Dermatology Life Quality Index: From 1 Different Sources
(DLQI) a validated questionnaire designed by Finlay in 1994 to assess the impact of skin diseases on psychological and social wellbeing. It is the most common *quality of life tool used as an endpoint in dermatology clinical trials. DLQI scores of more than 10 (indicating a severe impact on life) are required before biological treatments for psoriasis may be administered in the UK.
The average number of years of life remaining to a person at a particular age based on a given set of age-specific death rates, generally the mortality conditions existing in the period mentioned.... life expectancy
Body Mass Index (BMI) provides objective criteria of size to enable an estimation to be made of an individual’s level or risk of morbidity and mortality. The BMI, which is derived from the extensive data held by life-insurance companies, is calculated by dividing a person’s weight by the square of his or her height (kilograms/ metres2). Acceptable BMIs range from 20 to 25 and any ?gure above 30 characterises obesity. The Index may be used (with some modi?cation) to assess children and adolescents. (See OBESITY.)... body mass index
Emergency mouth-to-mouth resuscitation of an unconscious person (see APPENDIX 1: BASIC FIRST AID).... kiss of life
In essence, this is the study of the skin. As well as being an organ in its own right, the skin is a stage on which other organs as well as the emotions most visibly play out their roles. Changes in its blood vessels – and hence blood ?ow through the skin – may indicate a major immunological response to a range of potential factors (see SKIN, DISEASES OF).... dermatology
Care of older persons who are dying.... end-of-life care
The time taken for the PLASMA concentration of an administered drug to decline by half as a result of redistribution, METABOLISM and EXCRETION.... half life
1 The entire course of a person’s life – from infancy to old age. 2 The genetically prescribed course followed by all living organisms, including humans.... life cycle
A colloquial description of the feelings of anxiety and distress experienced by some individuals in early middle age. They realise that by 45 years of age they are no longer young, and men in particular try to turn the clock back by changing jobs, dressing trendily, taking up energetic or unusual sports or engaging in extramarital liaisons. Sometimes those in mid-life crises develop mild or even serious DEPRESSION. The feelings of anxiety and insecurity usually disappear with time but some people may bene?t from counselling.... mid-life crisis
The product of the interplay between social, health, economic and environmental conditions which affect human and social development. It is a broad-ranging concept, incorporating a person’s physical health, psychological state, level of independence, social relationships, personal beliefs and relationship to salient features in the environment. As people age, their quality of life is largely determined by their ability to access needed resources and maintain autonomy and independence.... quality of life
In anticancer therapy, this is the ratio of a dose of the treatment agent that damages normal cells to the dose necessary to produce a determined level of anticancer activity. The index shows the e?ectiveness of the treatment against the cancer.... therapeutic index
See ALTE.... acute life-threatening event (alte)
See CLIMACTERIC; MENOPAUSE.... change of life
The outcome of care/service from an individual/user’s point of view. It is how well the care service supports the client/user to improve his/her quality of life.... client quality
A modification of conventional life expectancy to account for time lived with disability. It is the number of healthy years of life that can be expected on average in a given population. It is generally calculated at birth, but estimates can also be prepared at other ages. It adjusts the expectation of years of life for the loss on account of disability, using explicit weights for different health states.... disability-adjusted life expectancy
The number of healthy years of life lost due to premature death and disability.... disability-adjusted life years (dalys)
The average number of years an individual of a given age is expected to live if current mortality rates continue to apply. See “life expectancy”.... expectation of life
A characteristic of an individual, population or environment which is subjected to measurement and can be used to describe one or more aspects of the health of an individual or population (quality, quantity and time). A health index comprises a number of indicators.... health indicator / index
Individual outcome measure that extends beyond traditional measures of mortality and morbidity to include such dimensions as physiology, function, social activity, cognition, emotion, sleep and rest, energy and vitality, health perception and general life satisfaction (some of these are also known as health status, functional status or quality-of-life measures).... health-related quality-of-life (hrql) measure
See “disability-adjusted life expectancy”.... healthy life expectancy
A composite index that measures the overall achievements in a country in three basic dimensions of human development— longevity, knowledge and a decent standard of living. It is measured by life expectancy, educational attainment and adjusted income per capita in purchasing power parity (PPP) US dollars. The HDI is a summary, not a comprehensive measure of human development.... human development index (hdi)
In epidemiology and related sciences, this word usually means a rating scale, e.g. a set of numbers derived from a series of observations of specified variables.... index
A monthly publication produced by the National Library of Medicine in the USA. The publication indexes leading biomedical literature from throughout the world. Indexing is by author and by subject.... index medicus
