Decision support system Health Dictionary

Decision Support System: From 1 Different Sources


See “decision analysis”.
Health Source: Community Health
Author: Health Dictionary

Central Nervous System

A collective term for the brain, spinal cord, their nerves, and the sensory end organs. More broadly, this can even include the neurotransmitting hormones instigated by the CNS that control the chemical nervous system, the endocrine glands.... central nervous system

Limbic System

A functional, not physical, system in the brain, generally considered to mediate emotions with metabolism.... limbic system

Immune System

See IMMUNITY.

Age Disease and mode of administration

3 days BCG (Bacille Calmette-Guerin) by injection if tuberculosis in family in past 6 months.

2 months Poliomyelitis (oral); adsorbed diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

3 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

4 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

12–18 months Measles, mumps, and rubella (German measles)4 (given together live by injection).

(SCHOOL ENTRY)

4–5 years Poliomyelitis (oral); adsorbed diphtheria and tetanus (given together by injection); give MMR vaccine if not already given at 12–18 months.

10–14 females Rubella (by injection) if they have missed MMR.

10–14 BCG (Bacille Calmette-Guerin) by injection to tuberculin-negative children to prevent tuberculosis.

15–18 Poliomyelitis single booster dose (oral); tetanus (by injection).

1 Pertussis may be excluded in certain susceptible individuals.

2 Known as DPT or triple vaccine.

3 Haemophilus in?uenzae immunisation (type B) is being introduced to be given at same time, but di?erent limb.

4 Known as MMR vaccine. (Some parents are asking to have their infants immunised with single-constituent vaccines because of controversy over possible side-effects – yet to be con?rmed scienti?cally – of the combined MMR vaccine.)

Recommended immunisation schedules in the United Kingdom... immune system

Respiratory System

All the organs and tissues associated with the act of RESPIRATION or breathing. The term includes the nasal cavity (see NOSE) and PHARYNX, along with the LARYNX, TRACHEA, bronchi (see BRONCHUS), BRONCHIOLES and LUNGS. The DIAPHRAGM and other muscles, such as those between the RIBS, are also part of the respiratory system which is responsible for oxygenating the blood and removing carbon dioxide from it.... respiratory system

Nervous System

This extensive, complex and ?nely tuned network of billions of specialised cells called neurones (see NEURON(E)) is responsible for maintaining the body’s contacts with and responses to the outside world. The network also provides internal communication links – in concert with HORMONES, the body’s chemical messengers – between the body’s diverse organs and tissues, and, importantly, the BRAIN stores relevant information as memory. Each neurone has a ?lamentous process of varying length called an AXON along which passes messages in the form of electrochemically generated impulses. Axons are bundled together to form nerves (see NERVE).

The nervous system can be likened to a computer. The central processing unit – which receives, processes and stores information and initiates instructions for bodily activities – is called the central nervous system: this is made up of the brain and SPINAL CORD. The peripheral nervous system – synonymous with the cables that transmit information to and from a computer’s processing unit – has two parts: sensory and motor. The former collects information from the body’s many sense organs. These respond to touch, temperature, pain, position, smells, sounds and visual images and the information is signalled to the brain via the sensory nerves. When information has been processed centrally, the brain and spinal cord send instructions for action via motor nerves to the ‘voluntary’ muscles controlling movements and speech, to the ‘involuntary’ muscles that operate the internal organs such as the heart and intestines, and to the various glands, including the sweat glands in the skin. (Details of the 12 pairs of cranial nerves and the 31 pairs of nerves emanating from the spinal cord are given in respective texts on brain and spinal cord.)

Functional divisions of nervous system As well as the nervous system’s anatomical divisions, the system is divided functionally, into autonomic and somatic parts. The autonomic nervous system, which is split into sympathetic and parasympathetic divisions, deals with the automatic or unconscious control of internal bodily activities such as heartbeat, muscular status of blood vessels, digestion and glandular functions. The somatic system is responsible for the skeletal (voluntary) muscles (see MUSCLE) which carry out intended movements initiated by the brain – for example, the activation of limbs, tongue, vocal cords (speech), anal muscles (defaecation), urethral sphincters (urination) or vaginal muscles (childbirth). In addition, many survival responses – the most powerfully instinctive animal drives, which range from avoiding danger and pain to shivering when cold or sweating when hot – are initiated unconsciously and automatically by the nervous system using the appropriate neural pathways to achieve the particular survival reaction required.

The complex functions of the nervous system include the ability to experience emotions, such as excitement and pleasure, anxiety and frustration, and to undertake intellectual activities. For these experiences an individual can utilise many built-in neurological programmes and he or she can enhance performance through learning – a vital human function that depends on MEMORY, a three stage-process in the brain of registration, storage and recall. The various anatomical and functional divisions of the nervous system that have been unravelled as science has strived to explain how it works may seem confusing. In practical terms, the nervous system works mainly by using automatic or relex reactions (see REFLEX ACTION) to various stimuli (described above), supplemented by voluntary actions triggered by the activity of the conscious (higher) areas of the brain. Some higher functions crucial to human activity – for example, visual perception, thought, memory and speech – are complex and subtle, and the mechanisms are not yet fully understood. But all these complex activities rest on the foundation of relatively simple electrochemical transmissions of impulses through the massive network of billions of specialised cells, the neurones.... nervous system

Systemic

Involving the whole body or organism, and not just individual parts.... systemic

Autonomic Nervous System

Part of the nervous system which regulates the bodily functions that are not under conscious control: these include the heartbeat, intestinal movements, salivation, sweating, etc. The autonomic nervous system consists of two main divisions – the SYMPATHETIC NERVOUS SYSTEM and the PARASYMPATHETIC NERVOUS SYSTEM. The smooth muscles, heart and most glands are connected to nerve ?bres from both systems and their proper functioning depends on the balance between these two. (See also NERVES; NERVOUS SYSTEM.)... autonomic nervous system

Extrapyramidal System

This is a complex part of the nervous system, extending from the cortex to the medulla in the BRAIN, from which emerge descending spinal pathways which in?uence voluntary motor activity throughout the body. Although the normal functions of the system are poorly understood, there are characteristic signs of an extrapyramidal LESION. These include disturbance of voluntary movements, notably slowness and ‘poverty’ of movement; disturbance of muscular tone, which may be increased or decreased; and involuntary movements, such as a tremor, irregular jerking movements, or slow writhing movements.

