Health

Health is the general condition of a person in all aspects. It is also a level of functional and/or metabolic efficiency of an organism, often implicitly human. The Caduceus. At the time of the creation of the World Health Organization (WHO), in 1948, health was defined as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" Only a handful of publications have focused specifically on the definition of health and its evolution in the first 6 decades. Some of them highlight its lack of operational value and the problem created by use of the word "complete." Others declare the definition, which has not been modified since 1948, "simply a bad one." In 1986, the WHO, in the Ottawa Charter for Health Promotion, said that health is "a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities." Classification systems such as the WHO Family of International Classifications (WHO-FIC), which is composed of the International Classification of Functioning, Disability, and Health (ICF) and the International Classification of Diseases (ICD) also define health.

Overall health is achieved through a combination of physical, mental, and social wellbeing, which, together is commonly referred to as the Health Triangle.

International Statistical Classification of Diseases and Related Health Problems

The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Under this system, every health condition can be assigned to a unique category and given a code, up to six characters long. Such categories can include a set of similar diseases. The International Classification of Diseases is published by the World Health Organization (WHO) and used worldwide for morbidity and mortality statistics, reimbursement systems and automated decision support in medicine. This system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics. The ICD is a core classification of the WHO Family of International Classifications (WHO-FIC).
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The ICD is revised periodically and is currently in its tenth edition. The ICD-10, as it is therefore known, was developed in 1992 to track mortality statistics. ICD-11 is planned for 2015 [1] and will be revised using Web 2.0 principles.[2] Annual minor updates and three-yearly major updates are published by the WHO. The ICD is part of a "family" of guides that can be used to complement each other, including also the International Classification of Functioning, Disability and Health which focuses on the domains of functioning (disability) associated with health conditions, from both medical and social perspectives. In 1893, a French physician, Jacques Bertillon, introduced the Bertillon Classification of Causes of Death at the International Statistical Institute in Chicago. A number of countries adopted Dr. Bertillons system, and in 1898, the American Public Health Association (APHA) recommended that the registrars of Canada, Mexico, and the United States also adopt it. The APHA also recommended revising the system every ten years to ensure the system remained current with medical practice advances. As a result, the first international conference to revise the International Classification of Causes of Death convened in 1900; with revisions occurring every ten years thereafter. At that time the classification system was contained in one book, which included an Alphabetic Index as well as a Tabular List. The book was small compared with current coding texts. The revisions that followed contained minor changes, until the sixth revision of the classification system. With the sixth revision, the classification system expanded to two volumes. The sixth revision included morbidity and mortality conditions, and its title was modified to reflect the changes: Manual of International Statistical Classification of Diseases, Injuries and Causes of Death (ICD). Prior to the sixth revision, responsibility for ICD revisions fell to the Mixed Commission, a group composed of representatives from the International Statistical Institute and the Health Organization of the League of Nations. In 1948, the World Health Organization (WHO) assumed responsibility for preparing and publishing the revisions to the ICD every ten years. WHO sponsored the seventh and eighth revisions in 1957 and 1968, respectively. In 1959, the U.S. Public Health Service published The International Classification of Diseases, Adapted for Indexing of Hospital Records and Operation Classification (ICDA). It was completed in 1962 and a revision of this adaptation considered to be the seventh revision of ICD expanded a number of areas to more completely meet the indexing needs of hospitals. The U.S. Public Health Service later published the Eighth Revision, International Classification of Diseases, Adapted for Use in the United States. Commonly referred to as ICDA-8, this classification system fulfilled its purpose to code diagnostic and operative procedural data for official morbidity and mortality statistics in the United States.

Historical synopsis
From the publication entitled Medical Classification in Canada: Past, Present and Future (April 1995) The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) which was adopted by the World Health Assembly in 1990 is the most recent revision of an international classification which has its roots in the last century.
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1893
The first International List of Causes of Death (at that time called the Bertillon Classification of Causes of Death) was adopted by the International Statistical Institute at a meeting in Chicago.[3]

1898
At a meeting of the American Public Health Association in Ottawa, the International List of Causes of Death (Bertillon Classification) was recommended for use by registrars of Canada, Mexico, and the United States of America.

19001929
The Government of France convened the first International Conference for the Revision of the Bertillon or International List of Causes of Death in 1900. The desirability of decennial revisions was recognized and the Government of France called the succeeding conferences in 1910, 1920, 1929, and 1938. Following the death of Jacques Bertillon in 1922, an international commission, known as the Mixed Commission was created with equal representation from the International Statistical Institute and the Health Organization of the League of Nations. This Commission drafted the proposals for the Fourth and Fifth revisions of the International List of Causes of Death.

1938
The need for a parallel classification of diseases that affect health as well as diseases that are fatal was recognized even before the first International Conference for the Revision of the International List of Causes of Death. A number of subdivisions or expansions of the International List were produced over the years but failed to receive general acceptance. A number of countries produced national lists in the intervening years, including the Standard Morbidity Code for Canada, accepted by the Dominion Council for Health in 1938. A draft of the Canadian code was the only morbidity code presented at the Fifth International Conference for the Revision of the International List of Causes of Death. Recognizing the growing need for a corresponding international list of diseases, the 1938 Conference adopted a resolution that included a recommendation that various national lists should, as far as possible, be brought into line with the detailed International List of Causes of Death. There was a belief that, in order to utilize fully both morbidity and mortality statistics, not only should the classification of diseases for both purposes be comparable, but if possible there should be a single list. Work by some members of a committee with representation from the United States, Canada, the United Kingdom, and the Health Section of the League of Nations produced a preliminary draft of a Proposed Statistical Classification of Diseases, Injuries and Causes of Death.

1948
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The International Conference for the Sixth Revision of the International Lists of Diseases and Causes of Death was convened in Paris. Later in the same year, the First World Health Assembly endorsed the report of the Revision Conference and the publication of the Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death (more commonly referred to as ICD-6).

19551983
Succeeding decennial revision conferences (in 1955, 1965 and 1975) recognized the increasing use of ICD for the indexing of hospital medical records. As a result, non fatal diseases, symptoms, and other conditions necessitating contact with health services became more prominent in the classification structure in the Seventh, Eighth and Ninth revisions. Other classification needs were also being recognized, beyond the scope of the ICD. Based on the recommendations of the International Conference for the Ninth Revision (1975), the World Health Assembly approved the publication (for trail purposes) of two supplementary classifications: the International Classification of Procedures in Medicine (ICPM, published in two volumes in 1978); and the International Classification of Impairments, Disabilities, and Handicaps (ICIDH, published in 1980). In 1976, another classification, an extension of the neoplasm chapter of the ICD-9 was also published by WHO: the International Classification of Diseases for Oncology (ICD-O). Realizing that the ICD alone could not cover all the information required, at the first preparatory meeting for the Tenth revision, a new concept of a family of disease and health-related classifications was recommended.

