The state wherein the person is well adjusted.
Organized services to provide mental health care.
Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.
Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.
The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.
Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.
The concept concerned with all aspects of providing and distributing health services to a patient population.
A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.
Facilities which administer the delivery of psychologic and psychiatric services to people living in a neighborhood or community.
Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.
The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.
Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.
Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.
Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.
A component of the NATIONAL INSTITUTES OF HEALTH concerned with research, overall planning, promoting, and administering mental health programs and research. It was established in 1949.
Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)
Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.
Public attitudes toward health, disease, and the medical care system.
The state of the organism when it functions optimally without evidence of disease.
The seeking and acceptance by patients of health service.
The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)
The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.
Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.
Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)
Planning for needed health and/or welfare services and facilities.
Services for the diagnosis and treatment of disease and the maintenance of health.
Insurance providing benefits to cover part or all of the psychiatric care.
The concept pertaining to the health status of inhabitants of the world.
Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.
Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.
Social and economic factors that characterize the individual or group within the social structure.
Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.
The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.
Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).
Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.
The promotion and maintenance of physical and mental health in the work environment.
A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)
Management of public health organizations or agencies.
Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.
Depressive states usually of moderate intensity in contrast with major depression present in neurotic and psychotic disorders.
Stress wherein emotional factors predominate.
The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.
Organized services to provide health care for children.
The concept covering the physical and mental conditions of women.
Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.
Persons with psychiatric illnesses or diseases, particularly psychotic and severe mood disorders.
Special hospitals which provide care to the mentally ill patient.
Planning for the equitable allocation, apportionment, or distribution of available health resources.
Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.
Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).
A specialty concerned with the application of psychiatric principles in caring for the mentally ill. It also includes the nursing care provided the mentally ill patient.
A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.
The status of health in urban populations.
A class of traumatic stress disorders with symptoms that last more than one month. There are various forms of post-traumatic stress disorder, depending on the time of onset and the duration of these stress symptoms. In the acute form, the duration of the symptoms is between 1 to 3 months. In the chronic form, symptoms last more than 3 months. With delayed onset, symptoms develop more than 6 months after the traumatic event.
Components of a national health care system which administer specific services, e.g., national health insurance.
Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.
The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.
The status of health in rural populations.
A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.
Diagnostic, therapeutic and preventive health services provided for individuals in the community.
Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc.
The activities and endeavors of the public health services in a community on any level.
Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
The term "United States" in a medical context often refers to the country where a patient or study participant resides, and is not a medical term per se, but relevant for epidemiological studies, healthcare policies, and understanding differences in disease prevalence, treatment patterns, and health outcomes across various geographic locations.
Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.
Economic sector concerned with the provision, distribution, and consumption of health care services and related products.
Disorders related to substance abuse.
Legal process required for the institutionalization of a patient with severe mental problems.
An agency of the PUBLIC HEALTH SERVICE concerned with the overall planning, promoting, and administering of programs pertaining to substance abuse and mental health. It is commonly referred to by the acronym SAMHSA. On 1 October 1992, the United States Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) became SAMHSA.
An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.
Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Use of all social work processes in the treatment of patients in a psychiatric or mental health setting.
The practice of caring for individuals in the community, rather than in an institutional environment with resultant effects on the individual, the individual's family, the community, and the health care system.
Brief therapeutic approach which is ameliorative rather than curative of acute psychiatric emergencies. Used in contexts such as emergency rooms of psychiatric or general hospitals, or in the home or place of crisis occurrence, this treatment approach focuses on interpersonal and intrapsychic factors and environmental modification. (APA Thesaurus of Psychological Index Terms, 7th ed)
A state of harmony between internal needs and external demands and the processes used in achieving this condition. (From APA Thesaurus of Psychological Index Terms, 8th ed)
Studies in which variables relating to an individual or group of individuals are assessed over a period of time.
Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)
Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.
The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.
Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.
Organized services to provide immediate psychiatric care to patients with acute psychological disturbances.
Planning for health resources at a regional or multi-state level.
Calamities producing great damage, loss of life, and distress. They include results of natural phenomena and man-made phenomena. Normal conditions of existence are disrupted and the level of impact exceeds the capacity of the hazard-affected community.
A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
A preconceived judgment made without factual basis.
The state of being engaged in an activity or service for wages or salary.
Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.
Great Britain is not a medical term, but a geographical name for the largest island in the British Isles, which comprises England, Scotland, and Wales, forming the major part of the United Kingdom.
Differences in access to or availability of medical facilities and services.
Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.
A geographic area defined and served by a health program or institution.
Institutions which provide medical or health-related services.
Facilities which administer the delivery of health care services to people living in a community or neighborhood.
State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.
Feeling or emotion of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS.
The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.
Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness.
Persons fleeing to a place of safety, especially those who flee to a foreign country or power to escape danger or persecution in their own country or habitual residence because of race, religion, or political belief. (Webster, 3d ed)
Non-frontal low-pressure systems over tropical or sub-tropical waters with organized convection and definite pattern of surface wind circulation.
Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Health services for employees, usually provided by the employer at the place of work.
Assessment of psychological variables by the application of mathematical procedures.
Persistent and disabling ANXIETY.
Hostile conflict between organized groups of people.
The inhabitants of a city or town, including metropolitan areas and suburban areas.
Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services.
Preventive health services provided for students. It excludes college or university students.
Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.
Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.
