Long-term care facility Health Dictionary

A short period of intensive rehabilitation and treatment to enable people to return home following hospitalization or to prevent admission to hospital or residential care.... intermediate care

Basic or general health care focused on the point at which a patient ideally first seeks assistance from the medical care system. It is the basis for referrals to secondary and tertiary level care.... primary care

The provision of barrier-free access to the necessary range of health care services over any given period of time, with the level of care varying according to individual needs.... continuity of care

Specialist care provided on an ambulatory or inpatient basis, usually following a referral from primary care.... secondary care

The provision of highly specialized services in ambulatory and hospital settings.... tertiary care

The protocol which doctors and midwives follow to ensure that the pregnant mother and her FETUS are kept in good health, and that the pregnancy and birth have a satisfactory outcome. The pregnant mother is seen regularly at a clinic where, for example, her blood pressure is checked, the growth and development of her child-to-be are carefully assessed, and any problem or potential problems dealt with. Most antenatal care deals with normal pregnancies and is supervised by general practitioners and midwives in primary-care clinics. If any serious problems are identi?ed, the mother can be referred to specialists’ clinics in hospitals. (See PREGNANCY AND LABOUR.)... antenatal care

Services and support to help people with care needs to live as independently as possible in their communities.... community care

Care of older persons who are dying.... end-of-life care

Services provided to individuals or communities by health service providers for the purpose of promoting, maintaining, monitoring or restoring health.... health care

Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in a specially equipped unit of a health care facility. It can also be administered at home under certain circumstances (dialysis, respirators, etc.).... intensive care

A health care delivery system which entails interventions to control the price, volume, delivery site and intensity of health services provided, the goal of which is to maximize the value of health benefits and the coordination of health care management for a covered population.... managed care

The active total care offered to a person and that person’s family when it is recognized that the illness is no longer curable, in order to concentrate on the person’s quality of life and the alleviation of distressing symptoms. The focus of palliative care is neither to hasten nor postpone death. It provides relief from pain and other distressing symptoms and integrates the psychological and spiritual aspects of care. It offers a support system to help relatives and friends cope during an individual’s illness and with their bereavement.... palliative care

See GENERAL PRACTITIONER (GP)... primary care trust

Medical and nursing care of persons in the terminal stage of an illness. See also “palliative care”.... terminal care

A specialist ward for the care of acutely ill patients who may be suffering, or who have suffered, a myocardial infarction (heart attack) or another serious cardiovascular disorder.... coronary care unit

Care that is generally provided for a short period of time to treat a new illness or a flare-up of an existing condition. This type of care may include treatment at home, short-term hospital stays, professional care, surgery, X-rays and scans, as well as emergency medical services.... acute care / acute health care

Housing that has been specially built for, or changed to a certain standard to accommodate people with disabilities.... adapted living facility / housing

A residence which offers housing and personal care services to a number of residents. Services (such as meals, supervision and transportation) are usually provided by the owner or manager. Usually 24-hour professional health care is not provided on site. See also “assisted living facility”.... adult care home / residential facility

See “day care centre”.... adult day care

Planning in advance for decisions that may have to be made prior to incapability or at the end of life. People may choose to do this planning formally, by means of advance directives, or informally, through discussions with family members, friends and health care and social service providers, or a combination of both methods.... advance care planning

Care provided to individuals after their release from institutional care.... after-care

Services provided to people deemed to be aged or elderly.... aged care

Multidisciplinary team of health professionals that is responsible for comprehensive assessments of the needs of older persons, including their suitability for hospital, home or institutional care.... aged care assessment team

Health care practices that are not currently an integral part of conventional medicine. The list of these practices changes over time as the practices and therapies are proven safe and effective and become accepted as mainstream health care practices. These unorthodox approaches to health care are not based on biomedical explanations for their effectiveness. Examples include homeopathy, herbal formulas, and use of other natural products as preventive and treatment agents.... alternative and complementary health care / medicine / therapies

Health services provided on an outpatient basis in contrast to services provided in the home or to persons who are inpatients. While many inpatients may be ambulatory, the term ambulatory care usually implies the patient travels to a location to receive services and no overnight stay in hospital is required. Many surgeries and treatments are now provided on an outpatient basis, while previously they were considered reason for inpatient hospitalization.... ambulatory care

Establishment which provides accommodation and care for older or disabled persons who cannot live independently but do not need nursing care. Residents are also provided with domestic assistance (meals, laundry, personal care).... assisted living facility / assisted care living facility

Personal care for people with disabilities in non-institutionalized settings generally by paid, non-family carers.... attendant care

See “adult care home”.... board and care home

The application of knowledge to the benefit of a community or individual. There are various levels of care:... care

1 A well planned entity of inter- and intra-organizational care processes to solve the complexity of problems of an individual, and accompanied by systematic follow-up actions. Care chains are integrated to the extent that there are no gaps, barriers or breaks in the process leaving the older person without proper care. 2 A description of the different parts of care.... care chain / chain of care

A residential facility that provides accommodation and offers a range of care and support services. Care homes may provide a limited number of services to support low dependency or may provide a wide range of services to cater for the continuum from low to high dependency care. See “assisted living facility”; “high dependency care facility”.... care home

See COMMUNITY CARE.... care in community

See “case management”.... care management

Some state of deficiency decreasing quality of life and affecting a demand for certain goods and services. For the older population, lowered functional and mental abilities are decisive factors that lead to the need for external help.... care need

A combination of services designed to meet a person’s assessed needs.... care package

An agreed and explicit route an individual takes through health and social care services. Agreements between the various providers involved will typically cover the type of care and treatment, which professional will be involved and their level of skills, and where treatment or care will take place. See also “care plan”; “care programme”.... care pathway

A dynamic document based on an assessment which outlines the types and frequency of care services that a client receives. It may include strategies, interventions, continued evaluation and actions intended to help an older person to achieve or maintain goals.... care plan

A documented arrangement of integrated care, based on the analysed needs of a specific group of people, from intake to supply of care and services, as well as the intended outcomes, and including a description of the way the arrangement should be applied in order to match the needs of individual persons.... care programme