Diseases There are several diseases that result from lesions to the extrapyramidal system, of which the most common is PARKINSONISM. Others include WILSON’S DISEASE, KERNICTERUS, CHOREA and ATHETOSIS.... extrapyramidal system

Peripheral Nervous System

See NERVOUS SYSTEM.... peripheral nervous system

System

A network of interdependent components that work together to attain the goals of the complex whole.... system

Sympathetic Nervous System

Part of the AUTONOMIC NERVOUS SYSTEM. It consists of scattered collections of grey matter known as ganglia, united by an irregular network of nerve-?bres; those portions where the ganglia are placed most closely and where the network of ?bres is especially dense being known as plexuses. The chief part of the sympathetic system consists of two ganglionated cords that run through the neck, chest, and abdomen, lying close in front of the spine. In conjunction with the other part of the autonomic nervous system – the parasympathetic – this part controls many of the body’s involuntary activities involving glands, organs and other tissues. (For further details, see NERVOUS SYSTEM.)... sympathetic nervous system

Lymphatic System

Lymph is the same fluid which oozes from a cut when bleeding stops. It surrounds every living cell. Lymph conveys to the blood the final products of digestion of food. It also receives from the blood waste products of metabolism. This is a two-way traffic.

Lymph fluid, loaded with waste, excess protein, etc, is sucked into the lymph tubes to be filtered by the spleen and the lymph nodes. The tubes are filled with countless one-way valves referred to collectively as the lymphatic pump, which propels the flow of lymph forwards. Lymph ultimately is collected in the main thoracic duct rising upwards in front of the spine to enter the bloodstream at the base of the neck.

A number of disorders may arise when the fluid becomes over-burdened by toxaemia, poor drainage and enlarged nodes (glands). Such un-eliminated wastes form cellulite – unwanted tissue formation and swelling. Thus, the soil may be prepared for various chronic illnesses from glandular disorders to arthritis. If the lymph is circulating freely it is almost impossible to become sick.

This system is capable of ingesting foreign particles and building up an immunity against future infection. Some herbal Lymphatics are also antimicrobials, natural alternatives to conventional antibiotics.

Treatment. Clivers is particularly relative to glandular swellings of neck and axillae.

For active inflammation: Echinacea, Goldenseal, Ginseng (Panax).

Alternatives. Teas: Clivers, Red Clover, Agnus Castus herb, Bladderwrack, Violet leaves, Marigold petals.

Decoctions: Blue Flag, Echinacea, Fenugreek seeds, Saw Palmetto.

Tablets/capsules. Agnus Castus, Echinacea, Bladderwrack, Red Clover, Thuja, Poke root, Fenugreek. Formula No 1. Echinacea 2; Clivers 1; Burdock 1; Poke root half. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Formula No 2. Equal parts: Blue Flag root, Poke root, Senna. Dose: as above.

Topical. Poultices: Slippery Elm, Fenugreek seeds, Marshmallow. Horsechestnut (Aesculus) ointment. ... lymphatic system

Cardiovascular System

This refers to the whole circulatory system: the heart, the systemic circulation (the arteries and veins of the body) and the pulmonary circulation (the arteries and veins of the lungs). Blood circulates throughout the cardiovascular system bringing oxygen and nutrients to the tissues and removing carbon dioxide and other waste products.... cardiovascular system

Hla System

The major histocompatibility complex, or human leucocyte antigen (HLA) region, consists of genetically determined antigens, situated on chromosome 6. Found in most tissues, though to a di?ering extent, the four gene loci are known as A, B, C, D, while the individual alleles at each locus are numbered 1, 2, 3, etc. The number of possible combinations is thus enormous, and the chance of two unrelated people being identical for HLA is very low.

HLA incompatibility causes the immune response, or rejection reaction, that occurs with unmatched tissue grafts. Strong associations between HLA and susceptibility to certain diseases – notably the AUTOIMMUNE DISORDERS such as rheumatoid arthritis, insulin-dependent diabetes, and thyrotoxicosis – have been described. Certain HLA antigens occur together more frequently than would be expected by chance (linkage disequilibrium), and may have a protective e?ect, conferring resistance to a disease. (See IMMUNITY.)... hla system

Portal System

A vein or collection of veins which ?nish at both ends in a bed of capillary blood vessels. An important example is the hepatic portal system, comprising the portal vein and its tributaries. Blood from the stomach, pancreas, spleen and intestines drains into the veins that join up to comprise the portal vein into the liver, where it branches into sinusoids.... portal system

Reproductive System

A collective term for all the organs involved in sexual reproduction. In the female these are the OVARIES, FALLOPIAN TUBES, UTERUS, VAGINA and VULVA. In the male these are the testes (see TESTICLE), VAS DEFERENS, SEMINAL VESICLES, URETHRA and PENIS.... reproductive system

Parasympathetic Nervous System

That part of the AUTONOMIC NERVOUS SYSTEM which is connected with the BRAIN and SPINAL CORD through certain nerve centres in the midbrain, medulla, and lower end of the cord. The nerves from these centres are carried in the third, seventh, ninth and tenth cranial nerves and the second, third and fourth sacral nerves. The action of the parasympathetic system is usually antagonistic to that of the sympathetic system. Thus it inhibits the action of the HEART and augments the action of the INTESTINE; whereas the sympathetic augments the action of the heart and inhibits that of the intestine. (See diagram of sympathetic and parasympathetic nervous systems under NERVOUS SYSTEM.)... parasympathetic nervous system

Systemic Lupus Erythematosus (sle)

See separate dictionary entry.... systemic lupus erythematosus (sle)

Circulatory System

The heart and blood vessels, which together maintain a continuous flow of blood throughout the body. The system provides tissues with oxygen and nutrients, and carries away waste products. The circulatory system consists of 2 main parts: the systemic circulation, which supplies blood to the whole body apart from the lungs; and the pulmonary circulation to the lungs. Within the systemic circulation, there is a bypass (the portal circulation), which carries nutrient-rich blood from the stomach, intestine, and other digestive organs to the liver for processing, storage, or re-entry into general circulation.