US developments
1955present
For morbidity purposes in the United States, beginning with the ICD-7, a series of adaptations/modifications of the WHO publication were developed, each containing a section for the classification of procedures. The first was the International Classification of Diseases, Adapted for Indexing Hospital Records by Diseases and Operations, referred to as the ICDA (or sometimes, ICDA-7). This was followed by the Eighth Revision International Classification of Disease Adapted for Use in the United States (ICDA-8). (The latter was translated into French and published by Statistics Canada as CIMA-8.) The current US morbidity standard is the ICD9-Clinical Modification (ICD-9-CM) which was implemented in 1979. Although the three classifications mentioned above were developed by or under the auspices of the US government, there were two successive modifications of the ICDA-8 produced by an independent organization, the Commission on Professional and Hospital Activities (CPHA) for use in its data abstracting system, the Professional Activity Study (PAS). The current annual ICD-9-CM coordination and maintenance process is jointly controlled by two branches of the US governmentthe National Center for Health Statistics (NCHS) for the diagnosis component and the Health Care Financing Administration (HCFA) for the procedure component. The actual classification is published in a variety of formats by several independent publishing companies, each with its own unique features or variations. The ICD-9-CM has been adopted by some users outside the United States. Few countries have adopted it as their national morbidity standard,
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however. One recent exception (in 199293) was Australia. An Australian version/adaptation of ICD-9-CM is being published for implementation July 1, 1995.[4]

ICD-9-CM
International Classification of Diseases, Clinical Modification (ICD-9-CM) is a classification used in assigning codes to diagnoses associated with inpatient, outpatient, and physician office utilization in the U.S. The ICD-9-CM is based on the ICD-9 but provides for additional morbidity detail and is annually updated on October 1.[6] It was created by the U.S. National Center for Health Statistics as an extension of ICD-9 system so that it can be used to capture more morbidity data and a section of procedure codes was added.[7] The National Center for Health Statistics (NCHS) and the Centers for Medicare and Medicaid Services are the U.S. governmental agencies responsible for overseeing all changes and modifications to the ICD-9-CM.

ICD-10
Work on ICD-10 began in 1983 and was completed in 1992.[8] The code set allows more than 155,000 different codes and permits tracking of many new diagnoses and procedures, a significant expansion on the 17,000 codes available in ICD-9.[9] Adoption was relatively swift in most of the world. Some countries have created their version of "ICD-10-AM" in 1998, and Canada introduced "ICD-10-CA" in 2000. Several materials are made available online by WHO, as the manual (Volume 2), training, a browser, and files for download.

ICD-10-CM
Adoption of ICD-10 has been slow in the United States. Since 1988, the USA had required ICD9-CM codes for Medicare and Medicaid claims, and most of the rest of the American medical industry followed suit. On 1 January 1999 the ICD-10 (without clinical extensions) was adopted for reporting mortality, but ICD-9-CM was still used for morbidity. Meanwhile, NCHS received permission from the WHO to create a clinical modification of the ICD-10, and has produced these two systems: On August 21, 2008, the US Department of Health and Human Services (HHS) proposed new code sets to be used for reporting diagnoses and procedures on health care transactions. Under the proposal, the ICD-9-CM code sets would be replaced with the ICD-10 code sets, effective October 1, 2013.[10]

ICD-11
The first (alpha) draft of the ICD-11 system (authored by WHO) is expected on May 10, 2010, with a beta draft due May 10, 2011. The final draft will be submitted to World Health Assembly
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(WHA) by 2014. Pilot implementation is scheduled to begin in March 2014.[1][11] The ICD revision process is open to all comers willing to register, back their suggestions with evidence from medical literature and participate in online debate over proposed changes through an ICD Update and Revision Platform extranet. WHO is using Web 2.0 principles for the first time to revise ICD via a multi-author drafting platform known as the iCAT (Initial ICD-11 Collaborative Authoring Tool). The iCAT production server is viewable by all but until the beta draft stage is reached, editing rights will be restricted to WHO, Revision Steering Group, Topic Advisory Groups and external peer reviewers of proposals and content. More detailed information on the revision process, access to the revision platform and iCAT is available at the WHO website.[2]

Current use
This section overlaps with other sections too much. It should be combined with the rest of the article.

ICD is the most widely used statistical classification system for diseases in the world. (See WHO official links.) Although some countries found ICD sufficient for hospital indexing purposes, many others felt that it did not provide adequate detail for diagnostic indexing. The original revisions of ICD also did not provide procedure codes for classification of operative or diagnostic procedures. As a result many countries developed their own adaptations of ICD.

Usage - United States

In the United States, hospitals and other healthcare facilities index healthcare data by referring and adhering to a classification system published by the U.S. Department of Health and Human Services: ICD, 9th Revision, Clinical Modification (ICD-9-CM). The Clinical Modification or CM system was developed and implemented in order to better describe the clinical picture of the patient. The CM codes are more precise than those needed only for statistical groupings and trend analysis. The diagnosis component of ICD-9-CM is completely consistent with ICD-9 codes. ICD-10 was adopted in 1999 for reporting mortality, but the ICD-9-CM remains the data standard for reporting morbidity. Revisions of the ICD-10 have progressed to incorporate both clinical code (ICD-10-CM) and procedure code (ICD-10-PCS) with the revisions completed in 2003. Centers for Medicare and Medicaid Services has announced it will begin using ICD-10 on April 1, 2010, with full compliance by all involved parties by 2013. [9]

Public data reporting

International health statistics are available at the WHO Statistical Information System (WHOSIS).

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In the United States ICD codes also have an active role in reporting of data from The Joint Commission [2] but also the current public data on hospitals released by the Centers for Medicare and Medicaid Services (CMS).

