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

This English common name can refer to more than one species. For the banana-like plantain fruit, see Plátano; for the low-lying herb whose leaves are primarily used medicinally, see Llantén.... plantain

See FASCIITIS.... plantar fasciitis

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

An inflammatory skin eruption with small shiny pimples starting from the wrists and spreading towards the trunk. Associated with lesions on mucous surfaces – vulva, penis, mouth. Cause is unknown but sometimes related to tuberculosis or drug poisoning. Usually over front of wrists, trunk and shins.

Symptoms: Severe itching. Thickened skin with shiny red patches which later become brown and scaly. Distinguish from psoriasis. Nails ridged and split.

Alternatives. Relief from itching by use of antihistamines: Garlic, Goldenseal, Ephedra, Lobelia.

Teas. Nettles, Boneset, Chickweed, Heartsease, Yucca.

Decoctions. (1) Combine: equal parts: Burdock, Sarsaparilla, Passion flower. OR (2) Combine: equal parts: Echinacea, Blue Flag root, Sarsaparilla. Half an ounce (14g) to 1 pint (500ml) water gently simmered 20 minutes. Dose: half-1 cup thrice daily.

Cold infusion. One heaped teaspoon Barberry (Berberis Vul) to cup cold water. Steep overnight. Half-1 cup thrice daily.

Powders, Liquid Extracts or Tinctures. Equal parts: Wild Yam, Blue Flag root, Fringe Tree bark. Powders: 500mg. Liquid Extracts: 30-60 drops in water. Tinctures: 1-2 teaspoons in water. Thrice daily before meals.

Mouth ulcers: Rinse mouth with Goldenseal and Myrrh drops, in water.

Topical. Ointment or pulp from any one: Aloe Vera, Comfrey, Chickweed, Houseleek, Marshmallow. Vaginal lesion. Aloe Vera pulp or gel.

Diet. Avoid citrus fruits and milk.

Vitamins. A. B-complex, B12, C. E. F. PABA.

Minerals. Dolomite. Zinc. Cod Liver oil: one dessertspoon daily. ... lichen planus

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

The technical name for FLAT-FOOT.... pes planus

Describing anything related to the sole of the foot.... plantar

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

Tropical countries are a treasure house of a wide variety of medicinal plants. Some species are found wild, while a number of species have been domesticated by the farmers. Many species have been grown in homesteads and become part of traditional home remedies. A limited number of species are commercially cultivated though a few more have potential for large-scale production. The important tropical and subtropical medicinal plants are discussed here highlighting the importance, medicinal and other uses, distribution, botany, agrotechnology, chemical constituents and activity. For practical convenience of the discussion in this book, they are classified under the following four broad groups.

a) Medicinal herbs

b) Medicinal shrubs

c) Medicinal climbers

d)Medicinal trees... tropical medicinal plants

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 deliberate limitation or spacing of births. Strategies for family planning include the different methods of contraception. (See also birth control.)... family planning

See wart, plantar.... plantar wart

The Crown-of-thorns starfish, known for the considerable damage that it may cause to coral reefs. It seems to occur in epidemics. The spines are venom-tipped, but usually the envenomation leads only to a painful spike wound which may sometimes get infected. Multiple spikes, either in one episode, or many individual stings rarely lead to systemic symptoms, but may lead to hypersensitivity.... acanthaster planci

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

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

Musa species

Description: These are treelike plants with several large leaves at the top. Their flowers are borne in dense hanging clusters.

Habitat and Distribution: Look for bananas and plantains in open fields or margins of forests where they are grown as a crop. They grow in the humid tropics.

Edible Parts: Their fruits are edible raw or cooked. They may be boiled or baked. You can boil their flowers and eat them like a vegetable. You can cook and eat the rootstocks and leaf sheaths of many species. The center or “heart” or the plant is edible year-round, cooked or raw.