The inhabitants of rural areas or of small towns classified as rural.
Activities concerned with governmental policies, functions, etc.
The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)
A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication.
Individual or group aggressive behavior which is socially non-acceptable, turbulent, and often destructive. It is precipitated by frustrations, hostility, prejudices, etc.
Services designed for HEALTH PROMOTION and prevention of disease.
The state of not being engaged in a gainful occupation.
Female parents, human or animal.
A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents).
Those actions designed to carry out recommendations pertaining to health plans or programs.
Psychiatry in its legal aspects. This includes criminology, penology, commitment of mentally ill, the psychiatrist's role in compensation cases, the problems of releasing information to the court, and of expert testimony.
The act of killing oneself.
The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members.
The physical condition of human reproductive systems.
I'm sorry for any confusion, but 'England' is not a medical term and does not have a medical definition. England is a country that is part of the United Kingdom, known for its rich history, cultural heritage, and contributions to medical science. However, in a medical context, it may refer to the location of a patient, healthcare provider, or research study, but it is not a term with a specific medical meaning.
Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.
Educational attainment or level of education of individuals.
Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.
Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.
Emergency care or treatment given to a person who suddenly becomes ill or injured before full medical services become available.
The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children.
The reciprocal interaction of two or more persons.
Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)
Persons including soldiers involved with the armed forces.
Organized services to provide health care to expectant and nursing mothers.
Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.
People who leave their place of residence in one country and settle in a different country.
A social group consisting of parents or parent substitutes and children.
Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.
Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.
A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.
Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent.
The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).
A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income.
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Place or physical location of work or employment.
A directed conversation aimed at eliciting information for psychiatric diagnosis, evaluation, treatment planning, etc. The interview may be conducted by a social worker or psychologist.
Former members of the armed services.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
A nursing specialty concerned with promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences to develop local, regional, state, and national health policy and research. It is population-focused and community-oriented, aimed at health promotion and disease prevention through educational, diagnostic, and preventive programs.
An armed intervention involving multi-national forces in the country of IRAQ.
Professions or other business activities directed to the cure and prevention of disease. For occupations of medical personnel who are not physicians but who are working in the fields of medical technology, physical therapy, etc., ALLIED HEALTH OCCUPATIONS is available.
Statistical interpretation and description of a population with reference to distribution, composition, or structure.
The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.
Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.
Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.
A cabinet department in the Executive Branch of the United States Government concerned with overall planning, promoting, and administering programs pertaining to VETERANS. It was established March 15, 1989 as a Cabinet-level position.
Persons who provide care to those who need supervision or assistance in illness or disability. They may provide the care in the home, in a hospital, or in an institution. Although caregivers include trained medical, nursing, and other health personnel, the concept also refers to parents, spouses, or other family members, friends, members of the clergy, teachers, social workers, fellow patients.
An oversimplified perception or conception especially of persons, social groups, etc.
Multinational coalition military operation initiated in October 2001 to counter terrorism and bring security to AFGHANISTAN in collaboration with Afghan forces.
Persons living in the United States having origins in any of the black groups of Africa.
Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)
Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.
The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.
Federal, state, or local government organized methods of financial assistance.
The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community.
Method for obtaining information through verbal responses, written or oral, from subjects.
Those occurrences, including social, psychological, and environmental, which require an adjustment or effect a change in an individual's pattern of living.
Interactions between health personnel and patients.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
The concept covering the physical and mental conditions of men.
Groups of persons whose range of options is severely limited, who are frequently subjected to COERCION in their DECISION MAKING, or who may be compromised in their ability to give INFORMED CONSENT.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
A perceived attribute that is deeply discrediting and is considered to be a violation of social norms.
The individual's experience of a sense of fulfillment of a need or want and the quality or state of being satisfied.
Families who care for neglected children or patients unable to care for themselves.
A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.
An interactive process whereby members of a community are concerned for the equality and rights of all.
A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.
Providing for the full range of personal health services for diagnosis, treatment, follow-up and rehabilitation of patients.
An operating division of the US Department of Health and Human Services. It is concerned with the overall planning, promoting, and administering of programs pertaining to health and medical research. Until 1995, it was an agency of the United States PUBLIC HEALTH SERVICE.
Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.
Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.
The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies.
The interrelationship of psychology and religion.
Persons who have no permanent residence. The concept excludes nomadic peoples.
Field of psychology concerned with the normal and abnormal behavior of adolescents. It includes mental processes as well as observable responses.
Abuse of children in a family, institutional, or other setting. (APA, Thesaurus of Psychological Index Terms, 1994)
Disturbances considered to be pathological based on age and stage appropriateness, e.g., conduct disturbances and anaclitic depression. This concept does not include psychoneuroses, psychoses, or personality disorders with fixed patterns.
Recommendations for directing health planning functions and policies. These may be mandated by PL93-641 and issued by the Department of Health and Human Services for use by state and local planning agencies.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals.
Persons diagnosed as having significantly lower than average intelligence and considerable problems in adapting to everyday life or lacking independence in regard to activities of daily living.
Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.
Health care services related to human REPRODUCTION and diseases of the reproductive system. Services are provided to both sexes and usually by physicians in the medical or the surgical specialties such as REPRODUCTIVE MEDICINE; ANDROLOGY; GYNECOLOGY; OBSTETRICS; and PERINATOLOGY.