Legislation (approved by the UK parliament in 2001) that sets up a new, independent regulatory body for social care and private and voluntary health-care services. The new body is called the National Care Standards Commission and covers England and Wales, but in the latter the National Assembly is the regulatory body. Independent councils register social-care workers, set social-care work standards and regulate the education and training of social workers in England and Wales. The Act also gives the Secretary of State for Health the authority to keep a list of individuals considered unsuitable to work with vulnerable adults. In addition, the legislation reforms the regulation of childminders and day-care provision for young children, responsibility for overseeing these services having been transferred from local authorities to the Chief Inspector of Schools. Services covered by the Act range from residential care homes and nursing homes, children’s homes, domiciliary-care agencies, fostering agencies and voluntary adoption agencies through to private and voluntary health-care services. This includes private hospitals and clinics and private primary-care premises. For the ?rst time, local authorities will have to meet the same standards as independent-sector providers.... care standards act

The types and volumes of services available.... care supply

Persons with chronic illnesses and/or impairments which lead to long-lasting disabilities in functioning and reliance on care (personal care, domestic life, mobility, self direction).... care-dependent

The ongoing provision of medical, functional, psychological, social, environmental and spiritual care services that enable people with serious and persistent health and/or mental conditions to optimize their functional independence and well-being, from the time of condition onset until problem resolution or death. Chronic care conditions are multidimensional, interdependent, complex and ongoing.... chronic care

Professional specialized or therapeutic care that requires ongoing assessment, planning, intervention and evaluation by health care professionals.... clinical care

Assistance provided free of charge or at reduced rates to members of a group or society. Other members of the group or society generally provide care on a voluntary basis.... communal care

Includes health services and integrates social care. It promotes self care, independence and family support networks.... community health care

The blend of health and social services provided to an individual or family in his/her place of residence for the purpose of promoting, maintaining or restoring health or minimizing the effects of illness and disability. These services are usually designed to help older people remain independent and in their own homes. They can include senior centres, transportation, delivered meals or congregate meals sites, visiting nurses or home health aides, adult day care and homemaker services.... community-based care / community-based services / programmes

Provision of a complete range of health services, from diagnosis to rehabilitation.... comprehensive health care

The provision of one or more elements of care (nursing, medical, health-related services, protection or supervision, or assistance with personal daily living activities) to an older person for the rest of his or her life.... continuing care

A facility which provides continuing care.... continuing care facility

A community which provides several levels of housing and services for older people, ranging from independent living units to nursing homes, on one site but generally in separate buildings.... continuing care retirement community

The entire spectrum of specialized health, rehabilitative and residential services available to the frail and chronically ill. The services focus on the social, residential, rehabilitative and supportive needs of individuals, as well as needs that are essentially medical in nature.... continuum of care

A collaborative process that promotes quality care, continuity of care and cost-effective outcomes which enhance the physical, psychosocial and vocational health of individuals. It includes assessing, planning, implementing, coordinating, monitoring and evaluating health-related service options. It may also include advocating for the older person.... coordinated care

A specialised hospital unit equipped and sta?ed to provide intensive care (see INTENSIVE THERAPY UNIT (ITU)) for patients who have had severe heart attacks or undergone surgery on the heart.... coronary care unit (ccu)

Medical treatment and care that cures a disease or relieves pain and promotes recovery.... curative care

Board, room and other personal assistance services generally provided on a long-term basis. It excludes regular medical care.... custodial care

A facility, operated by a local authority, voluntary organization, geriatric centre or acute hospital, providing activities for older people. These activities, usually during the day for a determined period, are intended to promote independence and enhance living skills, and can include the provision of personal care and preparation of meals.... day care centre

Any activities by a health professional involving direct interaction, treatment, administration of medications or other therapy or involvement with a patient.... direct patient care

Care provided in an individual’s own home.... domiciliary care

A legal requirement that a person act towards others and the public with the watchfulness, attention, caution and prudence that a reasonable person would use in the circumstance. If a person’s actions do not meet this standard of care, then the acts are considered negligent, and any damages resulting may be claimed in a lawsuit for negligence.... duty of care

Costs are the measure of the economic function of care. Total costs and unit costs are the basic indicators.... economy of care

See “aged care”.... elder care

The description and measurement of the various health care services and encounters rendered in connection with an identified injury or period of illness.... episode of care

Fair treatment of needs, regarding both the distribution of services and allocation of resources.... equity of care

The basic evaluative principles which (should) guide “good” care. Principles typically refer to respect for, and the dignity of, human beings. Basic dimensions are “autonomy” (respect for self determination), “well-being” (respect for happiness, health and mental integrity) and “social justice” (justifiable distribution of scarce goods and services). More specifically, ethics of care refer to ethical standards developed for the care professions which are designed to implement ethical principles in the practice of care provision.... ethics (of care)

The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individuals. This approach must balance the best external evidence with the desires of the individual and the clinical expertise of health care providers.... evidence-based care

A facility that offers sub-acute care, providing treatment services for people requiring inpatient care who do not currently require continuous acute care services, and admitting people who require convalescent or restorative services or rehabilitative services or people with terminal disease requiring maximal nursing care.... extended care facility (ecf)

Housing where there is additional support (such as the provision of meals and extra communal facilities) to that usually found in sheltered housing. Sometimes called ‘very sheltered housing’.... extra care sheltered housing

See “formal assistance”.... formal care

A form of assisted housing, usually provided in private homes owned and occupied by individuals or families, offering a place of residence, meals, housekeeping services, minimum supervision, and personal care for a fee to non-family members who do not require supervision by skilled medical personnel.... foster care

Care of older persons that encompasses a wide range of treatments from intensive care to palliative care.... geriatric care

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

Any establishment that is engaged in direct patient care on site.... health care institution / facility

A group comprising a variety of professionals (medical practitioners, nurses, physical and occupational therapists, social workers, pharmacists, spiritual counsellors), as well as family members, who are involved in providing coordinated and comprehensive care. There are three types of health care team, defined by the degree of interaction among members and the sharing of responsibility for care:... health care team

The systematic evaluation of properties, effects and/or impacts of health care technology. It may address the direct, intended consequences of technologies as well as their indirect, unintended consequences.... health care technology assessment (hcta)

As the needs and demands of patients, and the costs of health care of populations, have risen sharply in recent years, governments and health-care providers – whether tax-funded, insurance-based, employer-provided or a mix of these – have had increasingly to face the dilemma of what services a country or a community can a?ord to provide. As a result, various techniques for deciding priorities of care and treatment are evolving. In the United Kingdom, priorities were for many years based on the decisions of individual clinicians who had wide freedom to prescribe the most appropriate care. Increasingly, this clinical freedom is being circumscribed by managerial, community and political decisions driven in part by the availability of resources and by what people want. Rationing services, however, is not popular and as yet no broadly agreed consensus has emerged, either in western Europe or in North America, as to how priorities can be decided that have broad community support and which can be a?orded. (See CLINICAL GOVERNANCE; EVIDENCE-BASED MEDICINE.)... health-care priorities