In the systemic circulation, oxygen-rich blood from the pulmonary circulation is pumped under high pressure from the left ventricle of the heart into the aorta, from where it travels through arteries and smaller arterioles to all parts of the body. Within body tissues, the arterioles branch into networks of fine blood vessels called capillaries. Oxygen and other nutrients pass from the blood through the capillaries’ thin walls into body tissues; carbon dioxide and other wastes pass in the opposite direction. Deoxygenated blood is returned to the heart via venules, veins, and the venae cavae.

Venous blood returns to the right atrium of the heart to enter the pulmonary circulation. It is pumped from the right ventricle through the pulmonary artery

to the lungs, where carbon dioxide is exchanged for oxygen. The reoxygenated blood then returns through the pulmonary veins to the heart and re-enters the systemic circulation.... circulatory system

Systemic Sclerosis

Also known as scleroderma, a rare autoimmune disorder that can affect many organs and tissues, particularly the skin, arteries, kidneys, lungs, heart, gastrointestinal tract, and

joints. The condition is 3 times as common in women and is most likely to appear between the age of 30 and 50.

The number and severity of symptoms varies. The most common symptom is Raynaud’s phenomenon. Also common are changes in the skin, especially of the face and fingers, which becomes shiny, tight, and thickened, leading to difficulty with movements. Other parts of the body may also be affected, leading to difficulty in swallowing, shortness of breath, palpitations, high blood pressure, joint pain, or muscle weakness. Progression of scleroderma is often rapid in the first few years and then slows down or even stops. In a minority of people, degeneration is rapid, and leads to death from heart failure, respiratory failure, or kidney failure.

There is no cure for scleroderma, but many of the symptoms can be relieved.... systemic sclerosis

All Payer System

A system in which prices for health services and payment methods are the same, regardless of who is paying. For instance, in an all payer system, federal or state government, a private insurer, a self-insured employer plan, an individual, or any other payer could pay the same rates. The uniform fee bars health care providers from shifting costs from one payer to another. See “cost shifting”.... all payer system

Alternative Medical System

A complete system of theory and practices that has evolved independently of, and often prior to, the conventional biological approach. Many are traditional systems of medicine that are practised by individual cultures throughout the world. Traditional Oriental medicine and Ayurveda, India’s traditional system of medicine, are two examples.... alternative medical system

Appointment Scheduling System

A system for planning of appointments between resources such as clinicians and facilities and patients. It is used in order to minimize waiting times, prioritize appointments and optimize the utilization of resources.... appointment scheduling system

Assessment System

A structured process developed to ensure that assessment is relevant, consistent, fair and valid. The system requires rules of operation, a regular review process and competent assessors.... assessment system

Buffering System

The several blood factors that enable the acid waste products of metabolism to be carried in the alkaline blood without disrupting its chemistry. These include carbolic acid, carbonates, phosphates, electrolytes, blood proteins, and erythrocyte membranes.... buffering system

Circulatory System Of The Blood

The course of the circulation is as follows: the veins pour their blood, coming from the head, trunk, limbs and abdominal organs, into the right atrium of the HEART. This contracts and drives the blood into the right ventricle, which then forces the blood into the LUNGS by way of the pulmonary artery. Here it is contained in thin-walled capillaries, over which the air plays freely, and through which gases pass readily out and in. The blood gives o? carbon dioxide (CO2) and takes up oxygen (see RESPIRATION), and passes on by the pulmonary veins to the left atrium of the heart. The left atrium expels it into the left ventricle, which forces it on into the aorta, by which it is distributed all over the body. Passing through capillaries in the various tissues, it enters venules, then veins, which ultimately unite into two great veins, the superior and the inferior vena cava, these emptying into the right atrium. This complete circle is accomplished by any particular drop of blood in about half a minute.

In one part of the body there is a further complication. The veins coming from the bowels, charged with food material and other products, split up, and their blood undergoes a second capillary circulation through the liver. Here it is relieved of some food material and puri?ed, and then passes into the inferior vena cava, and so to the right atrium. This is known as the portal circulation.

The circle is maintained always in one direction by four valves, situated one at the outlet from each cavity of the heart.

The blood in the arteries going to the body generally is bright red, that in the veins dull red in colour, owing to the former being charged with oxygen and the latter with carbon dioxide (see RESPIRATION). For the same reason the blood in the pulmonary artery is dark, that in the pulmonary veins is bright. There is no direct communication between the right and left sides of the heart, the blood passing from the right ventricle to the left atrium through the lungs.

In the embryo, before birth, the course of circulation is somewhat di?erent, owing to the fact that no nourishment comes from the bowels nor air into the lungs. Accordingly, two large arteries pass out of the navel, and convey blood to be changed by contact with maternal blood (see PLACENTA), while a large vein brings this blood back again. There are also communications between the right and left atria, and between pulmonary artery and aorta. The latter is known as the ductus arteriosus. At birth all these extra vessels and connections close and rapidly shrivel up.... circulatory system of the blood

Clinical Information System

An information system that collects, stores and transmits information that is used to support clinical applications (e.g. transmission of laboratory test results, radiology results, prescription drug orders). Electronic medical records are one method by which clinical information systems can be created.... clinical information system

Complement System

This is part of the body’s defence mechanism that comprises a series of 20 serum peptides (see PEPTIDE). These are sequentially activated to produce three signi?cant effects: ?rstly, the release of small peptides which provoke in?ammation and attract phagocytes (see PHAGOCYTE); secondly, the deposition of a substance (component C3b) on the membranes of invading bacteria or viruses, attracting phagocytes to destroy the microbes; thirdly, the activation of substances that damage cell membranes – called lytic components – which hasten the destruction of ‘foreign’ cells. (See IMMUNOLOGY.)... complement system

