Patient protection and affordable care act Health Dictionary

A chronic infectious condition caused by an anaerobic micro-organism, Actinomyces israelii, that often occurs as a COMMENSAL on the gums, teeth and tonsils. Commonest in adult men, the sites most affected are the jaw, lungs and intestine, though the disease can occur anywhere. Suppurating granulomatous tumours develop which discharge an oily, thick pus containing yellowish (‘sulphur’) granules. A slowly progressive condition, actinomycosis usually responds to antibiotic drugs but improvement may be slow and surgery is sometimes needed to drain infected sites. Early diagnosis is important. Treatment is with antibiotics such as penicillin and tetracyclines. The disease occurs in cattle, where it is known as woody tongue.... actinomycosis

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

See DACTINOMYCIN.... actinomycin d

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

A person in contact with the health system seeking attention for a health condition.... patient

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

Disposable sanitary towels or tampons (see TAMPON) used to protect clothing from bloodstains during MENSTRUATION. They are available in different absorbencies to meet women’s individual needs.... sanitary protection

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

A protein involved in muscle contraction, in which microscopic filaments of actin and another protein, myosin, slide in between each other.... actin

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

The common abbreviation for adrenocorticotrophic hormone (also called corticotrophin). is produced by the anterior pituitary gland and stimulates the adrenal cortex (outer layer of the adrenal glands) to release various corticosteroid hormones, most importantly hydrocortisone (cortisol) but also aldosterone and androgen hormones.

production is controlled by a feedback mechanism involving both the hypothalamus and the level of hydrocortisone in the blood. levels increase in response to stress, emotion, injury, infection, burns, surgery, and decreased blood pressure.

A tumour of the pituitary gland can cause excessive production which leads to overproduction of hydrocortisone by the adrenal cortex, resulting in Cushing’s syndrome. Insufficient production results in decreased production of hydrocortisone, causing low blood pressure. Synthetic is occasionally given by injection to treat arthritis or allergy.... acth

Linn.

Synonym: A. acuminata Wall. ex Royle

Family: Ranunculaceae.

Habitat: Native to Europe; grows in temperate Himalayas from Hazara to Bhutan.

English: Baneberry Grapewort.

Folk: Visha-phale (Kannada).

Action: Root—antirheumatic, anti-inflammatory, nerve sedative, emetic, purgative; used in the treatment of rheumatic fever, lumbago, scrofula, nervous disorders, chorea.

The plant is reported to contain trans-aconitic acid, which shows a strong cytostatic action. Its Me ether is active against Ehrlich's ascites tumours.

In folk medicine, roots are used in cases of ovarian neuralgia, uterine tenderness and sub-involution. They are adulterant of the roots of Helleborus niger. Berries are poisonous; used topically for skin diseases. The toxic constituent is protoanemonin (lactone). It is irritant to mucous membrane.... actaea spicata

ACTH is the commonly used abbreviation for CORTICOTROPIN.... acth (adrenocorticotrophic hormone)

Kuhn.

Synonym: A. australis (L. f.) Link. A. radiata (Sw.) Link. A. dichotoma Kuhn.

Family: Adiantaceae.

Habitat: Throughout India, especially common in Kumaon Hills and the Nilgiris, below an altitude of 1,200 m.

English: Peacocks tail.

Ayurvedic: Mayurshikhaa, Madhu- chhadaa, Sahastrahi, Vahrishikhaa.

Action: Styptic, antibacterial, antipyretic.

The stems and leaves contain rutin, a styptic active principle. Anthelmintic activity, attributed to the fern, was not observed in experiments on mice.

Dosage: Root—3-5 g powder. (CCRAS.)... actiniopteris dichotoma

Meissn.

Synonym: A. angustifolia Nees.

Family: Lauraceae.

Habitat: The western Ghats, Orissa and Sikkim up to 1,500 m.

Siddha/Tamil: Thali, Paratathali.

Folk: Pisaa (Maharashtra).

Action: Infusion of leaves—urinary tract disinfectant, antidiabetic, spasmolytic.

The leaves contain a very small amount of an amorphous alkaloid. They also contain beta-sitosterol, hen- triacontanone, hentriacontanol and quercetin-3-rhamnoside and hydrocarbons.

The bark gives an alkaloid, actino- daphnine.