An establishment primarily engaged in providing inpatient nursing and rehabilitative services to individuals requiring nursing care.... high dependency care facility

See “community-based care”.... home and community-based services; home and community care programme

A public or private organization that provides home health services supervised by a licensed health professional in a person’s home, either directly or through arrangements with other organizations.... home health agency (hha) / home health care agency

See “domiciliary care”.... home health care / home care

Schemes providing nursing care, personal care or practical help for older people who have returned home after a stay in hospital.... home-from-hospital / hospital after-care schemes

A cluster of comprehensive services that address the needs of dying persons and their families, including medical, spiritual, legal, financial and family support services.... hospice care

A range of housing schemes providing high levels of care.... housing with care

A rental unit in which services are not included as part of the rent, although services may be available on site and may be purchased by residents for an additional fee.... independent living facility

See “informal assistance”.... informal care

Health services delivered on an inpatient basis in hospitals, nursing homes or other inpatient institutions. The term may also refer to services delivered on an outpatient basis by departments or other organizational units of such institutions, or sponsored by them.... institutional (care) health services

The methods and strategies for linking and coordinating the various aspects of care delivered by different care systems, such as the work of general practitioners, primary and specialty care, preventive and curative services, and acute and long-term care, as well as physical and mental health services and social care, to meet the multiple needs/problems of an individual client or category of persons with similar needs/problems.... integrated care

Care provided in geriatric centres and acute hospitals to older persons who are in need of limited medical care and who are awaiting nursing home placement.... interim nursing home care

An institution which is licensed to provide, on a regular basis, health-related care and services to individuals who do not require the degree of care or treatment which a hospital or skilled nursing facility is designed to provide.... intermediate care facility (icf)

A classification of diseases, conditions and other reasons for attendance for primary care. This classification is an adaptation of the ICD but makes allowance for the diagnostic uncertainty that prevails in primary care.... international classification of health problems in primary care (ichppc)

The official classification of the World Organisation of Family Doctors. It includes three elements of the doctor-patient encounter: the reason for the encounter; the diagnosis; and the treatment or other action or intervention.... international classification of primary care (icpc)

Also known as hypermetropia: see under EYE, DISORDERS OF – Errors of refraction.... long-sight

A range of health care, personal care and social services provided to individuals who, due to frailty or level of physical or intellectual disability, are no longer able to live independently. Services may be for varying periods of time and may be provided in a person’s home, in the community or in residential facilities (e.g. nursing homes or assisted living facilities). These people have relatively stable medical conditions and are unlikely to greatly improve their level of functioning through medical intervention.... long-term care (ltc) / long-term aged care

The origin of this important branch of medicine lies in the e?ective use of positive-pressure VENTILATION of the lungs to treat respiratory breathing failure in patients affected by POLIOMYELITIS in an outbreak of this potentially fatal disease in Denmark in 1952. Doctors reduced to 40 per cent, the 90 per cent mortality in patients receiving respiratory support with the traditional cuirass ventilator by using the new technique. They achieved this with a combination of manual positive-pressure ventilation provided through a TRACHEOSTOMY by medical students, and by looking after the patients in a speci?c area of the hospital, allowing the necessary sta?ng and equipment resources to be concentrated in one place.

The principle of one-to-one, 24-hours-a-day care for seriously ill patients has been widely adopted and developed for the initial treatment of many patients with life-threatening conditions. Thus, severely injured patients – those with serious medical conditions such as coronary thrombosis or who have undergone major surgery, and individuals suffering from potentially lethal toxic affects of poisons – are treated in an INTENSIVE THERAPY UNIT (ITU). Patients whose respiratory or circulatory systems have failed bene?t especially by being intensively treated. Most patients, especially post-operative ones, leave intensive care when their condition has been stabilised, usually after 24 or 48 hours. Some, however, need support for several weeks or even months. Since 1952, intensive medicine has become a valued specialty and a demanding one because of the range of skills needed by the doctors and nurses manning the ITUs.... intensive care medicine

Insurance policies which pay for long-term care services (such as nursing home and home care) that are generally not covered by other health insurance.... long-term care insurance

is needed for patients with personality disorders or recurrent psychotic states, where the aim of treatment is to prevent deterioration and help the patient to achieve an optimal adaptation, making the most of his or her psychological assets. Such patients may ?nd more profound and unstructured forms of therapy distressing.

Behavioural therapy and cognitive therapy, often carried out by psychologists, attempt to clarify with the patient speci?c features of behaviour or mental outlook respectively, and to identify step-by-step methods that the patient can use for controlling the disorder. Behaviour therapy is commonly used for AGORAPHOBIA and other phobias, and cognitive therapy has been used for depression and anxiety. (See MENTAL ILLNESS.)... long-term supportive psychotherapy

... lyssa is another term for rabies.

A health plan that uses managed care arrangements and has a defined system of selected providers who contract with the plan. Those enrolled have a financial incentive to use participating providers who agree to furnish a broad range of services to them. Providers may be paid on a pre-negotiated basis.... managed care plan

This process aims to reduce the costs of health care while maintaining its quality. The concept originated in the United States but has attracted interest in the United Kingdom and Europe, where the spiralling costs of health care have been causing widespread concern. Managed care works through changing clinical practice, but it is not a discrete entity: the American I. J. Iglehart has de?ned it as ‘a variety of methods of ?nancing and organising the delivery of comprehensive health care in which an attempt is made to control costs by controlling the provision of services’. Managed care has three facets: health policy; how that policy is managed; and how individuals needing health care are dealt with. The process and its applications are still evolving and it is likely that di?erent health-care systems will adapt it to suit their own particular circumstances.... managed health care

This was set up under the CARE STANDARDS ACT 2000 as an independent regulator in respect of homes for the elderly, the disabled and children in the state and private sectors in the UK.... national care standards commission

The provision of a dedicated unit with special facilities, including one-to-one nursing and appropriate technology, for caring for premature and seriously ill newborn babies. Paediatricians and neonatologists are involved in the running of such units. Not every maternity unit can provide intensive care: for example, the provision of arti?cial ventilation, other than as a holding procedure until a baby can be transferred to a better-equipped and better-serviced unit. Such hospitals tend to have special-care baby units, which are capable of looking after the needs of most, but not all, premature or ill babies.... neonatal intensive care

Licensed facility that provides skilled nursing care and rehabilitation services to functionally disabled, injured or sick individuals.... nursing facility

See “care plan”.... patient care planning

An approach to care that consciously adopts a patient’s perspective. This perspective can be characterized around dimensions such as respect for patients’ values, preferences and expressed needs; coordination and integration of care; information, communication and education; physical comfort, emotional support and alleviation of fear and anxiety; involvement of family and friends; or transition and continuity.... patient-centred care

Piper longum

Piperaceae: San: Pippali;

Hin, Ben, Pun: Piplamul; Kan, Mal:Thippali ;

Tam: Thippili; Mar: Pimpli;

Tel: Pipppaloo; Ass: Piplu.