Cleavers Tea - Best Tonic For The Lymphatic System Available In Nature

Cleavers tea has been used for centuries, even in ancient Greece. It is considered probably the best tonic for the lymphatic system available. Discover all of its benefits and learn how to make the most of this type of tea. Description of Cleavers tea Cleavers is an annual green plant that grows mostly in Britain, North America and Eurasia regions. The green to white flowers look like small balls and they are very sticky, similar to the leaves. Scientifically named gallium aparine, cleavers is also called bedstraw, barweed, catchweed, grip grass. The entire cleavers plant is used in herbal medicine and is harvested just before it blooms in early summer. The active constituents of cleavers tea are chlorophyll, citric acide, rubichloric acid, galiosin and tannins. To benefit the most from these constituents, you can consume cleavers, usually found in the form of tea, extracts, capsule, or fresh for many cooking recipes. The roasted seeds are used as a coffee substitute and the young leaves can be eaten like spinach. Cleavers tea has a slightly bitter taste and no odor. Cleavers tea brew For a tasty Cleavers tea, take 2 to 3 teaspoons of the dried above-ground parts of the plant and infuse them in a 250 mg cup of hot water for 10 or 15 minutes. You may add sugar or honey to improve its taste and drink up to three times per day. Cleavers tea  Benefits Cleavers tea is a strong detoxifying for the lymphatic system. It is diuretic, thus treating most of urinary tract infections. It cleans the blood, the liver and kidneys. The tea can be used together with Uva Ursi or Echinacea for best results. Applied topically, Cleavers tea helps in the treatment of many skin conditions like acne, eczema, psoriasis, dandruff, itchy scalp, sunburns or even wounds. Cleavers tea can be used as a facial tonner because it helps clear the complexion. Cleavers tea Side effects Cleavers tea has no known side effects. Though it is widely safe, children, pregnant or nursing women should drink it with precaution. Cleavers tea can surely be included in a healthy lifestyle. As long as you don’t exaggerate with it, you can enjoy the benefits of this tea and even use the plant to prepare many tasty recipes and salads.... cleavers tea - best tonic for the lymphatic system available in nature

Comprehensive Health System

A health system that includes all the elements required to meet all the health needs of the population.... comprehensive health system

Computerised Decision-support Systems

Also known as ‘expert systems’, these are computer software systems intended to help doctors make clinical decisions. Primary care medicine is especially noted for its uncertainty by virtue of being most patients’ ?rst point of contact with health care, confronting the clinician with many ‘undi?erentiated’ health problems. So far, these systems have not been as e?ective as expected because of a failure to ana-lyse the needs of primary care. Simple procedures to prompt the delivery of treatment to patients with chronic conditions have improved care quality, but work needs to be done on their cost-e?ectiveness. The aim of more complex computerised support systems will be to forecast likely future events and the possible e?ectiveness of proposed interventions, based on available information about the patient and an understanding of the risks and e?cacy of interventions by doctors and other experts.

One example, called ISABEL, can be accessed by paediatricians to check on their diagnosis and management of many childhood disorders.... computerised decision-support systems

Decision Analysis

An approach to decision-making that involves modelling the sequences or pathways of multiple possible strategies (e.g. of diagnosis and treatment for a particular clinical problem) to determine which is optimal. It is based upon available estimates (drawn from the literature or from experts) of the probabilities that certain events and outcomes will occur and the values of the outcomes that would result from each strategy.... decision analysis

Evidence-based Decision-making

In a policy context, evidence-based decision-making is the application of the best available scientific evidence to policy decisions about specific treatments or care, as well as changes in the delivery system.... evidence-based decision-making

Health Care Delivery System

See “health system”.... health care delivery system

Health Information System

The generation and the use of appropriate health information to support decision-making, health care delivery and management of health services at national and subnational level.... health information system

Health System Infrastructure

Services, facilities, institutions, personnel or establishments, organizations and those operating them for the delivery of a variety of health programmes.... health system infrastructure

Health Systems Research

Research dealing with the entire health system or only part of it, the object being to ensure that the system is optimally planned and organized and that programmes are carried out by the health system infrastructure efficiently and effectively and with appropriate technology.... health systems research

Integrated Delivery System / Integrated Services Network (isn)

A network of organizations, usually including hospitals and medical practitioner groups, that provides or arranges to provide a coordinated continuum of services to a defined population and is held both clinically and financially accountable for the outcomes in the populations served.... integrated delivery system / integrated services network (isn)

Management Information System

A system of databases designed to process and exchange information to support decision-making as well as implementation, monitoring and evaluation of programmes, activities and projects. See also “health information system”.... management information system

Health System

The people, institutions and resources, arranged together in accordance with established policies, to improve the health of the population they serve, while responding to people’s legitimate expectations and protecting them against the cost of ill-health through a variety of activities, the primary intent of which is to improve health. Health systems fulfil three main functions: health care delivery, fair treatment of all, and meeting non-health expectations of the population. These functions are performed in the pursuit of three goals: health, responsiveness and fair financing. A health system is usually organized at various levels, starting at the community level or the primary level of health care and proceeding through the intermediate (district, regional or provincial) to the central level.... health system

Nervous System, Disorders Of

The following conditions are discussed under their individual headings: APHASIA; BRAIN, DISEASES OF; CATALEPSY; CHOREA; CRAMP; EPILEPSY; HYSTERIA; LEARNING DISABILITY; MEMORY; MENTAL ILLNESS; MULTIPLE SCLEROSIS (MS); NERVES, INJURIES TO; NEURALGIA; NEURITIS; PARALYSIS; PSYCHOSOMATIC DISEASES; SPINE AND SPINAL CORD, DISEASES AND INJURIES OF; STROKE; TABES.... nervous system, disorders of

Organized Delivery System

See “integrated delivery system”.... organized delivery system

Pluralistic System

A system that is based on incorporating divergent provider modalities (e.g. public, private, non-profit, etc.).... pluralistic system

Prospective Payment System

A system whereby reimbursement rates are set for a given period of time prior to the circumstances giving rise to actual reimbursement claims.... prospective payment system

Reticulo-endothelial System

This consists of highly specialised cells scattered throughout the body, but found mainly in the SPLEEN, BONE MARROW, LIVER, and LYMPH nodes or glands. Their main function is the ingestion of red blood cells and the conversion of HAEMOGLOBIN to BILIRUBIN. They are also able to ingest bacteria and foreign colloidal particles.... reticulo-endothelial system

Social Support

Emotional, instrumental and financial assistance obtained from an individual’s social network. Social support provided by family, friends and neighbours is referred to as ‘informal support’, whereas social support provided by formal service agencies is called ‘formal support’.... social support

State Medicine (health Care Systems)

Major government schemes to ensure adequate health services to substantial sectors of the community through direct provision of services.... state medicine (health care systems)

Support Group

A group of people who share a common bond (e.g. caregivers, patients, families of patients) who come together on a regular basis to share problems and experiences or keep in contact in other ways (e.g. the Internet).... support group

