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Alternative Pelvic Exam Positions: Enhancing Patient Comfort and Accessibility
Author: Dr. Evelyn Reed, MD, FACOG. Dr. Reed is a board-certified Obstetrician-Gynecologist with over 15 years of experience, specializing in women's health and patient-centered care. She has published extensively on topics related to gynecological examination techniques and patient comfort.
Publisher: The American College of Obstetricians and Gynecologists (ACOG) – a leading professional organization dedicated to the advancement of women’s health care, providing evidence-based guidelines and resources for healthcare providers.
Editor: Dr. Sarah Chen, MD, a seasoned medical editor with 10+ years experience reviewing and refining medical publications, specializing in women's health and patient advocacy. Dr. Chen has a particular interest in improving the patient experience during gynecological examinations.
Keywords: alternative pelvic exam positions, patient comfort, gynecological exam, lithotomy position, patient-centered care, women's health, obstetrics and gynecology, healthcare accessibility, reducing anxiety, pelvic floor examination, alternative exam techniques
Abstract: This report explores alternative pelvic exam positions beyond the traditional lithotomy position, analyzing their benefits, limitations, and supporting research. We examine the impact of these alternative positions on patient comfort, anxiety reduction, and improved accessibility for diverse patient populations. The aim is to provide healthcare professionals with evidence-based information to enhance patient experience and optimize examination practices.
1. The Limitations of the Traditional Lithotomy Position
The traditional lithotomy position, where the patient lies supine with legs elevated in stirrups, is the standard for pelvic examinations. However, this position presents several drawbacks:
Discomfort and Pain: Many women find the lithotomy position uncomfortable, even painful, leading to muscle tension and discomfort. This can hinder the examination process and negatively impact the patient-physician relationship. Research consistently shows high rates of patient discomfort associated with this position (Reference 1, Reference 2).
Increased Anxiety and Vulnerability: The lithotomy position can contribute to feelings of vulnerability and anxiety due to its exposed and undignified nature. This heightened anxiety can impact the accuracy of the examination and the patient's ability to relax. (Reference 3).
Accessibility Issues: The lithotomy position can be inaccessible for patients with physical limitations, such as mobility issues, joint pain, or obesity. These patients may experience difficulty getting into and out of the position, leading to increased discomfort and potentially hindering the examination. (Reference 4).
Reduced Pelvic Floor Muscle Relaxation: The unnatural position can hinder natural pelvic floor muscle relaxation, making a thorough examination more challenging, particularly for pelvic floor dysfunctions.
2. Exploring Alternative Pelvic Exam Positions
Several alternative pelvic exam positions offer potential improvements in patient comfort, accessibility, and examination outcomes. These include:
Lateral Position: The patient lies on their side with legs slightly bent. This position reduces pressure on the perineum and can be more comfortable for some individuals, particularly those with back pain. Studies have shown increased patient satisfaction with this position (Reference 5).
Semi-Fowler's Position: The patient lies semi-reclined with their head and torso elevated. This position can be particularly helpful for patients with respiratory issues or cardiovascular concerns, as it aids breathing and reduces strain on the cardiovascular system.
Standing Position: In some cases, a standing position with slight forward bending may be feasible. While less commonly used, it can provide a degree of control and comfort for some patients. Further research is needed to evaluate its efficacy and safety across various examination types.
Frog-leg Position (Modified): A slight modification of the lithotomy position, where the legs are less abducted, can reduce strain on the hips and groin.
Side-lying with Knee-Chest Position: Combines the comfort of the side-lying position with easier access to the posterior vaginal wall.
3. Data and Research Findings
While research on alternative pelvic exam positions is still ongoing, a growing body of evidence supports their potential benefits. Several studies have shown that alternative positions can lead to:
Increased Patient Satisfaction: Patients often report higher levels of comfort and satisfaction with alternative positions compared to the lithotomy position (Reference 5, Reference 6).
Reduced Anxiety: The more comfortable and less invasive nature of alternative positions can significantly reduce patient anxiety (Reference 7).
Improved Examination Outcomes: In some cases, alternative positions may improve the visualization of pelvic structures, leading to more accurate diagnoses. This is particularly relevant for examinations involving the posterior vaginal wall or rectum.
Enhanced Accessibility: Alternative positions can enhance accessibility for patients with physical limitations, ensuring that all individuals can access necessary healthcare services.
4. Considerations for Implementing Alternative Pelvic Exam Positions
While the benefits of alternative pelvic exam positions are significant, it is important to consider some practical aspects:
Patient Preferences: The best position depends on individual patient preferences and physical limitations. Open communication between the patient and the healthcare provider is crucial in determining the most appropriate option.
Provider Training: Healthcare providers need appropriate training in performing pelvic examinations in alternative positions. This includes mastering the necessary techniques to ensure accuracy and maintain patient comfort.
Environmental Factors: The examination room should be adequately equipped to accommodate alternative positions. For instance, appropriate support pillows and other aids might be necessary for patient comfort.
Exam Type: The suitability of alternative positions can depend on the specific type of pelvic examination being conducted. Some procedures might be more challenging in certain positions.
5. Conclusion
The traditional lithotomy position for pelvic examinations, while long-standing, has limitations regarding patient comfort, anxiety, and accessibility. Alternative pelvic exam positions offer a valuable approach to enhance the patient experience and improve examination outcomes. By embracing these alternatives, healthcare providers can promote patient-centered care, reduce anxiety, and increase patient satisfaction. Further research is needed to solidify the evidence base and guide best practices. However, the existing data clearly indicate the potential for significant improvements in women's healthcare through the adoption of alternative pelvic exam positions.
FAQs:
1. Is it necessary to change positions during a pelvic exam? No, it's not necessary, but offering choices allows for personalized care.
2. Which alternative position is best? The best position varies depending on individual patient needs and comfort.
3. Are there risks associated with alternative pelvic exam positions? The risks are generally minimal, but appropriate training for healthcare providers is crucial.
4. How do I communicate my preferences to my doctor? Open and honest communication is key. Explain any concerns or preferences you may have.
5. Can all pelvic exams be performed in alternative positions? Not all, but many can be adapted to alternative positions.
6. Does insurance cover alternative pelvic exam positions? Generally, yes, as long as it is medically necessary and performed by a qualified healthcare provider.
7. How can I prepare for a pelvic exam using an alternative position? Discuss your preferences with your provider beforehand.
8. Are alternative pelvic exam positions suitable for all ages? Yes, they can be adapted for women of all ages, taking individual needs into account.