Introduction: Long pepper is a slender aromatic climber whose spike is widely used in ayurvedic and unani systems of medicine particularly for diseases of respiratory tract. Pipalarishta, Pippalyasava, Panchakola, Pippalayadilauha, and Lavana bhaskar churan are common ayurvedic preparations made out of the dry spikes of female types. Ittrifal fauladi, Angaruya-i-kabir and Majun khadar are well known unani preparations of long pepper. Its roots also have several medicinal uses. The root is useful in bronchitis, stomach ache, diseases of spleen and tumours. Fruit is useful in vata and kapha, asthma, bronchitis, abdominal complaints, fever, leucoderma, urinary discharges, tumours, piles, insomnia and tuberculosis. Root and fruit are used in gout and lumbago. The infusion of root is prescribed after parturition to induce the expulsion of placenta. The root and fruit decoction are used in acute and chronic bronchitis and cough. It contains the alkaloid piperine which has diverse pharmacological activities, including nerve depressant and antagonistic effect on electro- shock and chemo -shock seizures as well as muscular incoordination.

Distribution: The plant is a native of Indo-Malaya region. It was very early introduced to Europe and was highly regarded as a flavour ingredient by the Romans. The Greek name “Peperi”, the Latin “Piper” and the English “Pepper” were derived from the Sanskrit name “Pippali”. It grows wild in the tropical rain forests of India, Nepal, Indonesia, Malaysia, Sri lanka, Rhio, Timor and the Philippines. In India, it is seen in Assam, West Bengal, Uttar Pradesh, Madhya Pradesh, Maharashtra, Kerala, Karnataka.and Tamil Nadu. It is also cultivated in Bengal, Chirapunchi area of Assam, Akola-Amravati region of Maharashtra, Anamalai hills of Tamil Nadu, Orissa, Uduppi and Mangalore regions of Karnataka. Bulk of Indian long pepper comes from its wild growth in Assam, Shillong and West Bengal, supplemented by imports from Sri Lanka and Indonesia (Viswanathan,1995)

Botany: Piper longum Linn. is a member of Piperaceae family. The plant is a glabrous perennial under-shrub with erect or sub-scandent nodose stem and slender branches, the latter are often creeping or trailing and rooting below or rarely scandent reaching a few metres height. Leaves are simple, alternate, stipulate, and petiolate or nearly sessile; lower ones broadly ovate, cordate; upper ones oblong, oval, all entire, smooth, thin with reticulate venation; veins raised beneath. It flowers nearly throughout the year. Inflorescence is spike with unisexual small achlamydeous densely packed flowers and form very close clusters of small greyish green or darker grey berries. Female spikes with short thick stalk varying from 1.5 to2.5 cm in length and 0.5 to 0.7 cm in thickness.

A number of geographical races are available in different agroclimatic regions of India; the most popular being Assam, West Bengal and Nepal races. Piper officinarum DC; syn. Chavica officinarum Miquel, Piper pepuloides and Piper chaba Hunter are the other related species of importance.

Agrotechnology: Long pepper is a tropical plant adapted to high rainfall areas with high humidity. An elevation of 100-1000 m is ideal. It needs partial shade to the tune of 20-30% for best growth. The natural habitat of the plant is on the borders of streams. It is successfully cultivated in well drained forest soils rich in organic matter. Laterite soils with high organic matter content and moisture holding capacity are also suitable for cultivation.

Long pepper is propagated by suckers or rooted vine cuttings.15-20 cm long 3-5 nodded rooted vine cuttings establishes very well in polybags. The best time for raising nursery is March-April. Normal irrigation is given on alternate days. The rooted cuttings will be ready for transplanting in 2 months time. With the onset of monsoon in June the field is ploughed well and brought to good tilth. 15-20 cm raised beds of convenient length and breadth are taken. On these beds, pits are dug at 60 x 60 cm spacing and well decomposed organic manure at 100 g/pit is applied and mixed with the soil. Rooted vine cuttings from polybags are transplanted to these pits. Gap filling can be done after one month of planting.The crop needs heavy manuring at the rate of 20 t FYM/ha every year. Application of heavy dose organic matter and mulching increase water retention in the soil and control weeds. Small doses of chemical fertilisers can also be used. The crop needs irrigation once a week. Sprinkler irrigation is ideal. With irrigation the crop continues to produce spikes and off-season produce will be available. However, it is reported that unirrigated crop after the onset of monsoon grows vigorously and shows much hardiness than the irrigated crop.

Crop losses can be heavy due to pests and diseases. Mealy bugs and root grubs, attack the plant particularly during summer. Infested plants show yellowing and stunted growth. Application of systemic insecticides like nuvacron or dimecron will control the pests. Adults and nymphs of Helopeltis theivora severely feeds on the foliage which can be controlled by 0.25% neem kernel suspension. Rotting of leaves and vines during monsoon season is caused by Colletotrichum glorosporiodes and necrotic lesions and blights on the leaves during summer is caused by Colletotrichum and Cercospora spp. These diseases can be controlled by spraying of 1% Bordeaux mixture repeatedly. A virus like disease characterised by yellowing and crinkling of leaves, stunted growth and production of spikes of smaller size and inferior quality was also recently reported.

The vines start flowering six months after planting and flowers are produced almost throughout the year. The spikes mature in 2 months time. The optimum stage of harvest is when the spikes are blackish green. The pungency is highest at this stage. Spikes are hand picked when they become mature and then dried. The yield of dry spike is 400 kg /ha during first year, increases to 1000kg during third year and thereafter it decreases. Therefore, after 3 years the whole plant is harvested. The stem is cut close to the ground and roots are dug up. Average yield is 500 kg dry roots/ha (Viswanathan,1995).

Piper longum can also be cultivated as an intercrop in plantations of coconut, subabul and eucalyptus.