Other Uses: You can use the layers of the lower third of the plants to cover coals to roast food. You can also use their stumps to get water (see Chapter 6). You can use their leaves to wrap other foods for cooking or storage.... banana and plantain

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

A process by which an admitted inpatient’s needs on discharge are anticipated, planned for or arranged.... discharge planning

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

If you haven’t heard much about plantain tea, it’s time to find out! As an herbal tea, it has a pretty pleasant, earthy taste, as well as many health benefits. About Plantain Tea Plantain tea is made from plantain. It is a perennial plant that grows all around the world, in Europe, Asia, Africa and America. The plantain has a tough rhizome with several large, dark green leaves. The flowers of the plant are brown, with four stamens and purple-colored anthers and the fruit is a two-celled capsule with seeds inside it. Many consider this plant to be a weed. However, the leaves are edible, and are often used in salads, or cooked as greens. Plantain Tea constituents Plantain, as an herbal plant, has many important active constituents. They include beta carotene, calcium, linoleic acid, oleanolic acid, sorbitol, tannin, and vitamin C. They are all transferred to plantain tea, as well. How to prepare Plantain Tea For a cup of plantain tea, you can use the leaves, roots and/or seeds of the plant. Just add one tablespoon of the dried plants to a cup of freshly boiled water. Let it steep for about 10 minutes, then strain. You can drink it both hot and cold. Plantain Tea Benefits Plantain tea is often used in the treatment of various respiratory problems, as it acts as a mild expectorant. These include asthma, bronchitis, sinusitis, sore throats, and coughs. Plantain tea can also be used to lower blood pressure and control sugar blood levels. Drinking plantain tea can help you if you’ve got diarrhea or dysentery. It is also used to treat irritated or bleeding hemorrhoids, kidney and bladder problems, bleeding caused by cystitis, and urinary tract infections. Plantain tea can be used topically, as well. It works as an antivenin, and it also promotes the healing of various wounds, skin inflammations, scars, cuts, rashes, and swellings. It can also be applied to the eye, in case your eyes are irritated. Plantain Tea Side Effects If you’re pregnant, it’s best to avoid drinking plantain tea. It can affect the uterus, which might lead to unwanted miscarriages. It is not known how safe it is to drink plantain tea if you’re breast feeding, but it is recommended to avoid it, just in case it might affect the baby. Don’t drink plantain tea if you’re allergic to any plants part of the plantain family. Also, you might get an allergic reaction from drinking the tea if you’re allergic to melon. Drinking too much plantain tea may lead to some side effects, as well. Generally, it is recommended that you not drink more than 5-6 cups of tea, no matter the type of tea. If you’re drinking too much tea, you might get some of the following symptoms: diarrhea, low blood pressure, headaches, loss of appetite, vomiting, insomnia, dizziness, and irregular heartbeats. Plantain tea helps you stay healthy! It is considered safe for both children and adults. Just be careful with the few side effects and you’re free to enjoy plantain tea!... drink more plantain tea

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)

Planning for the improvement of the health of a population or community, for a particular population, type of health service, institution or health programme.... health planning

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

Provides reimbursement to the insured without regard to the expenses actually incurred.... indemnity plan

Indian Medicinal Plants

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... indian medicinal plants

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

See “care plan”.... individual programme plan

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

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

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)

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

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

Medicinal Plants

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... medicinal plants

Medicinal Plants Glossary

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... medicinal plants glossary

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 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

Planning processes which involve the allocation of resources on the basis of community need.... needs-based planning

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

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

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”.... plan of care

Service provision targets established by an authority on a population basis.... planning ratio

Cav. var. bauphula (Edgew.) Pilger.

Family: Plantaginaceae.

Habitat: Punjab, Rajasthan and Delhi.

English: Brown Ispaghula.

Unani: Aspaghol.

Action: Seed—astringent. Seed coat—demulcent.

See Plantago ovata.... plantago amplexicaulis

Linn.

Family: Plantaginaceae.

Habitat: Western Himalayas, from Kashmir to Garhwal and Simla.

English: Rib Grass, Ribwort Plantain, English Plantain, Buckhorn Plantain.

Unani: Baartang, Aspaghol.

Folk: Balatang.

Action: Leaf and root—astringent, bechic, antiasthmatic, anti-inflammatory, hypothermic, diuretic. Seed—cathartic, diuretic, haemostatic.

Key application: Internally, for catarrhs of the respiratory tract and inflammatory alterations of the oral and pharyngeal mucosa; externally for inflammatory reactions of the skin. (German Commission E, ESCOP.)

Globularin and methyl ester of de- sacetyl asperulosidic acid were isolated from the plant along with cat- apol. A crude mucilage, isolated from the leaves, contains L-arabinose 26.0, D-galactose 35.8, D-glucose 21.9, D- mannose 4.6, L-rhamnose 4.6 and uronic acid 6.9%. Alpha-D-glucan was separated from this mucilage.

Leaves gave aucubin and esculetin, in addition to polysaccharides. The whole plant yielded rhamnosidoglyco- side of caffeic acid. Seeds contain 1.1% aucubin. Aucubin exhibits antibacterial activity. Hepatoprotective effect is also attributed to the aucubin content.

