Hospitals engaged in educational and research programs, as well as providing medical care to the patients.

Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.

A republic in western Africa, south of NIGER between BENIN and CAMEROON. Its capital is Abuja.

Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients.

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.

The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).

Hospitals located in metropolitan areas.

Personnel who provide nursing service to patients in a hospital.

'Hospital Bed Capacity, 500 and over' refers to the maximum number of hospital beds equaling or exceeding 500 that are medically staffed and equipped to provide patient care and accommodation within a healthcare facility.

'Animal hospitals' are specialized medical facilities primarily dedicated to the diagnosis, treatment, and care of sick, injured, or adopted animals, providing advanced veterinary services, surgeries, and intensive care units, often staffed with trained veterinarians and support personnel.

The period of confinement of a patient to a hospital or other health facility.

The number of beds which a hospital has been designed and constructed to contain. It may also refer to the number of beds set up and staffed for use.

Special hospitals which provide care for ill children.

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

Instructional materials used in teaching.

Major administrative divisions of the hospital.

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.

Government-controlled hospitals which represent the major health facility for a designated geographic area.

A class of hospitals that includes profit or not-for-profit hospitals that are controlled by a legal entity other than a government agency. (Hospital Administration Terminology, AHA, 2d ed)

Hospitals which provide care for a single category of illness with facilities and staff directed toward a specific service.

Economic aspects related to the management and operation of a hospital.

The period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D.

The confinement of a patient in a hospital.

Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.

The obtaining and management of funds for hospital needs and responsibility for fiscal affairs.

Those areas of the hospital organization not considered departments which provide specialized patient care. They include various hospital special care wards.

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

Any infection which a patient contracts in a health-care institution.

Use for general articles concerning medical education.

Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree.

Professional medical personnel approved to provide care to patients in a hospital.

The prices a hospital sets for its services. HOSPITAL COSTS (the direct and indirect expenses incurred by the hospital in providing the services) are one factor in the determination of hospital charges. Other factors may include, for example, profits, competition, and the necessity of recouping the costs of uncompensated care.

The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.

Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.

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.

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

Hospital department which administers all departmental functions and the provision of surgical diagnostic and therapeutic services.

The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.

The teaching staff and members of the administrative staff having academic rank in a medical school.

A medical facility which provides a high degree of subspecialty expertise for patients from centers where they received SECONDARY CARE.

A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.

Hospital department which administers and provides pathology services.

Systematic discussions and teaching relating to patient care.

Compilations of data on hospital activities and programs; excludes patient medical records.

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

Hospitals controlled by the county government.

A republic in western Africa, south of BURKINA FASO and west of TOGO. Its capital is Accra.

An infant during the first month after birth.

Areawide planning for hospitals or planning of a particular hospital unit on the basis of projected consumer need. This does not include hospital design and construction or architectural plans.

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.

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.

Individuals enrolled in a school of medicine or a formal educational program in medicine.

Information centers primarily serving the needs of hospital medical staff and sometimes also providing patient education and other services.

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.

Hospital units providing continuous surveillance and care to acutely ill patients.

Special hospitals which provide care to the mentally ill patient.

Substances that reduce the growth or reproduction of BACTERIA.

'Hospital Bed Capacity, 100 to 299' refers to the medical facility's capacity to accommodate patients, specifically within the range of 100 to 299 beds, which allows for a moderate-sized hospital setting, enabling it to provide care for a substantial number of patients while maintaining relatively close proximity between healthcare professionals and individuals under their supervision.

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.

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

A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.

Hospital facilities equipped to carry out investigative procedures.

Hospital department responsible for the administration and management of services provided for obstetric and gynecologic patients.

Integrated, computer-assisted systems designed to store, manipulate, and retrieve information concerned with the administrative and clinical aspects of providing medical services within the hospital.

Care of a highly technical and specialized nature, provided in a medical center, usually one affiliated with a university, for patients with unusually severe, complex, or uncommon health problems.