Mental and behavioral disorders

The ICD includes a section classifying mental and behavioral disorders (Chapter V). This has developed alongside the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders and the two manuals seek to use the same codes. There are significant differences, however, such as the ICD including personality disorders on the same axis as other mental disorders, unlike the DSM. The WHO is revising their classifications in these sections as part the development of the ICD-11 (scheduled for 2015), and an "International Advisory Group" has been established to guide this.[12] An important alternative to the mental disorders section of the ICD is the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the primary diagnostic system for psychiatric and psychological disorders within the United States and some other countries, and is used as an adjunct diagnostic system in other countries. Since the 1990s, the APA and WHO have worked to bring the DSM and the relevant sections of ICD into concordance, but some differences remain. An international survey of psychiatrists in 66 countries comparing use of the ICD-10 and DSM-IV found that the former was more often used for clinical diagnosis while the latter was more valued for research

Determinants of health
The LaLonde report suggests that there are four general determinants of health including human biology, environment, lifestyle, and healthcare services.[3] Thus, health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. The Alameda County Study examines the relationship between lifestyle and health. It has found that people can improve their health via exercise, enough sleep, maintaining a healthy weight, limiting alcohol use, and avoiding smoking A major environmental factor affecting health is water quality, especially for the health of infants and children in developing countries. Studies show that in developed countries, the lack of neighborhood recreational space that includes the natural environment leads to lower levels of neighborhood satisfaction and higher levels of obesity; therefore, lower overall well being.[6] Therefore, the positive psychological benefits of natural space in urban neighborhoods should be taken into account in public policy and land use. According to the World Health Organization, the main determinants of health include the social and economic environment, the physical environment and the person's individual characteristics
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and behaviors.[7] Generally, the context in which an individual lives is of great importance on his life quality and health status. The social and economic environment are key factors in determining the health status of individuals given the fact that higher education levels are linked with a higher standard of life as well as a higher income. Generally, people who finish higher education are more likely to get a better job and therefore are less prone to stress by comparing to individuals with low education levels. The physical environment is perhaps the most important factor that should be considered when classifying the health status of an individual. This includes factors such as clean water and air, safe houses, communities and roads all contribute to good health.[7] Genetics are also part of the system based on which the health of the population can be established. Genetics are closely related to the habits and behaviors individuals develop during their life, particularly in terms of lifestyle choices. For instance, people who come from families whose members had a more active lifestyle and followed healthier diets, non-smoking and nondrinking are more likely to follow the same pattern in their life. The example set by the family as well as the relationship with friends and family can have a great impact on one's general health. Nonetheless, genetics may play a role in the manner in which people cope with stress. Moreover, the World Health Organization lists a wide range of other factors that can influence the well being of a person. According to WHO, the gender, social support networks and health services in terms of both quality and access to them are to be considered as health determinants. Access to health care is one of the large issues of the nowadays society, maybe even greater than the quality of the service. Individuals in developing countries are more prone to suffer from different health conditions because their access to the health care system is restricted mostly from financial reasons. Although many individuals are often criticized for not taking good care of their health based on the presumption that the mirror's of one's personality is one's health.[8], it is now accepted that there are many factors that have a significant impact on one's health and which cannot be controlled

Maintaining health
Achieving and maintaining health is an ongoing process. Effective strategies for staying healthy and improving one's health include the following elements:

Observations of Daily Living

Personal health depends partially on one's active, passive, and assisted observations about their health in their everyday life. The information gleaned from such observations may be used to inform personal decisions and actions (e.g., "I feel tired in the morning so I am going to try sleeping on a different pillow"), as well as clinical decisions and treatment plans (e.g., a patient
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who notices his or her shoes are tighter than usual may be having exacerbation of left-sided heart failure, and may require diuretic medication to reduce fluid overload) for patients who share their observations with their health care providers.[9]

Social Activity
Personal health depends partially on the social structure of one's life. The maintenance of strong social relationships is linked to good health conditions, longevity, productivity, and a positive attitude. This is because positive social interaction as viewed by the participant increases many chemical levels in the brain which are linked to personality and intelligence traits. Volunteering also can lead to a healthy life. To be a volunteer, while gaining plenty of social benefits, people also take their mind off their own troubles] Volunteering could even add years of life. According to a university study,[compared with people who did not volunteer, senior citizens who volunteered showed a 67% reduced risk of dying during a seven-year period.

Hygiene
Hygiene is the practice of keeping the body clean to prevent infection and illness, and the avoidance of contact with infectious agents. Hygiene practices include bathing, brushing and flossing teeth, washing hands especially before eating, washing food before it is eaten, cleaning food preparation utensils and surfaces before and after preparing meals, and many others. This may help prevent infection and illness. By cleaning the body, dead skin cells are washed away with the germs, reducing their chance of entering the body.

Stress management

Prolonged psychological stress may negatively impact health, and has been cited as a factor in cognitive impairment with aging, depressive illness, and expression of disease.[10]. Stress management is the application of methods to either reduce stress or increase tolerance to stress. Relaxation techniques are physical methods used to relieve stress. Psychological methods include cognitive therapy, meditation, and positive thinking which work by reducing response to stress. Improving relevant skills and abilities builds confidence, which also reduces the stress reaction to situations where those skills are applicable. Reducing uncertainty, by increasing knowledge and experience related to stress-causing situations, has the same effect. Learning to cope with problems better, such as improving problem solving and time management skills, may also reduce stressful reaction to problems. Repeatedly facing an object of one's fears may also desensitize the fight-or-flight response with respect to that stimuluse.g., facing bullies may reduce fear of bullies.

Autogenic training
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Autogenic training is a relaxation technique developed by the German psychiatrist Johannes Heinrich Schultz and first published in 1932. The technique involves the daily practice of sessions that last around 15 minutes, usually in the morning, at lunch time, and in the evening. During each session, the practitioner will repeat a set of visualisations that induce a state of relaxation. Each session can be practiced in a position chosen amongst a set of recommended postures (for example, lying down, sitting meditation, sitting like a rag doll). The technique can be used to alleviate many stress-induced psychosomatic disorders.[citation needed] Schultz emphasized parallels to techniques in yoga and meditation. It is a method for influencing one's autonomic nervous system. Abbe Faria and Emile Coue are the forerunners of Schultz. There are many parallels to progressive relaxation. In 1963 Luthe discovered the significance of "autogenic discharges", paroxistic phenomena of motor, sensorial, visual and emotional nature related to the traumatic history of the patient, and developed the method of "Autogenic Abreaction". His disciple Luis de Rivera, a McGill trained psychiatrist, introduced psychodynamic concepts[1] into Luthes approach, developing "Autogenic Analysis"[2] as a new method for uncovering the unconscious.

