Human Development Index (hdi): From 1 Different Sources
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.
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
A glycoprotein hormone secreted by the PLACENTA in early pregnancy, and stimulating the CORPUS LUTEUM within the ovary (see OVARIES) to secrete OESTROGENS, PROGESTERONE, and relaxin. The hormone is essential for the maintenance of pregnancy up to about 6–8 weeks of gestation. A RADIOIMMUNOASSAY can be used to detect its presence, and pregnancy can be diagnosed as early as six days after conception by testing for it in the urine. Some tumours also secrete human chorionic gonadotrophin, particularly HYDATIDIFORM MOLE, which produces large amounts.... human chorionic gonadotrophin
In simple terms, this is the genetic recipe for making a human being. GENOME is a combination of the words gene and chromosome, and a genome is de?ned as all the genetic material – known as deoxyribonucleic acid, or DNA – in a cell. Most genes encode sequences of AMINO ACIDS, the constituents of proteins, thus initiating and controlling the replication of an organism. The identi?cation and characterisation of the human genetic puzzle have been a key bioscience research target. The Human Genome Project was launched in 1990 (and completed in 2003) to produce a full sequence of the three million base pairs that make up the human genome.
Carried out as two separate exercises – one by a privately funded American team; another by an international joint venture between tax-funded American laboratories, a charitably funded British one and several other smaller research teams from around the world – the ?rst results were announced on 26 June 2000. In February 2001 the privately funded American group, known as Celera Genomics, announced that it had identi?ed 26,558 genes. At the same time the Human Genome Project consortium reported that it had identi?ed 31,000. Allowing for margins of error, this gives a ?gure much lower than the 100,000 or more human genes previously forecast by scientists. Interestingly, genes were found to make up only 3 per cent of the human genome. The remaining 97 per cent of the genome comprises non-coding DNA which, though not involved in producing the protein-initiating genetic activity, does have signi?cant roles in the structure, function and evolution of the genome.
One surprise from the Project so far is that the genetic di?erences between humans and other species seem much smaller than previously expected. For example, the Celera team found that people have only 300 genes that mice do not have; yet, the common ancestor of mice and men probably lived 100 million years or more in the past. Mice and humans, however, have around twice as many genes as the humble fruit ?y.
Cells die out when they become redundant during embryonic development: genes also die out during evolution, according to evidence from the Genome Project – a ?nding that supports the constant evolutionary changes apparent in living things; the Darwinian concept of survival of the ?ttest.
Apart from expanding our scienti?c knowledge, the new information – and promise of much more as the Genome Project continues – should enhance and expand the use of genetic engineering in the prevention and cure of disease. Studies are in progress on the gene for a receptor protein in the brain which will shed light on how the important neurotransmitter SEROTONIN in the brain works, and this, for example, should help the development of better drugs for the treatment of DEPRESSION. Another gene has been found that is relevant to the development of ASTHMA and yet another that is involved in the production of amyloid, a complex protein which is deposited in excessive amounts in both DOWN’S (DOWN) SYNDROME and ALZHEIMER’S DISEASE.... human genome
Various forms of group judgement in which a group (or panel) of experts interacts in assessing an intervention and formulating findings by vote or other informal or formal means, involving such techniques as the nominal group and Delphi techniques.... consensus development
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
The process of continuous, progressive improvement of the health status of individuals and groups in a population.... health development
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
The name of the causative agent of AIDS.... hiv (human immunodeficiency virus)
Human skills and capabilities generated by investments in education and health.... human capital
See ASSISTED CONCEPTION.... human fertilisation & embryology act 1990
See ASSISTED CONCEPTION.... human fertilisation & embryology authority (hfea)
See AIDS/HIV.... human immunodeficiency virus
See HLA SYSTEM.... human leucocyte antigen (hla)
UK legislation that lays down the framework and rules governing organ transplantation. The UK Transplant Support Service Authority (UKTSSA), a special health authority set up in 1991, is responsible for administering the NHS Organ Donor Registry and the Act (see APPENDIX 7: STATUTORY ORGANISATIONS).... human organs transplants act
Screening and surveillance uncover problems which then need careful attention. Most NHS districts have a CDT to carry out this task – working from child development centres – usually separate from hospitals. Various therapists, as well as consultant paediatricians in community child health, contribute to the work of the team. They include physiotherapists, occupational therapists, speech therapists, psychologists, health visitors and, in some centres, pre-school teachers or educational advisers and social workers. Their aims are to diagnose the child’s problems, identify his or her therapy needs and make recommendations to the local health and educational authorities on how these should be met. A member of the team will usually be appointed as the family’s ‘key worker’, who liaises with other members of the team and coordinates the child’s management. Regular review meetings are held, generally with parents sharing in the decisions made. Mostly children seen by CDTs are under ?ve years old, the school health service and educational authorities assuming responsibility thereafter.