The roots contain a flavanone glycoside.... actinodaphne hookeri

See ASH.... action on smoking and health

A family of research methodologies which pursue action (or change) and research (or understanding) at the same time.... action research

The process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age.... active ageing

A concept of functioning – activities of daily living are basic activities that are necessary to independent living, including eating, bathing and toileting. This concept has several assessment tools to determine an individual’s ability to perform the activity with or without assistance. See related “instrumental activities of daily living (IADL)”.... activities of daily living (adl)

A trained staff member who is responsible for leisure activities in a health care programme. Activity coordinators develop programmes for people based on individual abilities and interests.... activity coordinator

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

See also CORTICOTROPIN. A hormone which is released into the body during stress. Made and stored in the anterior PITUITARY GLAND, ACTH regulates the production of corticosteroid hormones from the ADRENAL GLANDS, and is vital for the growth and maintenance of the adrenal cortical cells. Its production is in part controlled by the amount of HYDROCORTISONE in the blood and also by the HYPOTHALAMUS. ACTH participates in the FEEDBACK MECHANISM of hormone production and actions involving particularly the hypothalamus and pituitary gland. The hormone is used to test adrenal function and treat conditions such as ASTHMA. (See also CUSHING’S SYNDROME.)... adrenocorticotrophic hormone (acth)

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

Collective efforts by communities which are directed towards increasing community control over the determinants of health and thereby improving health.... community action for health

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

Activities which are essential for daily living, such as self care, mobility and communication.... core activities

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

This legislation puts into e?ect the UK European Directive 95/46/EC on the processing of personal data, whether paper or computer records. The Act is based on eight principles, the ?rst of which stipulates that ‘personal data shall be processed fairly and lawfully’. Unfortunately this phrase is open to di?erent interpretations. Clari?cation is required to determine how the common-law duty of con?dentiality affects the health services in the context of using data obtained from patients for research work, especially epidemiological studies (see EPIDEMIOLOGY). Health authorities, trusts and primary care groups in the NHS have appointed ‘Caldicott guardians’ – named after a review of information that identi?es patients. A prime responsibility of the guardians is to agree and review internal protocols for the protection and use of identi?able information obtained from patients. The uncertainties over the interpretation of the legislation require clari?cation, but some experts have suggested a workable solution: to protect patients’ rights, researchers should ensure that data are fully anonymised whenever possible; they should also agree their project design with those responsible for data protection well in advance of its planned starting date. (See ETHICS.)... data protection act 1998

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

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

Activities with aspects of cognitive and social functioning, including shopping, cooking, doing housework, managing money and using the telephone. See also “activities of daily living (ADLs)”.... instrumental activities of daily living (iadl)

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)

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

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)

A recognized relationship between part or parts of different sectors of society which has been formed to take action on an issue to achieve health outcomes or intermediate health outcomes in a way which is more effective, efficient or sustainable than might be achieved by the health sector acting alone. For practical purposes, intersectoral action and multisectoral action are synonymous terms, the former perhaps emphasizing the element of coordination, the latter the contribution of a number of sectors.... intersectoral action / multisectoral action

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

See “high dependency care facility”.... long-term care facility

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

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

See “intersectoral action”.... multisectoral action

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

A National Health Service body intended to combat the increasing threat from infectious diseases and biological, chemical and radiological hazards. Covering England, the agency includes the Public Health Laboratory Service, the National Radiological Protection Board, the Centre for Applied Microbiology and Research, and the National Focus Group for Chemical Incidents.... national infection control and health protection agency

A broad intersectoral master plan for attaining national health goals through implementation of a strategy. It indicates what has to be done, who has to do it, during what time-frame, and with what resources. It is a framework leading to more detailed programming, budgeting, implementation and evaluation. It specifies, in operational terms, the steps to be taken in accordance with the strategy, keeping in mind the various objectives and targets to be attained and the programmes for attaining them.... national plan of action

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

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

Standardized tools to determine patient characteristics and abilities, what assistance they need and how they may be helped to improve or regain abilities. Patient assessment forms are completed using information gathered from medical records, interviews with the patient, other informants (e.g. family members) and direct observation.... patient assessment (resident)