Systematic Review

A review of studies in which evidence has been systematically searched for, studied, assessed and summarized according to predetermined criteria.... systematic review

Picture Archiving And Communications System (pacs)

The use of digital imaging systems to replace conventional X-ray pictures and other imaging techniques. Though expensive to operate, digital imaging and storage systems o?er promising possibilities for transmission of clinical images within and between hospitals and community health-care units, providing fast access and remote working that will bene?t patients and health-care sta? alike. When security and con?dentiality are assured, images could be transferred via the Internet and teleradiology. In future, hospitals might be able to eliminate the costly physical transfer and storage of X-ray ?lms. The integration of PACS with hospital information systems in the NHS will (hopefully) facilitate the introduction of electronic radiology.... picture archiving and communications system (pacs)

Systems Approach

A school of thought evolving from earlier systems analysis theory and propounding that virtually all outcomes are the result of systems rather than individuals. In practice, the systems approach is characterized by attempts to improve the quality and/or efficiency of a process through improvements to the system.... systems approach

Systems Error

An error that is not the result of an individual’s actions, but the predictable outcome of a series of actions and factors that comprise a diagnostic or treatment process.... systems error

Transplant Support Services Authority

In the UK, this NHS authority (UKTSSA) provides a 24-hour service for matching, allocating and distributing organs. It is also responsible for keeping the records of all patients awaiting transplants. Established in 1991, the authority allocates donor organs without favour, following protocols set by advisory groups. It also administers the Human Organ Transplant Act on behalf of the Department of Health. (See TRANSPLANTATION.)... transplant support services authority

Endocrine System

The collection of glands around the body that produce hormones.

These glands include the thyroid gland, pancreas, testes, ovaries, and adrenal glands.

Their hormones are responsible for numerous bodily processes, including growth, metabolism, sexual development and function, and response to stress.

Any increase or decrease in the production of a specific hormone interferes with the process it controls.

To prevent under- or overproduction, hormone secretion from many endocrine glands is regulated by the pituitary gland, which is in turn influenced by the hypothalamus in the brain according to a feedback mechanism.... endocrine system

Systemic Lupus Erythematosus

See lupus erythematosus.... systemic lupus erythematosus

Urinary System

See urinary tract.... urinary system

Abo System

see blood group.... abo system

Advanced Life Support

(ALS) a structured and algorithm-driven method of life support for use in the severest of medical emergencies, especially cardiac arrest. Doctors, nurses, and paramedic personnel involved in ALS receive special training in the use of equipment (e.g. defibrillators and appropriate drugs). Paediatric advanced life support (PALS) is ALS for use in severe medical emergencies in children, while advanced trauma life support(ATLS) is specifically for patients who have been subjected to major trauma, such as a serious road accident. Compare basic life support.... advanced life support

Tea For Immune System

Your immune system consists of a series of antibodies and other microorganisms whose main purpose is to defend your system against external attacks. When we have a cold or flu, the main thing that keeps us alive is this line of defense that keeps all bacteria, infections and microbes away from us. Unfortunately, our immune system is not strong enough to fight all causes, so we need to enhance its power by taking a treatment. How a Tea for Immune System Works A Tea for Immune System must contain enough active constituents to fight a wide range of diseases. First of all, it must contain minerals, manganese, magnesium, iron, volatile oils, acids, tannins, nutrients and enzymes. These teas can be taken as cures for a short amount of time (1 or 2 weeks) to enhance your body strength, so you mustn’t exaggerate when taking it. Efficient Tea for Immune System A Tea for Immune System must contain a lot of active constituents and it must be very effective. If you don’t know which teas to choose from, here’s a list to guide you on: - Garlic Tea – can be found almost anywhere on the globe and it has a wide range of uses, from cuisine to pharmaceutical purposes. Also a great cure for diarrhea, this Tea for Immune System has a rather unpleasant taste and smell. Feel free to add honey, lemon, ginger or mint in order to make it more adequate. - Green Tea – probably the most important tea in the world, Green Tea contains all the ingredients necessary to promote a healthy life, full of great benefits. However, don’t take it in case you suffer from menstrual and menopausal pains in order to avoid stomach and uterus irritations. - Yerba Mate Tea – the South American tea has a series of health advantages and it’s been named by the scientific society “the new green tea”. Drink it from a traditional bombilla or straight from a normal glass, but make sure you know which the risks are and that you’re taking this treatment under supervision. - Ginseng Tea – this wonderful Chinese Tea is used as a main ingredient in the Asian cuisine, but also as a great adjuvant in cases of nausea, vomiting and auto-immune deficiencies. However, make sure that you’re using the right amount of herbs when preparing this decoction in order to avoid developing a acid foods and drinks intolerance! Tea for Immune System Side Effects When taken properly, these teas are generally safe. However, drinking more tea than it’s recommended may lead to constipation, upset stomach or even death. Talk to your doctor before starting any kind of herbal treatment and find out which are the risks. Don’t take a treatment based on a Tea for Immune System if you’re pregnant, breastfeeding, on anti coagulants, blood thinners or preparing for a surgery. Also, children must be kept away from these teas since there’s no study to prove how safe it is for them. When in doubt, always ask your doctor. If he says there’s nothing that could interfere with your treatment, choose a tea that fits you best and enjoy its health benefits!... tea for immune system

Biliary System

The organs and ducts by which bile is formed, concentrated, and carried from the liver to the duodenum (the first part of the small intestine). Bile is secreted by the liver cells and collected by a network of bile ducts that carry the bile out of the liver by way of the hepatic duct. A channel called the cystic duct branches off the hepatic duct and leads to the gallbladder where bile is concentrated and stored. Beyond this junction, the hepatic duct becomes the common bile duct and opens into the duodenum at a controlled orifice called the ampulla of Vater. The presence of fat in the duodenum after a meal causes secretion of a hormone, which opens the ampulla of Vater and makes the gallbladder contract, squeezing stored bile into the duodenum.

The main disorders affecting the biliary system are gallstones, congenital biliary atresia and bile duct obstruction.