Alcoholic extract of young leaves exhibit antibacterial action against Streptococcus betahaemolyticus, Micrococ- cus pyogenes var. aureus and Bacillus subtilis, thus confirming their wound- healing properties.... plantago lanceolata

Linn.

Family: Plantaginaceae.

Habitat: The temperate and alpine Himalayas from Kashmir to Bhutan at altitudes of 600-3,500 m.

English: Broadleaf Plantain.

Ayurvedic: Ashvagola (var.).

Folk: Isabgol.

Action: Plant—haemostatic, antihistaminic, antibacterial, wound-healing in burns and inflammation of tissues. Leaves— cooling, astringent, diuretic, vulnerary, febrifuge. Used for diarrhoea, bacillary dysentery, hepatitis, urinary diseases, piles, ulcers and skin diseases. Leaves are used for cystitis with blood, haematuria and other bladder disorders.

The aqueous extract of the leaves showed anti-inflammatory activity in mice.

The aerial parts contain an iridoid glucoside, majoroside. The leaves contain a phenylpropanoid glycoside, plantamajoside, exhibiting antibacterial activity against several pathogenic bacteria including E. coli and Staphy- lococcus aureus. (The glycoside is less inhibitory than the free acids, caffeic, ferulic, and rosmarinic and esculetin.)... plantago major

Forsk

Synonym: P. Ispaghula Roxb.

Family: Plantaginaceae.

Habitat: Cultivated In Parts Of Rajasthan And Maharashtra.

English: Ispaghula, Spogel Seeds, Blond Psyllium.

Ayurvedic: Ashvagola. Ashwakarna (Also Equated With Shorea Robusta).

Unani: Aspaghol.

Siddha/Tamil: Isapppa.

Folk: Isabgol.

Action: Seed And Husk—Laxative, Diuretic, Demulcent, Bechic, Cholinergic. Used In Inflammatory Conditions Of The Mucous Membrane Of Gastrointestinal And Genitourinary Tract, Chronic Amoebic And Bacillary Dysentery; Also In Hypercholesterolemia.

Key Application ? In Chronic Constipation And Irritable Bowel. (German Commission E.) Also In Constipation Due To Duodenal Ulcer Or Diverticulitis (Who.) German Commission E Also Noted That Blond Psyllium Seed Lowers Serum Cholesterol Levels. It Has Also Been Shown To Slow Sugar Absorption Thereby Reducing Blood Glucose. (Escop.) Use Of Blond Psyllium Husk Up To Six Months Did Not Clinically Alter Vitamin Or Mineral Status In A Review Of Eight Human Trials. It Did Not Reduce Absorption Of Calcium. (J Am Geriatr Soc, 43, 1995; Am J Clin Nutr, 71, 2000; Natural Medicines Comprehensive Database, 2007.)

The Seed Contains Amino Acids Including Valine, Alanine, Glutamic Acid, Glycine, Cystine, Lysine, Leucine And Tyrosine; And A Mucilage Consisting Of A Mixture Of Polysaccharides Composed Mainly Of Xylose, Arabinose And Galacturonic Acid; Rhamnose And Galactose Are Also Present. The Seeds Also Gave Aucubin, The Antibacterial Principle. The Seed Coat Contains Fatty Acids Mainly Linoleic, Oleic And Palmitic Acids In Decreasing Concentrations.

The Seeds Show A Liver Protective Effect On Induced Hepatotoxicity In Mice. In China, The Plant Is Used Clinically To Treat Certain Types Of Hepatitis (Activity Due To Aucubin Content).

Dosage: Husk—5-10 G. (Ccras.)... plantago ovata

A common form of eczema (see DERMATITIS) of the soles of the feet typically seen in boys with an atopic (see ATOPY) background who constantly wear trainers.... plantar dermatosis

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

Plantago species

Description: The broad leaf plantain has leaves over 2.5 centimeters across that grow close to the ground. The flowers are on a spike that rises from the middle of the cluster of leaves. The narrow leaf plantain has leaves up to 12 centimeters long and 2.5 centimeters wide, covered with hairs. The leaves form a rosette. The flowers are small and inconspicuous.

Habitat and Distribution: Look for these plants in lawns and along roads in the North Temperate Zone. This plant is a common weed throughout much of the world.

Edible Parts: The young tender leaves are edible raw. Older leaves should be cooked. Seeds are edible raw or roasted.

