abstract
Evaluation requires not only that we assemble information on how the national health system performs, but also that we find clear and appropriate norms and standards against which its performance can be judged. (We use ‘norm’ and ‘standard’ here as roughly equivalent, the former being more often quantitative-’three hospital beds per thousand population’-and the latter qualitative-’the mother’s blood pressure to be checked on each antenatal visit’.)
The case-control study
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel 
Published: November 2023

Abstract
If a cluster-that is an unusual gathering of a specific disease, usually within a rather short time span-occurs at a given work site, this might of course be due to chance, but it could also be the result of a given set of exposures. For the work-place detective facing an outbreak of disease, the chance explanation is the last conclusion to be reached. If all other explanations have been ruled out, chance might remain as the last likely explanation, but other possible explanations should be considered and excluded first. Or, in the words of that excellent detective, Sherlock Holmes ‘When you have eliminated the impossible whatever remains, however improbable, must (may) be the truth’.
Problems
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel 
Published: November 2023

Abstract
It is often better to have no study than a poor study, because it is better to have an open mind than biased evidence, so do not start a study if you re not going to have confidence in the results. If you as the detective do not believe in the evidence, neither should the court. There are many possible flaws in research and you should be familiar with some of them, much as the detective should know that burglars often leave false clues. Problems arise in many phases of research; when the study subjects are selected, when information is collected, and when data are analysed. In a cross-sectional study the occurrence (prevalence) of the disease under study for the ‘exposed’ is compared with the same occurrence in the non-exposed. The exposure and disease status is examined for the same time period. We do not have data to establish exposure status before the onset of the disease.
Mortality studies
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel 
Published: November 2023

Abstract
The aim of preventive medicine is to stop the cause of illness as soon as possible. So, if the study group itself is to benefit from the results, the disease state should be in an early phase. Many published reports in occupational medicine concern mortality studies. In a follow-up study, the mortality due to a specific disease can be studied. If mortality rates among the exposed are compared with (divided by) the mortality rate for non-exposed, relative mortality rates are calculated (instead of relative morbidity rates). Often you find the term SMR (standardized mortality ratio) used in these studies, meaning that the rates are adjusted (standardized) for age-differences in the two groups compared. The SMR value gives the excess mortality in percentages. An SMR value of 130 means an excess mortality rate among the exposed of 30 percent.
Classification, anatomy, and embryology
Authors: Elwood Mark , Elwood Harold , Little Julian 
Published: November 2023

Abstract
The classification of neural tube defects is complex. Consideration of their embryology and anatomy indicates a great variety of manifestation while more recent chromosomal and genetic studies point towards some degree of aetiological heterogeneity (Holmes et al. 1976; Toriello and Higgins 1985). For anencephalus, the conventional clinical classification includes the many anatomical variations outlined by Naftagas (1925), Fig. 2.1. A detailed review of the anatomy of anencephalus is given by Lemire et al. (1978). Anencephalus affects structures derived from or associated with the cephalic end of the neural tube. Other cephalic conditions appear as herniation of brain tissues through a defect in the skull-these include cranial meningocoele and cranium bifidum, encephalocoele, and hydrencephalocoele, containing respectively meninges only, meninges and brain tissue, or meninges, brain tissue, and part of the ventricular system. It is possible that cranial meningocoele and encephalocoele are part of the same disordered growth process although they are much rarer than and often clinically distinct from anencephalus (Ingraham 1944).
Antenatal screening and diagnosis
Authors: Wald Nolichas , Cuckle Howard 
Published: November 2023