(See also gallbladder, disorders of.)... biliary system

Apache Scoring System

acute physiological and chronic health evaluation: a tool used to assess the severity of illness in a critically ill patient and to estimate mortality. The assessment uses information from 12 physiological measurements, including temperature, blood pressure, arterial pH, and certain blood results.... apache scoring system

Basic Life Support

the provision of treatment designed to maintain adequate circulation and ventilation to a patient in *cardiac arrest, without the use of drugs or specialist equipment. Compare advanced life support.... basic life support

Early Warning System

(EWS) a system to detect deteriorating patients on the ward. Certain physical parameters are accorded scores: the higher the scores for individual patients, the greater the deterioration in their condition. Parameters scored include blood pressure, respiratory rate, pulse rate, blood oxygen saturation, and level of consciousness. Adjustments can be made for increased age.... early warning system

Tea For Nervous System

The nervous system is responsible for almost any reaction that comes from your body. From eyes to muscles and even hair, your body is a very complex electric system directed by your brain. Most of the problems that a person has in a lifetime are related to a nervous system failure. In order to treat this kind of problems or prevent them from happening, you may want to try a tea instead of all those traditional pills. How a Tea for Nervous System Works A Tea for Nervous System is indeed helpful if it contains an important amount of nutrients, enzymes, tannins, volatile oils and minerals (sodium, iron, magnesium and manganese). You may want to avoid a tea that has an elevated acids level since it may cause you even more damages. A Tea for Nervous System will make your body send all the active constituents to the affected areas and heal the damaged tissue. Efficient Tea for Nervous System In order to work properly, a Tea for Nervous System must show results in a short time period and be one hundred percent safe (you don’t want any more complications than you already have). However, before starting any kind of herbal treatment, remember to take the indicated dose and never surpass it in order to avoid other health problems. If you don’t know which teas could be helpful for you, here’s a list for guidance: - Oolong Tea – contains half the amount of caffeine that other teas have so it’s best for your health to give it a try every once in a while. This Tea for Nervous System will also strengthen your entire organism and rejuvenate the aspect of your skin. However, don’t drink more than 2 cups per day. - Green Tea – as the scientists have proved, this decoction contains all the ingredients necessary to sustain life, so it’s good for a number of other health complaints, such as infertility, headaches, nausea, loss of appetite, anemia and asthenia. Just make sure you avoid it at all costs in case you’re experiencing some menstrual or menopausal symptoms (it may cause uterine contractions and internal bleedings). - Black Tea – some say that it does more damages than good for your nervous system and some others think that this tea is worth a try. Having an elevated level of caffeine, this tea is highly addictive. In right amount, it can treat infertility, erectile dysfunctions, sore throats and colds. However, ask an herbalist before starting a treatment based on this Tea for Nervous System in order to find out which are the risks. Tea for Nervous System Side Effects When taken according to specifications, these teas are generally safe. However, exceeding the number of cups recommended per day may lead to other health complaints, such as nausea, diarrhea, uterine contractions, internal bleedings and headaches. If you’ve tried one of these teas and something doesn’t feel quite right, talk to your doctor as soon as possible! Don’t take a Tea for Nervous System if you’re pregnant, breastfeeding, on blood thinners or anticoagulants. The same advice if you’re preparing for a surgery (some of the active compounds in these teas may interfere with your anesthetic and cause death). But if you have the green light from your doctor, choose a tea that fits best your requirements and enjoy its wonderful health benefits!... tea for nervous system

Digestive System

The group of organs responsible for digestion. It consists of the digestive tract (also known as the alimentary tract or canal) and various associated organs. The digestive tract consists of the mouth, pharynx, oesophagus, stomach, intestines, and the anus. The intestines are the small intestine (comprising the duodenum, jejunum, and ileum) and the large intestine (comprising the caecum, colon, and rectum). The associated organs, such as the salivary glands, liver, and pancreas, secrete digestive juices that break down food as it goes through the tract.

Food and the products of digestion are moved from the throat to the rectum by peristalsis (waves of muscular contractions of the intestinal wall).

Food is broken down into simpler substances before being absorbed into the bloodstream.Physical breakdown is performed by the teeth, which cut and chew, and the stomach, which churns the food. The chemical breakdown of food is performed by the action of enzymes, acids, and salts.

Carbohydrates are broken down into simple sugars. Proteins are broken down into polypeptides, peptides, and amino acids. Fats are broken down into glycerol, glycerides, and fatty acids.

In the mouth, saliva lubricates food and contains enzymes that begin to break down carbohydrates. The tongue moulds food into balls (called boli) for easy swallowing. The food then passes into the pharynx. From here, it is pushed into the oesophagus and squeezed down into the stomach, where it is mixed with hydrochloric acid and pepsin. Produced by the stomach lining, these substances help break down proteins. When the food has been converted to a semi-liquid consistency, it passes into the duodenum where bile salts and acids (produced by the liver) help to break down fats. Digestive juices released by the pancreas into the duodenum contain enzymes that further break down food. Breakdown ends in the small intestine, carried out by enzymes produced by glands in the intestinal lining. Nutrients are absorbed in the small intestine. The residue enters the large intestine, where water is absorbed. Undigested matter is expelled via the rectum and anus as faeces.... digestive system

Four-layer System

a continuous compression bandage consisting of four layers that are applied and left in situ for up to seven days to treat venous leg ulcers, increasing the chance of healing by up to 30%. Thorough assessment of the patient’s status must be undertaken before the application.... four-layer system

Haversian System

one of the cylindrical units of which compact *bone is made. A Haversian canal forms a central tube, around which are alternate layers of bone matrix (lamellae) and lacunae containing bone cells. The lacunae are linked by minute channels (canaliculi).... haversian system

House–brackmann Facial Nerve Grading System

(House–Brackmann score, House–Brackmann scale, House–Brackmann facial weakness scale) a six-point grading system for patients with *Bell’s palsy or other forms of facial nerve palsy. Grade I is normal function; grade VI is a total palsy. [J. W. House and D. E. Brackmann (21st century), US otorhinolarygologists]... house–brackmann facial nerve grading system

Muscular System

The muscles of the body that are attached to the skeleton. These muscles are responsible for voluntary movement, and also support and stabilize the skeleton. In most cases, a muscle attaches to a bone (usually by means of a tendon) and crosses over a joint to attach to another bone. Muscles can produce movement by contracting and shortening to pull on the bone to which they are attached. They can only pull, not push, and are therefore arranged so that the pull of one muscle or group of muscles is opposed to another, enabling a movement to be reversed. Although most actions of the skeletal muscles are under conscious control, reflex movements of certain muscles occur in response to stimuli.

