Travel beyond the earth's atmosphere.

Condition in which no acceleration, whether due to gravity or any other force, can be detected by an observer within a system. It also means the absence of weight or the absence of the force of gravity acting on a body. Microgravity, gravitational force between 0 and 10 -6 g, is included here. (From NASA Thesaurus, 1988)

An independent Federal agency established in 1958. It conducts research for the solution of problems of flight within and outside the Earth's atmosphere and develops, constructs, tests, and operates aeronautical and space vehicles. (From U.S. Government Manual, 1993)

Members of spacecraft crew including those who travel in space, and those in training for space flight. (From Webster, 10th ed; Jane's Aerospace Dictionary, 3d ed)

Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up.

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.

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.

Services for the diagnosis and treatment of disease and the maintenance of health.

A loose confederation of computer communication networks around the world. The networks that make up the Internet are connected through several backbone networks. The Internet grew out of the US Government ARPAnet project and was designed to facilitate information exchange.

Activity involved in transfer of goods from producer to consumer or in the exchange of services.

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.

Organized services to provide mental health care.

Health care programs or services designed to assist individuals in the planning of family size. Various methods of CONTRACEPTION can be used to control the number and timing of childbirths.

Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.

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)

Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.

Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.

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.

Diagnostic, therapeutic and preventive health services provided for individuals in the community.

A publication issued at stated, more or less regular, intervals.

Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.

Health care provided to individuals.

Longitudinal patient-maintained records of individual health history and tools that allow individual control of access.

The room or rooms in which the dentist and dental staff provide care. Offices include all rooms in the dentist's office suite.

Services designed for HEALTH PROMOTION and prevention of disease.

Organized services to provide health care for children.

Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.

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.

Elements of limited time intervals, contributing to particular results or situations.

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.

Organized services to provide health care to expectant and nursing mothers.

Use of computers or computer systems for doing routine clerical work, e.g., billing, records pertaining to the administration of the office, etc.

Services specifically designed, staffed, and equipped for the emergency care of patients.

Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.

Sequential operating programs and data which instruct the functioning of a digital computer.

Planning, organizing, and administering activities in an office.

The properties, processes, and behavior of biological systems under the action of mechanical forces.

The concept concerned with all aspects of providing and distributing health services to a patient population.

Outside services provided to an institution under a formal financial agreement.

Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.

Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.

Services offered to the library user. They include reference and circulation.

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)

A general concept referring to the organization and administration of nursing activities.

Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.

Complex pharmaceutical substances, preparations, or matter derived from organisms usually obtained by biological methods or assay.

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.

Organized services for the purpose of providing diagnosis to promote and maintain health.

A cabinet department in the Executive Branch of the United States Government concerned with administering those agencies and offices having programs pertaining to health and human services.

The seeking and acceptance by patients of health service.

A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories for solving biological problems including manipulation of models and datasets.

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.

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.

The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.

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.

The organization and administration of health services dedicated to the delivery of health care.

Organized services to provide diagnosis, treatment, and prevention of genetic disorders.

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.

Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.

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.

Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.

Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.

A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.

Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.

The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.

Services designed to promote, maintain, or restore dental health.

A component of the Department of Health and Human Services to oversee and direct the Medicare and Medicaid programs and related Federal medical care quality control staffs. Name was changed effective June 14, 2001.

The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation.

Social and economic factors that characterize the individual or group within the social structure.

Application of marketing principles and techniques to maximize the use of health care resources.

Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.

Health services for employees, usually provided by the employer at the place of work.

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.

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)

Descriptions of specific amino acid, carbohydrate, or nucleotide sequences which have appeared in the published literature and/or are deposited in and maintained by databanks such as GENBANK, European Molecular Biology Laboratory (EMBL), National Biomedical Research Foundation (NBRF), or other sequence repositories.

Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.

Air pollutants found in the work area. They are usually produced by the specific nature of the occupation.

Customer satisfaction or dissatisfaction with a benefit or service received.

Invisible boundaries surrounding the individual's body which are maintained in relation to others.

Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.

Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.

Public attitudes toward health, disease, and the medical care system.

The monitoring of the level of toxins, chemical pollutants, microbial contaminants, or other harmful substances in the environment (soil, air, and water), workplace, or in the bodies of people and animals present in that environment.

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 actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.

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.

Place or physical location of work or employment.

A method of data collection and a QUALITATIVE RESEARCH tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions.

Components of a national health care system which administer specific services, e.g., national health insurance.

Individuals licensed to practice medicine.

Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.

An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.

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)

Total pharmaceutical services provided by qualified PHARMACISTS. In addition to the preparation and distribution of medical products, they may include consultative services provided to agencies and institutions which do not have a qualified pharmacist.

A group of symptoms that are two- to three-fold more common in those who work in large, energy-efficient buildings, associated with an increased frequency of headaches, lethargy, and dry skin. Clinical manifestations include hypersensitivity pneumonitis (ALVEOLITIS, EXTRINSIC ALLERGIC); allergic rhinitis (RHINITIS, ALLERGIC, PERENNIAL); ASTHMA; infections, skin eruptions, and mucous membrane irritation syndromes. Current usage tends to be less restrictive with regard to the type of building and delineation of complaints. (From Segen, Dictionary of Modern Medicine, 1992)

Federal, state, or local government organized methods of financial assistance.

Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.

I'm sorry for any confusion, but "London" is a place name and not a medical term, so it doesn't have a medical definition. It's the capital city of England and the United Kingdom, known for its rich history, culture, and landmarks. If you have any questions related to health or medicine, I'd be happy to help answer those!

The inhabitants of rural areas or of small towns classified as rural.