Biofeedback
Biofeedback is the process of becoming aware of various physiological functions using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will.[1][2] Processes that can be controlled include brainwaves, muscle tone, skin conductance, heart rate and pain perception.[3] Biofeedback may be used to improve health or performance, and the physiological changes often occur in conjunction with changes to thoughts, emotions, and behavior. Eventually, these changes can be maintained without the use of extra equipment.[2] Biofeedback has been found to be effective for the treatment of headaches and migraines

Diaphragmatic breathing
Diaphragmatic breathing, abdominal breathing, belly breathing, deep breathing or costal breathing is the act of breathing deep into one's lungs by flexing one's diaphragm rather than breathing shallowly by flexing one's rib cage. This deep breathing is marked by expansion of the abdomen rather than the chest when breathing. It is generally considered a healthier and fuller way to ingest oxygen[1], and is often used as a therapy for hyperventilation, anxiety disorders and stuttering. Some yoga and meditation traditions draw a clear distinction between diaphragmatic breathing and abdominal breathing or belly breathing. The more specific technique of diaphragmatic breathing is said to be more beneficial. Although the diaphragm is the primary breathing muscle, it is believed that many people have little sensory awareness of it, almost no idea how to engage it more fully, and even how it works.
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Some breath therapists and breathing teachers believe that because of the increasing stress of modern life and the resulting over-stimulation of the sympathetic nervous system, as well as of the idealised hard, flat belly, many people carry excessive tension in the belly, chest, and back, which makes it difficult for the diaphragm to move freely through its full range of motion

Meditation
From Wikipedia, the free encyclopedia Jump to: navigation, search This article is about the mental discipline. For the form of alternative dispute resolution, see Mediation. For other uses, see Meditation (disambiguation).

A statue of the Buddha meditating, Borim Temple, Korea Meditation is a holistic discipline during which time the practitioner trains his or her mind in order to realize some benefit. Meditation is generally an internal, personal practice and most often done without any external involvement, except perhaps prayer beads to count prayers. Meditation often involves invoking or cultivating a feeling or internal state, such as compassion, or attending to a specific focal point. The term can refer to the state itself, as well as to practices or techniques employed to cultivate the state

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There are hundreds of specific types of meditation. [3] The word, 'meditation,' means many things dependent upon the context of its use. People practice meditation for many reasons, within the context of their social environment. Meditation is a component of many religions, and has been practiced since antiquity, particularly by monastics. A 2007 study by the U.S. government found that nearly 9.4% of U.S. adults (over 20 million) have used meditation within the past 12 months, up from 7.6% (more than 15 million people) in 2002. To date, the exact mechanism at work in meditation remains unclear,[5] while scientific research continues

Zen yoga
Zen Yoga is a holistic practice that unites the three parts of the self - body, mind and spirit. It combines the graceful movements of tai chi, the energized breathing of qigong and the relaxed stretching of Shanti (peace) yoga. The basic principle of Zen Yoga is that the benefits of simple breathing, movement and stretching exercises are available to anyone regardless of age, fitness ability or health status. While many modern yoga practices tend toward dynamic poses, Zen Yoga is more concerned with helping people feel better with simple and effective breathing and movement practices. Zen yoga is very different in attitude and experience to traditional Indian yoga. Like tai chi, it is very gentle, and well suited to helping people prevent ill health

Progressive muscle relaxation

Progressive muscle relaxation (or PMR) is a technique for reducing anxiety by alternately tensing and relaxing the muscles. It was developed by American physician Edmund Jacobson in the early 1920s.[1] Jacobson argued that since muscle tension accompanies anxiety, one can reduce anxiety by learning how to relax the muscular tension. PMR entails a physical and mental component. The physical component involves the tensing and relaxing of muscle groups over the legs, abdomen, chest, arms and face. With the eyes closed and in a sequential pattern, a tension in a given muscle group is purposefully done for approximately 10 seconds and then released for 20 seconds before continuing with the next muscle group. The mental component focuses on the difference between the feelings of the tension and relaxation. Because the eyes are closed, one is forced to concentrate on the sensation of tension and relaxation. In patients with anxiety, the mind often wanders with thoughts such as "I don't know if this will work" or "Am I feeling it yet." If such is the case, the patient is told to simply focus on the feelings of the tensed muscle. Because of the feelings of warmth and heaviness are felt in the relaxed muscle after it is tensed, a mental relaxation is felt as a result. With practice, the patient learns how to effectively relax and deter anxiety when it becomes at an unhealthy level where an anxiety attack would otherwise occur.[2]
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Jacobson trained his patients to voluntarily relax certain muscles in their body in order to reduce anxiety symptoms. He also found that the relaxation procedure is effective against ulcers, insomnia, and hypertension. There are many parallels with autogenic training, which was developed independently. The technique has also proven effective in reducing acute anxiety in people with Schizophrenia.[3] Jacobson's Progressive Relaxation has remained popular with modern physical therapists.

Relaxation method
Progressive relaxation involves alternately tensing and relaxing the muscles.[4] A person using PMR may start by sitting or lying down in a comfortable position. With the eyes closed, the muscles are tensed (10 seconds) and relaxed (20 seconds) sequentially through various parts of the body. The whole PMR session takes approximately 30 minutes. As this is a technique, practice with PMR does make perfect and will usually not work effectively as it should the first couple of times. Patients with generalized anxiety disorder who first try PMR with anxiety may become frustrated, feel rushed, or feel an increase in anxiety for various reasons such as being afraid to "let your guard down." As with doing anything new, this is to be expected and simply practiced again once or twice a day

Power nap
The power nap is thought to maximize the benefits of sleep versus time. It is used to supplement normal sleep, especially when a sleeper has accumulated a sleep deficit. Various durations are recommended for power naps, which are very short compared to regular sleep. The short duration of a power nap is designed to prevent nappers from sleeping so long that they enter a normal sleep cycle without being able to complete it. Entering a normal sleep cycle, but failing to complete it, can result in a phenomenon known as sleep inertia, where one feels groggy, disoriented, and even more sleepy than before beginning the nap. In order to attain maximum post-nap performance, it is critical that a power nap be limited to the beginning of a sleep cycle, specifically sleep stages I and II. Scientific experiments (see Benefits section below) and anecdotal evidence suggest that an average power nap duration of around 15-30 minutes is most effective. Any more time, and the body enters into its usual sleep cycle. People who regularly take power naps may develop a good idea of what duration works best for them, as well as what tools, environment, position, and associated factors help induce the best results. Others may prefer to take power naps regularly even if their schedules allow a full night's sleep. Mitsuo Hayashi, Ph.D. and Tadao Hori, Ph.D.[2] have demonstrated that a nap improves mental performance even after a full night's sleep.
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Benefits
For several years scientists have been investigating the benefits of napping, both the 20-minute power nap and much longer sleep durations as long as 12 hours. Performance across a wide range of cognitive processes has been tested. Studies demonstrate that naps are as good as a night of sleep for some types of memory tasks. A NASA study led by David F. Dinges, professor at the University of Pennsylvania School of Medicine, found that naps can improve certain memory functions and that long naps are better than short ones.[3] In that NASA study, volunteers spent several days living on one of 18 different sleep schedules, all in a laboratory setting. To measure the effectiveness of the naps, tests probing memory, alertness, response time, and other cognitive skills were used. The National Institute of Mental Health funded a team of doctors, led by Alan Hobson, M.D., Robert Stickgold, Ph.D., and colleagues at Harvard University for a study which showed that a midday snooze reverses information overload. Reporting in Nature Neuroscience, Sara Mednick, Ph.D., Stickgold and colleagues also demonstrated that "burnout" irritation, frustration and poorer performance on a mental task can set in as a day of training wears on. This study also proved that, in some cases, napping could even boost performance to an individual's top levels. The NIMH team wrote "The bottom line is: we should stop feeling guilty about taking that 'power nap' at work."[4]