Special needs The Children Act 1989, Education Acts 1981, 1986 and 1993, and the Chronically Sick and Disabled Persons Legislation 1979 impose various statutory duties to identify and provide assistance for children with special needs. They include the chronically ill as well as those with impaired development or disabilities such as CEREBRAL PALSY, or hearing, vision or intellectual impairment. Many CDTs keep a register of such children so that services can be e?ciently planned and evaluated. Parents of disabled children often feel isolated and neglected by society in general; they are frequently frustrated by the lack of resources available to help them cope with the sheer hard work involved. The CDT, through its key workers, does its best to absorb anger and divert frustration into constructive actions.
There are other groups of children who come to the attention of child health services. Community paediatricians act as advisers to adoption and fostering agencies, vital since many children needing alternative homes have special medical or educational needs or have behavioural or psychiatric problems. Many see a role in acting as advocates, not just for those with impairments but also for socially disadvantaged children, including those ‘looked after’ in children’s homes and those of travellers, asylum seekers, refugees and the homeless.
Child protection Regrettably, some children come to the attention of child health specialists because they have been beaten, neglected, emotionally or nutritionally starved or sexually assaulted by their parents or carers. Responsibility for the investigation of these children is that of local-authority social-services departments. However, child health professionals have a vital role in diagnosis, obtaining forensic evidence, advising courts, supervising the medical aspects of follow-up and teaching doctors, therapists and other professionals in training. (See CHILD ABUSE.)
School health services Once children have reached school age, the emphasis changes. The prime need becomes identifying those with problems that may interfere with learning – including those with special needs as de?ned above, but also those with behavioural problems. Teachers and parents are advised on how to manage these problems, while health promotion and health education are directed at children. Special problems, especially as children reach secondary school (aged 11–18) include accidents, substance abuse, psychosexual adjustment, antisocial behaviour, eating disorders and physical conditions which loom large in the minds of adolescents in particular, such as ACNE, short stature and delayed puberty.
There is no longer, in the UK, a universal school health service as many of its functions have been taken over by general practitioners and hospital and community paediatricians. However, most areas still have school nurses, some have school doctors, while others do not employ speci?c individuals for these tasks but share out aspects of the work between GPs, health visitors, community nurses and consultant paediatricians in child health.
Complementing their work is the community dental service whose role is to monitor the whole child population’s dental health, provide preventive programmes for all, and dental treatment for those who have di?culty using general dental services – for example, children with complex disability. All children in state-funded schools are dentally screened at ages ?ve and 15.
Successes and failures Since the inception of the NHS, hospital services for children have had enormous success: neonatal and infant mortality rates have fallen by two-thirds; deaths from PNEUMONIA have fallen from 600 per million children to a handful; and deaths from MENINGITIS have fallen to one-?fth of the previous level. Much of this has been due to the revolution in the management of pregnancy and labour, the invention of neonatal resuscitation and neonatal intensive care, and the provision of powerful antibiotics.