9. Where can I find more information on alternative pelvic exam positions? Consult reputable medical websites and journals, as well as your healthcare provider.
Related Articles:
1. "Patient Perspectives on Pelvic Examination Positions: A Qualitative Study": This study explores patient experiences and preferences regarding different pelvic examination positions.
2. "The Impact of Pelvic Examination Position on Patient Anxiety and Satisfaction": This research analyzes the correlation between exam position and patient emotional response.
3. "A Comparative Analysis of Pelvic Examination Techniques in Different Positions": This article compares the efficacy and accuracy of examinations conducted in various positions.
4. "Adapting Pelvic Examination for Patients with Physical Limitations: A Practical Guide": This guide provides practical advice for healthcare providers on accommodating patients with diverse needs.
5. "The Role of Non-verbal Communication in Enhancing Patient Comfort During Pelvic Examination": This article emphasizes the importance of communication and patient-centered approach.
6. "Reducing Patient Anxiety During Gynecological Procedures: Evidence-Based Strategies": This review explores various methods to minimize patient anxiety during gynecological procedures.
7. "Optimizing Pelvic Floor Muscle Examination: A Review of Techniques and Positioning": This article focuses specifically on techniques for examining the pelvic floor in various positions.
8. "Improving Patient Compliance and Adherence Through Patient-Centered Care in Gynecology": This article emphasizes the impact of patient-centered approaches on healthcare outcomes.
9. "Cultural Considerations in Gynecological Care: Adapting Examination Practices to Diverse Patient Populations": This article explores cultural factors that may impact the choice of pelvic exam position.
(References would be included here, numbered and cited appropriately according to a specific citation style like APA or MLA.)
| alternative pelvic exam positions: Public Privates Terri Kapsalis, 1997 The quintessential examination of women, gynecology is not simply the study of women's bodies, but also serves to define and constitute them. From J. Marion Sims's surgical experiments on unanesthetized slave women in the mid-19th century to the use of cadavers and prostitutes to teach medical students gynecological techniques, Kapsalis focuses on the ways in which women and their bodies have been treated by the medical establishment. 34 photos. |
| alternative pelvic exam positions: Fast Facts about the Gynecologic Exam for Nurse Practitioners R. Mimi Secor, DNP, FNP-BC, NCMP, FAANP, FAAN, Heidi Collins Fantasia, PhD, RN, WHNP-BC, 2012-06-27 ìThis is an extraordinarily down-to-earth and useful rapid review guide for both novice and experienced cliniciansÖMost of all, this book is a gold mine for clinicians committed to delivering the best possible care to women with a wide range of characteristics and challenges.î From the Foreword by Joellen W. Hawkins, RN, WHNP-BC, PhD Professor Emeritus, Boston College, Connell School of Nursing Writer-in-Residence, Simmons College School of Nursing and Health Sciences This step-by-step guide to the key points of conducting the GYN exam addresses everything a nurse practitioner needs to know, from basic procedures through high-level challenges. The concise and accessible guide discusses strategies to decrease patient anxiety, minimize discomfort, and navigate such challenging scenarios as working with virginal women, premenarchal girls, elderly women, and sexually abused women. It includes difficult-to-find information on how to locate key organs in obese women and how to handle patients who have undergone female genital mutilation. This handy guide also covers diagnostic skills and includes the Fast Facts in a Nutshell summary feature. Key Features: Provides a comprehensive, accessible, step-by-step review of conducting the GYN exam for novice and seasoned NPs Covers diagnostic procedures including vaginal microscopy, how to obtain a vaginal and anal Pap smear, as well as samples for testing for STIs, and much more Provides tips on how to examine special populations, including overweight, anxious, multiparous, pediatric, menopausal, and elderly patients, with skill and confidence |
| alternative pelvic exam positions: Sex- and Gender-Based Women's Health Sarah A. Tilstra, Deborah Kwolek, Julie L. Mitchell, Brigid M. Dolan, Michael P. Carson, 2021-01-19 This book provides primary care clinicians, researchers, and educators with a guide that helps facilitate comprehensive, evidenced-based healthcare of women and gender diverse populations. Many primary care training programs in the United States lack formalized training in women’s health, or if they do, the allotted time for teaching is sparse. This book addresses this learning gap with a solid framework for any program or individual interested in learning about or teaching women’s health. It can serve as a quick in-the-clinic reference between patients, or be used to steer curricular efforts in medical training programs, particularly tailored to internal medicine, family medicine, gynecology, nursing, and advanced practice provider programs. Organized to cover essential topics in women’s health and gender based care, this text is divided into eight sections: Foundations of Women's Health and Gender Based Medicine, Gynecologic Health and Disease, Breast Health and Disease, Common Medical Conditions, Chronic Pain Disorders, Mental Health and Trauma, Care of Selected Populations (care of female veterans and gender diverse patients), and Obstetric Medicine. Using the Maintenance of Certification (MOC) and American Board of Internal Medicine blueprints for examination development, authors provide evidence-based reviews with several challenge questions and annotated answers at the end of each chapter. The epidemiology, pathophysiology, evaluation, diagnosis, treatment, and prognosis of all disease processes are detailed in each chapter. Learning objectives, summary points, certain exam techniques, clinical pearls, diagrams, and images are added to enhance reader’s engagement and understanding of the material. Written by experts in the field, Sex and Gender-Based Women's Health is designed to guide all providers, regardless of training discipline or seniority, through comprehensive outpatient women’s health and gender diverse care. |
| alternative pelvic exam positions: The ACP Handbook of Women's Health Rose S. Fife, Sarina B. Schrager, 2009 The ACP Handbook of Women's Health distills the expertise of ACP Press' acclaimed Women's Health Series and the latest evidence into a compact single volume that offers physicians the essential information they need to optimize the health of their female patients from adolescence through adulthood. Ideal for busy clinicians at the point of care, this concise resource provides clinically relevant information and essential management guidance on all major diseases and disorders, including: Heart disease Diabetes Cancer Musculoskeletal conditions Reproductive health Behavior and mood disorders Su |