The caffeine nap

A caffeine nap is a short nap that is preceded by the intake of caffeine. In a driving simulator and a series of studies, Horne and Reyner investigated the effects of cold air, radio, a break with no nap, a nap, caffeine pill vs. placebo and a short nap preceded by caffeine on mildly sleepdeprived subjects. The last mentioned was by far the most effective in reducing driving "incidents" and subjective sleepiness. Caffeine in coffee takes up to a half-hour to have an alerting effect, hence "a short (<15min) nap will not be compromised if it is taken immediately after the coffee Pranayama (Devanagari: , pryma) is a Sanskrit compound. V. S. Apte provides fourteen different meanings for the word prana (Devanagari: , pra) including these:[11]

Breath, respiration The breath of life, vital air, principle of life (usually plural in this sense, there being five such vital airs generally assumed, but three, six, seven, nine, and even ten are also spoken of)[12] Energy, vigor The spirit or soul

Of these meanings, the concept of "vital air" is used by Bhattacharyya to describe the concept as used in Sanskrit texts dealing with pranayama.[13] Thomas McEvilley translates "prana" as "spirit14 |27 P a g e

energy".[14] Its most subtle material form is the breath, but is also to be found in blood, and its most concentrated form is semen in men and vaginal fluid in women.[15] Monier-Williams defines the compound pryma as (m., also pl.) "N. of the three 'breathexercises' performed during Sadhy (See praka, recaka, kumbhaka"[16][17] This technical definition refers to a particular system of breath control with three processes as explained by Bhattacharyya: praka (to take the breath inside), kumbhaka (to retain it), and recaka (to discharge it).[18] There are also other processes of pranayama in addition to this three-step model.
[18]

Macdonell gives the etymology as pra + yma and defines it as "m. suspension of breath (sts. pl.)".[19] Apte's definition of yma derives it from + ym and provides several variant meanings for it when used in compounds. The first three meanings have to do with "length", "expansion, extension", and "stretching, extending", but in the specific case of use in the compound pryma he defines yma as meaning "restrain, control, stopping".[20] An alternative etymology for the compound is cited by Ramamurti Mishra, who says that: "Expansion of individual energy into cosmic energy is called pryma (pra, energy + aym, expansion)."[21] The word "yama" (Devanagari: , yma) means "cessation"[22][23] or more generally "control" or "restraint".[24][23]

Hatha and Raja Yoga Varieties

Some scholars distinguish between hatha and raja yoga varieties of pranayama, with the former variety usually prescribed for the beginner. According to Taimni, hatha yogic pranayama involves manipulation of pranic currents through breath regulation for bringing about the control of chitta-vrittis and changes in consciousness, whereas raja yogic pranayama involves the control of chitta-vrittis by consciousness directly through the will of the mind.[25] Students qualified to practice pranayama are therefore always initiated first in the techniques of hatha pranayama.[26]

Bhagavad Gita
Pranayama is mentioned in verse 4.29 of the Bhagavat Gita.[27]

Quotes
Prana is a subtle invisible force. It is the life-force that pervades the body. It is the factor that connects the body and the mind, because it is connected on one side with the body and on the other side with the mind. It is the connecting link between the body and the mind. The body and the mind have no direct connection. They are connected through Prana only.
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 Swami Chidananda Saraswati[28] Yoga works primarily with the energy in the body, through the science of pranayama, or energycontrol. Prana means also breath. Yoga teaches how, through breath-control, to still the mind and attain higher states of awareness. The higher teachings of yoga take one beyond techniques, and show the yogi, or yoga practitioner, how to direct his concentration in such a way as not only to harmonize human with divine consciousness, but to merge his consciousness in the Infinite. Paramahansa Yogananda[29] Praanaayaama can also be interpreted as Pra+Ana+ayama=Praanaayaama.Ana means breath or Animation--According to Monnier Williams the lexicographers have to say that prefix"Pra" increases the meaning of the noun it qualifies more than an ordinary adjevtive--as in "Pra"siddhi,"Pra"meyam,"Pra"katanam etc--In the Interpretation of Gaayatri Mantram--Praana is said to be one of the 5 "Gayas"=Vital Energies---"Gayas Traayathethi Gaayatri"and in the Poorvaangam of Gayatri japam the mantram "Praanopaana Vyaanodhaana Samaana Sahpraanaha"=Praana-Apaana--Vyaana--Udhaana-Samaana comes

Yoga Sutras of Patanjali

Pranayama is the fourth 'limb' of the eight limbs of Raja Yoga mentioned in verse 2.29 in the Yoga Sutras of Patanjali.[10][30] Patanjali discusses his specific approach to pranayama in verses 2.49 through 2.51, and devotes verses 2.52 and 2.53 to explaining the benefits of the practice.[31] Patanjali does not fully elucidate the nature of prana, and the theory and practice of pranayama seem to have undergone significant development after him.[32] He presents pranayama as essentially an exercise that is preliminary to concentration, as do the earlier Buddhist texts.[32] Many yoga teachers advise that pranayama should be part of an overall practice that includes the other limbs of Patanjali's Raja Yoga teachings, especially Yama, Niyama, and Asana.[33]

Buddhism
According to the Pali Buddhist Canon, the Buddha prior to his enlightenment practiced a meditative technique which involved pressing the palate with the tongue and forcibly attempting to restrain the breath. This is described as both extremely painful and not conducive to enlightenment.[34] According to the Buddhist scheme, breathing stops with the fourth jhana, though this is a side-effect of the technique and does not come about as the result of purposeful effort.[35] The Buddha did incorporate moderate modulation of the length of breath as part of the preliminary tetrad in the Anapanasati Sutta. Its use there is preparation for concentration. [32] According to commentarial literature, this is appropriate for beginners.[36]

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For the Buddha, the most important aspect of breath meditation is the consciousness attending to the breath.[37] Buddhist tradition in general has urged moderation in the area of manipulation of the breath.[38]