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

See ETHICS.... patient choice

See ETHICS.... patient consent

At a personal level, the engagement of individuals in decisions about their health and about the diagnosis, treatment and after-care of their illness, injuries and other disorders. At a public level, the engagement of all members of the public in the planning, provision and performance of their health-care services. Traditionally, at both personal and public levels, the patient has generally been regarded as naturally subordinate to the politicians and managers who plan and run the health-care system(s), and to health professionals and medical institutions who provide personal health care. The public and patients are increasingly unwilling to accept this traditional model and are asserting themselves, for example through patient help groups, complaints, litigation and local political action with the aim of securing changes in how health care is organised and a much greater say in their own care.... patient empowerment

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

A technique whereby a patient can deliver an analgesic substance (see ANALGESICS) in amounts related to the extent of the PAIN that he or she is suffering. For example, to combat post-operative pain, some hospitals use devices which allow patients to give themselves small intravenous amounts of opiates when they are needed. Pain is more e?ectively controlled if it is not allowed to reach a high level, a situation which tends to happen when patients receive analgesics only on ward drug rounds or when they ask the nursing sta? for them.... patient-controlled analgesia

A study, generally undertaken by an individual health programme or health planning agency to determine the geographic distribution of the residences of the patients served by one or more health programmes. Such studies help define catchment and medical trade areas and are useful in locating and planning the development of new services.... patient-origin study

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

Any form of exercise or movement.... physical activity

See “care plan”.... plan of care

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

Drugs that have the ability to dilate ARTERIES and VEINS and are used to relieve pain in ANGINA of the HEART. Nicorandil is the main example.... potassium-channel activators

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

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

One of the simplest forms of activity of the nervous system. (For the mechanism upon which it depends, see NERVOUS SYSTEM; NEURON(E).) Re?ex acts are divided usually into three classes.

Super?cial re?exes comprise the sudden movements which result when the skin is brushed or pricked, such as the movement of the toes that results from stroking the sole of the foot.

Deep re?exes depend upon the state of mild contraction in which muscles are constantly maintained when at rest, and are obtained, as in the case of the knee-jerk (see below), by sharply tapping the tendon of the muscle in question.

Visceral re?exes are those connected with various organs, such as the narrowing of the pupil when a bright light is directed upon the EYE, and the contraction of the URINARY BLADDER when distended by urine.

Faults in these re?exes give valuable evidence as to the presence and site of neurological disorders. Thus, absence of the knee-jerk, when the patellar tendon is tapped, means some interference with the sensory nerve, nerve-cells, or motor nerve upon which the act depends – as, for example, in POLIOMYELITIS, or peripheral NEURITIS; whilst an exaggerated jerk implies that the controlling in?uence exerted by the BRAIN upon this re?ex mechanism has been cut o? – as, for example, by a tumour high up in the SPINAL CORD, or in the disease known as MULTIPLE SCLEROSIS (MS).... reflex action

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

“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

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 natural PROTEIN that occurs in the body. It has the property of breaking down a THROMBUS in a blood vessel (see THROMBOLYSIS). It is e?ective only in the presence of FIBRIN and activates plasminogen, which occurs normally on the surface of the ?brin. TPA is an important thrombolytic treatment immediately after a myocardial infarction (see HEART, DISEASES OF).... tissue plasminogen activator (tpa, tpa)

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

There are active and passive (in-active) constituents in all plants. An active principle is the most active constituent.

The amount of active constituent of a plant is not constant. The percentage of active constituent varies greatly. For this reason official pharmacy standardises drugs. See: WHOLE PLANT. ... active principle

An agent which stimulates the adrenal glands thereby increasing secretion of cortisol and adrenal hormones. A herb with a mild cortico-steroid effect. Liquorice. Ginseng. Sarsaparilla. ... adrenal-activator

Impulsive actions that may reflect unconscious wishes. The term is most often used by psychotherapists to describe behaviour during analysis when the patient “acts out” rather than reports fantasies, wishes, or beliefs. Acting out can also occur as a reaction to frustrations encountered in everyday life, often taking the form of antisocial, aggressive behaviour.... acting out

Pertaining to changes caused by the ultraviolet rays in sunlight, as in actinic dermatitis (inflammation of the skin) and actinic keratosis (roughness and thickening of the skin).... actinic

The transference of feelings from one object or person to another.

This is usually performed consciously to obtain emotional relief in a manner that will not cause harm to oneself or to another person.