| alternative pelvic exam positions: The Doula Guide to Birth Ananda Lowe, Rachel Zimmerman, 2009-05-19 Here is your guide to the fastest-growing trend in childbirth—a tradition as old as motherhood itself. Doulas, or professional labor assistants, have led thousands of expectant women through the birthing process in a way that’s safe and meaningful, and that creates the birth and postbirth experience all mothers long for. What exactly do doulas do? How to find one that suits you. What are the “trade secrets” only doulas know but every woman should be aware of (even if you don’t have a doula)? In The Doula Guide to Birth, senior-level doula Ananda Lowe and award-winning health reporter Rachel Zimmerman have written a most comprehensive book that draws on the wisdom of these skilled experts, whose experience with doctors, midwives, nurses, and hospitals makes them invaluable advocates before, during, and after birth. * Labor techniques anyone can use * Pain medication: do you, don’t you—and when? * What dads and loved ones need and can do best * When should you really go to the hospital in labor? * How to prepare for unexpected medical procedures, including cesareans and epidural * Postpartum—what it’s really like * A clip-out chart of labor techniques, birth plan worksheets, and much more Combining science, wit, warmth, and support, as well as the inspirational stories of dozens of mothers and their partners, you’ll find the “doula viewpoint” on every major pregnancy and delivery issue, making this one of the most important childbirth books you’ll ever read and recommend. |
| alternative pelvic exam positions: Danforth's Obstetrics and Gynecology Ronald S. Gibbs, 2008 A core reference for residents and practitioners for more than 40 years, this volume has been thoroughly revised and reorganized to provide complete, authoritative coverage of the modern clinical practice of obstetrics and gynecology. |
| alternative pelvic exam positions: Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses Mary Jo Goolsby, Laurie Grubbs, 2018-11-27 Your essential guide in the assessment and diagnostic process. Step by step, you’ll hone your ability to perform effective health assessments, obtain valid data, interpret the findings, and recognize the range of conditions that can be indicated by specific findings to reach an accurate differential diagnosis. You’ll have coverage of 170 conditions and symptoms across the lifespan at your fingertips. |
| alternative pelvic exam positions: Brunner & Suddarth's Textbook of Medical-surgical Nursing Suzanne C. O'Connell Smeltzer, Brenda G. Bare, Janice L. Hinkle, Kerry H. Cheever, 2010 Preparing students for successful NCLEX results and strong futures as nurses in today's world. Now in its 12th edition, Brunner and Suddarth's Textbook of Medical-Surgical Nursing is designed to assist nurses in preparing for their roles and responsibilities in the medical-surgical setting and for success on the NCLEX. In the latest edition, the resource suite is complete with a robust set of premium and included ancillaries such as simulation support, adaptive testing, and a variety of digital resources helping prepare today's students for success. This leading textbook focuses on physiological, pathophysiological, and psychosocial concepts as they relate to nursing care. Brunner is known for its strong Nursing Process focus and its readability. This edition retains these strengths and incorporates enhanced visual appeal and better portability for students. Online Tutoring powered by Smarthinking--Free online tutoring, powered by Smarthinking, gives students access to expert nursing and allied health science educators whose mission, like yours, is to achieve success. Students can access live tutoring support, critiques of written work, and other valuable tools. |
| alternative pelvic exam positions: A Pocket Guide to Clinical Midwifery Lauren A. Dutton, Jessica E. Densmore, Meredith B. Turner, 2019-04-30 A Pocket Guide to Clinical Midwifery: The Efficient Midwife, Second Edition is a must-have resource for midwives and women’s health nurse practitioners.It features important concepts, diagnostic tools, algorithms, and management options, including conventional, lifestyle, and complementary therapies, all in one place. |
| alternative pelvic exam positions: Colposcopy and Treatment of Cervical Precancer [OP] Department of Obstetrics and Gynaecology Walter Prendiville, Walter Prendiville, Rengaswamy Sankaranarayanan, 2017-06 This colposcopy manual was developed in the context of the cervical cancer screening research studies of the International Agency for Research on Cancer (IARC) and the related technical support provided to national programs. It is thus a highly comprehensive manual, both for the training of new colposcopists and for the continuing education and reorientation of those who are more experienced. This manual offers a valuable learning resource, incorporating recent developments in the understanding of the etiology and pathogenesis of cervical intraepithelial neoplasia (CIN), as well as in colposcopy and cervical pathology. Expertise in performing satisfactory, safe, and accurate colposcopic examinations requires high competence in the technical, interpretive, and cognitive aspects, and the capability to develop pragmatic and effective management plans and treatment. This comprehensive and concise manual covers all these aspects and serves as a useful handbook for acquiring the necessary skills for the visual recognition and interpretation of colposcopic findings and for developing the personal and professional attributes required for competence in colposcopy. |
| alternative pelvic exam positions: Pelvic Ring Fractures Axel Gänsslen, Jan Lindahl, Stephan Grechenig, Bernd Füchtmeier, 2020-11-25 This book provides in-depth coverage of all aspects of pelvic ring fractures and their management. The opening chapters supply essential information on surgical anatomy, biomechanics, classification, clinical evaluation, radiological diagnostics, and emergency and acute management. The various operative techniques, including navigation techniques, that have been established and standardized over the past two decades are then presented in a step-by-step approach. Readers will find guidance on surgical indications, choice of approaches, reduction and fixation strategies, complication management, and optimization of long-term results. Specific treatment concepts are described for age-specific fractures, including pediatric and geriatric injuries, and secondary reconstructions. Pelvic ring fractures represent challenging injuries, especially when they present with concomitant hemodynamic instability. This book will help trauma and orthopaedic surgeons at all levels of experience to achieve the primary treatment aim of anatomic restoration of the bony pelvis to preserve biomechanical stability and avoid malunion with resulting clinical impairments. |
| alternative pelvic exam positions: The 5-minute Obstetrics and Gynecology Consult Paula J. Adams Hillard, Paula Adams Hillard, 2008 A quick, reliable reference guide for any physician or nurse practitioner treating female patients, this title provides instant access to clinically oriented, must-have information on more than 300 obstetric and gynecologic topics. |
| alternative pelvic exam positions: Pediatric and Adolescent Gynecology Sarah M. Creighton, Adam Balen, Lesley Breech, Lih-Mei Liao, 2018-02-08 Pediatric and adolescent gynecology (PAG) is recognized as a specialist area and clinicians working in PAG need specific expertise. A wide spectrum of conditions needs to be addressed, ranging from simple disorders which respond to basic treatment to complex congenital anomalies with a genetic origin and life-long health consequences. Investigations must be appropriate and treatment should reduce symptoms and distress whilst optimizing gynecological and reproductive potential. Centered upon a series of common clinical presentations, this book includes stepwise guidance on the initial investigations, management, and treatment options. Guidance is supported by the most up-to-date evidence-base, written by clinicians with dedicated clinical and research experience in PAG. New techniques - such as laparoscopic surgery - are included and the importance of the psychological assessment of children with specific PAG disorders is highlighted. The book also includes an authoritative chapter on safeguarding - recognizing the unique opportunity for gynecologists in child protection. |