Medical
Several researchers have reported that pranayama techniques are beneficial in treating a range of stress related disorders,[39] improving autonomic functions,[40] relieving symptoms of asthma,[41][42] and reducing signs of oxidative stress.[43][44] Practitioners report that the practice of pranayama develops a steady mind, strong will-power, and sound judgement,[33] and also claim that sustained pranayama practice extends life and enhances perception.[45]

Cautions
Many yoga teachers recommend that pranayama techniques be practiced with care, and that advanced pranayama techniques should be practiced under the guidance of a teacher. These cautions are also made in traditional Hindu literature

Mental image
A mental image is an experience that, on most occasions, significantly resembles the experience of perceiving some object, event, or scene, but occurs when the relevant object, event, or scene is not actually present to the senses.[1][2][3][4] There are sometimes episodes, particularly on falling asleep (hypnagogic imagery) and waking up (hypnopompic), when the imagery, being of a rapid, phantasmagoric and involuntary character, defies perception, presenting a kaleidoscopic field, in which no distinct object can be discerned.[5] The nature of these experiences, what makes them possible, and their function (if any) have long been subjects of research and controversy in philosophy, psychology, cognitive science, and more recently, neuroscience. As contemporary researchers use the expression, mental images (or mental imagery) can occur in the form of any sense, so that we may experience auditory images [6] , olfactory images,[7] and so forth. However, the vast majority of philosophical and scientific investigations of the topic focus upon visual mental imagery. It has been assumed that, like humans, many types of animals are capable of experiencing mental images.[8] Due to the fundamentally subjective nature of the phenomenon, there is little to no evidence either for or against this view.

Philosophers such as George Berkeley and David Hume, and early experimental psychologists such as Wilhelm Wundt and William James, understood ideas in general to be mental images, and today it is very widely believed that much imagery functions as mental representations (or mental models), playing an important role in memory and thinking.[9][10][11][12] Some have gone so far as to suggest that images are best understood to be, by definition, a form of inner, mental or neural representation;[13][14] in the case of hypnagogic and hypnapompic imagery, it is not representational at all. Others reject the

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view that the image experience may be identical with (or directly caused by) any such representation in the mind or the brain,[15][16][17][18][19][20] but do not take account of the nonrepresentational forms of imagery.

How mental images form in the brain

Common examples of mental images include daydreaming and the mental visualization that occurs while reading a book. When a musician hears a song, he or she can sometimes "see" the song notes in their head, as well as hear them with all their tonal qualities.[21] This is considered different from an after-effect, such as an after-image. Calling up an image in our minds can be a voluntary act, so it can be characterized as being under various degrees of conscious control. According to psychologist and cognitive scientist Steven Pinker,[22] our experiences of the world are represented in our minds as mental images. These mental images can then be associated and compared with others, and can be used to synthesize completely new images. In this view, mental images allow us to form useful theories of how the world works by formulating likely sequences of mental images in our heads without having to directly experience that outcome. Whether other creatures have this capability is debatable.

Philosophical ideas about mental images

Mental images are an important topic in classical and modern philosophy, as they are central to the study of knowledge. In the Republic, book VII, Plato uses the metaphor of a prisoner in a cave, bound and unable to move, sitting with his back to a fire and watching the shadows cast on the wall in front of him by people carrying objects behind his back. The objects that they are carrying are representations of real things in the world. The prisoner, explains Socrates, is like a human being making mental images from the sense data that he experiences. More recently, Bishop George Berkeley has proposed similar ideas in his theory of idealism. Berkeley stated that reality is equivalent to mental images our mental images are not a copy of another material reality, but that reality itself. Berkeley, however, sharply distinguished between the images that he considered to constitute the external world, and the images of individual imagination. According to Berkeley, only the latter are considered "mental imagery" in the contemporary sense of the term. David Deutsch addresses Johnson's objection to idealism in The Fabric of Reality when he states that if we judge the value of our mental images of the world by the quality and quantity of the sense data that they can explain, then the most valuable mental image or theory that we currently have is that the world has a real independent existence and that humans have successfully evolved by building up and adapting patterns of mental images to explain it. This is an important idea in scientific thought.[why?] Critics of scientific realism ask how the inner perception of mental images actually occurs. This is sometimes called the "homunculus problem" (see also the mind's eye). The problem is similar to asking how the images you see on a computer screen exist in the memory of the computer. To
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scientific materialism, mental images and the perception of them must be brain-states. According to critics,[who?] scientific realists cannot explain where the images and their perceiver exist in the brain. To use the analogy of the computer screen, these critics argue that cognitive science and psychology has been unsuccessful in identifying either the component in the brain (i.e. "hardware") or the mental processes that store these images (i.e. "software").

Mental imagery in experimental psychology

Cognitive psychologists and (later) cognitive neuroscientists have empirically tested some of the philosophical questions related to whether and how the human brain uses mental imagery in