Some psychotherapists believe that displacement is an unconscious defence mechanism, which prevents disturbing feelings from entering consciousness.... displacement activity

See tissue plasminogen activator.... plasminogen activator

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

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

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

See oral hygiene.... teeth, care of

A substance produced by body tissues that prevents abnormal blood clotting. Also called , it is produced by the inner lining of blood vessels. can be prepared artificially for use as a thrombolytic drug, which is called alteplase. This is used in the treatment of myocardial infarction, severe angina pectoris, and arterial embolism, including pulmonary embolism. Possible side effects include bleeding or the formation of a haematoma at the injection site and an allergic reaction. (See also fibrinolysis.)... tissue-plasminogen activator

n. a genus of Gram-negative nonmotile aerobic bacteria that are characteristically spherical or rodlike in shape but occasionally grow into branching filaments. Actinobacilli cause disease in animals that can be transmitted to humans.... actinobacillus

n. a genus of Gram-positive nonmotile fungus-like bacteria that cause disease in animals and humans. The species A. israelii is the causative organism of human *actinomycosis.... actinomyces

n. the treatment of disorders with *infrared or *ultraviolet radiation.... actinotherapy

the change in voltage that occurs across the membrane of a nerve or muscle cell when a *nerve impulse is triggered. It is due to the passage of charged particles across the membrane (see depolarization) and is an observable manifestation of the passage of an impulse.... action potential

adj. the ethical distinction between actively doing something to a patient and simply allowing it to happen or failing to act (the acts and omissions doctrine). For instance, doctors should act to save life if possible, but when death is inevitable it is permissible to let it happen, although the prohibition against killing would not allow active intervention. See also dying.... active/passive

(in biochemistry) an energy-dependent process in which certain substances (including ions, some drugs, and amino acids) are able to cross cell membranes against a concentration gradient. The process is inhibited by substances that interfere with cellular metabolism (e.g. high doses of digitalis).... active transport

n. a protein complex that enhances the biosynthesis and secretion of follicle-stimulating hormone and helps to regulate the menstrual cycle. Inhibin is closely related and exerts an opposite effect: it down-regulates FSH synthesis and inhibits FSH secretion.... activin

(ADLs) the tasks of everyday life. Basic ADLs include self-care tasks, such as bathing, dressing, eating, grooming, toileting, and moving. Instrumental ADLs include housework, shopping, managing finances, taking medication, and cooking. Inability to perform ADLs is a practical measure of disability in many disorders; problems are much more prevalent in the elderly.... activities of daily living

n. a protein complex formed in muscle between actin and myosin during the process of contraction. See striated muscle.... actomyosin

(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

(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

(in Britain) a confidential list of children whose social circumstances render them at risk of neglect or abuse. Each local authority maintains a register of children who are subject to a child protection plan, who will receive extra support and surveillance from health and/or social services. See also safeguarding.... child protection register

(CHP) a consultant within *Public Health England who is responsible for the surveillance, prevention, and control of communicable disease and noncommunicable environmental exposures. While no longer the preferred term, the older form Consultant in Communicable Disease Control (CCDC) is still sometimes used. See also public health consultant.... consultant in health protection

the route that a patient takes through the health-care system, from first admission to a hospital or treatment centre to final discharge. This may consist of one or more *spells in particular hospitals and one or more *finished consultant episodes. For example, a patient admitted to a district general hospital, transferred to a tertiary hospital for a specialist procedure, and then transferred back to the district general hospital for recovery would experience one continuous patient pathway but three spells.... continuous patient pathway

the toxic effects of a drug produced by repeated administration of small doses at intervals that are not long enough for it to be either broken down or excreted by the body.... cumulative action

(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

the branch of *public health medicine that is concerned with protecting the population from communicable diseases, chemicals and poisons, radiation, and other potential threats to health. See Public Health England.... health protection

legal safeguards relating to the use and storage of personal information about a living person. Under the Data Protection Act 2018, which implements the EU’s General Data Protection Regulation (GDPR) and supersedes the Data Protection Act 1998, individuals have a basic right to control information stored about them. Information concerning health, considered ‘sensitive personal data’ under the legislation, must be used only for the purpose (health care of the individual) for which it was gathered, must be kept secret, and cannot be used or passed on to others without the knowledge of the subject. However, anonymized health data from individual patients’ electronic records may be used for research purposes or to improve medical treatment and health-service delivery.... data protection

