Measurement of the internal dimensions of the PELVIS. The four diameters measured are: transverse, anterioposterior, and left and right oblique. These measurements help to establish whether a fetus can be delivered normally. If the outlet is abnormally small, the mother will have to be delivered by CAESAREAN SECTION.... pelvimetry
A category in a classification or typology of clients. Clients can be classified in various dimensions, e.g. by dependency level, by diagnosis.... client group
Traditionally, doctors have been trained to treat a patient on the basis of his or her personal clinical needs. Increasingly, however, the practice of medicine has been in?uenced by patients’ social circumstances and more recently by community-and government-driven national priorities. One critical aspect of these widening in?uences has been the cost of medical care which, as medicine becomes more complex, has been rising sharply. Thus health economics has become an integral part of the provision of health care. Cost-of-illness studies now appear commonly in medical publications. Such studies aim to identify and measure all the costs of a particular disease, including, where feasible, the direct, indirect and intangible dimensions. The information obtained is intended to help the development of health policies, nationally and internationally. The application of information from such studies is, however, proving controversial. Firstly, doctors still see their clinical responsibilities to patients as a priority. Secondly, cost-of-care studies are often criticised for excluding broader economic aspects of health care – for example, analyses of the cost-e?ectiveness of prevention as well as the treatment of illness. This requires assessment of potential and actual outcomes as well as the costs of illnesses. Even so, the increasing complexity of medicine, with its commensurately rising costs affecting both state- and privately funded medical care, makes it inevitable that the cost of maintaining a population’s good health will be a growing factor in the provision of health care that seems bound to impinge on how doctors are enabled to treat their individual patients.... cost of illness
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 state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Health has many dimensions (anatomical, physiological and mental) and is largely culturally defined.... health
Individual outcome measure that extends beyond traditional measures of mortality and morbidity to include such dimensions as physiology, function, social activity, cognition, emotion, sleep and rest, energy and vitality, health perception and general life satisfaction (some of these are also known as health status, functional status or quality-of-life measures).... health-related quality-of-life (hrql) measure
A composite index that measures the overall achievements in a country in three basic dimensions of human development— longevity, knowledge and a decent standard of living. It is measured by life expectancy, educational attainment and adjusted income per capita in purchasing power parity (PPP) US dollars. The HDI is a summary, not a comprehensive measure of human development.... human development index (hdi)
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
An aid to diagnosis practised by striking the patient’s body with the ?ngers, in such a way as to make it give out a note. It was introduced in 1761 by Leopold Auenbrugger (1722–1809) of Vienna, the son of an innkeeper, who derived the idea from the habit of his father tapping casks of wine to ascertain how much wine they contained. According to the degree of dullness or resonance of the note, an opinion can be formed as to the state of CONSOLIDATION of air-containing organs, the presence of abnormal cavities in organs, and the dimensions of solid and air-containing organs, which happen to lie next to one another. Still more valuable evidence is given by AUSCULTATION.... percussion
The lengthening and intensi?cation of sound produced by striking the body over an air-containing structure such as the lung. Decrease of resonance is called dullness and increase of resonance is called hyper-resonance. The process of striking the chest or other part of the body to discover its degree of resonance is called PERCUSSION, and according to the note obtained, an opinion can be formed as to the state of consolidation of air-containing organs, the presence of abnormal cavities, and the dimensions and relations of solid and air-containing organs lying together. (See also AUSCULTATION.)... resonance
n. a special standardized X-ray picture of the craniofacial area that can be used to measure alterations in the growth of skull bones, as used especially during orthodontic treatment. A lateral cephalometric radiograph is used to analyse skeletal, dentoalveolar, and soft tissue relationships in the anteroposterior and vertical dimensions.... cephalogram
(colonography) n. imaging of the colon. CT colography uses *computerized tomography to obtain multiple *axial thin-slice images (usually less than 3 mm thick), which can be electronically reformatted in two or three dimensions (see multiplanar reconstruction). It has the added advantage of visualizing all the other abdominal organs. Although less invasive than *colonoscopy, it cannot be used for biopsies or therapeutic procedures. MR colography, using *magnetic resonance imaging, is becoming more commonplace; its advantage over CT colography is that the patient is not exposed to irradiation.... colography
QAPI establishes strategies for promoting high quality health care. First, each organization must meet certain required levels of performance when providing specific health care and related services. Second, organizations must conduct performance improvement projects that are outcome-oriented and that achieve demonstrable and sustained improvement in care and services. It is expected that an organization will continuously monitor its own performance on a variety of dimensions of care and services, identify its own areas for potential improvement, carry out individual projects to undertake system interventions to improve care, and monitor the effectiveness of those interventions.... quality assessment and performance improvement programme (qapi)
n. imaging of blood vessels (see also coronary angiography; lymphangiography). In the older form of angiography X-ray imaging was carried out after injection of *radiopaque contrast medium and *digital subtraction applied to enhance visualization. The use of X-rays has now been largely replaced by methods using MRI or CT scanners. Magnetic resonance angiography (MRA) can be performed with (contrast-enhanced) or without (noncontrast) injection of a magnetic resonance contrast agent (see contrast medium). Contrast-enhanced MRA will show the vessels better. These images can be reconstructed in two or three dimensions. Computerized tomographic angiography (CTA) uses a radiographic contrast agent, usually injected into a vein, to increase the visibility of the blood vessels. Fluorescein angiography is a common method of investigation in ophthalmology. *Fluorescein sodium is injected into a vein in the arm, from which it circulates throughout the body. Light of an appropriate wavelength is shone into the eye, causing the dye in the retinal blood vessels to fluoresce. This allows the circulation through the retinal blood vessels to be observed and photographed. Indocyanine green (ICG) angiography uses indocyanine green dye, which fluoresces in infrared light. It is valuable in assessing circulation in the deeper layers of the *fundus.... angiography
n. a method of separating particles of different dimensions in a liquid mixture, using a thin semipermeable membrane whose pores are too small to allow the passage of large particles, such as proteins, but large enough to permit the passage of dissolved crystalline material. A solution of the mixture is separated from distilled water by the membrane; the solutes pass through the membrane into the water while the proteins, etc., are retained. The principle of dialysis is used in the *dialyser (see also haemodialysis). The peritoneum is used as an autogenous semipermeable membrane in the technique of *peritoneal dialysis.... dialysis
n. the use of *ultrasound waves to investigate and display the action of the heart as it beats. Used in the diagnosis and assessment of congenital and acquired heart diseases, it is safe, painless, and reliable and reduces the need for cardiac *catheterization. M-mode echocardiography uses a single beam of ultrasound. The image produced is not anatomical but permits precise measurement of cardiac dimensions and the diagnosis of valvular, myocardial, and pericardial disease. 2-D echocardiography uses a pulsed array of ultrasound beams to build up a moving image on a TV monitor of the chambers and valves of the heart. In Doppler echocardiography ultrasound reflected from moving red blood cells is subject to the Doppler effect (change of frequency with velocity relative to the observer), which can be used to calculate blood flow and pressure within the heart and great vessels. It is useful in the diagnosis and assessment of valve disease and intracardiac shunts. In transoesophageal echocardiography (TOE) the ultrasound probe is mounted on an oesophageal endoscope. The examination from within the oesophagus allows the probe to be placed directly against the back of the heart, which enables improved visualization of the posterior structures.... echocardiography
n. (in psychology) an enduring disposition to act and feel in particular ways that differentiate one individual from another. These patterns of behaviour are sometimes conceptualized as different categories (see personality disorder) and sometimes as different dimensions (see extroversion; neuroticism).... personality
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