Abstract
Antenatal screening and diagnosis of neural tube defects is carried out by ultrasound examination and alpha-fetoprotein (AFP) measurement in maternal serum or amniotic fluid. Amniotic fluid acetylcholinesterase (AChE) determination is an additional diagnostic test. Anencephalus can readily be detected by means of ultrasound alone with a negligible false-positive rate. The ultrasound examinations, usually performed early in the 2nd trimester of pregnancy, are carried out either selectively on women who are known to be at high risk of having a pregnancy with a neural tube defect, or routinely on all women receiving antenatal care. (In this chapter women known to be at high risk of having a neural tube defect pregnancy are those who have a raised serum AFP level or those with a positive family history, usually having had a previous pregnancy associated with a neural tube defect.) In a recent summary of the literature including nine studies, all 207 cases of anencephalus were detected in women who had an ultrasound scan because they were at high risk (Wald et al. 1991a). More than nine out of ten anencephalic pregnancies are associated with raised maternal serum AFP levels so that centres performing routine maternal serum AFP screening followed by ultrasound on those who have raised levels will detect nearly all affected pregnancies. While the performance of a routine ultrasound examination in the detection of neural tube defects is poorly documented, the detection rate for anencephalus is likely to be close to 100 per cent. A positive ultrasound scan is usually sufficient to offer a woman a termination of pregnancy without the need to perform a diagnostic amniocentesis.
The current situation of Village Health Worker programmes in China
Authors: Kan Xuegui 
Published: November 2023

Abstract
In the late 1950s the Chinese created and began to use ‘barefoot doctors’ in an attempt to extend the basic preventive, promotive, and curative health services to the under-served rural population. It was hoped to provide a bridge between the community and the professional health service, to mobilize community resources and thereby overcome the difficulties in government health resources, and ultimately, to achieve more improvement in the health status of the people at a cost that the country could afford. Today, an impressive improvement in the health status of the Chinese people has indeed been made, with life expectancy of nearly 70 years, and irtfant mortality about 35 per 1000 live births, despite fairly low per capita income. Although many factors could have contributed to this achievement (for example, improvements in nutrition, education, housing, sanitation, and other policies in the health sector, such as the use of traditional medicine and family planning), the use of village health workers (VHWs) can at least be considered as one of the contributing factors. (For the purposes of this chapter VHWs include only barefoot doctors and their successors-village doctors and health aides.)
Community health work: India’s experience
Authors: Desai P B 
Published: November 2023

Abstract
The purpose of this contribution is to reflect on the steps taken in India in the direction of universalizing access to primary health care (PHC) through a large cadre of what are called community health workers (CHWs). The creation of this cadre was initiated by the first ever non-Congress government, that of the Janata Party, on 2 October 1977 (the birthday of M. K. Gandhi, the ‘Father of the Nation’). On that day, the government introduced their Rural Health Scheme, which was projected as a measure designed to place ‘people’s health in people’s own hands’.
The limits of participation in health: brigadista programmes in Nicaragua
Authors: Coyle Edward , Davey Smith George , Sandiford Peter 
Published: November 2023

Abstract
The development of health services in Nicaragua following the popular revolution in 1979 has particular international relevance, since this period coincides with the programme for primary health care (PHC) launched by the World Health Organization and UNICEF at the Alma-Ata Conference (WHO 1978a). PHC was an essential component of the WHO programme for ‘Health for All by the Year 2000’. For developing countries community health workers (CHWs) were seen to be ‘the most realistic solution for attaining total population coverage with essential health services’. The origin of CHWs from the communities they served, and the continuous participation of the community in the quest for health, were advanced as key elements in this strategy.
Introduction
Authors: Wagstaff Adam , Doorslaer, Eddy Van , Rutten Frans 
Published: November 2023

Abstract
Health care reform looks set to stay high on the policy-making agenda during the 1990s. Some reforms that were planned during the 1980s have already begun to be implemented. These include the so-called internal market programme in the UK, the move from fee-for-service to capitation payments for general practitioners’ low-income patients in Ireland, and the switch from social insurance to tax financing in Spain. Other reforms are likely to follow elsewhere. The current Secretary of State in the Netherlands seems determined to push for a gradual implementation of a diluted version of the 1988 ‘Dekker Plan’ (see van de Ven 1990). The Swiss look set to vote in favour of a referendum proposing a large increase in the role of taxation in the financing of health care. In addition, reforms to the American health care system look increasingly likely, as health care costs and the number of uninsured continue to rise remorselessly.
Equity in the finance and delivery of health care: concepts and definitions
Authors: Wagstaff Adam , Doorslaer Eddy Van 
Published: November 2023