Other Uses: To relieve pain from wounds and sores, wash and soak the entire plant for a short time and apply it to the injured area. To treat diarrhea, drink tea made from 28 grams (1 ounce) of the plant leaves boiled in 0.5 liter of water. The seeds and seed husks act as laxatives.... plantain, broad and narrow leaf

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

Psoriasis of the sole... psoriasis plantaris

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

See “care plan”.... service plan

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 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

Alisma plantago-aquatica

Description: This plant has small, white flowers and heart-shaped leaves with pointed tips. The leaves are clustered at the base of the plant.

Habitat and Distribution: Look for this plant in fresh water and in wet, full sun areas in Temperate and Tropical Zones.

Edible Parts: The rootstocks are a good source of starch. Boil or soak them in water to remove the bitter taste.

CAUTION

To avoid parasites, always cook aquatic plants.... water plantain

Protection... wax plant

TRANSPLANTATION of organs from one species to another – for example, from pigs to humans. The use of organs from appropriately cloned animals was seen as a possible solution to the shortage of human organs for transplantation; however, research has shown that rejection remains a problem and there is also an unresolved possibility that diseases might be transmitted across the species barrier. It seems likely that STEM CELL research will provide a more realistic source of tissues for transplantation to replace diseased organs in humans.... xenotrans plantation

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

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

The previous subject is obviously an endless one, but as this is the glossary of an herbal nature, let me assure you, virtually no plants have a direct steroid hormone-mimicking effect. There are a few notable exceptions with limited application, like Cimicifuga and Licorice. Plant steroids are usually called phytosterols, and, when they have any hormonal effect at all, it is usually to interfere with human hormone functions. Beta sitosterol, found in lots of food, interferes with the ability to absorb cholesterol from the diet. Corn oil and legumes are two well-endowed sources that can help lower cholesterol absorption. This is of only limited value, however, since cholesterol is readily manufactured in the body, and elevated cholesterol in the blood is often the result of internal hormone and neurologic stimulus, not the diet. Cannabis can act to interfere with androgenic hormones, and Taraxacum phytosterols can both block the synthesis of some new cholesterol by the liver and increase the excretion of cholesterol as bile acids; but other than that, plants offer little direct hormonal implication. The first method discovered for synthesizing pharmaceutical hormones used a saponin, diosgenin, and a five-step chemical degradation, to get to progesterone, and another, using stigmasterol and bacterial culturing, to get to cortisol. These were chemical procedures that have nothing to do with human synthesis of such hormones, and the plants used for the starting materials-Mexican Wild Yam, Agave, and Soy were nothing more than commercially feasible sources of compounds widely distributed in the plant kingdom. A clever biochemist could obtain testosterone from potato sterols, but no one would be likely to make the leap of faith that eating potatoes makes you manly (or less womanly), and there is no reason to presume that Wild Yam (Dioscorea) has any progesterone effects in humans. First, the method of synthesis from diosgenin to progesterone has nothing to do with human synthesis of the corpus luteum hormone; second, oral progesterone has virtually no effect since it is rapidly digested; and third, orally active synthetic progesterones such as norethindrone are test-tube born, and never saw a Wild Yam. The only “precursor” the ovaries, testes and adrenal cortices EVER need (and the ONLY one that they can use if synthesizing from scratch) is something almost NONE of us ever run out of...Low Density Cholesterol. Unless you are grimly fasting, anorectic, alcoholic, seriously ill or training for a triathlon, you only need blood to make steroid hormones from. If hormones are off, it isn’t from any lack of building materials...and any product claiming to supply “precursors” better contain lard or butter (they don’t)...or they are profoundly mistaken, or worse. The recent gaggle of “Wild Yam” creams actually do contain some Wild Yam. (Dioscorea villosa, NOT even the old plant source of diosgenin, D. mexicana...if you are going to make these mistakes, at least get the PLANT right) This is a useful and once widely used antispasmodic herb...I have had great success using it for my three separate bouts with kidney stones...until I learned to drink more water and alkalizing teas and NEVER stay in a hot tub for three hours. What these various Wild Yam creams DO contain, is Natural Progesterone. Although this is inactive orally (oral progesterone is really a synthetic relative of testosterone), it IS active when injected...or, to a lesser degree, when applied topically. This is pharmaceutical progesterone, synthesized from stigmasterol, an inexpensive (soy-bean oil) starting substance, and, although it is identical to ovarian progesterone, it is a completely manufactured pharmaceutical. Taking advantage of an FDA loophole (to them this is only a cosmetic use...they have the misguided belief that it is not bioactive topically), coupled with some rather convincing (if irregular) studies showing the anti-osteoporotic value of topical progesterone for SOME women, a dozen or so manufacturers are marketing synthetic Natural Progesterone for topical use, yet inferring that Wild Yam is what’s doing good. I am not taking issue with the use of topical progesterone. It takes advantage of the natural slow release into the bloodstream of ANY steroid hormones that have been absorbed into subcutaneous adipose tissue. It enters the blood from general circulation the same way normal extra-ovarian estradiol is released, and this is philosophically (and physiologically) preferable to oral steroids, cagily constructed to blast on through the liver before it can break them down. This causes the liver to react FIRST to the hormones, instead of, if the source is general circulation, LAST. My objection is both moral and herbal: the user may believe hormonal effects are “natural”, the Wild Yam somehow supplying “precursors” her body can use if needed, rejected if not. This implies self-empowerment, the honoring of a woman’s metabolic choice...something often lacking in medicine. This is a cheat. The creams supply a steady source of pharmaceutical hormone (no precursor here) , but they are being SOLD as if the benefits alone come from the Wild Yam extract, seemingly formulated with the intent of having Wild Yam the most abundant substance so it can be listed first in the list of constituents. I have even seen the pharmaceutical Natural Progesterone labeled as “Wild Yam Progesterone” or “Wild Yam Estrogen precursor” or, with utter fraud, “Wild Yam Hormone”. To my knowledge, the use of Mexican Yam for its saponins ceased to be important by the early 1960’s, with other processes for synthesizing steroids proving to be cheaper and more reliable. I have been unable to find ANY manufacturer of progesterone that has used the old Marker Degradation Method and/or diosgenin (from whatever Dioscorea) within the last twenty years. Just think of it as a low-tech, non invasive and non-prescription source of progesterone, applied topically and having a slow release of moderate amounts of the hormone. Read some of the reputable monographs on its use, make your choice based solely on the presence of the synthetic hormone, and use it or don’t. It has helped some women indefinitely, for others it helped various symptoms for a month or two and then stopped working, for still other women I have spoken with it caused unpleasant symptoms until they ceased its use. Since marketing a product means selling as much as possible and (understandably) presenting only the product’s positive aspects, it would be better to try and find the parameters of “use” or “don’t use” from articles, monographs, and best of all, other women who have used it. Then ask them again in a month or two and see if their personal evaluation has changed. If you have some bad uterine cramps, however, feel free to try some Wild Yam itself...it often helps. Unless there is organic disease, hormones are off is because the whole body is making the wrong choices in the hormones it does or doesn’t make. It’s a constitutional or metabolic or dietary or life-stress problem, not something akin to a lack of essential amino acids or essential fatty acids that will clear up if only you supply some mythic plant-derived “precursor”. End of tirade.... steroids, plant