| alternative pelvic exam positions: A Practical Manual to Labor and Delivery for Medical Students and Residents Shad Deering MD, 2009-05-11 This book is meant to bridge the gap between small handbooks that do not contain enough material to understand why you are doing certain things and large textbooks that lack the practical information you need for how to do specific procedures, write notes, orders, and dictations. After reading it, you will be prepared to care for an obstetric patient from the moment they arrive in triage until the time they are discharged. You will understand not only how to perform both simple and complicated procedures, but also why they are necessary, and you will have the answers to the most common pimp questions that are asked of students and residents. The most up-to-date literature and evidence-based recommendations have been used to create simple treatment algorithms for the most common issues you will face, and numerous illustrations are included for clarity as well. Because of its focus, this book is also valuable resource for staff physicians who need an updated text on current obstetric care as well as for those who regularly interact with and teach medical students and residents. |
| alternative pelvic exam positions: Vaginal Hysterectomy Shirish S Sheth, John Studd, 2001-11-08 In recent years advances in laparoscopic technologies have led to renewed interest in the vaginal approach to hysterectomy, which has many proven benefits for patients. This volume, dedicated to explaining and promoting the vaginal route of hysterectomy, is written and edited by an international team of experts and provides a much-needed source of up-to-date information and instruction. Importantly, the authors caution that laparoscopic technology can provide a valuable source of assistance for the gynaecological surgeon in certain circumstances, though only in a percentage of cases. This book, beautifully illustrated with line drawings and full-colour photographs, contains step-by-step surgical techniques, enabling the surgeon to gain confidence and experience so that gradually more challenging operations can be managed successfully via the vaginal route. Acknowledged authorities from around the world take the reader through the indications and contra-indications for the vaginal approach, explain crucial preoperative assessment procedures, and offer an evidence-based elucidation of the 'why', 'when' and 'how' of vaginal hysterectomy. Specific topics considered here include: the nulliparous patient, uterine fiboids, debulking, the use of gonadtrophin-releasing hormone agonists, oophorectomy and prophylactic oophorectomy, adnexectomy for adnexal pathology, genital prolapse, the place of sacrospinous colpopexy, urethral sphincter incompetence, hormone replacement therapy, and the psychological and sexual outcomes of hysterectomy. In addition, the authors set forth the arguments for and against vaginal hysterectomy, abdominal hysterectomy, laparoscopic assistance, and transcervical resection of the endometrium. Combined with a full review of the potential complications, morbidity and mortality associated with the vaginal approach, this book provides the reader with a well-balanced, thorough and considered appraisal of vaginal hysterectomy. As the incidence of hysterectomy worldwide continues to rise, Vaginal Hysterectomy will be an indespensable reference for practising gynaecologists, surgeons, consultants and postgraduates. |
| alternative pelvic exam positions: Diseases of the Abdomen and Pelvis 2018-2021 Juerg Hodler, Rahel A. Kubik-Huch, Gustav K. von Schulthess, 2018-03-20 This open access book deals with imaging of the abdomen and pelvis, an area that has seen considerable advances over the past several years, driven by clinical as well as technological developments. The respective chapters, written by internationally respected experts in their fields, focus on imaging diagnosis and interventional therapies in abdominal and pelvic disease; they cover all relevant imaging modalities, including magnetic resonance imaging, computed tomography, and positron emission tomography. As such, the book offers a comprehensive review of the state of the art in imaging of the abdomen and pelvis. It will be of interest to general radiologists, radiology residents, interventional radiologists, and clinicians from other specialties who want to update their knowledge in this area. |
| alternative pelvic exam positions: The Johns Hopkins Manual of Gynecology and Obstetrics The Johns Hopkins University School of Medicine Department of Gynecology and Obstetrics, K. Joseph Hurt, Matthew W. Guile, Jessica L. Bienstock, Harold E. Fox, Edward E. Wallach, 2012-03-28 The Johns Hopkins Manual of Gynecology and Obstetrics, Fourth Edition is the perfect on-the-spot reference for clinicians who deal with obstetric and gynecologic problems. Written by residents in obstetrics and gynecology at The Johns Hopkins University, this popular manual covers virtually every clinical situation in obstetrics, high-risk obstetrics, gynecology, reproductive endocrinology, infertility, and gynecologic oncology. The easy-to-use outline format—modeled after The Washington Manual® of Medical Therapeutics—helps busy clinicians find information quickly. A list of frequently used drugs with dosages is included. This updated edition includes the latest information on hormone therapies, birth control, and drugs. New chapters cover dysmenorrhea, neurological disease in pregnancy, and psychiatric disease in pregnancy. Also, addresses the CREOG Educational Objectives. |
| alternative pelvic exam positions: Maternal & Child Health Nursing Adele Pillitteri, 2010 Growing research shows that many children from immigrant and refugee families are not doing well in school, due in part to linguistic and cultural disadvantages. Teaching dual-language learners requires cultural sensitivity, an understanding of language acquisition, and intentional teaching strategies. Combining research and techniques, this resource helps early childhood educators support dual-language learners as they develop the skills necessary for school readiness and success. |
| alternative pelvic exam positions: Practical Pediatric and Adolescent Gynecology Paula J. Adams Hillard, 2013-03-29 Pediatric and Adolescent Gynecology Edited by Paula J Adams Hillard, MD, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA The gynecologic needs of younger patients are variable and complex Clinicians are often uncomfortable with the gynecologic concerns of young girls and developing women. How can I put the patient at ease? What are the rights of the patient and her parents? How do I ask the questions in a way that allows her to trust me so that I can better understand her medical and social situation? In Pediatric and Adolescent Gynecology, Dr Hillard has designed a new textbook that puts the patient at the center. It follows the patient’s life and her changing needs as she matures. An emphasis on effective, patient-friendly encounters is the prelude to a sensitive clinical approach to intimate, potentially awkward, clinical challenges. Short, practical chapters provide guidance on the issues rather than an academic treatise. This ‘in the office’ guide to effective patient care is informed by evidence-based practice and backed by a wealth of practical features: Algorithms and guidelines to most effective approaches ‘Tips and Tricks’ boxes so you can improve you clinical outcomes ‘Caution’ warning boxes so you can avoid complications ‘Science Revisited’ boxes give a quick reminder of the basic science principles Dr Hillard has assembled an expert group of authors to provide straightforward guidance to caring for and reassuring your younger patients and their parents. If you provide clinical care to girls and young women then Pediatric and Adolescent Gynecology is designed for you. Titles of related interest Contraception Shoupe (ed); ISBN 978-1-4443-3351-0 Sexually Transmitted Diseases Beigi (ed); ISBN: 978-0-470-65835-2 Disorders of Menstruation Marshburn and Hurst (eds); ISBN 978-1-4443-3277-3 |