Post harvest technology: The harvested spikes are dried in sun for 4-5 days until they are perfectly dry. The green to dry spike ratio is 10:1.5 by weight. The dried spikes have to be stored in moisture proof containers. Stem and roots are cleaned, cut into pieces of 2.5-5 cm length, dried in shade and marketed as piplamool. There are three grades of piplamool, based on the thickness. The commercial drug consists 0.5-2.5 cm long ,0.5-2.5 mm thick, cylindrical pieces dirty light brown in colour and peculiar odour with a pungent bitter taste, producing numbness to the tongue.

Properties and activity: The spike of long pepper contains 4-5% piperine, piplartin, piperolactam, N-isobutyl deca trans-2-trans-4-dienamide and piporadione alkaloides, besides 0.7 % essential oil. Roots gave the alkaloids piperine, piperlongumine (piplartine) and piperlonguminine; sesamine, methyl 3, 4, 5-trimethoxy cinnamate. Stem gave triacoutane 22, 23 - dihydrostigmasterol. Fruit essential oil contains piperidine, caryophyllene and sesquiterpene alcohol (Atal et al, 1975).

The root is plungent, hot, stomachic, laxative, anthelmintic and carminative. The fruit is sweetish, pungent, hot, stomachic, aphrodisiac, alterative, laxative, antidysenteric, emmenagogue, abortifacient, diuretic and tonic. The essential oil is antimicrobial and anthelmintic.

N-isobutyl-deca-trans-2-trans-4-dienamide is antitubercular.

Piperine is hypotensive, antipyretic, analeptic, and nerve stimulant (Warrier et al, 1995).... long pepper

Assistance with those functions and activities normally associated with body hygiene, nutrition, elimination, rest and ambulation, which enables an individual to live at home or in the community.... personal care

See “care plan”.... personal care plan

See “care plan”.... plan of care

See “transitional care”.... post-acute care

Care that has the aim of preventing disease or its consequences. It includes health care programmes aimed at warding off illnesses, early detection of disease, and inhibiting further deterioration of the body.... preventive care

Sometimes called primary medical care, this is the care provided by a GENERAL PRACTITIONER (GP) – traditionally entitled the family doctor – or other health professionals who have ?rst contact with a patient needing or wanting medical attention. In the NHS, the primary health-care services include those provided by the general, dental, ophthalmic and pharmaceutical services as well as the family doctor service. Community health services provided outside the hospitals also o?er some primary health care.... primary health care

The provision of medical and dental care to patients who pay for the care either directly, through private medical insurance, or through employer-funded private insurance. In the UK, most patients are treated and cared for by the community- or hospital-based NHS. Although not forbidden to do so, few NHS general practitioners see private patients. NHS consultants are – within certain prescribed circumstances – allowed to treat private patients and many, especially surgeons, do so; but consultations and treatment are usually done on private-health premises. Some NHS hospitals have private facilities attached, but most private care is carried out in separate, privately run clinics and hospitals.

Certain specialties – for example, orthopaedic and reconstructive/cosmetic surgery and mental health – attract more private patients than others, such as paediatrics or medicine for the elderly. The standards of clinical care are generally the same in the two systems, but private patients can see the specialist of their choice at a time convenient to them. Waiting times for consultations and treatment are short and, when in hospital, private patients usually have their own room, telephone, TV, open visiting hours, etc.

A substantial proportion of private medical-care services are those provided for elderly people requiring regular nursing care and some medical supervision. The distinction between residential care and nursing care for the elderly is often blurred, but the government policy of providing means-tested state funding only for people genuinely needing regular nursing care – a system operated by local-authority social-service departments in England and Wales – has necessitated clearer de?nitions of the facilities provided for the elderly by private organisations. The strict criteria for state support (especially in England), the budget-conscious approach of local authorities when negotiating fees with private nursing homes, and the fact that NHS hospital trusts also have to pay for some patients discharged to such homes (to free-up hospital beds for new admissions) have led to intense ?nancial pressures on private facilities for the elderly. This has caused the closure of many homes, which, in turn, is worsening the level of BED-BLOCKING by elderly patients who do not require hospital-intensity nursing but who lack family support in the community and cannot a?ord private care.... private health care

Institutions which provide a domestic setting for confused, older people who require 24-hour care, but whose behaviour makes them unsuitable for accommodation in a general purpose facility.... psychogeriatric facility

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

See “residential care”; “assisted living facility”.... residential aged care facility

Provides accommodation and other care, such as domestic services (laundry, cleaning), help with performing daily tasks (moving around, dressing, personal hygiene, eating) and medical care (various levels of nursing care and therapy services). Residential care is for older people with physical, medical, psychological or social care needs which cannot be met in the community.... residential care

Accommodation and support for people who can no longer live at home.... residential care services

Services provided in the home, at a day care centre or by temporary placement in a nursing home or residential home to functionally disabled or frail individuals to provide occasional or systematic relief to informal caregivers.... respite care

Services provided to older people on a short-term basis to restore their physical condition to a level which would allow them to return home with appropriate support. See “rehabilitation”.... restorative care

Health activities, including promotion, maintenance, treatment, care and health related decision-making, carried out by individuals and families.... self care

Involves care designed to improve the physical wellbeing and restore the health of older people to an optimum level following a serious illness.... short-term aged care

is aimed at stabilising and strengthening the psychological defence mechanisms of those patients who are confronted by a crisis which threatens to overwhelm their ability to cope, or who are struggling with the aftermath of major life events.... short-term supportive psychotherapy

“Higher level” of care (such as injections, catheterization and dressing changes) provided by trained health professionals, including nurses, doctors and therapists.... skilled care

Daily nursing and rehabilitative care that can only be performed by, or under the supervision of, skilled nursing personnel.... skilled nursing care

Nursing homes that are certified to provide a fairly intensive level of care, including skilled nursing care.... skilled nursing facility

Assistance with the activities of daily life (personal care, domestic maintenance, self-direction) delivered by a personal care helper, home helper or social worker and aimed at supporting older people who experience disabilities in functioning.... social care service

See “informal care”.... social network care

A long-term care facility unit with services specifically for persons with particular diseases, disorders or injuries.... special care unit

Nursing care needs that require the advanced and specialized clinical skills and knowledge of a registered nurse.... specialized nursing care needs

People or groups who have an involvement or interest in the aged care system, including beneficiaries, providers and funders.... stakeholders (in aged care)

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

Sub-acute care is a bridge between acute care and home care. It is medical and skilled nursing services provided to persons who are not in the acute phase of an illness but who require a level of care higher than that provided in a long-term care setting.... sub-acute care

A type of short-term care provided by some long-term care facilities and hospitals, which may include rehabilitation services, specialized care for certain conditions (such as stroke and diabetes) and/or post-surgical care and other services associated with the transition between hospital and home.... transitional care

Hair, like nails and skin, is a protein material built up on amino acids. It is rich in minerals, especially sulphur. A sebaceous gland at the base of the hair follicle secretes sebum, an oily substance, which acts as a lubricant. When vital minerals and vitamins are lacking in the blood the quality of fibre and sebum deteriorates resulting in lustreless hair and change of texture. Healthy hair depends upon good personal hygiene, brushing, and washing with gentle-acting materials instead of harsh detergent shampoos which remove natural oils from the scalp and spoils its condition.