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

(HPA) formerly, a nondepartmental public body set up as a special health authority in 2003 to protect the health of the UK population via advice and support to the NHS, local authorities, the Department of Health, emergency services, and others. The HPA was abolished in April 2013; its responsibilities were largely passed to *Public Health England. See Consultant in Health Protection.... health protection agency

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

n. a patient who is admitted to a bed in a hospital ward and remains there for a period of time for treatment, examination, or observation. Compare out-patient.... in-patient

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

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

(NPSA) formerly, a special health authority that led and coordinated work to improve all aspects of patient safety in England. The NPSA comprised three divisions: the National Reporting and Learning Service, the National Research Ethics Service, and the National Clinical Assessment Service. It closed in 2012, with its key functions transferred to *NHS England. In 2016 the same functions were transferred from NHS England to the newly formed *NHS Improvement.... national patient safety agency

the property possessed by some substances of rotating the plane of polarization of polarized light. A compound that rotates the plane to the left is described as laevorotatory (or l-); one that rotates the plane to the right is described as dextrorotatory (or d-).... optical activity

n. a patient who receives treatment at a hospital, either at a single attendance or at a series of attendances, but is not admitted to a bed in a hospital ward. Large hospitals have *clinics at which out-patients with various complaints can be given specialist treatment. Compare in-patient.... out-patient

(PAR) a radical approach to public health issues that actively involves communities in collaboration, reflection, data collection, and activities that empower them to improve their own health. See empowerment.... participatory action research

(PALS) (in England) a confidential service provided by each NHS trust to support patients, their families, and carers by giving advice and information in response to questions and concerns about local NHS services. See also advocacy.... patient advice and liaison service

see PHQ-9.... patient health questionnaire

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

enzymes that convert the inactive substance *plasminogen to the active enzyme *plasmin, which digests blood clots (see fibrinolysis). There are two types of plasminogen activators, *tissue-type plasminogen activator (tPA) and urokinase-like plasminogen activator (uPA). See blood coagulation.... plasminogen activators

the process whereby platelets adhere to collagen released from endothelial cells in damaged blood vessels and aggregate to form a plug. An important metabolic pathway in platelets converts membrane phospholipids to *thromboxane A2 (TXA2), which can activate platelets. ADP, released from platelet granules, and *thrombin are other activators. The adhesive and aggregation reactions of platelets are mediated through surface membrane glycoproteins (Glp), Glp Ib and Glp IIb/IIIa. Aspirin acts as an *antiplatelet drug by irreversibly inhibiting one of the enzymes of this pathway, cyclo-oxygenase. Clopidrogel inhibits the ADP receptor on platelet membranes, and *abciximab blocks platelet aggregation by inhibiting Glp IIb/IIIa (see illustration overleaf).... platelet activation

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

any one of a class of drugs that enhance the movement of potassium ions through the *ion channels in cell membranes. In the case of smooth muscle cells, such as those in the walls of arteries, their sensitivity to the normal stimuli to contract is reduced. The result is relaxation of the muscle fibres and widening of the arteries. Potassium-channel activators are used for improving the blood supply to the heart muscle in angina pectoris. Possible side-effects include headache, flushing, vomiting, dizziness, and weakness. A currently available member of the class is nicorandil.... potassium-channel activator

see PICU.... psychiatric intensive care unit

(electromechanical dissociation) the appearance of normal-looking complexes on the electrocardiogram that are, however, associated with a state of *cardiac arrest. It is usually caused by large pulmonary emboli (see pulmonary embolism), *cardiac tamponade, tension *pneumothorax, severe disturbance of body salt levels, severe haemorrhage, or hypothermia causing severe lack of oxygen to the heart muscle.... pulseless electrical activity

measures designed to limit the dose of harmful radiation to patients and workers. Medical exposure to radiation is governed in the UK by the Department of Health and Social Care under the Ionising Radiation (Medical Exposures) Regulations 2000 (IRMER). A guiding theme of protection is the ALARA principle (“as low as reasonably achievable”).... radiation protection

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

(tPA, TPA) a natural protein, found in the body and able to be manufactured by genetic engineering, that can break up a thrombus (see thrombolysis). It requires the presence of *fibrin as a cofactor and is able to activate *plasminogen on the fibrin surface, which distinguishes it from the other plasminogen activators, *streptokinase and *urokinase. tPAs include reteplase and tenecteplase, given to treat acute myocardial infarction, and *alteplase.... tissue-type plasminogen activator

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