At the same time, some children acquire HIV infection and AIDS from their affected mothers (see AIDS/HIV); the prevalence of atopic (see ATOPY) diseases (ASTHMA, eczema – see DERMATITIS, HAY FEVER) is rising; more children attend hospital clinics with chronic CONSTIPATION; and little can be done for most viral diseases.
Community child health services can also boast of successes. The routine immunisation programme has wiped out SMALLPOX, DIPHTHERIA and POLIOMYELITIS and almost wiped out haemophilus and meningococcal C meningitis, measles and congenital RUBELLA syndrome. WHOOPING COUGH outbreaks continue but the death and chronic disability rates have been greatly reduced. Despite these huge health gains, continuing public scepticism about the safety of immunisation means that there can be no relaxation in the educational and health-promotion programme.
Services for severely and multiply disabled children have improved beyond all recognition with the closure of long-stay institutions, many of which were distinctly child-unfriendly. Nonetheless, scarce resources mean that families still carry heavy burdens. The incidence of SUDDEN INFANT DEATH SYNDROME (SIDS) has more than halved as a result of an educational programme based on ?rm scienti?c evidence that the risk can be reduced by putting babies to sleep on their backs, avoidance of parental smoking, not overheating, breast feeding and seeking medical attention early for illness.
Children have fewer accidents and better teeth but new problems have arisen: in the 1990s children throughout the developed world became fatter. A UK survey in 2004 found that one in ?ve children are overweight and one in 20 obese. Lack of exercise, the easy availability of food at all times and in all places, together with the rise of ‘snacking’, are likely to provoke signi?cant health problems as these children grow into adult life. Adolescents are at greater risk than ever of ill-health through substance abuse and unplanned pregnancy. Child health services are facing new challenges in the 21st century.... child development teams (cdts)
The study of the interrelationships between humans, the tools they use, and the environment in which they live and work.... human-factor research
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
A process of development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs.... sustainable development
Creutzfeldt-Jakob disease. See: BOVINE SPONGIFORM ENCEPHALOPATHY. ... mad-cow disease, human
Wounds caused by one person biting another. Human bites rarely cause serious tissue damage or blood loss, but infection is likely, particularly if the bite is deep. There is a risk of tetanus infection. Transmission of hepatitis B, herpes simplex, and AIDS by a bite is a theoretical hazard.... bites, human
The complete set of human genetic material. The human genome consists of 23 chromosomes, which, together, contain about 30,000 genes. All body cells contain 2 sets of the 23 chromosomes, one set inherited from the father and the other from the mother. An international research programme, the Human Genome Project, was launched in 1990 with the aim of identifying all the human genes. The first rough draft of the project was published in 2000.... genome, human
A hormone produced by the placenta in early pregnancy. Human chorionic gonadotrophin (HCG) stimulates the ovaries to produce oestrogen and progesterone, which are needed for a healthy pregnancy. HCG is excreted in the urine, and its presence in urine is the basis of pregnancy tests on urine samples. ... gonadotrophin, human chorionic
(HLA) A type of protein belonging to the group known as histocompatibility antigens, which play a role in the immune system.... human leukocyte antigen
the number of *apnoea episodes per hour of sleep.... apnoea index
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
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
(HHS) the major US government agency providing health care. The department was created in 1953 and assumed its current name in 1980. HHS administers more than 300 health and health-related programmes and services, including *Medicare and *Medicaid. Other activities include research, immunization services, and providing financial assistance for low-income families. Almost a quarter of federal spending occurs through HHS.... department of health and human services
(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.... dermatology life quality index
(DSDs) see intersex.... differences of sexual development
(DSDs) see intersex.... disorders of sexual development
a nondepartmental public body set up in 2007 to promote human rights and equality in regard to age, disability, gender, race, religion and belief, pregnancy and maternity, marriage and civil partnership, sexual orientation, and human rights. It replaced the Commission for Racial Equality, the Disability Rights Commission, and the Equal Opportunities Commission.... equality and human rights commission