There are more than 600 muscles in the body, classified according to the type of movement they produce.

An extensor opens out a joint, a flexor closes it; an adductor draws a part of the body inwards, an abductor moves it outwards; a levator raises it, a depressor lowers it; and constrictor or sphincter muscles surround and close orifices.... muscular system

Reproductive System, Female

The female organs involved in ovulation, sexual intercourse, nourishing a fertilized ovum until it has developed into a full-grown fetus, and childbirth. With the exception of the vulva, which protects the opening of the vagina, these organs lie within the pelvic cavity.

Ova (eggs) are released at monthly intervals from the 2 ovaries, which also secrete oestrogen hormone; and progesterone hormones that control the reproductive cycle. The ova travel through the fallopian tubes to the uterus. Fertilization takes place if a sperm released into the vagina during sexual intercourse travels through the cervix and uterus to penetrate an ovum while it is in the fallopian tube.... reproductive system, female

Reproductive System, Male

The male organs involved in the production of sperm and in sexual intercourse. Sperm and male sex hormones (androgen hormones) are produced in the testes, which are suspended in the scrotum. From each testis, sperm pass into an epididymis, where they mature and are stored. Shortly before ejaculation, sperm are propelled into a duct called the vas deferens, which carries the sperm to the seminal vesicles behind the bladder. These 2 sacs produce seminal fluid, which is added to the sperm to produce semen.

Semen travels along 2 ducts to the urethra.

The ducts pass through the prostate gland, which produces secretions that are added to the semen.

At orgasm, semen is ejaculated from the urethra through the erect penis, which is placed in the woman’s vagina during sexual intercourse.... reproductive system, male

Advance Directive, Decision, Or Statement

(in England and Wales under the Mental Capacity Act 2005) a legally recognized decision or statement by an adult with *capacity identifying any specific or general treatment the patient does not want in the event that he or she loses capacity. An advance directive or decision (formerly often called a living will) should be informed, made voluntarily, and must be valid and applicable to the medical situation that arises; at the extreme it can constitute an advance refusal of potentially life-saving treatment. It cannot, however, be used to demand future treatment and does not apply as long as the person retains capacity. An advance statement is a more general and less legally binding expression of the person’s values and views on the sort of treatment he or she may or may not wish to undergo. Directives and statements can raise ethical questions: for example, should life-saving treatment refused in advance nevertheless be given if it could restore the patient to a quality of life with which he or she was content before losing capacity.... advance directive, decision, or statement

Human Leucocyte Antigen System

see HLA system.... human leucocyte antigen system

Income Support

an income-related benefit payable to those whose income and savings do not exceed a specified maximum level and who do not work full-time. It is currently being replaced by *universal credit.... income support

Induction Loop System

(loop system) a device for helping people with some types of *hearing aid or *cochlear implant to hear more effectively in certain situations. Electrical signals from a television, sound system, or microphone are passed through an amplifier to a wire that is positioned in a loop encompassing the desired listening area. This creates an electromagnetic field that can be picked up by a coil within the hearing aid or cochlear implant. Induction loops are installed in such places as public buildings, lecture theatres, classrooms, and churches. See also assistive listening device.... induction loop system

Injury Scoring System

(injury severity scale, ISS) a system used, particularly in *triage, for grading the severity of an injury. See also abbreviated injury scale.... injury scoring system

Intrauterine System

see IUS.... intrauterine system

Complaints System

a process that enables patients to voice concerns about the standard of care they receive. In the UK, any complaints should be raised as soon as possible, in the first instance locally with the NHS provider involved. Various statutory and voluntary advice and advocacy services are available to assist in this. If a patient is not satisfied with the outcome of local resolution, the matter can be referred to the *Parliamentary and Health Service Ombudsman. Legal action cannot usually proceed at the same time and only a small proportion of complaints proceed to law. Disciplinary procedures are separate from the complaints procedure although complaints may prompt or inform disciplinary action.... complaints system

Employment And Support Allowance

(in Britain) an allowance payable to people under state retirement age who are unable to work because of illness or disability. Entitlement depends on either an adequate record of National Insurance contributions or satisfying income-related criteria. An assessment-phase allowance is paid during the first 13 weeks of a claim, and eligible claimants are paid the main-phase rate following a work capability assessment. The part of this allowance based on income is currently being replaced by a component of *universal credit; the part based on National Insurance contributions will remain in place.... employment and support allowance

Loop System

see induction loop system.... loop system

Multiple System Atrophy

(MSA) a condition that results from degeneration of cells in the *basal ganglia (resulting in *parkinsonism), the *cerebellum (resulting in *ataxia), the *pyramidal system, and the *autonomic nervous system (resulting in symptoms of autonomic failure, such as postural hypotension).... multiple system atrophy

Nephrogenic Systemic Fibrosis

(NSF, nephrogenic fibrosing dermopathy) a rare condition, first reported in 1997, that occurs exclusively in patients with chronic kidney disease (CKD), who develop large areas of hardened skin with fibrotic nodules and plaques. Flexion contractures with an accompanying limitation of range of motion can also occur. Exposure to gadolinium, used as a contrast agent in magnetic resonance imaging, has been identified as a causative factor, but many patients with severe CKD have been exposed to gadolinium without consequence. Linear gadolinium preparations (Omniscan, OptiMARK) appear to carry the highest risk of NSF. There is no cure for the condition.... nephrogenic systemic fibrosis

Neuroendocrine System

the system of dual control of certain activities of the body by means of both nerves and circulating hormones. The functioning of the autonomic nervous system is particularly closely linked to that of the pituitary and adrenal glands. The system can give rise to neuroendocrine tumours (NETs), which have special structural features and often produce active hormones. See also neurohormone; neurosecretion.... neuroendocrine system

Picture Archiving And Communication System

see PACS.... picture archiving and communication system

Proxy Decision

(surrogate decision) a decision made with or on behalf of a person who lacks full legal capacity to *consent to or refuse medical treatment. See best interests; Gillick competence; parental responsibility; power of attorney; substituted judgment.... proxy decision