The sequence of PURINES and PYRIMIDINES in nucleic acids and polynucleotides. It is also called nucleotide sequence.

The giving of advice and assistance to individuals with educational or personal problems.

The interactions between physician and patient.

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.

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 privacy of information and its protection against unauthorized disclosure.

Diseases caused by factors involved in one's employment.

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.

Self-directing freedom and especially moral independence. An ethical principle holds that the autonomy of persons ought to be respected. (Bioethics Thesaurus)

Time period from 1901 through 2000 of the common era.

A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)

The contamination of indoor air.

The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.

Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.

I'm sorry for any confusion, but "California" is a place, specifically a state on the western coast of the United States, and not a medical term or concept. Therefore, it doesn't have a medical definition.

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)

Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.

Delivery of health services via remote telecommunications. This includes interactive consultative and diagnostic services.

Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.

A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.

Payment by individuals or their family for health care services which are not covered by a third-party payer, either insurance or medical assistance.

A type of MICROCOMPUTER, sometimes called a personal digital assistant, that is very small and portable and fitting in a hand. They are convenient to use in clinical and other field situations for quick data management. They usually require docking with MICROCOMPUTERS for updates.

The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining PROTEIN CONFORMATION.

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.

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.

Amounts charged to the patient as payer for health care services.

Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.

Small computers using LSI (large-scale integration) microprocessor chips as the CPU (central processing unit) and semiconductor memories for compact, inexpensive storage of program instructions and data. They are smaller and less expensive than minicomputers and are usually built into a dedicated system where they are optimized for a particular application. "Microprocessor" may refer to just the CPU or the entire microcomputer.

The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.

Amounts charged to the patient as payer for medical services.

The promotion and maintenance of physical and mental health in the work environment.

Processes or methods of reimbursement for services rendered or equipment.

The planning of the furnishings and decorations of an architectural interior.

Organized services to provide immediate psychiatric care to patients with acute psychological disturbances.

An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.

Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.

Non-medical support services, such as food preparation and bathing, given by trained personnel to disabled, sick or convalescent individuals in their home.

Consumer Product Safety refers to the measures and regulations implemented to ensure household items, toys, and other consumer products are designed, manufactured, and distributed in a manner that minimizes risks of harm, injury, or death to consumers during normal use or foreseeable misuse.

Insurance providing benefits for the costs of care by a physician which can be comprehensive or limited to surgical expenses or for care provided only in the hospital. It is frequently called "regular medical expense" or "surgical expense".

The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).

A geographic area defined and served by a health program or institution.

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 teaching or training of patients concerning their own health needs.

Management of public health organizations or agencies.

Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo.

The organization and operation of the business aspects of a physician's practice.

The inhabitants of a city or town, including metropolitan areas and suburban areas.

An infant during the first month after birth.

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.

Organized services in a hospital which provide medical care on an outpatient basis.

Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988)

Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice.

A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.

Persons including soldiers involved with the armed forces.

Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)

The portion of an interactive computer program that issues messages to and receives commands from a user.

The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.

The exposure to potentially harmful chemical, physical, or biological agents by inhaling them.

Differences in access to or availability of medical facilities and services.

The area of a nation's economy that is tax-supported and under government control.

The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.

The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.

Introduction of changes which are new to the organization and are created by management.

An occupation limited in scope to a subsection of a broader field.

I'm sorry for any confusion, but "Wales" is not a medical term and does not have a medical definition. It is a country that is part of the United Kingdom, located in Europe. If you have any questions about a specific medical topic, I would be happy to help answer those!

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).

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)

Excessive, under or unnecessary utilization of health services by patients or physicians.

Planning for needed health and/or welfare services and facilities.

The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.

The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.

The expected function of a member of the medical profession.

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.

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.

Interactions between health personnel and patients.

That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.

Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures.

Facilities which administer the delivery of health care services to people living in a community or neighborhood.

The individual's experience of a sense of fulfillment of a need or want and the quality or state of being satisfied.

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.

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.

A geographic location which has insufficient health resources (manpower and/or facilities) to meet the medical needs of the resident population.

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 art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.

The capability to perform acceptably those duties directly related to patient care.

Integrated set of files, procedures, and equipment for the storage, manipulation, and retrieval of information.

Systems where the input data enter the computer directly from the point of origin (usually a terminal or workstation) and/or in which output data are transmitted directly to that terminal point of origin. (Sippl, Computer Dictionary, 4th ed)

The expected function of a member of a particular profession.

A system containing any combination of computers, computer terminals, printers, audio or visual display devices, or telephones interconnected by telecommunications equipment or cables: used to transmit or receive information. (Random House Unabridged Dictionary, 2d ed)

Hospitals controlled by various types of government, i.e., city, county, district, state or federal.

Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).

Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.

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.

'Medical Libraries' are repositories or digital platforms that accumulate, organize, and provide access to a wide range of biomedical information resources including but not limited to books, journals, electronic databases, multimedia materials, and other evidence-based health data for the purpose of supporting and advancing clinical practice, education, research, and administration in healthcare.

Protective measures against unauthorized access to or interference with computer operating systems, telecommunications, or data structures, especially the modification, deletion, destruction, or release of data in computers. It includes methods of forestalling interference by computer viruses or so-called computer hackers aiming to compromise stored data.

The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)

I'm sorry for any confusion, but "Scotland" is not a medical term and does not have a medical definition. Scotland is one of the four constituent countries of the United Kingdom, located in the northern part of Great Britain. If you have any questions related to healthcare or medical terminology, I would be happy to help answer those!

The reciprocal interaction of two or more professional individuals.

Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.

A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.

Preventive health services provided for students. It excludes college or university students.

Recording of pertinent information concerning patient's illness or illnesses.

The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.