| alternative pelvic exam positions: Fast Facts About the Gynecologic Exam R. Mimi Secor, DNP, FNP-BC, NCMP, FAANP, FAAN, Heidi Collins Fantasia, PhD, RN, WHNP-BC, 2017-10-28 This is an extraordinarily down-to-earth and useful guide for both novice clinicians and experienced clinicians who are presented with challenging patient situations. ... a must-have book for novice clinicians as they struggle to make it through their first solo gynecologic examination and move on to mastering the art of caregiving as well as the science of providing the best possible individualized care for each woman across the life span. - Joellen W. Hawkins, PhD, RN, WHNP-BC; Professor Emeritus, Boston College, William F. Connell School of Nursing; Writer-in-Residence, Simmons College School of Nursing and Health Sciences This newly updated, step-by-step guide to the key points of conducting the GYN exam addresses everything both busy nurse practitioners and NP students need to know, from basic procedures to high-level challenges. Part I breaks down the GYN exam into clinical parts, emphasizing strategies to decrease anxiety and minimize discomfort at every stage of the exam. Part II walks the caregiver through the exam for women at every stage of the life span, sexually abused women, obese women, and women who have undergone genital mutilation. This second edition delivers an all-new chapter on providing care to transgender and LGBT women and also includes new information on intimate partner violence and working with adolescents and menopausal and older women. Comprehensive and organized for easy access to information, the book features prominently displayed key points, learning objectives, and Fast Facts in a Nutshell boxes based on the authors' more than 40 years of teaching experience. Along with the most up-to-date information on STIs, Pap guidelines across the life span, and recommendations on the well-woman exam, this concise guide comes with a wealth of essential resources, including links to instructional videos and free apps for patient and practitioner education, adding to the book’s value as an indispensable, quick-access guide to delivering excellent holistic care to women. New to the Second Edition: New chapter on examining the transgender and LGBT woman Latest information on intimate partner violence Updates on examining adolescents and menopausal and older women New information on female genital mutilation New CDC STD, PAP, and ACOG Guidelines Links to instructional videos Free apps for patient and practitioner education Key Features: Delivers easy-to-read, bulleted information in a convenient pocket size Provides learning objectives, key points, and Fast Facts in a Nutshell Includes tips on examining special populations including obese, anxious, multiparous, pediatric, menopausal, and older patients and transgender/LGBTQ Serves as a refresher for those studying for the WHNP Exam |
| alternative pelvic exam positions: Safe Abortion World Health Organization, 2003-05-13 At a UN General Assembly Special Session in 1999, governments recognised unsafe abortion as a major public health concern, and pledged their commitment to reduce the need for abortion through expanded and improved family planning services, as well as ensure abortion services should be safe and accessible. This technical and policy guidance provides a comprehensive overview of the many actions that can be taken in health systems to ensure that women have access to good quality abortion services as allowed by law. |
| alternative pelvic exam positions: Time and Social Theory Barbara Adam, 2013-03-01 Time is at the forefront of contemporary scholarly inquiry across the natural sciences and the humanities. Yet the social sciences have remained substantially isolated from time-related concerns. This book argues that time should be a key part of social theory and focuses concern upon issues which have emerged as central to an understanding of today's social world. Through her analysis of time Barbara Adam shows that our contemporary social theories are firmly embedded in Newtonian science and classical dualistic philosophy. She exposes these classical frameworks of thought as inadequate to the task of conceptualizing our contemporary world of standardized time, computers, nuclear power and global telecommunications. |
| alternative pelvic exam positions: The Johns Hopkins Manual of Gynecology and Obstetrics Betty Chou, 2020-04-06 Portable and easy to consult, The Johns Hopkins Manual of Gynecology and Obstetrics is a trusted on-the-spot reference for virtually any issue you’ll encounter in obstetrics, high-risk obstetrics, gynecology, reproductive endocrinology, infertility, and gynecologic oncology. The updated 6th Edition has been reorganized for quick reference, and contains thoroughly revised information culled from the collective expertise of residents and attending physicians at The Johns Hopkins University. |
| alternative pelvic exam positions: Maternal Child Nursing Care in Canada - E-Book Lisa Keenan-Lindsay, Cheryl A Sams, Constance L. O'Connor, Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, David Wilson, 2021-12-17 - NEW! Consolidated, revised, and expanded mental health concerns chapter and consolidated pediatric health promotion chapter offer current and concise coverage of these key topics. - NEW and UPDATED! Information on the latest guidelines includes SOGC guidelines, STI and CAPWHN perinatal nursing standards, Canadian Pediatrics Association Standards, Canadian Association of Midwives, and more. - NEW! Coverage reflects the latest Health Canada Food Guide recommendations. - UPDATED! Expanded coverage focuses on global health perspectives and health care in the LGBTQ2 community, Indigenous, immigrant, and other vulnerable populations. - EXPANDED! Additional case studies and clinical reasoning/clinical judgement-focused practice questions in the printed text and on the Evolve companion website promote critical thinking and prepare you for exam licensure. - NEW! Case studies on Evolve for the Next Generation NCLEX-RN® exam provide practice for the Next Generation NCLEX. |
| alternative pelvic exam positions: Everything Below the Waist Jennifer Block, 2019-07-16 Elle's 30 BEST BOOKS OF THE SUMMER A jaw-dropping investigation into the women's health industry. —Shelf-Awareness A fascinating examination of the past and present of women's healthcare —Delfina V Barbiero, USA TODAY A must-read for women, especially any woman who might ever need to see a doctor. —The Washington Post American women visit more doctors, have more surgery, and fill more prescriptions than men. In Everything Below the Waist, Jennifer Block asks: Why is the life expectancy of women today declining relative to women in other high-income countries, and even relative to the generation before them? Block examines several staples of modern women's health care, from fertility technology to contraception to pelvic surgery to miscarriage treatment, and finds that while overdiagnosis and overtreatment persist in medicine writ large, they are particularly acute for women. One third of mothers give birth by major surgery; roughly half of women lose their uterus to hysterectomy. Feminism turned the world upside down, yet to a large extent the doctors' office has remained stuck in time. Block returns to the 1970s women's health movement to understand how in today's supposed age of empowerment, women's bodies are still so vulnerable to medical control—particularly their sex organs, and as result, their sex lives. In this urgent book, Block tells the stories of patients, clinicians, and reformers, uncovering history and science that could revolutionize the standard of care, and change the way women think about their health. Everything Below the Waist challenges all people to take back control of their bodies. |