See “life cycle”.... life course
Longevity, Health, Healing... life everlasting
Insurance providing for payment of a stipulated sum to a designated beneficiary upon death of the insured.... life insurance
See “well-being”.... life satisfaction
The longest period over which the life of any plant or animal organism or species may extend, according to the available biological knowledge concerning it.... life span
Drugs, medical devices, or procedures that can keep alive a person who would otherwise die within a foreseeable, though usually uncertain, time. Examples include cardiopulmonary resuscitation, mechanical ventilation, renal dialysis, nutritional support (i.e. tube or intravenous feeding) and provision of antibiotics to fight life-threatening infections.... life-sustaining treatment
QAPI establishes strategies for promoting high quality health care. First, each organization must meet certain required levels of performance when providing specific health care and related services. Second, organizations must conduct performance improvement projects that are outcome-oriented and that achieve demonstrable and sustained improvement in care and services. It is expected that an organization will continuously monitor its own performance on a variety of dimensions of care and services, identify its own areas for potential improvement, carry out individual projects to undertake system interventions to improve care, and monitor the effectiveness of those interventions.... quality assessment and performance improvement programme (qapi)
Standardized procedures, methods or philosophy for collecting, processing or analysing data, which is performed on an ongoing basis and aimed at maintaining or improving the appropriateness and reliability of health care services.... quality assurance (qa)
An instrument for quality enhancement and quality assurance which uses groups of peers to assess and discuss the quality of their own work and develop strategies for improvement.... quality circle
The sum of all the activities which prevent unwanted change in quality. In the health care setting, quality control requires a repeated series of feedback loops which monitor and evaluate the care of the individual (and other elements in the health care process). These feedback loops involve checking the care being delivered against standards of care, identification of any problems or opportunities for improvement, and prompt corrective action, so that the quality is maintained.... quality control (qc)
The sum of all the activities which create desired change in quality. In the health care setting, quality improvement requires a feedback loop which involves the identification of patterns of the care of individuals (or of the performance of other systems involved in care), the analysis of those patterns in order to identify opportunities for improvement (or instances of departure from standards of care), and then action to improve the quality of care for future patients. An effective quality improvement system results in step-by-step increases in quality of care.... quality improvement / continuous quality improvement
The quality of non-clinical attributes of health care units, such as cleanliness of the facility, adequacy of the furniture and quality of the food.... quality of basic amenities
The degree to which delivered health services meet established professional standards and are judged to be of value to the consumer. Quality may also be seen as the degree to which actions taken or not taken maximize the probability of beneficial health outcomes and minimize risk and other outcomes, given the existing state of medical science and art.... quality of care
Years of life saved by a medical technology or service, adjusted according to the quality of those years (as determined by some evaluative measure). QALYs are the most commonly used unit to express the results in some types of cost-effectiveness analysis.... quality-adjusted life years (qalys)
TQM is synonymous with continuous quality improvement (CQI). It is an integrative management concept of continuously improving the quality of delivered goods and services through the participation of all level and functions of the organization to meet the needs and expectations of the customer.... total quality management (tqm)
See “client quality”.... user quality
(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
the number of *apnoea episodes per hour of sleep.... apnoea index
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
the volume of blood pumped from the heart’s left ventricle divided by body surface area, expressed as litres per minute per square metre (l/min/m2). It is determined by heart rate and stroke volume index (the volume of blood pumped by the heart with each beat), and provides a normal range (2.5–4.0 l/min/m2) regardless of the size of the patient.... cardiac index
(CQC) a publicly funded independent organization established in 2009 and responsible for regulation of health and social care in England; it replaced the Healthcare Commission, the Commission for Social Care Inspection, and the Mental Health Act Commission. The responsibilities of the commission include publication of national health-care standards; annual assessment of the performance of NHS and social-care organizations; reviewing other (i.e. private and voluntary) health- and social-care organizations; reviewing complaints about the services when it has not been possible to resolve them locally; and investigating serious service failures.... care quality commission
a measure of the shape of a skull, commonly used in *craniometry: the ratio of the greatest breadth, multiplied by 100, to the greatest length of the skull. See also brachycephaly; dolichocephaly.... cephalic index