cognition. One theory of the mind that was examined in these experiments was the "brain as serial computer" philosophical metaphor of the 1970s. Psychologist Zenon Pylyshyn theorized that the human mind processes mental images by decomposing them into an underlying mathematical proposition. Roger Shepard and Jacqueline Metzler challenged that view by presenting subjects with 2D line drawings of groups of 3D block "objects" and asking them to determine whether that "object" was the same as a second figure, some of which were rotations of the first "object". [23] Shepard and Metzler proposed that if we decomposed and then mentally re-imaged the objects into basic mathematical propositions, as the then-dominant view of cognition "as a serial digital computer"[24] assumed, then it would be expected that the time it took to determine whether the object was the same or not would be independent of how much the object was rotated. Shepard and Metzler found the opposite: a linear relationship between the degree of rotation in the mental imagery task and the time it took participants to reach their answer. This mental rotation finding implied that the human mind and the human brain maintains and manipulates mental images as topographic and topological wholes, an implication that was quickly put to test by psychologists. Stephen Kosslyn and colleagues [25] showed in a series of neuroimaging experiments that the mental image of objects like the letter "F" are mapped, maintained and rotated as an image-like whole in areas of the human visual cortex. Moreover, Kosslyn's work showed that there were considerable similarities between the neural mappings
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for imagined stimuli and perceived stimuli. The authors of these studies concluded that while the neural processes they studied rely on mathematical and computational underpinnings, the brain also seems optimized to handle the sort of mathematics that constantly computes a series of topologically-based images rather than calculating a mathematical model of an object. Recent studies in neurology and neuropsychology on mental imagery have further questioned the "mind as serial computer" theory, arguing instead that human mental imagery manifests both visually and kinesthetically. For example, several studies have provided evidence that people are slower at rotating line drawings of objects such as hands in directions incompatible with the joints of the human body,[26] and that patients with painful, injured arms are slower at mentally rotating line drawings of the hand from the side of the injured arm.[27] Some psychologists, including Kosslyn, have argued that such results occur because of interference in the brain between distinct systems in the brain that process the visual and motor mental imagery. Subsequent neuroimaging studies[28] showed that the interference between the motor and visual imagery system could be induced by having participants physically handle actual 3D blocks glued together to form objects similar to those depicted in the line-drawings. Amorim et al. have recently shown that when a cylindrical "head" was added to Shepard and Metzler's line drawings of 3D block figures, participants were quicker and more accurate at solving mental rotation problems.[29] They argue that motoric embodiment is not just "interference" that inhibits visual mental imagery, but is capable of facilitating mental imagery. These and numerous related studies have led to a relative consensus within cognitive science, psychology, neuroscience and philosophy on the neural status of mental images. Researchers generally agree that while there is no homunculus inside the head viewing these mental images, our brains do form and maintain mental images as image-like wholes. [30] The problem of exactly how these images are stored and manipulated within the human brain, particularly within language and communication, remains a fertile area of study. One of the longest running research topics on the mental image has been the fact that people report large individual differences in the vividness of their images. Special questionnaires have been developed to assess such differences, including the Vividness of Visual Imagery Questionnaire (VVIQ) developed by David Marks. Laboratory studies have suggested that the subjectively reported variations in imagery vividness are associated with different neural states within the brain and also different cognitive competences such as the ability to accurately recall information presented in pictures [31] Rodway, Gillies and Schepman used a novel long-term change detection task to determine whether participants with low and high vividness scores on the VVIQ2 showed any performance differences.[32] Rodway et al. found that high vividness participants were significantly more accurate at detecting salient changes to pictures compared to low vividness participants.[33] This replicated an earlier study.[34] Recent studies have found that individual differences in VVIQ scores can be used to predict changes in a person's brain while visualizing different activities. [35] Functional magnetic resonance imaging (fMRI) was used to study the association between early visual cortex activity relative to the whole brain while participants visualized themselves or another person bench pressing or stair climbing. Reported image vividness correlates significantly with the relative
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fMRI signal in the visual cortex. Thus individual differences in the vividness of visual imagery can be measured objectively.

Training and learning styles

Some educational theorists[who?] have drawn from the idea of mental imagery in their studies of learning styles. Proponents of these theories state that people often have learning processes which emphasize visual, auditory, and kinesthetic systems of experience.[citation needed] According to these theorists, teaching in multiple overlapping sensory systems benefits learning, and they encourage teachers to use content and media that integrates well with the visual, auditory, and kinesthetic systems whenever possible. Educational researchers have examined whether the experience of mental imagery affects the degree of learning. For example, imagining playing a 5-finger piano exercise (mental practice) resulted in a significant improvement in performance over no mental practice though not as significant as that produced by physical practice. The authors of the study stated that "mental practice alone seems to be sufficient to promote the modulation of neural circuits involved in the early stages of motor skill learning." [36]

Mental imagery, visualization and the Himalayan traditions

Vajrayana Buddhism, Bn and Tantra in general, utilize sophisticated visualization or imaginal (in the language of Jean Houston of Transpersonal Psychology) processes in the thoughtform construction of the yidam sadhana, kye-rim, and dzog-rim modes of meditation and in the yantra, thangka, and mandala traditions, where holding the fully realized form in the mind is a prerequisite prior to creating an 'authentic' new art work that will provide a sacred support or foundation for deity

Yoga-nidra
Yoga-nidra may be rendered in English as "yoga sleep". It is a sleep-like state that occurs with some practitioners of meditation, details of which have been handed down by guru-to-disciple transmission (parampara) within the Indian religions. These aspects may include relaxation and guided visualization techniques as well as the psychology of dream, sleep and yoga. Yoga-nidra should not be confused with hypnotic states, known as "yoga tandra".

The practice of yoga relaxation has been found to reduce tension and anxiety. The autonomic symptoms of high anxiety such as headache, giddiness, chest pain, palpitations, sweating, abdominal pain respond well. It has been used to help soldiers from war cope with

History of Yoga Nidra

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The Vedic literature and Upanishads are pregnant with Yogic knowledge but we don't find the term 'Yoga Nidra'. However, the Puranas mention it several times, in different context. Markandeya Purana, Vishnu Purana, Devi Bhagvat and other common scriptures highlight the importance of it. Yoga Nidra is very well defined by Adya Sankaracharya in his text Yoga Tadavali. Hatha Yogic Text Hatha Yoga Pradipika also used this term in different context. Later on, contemporary Yogis like Swami Rama, Swami Satyananda and Pandit Sriram Sharma Acharya propagated their own techniques, which are very common today. More recently, several scientific studies are going on in different parts of the world relating to this technique[2].

Authors
Yoga-nidra was first experienced by Sw. Satyananda Saraswati when he was living with his guru Swami Shivananda in Rishikesh. He began studying the Tantric scriptures and, after practice, constructed a system of relaxation, which he began popularizing in the mid 20th CCE.[citation needed]. He explained Yoga-nidra as a state of mind between wakefulness and dream that opened deep phases of the mind, suggesting a connection with the ancient tantric practice called nyasa, whereby Sanskrit mantras are mentally placed within specific body parts, while meditating on each part (of the bodymind). The form of practice taught by Swami Satyananda includes eight stages (Internalisation, Sankalpa, Rotation of Consciousness, Breath Awareness, Manifestation of Opposites, Creative Visualization, Sankalpa and Externalisation). Teachers such as Osho[3] and Anandmurti Gurumaa define yoga-nidra as a state of conscious deep sleep. One appears to be sleeping but the unconscious mind is functioning at a deeper level: it is sleep with a trace of deep awareness. In normal sleep we lose track of our self but in yoga-nidra, while consciousness of the world is dim and relaxation is deep, there remains an inward lucidity and experiences may be absorbed to be recalled later. Since yoga-nidra involves an aimless and effortless relaxation it is often held to be best practised with an experienced yoga teacher who verbally delivers instructions. and purifying the unconscious mind. The state may lead to realisation (samdhi) and beingawareness-bliss (satchitananda).[citation needed]The yogi is held to be in communion with the divine. A tantrika engaged in this sadhana may become aware of past or future lives (refer bhumi) or experience the astral planes.[citation needed] Yoga-nidra is also associated with the Breatharian movement. Paramyogeshwar Sri Devpuriji was an early modern proponent who passed Anandmurti Gurumaa taught two techniques based on creative visualization. [4]. Yoga-nidra as Yoga of Clear Light is proposed as a spiritual path (sadhana) in its own right, held to prepare and refine a seeker (sadhaka) spiritually, emotionally, mentally and physically for consciousness and awareness. The yogi may work through the consequences of deeds (karma), cleansing the store consciousnessit on to Sri Deep Narayan Mahaprabhuji: it was taught to his disciples since 1880. [citation needed] On his journeys to the Himalayas Sri Devpuriji met Swami Sivananda of Rishikesh, who conveyed the technique to several yogis and swamis, such as Swami Satyananda Saraswati. [citation needed] Swami Rama was another proponent of the sadhana. [5]