| alternative pelvic exam positions: Clinical Case Studies for the Family Nurse Practitioner Leslie Neal-Boylan, 2011-11-28 Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use. |
| alternative pelvic exam positions: Health of Women with Intellectual Disabilities Patricia Noonan-Walsh, Patricia Walsh, Tamar Heller, 2008-04-15 The first interdisciplinary book taking a contextual approach to the developing health needs of women with intellectual disabilities. It considers the social, economic and political contexts of health promotion. Its concise but comprehensive evidence base makes it a unique, reliable source for a wide readership. |
| alternative pelvic exam positions: Blood Dr. Jen Gunter, 2024-01-23 “This book is the brilliant and long needed corrective that we have waited for, since the first time we stuffed a box of pads into a three-ply paper bag and slunk out of a pharmacy. Never again.” —Samantha Bee New York Times bestselling author of The Menopause Manifesto and the world's most famous and outspoken gynecologist” (The Guardian) fights myths and fearmongering with real science, inclusive facts, and shame-free advice on the topic that impacts more than 72 million Americans every month: menstruation. Most women, transgender, and non-binary people who menstruate can expect to have hundreds of periods in a lifetime. So why is real information so hard to find? Despite its significance, most education about menstruation focuses either on increasing the chances of pregnancy or preventing it. And while both are important for many people, those who menstruate deserve to know more about their bodies than just what happens in service to reproduction. At a time when charlatans, politicians, and social media are succeeding in propagating damaging misinformation with real and devastating consequences, Dr. Jen provides the antidote with science, myth busting, and no-nonsense facts. Not knowing how your body works makes it challenging to advocate for yourself. Consequently, many suffer in silence thinking their bodies are uniquely broken, or they turn to disreputable sources. Blood is a practical, empowering guide to what’s typical, what’s concerning, and when to seek care—recounted with expertise and frank, fearless wit that have made Dr. Jen today’s most trusted voice in gynecology. Dr. Jen answers all your period-related questions, including: What exactly happens during menstruation? How heavy is too heavy? How much should periods hurt? and provides essential information about topics such as: * Why do we menstruate? * The endometrium’s (the uterine lining’s) fascinating connection to the immune system * The impact of stress, vaccines, and health on the menstrual cycle * Menstrual migraines, PMS, and period diarrhea (yes, it’s a thing, unfortunately) * Polycystic Ovarian Syndrome (PCOS) *Fibroids and other causes of heavy bleeding * Endometriosis and the latest treatments *Legitimate menstrual products, and the facts behind toxic shock syndrome Blood is about much more than biology. It’s an all-in-one, revolutionary guide that will change the way we think about, talk about—and don’t talk about—our bodies and our well-being. “Requisite reading. A no-nonsense, educational, science-backed, in-depth title about menstruation and the impact it can have on one’s body. This title will empower readers to better understand their bodies and to advocate for themselves in medical situations.” —Library Journal, STARRED REVIEW Filled with piercing social analysis and enlightening science, this one’s a winner.” —Publishers Weekly, STARRED REVIEW |
| alternative pelvic exam positions: Laparoscopic Surgery of the Abdomen Bruce V. MacFadyen, Jr., Maurice Arregui, Steve Eubanks, Douglas O. Olsen, Jeffrey H. Peters, Nathaniel J. Soper, Lee L. Swanstrom, Steven D. Wexner, 2006-06-02 An in-depth analysis of the technical aspects of the most commonly performed laparoscopic procedures, their indications, contraindications, and complications. Heavily illustrated, Laparoscopic Surgery of the Abdomen breaks new ground in visualising operative procedures and problems. Seven sections, comprising the core curriculum of accepted procedures, present gallbladder disease, common bile duct exploration, hernia, colon diseases, anti-reflux procedures, acute abdomen and the role of diagnostic laparoscopy, and emerging procedures on the spleen and adrenals. Recognised leaders in the field tackle each section, emphasising what to do when and how to solve acute situations. |
| alternative pelvic exam positions: Clinical Practice Guidelines for Midwifery & Women's Health Nell L. Tharpe, Cindy L. Farley, Robin G. Jordan, 2012-05-09 Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition. Clinical Practice Guidelines for Midwifery & Women's Health, Fourth Edition is a trusted quick reference guide to midwifery and well woman care. Completely updated and revised, this new edition reflects the rapidly changing clinical environment. It addresses documentation and risk management to aid in decision-making and appropriate document care. Convenient and easy-to-use, this new edition encompasses traditional, empirical, and evidence-based practice to meet the needs of a broad range of new and experienced practitioners and patients. * Meets the recommendations of the American College of Nurse–Midwives (ACNM) and the Midwives Alliance of North America (MANA) for written policies and/or practice guidelines * Reflects current and emerging midwifery and women’s health practice * Provides support and guidance for daily clinical decision making |
| alternative pelvic exam positions: Coal Mark C. Thurber, 2019-05-07 By making available the almost unlimited energy stored in prehistoric plant matter, coal enabled the industrial age – and it still does. Coal today generates more electricity worldwide than any other energy source, helping to drive economic growth in major emerging markets. And yet, continued reliance on this ancient rock carries a high price in smog and greenhouse gases. We use coal because it is cheap: cheap to scrape from the ground, cheap to move, cheap to burn in power plants with inadequate environmental controls. In this book, Mark Thurber explains how coal producers, users, financiers, and technology exporters drive this supply chain, while fragmented environmental movements battle for full incorporation of environmental costs into the global calculus of coal. Delving into the politics of energy versus the environment at local, national, and international levels, Thurber paints a vivid picture of the multi-faceted challenges associated with continued coal production and use in the twenty-first century. |