An adequate daily intake of essential fatty acids is assured by the golden oils (Sunflower, Corn, etc) which can be well supported by Evening Primrose oil capsules.

Internal: Bamboo gum. Nettle tea, Alfalfa, Horsetail, Soya.

Topical. Shampoo. Soapwort or Yucca. Chop 2 tablespoons (dry) or 1 tablespoon (fresh) leaves or root. Place in cup of warm water. Stir until a froth is produced. Decant and massage liquor into scalp.

Aloe Vera gel is noted for its moisturising effect and to provide nutrients. It may be used as a shampoo, hair set and conditioner. Jojoba oil has been used for centuries by the Mexican Indians for a healthy scalp; today, it is combined with Evening Primrose and Vitamin E with good effect. Olive oil stimulates strong growth.

One of several herbs may be used as a rinse, including Nettles, Rosemary, Southernwood, Fennel, Chamomile, Yellow Dock and Quassia. Hair should be washed not more than once weekly with warm water and simple vegetable soap; rinse four times with warm rinse, finishing off with cold. Brunettes should add a little vinegar; blondes, lemon juice. Selenium once had a reputation as a hair conditioner; recent research confirms. Selenium shampoos are available.

Supplements: Vitamins B (complex), B6, Choline, C and E. Copper, Zinc, Selenium, Vitamin B12 (50mg thrice daily).

Aromatherapy. 2 drops each: Sage, Nettles, Thyme; to 2 teaspoons Gin or Vodka, and massage into the scalp daily. ... hair care

Care of the mother after childbirth until about 6 weeks later.... postnatal care

6.5 cm wide, 5 cm thick, and weighs around 140 grams.

Adult kidneys have a smooth exterior, enveloped by a tough ?brous coat that is bound to the kidney only by loose ?brous tissue and by a few blood vessels that pass between it and the kidney. The outer margin of the kidney is convex; the inner is concave with a deep depression, known as the hilum, where the vessels enter. The URETER, which conveys URINE to the URINARY BLADDER, is also joined at this point. The ureter is spread out into an expanded, funnel-like end, known as the pelvis, which further divides up into little funnels known as the calyces. A vertical section through a kidney (see diagram) shows two distinct layers: an outer one, about 4 mm thick, known as the cortex; and an inner one, the medulla, lying closer to the hilum. The medulla consists of around a dozen pyramids arranged side by side, with their base on the cortex and their apex projecting into the calyces of the ureter. The apex of each pyramid is studded with tiny holes, which are the openings of the microscopic uriniferous tubes.

In e?ect, each pyramid, taken together with the portion of cortex lying along its base, is an independent mini-kidney. About 20 small tubes are on the surface of each pyramid; these, if traced up into its substance, repeatedly subdivide so as to form bundles of convoluted tubules, known as medullary rays, passing up towards the cortex. One of these may be traced further back, ending, after a tortuous course, in a small rounded body: the Malpighian corpuscle or glomerulus (see diagram). Each glomerulus and its convoluted tubule is known as a nephron, which constitutes the functional unit of the kidney. Each kidney contains around a million nephrons.

After entering the kidney, the renal artery divides into branches, forming arches where the cortex and medulla join. Small vessels come o? these arches and run up through the cortex, giving o? small branches in each direction. These end in a tuft of capillaries, enclosed in Bowman’s capsule, which forms the end of the uriniferous tubules just described; capillaries with capsule constitute a glomerulus.

After circulating in the glomerulus, the blood leaves by a small vein, which again divides into capillaries on the walls of the uriniferous tubules. From these it is ?nally collected into the renal veins and then leaves the kidney. This double circulation (?rst through the glomerulus and then around the tubule) allows a large volume of ?uid to be removed from the blood in the glomerulus, the concentrated blood passing on to the uriniferous tubule for removal of parts of its solid contents. Other arteries come straight from the arches and supply the medulla direct; the blood from these passes through another set of capillaries and ?nally into the renal veins. This circulation is con?ned purely to the kidney, although small connections by both arteries and veins exist which pass through the capsule and, joining the lumbar vessels, communicate directly with the aorta.

Function The kidneys work to separate ?uid and certain solids from the blood. The glomeruli ?lter from the blood the non-protein portion of the plasma – around 150–200 litres in 24 hours, 99 per cent of which is reabsorbed on passing through the convoluted tubules.

Three main groups of substances are classi?ed according to their extent of uptake by the tubules:

(1) SUBSTANCES ACTIVELY REABSORBED These include amino acids, glucose, sodium, potassium, calcium, magnesium and chlorine (for more information, see under separate entries).

(2) SUBSTANCES DIFFUSING THROUGH THE TUBULAR EPITHELIUM when their concentration in the ?ltrate exceeds that in the PLASMA, such as UREA, URIC ACID and phosphates.

(3) SUBSTANCES NOT RETURNED TO THE BLOOD from the tubular ?uid, such as CREATINE, accumulate in kidney failure, resulting in general ‘poisoning’ known as URAEMIA.... structure each kidney is about 10 cm long,

Physical and psychological care with the aim of making the final period of a dying person’s life as free from pain, discomfort, and emotional distress as possible. Carers may include doctors, nurses, other medical professionals, counsellors, social workers, clergy, family, and friends.

Pain can be relieved by regular low doses of analgesic drugs. Opioid analgesics, such as morphine, may be given if pain is severe. Other methods of pain relief include nerve blocks, cordotomy, and TENS. Nausea and vomiting may be controlled by drugs. Constipation can be treated with laxatives. Breathlessness is another common problem in the dying and may be relieved by morphine.