Abstract
Equity, like efficiency, is a goal that is pursued by policy-makers in all types of health care system. But what is equity? How should it be defined? And how is it to be measured? Answers to these questions are far from self-evident but are clearly required if meaningful cross-country comparisons are to be performed. This chapter addresses the first two of these questions. The third is addressed in Chapters 3 and 4, which also summarizes the methods and results of the COMAC-HSR study.
Equity in health care and health care financing: evidence from five developing countries
Authors: Baker Judy L , Gaag Jacques van der 
Published: November 2023

Abstract
It is often argued that a country’s per capita income is a poor indicator of the welfare of its population. One objection to this average measure is that it ignores distributional aspects. For example, a country with a relatively high per capita income can still have large numbers of poor people due to a highly skewed income distribution. Average per capita income says nothing about the living conditions of these people.
Experimental models in wound healing
Authors: Ehrlich H P , Gottrup F 
Published: November 2023

Abstract
Tissue injury resulting in irreversible cell death and connective tissue disruption initiates the repair process. The number of causes that produce tissue injury and tissue loss outnumber the responses the host has to repair the defect. In a superficial injury, where only the epidermal surface is damaged and destroyed (such as a sun burn), the repair process is limited to cellular replacement. Through a process of epidermal cell migration and duplication, the defect is resurfaced in a regen erative manner in the absence of scarring. In contrast, with deeper tissue loss where the connective tissue matrix is de stroyed, healing occurs by scarring with the introduction of new cell populations residing in a newly constructed connec tive tissue matrix and having a new blood supply.
Clinical trials and statistics
Authors: Leaper D J , Mulder G D 
Published: November 2023

Abstract
The rapid increase in attention focused on wound repair during the past two to three decades has paralleled an increased demand for clinical trials examining efficacy and safety of new wound care devices, pharmaceuticals, and other products. Fierce competition has necessitated the implementation of clinical trials which need to be completed with a large patient population in a relatively short time frame. Subsequently, the quality of science and research have been compromised to some extent for the sake of obtaining, questionably valid, published results.
Introducing management and organizations
Authors: Collins Charles 
Published: November 2023

Abstract
There is no easy route to developing management skills, yet neither is it an impossible task. To the health professional, management is often a new activity for which they have had little opportunity to reflect upon. The objective of this first chapter is to develop precisely that reflection. Management and the structuring of organizations has to be placed upon firm foundations for them to be effective. This may be done by facing up to some of the most common and basic questions that a manager faces in his or her work.
Grouping work in the Ministry of Health
Authors: Collins Charles 
Published: November 2023

Abstract
Jobs within an organization do not operate in isolation from one another but are brought together in divisions, departments, units, sections, and groups. In the previous chapter we looked at vertical differentiation in the work levels, spans of control and the overall shape of an organization. Here we shall be looking at the horizontal process of differentiation in an organization, i.e. grouping activities together in the most appropriate fashion. The two forms of differentiation—vertical and horizontal—are related and may be analysed in a series of organizational design problems.
Unplanned pregnancy: your choices
Authors: Furedi Ann 
Published: November 2023

Abstract
This book is written for all women who find themselves unexpectedly pregnant and want information and advice on the available options facing them. It explains what will be inolved if the woman decides on adoptions, abortion, or motherhood. It also discusses why unplanned pregnancies occur and what happens to a woman's body in early pregnancy. The whole book is brought to life iwth many extracts from interviews with women who have had unplanned pregnancies talking about their varied experiences and the choices they took.
Some implications of population change
Authors: Rose Geoffrey 
Published: November 2023

Abstract
Society seeks to distance itself from its deviants, either physically (as by segregating those with mental illness or AIDS), or by categorizing them (‘hypertensives’, ‘depressives’, ‘hooligans’), or by denying responsibility for their problems (such as obesity, poverty-related illness, alcoholism, or violence). Yet in truth the deviants are simply the tail of the population’s own distribution; they belong to each other and society is one, whether it likes it or not. There now follows an explanation of these interrelations between the population and its deviants, and the health implications for the deviants of changes in the population. This will be followed by consideration of the health implications of such changes for the population as a whole.
In search of health
Authors: Rose Geoffrey 
Published: November 2023