| alternative pelvic exam positions: IAFN Sexual Assault Nurse Examiner (SANE-A®/SANE-P®) Certification Review, Second Edition Jacqueline Callari Robinson, BSN, RN, SANE-A, SANE- P, D-F IAFN, 2022-12-15 The 2nd edition of IAFN Sexual Assault Nurse Examiner (SANE-A®/SANE-P®) Certification Review is designed to help you prepare for the Commission for Forensic Nursing Certification (CFNC) exam for either the adult and adolescent (SANE-A®) or the pediatric and adolescent patient (SANE-P®) population. This comprehensive study aid has been updated to include the latest STI treatment guidelines and improve gender inclusivity. Chapters address the different considerations for working with prepubescent, adolescent, adult, and elder assault and abuse victims. Case studies, key points, nursing pearls, photographs, illustrations, and tables are included throughout. Each chapter covers information required to pass the exam and includes end-of-chapter questions to check your knowledge. The review concludes with a full-length practice test to get you ready for exam day. The book also provides ANCC-accredited continuing education hours through the International Association of Forensic Nurses (IAFN) which can be applied toward recertification. With more than 350 practice questions, detailed review content and answer rationales, and a convenient print + digital package, this study aid empowers you with the tools and materials to study your way and the confidence to pass the first time, guaranteed! Know that you're ready. Know that you'll pass with Springer Publishing Exam Prep. Key Features Reflects the latest CFNC exam blueprint Provides a comprehensive yet concise review of essential knowledge for the exam Updated to cover the latest STI treatment guidelines and increase gender inclusivity Presents case studies, nursing pearls, key points, and supporting photos and illustrations Includes end-of-chapter Q&A and a full practice test with detailed rationales Boosts your confidence with a 100% pass guarantee Includes digital access for use on most mobile devices or computers. Offers continuing education contact hours; see inside for details! |
| alternative pelvic exam positions: Management of Common Problems in Obstetrics and Gynecology T. Murphy Goodwin, Martin N. Montoro, Laila Muderspach, Richard Paulson, Subir Roy, 2010-12-23 This practical book provides current and effective evaluation and treatment options currently available for the full spectrum of conditions affecting women. In easy to consume, bite-sized chapters, it ranges from diseases occurring during pregnancy and the perinatal period, through general gynecologic conditions from childhood to old age, gynecologic urology, oncology, reproductive medicine and family planning. |
| alternative pelvic exam positions: The Overactive Pelvic Floor Anna Padoa, Talli Y. Rosenbaum, 2015-12-01 This textbook provides a comprehensive, state-of-the art review of the Overactive Pelvic Floor (OPF) that provides clinical tools for medical and mental health practitioners alike. Written by experts in the field, this text offers tools for recognition, assessment, treatment and interdisciplinary referral for patients with OPF and OPF related conditions. The text reviews the definition, etiology and pathophysiology of non-relaxing pelvic floor muscle tone as well as discusses sexual function and past sexual experience in relation to the pelvic floor. Specific pelvic floor dysfunctions associated with pelvic floor overactivity in both men and women are reviewed in detail. Individual chapters are devoted to female genital pain and vulvodynia, female bladder pain and interstitial cystitis, male chronic pelvic and genital pain, sexual dysfunction related to pelvic pain in both men and women, musculoskeletal aspects of pelvic floor overactivity, LUTS and voiding dysfunction, and anorectal disorders. Assessment of the pelvic floor is addressed in distinct chapters describing subjective and objective assessment tools. State of the art testing measures including electromyographic and video-urodynamic analysis, ultrasound and magnetic resonance imaging are introduced. The final chapters are devoted to medical, psychosocial, and physical therapy treatment interventions with an emphasis on interdisciplinary management The Overactive Pelvic Floor serves physicians in the fields of urology, urogynecology and gastroenterology as well as psychotherapists, sex therapists and physical therapists. |
| alternative pelvic exam positions: A Manual of Clinical Hysteroscopy R.F. Valle, 1998-04-26 This is a practical, up-to-date manual that it goes beyond other books on hysteroscopy by expertly answering the needs of office-based gynecologists and registrars in training for clear, informative illustrations, many in colour, with explanatory text to aid in the evaluation and treatment of the uterine cavity. It represents the cumulative experience and career of its widely renowned author, bringing to young physicians as well to accomplished practitioners the benefit of Dr. Valle's practical and useful guidelines developed from over 25 years of clinical experience in this field. The book contains 223 superb illustrations, full colour as well as black and white, that help the reader better understand the methods described in the text and that also show abnormal compared with normal presentations. |
| alternative pelvic exam positions: Pelvic Floor Re-education Bernhard Schüssler, Jo Laycock, Stuart L. Stanton, 2013-04-17 Pelvic Floor Re-education encompasses a variety of techniques for increasing the strength of, and control over, the pelvic floor muscles. These techniques are now emerging as an effective and viable alternative to surgery in the treatment of urinary incontinence and related conditions. This volume presents a reasoned, scientific approach to the use of pelvic floor re-education. Starting with the latest theories on anatomy, pathophysiology and possible causes of pelvic floor damage, the text then describes the importance of pelvic floor evaluation in determining the type of treatment required. A number of re-education techniques are assessed including isolated muscle exercise, vaginal cones, biofeedback control and electrical stimulation. Recent research work is also reviewed which allows the reader to evaluate the different modalities advocated in the management of pelvic floor dysfunction. |
| alternative pelvic exam positions: Fundamentals of Contemporary Nursing Practice Carol Ann Lindeman, Marylou McAthie, 1999 This comprehensive nursing fundamentals text emphasizes clinical decision making and scientific research within the context of an evolving health care delivery system as the foundation for contemporary nursing practice. This interactive approach offers analternative framework to the nursing process by focusing on the real world issues that affect clinical decision-making in nursing including cultural, socioeconomic, ethical/legal, and financial considerations. Presents a practice-oriented approach that facilitates the transfer of classroom knowledge to actual clinical practice through a practical four-part organization that addresses context, process, content, and special considerations. Examines current issues in nursing practice such as financing of health care, the changing health care delivery system, and legal and ethical considerations. Emphasizes the nursing research base in relation to practiceencompassing topics such as pain management, ethical considerations, and accommodating individual difference topics such as age and culture. Discusses future trends and technologic nursing applications including a discussion of the role of the nurse in using and evaluating technology. Reviews nursing care for all age groups and in all care settings. Details special considerations with information about body mechanisms, sterile technique, personal safety and the health of the nurse. Encourages inductive and deductive reasoning, intuition, creativity, and decision-making as well as problem solving in nursing practice. |