Towards the end, the dying person may be restless and may suffer from breathing difficulty due to heart failure or pneumonia. These symptoms can be relieved by drugs and by placing the patient in a more comfortable position.

Emotional care is as important as the relief of physical symptoms.

Many dying people feel angry or depressed and feelings of guilt or regret are common responses.

Loving, caring support from family, friends, and others is important.

Many terminally ill people prefer to die at home.

Few terminally ill patients require complicated nursing for a prolonged period.

Care in a hospice may be offered.

Hospices are small units that have been established specifically to care for the dying and their families.... dying, care of the

See oral hygiene.... teeth, care of

(ACA)... affordable care act 2010

a person who helps with the general care of a patient, usually assisting a nurse or social worker with care of the vulnerable elderly in the community. Care assistants include home helps.... care assistant

(HSCIC) formerly, an executive nondepartmental public body set up in April 2013 to collect, analyse, and publish UK national health data and supply IT systems and services to health-care providers nationwide. It was rebranded as *NHS Digital in August 2016.... health and social care information centre

identifying services required to meet population health-care needs and obtaining such services from an appropriate service provider via allocation of resources and contracting arrangements. Commissioners monitor the quality of commissioned services, including adherence to any appropriate national standards. Most NHS commissioning is undertaken by *clinical commissioning groups or *NHS England.... health-care commissioning

(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

any of several professionals supporting a dentist, formerly referred to as dental auxiliaries and professionals complementary to dentistry. A dental hygienist performs scaling and instruction in oral hygiene. A dental nurse helps the dentist at the chairside by preparing materials, passing instruments, and aspirating fluids from the patient’s mouth. A dental technician constructs dentures, crowns, and orthodontic appliances in the laboratory for the dentist. A clinical dental technician provides dentures directly to patients. A dental therapist performs non-complex treatment under the prescription of a dentist. In the UK dental care professionals are required to be statutorily registered with the General Dental Council (GDC).... dental care professional

(DHSC) (in Britain) a department of central government that supports the Secretary of State for Health and Social Care in meeting his or her obligations, which include the *National Health Service, the promotion and protection of the health of the nation, and social care, including some oversight of personal social services provided by local authorities. The department is staffed by civil servants, including some health professionals. Following the reforms of the Health and Social Care Act 2012, the Department no longer has direct control of the NHS, which has passed to *NHS England. The name of the department was expanded from ‘Department of Health’ in 2018. Equivalent departments support the ministers responsible for health services in Scotland, Wales, and Northern Ireland.

DHSC section of the website: provides information on a wide range of public health issues... department of health and social care

a multidisciplinary plan for delivering health and social care to patients with a specific condition or set of symptoms. Such plans are often used for the management of common conditions and are intended to improve patient care by reducing unnecessary deviation from best practice. See clinical governance.... integrated care pathway

an ironic ‘law’ stating that where good health care is most needed, it is usually least available. It was first stated by the Welsh GP Tudor Hart to underline the great difficulty in bringing areas of health-care poverty up to acceptable levels. See health inequalities; justice; need; rationing.... inverse care law

prolongation of the *Q–T interval on the electrocardiogram. It indicates susceptibility to ventricular tachycardia (especially *torsades de pointes), ventricular fibrillation, and sudden death. It may be familial or caused by certain drugs (e.g. sotalol, amiodarone, certain antipsychotic drugs).... long qt syndrome

n. see hypermetropia.... long-sightedness

a bandage consisting of padding and/or crepe and material containing elastic fibres that can stretch to up 300% of their original length. It is used in the treatment of venous leg ulcers and may be applied dry or as a cohesive layer. The fibres provide constant pressure and should not be worn overnight or during extended periods of rest.... long-stretch bandage

see NICE.... national institute for health and care excellence

(PPACA) see Affordable Care Act 2010.... patient protection and affordable care act

an approach to health care that focuses on the needs of the individual care user, rather than providing a standardized response to their condition. The patient is encouraged to take an active role in discussing a health-care plan that reflects their own needs, circumstances, and values.... person-centred care

medical care given to an individual who has survived a *cardiac arrest. This will usually consist of a 12-lead electrocardiogram (see lead2), a chest X-ray, a number of venous and arterial blood tests, and transfer to a high-dependency or coronary care unit for further intensive monitoring and drug administration.... postresuscitation care

a pregnancy that has gone beyond 42 weeks gestation or 294 days from the first date of the last menstrual period.... post-term pregnancy

see PICU.... psychiatric intensive care unit

Acne (M,S,F,B,I,N):

Bergamot, camphor (white), cananga, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), clove bud, galbanum, geranium, grapefruit, immortelle, juniper, lavandin, lavender (spike & true), lemon, lemongrass, lime, linaloe, litsea cubeba, mandarin, mint (peppermint & spearmint), myrtle, niaouli, palmarosa, patchouli, petitgrain, rosemary, rosewood, sage (clary & Spanish), sandalwood, tea tree, thyme, vetiver, violet, yarrow, ylang ylang.

Allergies (M,S,F,B,I):

Melissa, chamomile (German & Roman), immortelle, true lavender, spikenard.

Athlete’s foot (S):

Clove bud, eucalyptus, lavender (true &spike), lemon, lemongrass, myrrh, patchouli, tea tree.

Baldness & hair care (S,H):

West Indian bay, white birch, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), grapefruit, juniper, patchouli, rosemary, sage (clary & Spanish), yarrow, ylang ylang.

Boils, abscesses & blisters (S,C,B):

Bergamot, chamomile (German & Roman), eucalyptus blue gum, galbanum, immortelle, lavandin, lavender (spike & true), lemon, mastic, niaouli, clary sage, tea tree, thyme, turpentine.

Bruises (S,C):

Arnica (cream), borneol, clove bud, fennel, geranium, hyssop, sweet marjoram, lavender, thyme.

Burns (C,N):

Canadian balsam, chamomile (German & Roman), clove bud, eucalyptus blue gum, geranium, immortelle, lavandin, lavender (spike & true), marigold, niaouli, tea tree, yarrow.

Chapped & cracked skin (S,F,B):

Peru balsam, Tofu balsam, benzoin, myrrh, patchouli, sandalwood.

Chilblains (S,N):

Chamomile (German & Roman), lemon, lime, sweet marjoram, black pepper.

Cold sores/herpes (S):

Bergamot, eucalyptus blue gum, lemon, tea tree.

Congested & dull skin (M,S,F,B,I):

Angelica, white birch, sweet fennel, geranium, grapefruit, lavandin, lavender (spike & true), lemon, lime, mandarin, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), palmarosa, rose (cabbage & damask), rosemary, rosewood, ylang ylang.