an international index, published by the World Health Organization, that grades the degree of recovery after serious injury.... functional recovery 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
see human placental lactogen.... human chorionic somatomammotrophin
Acts of the UK parliament in 1990 and 2008, establishing and amending principles for the legal supervision, by the Human Fertilisation and Embryology Authority, of the creation, use, and storage of human embryos outside the body and of their use in treatment and research. The 2008 amendments included a ban on sex selection for social reasons, recognition of same-sex couples as potential legal parents, and regulations related to developing areas of research using embryos. The 1990 Act had also reduced the legal time limit for most abortions from 28 weeks gestation (as in the 1967 Abortion Act) to 24 weeks. Interpretation and regulation of principles and practice in this rapidly developing area of research and practice continue and are often controversial.... human fertilisation and embryology acts
a massive international research project to isolate all the genes in human DNA and determine the sequence of genes on human chromosomes. The project began in 1988 and the full draft sequence was published in 2001; the high-quality sequence was completed in 2003. The human genome comprises some 3 × 109 nucleotide base pairs (see DNA) forming 22,000–25,000 genes, distributed among 23 pairs of chromosomes. Knowledge of the entire human genome has already resulted in the identification of the genes associated with many hereditary disorders and revealed the existence of a genetic basis or component for many other diseases not previously known to have one. Theoretically, this would enable the development of targeted drugs and the large-scale genetic screening of populations. See pharmacogenomics; targeted agent.... human genome project
see HIV.... human immunodeficiency virus
see HLA system.... human leucocyte antigen system
commercially available preparations of *follicle-stimulating hormone and *luteinizing hormone. They are used mainly to treat infertility in women with gonadotrophin deficiency due to hypopituitarism and to stimulate superovulation in women undergoing in vitro fertilization.... human menopausal gonadotrophins
(human chorionic somatomammotrophin) a protein hormone of 190 amino acids produced by the placenta during most but not all pregnancies. Despite its name it does not appear to have a role in lactation and its exact function remains obscure. It does, however, seem to contribute to the development of diabetes in some pregnancies.... human placental lactogen
a legal framework adopted by the United Nations following World War II that sought to define and promote fundamental entitlements, conditions, and freedoms to be afforded to all human beings. In the UK the Human Rights Act 1998 enacts the provisions of the 1950 European Convention on Human Rights, which sets out, via fourteen articles, an individual’s rights, entitlements, and freedoms.... human rights
the UK government agency, established by the Human Tissue Act 2004, that regulates the removal, use, and storage of human organs and tissue from both the living and the deceased for certain purposes as defined by the statute. These purposes include clinical research, clinical audit, and medical education. Anyone handling such material for those purposes should have a licence issued by the authority. Membership of the authority comprises clinical, scientific, academic, and lay representatives.... human tissue authority
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
the proportion of cells in a tissue that are dividing at a given time.... mitotic index
formerly, a *special health authority of the NHS established under the Health and Social Care Act 2012 to oversee NHS trusts without *foundation trust status and to support their transition to such status. The Authority closed in 2016, when its functions were transferred to the newly established *NHS Improvement.... nhs trust development authority
a policy of actively and continuously improving patient care, with an emphasis on interprofessional collaboration and the integration of evidence-based practice with *person-centred care.... practice development
(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
the process by which an individual becomes more mature in his or her sexual feelings and behaviour. Gender identity, sex-role behaviour, and choice of sexual partner are the three major areas of development. In Freudian psychoanalysis the phrase is sometimes used specifically for a sequence of stages, supposed by psychoanalytic psychologists to be universal, in which oral, anal, phallic, latency, and genital stages successively occur. These stages reflect the parts of the body on which sexual interest is concentrated during childhood development.... psychosexual development
(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
Health Encyclopedia