Palma Christi. Ricinus communis L. Part used: oil expressed cold drawn from the seeds without the aid of heat. Versatile agent for skin diseases. “Biochemical precursor of prostaglandins . . . a trigger mechanism to immune system T-cells in the skin causing them to activate a local immune system reaction through the lymphatics.” (Harvey Grady, Edgar Cayce Foundation, Virginia Beach, Va., USA)

Action: anti-allergenic, galactagogue. Canary Island nursing mothers bind leaves to the breast to increase secretion of milk. Vitality of cells is upgraded by contact with the oil. Oral contraceptive. (V.J. Brondegaard, Plants Med. 23, 167, 1973) A traditional purgative.

Uses: Internal. Rarely used, except for varied forms of allergy (penicillin, hay fever, etc): 5 drops oil in honey, 3-4 times daily. Mouth ulcers, smear with oil. Large doses avoided.

Topical. Anti-fungal, emollient, anodyne.

Application to warts, corns, bunions, skin disorders, psoriasis, eczema, nail infection, bedsores, pigmented mole, ringworm, itch, ear-infection in children (drops), leg ulcers – dab with smear for pain relief, rodent ulcers made bearable, gangrene (with tincture Myrrh drops). Oil massaged into scalp for 20 minutes daily for falling hair. Eyelids, to soothe and heal. Age spots: brown patches on face, arms or hands have been known to disappear when persevering with a smear of each – Castor oil and Bicarbonate of Soda.

Preparations: Internal use: oil – 5 to 20ml, as prescribed.

External use: Zinc and Castor oil cream, or ointment. Or, Castor oil only.