A self-learning technique, usually online, involving interaction of the student with programmed instructional materials.

The assessing of academic or educational achievement. It includes all aspects of testing and test construction.

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 number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.

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 selection, appointing, and scheduling of personnel.

Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.

Hospitals controlled by the city government.

Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.)

The biological science concerned with the life-supporting properties, functions, and processes of living organisms or their parts.

A measure of inpatient health facility use based upon the average number or proportion of beds occupied for a given period of time.

I'm sorry for any confusion, but "India" is not a medical term that can be defined in a medical context. It is a geographical location, referring to the Republic of India, a country in South Asia. If you have any questions related to medical topics or definitions, I would be happy to help with those!

Educational institutions for individuals specializing in the field of medicine.

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

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

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 hospital department which is responsible for the organization and administration of nursing activities.

Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage.

A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.

Any materials used in providing care specifically in the hospital.

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

I'm sorry for any confusion, but "Brazil" is not a medical term or concept, it is a country located in South America, known officially as the Federative Republic of Brazil. If you have any questions related to health, medicine, or science, I'd be happy to help answer those!

Subsequent admissions of a patient to a hospital or other health care institution for treatment.

A specialty in which manual or operative procedures are used in the treatment of disease, injuries, or deformities.

The individuals employed by the hospital.

Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.

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.

Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area.

Situations or conditions requiring immediate intervention to avoid serious adverse results.

Instructional use of examples or cases to teach using problem-solving skills and critical thinking.

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.

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

Physicians who are employed to work exclusively in hospital settings, primarily for managed care organizations. They are the attending or primary responsible physician for the patient during hospitalization.

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).

Professional practice as an employee or contractee of a health care institution.

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.

Theoretical models which propose methods of learning or teaching as a basis or adjunct to changes in attitude or behavior. These educational interventions are usually applied in the fields of health and patient education but are not restricted to patient care.

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.

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 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.

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.

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

Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.

The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.

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

The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility.

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.

Individuals licensed to practice medicine.

The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

I'm sorry for any confusion, but "Kuwait" is not a medical term that has a definition in the field of medicine. Kuwait is actually a country located in the Middle East, known officially as the State of Kuwait. It might be that you have confused it with a medical condition or term, if so, I would be happy to help clarify or provide information on that topic instead.

A professional society in the United States whose membership is composed of hospitals.

The teaching staff and members of the administrative staff having academic rank in an educational institution.

Undergraduate education programs for second- , third- , and fourth-year students in health sciences in which the students receive clinical training and experience in teaching hospitals or affiliated health centers.

Hospitals providing medical care to veterans of wars.

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)

Hospitals which provide care for the military personnel and usually for their dependents.

Auditory and visual instructional materials.

Overall systems, traditional or automated, to provide medication to patients in hospitals. Elements of the system are: handling the physician's order, transcription of the order by nurse and/or pharmacist, filling the medication order, transfer to the nursing unit, and administration to the patient.

Hospital department that manages and supervises the dietary program in accordance with the patients' requirements.

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.

Use for general articles concerning nursing education.

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

Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent.

Hospital department responsible for the organization and administration of psychiatric services.

The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.

Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms.

A parliamentary democracy with a constitutional monarch in southeast Asia, consisting of 11 states (West Malaysia) on the Malay Peninsula and two states (East Malaysia) on the island of BORNEO. It is also called the Federation of Malaysia. Its capital is Kuala Lumpur. Before 1963 it was the Union of Malaya. It reorganized in 1948 as the Federation of Malaya, becoming independent from British Malaya in 1957 and becoming Malaysia in 1963 as a federation of Malaya, Sabah, Sarawak, and Singapore (which seceded in 1965). The form Malay- probably derives from the Tamil malay, mountain, with reference to its geography. (From Webster's New Geographical Dictionary, 1988, p715 & Room, Brewer's Dictionary of Names, 1992, p329)

I'm sorry for any confusion, but "Nepal" is not a medical term that has a definition in the field of medicine. It is actually the name of a country located in South Asia, known officially as the Federal Democratic Republic of Nepal. If you have any questions related to medicine or health, I would be happy to try and help answer those for you!