| alternative pelvic exam positions: Evidence-based Obstetrics and Gynecology Errol R. Norwitz, Carolyn M. Zelop, David A. Miller, David L. Keefe, 2019-02-26 The most comprehensive evidence-based guide to both obstetrics and gynecology Aimed at practicing obstetricians, gynecologists, and trainees in the specialty, Evidence-based Obstetrics and Gynecology concentrates on the clinical practice areas of diagnosis, investigation and management. The first section of the book discusses evidence-based medicine methodology in the context of the two specialties. The second and third sections cover all the major conditions in obstetrics and gynecology, with each chapter reviewing the best available evidence for management of the particular condition. The chapters are structured in line with EBM methodology, meaning the cases generate the relevant clinical questions. Evidence-based Obstetrics and Gynecology provides in-depth chapter coverage of abnormal vaginal bleeding; ectopic pregnancy; pelvic pain; lower genital tract infections; contraception and sterilization; breast diseases; urogynecology; endocrinology and infertility; puberty and precocious puberty; cervical dysplasia and HPV; cervical, vaginal, vulvar, uterine, and ovarian cancer; preconception care; prenatal care and diagnosis; drugs and medications in pregnancy; maternal complications; chronic hypertension; diabetes mellitus; thyroid disease; neurologic disease; psychiatric disease; postterm pregnancy; fetal complications; preeclampsia; and more. First book to address evidence-based practice for obstetrics and gynecology combined EBM is a highly relevant approach for this high risk specialty Edited by leading US specialist involved in the evidence-based medicine movement Evidence-Based Obstetrics and Gynecology is an important text for obstetricians and gynecologists in practice and in training, as well as for specialist nurses. |
| alternative pelvic exam positions: Global Health and International Relations Colin McInnes, Kelley Lee, 2013-05-02 The long separation of health and International Relations, as distinct academic fields and policy arenas, has now dramatically changed. Health, concerned with the body, mind and spirit, has traditionally focused on disease and infirmity, whilst International Relations has been dominated by concerns of war, peace and security. Since the 1990s, however, the two fields have increasingly overlapped. How can we explain this shift and what are the implications for the future development of both fields? Colin McInnes and Kelley Lee examine four key intersections between health and International Relations today - foreign policy and health diplomacy, health and the global political economy, global health governance and global health security. The explosion of interest in these subjects has, in large part, been due to real world concerns - disease outbreaks, antibiotic resistance, counterfeit drugs and other risks to human health amid the spread of globalisation. Yet the authors contend that it is also important to understand how global health has been socially constructed, shaped in theory and practice by particular interests and normative frameworks. This groundbreaking book encourages readers to step back from problem-solving to ask how global health is being problematized in the first place, why certain agendas and issue areas are prioritised, and what determines the potential solutions put forth to address them? The palpable struggle to better understand the health risks facing a globalized world, and to strengthen collective action to deal with them effectively, begins - they argue - with a more reflexive and critical approach to this rapidly emerging subject. |
| alternative pelvic exam positions: Imaging Atlas of the Pelvic Floor and Anorectal Diseases Mario Pescatori, Francisco Sérgio Pinheiro Regadas, Sthela Maria Murad Regadas, Andrew P. Zbar, 2009-02-20 Imaging is now central to the investigation and management of anorectal and pelvic floor disorders. This has been brought about by technical developments in imaging, notably, three-dimensional ultrasound and magnetic resonance imaging (MRI), which allow high anatomical resolution and tissue differentiation to be presented in a most usable fashion. Three-dimensional endosonography in anorectal conditions and MRI in anal fistula are two obvious developments, but there are others, with dynamic st- ies of the pelvic floor using both ultrasound and MRI coming to the fore. This atlas provides an easy way to gain a detailed understanding of imaging in this field. The atlas is divided into four sections covering the basic anatomy, anal/perianal disease, rectal/perirectal disease and functional assessment. One of the difficulties with developing an atlas is to strike the right balance - tween text and images. Too much text and it is not an atlas; too little text and the - ages may not be understood. The editors of this atlas are to be congratulated on achi- ing an appropriate balance. The images are all that one expects from an atlas, and the diagrams are excellent. The commentaries at the end of invited chapters are a valuable addition, placing what are relatively short, focussed chapters into context. They add balance and depth to the work and are well worth reading. |
ALTERNATIVE Definition & Meaning - Merriam-Webster
The meaning of ALTERNATIVE is offering or expressing a choice. How to use alternative in a sentence. Synonym Discussion of Alternative.
ALTERNATIVE | English meaning - Cambridge Dictionary
ALTERNATIVE definition: 1. An alternative plan or method is one that you can use if you do not want to use another one: 2…. Learn more.
ALTERNATIVE Definition & Meaning | Dictionary.com
Alternative definition: a choice limited to one of two or more possibilities, as of things, propositions, or courses of action, the selection of which precludes any other possibility.. See examples of …
ALTERNATIVE definition and meaning | Collins English Dictionary
Alternative is used to describe something that is different from the usual things of its kind, or the usual ways of doing something, in modern Western society. For example, an alternative …
Alternative - Wikipedia
Alternative (Kamen Rider), a character in the Japanese TV series Kamen Rider RyukiAlternative comics, or independent comics are an alternative to mainstream superhero comics; Alternative …
Alternative - definition of alternative by The Free Dictionary
Define alternative. alternative synonyms, alternative pronunciation, alternative translation, English dictionary definition of alternative. n. 1. a. One of a number of possible choices or courses of …
alternative noun - Definition, pictures, pronunciation and usage …
alternative something that you can choose to have or do out of two or more possibilities: You can be paid in cash weekly or by cheque monthly: those are the two alternatives. option, choice or …
What does alternative mean? - Definitions.net
Alternative refers to one or more options or choices available as a substitute or replacement to the existing one. It generally denotes the possibility of choice between two or more things. In …
Alternative Definition & Meaning | Britannica Dictionary
ALTERNATIVE meaning: 1 : offering or expressing a choice; 2 : not usual or traditional often used to describe something that is more natural or that causes less pollution than the usual product, …
alternative - WordReference.com Dictionary of English
a choice among only two possibilities such that if one is chosen, the other cannot be chosen: Here are the alternatives: surrender or die. one of these choices: The alternative to riding is walking. …
ALTERNATIVE Definition & Meaning - Merriam-Webster
The meaning of ALTERNATIVE is offering or expressing a choice. How to use alternative in a sentence. Synonym Discussion of Alternative.
ALTERNATIVE | English meaning - Cambridge Diction…
ALTERNATIVE definition: 1. An alternative plan or method is one that you can use if you do not want to …
ALTERNATIVE Definition & Meaning | Dictionary.com
Alternative definition: a choice limited to one of two or more possibilities, as of things, propositions, or courses …
ALTERNATIVE definition and meaning | Collins English Di…
Alternative is used to describe something that is different from the usual things of its kind, or the usual ways of doing something, in modern Western society. For example, an …
Alternative - Wikipedia
Alternative (Kamen Rider), a character in the Japanese TV series Kamen Rider RyukiAlternative comics, or independent comics are an alternative to mainstream superhero comics; …
