Todos cuantos aman el libro y cuantos trabajan con cualquier tipo de documento o material en papel encontrarán en esta obra información detallada para comprender las causas, múltiples e interconectadas, que concurren en la degradación del papel. Partiendo de la consideración de las diversas fases técnicas de la producción del papel y los mecanismos de su deterioro —unas generales y otras excepcionales y de difícil previsión—, se exponen ante el lector las distintas opciones operativas que existen en la actualidad para prevenir los posibles daños, y conservar y restaurar el papel en todas sus formas. La obra incorpora de manera anexa un modelo de "Informe de restauración", instrumento ya adoptado por numerosas instituciones, de gran utilidad para la elaboración de un archivo general de referencia. Asimismo un amplio apéndice final ofrece información actualizada de recursos bibliográficos y electrónicos necesarios para afrontar este campo de intervención, de por sí extremadamente especializado.

Health systems should function in such a way that the amount of inappropriate care is minimized, while at the same time stinting as little as possible on appropriate and necessary care. The ability to determine and identify which care is overused and which is underused is essential to this functioning. To this end, the "RAND/UCLA Appropriateness Method" was developed in the 1980s. It has been further developed and refined in North America and, increasingly, in Europe. The rationale behind the method is that randomized clinical trials--the "gold standard" for evidence-based medicine--are generally either not available or cannot provide evidence at a level of detail sufficient to apply to the wide range of patients seen in everyday clinical practice. Although robust scientific evidence about the benefits of many procedures is lacking, physicians must nonetheless make decisions every day about when to use them. Consequently, a method was developed that combined the best available scientific evidence with the collective judgment of experts to yield a statement regarding the appropriateness of performing a procedure at the level of patient-specific symptoms, medical history, and test results. This manual presents step-by-step guidelines for conceptualising, designing, and carrying out a study of the appropriateness of medical or surgical procedures (for either diagnosis or treatment) using the RAND/UCLA Appropriateness Method. The manual distills the experience of many researchers in North America and Europe and presents current (as of the year 2000) thinking on the subject. Although the manual is self-contained and complete, the authors do not recommend that those unfamiliar with the RAND/UCLA Appropriateness Method independently conduct an appropriateness study; instead, they suggest "seeing one" before "doing one." To this end, contact information is provided to assist potential users of the method.