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Swami Satyananda's extensive worldwide tours with Paramhans Swami Maheshwarananda teaching the yoga-nidra practice of Satyananda Yoga gradually spread the idea throughout India, Europe, Australia and the United States.[citation needed]

Yoga-nidra and Hindu scripture

Yoga-nidra refers to the conscious awareness of the deep sleep state, referred to as "prajna" in Mandukya Upanishad.[6] This is the third of the four levels of consciousness of Omkara mantra, the state represented by the M of AUM. The state of sleep is beyond or subtler than the imagery and mental process of the waking and non-lucid dreaming states. In a number of texts such as the Devi Mahatmya and the Bhagavata Purana, Vishnu reclines on the nga shesha during yoga-nidra. The phenomenal world is the dream of Vishnu.[citation needed]

Scientific evaluation
Rosch & Fallah (undated PDF) in a critique of Harrington & Zajonc (2003) mention Swami Rama and the Menninger Foundation and state that: ...in 1970 Swami Rama, a Hindu yogi, was extensively studied at the Menninger Foundation where he demonstrated a variety of extreme abilities, including the voluntary death-like state of physiological arrest called yoga nidra (Anand, Chhina & Singh, 1961, Kasamatsu & Hirai, 1969, Boyd, 1995).[7] Dr. Kamakhya Kumar in 2006 awarded by Ph. D. degree by Dr. A. P J Abdul Kalam (President of India) for his work "Psycho-physiological Changes as Related to Yoga Nidra". He observed six months effects of Yoga Nidra on some Physiological, hematological and some Psychological parameters on the practitioners and he found a significant change on above mentioned parameters. One of the research published entitled "A study on the impact on stress and anxiety through Yoga nidra; Indian Journal of Traditional Knowledge, Vol. 7 No 3".(Published through NISCAIR)

Health care
Health care is the prevention, treatment, and management of illness and the preservation of mental and physical well being through the services offered by the medical, nursing, and allied health professions. Workplace wellness programs Workplace wellness programs are recognized by an increasingly large number of companies for their value in improving the health and well-being of their employees, and for increasing morale, loyalty, and productivity] Workplace wellness programs can include things like onsite fitness centers, health presentations, wellness newsletters, access to health coaching, tobacco cessation
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programs and training related to nutrition, weight and stress management. Other programs may include health risk assessments, health screenings and body mass index monitoring. Wellness programs may also be found in such places neighborhood community centers and schools. These typically require participants to have a greater degree of commitment to themselves, as they are voluntary.[

Public health

Postage stamp, New Zealand, 1933. Public health has been promoted - and depicted - in a wide variety of ways. Public health is "the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organizations, public and private, communities and individuals." (Winslow, 1920)] It is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). Public health has many sub-fields, but is typically divided into the categories of epidemiology, biostatistics and health services. Environmental, social and behavioral health, and occupational health, are also important fields in public health. The focus of public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors. In addition to these activities, in many cases treating a disease can be vital to preventing it in others, such as during an outbreak of an infectious disease. Vaccination schedules and distribution of condoms are examples of public health measures. Unlike clinical professionals, public health is more focused on entire populations rather than on individuals. Its aim is preventing from happening or re-occurring health problems by implementing educational programs, developing policies, administering services, and conducting research.[12]
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Public health also takes several actions to limit the health disparities between different areas of the country, continent or world. The great issue this system is trying to solve is the access of individuals to health care which has always been restricted for those who did not dispose of the necessary financial means. Other academic disciplines that are comprised by this field include maternal and child health, health services administration, global health, public health practice, public health policy and nutrition. The great positive impact of public health programs is widely admitted. Because of the health policies and the actions public health professionals develop, the 20th century has registered a decrease of the mortality rates in infants and children and a constant increase in life expectancy. It is estimated that the life expectancy for Americans has increased by thirty years since 1900

Role of science in health

Health science is the branch of science focused on health, and it includes many subdisciplines. There are two approaches to health science: the study and research of the human body and health-related issues to understand how humans (and animals) function, and the application of that knowledge to improve health and to prevent and cure diseases.

Sources
Health research builds primarily on the basic sciences of biology, chemistry, and physics as well as a variety of multidisciplinary fields (for example medical sociology). Some of the other primarily research-oriented fields that make exceptionally significant contributions to health science are biochemistry, epidemiology, and genetics.

Application
Applied health sciences also endeavor to better understand health, but in addition they try to directly improve it. Some of these are: health education, biomedical engineering, biotechnology, nursing, nutrition, pharmacology, pharmacy, public health (see above), social work, psychology, physical therapy, and medicine. The provision of services to maintain or improve people's health is referred to as health care (see above). Irene

Healthcare
The Healthcare Practice

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Strategic Planning We provide assistance across a full range of strategic issues from the documenting, consultancy and NABH/NABL accreditation process and in operating aspects of each. Our solutions, whether comprehensive strategy plans or the resolution of a complex question/issue are creative, yet pragmatic, identifying the organizational, medical services and situational requirements enabling successful implementation of the NABL/NABH accreditation. Hospital/Laboratory business assessments and quality positioning Competitive strategy Hospitality and Laboratory development Identification of competitive advantages Option development Action planning and implementation assistance Resource prioritization and strategic healthcare planning for the accreditation process. Health Care Planning Because health care is local, how well a hospital or health system serves its market area and quality rules and regulations with a proper implementaion is an important determinant of its success. We have methodologies and strategy tool to analyze and understand the service area, management planning, comply requirements according to international and NABL standards and competitive actions and reactions. These well planned methodologies and strategy are the main building blocks we use to employ our clients to determine the capacity needs, size their system, develop their medical staff, grow programs and services and mainly in the accreditation process enhancing the quality and employees and customer satisfaction. Performance Enhancement Operations & industry expertise to enhance the performance and value of customer base.
Operations Strategy Productivity Enhancement Quality and Accreditation Support

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