Cuts/sores (S,C):

Canadian balsam, benzoin, borneol, cabreuva, cade, chamomile (German & Roman), clove bud, elemi, eucalyptus (blue gum, lemon & peppermint), galbanum, geranium, hyssop, immortelle, lavender (spike & true), lavandin, lemon, lime, linaloe, marigold, mastic, myrrh, niaouli, Scotch pine, Spanish sage, Levant styrax, tea tree, thyme, turpentine, vetiver, yarrow.

Dandruff (S,H):

West Indian bay, cade, cedarwood (Atlas, Texas & Virginian), eucalyptus, spike lavender, lemon, patchouli, rosemary, sage (clary & Spanish), tea tree.

Dermatitis (M,S,C,F,B):

White birch, cade, cananga, carrot seed, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), geranium, immortelle, hops, hyssop, juniper, true lavender, linaloe, litsea cubeba, mint (peppermint & spearmint), palmarosa, patchouli, rosemary, sage (clary & Spanish), thyme.

Dry & sensitive skin (M,S,F,B):

Peru balsam, Tolu balsam, cassie, chamomile (German & Roman), frankincense, jasmine, lavandin, lavender (spike & true), rosewood, sandalwood, violet.

Eczema (M,S,F,B):

Melissa, Peru balsam, Tolu balsam, bergamot, white birch, cade, carrot seed, cedarwood (Atlas, Texas & Virginian), chamomile (German & Roman), geranium, immortelle, hyssop, juniper, lavandin, lavender (spike & true), marigold, myrrh, patchouli, rose (cabbage & damask), rosemary, Spanish sage, thyme, violet, yarrow.

Excessive perspiration (S,B):

Citronella, cypress, lemongrass, litsea cubeba, petitgrain, Scotch pine, Spanish sage.

Greasy or oily skin/scalp (M,S,H,F,B):

West Indian bay, bergamot, cajeput, camphor (white), cananga, carrot seed, citronella, cypress, sweet fennel, geranium, jasmine, juniper, lavender, lemon, lemongrass, !itsea cubeba, mandarin, marigold, mimosa, myrtle, niaouli, palmarosa, patchouli, petitgrain, rosemary, rosewood, sandalwood, clary sage, tea tree, thyme, vetiver, ylang ylang.

Haemorrhoids/piles (S,C,B):

Canadian balsam, Copaiba balsam, coriander, cubebs, cypress, geranium, juniper, myrrh, myrtle, parsley, yarrow.

Insect bites (S,N):

French basil, bergamot, cajeput, cananga, chamomile (German & Roman), cinnamon leaf, eucalyptus blue gum, lavandin, lavender (spike & true), lemon, marigold, melissa, niaouli, tea tree, thyme, ylang ylang.

Insect repellent (S,V):

French basil, bergamot, borneol, camphor (white), Virginian cedarwood, citronella, clove bud, cypress, eucalyptus (blue gum & lemon), geranium, lavender, lemongrass, litsea cubeba, mastic, melissa, patchouli, rosemary, turpentine.

Irritated & inflamed skin (S,C,F,B):

Angelica, benzoin, camphor (white), Atlas cedarwood, chamomile (German & Roman), elemi, immortelle, hyssop, jasmine, lavandin, true lavender, marigold, myrrh, patchouli, rose (cabbage & damask), clary sage, spikenard, tea tree, yarrow.

Lice (S,H):

Cinnamon leaf, eucalyptus blue gum, galbanum, geranium, lavandin, spike lavender, parsley, Scotch pine, rosemary, thyme, turpentine.

Mouth & gum infections/ulcers (S,C):

Bergamot, cinnamon leaf, cypress, sweet fennel, lemon, mastic, myrrh, orange (bitter & sweet), sage (clary & Spanish), thyme.

Psoriasis (M,S,F,B):

Angelica, bergamot, white birch, carrot seed, chamomile (German & Roman), true lavender.

Rashes (M,S,C,F,B):

Peru balsam, Tofu balsam, carrot seed, chamomile (German & Roman), hops, true lavender, marigold, sandalwood, spikenard, tea tree, yarrow.

Ringworm (S,H):

Geranium, spike lavender, mastic, mint (peppermint & spearmint), myrrh, Levant styrax, tea tree, turpentine.

Scabies (S):

Tolu balsam, bergamot, cinnamon leaf, lavandin, lavender (spike & true), lemongrass, mastic, mint (peppermint & spearmint), Scotch pine, rosemary, Levant styrax, thyme, turpentine.

Scars & stretch marks (M,S):

Cabreuva, elemi, frankincense, galbanum, true lavender, mandarin, neroli, palmarosa, patchouli, rosewood, sandalwood, spikenard, violet, arrow.

Slack tissue (M,S,B):

Geranium, grapefruit, juniper, lemongrass, lime, mandarin, sweet marjoram, orange blossom, black pepper, petitgrain, rosemary, yarrow.

Spots (S,N):

Bergamot, cade, cajeput, camphor (white), eucalyptus (lemon), immortelle, lavandin, lavender (spike & true), lemon, lime, litsea cubeba, mandarin, niaouli, tea tree.

Ticks (S,N):

Sweet marjoram.

Toothache & teething pain (S,C,N):

Chamomile (German & Roman), clove bud, mastic, mint (peppermint & spearmint), myrrh.

Varicose veins (S,C):

Cypress, lemon, lime, neroli, yarrow.

Verrucae (S,N):

Tagetes, tea tree.

Warts & corns (S,N):

Cinnamon leaf, lemon, lime, tagetes, tea tree.

Wounds (S,C,B):

Canadian balsam, Peru balsam, Tolu balsam, bergamot, cabreuva, chamomile (German & Roman), clove bud, cypress, elemi, eucalyptus (blue gum & lemon), frankincense, galbanum, geranium, immortelle, hyssop, juniper, lavandin, lavender (spike & true), linaloe, marigold, mastic, myrrh, niaouli, patchouli, rosewood, Levant styrax, tea tree, turpentine, vetiver, yarrow.

Wrinkles & mature skin (M,S,F,B):

Carrot seed, elemi, sweet fennel, frankincense, galbanum, geranium, jasmine, labdanum, true lavender, mandarin, mimosa, myrrh, neroli, palmarosa, patchouli, rose (cabbage & damask), rosewood, clary sage, sandalwood, spikenard, ylang ylang.... skin care