The legal relation between an entity (individual, group, corporation, or-profit, secular, government) and an object. The object may be corporeal, such as equipment, or completely a creature of law, such as a patent; it may be movable, such as an animal, or immovable, such as a building.

The former British crown colony located off the southeast coast of China, comprised of Hong Kong Island, Kowloon Peninsula, and New Territories. The three sites were ceded to the British by the Chinese respectively in 1841, 1860, and 1898. Hong Kong reverted to China in July 1997. The name represents the Cantonese pronunciation of the Chinese xianggang, fragrant port, from xiang, perfume and gang, port or harbor, with reference to its currents sweetened by fresh water from a river west of it.

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!

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

Educational programs designed to inform physicians of recent advances in their field.

The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.

Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.

Interactions between hospital staff or administrators and patients. Includes guest relations programs designed to improve the image of the hospital and attract patients.

A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease.

Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.

Persons who receive ambulatory care at an outpatient department or clinic without room and board being provided.

Facilities equipped for performing surgery.

A specialty concerned with the study of anesthetics and anesthesia.

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

Private hospitals that are owned or sponsored by religious organizations.

The capability to perform the duties of one's profession generally, or to perform a particular professional task, with skill of an acceptable quality.

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.

Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.

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

Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses).

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)

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)

A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.

The transmission of messages to staff and patients within a hospital.

Disease having a short and relatively severe course.

Child hospitalized for short term care.

Formularies concerned with pharmaceuticals prescribed in hospitals.

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.

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

The development of systems to prevent accidents, injuries, and other adverse occurrences in an institutional setting. The concept includes prevention or reduction of adverse events or incidents involving employees, patients, or facilities. Examples include plans to reduce injuries from falls or plans for fire safety to promote a safe institutional environment.

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).

Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.

Infections with bacteria of the genus STAPHYLOCOCCUS.

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

Special hospitals which provide care to women during pregnancy and parturition.

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.

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

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

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 specially equipped units of a health care facility.

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)

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

I am not aware of any established medical definition for "Iran" as it is primarily used to refer to a country located in the Middle East, known officially as the Islamic Republic of Iran. If you are looking for information on healthcare or medical conditions within Iran, I would be happy to help with that!

Penetrating stab wounds caused by needles. They are of special concern to health care workers since such injuries put them at risk for developing infectious disease.

Use for articles concerning dental education in general.

Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.

Onset of HYPERREFLEXIA; SEIZURES; or COMA in a previously diagnosed pre-eclamptic patient (PRE-ECLAMPSIA).

Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.

Financial support for training including both student stipends and loans and training grants to institutions.

Cooperation among hospitals for the purpose of sharing various departmental services, e.g., pharmacy, laundry, data processing, etc.

The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion.

Directions written for the obtaining and use of DRUGS.

Hospital department which is responsible for the administration and provision of x-ray diagnostic and therapeutic services.

A surgical specialty which utilizes medical, surgical, and physical methods to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures.

A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.

Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.

Efforts to reduce risk, to address and reduce incidents and accidents that may negatively impact healthcare consumers.

Institutions with an organized medical staff which provide medical care to patients.

Care given to patients by nursing service personnel.

A branch of biology dealing with the structure of organisms.

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 branch of medicine concerned with the physiological and pathological aspects of the aged, including the clinical problems of senescence and senility.

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.

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.

Hospital department responsible for the administration and provision of diagnostic and therapeutic services for the urologic patient.

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)

Studies beyond the bachelor's degree at an institution having graduate programs for the purpose of preparing for entrance into a specific field, and obtaining a higher degree.

Diseases of the domestic dog (Canis familiaris). This term does not include diseases of wild dogs, WOLVES; FOXES; and other Canidae for which the heading CARNIVORA is used.

Institutional health care of patients during the day. The patients return home at night.

Individuals referred to for expert or professional advice or services.