Pyramidal System

a collection of nerve fibres in the central nervous system that extend from the *motor cortex in the brain to the spinal cord and are responsible for initiating movement. In the medulla oblongata the fibres form a *pyramid (hence the name), within which they cross from one side of the brain to the opposite side of the spinal cord; this is called the decussation of the pyramids. Damage to the pyramidal system manifests in a specific pattern of weakness in the face, arms, and legs, abnormally brisk reflexes, and an extensor *plantar reflex (Babinski response).... pyramidal system

Radiology Information System

(RIS) a computer database used to keep details of all the patients attending a clinical radiology department. It records patient demographics, imaging procedures done, medications given and dosage, person performing the imaging, and time and place of examination. Radiologist reports interpreting the images will also feature here. The RIS is vital to the functioning of a picture archiving and communications system (see PACS) and the electronic medical record system.... radiology information system

Reticular Activating System

the system of nerve pathways in the brain concerned with the level of consciousness – from the states of sleep, drowsiness, and relaxation to full alertness and attention. The system integrates information from all of the senses and from the cerebrum and cerebellum and determines the overall activity of the brain and the autonomic nervous system and patterns of behaviour during waking and sleeping.... reticular activating system

Reticuloendothelial System

(RES) a community of cells – *phagocytes – spread throughout the body. It includes *macrophages and *monocytes. The RES is concerned with defence against microbial infection and with the removal of worn-out blood cells from the bloodstream. See also spleen.... reticuloendothelial system

Scoring System

any of various methods in which the application of an agreed numerical scale is used as a means of estimating the degree of a clinical situation, e.g. the severity of an injury, the degree of patient recovery, or the extent of malignancy. Examples include the *Glasgow Coma Scale (or scoring system) and the *injury scoring system.... scoring system

Single-payer System

a type of health-care system in which there is only one purchaser of health-care services, usually the government. The NHS is a single-payer system.... single-payer system

Surrogate Decision

see proxy decision.... surrogate decision

Systemic Circulation

the system of blood vessels that supplies all parts of the body except the lungs. It consists of the aorta and all its branches, carrying oxygenated blood to the tissues, and all the veins draining deoxygenated blood into the vena cava. Compare pulmonary circulation.... systemic circulation

Systemic Inflammatory Response

see shock.... systemic inflammatory response

Vascular System

see cardiovascular system.... vascular system

Vestibular System

those parts of the body involved in balance. The peripheral vestibular system, or *vestibular apparatus, is in the inner ear. The central vestibular system comprises those parts of the brain that are involved in balance. The central vestibular system receives other inputs as well as from the ear, in particular inputs from the eyes and proprioceptors.... vestibular system

Genito-urinary And Endocrine Systems

Amenorrhoea/lack of menstruation (M,B):

French basil, carrot seed, celery seed, cinnamon leaf, dill, sweet fennel, hops, hyssop, juniper, laurel, lovage, sweet marjoram, myrrh, parsley, rose (cabbage & damask), sage (clary & Spanish), tarragon, yarrow.

Dysmenorrhoea/cramp, painful or difficult menstruation (M,C,B):

Melissa, French basil, carrot seed, chamomile (German & Roman), cypress, frankincense, hops, jasmine, juniper, lavandin, lavender (spike & true), lovage, sweet marjoram, rose (cabbage & damask), rosemary, sage (clary & Spanish), tarragon, yarrow.

Cystitis (C,B,D):

Canadian balsam, copaiba balsam, bergamot, cedarwood (Atlas, Texas & Virginian), celery seed, chamomile (German & Roman), cubebs, eucalyptus blue gum, frankincense, juniper, lavandin, lavender (spike & true), lovage, mastic, niaouli, parsley, Scotch pine, sandalwood, tea tree, thyme, turpentine, yarrow.

Frigidity (M,S,B,V):

Cassie, cinnamon leaf, jasmine, neroli, nutmeg, parsley, patchouli, black pepper, cabbage rose, rosewood, clary sage, sandalwood, ylang ylang.

Lack of nursing milk (M):

Celery seed, dill, sweet fennel, hops.

Labour pain & childbirth aid (M,C,B):

Cinnamon leaf, jasmine, true lavender, nutmeg, parsley, rose (cabbage & damask), clary sage.

Leucorrhoea/white discharge from the vagina (B,D):

Bergamot, cedarwood (Atlas, Texas & Virginian), cinnamon leaf, cubebs, eucalyptus blue gum, frankincense, hyssop, lavandin, lavender (spike & true), sweet marjoram, mastic, myrrh, rosemary, clary sage, sandalwood, tea tree, turpentine.

Menopausal problems (M,B,V):

Cypress, sweet fennel, geranium, jasmine, rose (cabbage & damask).

Menorrhagia/excessive menstruation (M,B):

Chamomile (German & Roman), cypress, rose (cabbage & damask).

Premenstrual tension/PMT (M,B,V):

Carrot seed, chamomile (German & Roman), geranium, true lavender, sweet marjoram, neroli, tarragon.

Pruritis/itching (D):

Bergamot, Atlas cedarwood, juniper, lavender, myrrh, tea tree.

Sexual overactivity (M,B):

Hops, sweet marjoram.

Thrush/candida (B,D):

Bergamot, geranium, myrrh, tea tree.

Urethritis (B,D):

Bergamot, cubebs, mastic, tea tree, turpentine.

Immune System

Chickenpox (C,S,B):

Bergamot, chamomile (German & Roman), eucalyptus (blue gum & lemon), true lavender, tea tree.

Colds/’flu (M,B,V,I):

Angelica, star anise, aniseed, copaiba balsam, Peru balsam, French basil, West Indian bay, bergamot, borneol, cabreuva, cajeput, camphor (white), caraway, cinnamon leaf, citronella, clove bud, coriander, eucalyptus (blue gum, lemon & peppermint), silver fir, frankincense, ginger, grapefruit, immortelle, juniper, laurel, lemon, lime, sweet marjoram, mastic, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), pine (longleaf & Scotch), rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, turpentine, yarrow.

Fever (C,B):

French basil, bergamot, borneol, camphor (white), eucalyptus (blue gum, lemon & peppermint), silver fir, ginger, immortelle, juniper, lemon, lemongrass, lime, mint (peppermint & spearmint), myrtle, niaouli, rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, yarrow.

Measles (S,B,I,V):

Bergamot, eucalyptus blue gum, lavender (spike & true), tea tree.... genito-urinary and endocrine systems




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