measurement of the resistance of the cervix during the passage of a series of metal (Hegar) dilators. Lack of resistance in a nonpregnant women may suggest cervical weakness when she has experienced a previous second-trimester pregnancy loss or if she has had previous surgery to the cervix, and may indicate *cervical cerclage in the event of future pregnancies.... cervical resistance index
(DALY) a common research measure of disease burden that accounts for both morbidity and mortality. One year lived in full health is equivalent to one DALY. Disabilities and disease states are assigned a weighting that reduces this figure, such that a year lived with disability is equivalent to less than one DALY. Some studies also use social weighting, in which years lived as a young adult receive a greater DALY weight than those lived as a young child or older adult. See also health-adjusted life expectancy; quality of life.... disability-adjusted life year
an international index, published by the World Health Organization, that grades the degree of recovery after serious injury.... functional recovery index
a measure developed by the World Health Organization to capture life expectancy in terms of both morbidity and mortality. The number of years lived with ill-health, weighted according to severity, are subtracted from the overall life expectancy. Previously known as disability-adjusted life expectancy, it is sometimes referred to as healthy life expectancy. See also disability-adjusted life year.... health-adjusted life expectancy
the proportion of cells in a sample of tissue that are producing DNA. Cells that are synthesizing DNA take up tritiated thymidine, which shows up on an autoradiograph (see autoradiography) of the sample.... labelling index
(GI) a ranking system measuring the effect carbohydrate (CHO) ingestion has on blood glucose levels. Glucose is used as the standard reference value (50 g glucose has a GI of 100). A portion of food containing 50 g CHO is ingested and the effect on blood glucose levels measured over a three-hour period and compared with the effect of 50 g of glucose. Foods with a low GI (<60), such as apples, yoghurt, and beans, are slowly absorbed, causing a lower and more prolonged increase in blood glucose levels, than foods with a high GI (>70), e.g. white bread, white rice, and potatoes. Low GI foods help with diabetes control and may be beneficial in the treatment of *polycystic ovary syndrome. The glycaemic load (GL) also takes into account the amount of food that is eaten: GL = (g CHO in food portion eaten × GI)/100.... glycaemic index
an actuarial presentation of the ages at which a group of males and/or females are expected to die and from which mean life expectancy at any age can be estimated, based on the assumption that mortality patterns current at the time of preparation of the table will continue to apply.... life table
the proportion of cells in a tissue that are dividing at a given time.... mitotic index
(PI) the ratio of the pressure in the posterior tibial artery to that in the brachial artery, which reflects the degree of arterial obstruction in the artery of the lower limb.... pressure index
(PASI) a semiobjective severity score for psoriasis, including measurement of surface area affected and the degree of erythema, induration, and scale. It is commonly used in clinical trials and to ration expensive treatments for psoriasis. Severe disease equates to scores over 10 and it is often interpreted with the *dermatology life quality index (DLQI) score.... psoriasis area severity index
(QOF) a system, introduced as part of the new general medical services (nGMS) contract (see general practitioner), whereby practices are rewarded for implementing good medical practice. There are four main domains: clinical, organizational, patient experience, and additional services. Each domain has various criteria based on best practice, which have a number of points allocated for achievement. The points are collated at the end of the financial year and converted into payment for the practice.... quality and outcomes framework
setting, monitoring, and maintaining standards for the quality of a service. See clinical governance.... quality assurance
(RMI) a scoring system that combines ultrasound findings, menopausal status and age, and serum CA125 levels to give an estimate of the risk of malignancy in a woman with a mass in the Fallopian tubes or ovaries. If the total RMI score is <200 the risk of malignancy is considered to be low. If the total RMI score is >200 the chances of malignancy are raised and management should be planned with a gynaecological oncologist.... risk of malignancy index
the religious or moral belief that all life – and especially all human life – is intrinsically valuable and so should never be deliberately harmed or destroyed. Many of those who hold such a view will have ethical objections to *euthanasia, *abortion, and *embryo research. The phrase may also be used to denote that the value of life should always be respected, whatever the perceived quality of that life. See also humanity; personhood.... sanctity of life
(YLL, years of potential life lost, YPLL, potential years of life lost, PYLL) a measure of premature mortality that calculates the number of additional years a person could have expected to live, on average, had they not died prematurely. A reference age intended to represent the total number of years a person can expect to live, on average, is required for the calculation: this is often given in square brackets after YLL. Negative values for YLL are not used: if somebody survives longer than the reference age, their YLL is calculated as 0. YLLs for different diseases can be compared across populations to give an indication of which diseases carry the greatest burden of premature mortality.... years of life lost
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