Abstract
The Romans’ ideal for personal health was mens sana in corpora sano—a healthy mind in a healthy body. The comparable ideal for those concerned with public health would be ‘a healthy life-style in a healthy environment’. The occurrence of most diseases relates to what people eat and drink, to their daily activities, and to their physical and social environment. Some individuals are particularly susceptible to the harmful consequences of impaired circumstances, and in such cases it is appropriate to seek (or offer) a focused relief, but if either the causes or the susceptibility are wide spread, then a more general change is necessary.
Psychosomatic disorders: historical perspectives
Authors: Porter Roy 
Published: November 2023

Abstract
The historian Roy Porter provides a historical background to the major and more recent themes of the remainder of the book. He describes examples from the sixteenth to nineteenth centuries of attempts by physicians, philosophers, and others to explain and categorize in medical and philosophical terms what, in this book, are described as functional somatic symptoms. None of these have satisfactorily resolved fundamental difficulties in understanding the mind-brain relationship.
Psychological treatment and the health care system: the chaotic case of back pain. Is there a need for a paradigm shift?
Authors: Main Chris J , Benjamin Sidney 
Published: November 2023

Abstract
In the second of their two chapters, Dr Main and Dr Benjamin examine the social context of treatment. They begin by discussing the ways in which occupational, financial, and other social factors contribute to the aetiology and influence the prognosis of chronic pain and then consider the various types of pain management programmes. The section on treatment guidelines is concerned particularly with specialist programmes. The final section makes recommendations for service development in terms of community education, improved health care delivery, and changes in health care policy. The issues discussed in this chapter are relevant to the provision of care for all the functional somatic syndromes discussed in this book. They are considered further in Chapters 21 and 22.
Management in primary care
Authors: Gask Linda 
Published: November 2023

Abstract
In this chapter Dr Gask describes the high prevalence of functional somatic symptoms in primary care settings and outlines those factors which predict poor out come. She also describes a practical model for the detection, acknowledgement, and management of functional somatic symptoms which can be easily learned and used in primary care. Finally, the management of chronic somatization in primary care is described and the importance of shared care between the psychiatrist and primary health care team is emphasized.
Examination and assessment
Authors: Hope R A , Fulford, K W M , Yates Anne 
Published: November 2023

Abstract
Appraisal of student learning - whether by formal examination or general clinical assessment - is essential to the successful development of training in practice skills: It motivates students, particularly those with little natural aptitude or interest It signals the importance of practice skills. So long as knowledge and technical skills are appraised, so must practice skills It provides essential feedback on the success of the course (see Appendix 11, How to Develop a New Seminar ) It is sometimes argued that it is impossible to ‘test’ practice skills (especially ethics). As with assessing other aspects of clinical competence, there are difficulties, and this is certainly an area in need of further development. However, several studies, and our own pilot work, suggests that with appropriate methods, all aspects of practice skills can be assessed no less reliably than other more technical aspects of clinical practice.
Introduction
Authors: Baraitser Michael 
Published: November 2023

Abstract
Over the past five years there has been a revolution in clinical neurogenetics that has effected the way neurology is practised. This is substantially due to developments in molecular biology. What began as a small number of diseases which were mapped when the last edition of this book was written, has now swelled to a volume of diseases which are not only mapped but in which mutations can be analysed. With these advances have come problems in the nomenclature. Diseases like DRPLA (see p. 270), almost unheard of by the majority of neurologists, are now over-represented in the literature and have a high profile, because molecular biology has found a way of diagnosing these diseases by simple measures. Neurologists who had gradually come to terms with the demise of Charcot-Marie-Tooth disease in favour of ‘hereditary motor and sensory neuropathy type l’, etc have now seen the return of Charcot-Marie-Tooth in a abbreviated form. We now have CMTlA, CMTlB, CMT2, etc., as more and more heterogeneity is identified and disorders need new names. The cerebellar ataxias are now SCA1-SCA5;