Castor oil pack, to stimulate the immune system: apply soft pad of material saturated with Castor oil; hold in position with elastic bandage for skin diseases, pains of arthritis or rheumatism; lacerated and well-sutured wounds that refuse to heal. Renew oil when pad becomes dry. Oil may be used as a vehicle for eye drops. ... castor oil plant

Panax schinseng, Nees. Panax ginseng. German: Gensang. French: Panax. Italian: Ginseng. Chinese: Huang shen. C.A. Meyer. Roots. More suited to men than women. Used as a medicine in the Far East for over 4,000 years. Source of natural steroids (oestrogens), raising natural immunity. All Ginsengs enhance the natural resistance and recuperative power of the body. Produces opposite effects; i.e. it is both sedative and stimulant; in some it raises, in others it lowers blood pressure. Raises some cholesterol factors while reducing the overall amount in the blood. Hypoglycaemic. Aphrodisiac. Heart tonic. Old age re-vitaliser. Adaptogen. Used by the People’s Republic of China for a wide range of disorders. Source of the element Germanium.

Constituents: gum, resin, starch, saponin glycosides, volatile oil.

Uses: Physical weakness, neurasthenia, recovery after surgery. Promotes physical and intellectual efficiency. A mood-raiser. Induces a feeling of well being and stability. Depression, sexual debility, sleeplessness. The sportsman’s remedy, improving running ability and endurance. Retards build-up of lactic acid which normally occurs during hard exercise and causes fatigue. Increases resistance to excess cold or heat exposure and to a working environment with a noisy background. Lessens side-effects of insulin in diabetes. To help the body adapt to a changed environment (jet lag). Enhances mental performance in students. Promotes biosynthesis of DNA and RNA.

Preparations: Miscellaneous products available. Single morning dose.

Decoction. Half-1 teaspoon to each cup water gently simmered 10 minutes, or added to a cup of domestic tea.

Powder. Half-1g daily.

Contra-indications: hyperactivity in children, pregnancy, high blood pressure, menopause. Not taken continuously but for periods from 1 week to 1 month. Should not be taken with coffee. ... ginseng - king plant

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

(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

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

Several species of plant, including foxglove, holly, deadly nightshade, and laburnum, are poisonous. Nettles, hogweed, poison ivy, and primula cause skin reactions, including rash and itching, on contact. Young children are the most commonly affected. Symptoms of poisoning vary according to the plant but may include abdominal pain, vomiting, flushing, breathing difficulties, delirium, and coma and require urgent medical advice. Skin reactions can be treated by application of alcohol or calamine lotion; corticosteroid drugs may be prescribed for severe reactions. Poisoning usually requires gastric lavage. Fatal poisoning is rare. (See also mushroom poisoning.)... plants, poisonous

(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

balancing the health and health-care needs of a community, assessed by such indices as mortality, morbidity, and disability, with the resources available to meet these needs in terms of human resources (including ensuring the numbers in training grades meet future requirements) and technical resources, such as hospitals (capital planning), equipment, and medicines. See also clinical audit.... health service planning

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 dermatosis.... juvenile plantar dermatosis

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

part of the *uvea, one of the three layers that comprise the eye. As a part of the *ciliary body, it is about 4 mm long, located near the point where the iris and sclera touch, and is scalloped in appearance. It is a good site of entry for intraocular surgery.... pars plana

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

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

(PIP) a tax-free benefit replacing (from April 2013) *disability living allowance (DLA) for people aged 16–64 (DLA is still paid to children). It has two components – a daily living component (including help with washing, dressing, using the toilet, preparing and eating food, and taking medicines) and a mobility component (for help with walking).... personal independence payment

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

n. a level or smooth surface, especially any of the imaginary flat surfaces – orientated in various directions – used to divide the body; for example, the *coronal and *sagittal planes.... plane

adj. describing a structure, such as a lens, that is flat on one side and concave on the other.... planoconcave

adj. describing a structure, such as a lens, that is flat on one side and convex on the other.... planoconvex

the arch in the sole of the foot formed by anastomosing branches of the plantar arteries.... plantar arch

a reflex obtained by drawing a bluntly pointed object (such as a key) along the outer border of the sole of the foot from the heel to the little toe. The normal flexor response is a bunching and downward movement of the toes. An upward movement of the big toe is called an extensor response (or Babinski reflex or response). In all persons over the age of 18 months this is a sensitive indication of damage to the *pyramidal system in either the brain or spinal cord.... plantar reflex

adj. walking on the entire sole of the foot: a habit of humans, bears, and some other animals.... plantigrade

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

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